The incidence of atherosclerosis is increasing rapidly all over the world. Inflammatory processes
have outstanding role in coronary artery disease (CAD) etiology and other atherosclerosis
manifestations. Recently attentions have been increased about gut microbiota in many fields of
medicine especially in inflammatory diseases like atherosclerosis. Ineffectiveness in gut barrier
functions and subsequent metabolic endotoxemia (caused by rise in plasma lipopolysaccharide
levels) is associated with low-grade chronic inflammation i.e. a recognized feature of
atherosclerosis. Furthermore, the role of trimethylamine-N-oxide (TMAO), a gut bacterial
metabolite has been suggested in atherosclerosis development. On the other hand, the effectiveness
of gut microbiota modulation that results in TMAO reduction has been investigated. Moreover,
considerable evidence supports a role for the endocannabinoid system (ECS) in atherosclerosis
pathology which affects gut microbiota, but their effects on atherosclerosis are controversial.
Therefore, we presented some evidence about the relationship between gut microbiota and ECS
in atherosclerosis. We also presented evidences that gut microbiota modulation by pre/probiotics
can have significant influence on the ECS.
Background:The objective of this study was to assess the results of the pulmonary artery (PA) banding in patients with congenital heart defects (CHD) and pulmonary hypertension (PH) in the current era.Methods:We analyzed data from 305 patients who underwent PA banding between April 2005 and April 2010 at our centre. All patients were approached through a left thoracotomy. Twenty percent of patients underwent PA banding based on Trusler's rule (Group 1), 55% of them underwent PA banding based on PA pressure measurement (Group 2), and the rest of them (25%) based on surgeon experience (Group 3). The follow-up period was 39 ± 20 month and 75% of patients (230 cases) had definitive repair at mean interval 23 ± 10 months.Results:The rate of anatomically and functionally effectiveness of PA banding in all groups was high (97% and 92%, respectively). There were no significant differences in anatomically and functionally efficacy rate between all groups (P=0.77, P=0.728, respectively). There was PA bifurcation stenosis in six cases (2%), and pulmonary valve injury in one case (0.3%). The mortality rate in PA banding was 2% and in definitive repair was 3%.Conclusions:We believe that PA banding still plays a role in management of patients with CHD, particularly for infants with medical problems such as sepsis, low body weight, intracranial hemorrhage and associated non cardiac anomalies. PA banding can be done safely with low morbidity and mortality.
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