Background:The main clinical criterion for abdominal aortic aneurysm (AAA) repair operations is an AAA diameter ≥5.5 cm. When AAAs increase in size, specific changes occur in the mechanical properties of the aortic wall. Pulse-wave velocity (PWV) has been used as an indicator of vascular stiffness. A low PWV may predict AAA rupture risk and is an early predictor of cardiovascular mortality.Methods:We investigated the prognostic value of PWV before and after elective AAA repair procedures. Twenty four patients scheduled for an open AAA repair underwent a preoperative carotid-femoral aortic PWV measurement. A second aortic PWV measurement was carried out 6 months postoperatively.Results:The mean aortic PWV increased from 7.84 ± 1.85 preoperatively to 10.08 ± 1.57 m/sec 6 months postoperatively (mean change: 2.25; 95% confidence interval 1.4 to 3.1 m/sec; p<0.0001). The preprocedural PWV measurement did not correlate with AAA diameter (Spearman’s rank correlation coefficient ρ=0.12; p=0.59).Conclusions:Whether the increase in aortic PWV postoperatively suggests a decreased cardiovascular risk following AAA repair remains to be established. Aortic PWV should also be investigated as an adjunct tool for assessing AAA rupture risk.
The unprecedented for modern medicine pandemic caused by the SARS-COV-2 virus ("coronavirus", Covid-19) creates in turn new data on the survival of cardiac arrest victims, but mainly on the safety of Cardiopulmonary Resuscitation (CPR) providers. The covid19 pandemic resulted in losses in thousands of lives, and many more people were hospitalized in simple beds or in intensive care units both globally and in Greece. More specifically, in victims of cardiac arrest, both in and out of hospital, the increased mortality and high contagiousness of the SARS-CoV-2 virus put the CPR rescuers in front of new questions of both medical and moral nature. What we all know in Resuscitation, is that we cannot harm the victim and therefore do the most/best we can, it is no longer the full reality. What we need to know and incorporate into decision-making in the resuscitation process is the distribution of limited human and material resources, the potentially very poor outcome of patients with covid-19 and cardiac arrest, and especially that a potential infection of health professionals can lead in the absence of health professionals in the near future. This review tries to incorporate the added skills and precautions for CPR providers in terms of both in hospital and out hospital CPR.
Heart failure (HF) is rapidly growing, conferring considerable mortality, morbidity, and costs. Dedicated HF clinics improve patient outcomes, and the development of a national HF clinics network aims at addressing this need at national level. Such a network should respect the existing health care infrastructures, and according to the capacities of hosting facilities, it can be organized into three levels. Establishing the continuous communication and interaction among the components of the network is crucial, while supportive actions that can enhance its efficiency include involvement of multidisciplinary health care professionals, use of structured HF‐specific documents, such as discharge notes, patient information leaflets, and patient booklets, and implementation of an HF‐specific electronic health care record and database platform.
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