Analysis of Minimally Invasive Left Thoracotomy HVAD Implantation - A Single-Center Experience
THORACIC AND CARDIOVASCULAR SURGEON
Authors: Reichart, D.; Brand, C. F.; Bernhardt, A. M.; Schmidt, S.; Schaefer, A.; Blankenberg, S.; Reichenspurner, H.; Wagner, F. M.; Deuse, T.; Barten, M. J.
Abstract
Background Minimally invasive left ventricular assist device (LVAD) implantation may reduce peri-/postoperative complications and risks associated with resternotomies. In this study, we describe our first results using a minimally invasive LVAD implantation technique (lateral thoracotomy [LT] group). These results were compared with LVAD implantations done via full median sternotomy (STX group). Methods HVAD (HeartWare, Framingham, Massachusetts, United States) implantations in 70 patients (LT group n =22, 5215 years old; STX group n =48, 5911 years old) were retrospectively analyzed. Minimally invasive access via left thoracotomy was feasible in 22 patients. Peri- and postoperative analyses of survival and adverse events were performed. Results No survival differences were observed between the LT and STX group ( p =0.43). LT patients without temporary right ventricular assist device (tRVAD) showed a significantly better survival rate compared to LT patients with concomitant tRVAD implantation ( p =0.02), which could not be demonstrated in the STX group ( p =0.11). Two LT and four STX patients were successfully bridged to heart transplantation and three STX patients were successfully weaned with subsequent LVAD explantations. LVAD-related infections ( n =4 LT group vs n =20 STX group, p =0.04) were less likely in the LT group. No wound dehiscence occurred in the LT group, whereas five were observed in the STX group ( p =0.17). The amount of perioperative blood transfusions (within the first 7 postoperative days) did not differ in both study groups ( p =0.48). Conclusion The minimally invasive approach is a viable alternative with the possibility to reduce complications and should be particularly considered for bridge-to-transplant patients.
Sorption of paralytic shellfish toxins (PSTs) in algal polysaccharide gels
ALGAL RESEARCH-BIOMASS BIOFUELS AND BIOPRODUCTS
Authors: Olano, Dave Eldon B.; Salvador-Reyes, Lilibeth A.; Montano, Marco Nemesio E.; Azanza, Rhodora, V
Abstract
Sorption mechanics of the paralytic shellfish toxins (PSTs), saxitoxin (STX) and neo-saxitoxin (neo-STX), on algal polysaccharide gels was characterized using surface chemistry models. Refined (RC), semi-refined (SRC) carrageenan and alginate showed sorption of STX and neo-STX. The sorption of PSTs on RC, SRC and alginate was affected by contact time and in part, temperature. From surface chemistry models, alginate followed a spontaneous endothermic physical monolayer sorption of STX and neo-STX. SRC and RC favoured the concurrence of physical and chemical monolayer sorption, being endothermic for SRC and exothermic for RC.