The Experts below are selected from a list of 3471 Experts worldwide ranked by ideXlab platform
Antonio Colombo - One of the best experts on this subject based on the ideXlab platform.
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a tricky percutaneous paravalvular leak closure two years after implantation of 3f enable sutureless bioprosthetic aortic valve
Hellenic Journal of Cardiology, 2016Co-Authors: Vasileios F Panoulas, Giovanni La Canna, Matteo Montorfano, Maurizio Taramasso, Gennaro Giustino, Azeem Latib, Antonio ColomboAbstract:Sutureless valves were designed in an attempt to simplify the aortic valve replacement procedure and reduce Extracorporeal Circuit time, whilst allowing complete excision of the calcified native valve using a minimally invasive approach. Elderly patients with significant comorbidities are considered to benefit the most, although randomized data are lacking. In registries of patients treated with implantation of a 3f Enable sutureless bioprosthetic aortic valve, all patients who developed paravalvular leak have been treated with valve explantation. This is the first case report describing a tricky yet successful percutaneous paravalvular leak closure 2 years after implantation of a 3f Enable sutureless aortic bioprosthesis.
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a tricky percutaneous paravalvular leak closure two years after implantation of 3f enable sutureless bioprosthetic aortic valve
Hellenic Journal of Cardiology, 2016Co-Authors: Vasileios F Panoulas, Giovanni La Canna, Matteo Montorfano, Maurizio Taramasso, Gennaro Giustino, Azeem Latib, Antonio ColomboAbstract:Sutureless valves were designed in an attempt to simplify the aortic valve replacement procedure and reduce Extracorporeal Circuit time, whilst allowing complete excision of the calcified native valve using a minimally invasive approach. Elderly patients with significant comorbidities are considered to benefit the most, although randomized data are lacking. In registries of patients treated with implantation of a 3f Enable sutureless bioprosthetic aortic valve, all patients who developed paravalvular leak have been treated with valve explantation. This is the first case report describing a tricky yet successful percutaneous paravalvular leak closure 2 years after implantation of a 3f Enable sutureless aortic bioprosthesis.
R. M. Knobler - One of the best experts on this subject based on the ideXlab platform.
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regional anticoagulation with acid citrate dextrose a for Extracorporeal photoimmunochemotherapy
Vox Sanguinis, 2002Co-Authors: R. Apsner, B. Uenver, Gere Sunderplassmann, R. M. KnoblerAbstract:Background and Objectives During photopheresis, intravenous heparin is used to prevent clotting in the Extracorporeal Circuit. Regional citrate anticoagulation could lower the risks associated with heparin treatment. Materials and Methods Four-hundred and six photophereses procedures that were anticoagulated by acid citrate dextrose-A (ACD-A) (of which 343 were performed in patients at risk for haemorrhage) were analysed together with 278 heparin-anticoagulated treatments. Results Four-hundred and four of 406 citrate treatments were completed. Seven transient paresthesias (1·73%), five of which occurred in the first 50 treatments, were observed. Bleeding complications were noted during heparin anticoagulation (1·07%), but not during citrate anticoagulation. During photopheresis, haemoglobin values and platelet counts decreased by 11·4% and 14·6%, respectively (P < 0·0001). Twenty-four hours after treatment, haemoglobin values, and platelet and leucocyte counts were still lower than at baseline (P < 0·0001). The changes of haemoglobin, platelet and leucocyte values did not differ for citrate and heparin. Conclusions In patients with contraindications against heparin use, ACD-A citrate anticoagulation during photopheresis is a safe and efficient alternative. Photopheresis induces profound changes of the blood count, irrespective of the anticoagulation method.
Vasileios F Panoulas - One of the best experts on this subject based on the ideXlab platform.
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a tricky percutaneous paravalvular leak closure two years after implantation of 3f enable sutureless bioprosthetic aortic valve
Hellenic Journal of Cardiology, 2016Co-Authors: Vasileios F Panoulas, Giovanni La Canna, Matteo Montorfano, Maurizio Taramasso, Gennaro Giustino, Azeem Latib, Antonio ColomboAbstract:Sutureless valves were designed in an attempt to simplify the aortic valve replacement procedure and reduce Extracorporeal Circuit time, whilst allowing complete excision of the calcified native valve using a minimally invasive approach. Elderly patients with significant comorbidities are considered to benefit the most, although randomized data are lacking. In registries of patients treated with implantation of a 3f Enable sutureless bioprosthetic aortic valve, all patients who developed paravalvular leak have been treated with valve explantation. This is the first case report describing a tricky yet successful percutaneous paravalvular leak closure 2 years after implantation of a 3f Enable sutureless aortic bioprosthesis.
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a tricky percutaneous paravalvular leak closure two years after implantation of 3f enable sutureless bioprosthetic aortic valve
Hellenic Journal of Cardiology, 2016Co-Authors: Vasileios F Panoulas, Giovanni La Canna, Matteo Montorfano, Maurizio Taramasso, Gennaro Giustino, Azeem Latib, Antonio ColomboAbstract:Sutureless valves were designed in an attempt to simplify the aortic valve replacement procedure and reduce Extracorporeal Circuit time, whilst allowing complete excision of the calcified native valve using a minimally invasive approach. Elderly patients with significant comorbidities are considered to benefit the most, although randomized data are lacking. In registries of patients treated with implantation of a 3f Enable sutureless bioprosthetic aortic valve, all patients who developed paravalvular leak have been treated with valve explantation. This is the first case report describing a tricky yet successful percutaneous paravalvular leak closure 2 years after implantation of a 3f Enable sutureless aortic bioprosthesis.
R. Apsner - One of the best experts on this subject based on the ideXlab platform.
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regional anticoagulation with acid citrate dextrose a for Extracorporeal photoimmunochemotherapy
Vox Sanguinis, 2002Co-Authors: R. Apsner, B. Uenver, Gere Sunderplassmann, R. M. KnoblerAbstract:Background and Objectives During photopheresis, intravenous heparin is used to prevent clotting in the Extracorporeal Circuit. Regional citrate anticoagulation could lower the risks associated with heparin treatment. Materials and Methods Four-hundred and six photophereses procedures that were anticoagulated by acid citrate dextrose-A (ACD-A) (of which 343 were performed in patients at risk for haemorrhage) were analysed together with 278 heparin-anticoagulated treatments. Results Four-hundred and four of 406 citrate treatments were completed. Seven transient paresthesias (1·73%), five of which occurred in the first 50 treatments, were observed. Bleeding complications were noted during heparin anticoagulation (1·07%), but not during citrate anticoagulation. During photopheresis, haemoglobin values and platelet counts decreased by 11·4% and 14·6%, respectively (P < 0·0001). Twenty-four hours after treatment, haemoglobin values, and platelet and leucocyte counts were still lower than at baseline (P < 0·0001). The changes of haemoglobin, platelet and leucocyte values did not differ for citrate and heparin. Conclusions In patients with contraindications against heparin use, ACD-A citrate anticoagulation during photopheresis is a safe and efficient alternative. Photopheresis induces profound changes of the blood count, irrespective of the anticoagulation method.
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dalteparin induced alopecia in hemodialysis patients reversal by regional citrate anticoagulation
Blood, 2001Co-Authors: R. Apsner, Walter H Horl, Gere SunderplassmannAbstract:Chronically intermittent hemodialysis for end-stage renal failure requires anticoagulation to prevent clotting in the Extracorporeal Circuit. Anticoagulation usually is performed by continuous infusion of unfractionated heparin or by bolus administration of low-molecular-weight heparin.[1][1] At our
Peter Bruins - One of the best experts on this subject based on the ideXlab platform.
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clinical evaluation of the air removal characteristics of an oxygenator with integrated arterial filter in a minimized Extracorporeal Circuit
International Journal of Artificial Organs, 2011Co-Authors: Marco C Stehouwer, Chris Boers, Roel De Vroege, Johannes C Kelder, Alaaddin Yilmaz, Peter BruinsAbstract:The use of minimized Extracorporeal Circuits (MECC) in cardiac surgery is an important measure to increase the biocompatibility of cardiopulmonary bypass during coronary artery bypass grafting (CABG). These Circuits eliminate volume storage reservoirs and bubble traps to minimize the Circuit. However, the reduction in volume may increase the risk of gaseous microemboli (GME). The MECC system as used by our group consists of a venous bubble trap, centrifugal pump, and an oxygenator. To further reduce the risk of introducing GME, an oxygenator with an integrated arterial filter was developed based on the concept of minimal volume and foreign surface. We studied the air removal characteristics of this oxygenator with and without integrated arterial filter. The quantity and volume of GME were measured with precision at both the inlet and outlet of the devices. Our results showed that integration of an arterial filter into this oxygenator increased GME reducing capacity from 69.2% to 92%. Moreover, we were able to obtain data on the impact of an arterial filter on the exact size-distribution of GME entering the arterial line. The present study demonstrates that an MECC system and oxygenator with integrated arterial filter significantly reduces the volume and size of GME. The use of an integrated arterial filter in an MECC system may protect the patient from the deleterious effects of CPB and may further improve patient safety.
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air removal efficiency of a venous bubble trap in a minimal Extracorporeal Circuit during coronary artery bypass grafting
Artificial Organs, 2010Co-Authors: Tamara P A Roosenhoff, Marco C Stehouwer, Roel De Vroege, Rene P Butter, Wimjan Van Boven, Peter BruinsAbstract:The use of minimized Extracorporeal Circuits (MECC) in cardiac surgery is expanding. These Circuits eliminate volume storage and bubble trap reservoirs to minimize the Circuit. However, this may increase the risk of gaseous micro emboli (GME). To reduce this risk, a venous bubble trap was designed. This study was performed to evaluate if incorporation of a venous bubble trap in a MECC system as compared to our standard minimized Extracorporeal Circuit without venous bubble trap reduces gaseous micro emboli during cardiopulmonary bypass (CPB). Forty patients were randomly assigned to be perfused either with or without an integrated venous bubble trap. After preliminary evaluation of the data of 23 patients, the study was terminated prior to study completion. The quantity and volume of GME were significantly lower in patients perfused with a venous bubble trap compared to patients perfused without a venous bubble trap. The present study demonstrates that a MECC system with a venous bubble trap significantly reduces the volume of GME and strongly reduces the quantity of large GME (>500 µm). Therefore, the use of a venous bubble trap in a MECC system is warranted.
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activation of the complement system during and after cardiopulmonary bypass surgery postsurgery activation involves c reactive protein and is associated with postoperative arrhythmia
Circulation, 1997Co-Authors: Peter Bruins, Te H Velthuis, A P Yazdanbakhsh, P G M Jansen, F W J Van Hardevelt, E M F H De Beaumont, C R H Wildevuur, Leon Eijsman, A Trouwborst, C E HackAbstract:Background Complement activation during cardiopulmonary bypass (CPB) surgery is considered to result from interaction of blood with the Extracorporeal Circuit. We investigated whether additional mechanisms may contribute to complement activation during and after CPB and, in particular, focused on a possible role of the acute-phase protein C–reactive protein (CRP). Methods and Results In 19 patients enrolled for myocardial revascularization, perioperative and postoperative levels of complement activation products, interleukin-6 (IL-6), CRP, and complement-CRP complexes, reflecting CRP-mediated complement activation in vivo, were measured and related to clinical symptoms. A biphasic activation of complement was observed. The ratio between the areas under the curve of perioperative and postoperative C3b/c and C4b/c were 3:2 and 1:46, respectively. IL-6 levels reached a maximum at 6 hours post-surgery. CRP levels peaked on the second postoperative day. Each complement-CRP complex had peak levels on the second...
