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Heart Model Simulates Mechanical Load on Cardiac Tissues
Researchers at Carnegie Mellon University, along with collaborators in the Netherlands, have developed a heart model consisting of engineered cardiac muscle tissue that is attached to an elastic material. The design allows the team to mimic the mechanical forces experienced by heart tissue in the body, which should provide them with more accurate data when using the model to replicate disease or study the effects of various treatments. The design may eventually lead to new ways of more accurately recreating heart muscle tissue in the lab, which could function as replacement tissue for cardiac disease patients. Tissue en...
Source: Medgadget - July 26, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Cardiac Surgery Cardiology Materials Source Type: blogs

Z- score classification of coronary aneurysms in Kawasaki disease
Z-score is the standard deviation from coronary artery internal lumen diameter normalized for body surface area. AHA classification of coronary artery aneurysms based on Z-score is as follows [1]: 1. No involvement with Z score less than 2 always. 2. Dilatation only with Z scores from 2 to less than 2.5 or a decrease in Z score of 1 or more during follow up if it was less than 2 initially. 3. Small aneurysm with Z score of more than 2.5, but less than 5. 4. Medium aneurysm with Z score 5 or more, but less than 5 and absolute dimension less than 8 mm. 5. Large or giant aneurysm with Z score 10 or more or absolute dimension...
Source: Cardiophile MD - July 24, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

Treatment of infective endocarditis
Discussion of whole list of options of antimicrobials for different varieties of endocarditis is quite a large topic. This discussion is only a broad outline of the antimicrobial treatment of infective endocarditis, meant mainly for exam purpose rather than actual clinical treatment. References to more detailed guidelines have been provided for those who wish to learn more. Inoculum Effect High microbial density as in vegetations cause less antimicrobial activity of some antimicrobial agents. This is known as inoculum effect and has been documented with β-lactams and glycopeptides but not linezolid, in the treatment of St...
Source: Cardiophile MD - July 16, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

3D Printing in Medicine And Healthcare – The Ultimate List In 2021
3D printing has demonstrated huge potential for the future of medicine in the previous years, and its development is unstoppable. Just look at the impressive list of 3D printed healthcare materials and medical equipment below! How does 3D printing in medicine work? 3D printing in medicine is part of the innovative process called additive manufacturing, which means producing three-dimensional solid objects from a digital file. How the technology works, we explained the technology in our article on bioprinting here. As technology evolves, researchers work on various solutions. For example, engineers from the University of B...
Source: The Medical Futurist - July 13, 2021 Category: Information Technology Authors: berci.mesko Tags: 3D Printing Biotechnology Future of Medicine Healthcare Design Medical Education Personalized Medicine bioprinting Innovation Video GC1 3d printed biomaterial tissue engineering Source Type: blogs

Aortic stenosis – TAVR (TAVI) vs SAVR
Discussion so far is based on ACC/AHA guidelines, 2020 [1]. ESC/EACTS guidelines for management of valvular heart disease were published in 2017 [2]. The guideline mentions that data on TAVI are limited for patients below 75 years and for low surgical risk patients. Hence SAVR was preferred in those patients. On this aspect, the more recent ACC/AHA guidelines incorporate more recent evidence. In ESC/EACTS guidelines, SAVR is preferred if STS/EuroSCORE II is less than 4% and TAVI if it is more than or equal to 4%. TAVI is preferred in those with severe comorbidity, previous cardiac surgery, frailty, and restricted mobility....
Source: Cardiophile MD - July 5, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Angiography and Interventions Cardiac Surgery Structural Heart Disease Interventions Source Type: blogs

Cardiology MCQs
Modified Blalock-Taussig shunt is: End to side anastomosis of subclavian artery to a pulmonary artery Side to side anastomosis of main pulmonary artery to aorta Side to side anastomosis of subclavian artery to a pulmonary artery using a conduit Anastomosis of superior vena cava to right pulmonary artery Correct answer: 3. Side to side anastomosis of subclavian artery to a pulmonary artery using a conduit In classic Blalock-Taussig shunt, the subclavian artery is divided and anastomosed to the pulmonary artery as an end to side anastomosis. In modified Blalock – Taussig shunt, a Gore – Tex graft is used to connect th...
Source: Cardiophile MD - July 4, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Ischemic preconditioning
The concept of ischemic preconditioning is that multiple short episodes of ischemia can protect the heart from a later sustained ischemia later [1]. In an experimental study, 4 episodes of 5 minutes each, separated by 5 minutes of reperfusion followed by 40 minutes of occlusion showed 75% reduction in infarct size compared to controls. But this benefit was not there when the final occlusion time was 3 hours. Authors suggested that multiple pre-infarction anginal episodes may have a similar effect on limiting infarct size if myocardial infarction occurs subsequently. Others have suggested that similar mechanism might opera...
Source: Cardiophile MD - July 1, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

Congenitally corrected transposition of great arteries
Congenitally corrected transposition of the great arteries (CCTGA or cTGA) is a condition in which there is atrioventricular and ventricular arterial discordance so that the circulation is physiological. Congenitally corrected transposition of great arteries is also known as l-transposition of great arteries (l-TGA) because of the levo transposition of aorta. Levo posed aorta forms a hump along the left upper heart border on chest X-ray. The right atrium connects to the morphological left ventricle, which in turn connects to the pulmonary artery so that systemic venous blood reaches the pulmonary circulation. The left atr...
Source: Cardiophile MD - June 24, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

Idarucizumab for reversal of direct thrombin inhibitor dabigatran
Idarucizumab is a monoclonal antibody fragment used to reverse the anticoagulant effect of direct thrombin inhibitor dabigatran. RE-VERSE AD (Reversal of Dabigatran Anticoagulant Effect With Idarucizumab) clinical trial evaluated the safety and efficacy of 5 g idarucizumab given intravenously [1]. An article on interim analysis of 90 patients was published first. In that report, 51 patients in group A of the study had serious bleeding while 39 patients in group B required an urgent procedure. Primary end point of the study was the maximum percentage reversal of the anticoagulant effect of dabigatran within four hours of a...
Source: Cardiophile MD - June 18, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

Non invasive cardiac output monitoring
Conventionally, measurement of cardiac output was done invasively. Initially with dye dilution techniques and later by thermodilution techniques. Both needed pulmonary artery catheterization, which in turn was likely to cause morbidity if used for continuous monitoring. Almost all non-invasive cardiac imaging modalities like echocardiography, computed tomography, magnetic resonance imaging and nuclear imaging can measure cardiac output. But these are not suitable for bedside monitoring, though echocardiography may be used for intermittent bedside assessment. Assessment of cardiac output though desirable, was most often ti...
Source: Cardiophile MD - June 6, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

PerQseal+ for Large Diameter Arterial Closure: Interview with Andrew Glass, CEO of Vivasure Medical
Vivasure Medical, a medtech company based in Galway, Ireland, has developed the PerQseal device, a synthetic implant designed to seal large bore blood vessel punctures. The implant has utility in a wide variety of transcatheter endovascular procedures, such as transcatheter aortic valve replacement (TAVR), thoracic endovascular aneurysm repair (TEVAR), and endovascular abdominal aneurysm repair (EVAR), and aims to significantly improve on current approaches to close large vessel punctures. The implant is an intravascular patch that is applied to the puncture from inside the vessel and is fully absorbable. The patch does...
Source: Medgadget - May 26, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Cardiac Surgery Cardiology Exclusive Radiology Vascular Surgery Vivasure Source Type: blogs

Fight Aging! Newsletter, May 10th 2021
This study suggests that some of those changes contribute to age-related hypertension, providing yet another reason to put resources into the near term development of therapies that can reverse the aging of the gut microbiome, such as flagellin vaccination or fecal microbiota transplantation. "Previous studies from our lab have shown that the composition of the gut microbiota in animal models of hypertension, such as the SHRSP (spontaneously hypertensive stroke-prone) rat model, is different from that in animals with normal blood pressure. Further, transplanting dysbiotic gut microbiota from a hypertensive animal ...
Source: Fight Aging! - May 9, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

Management of aortic dissection
Aortic dissection is the most common aortic emergency. It is one of the three acute aortic syndromes, the others being aortic intramural hematoma and penetrating aortic ulcer. It has a grave prognosis with 20% pre hospital and 30% in hospital mortality. Aortic dissection is generally considered as acute when diagnosis is made within 14 days of onset and chronic after that. An intimal and medial tear in the aorta causes blood to seep into the media and the false lumen usually progresses along a variable extend of the aorta. Important risk factors for aortic dissection are hypertension, Marfan syndrome and bicuspid aortic ...
Source: Cardiophile MD - May 4, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Angiography and Interventions Cardiac Surgery Source Type: blogs

Major aortopulmonary collateral arteries
Major aortopulmonary collateral arteries (MAPCA) occur in cyanotic congenital heart diseases with decreased pulmonary blood flow (tetralogy of Fallot like physiology). They are a natural protective mechanism to improve pulmonary blood flow. MAPCAs are more likely to occur in pulmonary atresia than in simple tetralogy of Fallot. MAPCAs can also occur in conditions other than the typical pulmonary atresia with ventricular septal defect. In a retrospective review of such cases, 33 had single ventricle anatomy while the rest had two ventricle anatomy. Among those with single ventricle, 15 had unbalanced complete atrioventricu...
Source: Cardiophile MD - April 23, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

Surgery for tetralogy of Fallot
Tetralogy of Fallot is the commonest cyanotic congenital heart disease. Surgical repair has improved remarkably ever since it was first published in 1955 by Lillehei CW et al [1]. Excellent long term survival is now feasible, with 30 year survival ranging from 68.5% to 90.5% [2]. Symptomatic infants with tetralogy of Fallot can undergo either primary surgical repair or a palliative procedure which could be either a systemic to pulmonary shunt or catheter based right ventricular outflow tract or pulmonary valve dilatation [3]. A retrospective study using the UK National Congenital Heart Disease Audit had 1662 infants with...
Source: Cardiophile MD - April 21, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiac Surgery Source Type: blogs