Nonpharmacological interventions for 'no-option' refractory angina patients.

Refractory angina pectoris (RAP) defined as chronic anginal chest pain because of coronary artery disease (CAD) is a major problem. The increase in the number of patients with RAP in recent years is because of the increasing aging population and improved survival rates among patients with CAD. Management of patients with RAP is often extremely challenging.

The Coronary Sinus Reducer Stent for the Treatment of Refractory Angina Pectoris: From the Conception of Innovation to Clinical Application.

The Neovasc Coronary Sinus Reducer Stent (CSRS) was developed for the treatment of patients who continue to suffer from disabling symptoms despite optimal medical therapy. This patient population with refractory angina symptoms is expected to grow, since life expectancy of individuals with atherosclerotic coronary artery disease is increasing. In this paper, we discussed the development of a novel device the CSRS and the upside-down strategy to rebuild a retrograde coronary pressure that was attenuated by the atherosclerotic disease.

Severe acidosis does not predict fatal outcomes in intensive care unit patients: a retrospective analysis.

Purpose: Severe acidosis is a potentially life-threatening acid-base imbalance. The outcome of patients with severe acidosis has only been anecdotally described. We therefore assessed the discharge rate of such patients from the intensive care unit (ICU) and survival time after the event.

Coronary sinus reducer stent for the treatment of chronic refractory angina pectoris: a prospective, open-label, multicenter, safety feasibility first-in-man study.

Objectives: This study sought to evaluate the safety of the Coronary Sinus Reducer (Neovasc Medical, Inc., Or Yehuda, Israel) as a potential alternate therapy for patients with refractory angina who are not candidates for conventional revascularization procedures.

Background: Increased coronary sinus (CS) pressure can reduce myocardial ischemia by redistribution of blood from nonischemic to ischemic territories.

Treatment of deep sternal wound infections post-open heart surgery by application of activated macrophage suspension.

Postoperative sternal wound infection remains a significant complication and generally causes considerable morbidity and mortality. Macrophages play a major role in the process of wound healing. In order to evaluate the efficacy of local injection of activated macrophage suspensions into open infected sternal wound space, a retrospective case-control study was conducted.

Minimally invasive video-assisted mitral and aortic valve surgery--our initial clinical experience.

Background: After the introduction of endoscopic techniques to other surgical fields like general surgery, gynecology and thoracic surgery, cardiac surgeons sought their own methods of using minimally invasive techniques.

Objectives: To examine whether this approach is less invasive and yields better results, more desirable cosmetic results, and a more rapid and complete rehabilitation, maintaining safety, efficacy, and outcome equivalent to those of more established procedures, such as median sternotomy.

Methods: From January 2000 to July 2001, 22 patients underwent video-assisted port-access mitral or aortic valve repair or replacement with the Heartport system in our department, and one underwent closure of atrial septal defect.

Mechanical alternatives to the human heart: intracorporeal assist systems and total artificial heart.

The currently available intracorporeal assist systems and total artificial heart provide long-term support for patients terminally ill with congestive heart failure, often in an out-of-hospital environment. While they are currently widely used mainly as a long-term bridge to heart transplantation, their inherent risks of infection or stroke are prompting interest in future devices that will be smaller, fully implantable and hopefully stroke-free. These devices will be described in the last part of this review.

Mechanical alternatives to the human heart: paracorporeal assist systems.

The currently available paracorporeal assist systems provide reliable short or long-term mechanical assistance to the failing heart, albeit necessitating continuous hospitalization. The intracorporeal assist systems, which provide out of hospital assistance, will be described in the next part of this review.