Laser fluorescence angiography reveals perfusion defects in retrograde cardioplegia

Perfusion ◽  
2011 ◽  
Vol 26 (6) ◽  
pp. 536-541 ◽  
Author(s):  
H Gorki ◽  
NC Patel ◽  
L Balacumaraswami ◽  
JB Pillai ◽  
VA Subramanian
Keyword(s):  
Software Package ◽  
Green Laser ◽  
Laser Fluorescence ◽  
Fluorescence Angiography ◽  
Retrograde Cardioplegia ◽  
Cardiac Veins ◽  
Perfusion Defects ◽  
Quantitative Analyses ◽  
The Right ◽  
Image Details

Background: Adequate perfusion of the right ventricle with retrograde cardioplegia has always been questioned. However, clinical studies suggested sufficient protection and, up to now, intraoperative assessment of cardioplegia distribution has been difficult. Methods: As a pilot study in 14 patients, we used indocyanine green laser fluorescence angiography (ICGLA) to assess vascular and myocardial perfusion of different areas of the right anterior ventricular wall. Regions of interest were analyzed quantitatively using a new software package. Results: ICGLA allowed rapid and reliable visualization of cardioplegic flow and distribution. Retrograde cardioplegia revealed perfusion defects in the territory of the right anterior cardiac veins when compared to antegrade delivery and to areas close to the left anterior descending vein(s), confirmed by quantitative analyses of maximal fluorescence intensity. Five patients were excluded from quantitative analyses. The learning curve, pitfalls, limitations and special image details are described. Conclusion: A larger study is necessary to examine the relevance of perfusion defects to metabolic changes in affected myocytes and to global right ventricular function.

Prevalence and Localization of Hibernating Myocardium Among Patients with Left Ventricular Dysfunction

2019 ◽  
Vol 15 (9) ◽  
pp. 884-889
Author(s):  
Emine Acar ◽  
Ayşegül Aksu ◽  
Gökmen Akkaya ◽  
Gamze Çapa Kaya
Keyword(s):  
Scar Tissue ◽  
Left Ventricular ◽  
Hibernating Myocardium ◽  
Circumflex Artery ◽  
Irrigation Area ◽  
Left Circumflex Artery ◽  
Pet Ct ◽  
Perfusion Defects ◽  
The Right ◽  
Fdg Pet Ct

Objective: This study evaluated how much of the myocardium was hibernating in patients with left ventricle dysfunction and/or comorbidities who planned to undergo either surgical or interventional revascularization. Furthermore, this study also identified which irrigation areas of the coronary arteries presented more scar and hibernating tissue. Methods: At rest, Tc-99m MIBI SPECT and cardiac F-18 FDG PET/CT images collected between March 2009 and September 2016 from 65 patients (55 men, 10 women, mean age 64±12) were retrospectively analyzed in order to evaluate myocardial viability. The areas with perfusion defects that were considered metabolic were accepted as hibernating myocardium, whereas areas with perfusion defects that were considered non-metabolic were accepted as scar tissue. Results: Perfusion defects were observed in 26% of myocardium, on average 48% were associated with hibernation whereas other 52% were scar tissue. In the remaining Tc-99m MIBI images, perfusion defects were observed in the following areas in the left anterior descending artery (LAD; 31%), in the right coronary artery (RCA; 23%) and in the Left Circumflex Artery (LCx; 19%) irrigation areas. Hibernation areas were localized within the LAD (46%), LCx (54%), and RCA (64%) irrigation areas. Scar tissue was also localized within the LAD (54%), LCx (46%), and RCA (36%) irrigation areas. Conclusion: Perfusion defects are thought to be the result of half hibernating tissue and half scar tissue. The majority of perfusion defects was observed in the LAD irrigation area, whereas hibernation was most often observed in the RCA irrigation area. The scar tissue development was more common in the LAD irrigation zone.

scholarly journals The potential for person-centred planning to support the community participation of adults with an intellectual disability

2021 ◽  
pp. 174462952110221
Author(s):  
Darren McCausland ◽  
Esther Murphy ◽  
Mary McCarron ◽  
Philip McCallion
Keyword(s):  
Intellectual Disability ◽  
Mixed Methods ◽  
Community Participation ◽  
Social Inclusion ◽  
Mixed Methods Approach ◽  
Complex Needs ◽  
Qualitative Case Studies ◽  
Quantitative Analyses ◽  
The Right ◽  
The Impact

Person-centred planning (PCP) puts individuals with an intellectual disability at the centre of service and support planning, identifying how individuals wish to live their lives and what is needed to make that possible. PCP has been identified as having the potential to facilitate improved social inclusion and community participation. A mixed-methods approach combined quantitative analyses with qualitative case studies of individuals with severe-profound intellectual disability to assess the impact of PCP on community participation for adults with an intellectual disability at a disability service in Dublin. We conclude that PCP may provide a good basis to plan community participation and, with the right supports in place, may provide opportunities for people with complex needs to improve their community participation. Supports including familiar staff and family are critical to the success of PCP for people with complex needs, and their absence may undermine the best intentions of PCP for this population.

scholarly journals Retrograde cardioplegia does not adequately perfuse the right ventricle

1995 ◽  
Vol 109 (6) ◽  
pp. 1116-1126 ◽  
Author(s):  
Bradley S. Allen ◽  
Jacqueline W. Winkelmann ◽  
Hanafy Hanafy ◽  
Renee S. Hartz ◽  
Kirk S. Bolling ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Retrograde Cardioplegia ◽  
The Right

scholarly journals Evaluating the Psychosocial Impact of Indoor Public Spaces in Complex Healthcare Settings

2018 ◽  
Vol 12 (3) ◽  
pp. 11-30 ◽  
Author(s):  
Giuseppe Lacanna ◽  
Cor Wagenaar ◽  
Tom Avermaete ◽  
Viren Swami
Keyword(s):  
Public Space ◽  
Well Being ◽  
Space Environment ◽  
Factual Knowledge ◽  
Qualitative And Quantitative ◽  
Healthcare Settings ◽  
A Value ◽  
Quantitative Analyses ◽  
The Right ◽  
The Impact

Objective: This article describes an approach to a metrics-based evaluation of public space in hospitals using cross-disciplinary qualitative and quantitative analyses. The method, Indoor Public Space Measurement (IPSM), is well suited to researchers and designers who intend to evaluate user-centered spatial solutions in hospitals and similar facilities. Background: Healthcare is transiting toward a value-based policy at all levels. Choosing the right set of qualitative and quantitative analyses to support value-based design solutions is not always an easy journey for healthcare design consultants. This article seeks to pull together the key analyses to evaluate the impact of the hospital indoor public space on the psychosocial well-being of the hospital users. Method: A step-by step guide to performing key analyses to evaluate the impact of hospital indoor public space environment on the users’ psychosocial well-being is provided. A case study from the authors’ research is utilized to illustrate the application of the method. Results: Interpolating the results of all the analyses, the reader can identify where in the layout most of interactions among users occur, identify their typology and evaluate the contribution to the general psychosocial well-being, and know which group of users is more exposed to a specific typology of interaction. Conclusions: The IPSM method can help design consultants to measure the impact of the built environment of hospital public space on its occupants’ psychosocial well-being: factual knowledge about the users’ behavioral response with respect to wayfinding and social interaction. The application of the method is not limited to healthcare settings only.

scholarly journals NUScon: A community-driven platform for quantitative evaluation of nonuniform sampling in NMR

2021 ◽  
Author(s):  
Yulia Pustovalova ◽  
Frank Delaglio ◽  
D. Levi Craft ◽  
Haribabu Arthanari ◽  
Ad Bax ◽  
...  
Keyword(s):  
Best Practices ◽  
Software Package ◽  
Formal Theory ◽  
Nonuniform Sampling ◽  
Data Sampling ◽  
Road Map ◽  
Computational Performance ◽  
Spectral Reconstruction ◽  
Weak Intensity ◽  
Quantitative Analyses

Abstract. Although the concepts of non-uniform sampling (NUS) and non-Fourier spectral reconstruction in multidimensional NMR began to emerge four decades ago (Bodenhausen and Ernst, 1981; Barna and Laue, 1987), it is only relatively recently that NUS has become more commonplace. Advantages of NUS include the ability to tailor experiments to reduce data collection time and to improve spectral quality, whether through detection of closely spaced peaks (i.e., “resolution”) or peaks of weak intensity (i.e., “sensitivity”). Wider adoption of these methods is the result of improvements in computational performance, a growing abundance and flexibility of software, support from NMR spectrometer vendors, and the increased data sampling demands imposed by higher magnetic fields. However, the identification of best practices still remains a significant and unmet challenge. Unlike the discrete Fourier transform, non-Fourier methods used to reconstruct spectra from NUS data are nonlinear, depend on the complexity and nature of the signals, and lack quantitative or formal theory describing their performance. Seemingly subtle algorithmic differences may lead to significant variabilities in spectral qualities and artifacts. A community-based critical assessment of NUS challenge problems has been initiated, called the “Nonuniform Sampling Contest” (NUScon), with the objective to determine best practices for processing and analyzing NUS experiments. We address this objective by constructing challenges from NMR experiments that we inject with synthetic signals and we process these challenges using workflows submitted by the community. In the initial rounds of NUScon our aim is to establish objective criteria for evaluating the quality of spectral reconstructions. We present here a software package for performing the quantitative analyses and we present the results from the first two rounds of NUScon. We discuss the challenges that remain and present a road-map for continued community-driven development with the ultimate aim to provide best practices in this rapidly evolving field. The NUScon software package and all data from evaluating the challenge problems are hosted on the NMRbox platform.

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