Fingerprint Dive into the research topics of Transmyocardial laser revascularization limits in vivo adenoviral-mediated gene transfer in porcine myocardium. Together they form a unique fingerprint. ...
What I have learned....... The TMR laser, literally blasts holes through the heart and creates channels, in which blood supply may return to ischemic myocardial tissue. This is done when there
BACKGROUND Transmyocardial laser revascularization (TMR) has been demonstrated effective for relieving angina, although prior studies have yielded inconsistent results regarding postoperative myocardial perfusion and function. This study evaluated long-term changes in myocardial perfusion and contractile reserve after TMR in a model of hibernating myocardium. METHODS Miniswine had subtotal left circumflex coronary artery occlusion to reduce resting blood flow to 10% of baseline. After 2 weeks in the low-flow state, positron emission tomography and dobutamine stress echocardiography were performed to document ischemic, viable (hibernating) myocardium in the left circumflex distribution. Animals then had sham redo thoracotomy (n = 4) or TMR (n = 6). Six months later the positron emission tomography and dobutamine stress echocardiography studies were repeated. RESULTS Myocardial blood flow in the left circumflex distribution as measured by positron emission tomography was significantly reduced in all
Exercise function was reported in few trials. Change in ETT time was significantly improved at 12 months for TMR versus MMT [WMD, 69.00 seconds; 95% CI, 27.14 to 110.86 seconds] and was not adequately reported at earlier time points for meta-analysis. The mean time on ETT did not differ at any time point. Patients with angina that led to limitation of exercise time on ETT was significantly decreased at 3 months [OR, 0.40; 95% CI, 0.26 to 0.60], 6 months [OR, 0.51; 95% CI, 0.27 to 0.95], and 1 year [OR, 0.35; 95% CI, 0.23 to 0.54].. All-cause mortality rate was not significantly different at 30 days [OR, 2.08; 95% CI, 0.85 to 5.09], 3 months [0.74; 95% CI, 0.26 to 2.13], 6 months, [0.72; 95% CI, 0.32 to 1.54], 1 year [OR, 1.08; 95% CI, 0.60 to 1.95], or 3 to 5 years [OR, 0.65; 95% CI, 0.41 to 1.05]. Major adverse coronary events (MACE) were significantly reduced with TMR compared with MMT at 1 year [OR, 0.23; 95% CI,0.15 to 0.34]. No significant difference was found for stroke and myocardial ...
TY - JOUR. T1 - Myocardium tissue ablation with nanosecond, ultraviolet pulses. T2 - Laser-Tissue Interaction XI: Photochemical, Photothermal, and Photomechanical. AU - Shimada, Tomoaki. AU - Sato, Shunichi. AU - Ishihara, Miya. AU - Arai, Tsunenori. AU - Matsui, Takemi. AU - Kurita, Akira. AU - Kikuchi, Makoto. AU - Wakisaka, Hitoshi. AU - Ashida, Hiroshi. AU - Obara, Minoru. PY - 2000/1/1. Y1 - 2000/1/1. N2 - To investigate the optimum irradiation conditions for the transmyocardial laser revascularization (TMLR), ablation characteristics have been explored in vitro with porcine myocardium tissues. With a nanosecond optical parametric oscillator (OPO), the ablation depth and the thickness of thermally damaged tissue were measured at a constant peak intensity or fluence in the ultraviolet spectral region of 230 - 400 nm. It was found that at a peak intensity of 80 MW/cm2, the ablation depth steeply increased for , 300 nm, while the thickness of thermally damaged tissue decreased with decreasing ...
A transmyocardial implant delivery system is disclosed for establishing a blood flow path through a myocardium between a heart chamber and a lumen of a coronary vessel residing on an exterior of the heart. The transmyocardial implant delivery assembly includes as conduit for defining a blood flow path, a temporary sheath, and a tool holding a second end of the conduit. The conduit includes a rigid portion adapted to be inserted into and retained within the heart wall of a heart chamber. The rigid conduit is sufficiently rigid to withstand collapsing in response to contraction forces of the heart wall. The conduit also includes a synthetic flexible portion that is in fluid communication with the rigid portion. An end of the flexible portion corresponding to the second end of the conduit is sized to be received in a lumen of a coronary vessel. The transmyocardial implant delivery system is inserted through the heart wall. After insertion the second end of the conduit is communicated with a lumen of
The system is intended for treatment of heart ischemia by method of transmyocardial laser revascularization (TMLR). The procedure employs laser radiation to vaporize holes in the muscle of the heart left ventricle in order to restore normal blood stream. As against the traditional technique of aortal-coronary bypass surgery, the TMLR method is more simple in use, less invasive and much lower in cost ...
Headquartered in New Delhi, with 20 centers and associated hospitals throughout India, Fortis Escorts Heart Institute and Research Center now manages nearly 900 beds and carries out 5,000 open-heart surgeries, 5,000 angioplasties, and 15,000 angiographies annually. The 285-bed New Delhi facility has nine operating rooms, with 200 doctors managing around 14,000 admissions annually.. Known primarily for heart work, the Institute also specializes in orthopedics, respiratory, kidney (transplant and dialysis), neurology (brain, spine and peripheral nerves) and dental surgery. In 2013, The Week/Nielson ranked the institute the top private heart hospital in Delhi and fifth best in cardiology in India.. Cardiac specialties include standard and specialty coronary bypass surgery, transmyocardial laser revascularization (TMLR), heart port surgery, robotic surgery for aortic aneurysms and dissections, carotid endarterectomy, valve surgery, and treatment of peripheral vascular disease.. Escorts also ...
Since 1993, The Medieval Review (TMR; formerly the Bryn Mawr Medieval Review) has been publishing reviews of current work in all areas of Medieval Studies.
Methods From January 2003 to August 2013, non-randomized 80 patients were treated with redo CABG in the Department of Cardiac Surgery, Peking University Third Hospital. Among these patients, 40 underwent on-pump CABG technique (redo-ONCAB group) and 40 underwent off-pump CABG technique (redo-OPCAB group). Furthermore, transmyocardial laser revascularization was performed in high-risk patients who were not suitable to conventional grafting. Clinical data of the two groups were recorded and analyzed including operation time, coronary grafts, incomplete revascularization, postoperative ventilation, perioperative stroke, and low output syndrome, etc ...
When the channels are created, the laser energy is absorbed by the blood, and a blast of steam (sometimes referred as a puff of smoke or fireworks) appears in the LV on TEE, signifying transmural penetration of the laser. However, absence of the blast of steam implies inadequate penetration, which can be communicated to the surgeon. In our experience, a 4C or 5C view allows visualization of the unique acoustic effect created by channels anywhere in the LV, including the inferior wall. Unlike CO2 lasers, for which TEE is mandatory to confirm transmural penetration, Ho:YAG lasers provide the surgeon with adequate tactile and auditory indications when the laser has completely channeled through the myocardium into the LV.1 Placement of the probe distorts the LV. An approximate position of the probe in relation to the important cardiac structures such as the mitral and aortic valves as well as the conduction system near the atrioventricular groove can be estimated, and this can be communicated ...
With its new fund, the Cleveland-based Evergreen Cooperatives have a bold goal: to make it easy to transition a business to worker-ownership.
TY - JOUR. T1 - Revascularization procedures in patients with transplant coronary artery disease. AU - Patel, V. S.. AU - Radovancevic, B.. AU - Springer, W.. AU - Frazier, O. H.. AU - Massin, E.. AU - Benrey, J.. AU - Kadipasaoglu, K.. AU - Cooley, D. A.. PY - 1997/7/3. Y1 - 1997/7/3. N2 - Objective: To assess the efficacy of revascularization in cardiac transplant patients who developed de novo coronary artery disease. Methods: Eighteen patients underwent one or more of four methods of revascularization percutaneous transluminal coronary angioplasty (PTCA), percutaneous transluminal coronary rotational atherectomy (PTCRA), coronary artery bypass grafting (CABG), and transmyocardial laser revascularization (TMLR). Eleven PTCA procedures were performed in 10 patients 55.3 ± 6.6 months after transplantation. Six patients underwent PTCRA 83.3 ± 11.2 months after transplantation. Five patients underwent CABG 54.0 ± 12.6 months after transplantation: the mean left ventricular ejection fraction ...
Totally Endoscopic and Robot-Assisted Transmyocardial Revascularization New codes have been proposed in subcategory 36.3, Other heart revascularization, to differentiate between endoscopic and percutaneous transmyocardial revascularization. According to the proposal, the description of code 36.32 would be revised to state endoscopic transmyocardial revascularization and new codes would be created for percutaneous transmyocardial revascularization and other transmyocardial revascularization. The traditional approach to transmyocardial revascularization (TMR) is through an anterolateral thoracotomy. TMR is a surgical technique that uses a laser to bore holes through the myocardium of the heart in an attempt to restore perfusion to areas of the heart not being reached by diseased or clogged arteries. This technique is used as a late or last resort for relief of symptoms of severe angina in patients with ischemic heart disease not amenable to direct coronary revascularization interventions, such ...
TY - JOUR. T1 - Current and future treatment strategies for refractory angina. AU - Yang, Eric H.. AU - Barsness, Gregory W.. AU - Gersh, Bernard J.. AU - Chandrasekaran, Krishnaswamy. AU - Lerman, Amir. PY - 2004/10. Y1 - 2004/10. N2 - Patients with refractory angina are not candidates for revascularization and have both class III or IV angina and objective evidence of ischemia despite optimal medical therapy. An estimated 300,000 to 900,000 patients In the United States have refractory angina, and 25,000 to 75,000 new cases are diagnosed each year. This review focuses on treatment strategies for refractory angina and includes the mechanism of action and clinical trial data for each strategy. The pharmacological agents that have been used are ranolazine, ivabradine, nicorandll, L-arginine, testosterone, and estrogen; currently, only L-arginine, testosterone, and estrogen are approved by the Food and Drug Administration. Results with the noninvasive treatments of enhanced external ...
Preliminary results from a randomized trial of a device for refractory angina were positive, and renal denervation will be studied in U.S. patients with moderate uncontrolled hypertension.
TY - JOUR. T1 - Transmyocardial revascularization ameliorates ischemia by attenuating paradoxical catecholamine-induced vasoconstriction. AU - Le, Dai-Trang (Elizabeth). AU - Powers, Eric R.. AU - Bin, Jian Ping. AU - Leong-Poi, Howard. AU - Goodman, N. Craig. AU - Kaul, Sanjiv. PY - 2007/4. Y1 - 2007/4. N2 - Background: The mechanism by which transmyocardial revascularization (TMR) offers clinical benefit is controversial. We hypothesized that TMR ameliorates ischemia by reversing paradoxical catecholamine-induced vasoconstriction. Methods and Results: Chronic ischemic cardiomyopathy was created in 11 dogs by placing ameroid constrictors on the proximal coronary arteries and their major branches. Six weeks later, 35 channels were created percutaneously in the left circumflex artery region, with the left anterior descending artery region serving as control. At rest, wall thickening and myocardial blood flow did not change in the treated region, whereas they deteriorated in the control bed. ...
Looking for online definition of c7E3 Fab Antiplatelt Therapy in Unstable Refractory Angina in the Medical Dictionary? c7E3 Fab Antiplatelt Therapy in Unstable Refractory Angina explanation free. What is c7E3 Fab Antiplatelt Therapy in Unstable Refractory Angina? Meaning of c7E3 Fab Antiplatelt Therapy in Unstable Refractory Angina medical term. What does c7E3 Fab Antiplatelt Therapy in Unstable Refractory Angina mean?
Impedance across a load, such as a pair of face-to-face electrodes and/or a patients transthoracic and transmyocardial impedance, respectively, is modeled as a resistor in series with a capacitor, wherein the reactance component of the impedance equals 2π*frequency/capacitance. A reference square wave voltage is applied to the load in series with a selected load resistor, and a response voltage is measured across the load. Both the reference voltage and the response voltage are then used to estimate a transfer function between them. Equating this transfer function to a resistor-capacitor circuit model results in estimation of the actual resistance and capacitance components of the true impedance. Alternately, the impedance may be measured with a high current load, such as during a defibrillator discharge. In this case, the voltage input and outputs are sampled at a much faster rate for the resistance component estimation, with the capacitance initialization adapted for the specific type of
Certain statements in this news release contain forward-looking statements within the meaning of the U.S. Private Securities Litigation Reform Act of 1995 and applicable Canadian securities laws that may not be based on historical fact, including without limitation statements containing the words believe, may, plan, will, estimate, continue, anticipate, intend, expect and similar expressions. Forward-looking statements may involve, but are not limited to, statements regarding the growing incidence of refractory angina and the growing cardiovascular marketplace. Many factors and assumptions could cause the Companys actual results, performance or achievements to differ materially from those expressed or implied by the forward-looking statements, including, without limitation, risks relating to the possibility that the Companys common shares may be delisted from the Nasdaq Capital Market or the Toronto Stock Exchange, including Nasdaqs discretionary public interest authority to ...
In simple terms, refractory angina (RFA) is a disabling chronic heart pain, as a result of heart disease. Angioplasty, coronary artery bypass surgery, or even medical therapy have failed to control this chest pain. A chronic chest pain can be determined if it occurs longer than three months. The blockage of arteries takes place due to a build-up of plaque. As a result, blood flow slows down and makes it hard for oxygen-rich blood to reach the heart. This causes angina or chest pain. Those suffering from angina may experience back, neck, shoulder, arm, or jaw pain. Those with RFA have angina symptoms that are more severe and difficult to manage than those who experience regular stable angina. The symptoms are usually unmanageable; however, there are few specialized treatments that can aid in reducing the severity of the symptoms. A non-invasive therapy known as Enhanced External Counter Pulsation (EECP) places compressive cuffs on the upper and lower legs (calves, upper, and thighs). Along with ...
ALBANY, New York, May 5, 2017 /PRNewswire/ -- Protein Ingredients Market Revenue Expected to Increase to US$ 64.3 Billion by 2027 - TMR.
Canadian Cardiovascular Society (CCS) Angina Class-Class I: Ordinary physical activity does not cause angina, such as walking and climbing stairs. Angina with strenuous or rapid or prolonged exertion at work or recreation; Class II: Slight limitation of ordinary activity. Walking or climbing stairs rapidly, walking uphill, walking or stair climbing after meals, or in cold, or in wind, or under emotional stress, or only during the few hours after awakening. Walking more than two blocks on the level and climbing more than one flight of ordinary stairs at a normal pace and in normal conditions; Class III: Marked limitation of ordinary physical activity. Walking one or two blocks on the level and climbing one flight of stairs in normal conditions and at normal pace; Class IV: Inability to carry on any physical activity without discomfort, anginal syndrome may be present at rest ...
It has been assumed for a long time that hearts of reptiles have a more poorly developed coronary vasculature than do hearts of mammals and that they derive direct myocardial perfusion from within the ventricle. However, details of this physiology have not been investigated previously. In the present study, we show that alligator hearts, including those of 300-kg alligators whose hearts are roughly the size of hearts from 20-kg dogs, have two morphologically distinct zones: a relatively thin epicardial zone of densely packed myocytes similar in appearance to mammalian myocardium and a thicker endocardial zone composed of more loosely packed myocardium whose sponge-like appearance derives from the extensive network of sinusoids and large channels that emanate from the LV chamber and richly innervate the myocardium. Contrary to expectations, there is also an extensive, well-developed epicardial coronary arterial network that links to a microcirculation that extends through the entire myocardial ...
include ,ppapi/cpp/core.h, #include ,ppapi/cpp/instance.h, #include global.h static google_smart_card::TypedMessageRouter tmr; void pcscNaClInit(pp::Instance *instance, pp::Core *core, const char *smartcardManagerAppId, const char *clientId) { new google_smart_card::PcscLiteOverRequesterGlobal(&tmr, instance, core); return; /* UNREACH: These are no longer used */ smartcardManagerAppId = smartcardManagerAppId; clientId = clientId; } bool pcscNaClHandleMessage(const pp::Var &message) { return(tmr.OnMessageReceived(message ...
Vitreous tamponades market was valued at USD 64.5 million in 2013 and is expected to grow at a CAGR of 2.5% during the forecast period from 2014 to 2020 to...