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Rösler ÁM, Lucchese FA, Pomerantzeff PMA, Passos LCS. Safety, Effectiveness, and Hemodynamic Performance of the Bovine Pericardium Organic Valvular Bioprosthesis. Braz J Cardiovasc Surg 2023; 38:e20230015. [PMID: 37797247 PMCID: PMC10549993 DOI: 10.21470/1678-9741-2023-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE To assess actual data on the safety, effectiveness, and hemodynamic performance of Bovine Pericardium Organic Valvular Bioprosthesis (BVP). METHODS The BIOPRO Trial is an observational, retrospective, non-comparative, non-randomized, and multicenter study. We collected data from 903 patients with symptomatic, moderate, or severe valve disease who underwent BVP implants in the timeframe from 2013 to 2020 at three Brazilian institutions. Death, valve-related adverse events (AEs), functional recovery, and hemodynamic performance were evaluated at the hospital, at discharge, and six months and one year later. Primary analysis compared late (> 30 days after implant) linearized rates of valve-related AEs, such as thromboembolism, valve thrombosis, major hemorrhage, major paravalvular leak, and endocarditis, following objective performance criteria (OPC). Analysis was performed to include at least 400 valve-years for each valve position (aortic and mitral) for complete comparisons to OPC. Kaplan-Meier survival and major adverse cardiovascular and cerebrovascular event analyses were also performed. RESULTS This retrospective study analyzed follow-up data collected from 903 patients (834.2 late patient-years) who have undergone surgery for 455 isolated aortic valve replacement (50.4%), 382 isolated mitral valve replacement (42.3%), and 66 combined valve replacement or other intervention (7.3%). The linearized rates of valve-related AEs were < 2 × OPC. One-year survival rates were 95.1% and 92.7% for aortic and mitral valve replacement, respectively. This study demonstrated an improvement in the New York Heart Association classification from baseline and hemodynamic performance within an expected range. CONCLUSION According to this analysis, BVP meets world standards for safety and clinical efficacy.
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Affiliation(s)
- Álvaro Machado Rösler
- Department of Cardiovascular Surgery, Hospital São
Francisco, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Rio
Grande do Sul, Brazil
| | - Fernando Antonio Lucchese
- Department of Cardiovascular Surgery, Hospital São
Francisco, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Rio
Grande do Sul, Brazil
| | - Pablo Maria Alberto Pomerantzeff
- Department of Cardiovascular Surgery, Instituto do
Coração, Hospital das Clínicas, Faculdade de Medicina,
Universidade de São Paulo (INCOR-HCFMUSP), São Paulo, São
Paulo, Brazil
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Vigliotti RC, Mestres G, Ruiz C, Guarnaccia G, Blanco C, Ramses R, Yugueros X, Riambau V. Impact of target visceral vessel anatomical configuration on early complications following endovascular repair of thoracoabdominal aortic aneurysms. Ann Vasc Surg 2021:S0890-5096(21)00877-3. [PMID: 34788702 DOI: 10.1016/j.avsg.2021.10.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/10/2021] [Accepted: 10/11/2021] [Indexed: 11/20/2022]
Abstract
Impact of target visceral vessel anatomical configuration on early complicatins following endovascular repair of thoracoabdominal aortic aneurysms Objectives: Fenestrated and branched endovascular aortic repair (fEVAR-bEVAR) is a viable treatment option for thoracoabdominal aortic aneurysms but target visceral stent (TVS) endoleak and thrombosis remain a limiting factor. This study aims to evaluate TVS anatomy impact on one-year risk of thrombosis and endoleak. METHODS Patients treated with fEVAR-bEVAR for thoracoabdominal aneurysms between 2008-2020 in our centre were enrolled. We recorded comorbidities, operative details, one-month postoperative CT scan (anatomical reference), and TVS behaviour: thrombosis and endoleak at one-year follow-up. For each TVS, different points were identified using a centre-lumen-line: (A) TVS origin, (B) end of branch/fenestration, (C) visceral vessel entry, (D) end of TVS, (E) 1-cm distally. We analyzed TVS tortuosity ((centre-lumen-line/straight distance)-1, in %), image vector analysis of each segment in 2D (antero-posterior, left-right) and 3D (craneo-caudal displacement), and centre-lumen-line analysis (bending in ABC and CDE). Three independent observers performed a blind analysis, and anatomical differences between bEVAR/fEVAR, and cases with/without 1-year thrombosis and TVS endoleak, were compared using Kaplan-Meier curves (Log-Rank test), and T-Test/Wilcoxon signed-ranks test respectively. RESULTS 54 patients (72±713 years mean age; 182 TVS: 50 branches, 132 fenestrations) met the inclusion criteria. bEVAR cases had longer stents, with more caudal 3D angulation and greater ABC angulated segment. After excluding bEVAR cases (low case number), 97 fEVAR TVS were analyzed. Five thrombosis and seven endoleaks were observed. While anatomical configuration showed no association to thrombosis, it was related to endoleak: these cases presented more tortuous stents (5.97%±0.10, 21.40%±0,22, P=.011), with more angulated centre-lumen-line at ABC segment (5.69°±15.77°, 7.18°±7.77°, P=.012), and more upward-pointing stents in the origin of the stent (AB: 89.07°±24.46°, 109.09°±16.56°, P=.012; BC: 87.86°±21.10°, 113.11°±22.23°, P=.026). CONCLUSIONS Anatomical configuration of the TVS is associated with stent type I-III endoleak, but not thrombosis, at one-year following fEVAR. Cases with endoleak presented more tortuous stents, with a more angulated exit from the endograft and upward-pointing of the origin of the stent.
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Ghoseiri K, Allami M, Murphy J, Page P, Button D. Investigation of Localized Skin Temperature Distribution Across the Transtibial Residual Limb. Can Prosthet Orthot J 2021; 4:35070. [PMID: 37614932 PMCID: PMC10443525 DOI: 10.33137/cpoj.v4i1.35070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 12/31/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Interventions to resolve thermal discomfort as a common complaint in amputees are usually chosen based on the residual limb skin temperature while wearing prosthesis; whereas, less attention has been paid to residual limb skin temperature while outside of the prosthesis. The objective of this study was to explore the localized and regional skin temperature over the transtibial residual limb (TRL) while outside of the prosthesis. METHODOLOGY Eight unilateral transtibial adults with traumatic amputation were enrolled in this cross-sectional study. Participants sat to remove their prostheses and rested for 30 minutes. Twelve sites were marked circumferentially in four columns (anterolateral, anteromedial, posteromedial, and posterolateral) and longitudinally in three rows (proximal, middle, and distal) over the residual limb and used for attachment of analog thermistors. Skin temperature was recorded and compared for 11 minutes. Furthermore, the relationship of skin temperature with participants' demographic and clinical characteristics was explored. FINDINGS The whole temperature of the TRL was 27.73 (SD=0.83)°C. There was a significant difference in skin temperature between anterior and posterior columns. Likewise, the distal row was significantly different from the proximal and middle rows. The mean temperature at the middle and distal zones of the anteromedial column had the highest and lowest skin temperatures (29.8 and 26.3°C, p<0.05), respectively. The mean temperature of the whole TRL had no significant relationships (p>0.05) with participants' demographic and clinical characteristics. CONCLUSIONS An unequal distribution of temperature over the TRL was found with significantly higher and lower temperatures at its anterior column and distal row, respectively. This temperature pattern should be considered for thermoregulation strategies. Further investigation of the residual limb temperature with and without prosthesis, while considering muscles thickness and blood perfusion rate is warranted.
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Affiliation(s)
- K. Ghoseiri
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - M. Allami
- Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
| | - J.R. Murphy
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - P. Page
- Department of Physical Therapy, Franciscan University, Baton Rouge Louisiana, USA
| | - D.C. Button
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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Xia RZ, Zhai ZJ, Chang YY, Li HW. Clinical Applications of 3-Dimensional Printing Technology in Hip Joint. Orthop Surg 2019; 11:533-544. [PMID: 31321905 PMCID: PMC6712410 DOI: 10.1111/os.12468] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/21/2018] [Accepted: 10/03/2018] [Indexed: 12/27/2022] Open
Abstract
Three‐dimensional (3D) printing is a digital rapid prototyping technology based on a discrete and heap‐forming principle. We identified 53 articles from PubMed by searching “Hip” and “Printing, Three‐Dimensional”; 52 of the articles were published from 2015 onwards and were, therefore, initially considered and discussed. Clinical application of the 3D printing technique in the hip joint mainly includes three aspects: a 3D‐printed bony 1:1 scale model, a custom prosthesis, and patient‐specific instruments (PSI). Compared with 2‐dimensional image, the shape of bone can be obtained more directly from a 1:1 scale model, which may be beneficial for preoperative evaluation and surgical planning. Custom prostheses can be devised on the basis of radiological images, to not only eliminate the fissure between the prosthesis and the patient's bone but also potentially resulting in the 3D‐printed prosthesis functioning better. As an alternative support to intraoperative computer navigation, PSI can anchor to a specially appointed position on the patient's bone to make accurate bone cuts during surgery following a precise design preoperatively. The 3D printing technique could improve the surgeon's efficiency in the operating room, shorten operative times, and reduce exposure to radiation. Well known for its customization, 3D printing technology presents new potential for treating complex hip joint disease.
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Affiliation(s)
- Run-Zhi Xia
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zan-Jing Zhai
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yong-Yun Chang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hui-Wu Li
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Pousett B, Lizcano A, Raschke S. An Investigation of the Structural Strength of Transtibial Sockets Fabricated Using Conventional Methods and Rapid Prototyping Techniques. Can Prosthet Orthot J 2019; 2:31008. [PMID: 37614804 PMCID: PMC10443464 DOI: 10.33137/cpoj.v2i1.31008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 04/04/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Rapid Prototyping is becoming an accessible manufacturing method but before clinical adoption can occur, the safety of treatments needs to be established. Previous studies have evaluated the static strength of traditional sockets using ultimate strength testing protocols outlined by the International Organization for Standardization (ISO). OBJECTIVE To carry out a pilot test in which 3D printed sockets will be compared to traditionally fabricated sockets, by applying a static ultimate strength test. METHODOLOGY 36 sockets were made from a mold of a transtibial socket shape,18 for cushion liners with a distal socket attachment block and 18 for locking liners with a distal 4-hole pattern. Of the 18 sockets, 6 were thermoplastic, 6 laminated composites & 6 3D printed Polylactic Acid. Sockets were aligned in standard bench alignment and placed in a testing jig that applied forces simulating individuals of different weight putting force through the socket both early and late in the stance phase. Ultimate strength tests were conducted in these conditions. If a setup passed the ultimate strength test, load was applied until failure. FINDINGS All sockets made for cushion liners passed the strength tests, however failure levels and methods varied. For early stance, thermoplastic sockets yielded, laminated sockets cracked posteriorly, and 3D printed socket broke circumferentially. For late stance, 2/3 of the sockets failed at the pylon. Sockets made for locking liners passed the ultimate strength tests early in stance phase, however, none of the sockets passed for forces late in stance phase, all broke around the lock mechanism. CONCLUSION Thermoplastic, laminated and 3D printed sockets made for cushion liners passed the ultimate strength test protocol outlined by the ISO for forces applied statically in gait. This provides initial evidence that 3D printed sockets are statically safe to use on patients and quantifies the static strength of laminated and thermoplastic sockets. However, all set-ups of sockets made for locking liners failed at terminal stance. While further work is needed, this suggests that the distal reinforcement for thermoplastic, laminated and 3D printed sockets with distal cylindrical locks may need to be reconsidered.
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Affiliation(s)
- B Pousett
- Barber Prosthetics Clinic, Vancouver, British Colombia, Canada
| | - A Lizcano
- Barber Prosthetics Clinic, Vancouver, British Colombia, Canada
| | - S.U. Raschke
- Biomedical Engineering Department, Universidad Iberoamericana, Ciudad de Mexico, Mexico
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Nikzadjamnani S, Azari A, Niakan S, Namdar SF. Fracture Resistance of Zirconia Restorations with a Modified Framework Design. J Dent (Tehran) 2017; 14:321-328. [PMID: 29942326 PMCID: PMC6015594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVES Chipping is one of the concerns related to zirconia crowns. The reasons of chipping have not been completely understood. This in-vitro study aimed to assess the effect of coping design on the fracture resistance of all-ceramic single crowns with zirconia frameworks. MATERIALS AND METHODS Two types of zirconia copings were designed (n=12): (1) a standard coping (SC) with a 0.5mm uniform thickness and (2) a modified coping (MC) consisted of a lingual margin of 1mm thickness and 2mm height connected to a proximal strut of 4mm height and a 0.3mm-wide facial collar. After veneer porcelain firing, the crowns were cemented to metal dies. Afterwards, a static vertical load was applied until failure. The modes of failure were determined. Data were calculated and statistically analyzed by independent samples T-test. P<0.05 was considered statistically significant. RESULTS The mean and standard deviation (SD) of the final fracture resistance equaled to 3519.42±1154.96 N and 3570.01±1224.33 N in SC and MC groups, respectively; the difference was not statistically significant (P=0.9). Also, the mean and SD of the initial fracture resistance equaled to 3345.34±1190.93 N and 3471.52±1228.93 N in SC and MC groups, respectively (P=0.8). Most of the specimens in both groups showed the mixed failure mode. CONCLUSIONS Based on the results, the modified core design may not significantly improve the fracture resistance.
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Affiliation(s)
- Sakineh Nikzadjamnani
- Associate Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Azari
- Associate Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayeh Niakan
- Assistant Professor, Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author: S. Niakan, Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,
| | - Seyedeh Fatemeh Namdar
- Assistant Professor, Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Rasaeipour S, Siadat H, Rasouli A, Sajedinejadd N, Ghodsi S. Implant Rehabilitation in Advanced Generalized Aggressive Periodontitis: A Case Report and Literature Review. J Dent (Tehran) 2015; 12:614-20. [PMID: 27123022 PMCID: PMC4847168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Dental implants have provided exceptional rehabilitative options for edentulous and partially edentulous patients. However, as more implants come into play, the more the clinicians come across problems where specific considerations must be taken into account to meet expectations. The Toronto Bridge is a treatment modality proposed for restoring several teeth lost in patients with increased crown height (interarch) space. Herein, we applied the Toronto Bridge to rehabilitate a patient with generalized aggressive periodontitis; this article suggests that an implant-supported Toronto Bridge can be a reliable and acceptable treatment modality for patients suffering from tooth loss and vertical bone loss as the result of generalized aggressive periodontal disease.
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Affiliation(s)
- Sasan Rasaeipour
- Assistant Professor, Dental Implant Research Center, Dentistry Research Institute, Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hakimeh Siadat
- Professor, Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences; Department of Prosthodontics, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Amiralireza Rasouli
- Associate Professor, Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Sajedinejadd
- Assistant Professor, Department of Periodontics, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Safoura Ghodsi
- Assistant Professor, Dental Implant Research Center, Dentistry Research Institute, Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author: S. Ghodsi, Dental Implant Research Center, Dentistry Research Institute, Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,
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