Minerva cardioangiologica
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Minerva cardioangiologica · Dec 2017
ReviewClinical cardiac imaging in cardiac arrest and periarrest.
Echocardiography during preresuscitation care, cardiopulmonary resuscitation and postresuscitation is suggested to be an important tool in critical care medicine. At present a structured process integrating advanced life support and transtoracic echocardiography is not included in guidelines of cardiac resuscitation. However identification and treatment of reversible causes or complicating factors during cardiopulmonary resuscitation is rational and aimed to improve the outcomes. Furthermore, echocardiography has the potential to define the efficiency of the chest compressions and the optimal duration of the resuscitation maneuvers and/or the right time to switch to extracorporeal resuscitation.
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Palliative care is an alternate therapeutic approach that involves specialised medical care of a patient diagnosed with serious life threatening illness like heart failure (HF). The prime aim of the palliative care is to provide patient with relief from the symptoms, pain, physical stress, and mental stress of the diagnosed disease. ⋯ Palliative care can complement traditional care to improve symptom amelioration, patient-caregiver communication, emotional support, and medical decision making. The present review summarized all the available on alternative palliative approaches provided to heart patient by a team of physicians, nurses and other healthcare professionals.
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Minerva cardioangiologica · Jun 2015
ReviewFractional flow reserve and instantaneous wave free ratio in 2015.
In the recent years it has become apparent that angiography-based assessment of coronary artery stenosis suffers from considerable inaccuracy and pitfalls. Besides interobserver variability in assessing stenosis severity, the correlation between angiographic severity and ischemia is suboptimal. ⋯ The correlation between FFR and symptoms, stress imaging and intravascular ultrasound are reviewed along with the inherent limitations and pitfalls of these diagnostic technologies. The data regarding the correlation between Instantaneous (vasodilator free) wave-free ratio (iFR) and conventional FFR is summarized.
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Minerva cardioangiologica · Feb 2015
ReviewThe fundamentals of extra-corporeal membrane oxygenation.
During the past 50 years, pharmacologic advancements for cardiovascular risk factors and device innovation for the management of coronary disease, including acute myocardial infarction have radically changed the landscape of heart disease. At present, nearly 25% of individuals develop chronic heart failure after an acute myocardial infarction. It is estimated that nearly 2.6% of the American population suffers from heart failure. ⋯ Extracorporeal membrane oxygenation (ECMO) is one of the earliest types of pMCS systems primarily used for cardiorespiratory failure. ECMO can be used in different configurations, which makes it a versatile hemodynamic support device for different patient scenarios. In this paper, the authors review different configurations, indications, and hemodynamic profile of ECMO in respiratory and cardiac failure patients.
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Minerva cardioangiologica · Apr 2014
Review Comparative StudyThe most relevant complications of transcatheter aortic valve implantation according to VARC criteria.
Transcatheter aortic valve implantation (TAVI) has been shown to be a viable alternative for high-risk patients who may not tolerate a surgical aortic valve replacement. The Edwards Sapien valve and the CoreValve are the most widely implanted valves worldwide. The indication may be expanded to intermediate and eventually low-risk patients in future; however, this will require a better understanding of potential complications and selecting the right valve for each individual patient. ⋯ However, as clinical experience with this technology has matured and expanded, certain definitions have become unsuitable or ambiguous. The VARC 2 recommendations try to define the following clinical endpoints: mortality, stroke, myocardial infarction, bleeding complications, acute kidney injury, vascular complications, conduction disturbances, and arrhythmias, as well as a miscellaneous category including relevant complications not otherwise categorized. This manuscript reviews the most relevant complications of TAVI-transapical and transfemoral.