This work aims to determine optimal balloon shape and volume during left intraventricular balloon pumping (IABP) in the fibrillating dog heart. A balloon volume equal to the left ventricular end-diastolic volume (LVEDV) maintained a higher systolic aortic pressure and flow (106.4 +/- 2.7 mmHg and 84.7 +/- 2.35 ml/kg/min, x +/- SEM, respectively) than a 25% smaller (97.8 +/- 3.3 mmHg, P = 0.002 and 63.7 +/- 4.1 ml/kg/min, P = 0.002, respectively) or a 25% larger balloon (87.4 +/- 2.3 mmHg, P = 0.002 and 70.9 +/- 3.4 ml/kg/min, P = 0.002, respectively). Among 5 different balloon shapes tested, a pear-shaped balloon inflated from the apex to the base of the left ventricle induced the highest (P varying from 0.042 to 0.01, compared to the remaining balloon shapes) systolic aortic pressure and flow (104.6 +/- 4.5 mmHg and 77.9 +/- 1.7 mg/kg/min, respectively). In conclusion, a pear shaped balloon, inflated to a volume equal to the LVEDV, from the apex to the base of the left ventricle, induced an optimal hemodynamic effect during LVBP.
The purpose of this study is to evaluate the early morphological and functional abnormalities of the heart in patients with collagen disease. The study population was free of risk factors for coronary artery disease and without any clinically evident cardiac manifestations. In 62 patients with collagen disease (25 with progressive systemic sclerosis, 19 with systemic lupus erythematosus, 15 with rheumatoid arthritis, three with dermatomyositis) and in 40 healthy subjects an echocardiographic study was performed. Echocardiographic examination from the apical four-chamber view was performed at rest and during the end of a 3 min isometric exercise with handgrip. Global and regional ejection fraction of the left ventricle were calculated. In the group with progressive systemic sclerosis the left ventricular mass index was significantly higher than in the control group (110.78 +/- 48.61 vs 82.18 +/- 28.46 g.m-2) and the ejection fraction (53.61 +/- 7.95%) was the lowest of all groups (control: 61.47 +/- 8.52%, systemic lupus erythematosus: 59.04 +/- 8.58%, rheumatoid arthritis: 62.38 +/- 6.88%). Regional ejection fraction analysis revealed a major dysfunction of the proximal segment of the interventricular septum, in all groups. During isometric exercise, the global and regional ejection fraction did not change significantly, although differences between groups disappeared. In rheumatoid arthritis, mitral and aortic valve leaflet separation appeared to be reduced. In the group with systemic lupus erythematosus, mild abnormalities were noticed, although the mean age and duration of the disease were the smallest compared with the other groups. In conclusion, patients with progressive systemic sclerosis mainly present left ventricular hypertrophy with a reduced ejection fraction while rheumatoid arthritis patients show a predominant valve dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)
Background: Pleuropericardial cysts (PPCs), account for 5 -10% of all mediastinal tumours, are rare lesions occurring in approximately 1 in 100000 persons and are usually congenital and rarely acquired. They are detected postmortem or incidentally on routine chest X-ray (CXR) and in most cases multi detector Computer Tomography is used to confirm the diagnosis. As benign course and clinical latency are characteristic features of such cysts and the occurrence of complications is rare, the majority of them can be left untreated.
Methods:The aim of the study is to review the literature regarding PPCs and create a table which summarises all the published cases in order to draw a conclusion about the epidemiology, as well as the diagnostic and therapeutic approach to PPCs exclusively. We reviewed retrospectively the clinical manifestation, diagnostic and therapeutic approach in 101 cases of PPCs since the 19 th century Results: Our statistical analysis led to the following results: mean age of initial detection: 48.7 ± 17.2 years, female:male ratio: about 3:2, presence of symptomatology: 37/101 cases, most common location: right cardiophrenic angle (RCPA), most common method of initial detection: CXR in 49/101 cases, mean maximal diameter: 8,3 ± 3 cm.
Conclusion:The management of a pleuropericardial cyst should be based on an algorithm in which the cyst's size, shape and compressibility along with clinical presentation and patient's fitness and preferences are be taken into consideration. When interventional is required, surgical resection by means of traditional open surgery or minimally invasive methods are considered to be the gold standard and along with percutaneous aspiration are the methods that have mostly been used.
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