Bilateral pectoralis major flap repair is a safe technique to cure severe mediastinitis necessitating complete sternal resection. Wounds close without extensive reconstructive surgery. Cosmetic results as well as stabilization of the chest were good. Patients reported an almost uncompromised quality of life without respiratory impairment.
The majority of patients with a history of AF show not only disorganized but also highly organized AT episodes, which can be successfully terminated by ATP.
Coronary blood flow was significantly influenced by mechanical aortic valve implantation and the orientation of prostheses. For both valve designs, the previously defined optimum orientation with respect to pressure gradients and turbulence demonstrated the highest left anterior descending flow rates. Even in its optimum orientation, the St Jude Medical valve showed significantly lower coronary flow than the other valves.
SCHERER, M., et al.: Extension of Generator Longevity by Use of High Impedance Ventricular Leads. The resistance of a pacing lead negatively correlates to current consumption. A prospective, randomized trial was conducted to evaluate the effect of a high impedance ventricular lead (CapSure Z) on generator longevity compared to a conventional lead (CapSure SP) eighty‐nine patients were included in the study (51 male, 37 female, age 70.0 ± 10.3 years). Forty‐six patients received a CapSure SP lead (5024 bipolar), and 43 patients received a CapSure Z lead (5034 bipolar) in a randomized fashion. Follow‐up data collected at 5 days, 3, 6, and 12 months postimplant included: lead impedance, pacing and sensing thresholds, impulse energy, and estimated time to replacement. All parameters were collected via pacemaker telemetry; the time to replacement was calculated automatically by a programmed algorithm of the pacemaker. There was no difference in the performance of the atrial lead when a dual chamber device was indicated. The CapSure Z leads displayed statistically significant higher impedance values than the CapSure SP lead in all follow‐up periods. There was no significant difference in lead related complications. No significant differences were observed between pacing and sensing thresholds in both groups. The CapSure Z leads provided a significant reduction in current drain, resulting in a reduction of mean energy consumption at the 12‐month follow‐up from 10.4 ± 5.0 μJ in the CapSure SP group to 6.6 ± 1.4 μJ in the CapSure Z group (median from 9.9 μJ to 6.9 μJ, respectively), providing an estimated increase in mean longevity of more than 1 year from 81.1 ± 23.5 months in the CapSure SP group to 94.5 ± 13.4 months in the CapSure Z group (median: 76.5 months to 95.0 months, respectively). The use of a high resistance lead for ventricular pacing appears to result in a clinically relevant extension of generator longevity.
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