Congenital Pulmonary vein stenosis - Diagnosis and treatment

Sasikumar, Navaneetha; Kuladhipati, Indra; Ramanan, Sowmya; Premsekar, Rajasekaran; Suramanyan, Raghavan; Rema, Krishna Manohar Soman

doi:10.17511/ijmrr.2013.i01.04

Cited by 33 publications

(2 citation statements)

References 38 publications

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“…(a) In cardiac catheterization, a cardiac catheter is inserted into the heart of a patient through his groin. (b) An angiographic image of a patient showing the catheter and the contrast agent [74]. .…”

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High‐Performance Flexible Magnetic Tunnel Junctions for Smart Miniaturized Instruments

et al. 2018

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MANUSCRIPT TEXT IntroductionFlexible electronics has become an established field that has seen tremendous developments over the last years. [1][2][3][4][5][6][7][8][9][10] The unique capability to adjust the geometry of devices to curved surfaces or surfaces of changing shape provides vast advantages over conventional electronics on rigid substrates. Hence, flexible printed circuit boards have already become an industrial standard for medical implants or consumer electronics [11][12][13][14] , where the main requirements are: large area, extreme thinness, and conformity to curved surfaces. The recent progress of organic [6,15,16] as well as inorganic [14,17,18] electronics, which are basically performed using printing or thin film technologies, has been very beneficial for the improvement of flexing electronic devices. In combination with other methods like screen or inkjet printing, novel concepts for flexible electronics have been developed for several applications including displays, [19] organic light-emitting diodes, [20] sensors, [21][22][23][24][25] radio frequency identification tags, [26][27][28] and organic solar cells. [29] Meanwhile, there are increasing activities on flexible magnetic field sensors and magnetoelectronics, [30,31] due to ubiquitous use of such kinds of devices. [18,32] By now, high-performance magnetic sensors based on the giant magnetoresistive (GMR) effect and the tunneling magnetoresistive (TMR) effect are mainly prepared using thin film fabrication technologies. [18,[33][34][35][36][37][38][39] This method allows for fabricating extremely sensitive magnetic sensors, especially on Si substrates, and it would therefore be a desirable solution to flex the silicon substrate, where the magnetic elements are fabricated onto. Magnetic tunnel junctions (MTJs) are of particular interest, because they constitute the main component of diverse spintronic devices such as spin-transfer oscillators, magnetic sensors, hard-disk-drive read-heads or Magnetic Random Access Memories. [40] MTJs are made of a magnetic multilayer thin film material. For sensor applications, the low power consumption [41] , high sensitivity and small size make them an attractive option. MTJs with amorphous Al-oxide barriers exhibit TMR ratios below 100 %. This can be improved by using (001)-oriented MgO barriers, achieving TMR ratios over 150 % at room temperature. [42][43][44] These high values can be exploited to design very sensitive TMR sensors, [45][46][47][48][49][50] such as biomagnetic field sensors [51] . They show an important change in resistance versus the magnetic field than other sensors such as those utilizing the anisotropic magnetoresistance or giant magnetoresistance. [52][53][54] Compared to conventionally used Hall effect and AMR sensors, a TMR sensor can also have higher sensitivity, lower power consumption [41] , better temperature stability and, in particular, compared to an AMR sensor, a wider linear range can be obtained. [54] Flexible MTJ devices have been reported with alumina [37,39] and MgO t...

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High‐Performance Flexible Magnetic Tunnel Junctions for Smart Miniaturized Instruments

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“…(a) A schematic of a patient that has a cardiac catheter inserted through the groin. (b) An x-ray image showing the catheter and the contrast dye is spread in the arteries[5].…”

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Flexible Magnetoresistive Sensors for Guiding Cardiac Catheters

Hawsawi

Amara

Mashraei

et al. 2018

2018 IEEE International Symposium on Medical Measurements and Applications (MeMeA)

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Cardiac catheterization is a procedure, in which a long thin tube that is called a "catheter" is inserted into the heart for diagnosis or treatment. Due to the excessive use of x-ray doses and contrast agents for orientation detection during the surgery, there is a need to find a better alternative. This paper presents magnetic tunnel junction sensors on flexible Si attached to the catheter tip for orientation detection during minimally invasive surgeries. Due to the small size of catheters, extreme minimization in terms of size, weight, thickness and power consumption is needed for any device implemented on it. The fabricated flexible magnetic tunnel junctions fulfill those requirements with size, thickness, weight and power consumption of 150 m 2 , 12 m, 8 g and 0.15 W, respectively, while still providing a high sensitivity of 4.93 %/Oe. The sensors can be bent with up to 500 m in diameter, which is more than needed for even the smallest catheters of size 1 mm (3 Fr) in diameter. This result is a stepping-stone towards the development of a versatile and low-cost smart catheter system that can help surgeons navigate inside the heart while minimizing the side effects.

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Congenital Pulmonary Vein Stenosis: Encouraging Mid-term Outcome

et al. 2015

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Congenital pulmonary vein stenosis (PVS) is a rare entity with limited outcome literature. Multiple interventional approaches have evolved including surgical and catheterization techniques. Our objective is to report our center experience and to compare short-term and mid-term outcomes among these therapeutic modalities. Retrospective study on 23 patients (n = 23) with PVS that required intervention over the last 13 years (2000-2013). Patients were divided into three groups based on type of initial intervention. Of these, 10 (43.5%) had balloon angioplasty, 3 (13.0 %) had surgical dilation, and 10 (43.5%) had surgical marsupialization. Mortality and number of re-interventions were our primary outcomes. Mean age at diagnosis was 10.9 ± 18.4 months. Mean age at initial intervention was 14.5 ± 18.0 months. Mean pre- and post-initial intervention PVS gradients were 9.2 ± 3.4 and 3.4 ± 2.2 mmHg, respectively. Mean survival time and re-intervention-free survival time were 4.8 ± 4.0 and 2.8 ± 3.4 years. No statistical significance was found between the interventions with respect to survival time (p = 0.52) and re-intervention free time (p = 0.78). High initial pre- and post-intervention gradients were significantly associated with re-intervention-free survival (p = 0.01 and p = 0.03, respectively). Patients with bilateral disease have increased mortality (p = 0.01) and decreased 5-year survival (p = 0.009) compared to patients with unilateral disease irrespective of type of intervention. No statistically significant difference in mortality or re-intervention rate was present among these different therapeutic modalities. This study has the longest follow-up so far reported in the current literature (58 months) with overall survival of 78%.

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Congenital Pulmonary vein stenosis - Diagnosis and treatment

Abstract: Congenital pulmonary vein stenosis is a rare and interesting condition. This disease was classically believed to have an exceptionally bad prognosis. This article reviews the pathophysiology of the disease and advancements in diagnosis and management.

Cited by 33 publications

References 38 publications

High‐Performance Flexible Magnetic Tunnel Junctions for Smart Miniaturized Instruments

High‐Performance Flexible Magnetic Tunnel Junctions for Smart Miniaturized Instruments

Flexible Magnetoresistive Sensors for Guiding Cardiac Catheters

Congenital Pulmonary Vein Stenosis: Encouraging Mid-term Outcome

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