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排序方式: 共有78条查询结果,搜索用时 15 毫秒
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Christopher Learn MD Alistair Phillips MD Joanne Chisolm BSN MSN ACNP‐BC Sharon Hill MSN ACNP‐BC John Cheatham MD Peter Winch MD MBA Mark Galantowicz MD Ralf Holzer MD 《Congenital heart disease》2012,7(2):111-121
Introduction. Pulmonary atresia with ventricular septal defect (VSD) continues to be associated with significant morbidity and mortality, with significant institutional variation in therapeutic strategies. This study reports a single center experience utilizing an intensive transcatheter approach to promote pulmonary vascular growth. Methods. A retrospective analysis of 20 patients undergoing surgical and transcatheter treatment for pulmonary atresia with VSD between 2002 and 2010. Results. The median age at initial surgical palliation was 6.3 months (8 days to 2.5 years). Eleven patients (group 1) underwent initial surgical palliation without VSD closure and nine patients (group 2) underwent an initial complete repair with fenestrated or complete VSD closure. Group 1 had a smaller Nakata index (54 mm2/m2 vs. 134 mm2/m2, P= .04) and a smaller absolute native pulmonary artery diameter (2.7 mm vs. 4.5 mm, P= .01) than group 2. Intraoperative angiography was performed in 10 cases to evaluate if early transcatheter intervention was warranted. The median follow‐up during the study period was 2.3 years (1.6 months to 8.3 years). Of the 16 patients who survived the initial early postoperative period, 15 patients (94%) went on to receive surgical (n = 11) and/or interventional (n = 25) catheterization procedures. There was improvement in the mean Nakata index from the initial presurgical evaluation to the most recent catheterization data (38.4 mm2/m2 vs. 169.7 mm2/m2, P≤ .05). To date, two of 11 (18%) patients in group 1 ultimately underwent surgical VSD closure. Overall mortality was six of 20 (30%) with four deaths in group 1 and two deaths in group 2. There were no procedural deaths. Conclusions. Combining surgical unifocalization procedures with subsequent early and intensive catheter‐based pulmonary artery rehabilitation may improve vascular growth, ultimately rendering many patients suitable for fenestrated VSD closure. Risk stratification, including intraoperative exit angiography, is essential to determine the need for early transcatheter interventions. 相似文献
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Chengyue Jin MD Joshua Hsu ScM Daniel Frenkel MD FHRS Jason T. Jacobson MD FHRS Sei Iwai MD FHRS Aileen Ferrick PhD ACNP RN FHRS 《Journal of cardiovascular electrophysiology》2021,32(2):551-553
We introduced a simple technique to eliminate electromagnetic interference between a left ventricular assist device (LVAD) and an implantable cardioverter defibrillator (ICD). A 43-year-old male with heart failure and a reduced ejection fraction who had an ICD presented with decompensated heart failure and received an LVAD as a bridge to transplant. Remote monitoring showed persistent atrial fibrillation causing an inappropriate ICD shock leading to a decision to disable shock therapies. However, an in-office interrogation was unsuccessful due to electromagnetic interference. Patient was instructed to extend his arm above his head on the ipsilateral side of the ICD, thus increasing the distance between LVAD and ICD, eliminating the interaction to allow reprogramming of the device. 相似文献
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Nancy H. Miller BSN Kathy Berra MSN NP-C Janet Long MSN ACNP 《Journal of clinical hypertension (Greenwich, Conn.)》2010,12(5):328-334
J Clin Hypertens (Greenwich). A Harris Interactive survey of 1548 hypertensive persons aged 44 and older confirms the findings of previous studies that showed suboptimal rates of adherence to medication and lifestyle regimens to lower blood pressure, despite a high level of awareness of the health consequences of uncontrolled blood pressure. When the study population was analyzed by age group (baby boomers, ages 44 to 62 years, and seniors, ages ≥63 years), nonadherence was greater in the baby boomer cohort, which nevertheless had a higher level of concern than the seniors. Poor communication between patients and health care providers contributes to nonadherence to treatment regimens. Patients’ age plays an important role in their attitudes and behaviors regarding illness and treatment as well as their preferences as to the types of educational materials they would find helpful and the ways those materials can best be delivered. Because of the growing population of baby boomers further studies are warranted to evaluate attitudes, knowledge, and behaviors concerning the identification and treatment of hypertension. 相似文献
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Macabasco-O'Connell A DeWalt DA Broucksou KA Hawk V Baker DW Schillinger D Ruo B Bibbins-Domingo K Holmes GM Erman B Weinberger M Pignone M 《Journal of general internal medicine》2011,26(9):979-986