Evaluation and Interventional Management of Cardiac Dysrhythmias.

This article focuses on the guideline-directed evaluation and management of cardiac dysrhythmias, particularly as they are important to the practice of a noncardiac surgeon. The focus is on atrial fibrillation (AF) as the most common arrhythmia encountered by surgeons. The authors discuss the importance of AF as a risk factor for perioperative morbidity and mortality.

Designing and Testing of a System for Aerosolization and Recovery of Viable Porcine Reproductive and Respiratory Syndrome Virus (PRRSV): Theoretical and Engineering Considerations.

Porcine reproductive and respiratory syndrome virus (PRRSV) infections cause significant economic losses to swine producers every year. Aerosols containing infectious PRRSV are an important route of transmission, and proper treatment of air could mitigate the airborne spread of the virus within and between barns. Previous bioaerosol studies focused on the microbiology of PRRSV aerosols; thus, the current study addressed the engineering aspects of virus aerosolization and collection.

Pilot-Scale Assessment of a Novel Farrowing Creep Area Supplementary Heat Source.

Pre-weaning morality (PWM) is attributed to a poor creep area microclimate and causes major economic and productivity losses for the US swine industry. Piglets need supplementary heat to overcome a high surface area to body weight ratio and minimal thermoregulation. A pilot-scale study was conducted to evaluate a semi-enclosed heated microclimate (SEHM) as a supplementary heat source for farrowing creep areas over six farrowing cycles (from January to July 2019) in two rooms with 24 farrowing stalls in each room.

Angiographic Efficacy of the Atriclip Left Atrial Appendage Exclusion Device Placed by Minimally Invasive Thoracoscopic Approach.

Objectives: This study sought to assess long-term left atrial appendage (LAA) closure efficacy of the Atriclip applied via totally thoracoscopic (TT) approach with computed tomographic angiography.

Background: LAA closure is associated with a low risk for atrial fibrillation-related embolic stroke. The Atriclip exclusion device allows epicardial LAA closure, avoiding the need for post-operative oral anticoagulation.

Hybrid Coronary Revascularization for the Treatment of Multivessel Coronary Artery Disease: A Multicenter Observational Study.

Background: Hybrid coronary revascularization (HCR) combines minimally invasive surgical coronary artery bypass grafting of the left anterior descending artery with percutaneous coronary intervention (PCI) of non-left anterior descending vessels. HCR is increasingly used to treat multivessel coronary artery disease that includes stenoses in the proximal left anterior descending artery and at least 1 other vessel, but its effectiveness has not been rigorously evaluated.

Objectives: This National Institutes of Health-funded, multicenter, observational study was conducted to explore the characteristics and outcomes of patients undergoing clinically indicated HCR and multivessel PCI for hybrid-eligible coronary artery disease, to inform the design of a confirmatory comparative effectiveness trial.

Summary of performance data for technologies to control gaseous, odor, and particulate emissions from livestock operations: Air management practices assessment tool (AMPAT).

The livestock and poultry production industry, regulatory agencies, and researchers lack a current, science-based guide and data base for evaluation of air quality mitigation technologies. Data collected from science-based review of mitigation technologies using practical, stakeholders-oriented evaluation criteria to identify knowledge gaps/needs and focuses for future research efforts on technologies and areas with the greatest impact potential is presented in the Literature Database tab on the air management practices tool (AMPAT). The AMPAT is web-based (available at www.

Staged versus Simultaneous Thoracoscopic Hybrid Ablation for Persistent Atrial Fibrillation Does Not Affect Time to Recurrence of Atrial Arrhythmia.

Introduction: Totally thoracoscopic (TT) epicardial ablation combined with endocardial catheter ablation is an emerging treatment for persistent AF. The effects of timing of the TT and endocardial portion on AT/AF recurrence are not known.

Methods: We retrospectively analyzed patients undergoing TT staged versus simultaneous hybrid AF ablation at our institution.

Improved quantification of livestock associated odorous volatile organic compounds in a standard flow-through system using solid-phase microextraction and gas chromatography-mass spectrometry.

Aerial emissions of odorous volatile organic compounds (VOCs) are an important nuisance factor from livestock production systems. Reliable air sampling and analysis methods are needed to develop and test odor mitigation technologies. Quantification of VOCs responsible for livestock odor remains an analytical challenge due to physicochemical properties of VOCs and the requirement for low detection thresholds.

Hypertension is associated with preamyloid oligomers in human atrium: a missing link in atrial pathophysiology?

Background: Increasing evidence indicates that proteotoxicity plays a pathophysiologic role in experimental and human cardiomyopathy. In organ-specific amyloidoses, soluble protein oligomers are the primary cytotoxic species in the process of protein aggregation. While isolated atrial amyloidosis can develop with aging, the presence of preamyloid oligomers (PAOs) in atrial tissue has not been previously investigated.

Quantitative Imaging of Preamyloid Oligomers, a Novel Structural Abnormality, in Human Atrial Samples.

Abnormalities in atrial myocardium increase the likelihood of arrhythmias, including atrial fibrillation (AF). The deposition of misfolded protein, or amyloidosis, plays an important role in the pathophysiology of many diseases, including human cardiomyopathies. We have shown that genes implicated in amyloidosis are activated in a cellular model of AF, with the development of preamyloid oligomers (PAOs).

High-risk lead removal by planned sequential transvenous laser extraction and minimally invasive right thoracotomy.

Introduction: Transvenous pacemaker or implantable cardioverter defibrillator (ICD) lead extraction via mechanical or excimer laser sheath is typically safe and effective. Longer duration from implant, presence of large vegetations or thrombi, fractured leads, and prior failed extraction are risk factors predicting higher complication rates or incomplete or failed lead removal. Techniques developed for minimally invasive valve surgery were used in conjunction with laser extraction to refine a "hybrid" technique for lead extraction.

A method to quantify infectious airborne pathogens at concentrations below the threshold of quantification by culture.

In aerobiology, dose-response studies are used to estimate the risk of infection to a susceptible host presented by exposure to a specific dose of an airborne pathogen. In the research setting, host- and pathogen-specific factors that affect the dose-response continuum can be accounted for by experimental design, but the requirement to precisely determine the dose of infectious pathogen to which the host was exposed is often challenging. By definition, quantification of viable airborne pathogens is based on the culture of micro-organisms, but some airborne pathogens are transmissible at concentrations below the threshold of quantification by culture.

Angiotensin-converting enzyme inhibition or mineralocorticoid receptor blockade do not affect prevalence of atrial fibrillation in patients undergoing cardiac surgery.

Objective: This study tested the hypothesis that interruption of the renin-angiotensin system with either an angiotensin-converting enzyme inhibitor or a mineralocorticoid receptor antagonist will decrease the prevalence of atrial fibrillation after cardiac surgery.

Design: Randomized double-blind placebo-controlled study.

Setting: University-affiliated hospitals.

Effect of temperature and relative humidity on ultraviolet (UV 254) inactivation of airborne porcine respiratory and reproductive syndrome virus.

The objective of this research was to estimate the effects of temperature and relative humidity on the inactivation of airborne porcine reproductive and respiratory syndrome (PRRS) virus by ultraviolet light (UV(254)). Aerosols of PRRS virus were exposed to one of four doses of UV(254) under nine combinations of temperature (n=3) and relative humidity (n=3). Inactivation constants (k), defined as the absolute value of the slope of the linear relationship between the survival fraction of the microbial population and the UV(254) exposure dose, were estimated using the random coefficient model.

Benefits of ambulatory axillary intra-aortic balloon pump for circulatory support as bridge to heart transplant.

Objective: Axillary intra-aortic balloon pump therapy has been described as a bridge to transplant. Advantages over femoral intra-aortic balloon pump therapy include reduced incidence of infection and enhanced patient mobility. We identified the patients who would benefit most from this therapy while awaiting heart transplantation.

Current status of hybrid coronary revascularization.

Hybrid coronary revascularization combines coronary artery bypass surgery with percutaneous coronary intervention techniques to treat coronary artery disease. The potential benefits of such a technique are to offer the patients the best available treatments for coronary artery disease while minimizing the risks of the surgery. Hybrid coronary revascularization has resulted in the establishment of new 'hybrid operating suites', which incorporate and integrate the capabilities of a cardiac surgery operating room with that of an interventional cardiology laboratory.

Minimally invasive mitral valve surgery expands the surgical options for high-risks patients.

Background: A simplified minimally invasive mitral valve surgery (MIMVS) approach avoiding cross-clamping and cardioplegic myocardial arrest using a small (5 cm) right antero-lateral incision was developed. We hypothesized that, in high-risk patients and in patients with prior sternotomy, this approach would yield superior results compared to those predicted by the Society of Thoracic Surgeons (STS) algorithm for standard median sternotomy mitral valve surgery.

Methods: Five hundred and four consecutive patients (249 males/255 females), median age 65 years (range 20-92 years) underwent MIMVS between 1/06 and 8/09.

Median infectious dose (ID₅₀) of porcine reproductive and respiratory syndrome virus isolate MN-184 via aerosol exposure.

The median infectious dose (ID(50)) of porcine reproductive and respiratory syndrome (PRRS) virus isolate MN-184 was determined for aerosol exposure. In 7 replicates, 3-week-old pigs (n=58) respired 10l of airborne PRRS virus from a dynamic aerosol toroid (DAT) maintained at -4°C. Thereafter, pigs were housed in isolation and monitored for evidence of infection.

Results of completion arteriography after minimally invasive off-pump coronary artery bypass.

Background: The benefits of a minimally invasive approach to off-pump coronary artery bypass remain controversial. The value of completion arteriography in validating this technique has not been investigated.

Methods: From April 2007 to October 2009, fifty-six patients underwent isolated minimally invasive coronary artery bypass grafting through a left thoracotomy without cardiopulmonary bypass.

Minimally invasive right lateral thoracotomy without aortic cross-clamping: an attractive alternative to repeat sternotomy for reoperative mitral valve surgery.

Background And Aim Of The Study: The study aim was to determine the safety and benefits of minimally invasive mitral valve surgery without aortic cross-clamping for mitral valve surgery after previous cardiac surgery.

Methods: Between January 2006 and August 2008, a total of 90 consecutive patients (38 females, 52 males; mean age 66 +/- 9 years) underwent minimally invasive mitral valve surgery after having undergone previous cardiac surgery. Of these patients, 80 (89%) underwent mitral valve replacement and 10 (11%) mitral valve repair utilizing a small (5 cm) right lateral thoracotomy along the 4th or 5th intercostal space under fibrillatory arrest (mean temperature 28 +/- 2 degrees C).

Off-pump coronary artery bypass: techniques, pitfalls, and results.

In an attempt to advance the surgical treatment of coronary artery disease, surgeons sought a way to offer the proven benefits of coronary revascularization and avoid the side effects of cardiopulmonary bypass by performing revascularization in the beating heart (off-pump coronary artery bypass). This review will describe the development and refinement of the technique, pitfalls to its widespread adoption, and an up-to-date assessment of current results.

Real-time airflow rate measurements from mechanically ventilated animal buildings.

This paper describes techniques used to determine airflow rate in multiple emission point applications typical of animal housing. An accurate measurement of building airflow rate is critical to accurate emission rate estimates. Animal housing facilities rely almost exclusively on ventilation to control inside climate at desired conditions.

Evaluation of wood chip-based biofilters to reduce odor, hydrogen sulfide, and ammonia from swine barn ventilation air.

A pilot-scale biofilter was developed in which two types of wood chips (western cedar [WC] and 2-in. hardwood [HW]) were examined to treat odor emissions from a deep-pit swine finishing facility in central Iowa. The biofilters were operated continuously for 13 weeks at different airflow rates resulting in variable empty bed residence times (EBRTs) from 1.

Forecasting daily source air quality using multivariate statistical analysis and radial basis function networks.

It is vital to forecast gas and particle matter concentrations and emission rates (GPCER) from livestock production facilities to assess the impact of airborne pollutants on human health, ecological environment, and global warming. Modeling source air quality is a complex process because of abundant nonlinear interactions between GPCER and other factors. The objective of this study was to introduce statistical methods and radial basis function (RBF) neural network to predict daily source air quality in Iowa swine deep-pit finishing buildings.