Archive for month: August, 2020

Hospital privacy curtains may harbour dangerous germs

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Without timely intervention, privacy curtains in hospitals can become breeding grounds for resistant bacteria, posing a threat to patient safety, according to new research published.
The longitudinal, prospective, pilot study tracked the contamination rate of ten freshly laundered privacy curtains in the Regional Burns/Plastics Unit of the Health Services Center in Winnipeg, Canada. While the curtains had minimal contamination when they were first hung, the curtains that were hung in patient rooms became increasingly contaminated over time — and by day 14, 87.5 percent of the curtains tested positive for methicillin-resistant Staphylococcus aureus (MRSA), a pathogen associated with significant morbidity and mortality. In contrast, control curtains that were not placed in patient rooms stayed clean the entire 21 days.
None of the rooms where the curtains were placed were occupied by patients with MRSA. Four curtains were placed in a four-bed room; four were placed in two double rooms; and two controls were placed in areas without direct patient or caregiver contact. Researchers took samples from areas where people hold curtains, suggesting that the increasing contamination resulted from direct contact.
"We know that privacy curtains pose a high risk for cross-contamination because they are frequently touched but infrequently changed," said Kevin Shek, BSc, the study’s lead author in the article. "The high rate of contamination that we saw by the fourteenth day may represent an opportune time to intervene, either by cleaning or replacing the curtains."
By day 21, almost all curtains exceeded 2.5 CFU/cm, the requirement for food processing equipment cleanliness in some locations, such as the United Kingdom.
"Keeping the patient’s environment clean is a critical component in preventing healthcare-associated infections," said 2018 APIC President Janet Haas, PhD, RN, CIC, FSHEA, FAPIC. "Because privacy curtains could be a mode of disease transmission, maintaining a schedule of regular cleaning offers another potential way to protect patients from harm while they are in our care."
ScienceDaily

https://tinyurl.com/y3kbgpxu

IHF gathers leading healthcare thinkers for the 43rd World Hospital Congress

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The 43rd World Hospital Congress of the International Hospital Federation has invited thought leaders, experts and top-level professionals to explore how health services can be better provided during peace and crisis. Topics have been lined up to explore how health services can be more responsive through better resilience, supportive through appropriate health investments and prospective through health impactful innovations.
The World Hospital Congress is a unique global forum where leaders of national and international hospital and healthcare organizations convene to share knowledge, expertise, experiences and best practices in leadership in hospital and healthcare management and service delivery.
Hosted by the Ministry of Health of the Sultanate of Oman on 6 to 9 November in Muscat, the Congress will feature more than 100 presenters in 40 sessions, poster displays, pre-conference session, hospital site visits, healthcare exhibition, special events and networking opportunities in three transformative days which will give delegates opportunities to learn, exchange, and engage with peers.
Keynote speakers include the following thought leaders and experts:

1.    Hon. Yuthar Mohammed Al Rawahy, Founder & Honorary Life President of the Oman Cancer Association will share her perspectives on the role of patients in time of peace and crisis from self-empowerment to social mobilization;

2.    Sir Andrew Dillon CBE, Chief Executive of the National Institute for Health and Care Excellence will share how to align the ambition of health systems and the life sciences industry for successful adoption of new health technologies;

3.    Dr. Melinda Estes, President and CEO of Saint Luke’s Health System and Chair-elect of the American Hospital Association will provide insights on how hospitals and health systems are driving community health and prosperity;

4.    Dr. Agnés Soucat, Director for Health Systems Governance and Financing at the World Health Organization will discuss the role of hospitals and health services in support to population well-being.

Besides keynote presentations, panel discussions with leading industry professionals and patient representatives will examine a range of topics including:

·         The role of hospitals in time of crisis;

·         Patient and community voice in time of peace and crisis;

·         Health service providers contributing to health and prosperity;

·         Health services in support to better well-being;

·         Taking the innovation to the service.

Early bird registration to the Congress closes on 15 August 2019. https://worldhospitalcongress.org/2019-registration/ congress@ihf-fih.org

Renewed ESR advocacy for the harmonization of the radiology profession

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The European Society of Radiology (ESR) has renewed its initiatives to harmonize medical training for radiologists across Europe. Following advocacy on the part of the radiology community, in close coordination with the European Union of Medical Specialists (UEMS), after the modernization of the Professional Qualifications Directive in 2013, the current political climate offers new opportunities for adapting the legal framework regulating the free movement of doctors and recognition of professional qualifications.
 
Considering the ongoing evaluation of the Professional Qualifications Directive, the ESR brings again to the attention of the European Commission its twofold request to change Annex V, Section 5.1.3. in order to safeguard the highest standards of medical training and patient care throughout Europe.

Once again, the ESR has joined forces with the UEMS, the authority on medical education in Europe, demonstrating its continuous commitment to collaborating with partner organizations on the harmonization of medical education.
 
In an official letter submitted to the European Commission, the ESR strongly urges the European Commission to adopt a delegated act to increase the minimum years of training for radiologists from four to five years, in full compliance with the European Training Curriculum for Radiology that was developed to further harmonize radiology education throughout Europe.

Growing training needs and the introduction of digital solutions in medical imaging require equally high standards of training that can only be met by implementing a full-fledged five-year radiology training.
 
In addition, the ESR calls on the Member States and the European Commission to change the name of the discipline from “Diagnostic Radiology” to “Radiology”, reflecting the profession’s current practice comprising both diagnostic and interventional procedures.

As Member States hold the competence to unilaterally enter the name of a profession into Annex V, individual Member States are strongly encouraged to unilaterally enter “Radiology” as the name of the discipline as a first step towards harmonization. Nevertheless, the ESR believes that an EU-wide solution is needed and therefore urges the Member States and the European Commission to enter into dialogue in the interest of the free movement of radiologists in Europe.
 
The ESR supports a multi-layered approach, simultaneously launching initiatives at national and EU levels, to strengthen the voice of radiology in the debate. Therefore, the ESR counts on the national radiological societies to be the messenger of the unified radiology position towards national Ministries of Health and health authorities.

Only a coordinated approach involving the ESR and its institutional members can lead to the highest standards and a true harmonization of radiology training and enhance the mobility of the radiology profession in Europe.

https://tinyurl.com/y2q4m5ht

Fujifilm Medical IT shows at HIMSS 2019 how artificial intelligence is driving the future of healthcare

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FUJIFILM is displaying its evolving portfolio of medical informatics and Enterprise Imaging innovations, by presenting REiLI, Artificial Intelligence (AI) Medical Imaging initiative at HIMSS & Health 2.0 Conference from 11th to 13th June, at Messukeskus Helsinki, Expo & Convention Centre, Helsinki, Finland.
It’s transformative time in medicine practice, and FUJIFILM is at the side of the medical world to reengineer imaging strategy. At HIMSS & Health 2.0 Conference 2019, Helsinki, Finland, discover how to design digital diagnostic data hubs delivering “total imaging care” that will benefit patients and physicians.
At the booth #6D1, our experts will show the latest innovations from our enterprise imaging portfolio and how they can help you:

  • Providing a complete picture of each patient’s health so that doctors across the care continuum can make more-informed decisions.
  • Understanding how an artificial intelligence platform can help impact patient care, improve workflows, and drive new research.
  • Building and implement an enterprise imaging strategy to reduce the cost of care and impact patient outcomes.

The AI revolution is underway, in an increasingly complex healthcare environment with larger datasets and rising demand for high quality care, Fujifilm, under the REiLI brand, is developing an open platform to realize a new diagnostic imaging workflow.
REiLI fits perfectly with our latest release Synapse 5: the server-side-rendering technology and the centralized processing of Synapse 5 allow the easy application of the Artificial Intelligence technology within the normal workflow management tool to support of health professionals. The new open platform will not only host Fujifilm’s AI technologies, but will also host various other AI technologies from external partners. We will strive to support our customers’ by combining diverse AI technologies offering them the best support for their daily work which is currently increasing due to the sheer volume of Imaging scans as well as the complexity of the diseases their patients are facing
The Fujifilm Healthcare IT platform Synapse displayed at HIMSS will include our comprehensive medical informatics and enterprise-imaging portfolio:
SYNAPSE 5 (PACS) sets a new standard for enterprise imaging. With a focus on speed and interactivity, Synapse 5 PACS provides remarkable on-demand access to massive datasets and the ability to immediately interact with the data.
SYNAPSE VNA (vendor-neutral archive) was designed for true imaging interoperability to enable practitioners to provide enhanced patient care across the enterprise. The VNA provides secure, easy-to-manage storage and access to the complete patient imaging record and links all HIT systems.
SYNAPSE Enterprise Viewer uses the latest server-side rendering technology to stream imaging securely and quickly to any authorized user. It can be used within applications, directly from your EHR, or on our mobile device apps. Both within and outside of the Enterprise, giving access to imaging immediately and helping clinicians making the most informed and accurate decisions. Synapse Enterprise Viewer allows multiple users to view images simultaneously, and to take control of them as they are presented in real time, thereby improving speed, efficiency and patient care.
SYNAPSE 3D is Fujifilm’s portfolio of clinical modules (currently 55) for advanced processing and analysis of the medical imaging: it is a state of the art system which provides powerful and complete tools not only for Oncology, Radiology and Cardiology Departments, but also supports the Clinical and Surgical workflow. Fast, reliable and accurate, based on our heritage of Excellence in Imaging (across, our Photography, Graphics, Film and other mature business domains) Image Intelligence Fujifilm technology, Synapse 3D is the software platform that fully meets the new requirements for advanced processing and displaying of clinical and diagnostic imaging and for oncology and surgical planning.
SYNAPSE CWM, Clinical Workflow Manager, is the most advanced Information System on the market today, covering Radiology, Endoscopy and multiple Screening services – Breast, Bowel, AAA and many others. It continues to evolve to support the unique imaging and information needs in today’s busy imaging departments. One platform can support acute care facilities, imaging centers, and radiology practices providing distributed diagnosis.
SYNCRO-DOSE is Fujifilms Radiation Dose Index Monitoring system, compliant with European Union Directive 2013/59 / EURATOM. Syncro-Dose is a comprehensive system for monitoring and managing patient radiation exposure at enterprise level across different imaging modalities and hospital facilities. It is a support for the optimization of radiological procedures and acquisition protocols, a tool for supporting clinical audit and it provides a comprehensive Patient Dosimetric History.
NEVER STOP… Innovating Healthcare
Fujifilm launched Fuji Computed Radiography (FCR), becoming the first company in the world to offer a digital X-ray diagnostic imaging system. Fujifilm saw the opportunity to leverage the technologies it had developed for FCR and contribute to the evolution of connectivity within and among medical facilities. What made Fujifilm’s SYNAPSE concept different was that it used the emerging Internet and web technologies instead of private networks. It was, in essence, a Web-based PACS: the first in the world in 1999
SYNAPSE’s rapid rate of adoption was due in large part to its capability, to contribute significantly to the quality of medical care by delivering images to clinicians fast and securely. We have over 800 Synapse sites in Europe, and over 5000 Synapse systems are installed in healthcare facilities around the world, earning the largest market share worldwide.
(*): Fujifilm’s artificial intelligence software is a work in progress and is not commercially available in Europe.
(**) Fujifilm estimation based on a set of data from multiple market research studies
(***) Synapse 3D is also known as Synapse Vincent is some global markets (Red Dot Award was given to Synapse Vincent)
Experts and product specialists are available at Fujifilm booth for product demonstration and to create tailor-made solutions for any healthcare provider.

FUJIFILM Healthcare IT booth: #6D1

https://synapse.fujifilm.eu/index.html

Sugary stent eases suturing of blood vessels

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Reconstructive procedures and organ transplants demand nimble fingers that can restore blood flow by stitching together millimeter-scale arteries. It’s a tough and time-consuming task for even the most skilled surgeon.
But a stent full of sugar may help the surgeries go down — in a 3D-printed way.
Designed by Nebraska engineer Ali Tamayol and nationwide colleagues, the small sugar-based tube fits inside the adjacent ends of a clipped artery. By sticking to the interiors, the stent holds those ends in place and provides structural support during the precarious sewing process.
“One of the plastic surgeons told us about the challenges of this kind of microsurgery — how time-consuming it is, how skill-dependent it is,” said Tamayol, assistant professor of mechanical and materials engineering.
The stent-assisted suturing took just five minutes when tested on pig arteries, the team reported, compared with the roughly 15 minutes required of a conventional clamp-based technique. Tamayol said the stent also reduces the risk of a surgeon mistakenly threading through both the top and bottom walls of an artery, which blocks subsequent blood flow.
Then, the finish: Minutes after the arteries are sutured, the resuming blood flow dissolves the stent and harmlessly sweeps it away.
In designing the stent, the researchers came up with a checklist of essential properties. It needed some flexibility — too brittle, and it could break during suturing — so the team added a glucose derivative called dextran. It needed enough stickiness to bind with the arteries, which glucose itself provided, plus a large dose of sucrose to help combat blood clotting. And it needed a pinch of sodium citrate to further diminish any chance of clotting when the stent dissolved.
University of Nebraska-Lincoln https://tinyurl.com/y38zwj9g

Tiny generators turn body motion into weight control and wound-healing therapies

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Although electrical stimulation has therapeutic potential for various disorders and conditions, ungainly power sources have hampered practical applications. Now bioengineers have developed implantable and wearable nanogenerators from special materials that create electrical pulses when compressed by body motions. The pulses controlled weight gain and enhanced healing of skin wounds in rat models.
The work was performed by a research team led by Xudong Wang, Ph.D., Professor of Material Sciences and Engineering, College of Engineering, University of Wisconsin-Madison, and supported by the National Institute of Biomedical Imaging and Bioengineering (NIBIB).
The researchers used what are known as piezoelectric and dielectric materials, including ceramics and crystals, which have a special property of creating an electrical charge in response to mechanical stress.
“Wang and colleagues have engineered solutions to a number of technical hurdles to create piezoelectric and dielectric materials that are compatible with body tissues and can generate a reliable, self-sufficient power supply. Their meticulous work has enabled a simple and elegant technology that offers the possibility of developing electrical stimulation therapies for a number of major diseases that currently lack adequate treatments,” explained David Rampulla, Ph.D., director of the Program in Biomaterials and Biomolecular Constructs at NIBIB.
Worldwide, more than 700 million people — over 100 million of them children — are obese, causing health problems such as cardiovascular disease, diabetes, kidney disease, and certain cancers. In 2015 approximately four million people died of obesity-related causes.
To address this crisis, Wang and his colleagues developed a vagal nerve stimulator (VNS) that dramatically improves appetite suppression through electrical stimulation of the vagus nerve. The approach is a promising one that has previously not proven practical because patients must carry bulky battery packs that require proper programming, and frequent recharging.
The VNS consists of a small patch, about the size of a fingernail, which carries tiny devices called nanogenerators. Minimally invasive surgery was used to attach the VNS to the stomachs of rats. The rat’s stomach movements resulted in the delivery of gentle electrical pulses to the vagus nerve, which links the brain to the stomach. With the VNS, when the stomach moved in response to eating, the electric signal told the brain that the stomach was full, even if only a small amount of food was consumed.
The device curbed the rat’s appetite and reduced body weight by a remarkable 40 percent. “The stimulation is a natural response to regulate food intake, so there are no unwanted side effects,” explained Wang. When the device was removed the rats resumed their normal eating patterns and their weight returned to pre-treatment levels.
“Given the simplicity and effectiveness of the system, coupled with the fact that the effect is reversible and carries no side-effects, we are now planning testing in larger animals with the hope of eventually moving into human trials,” said Wang.
In another NIBIB-funded study in a rat experimental model, the researchers used their nanogenerator technology to determine whether electrical stimulation would accelerate healing of wounds on the skin surface.
For this experiment, a band of nanogenerators was placed around the rat’s chest, where the expansion from breathing created a mild electric field. Small electrodes in a bandage-like device were placed over skin wounds on the rat’s back, where they directed the electric field to cover the wound area.
The technique reduced healing times to just three days compared with nearly two weeks for the normal healing process.
Similar to the case with appetite suppression, it was known that electricity could enhance wound healing, but the devices that had been developed were large and impractical. The nanogenerator-powered bandage is completely non-invasive and produced a mild electric field that is similar to electrical activity detected in the normal wound-healing process.
The researchers observed electrical activation of normal cellular healing processes that included the movement of healthy skin fibroblasts into the wound, accompanied by the release of biochemical factors that promote the growth of the fibroblasts and other cell types that expand to repair the wound space.
“The dramatic decrease in healing time was surprising,” said Wang, “We now plan to test the device on pigs because their skin is very similar to humans.”
The team believes the simplicity of the electric bandage will help move the technology to human trials quickly. In addition, Wang explained that the fabrication of the device is very inexpensive and a product for human use would cost about the same as a normal bandage.
NIBIB https://tinyurl.com/y3cxut6p

Indigestion remedy significantly slows kidney function decline and improves survival in late-stage chronic disease

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As chronic kidney disease (CKD) progresses, the kidneys become less able to maintain a healthy balance of acids in the body, a condition known as metabolic acidosis.
To maintain healthy acid levels, people with CKD are treated with alkaline substances such as sodium bicarbonate, also commonly used to neutralize heartburn and indigestion. The UBI study, a large randomized controlled trial, shows that sodium bicarbonate halves the risk of kidney disease progression, the likelihood of starting renal replacement therapy (RRT; dialysis or transplantation) and the overall risk of death in people with CKD [1].
Defined as serum bicarbonate less than 22 mmol/L [2], metabolic acidosis is common in people with CKD stages 4-5 (eGFR < 30 ml/min/1.73 m2) and is directly related to worsening kidney function. Metabolic acidosis is a problem because it is associated with complications such as bone disease, muscle wasting, high levels of blood potassium (hyperkalaemia), insulin resistance, high cholesterol (hyperlipidaemia), and with a more rapid decline in kidney function—shown by rising blood creatinine—and increased risk of death [3].
International guidelines recommend that, when serum bicarbonate concentration falls below 22 mmol/l, CKD patients should be treated with oral sodium bicarbonate to maintain serum bicarbonate within the normal range, unless contraindicated [2]. However, until recently, very few studies have tested the effectiveness of bicarbonate therapy in improving metabolic acidosis or its potential benefits in patients with CKD.
Results of the UBI trial announced for the first time during the ERA-EDTA Congress in Budapest, now provide strong evidence for the benefits of correcting metabolic acidosis with sodium bicarbonate in people with late-stage CKD.
The prospective, open-label, randomized controlled trial assigned 740 patients with CKD-3b and CKD stage 4 to either sodium bicarbonate (376 patients) or standard care without sodium bicarbonate (364 patients). The patients had a mean age of 67.8 years, creatinine clearance 30 ml/min, and serum bicarbonate 21.5 mmol/l. At the end of three years, doubling of creatinine occurred in significantly fewer patients randomized to sodium bicarbonate: 6.6% versus 17.0% receiving standard care, p<0.001. This translates into a relative risk reduction of 64% in kidney disease progression (hazard ratio [HR] 0.36; 95% confidence interval [CI] 0.22-0.58; p<0.001).
Similarly, the likelihood of starting RRT was also significantly lower in the sodium bicarbonate group. At the end of the study, 6.9% of patients receiving sodium bicarbonate had started RRT compared to 12.3% of the standard care group—a relative risk reduction of 50% (p=0.004; HR: 0.5; 95% CI: 0.31-0.81; p=0.005).  The risk of death was also significantly lower among sodium bicarbonate-treated patients at 3.1% compared to 6.8 % of the standard care group—a relative risk reduction of 57% (p=0.004; HR 0.43; 95%CI 0.22-0.87; p=0.01). Treatment with sodium bicarbonate was well tolerated, with no significant effects on blood pressure, total body weight or hospitalizations.
“There are relatively few treatments that have been shown to slow progression of CKD.  As nephrologist, we have used sodium bicarbonate to correct metabolic acidosis in people with CKD for some time, but definite evidence of benefit has been lacking. Our study shows that this very cost-effective treatment is safe and improves kidney and patient survival,” concluded lead investigator Dr Antonio Bellasi.
[1] Bellasi A, et al. Treatment of metabolic acidosis with sodium bicarbonate delays progression of chronic kidney disease: the UBI study. LBCT Abstract ERA-EDTA Congress 2019, Budapest
[2] KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl 3(1) January 2013
[3] Ahmed AR, Lappin D. Oral alkali therapy and the management of metabolic acidosis of chronic kidney disease: A narrative literature review. World J Nephrol 2018 0; 7(6): 117–122. www.era-edta.org

A promising new treatment for infants with Noonan Syndrome

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Noonan Syndrome (NS) is a rare genetic syndrome typically evident at birth and often linked to early-onset severe heart disease. NS is part of a group of diseases termed RASopathies that are caused by activating mutations of proteins belonging to the Ras and mitogen-activated protein kinase families.
In a new study, researchers at Université de Montréal and CHU Sainte-Justine Research Center show that a MEK inhibitor called trametinib can reverse hypertrophic cardiomyopathy (HCM) and valvular obstruction in patients with RIT1-associated NS.
“Up to this finding, our therapeutic options were limited to surgery, including heart transplant, and symptomatic relief with medication,” said the study’s author, Dr. Gregor Andelfinger, a paediatric cardiologist at CHU Sainte-Justine, a researcher at Sainte-Justine University Hospital Research Center in the fetomaternal and neonatal pathologies axis, and an associate research professor in the pediatrics department of Université de Montréal.
 “Trametinib treatment is the first approach specifically targeted to the molecular cause of RASopathies,” said Dr. Andelfinger. “While our numbers are still very limited, we report the first patients in whom we were not only able to stabilize, but to reverse the disease of the heart. These results pave the way for larger trials, which are now needed.”
Infants less than six months old with NS, HCM and congestive heart failure normally have a poor prognosis, with a one-year survival rate of 34 per cent. In the new study, the Sainte Justine clinical teams used trametinib, an inhibitor targeted specifically against the activating nature of the mutations, to try to treat NS in two patients.
They observed dramatic improvement of clinical and cardiac status in the patients only three months after treatment. Hypertrophy regressed in both patients, with sustained improvement over a total of 17 months of treatment, and normalization of laboratory values. One of the patients, who required ventilation, could be extubated after six weeks of treatment. Both patients showed better overall growth after treatment was started.
"The findings described in this report suggest that a life-threatening form of heart disease affecting young infants might be treatable, which, if true, would be unprecedented and so meaningful for the families whose lives this devastating problem touches,” commented Dr. Bruce Gelb, director of the Mindich Child Health and Development Institute at the Icahn School of Medicine at Mount Sinai,  in New York City.
“Now we need to perform a proper clinical trial to prove that this drug is definitely working for this particular problem," he said.
Santé Montréal https://tinyurl.com/y5xcgh43

Researchers test new imaging method for first time on human patients

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A new study by biomedical engineering researchers at the University of Arkansas could significantly improve methods for detecting and diagnosing congenital heart disease in infants and small children.
The researchers, collaborating with cardiologists at Arkansas Children’s Hospital in Little Rock, tested a new ultrasound technology called vector flow imaging for the first time on paediatric patients to create detailed images of the internal structure and blood flow of the babies’ hearts. The images can be still or moving, and can be taken from any angle.
“Vector flow imaging technology is not yet possible in adults, but we have demonstrated that it is feasible in paediatric patients,” said Morten Jensen, associate professor of biomedical engineering at the U of A. “Our group demonstrated that this commercially available technology can be used as a bedside imaging method, providing advanced detail of blood flow patterns within cardiac chambers, across valves and in the great arteries.”
Roughly 1 percent of all babies are born with some type of congenital heart defect. Fortunately, the majority of these defects will never have any significant impact as the child grows into adulthood and old age. Paediatric cardiologists detect and diagnose congenital heart disease through multiple processes, including echocardiography. This imaging method is based on ultrasound and assesses the overall health of the heart, including valves and muscle contraction.
Although ultrasound provides essential information about cardiac valve function in babies and small children, it has critical limitations. It cannot accurately obtain details of blood flow within the heart. This is due primarily to the inability to align the ultrasound beam with blood-flow direction.
Using a BK5000 Ultrasound machine with built-in vector flow imaging, the researchers performed successful tests on two pigs, one with normal cardiac anatomy and one with congenital heart disease due to a narrow pulmonary valve and a hole within the heart. The researchers then compared the vector flow images to direct examination of the pigs’ hearts. 
The researchers subsequently used the imaging system to take cardiac images of two three-month-old babies, one with a healthy, structurally normal heart and one with congenital heart disease because of an abnormally narrow aorta. With both patients, the technology enabled total transthoracic imaging of tissue and blood flow at a depth of 6.5 centimetres. Abnormal flow and detailed cardiac anomalies were clearly observed in the patient with congenital heart disease.
All procedures, both animal and human, were performed at Arkansas Children’s Hospital with assistance from Dr. Elijah Bolin, pediatric cardiologist at UAMS.
“We are still getting used to having this great, new information readily available, and we’re excited about the future in both research and direct clinical advancements,” Bolin said.
“This technology will increase our ability to provide the best possible bedside diagnosis and greatly enhances our understanding of what is happening in hearts with complex abnormalities,” Stanford’s Collins said.
University of Arkansas https://tinyurl.com/y47ac996

Study confirms treatment success in minimally invasive Mitral Valve Surgery

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Scientists at the Center for Cardiology of the Mainz University Medical Center have examined the success of more than 13,575 minimally invasive procedures on the mitral valve in the largest study of their kind to date. Key findings: Although patients grew older during the period from 2011 to 2015 and the number of procedures increased from year to year, mortality and complication rates remained consistently low.
Mitral valve insufficiency is the most common heart valve disease in Europe and the USA. About ten percent of people over the age of 75 are affected. The patients suffer from a weak closure and thus a leaky mitral valve. Until a few years ago, there was often only the possibility of a drug therapy, because for an open operation, the patients are usually too old, have too many comorbidities or the function of the left ventricle is too bad.
There is now a new option to treat this leaky heart valve minimally invasive with a Mitraclip implantation. Germany is one of the leading nations in this innovative, new process. "Several studies with small groups of patients have already been published for the evaluation of the procedure with regard to frequency of inserting the clip or the safety of the procedure, however, so far there have been no large data collections", explain the first and last authors of the study Dr. Ralph Stephan von Bardeleben, Dr. Lukas Hobohm and Dr. Karsten Keller. "That’s why it was a good idea to examine the implantation numbers and the complication rates in Germany on a larger scale."
Their results show: The annual implantation numbers in Germany increased more than fivefold from 815 in 2011 to 4,432 in 2015. In total, the study included 13,575 patients who had been treated with Mitraclip. Earlier studies referred to a maximum of 1,064 procedures. The patients were usually between 70 and 89 years old and on average they got older and older. Another important result is that the complication rate or mortality did not change significantly during the period studied. Important prognostic factors related to hospital death were cardiac insufficiency, blood transfusion due to bleeding complications, stroke, pulmonary embolism, or pericardial effusion.
The authors conclude from their findings that despite the dramatic fivefold increase in the implantation rate of the clip, the procedure has very low early-stage complication rates during hospitalization. "Catheter-assisted valvular heart valve therapy has evolved from a niche treatment of inoperable patients into a relevant and safe treatment option in only ten years, as our new study emphasizes once again", underlines Dr. von Bardeleben.
The Mainz University Medical Center occupies a leading position in the field of gentle heart valve therapy, both nationally and internationally. "In 2018, we implanted more than 700 heart valves, making us one of the largest university centers for minimally invasive heart valve therapy," explains Professor Dr. Thomas Münzel, Director of Cardiology I at the Center for Cardiology of the Mainz University Medical Center. "There were more than 200 Mitraclips. This number is unique in the world.” Cardiologists have also taken the opportunity to establish a new Heart Valve Unit in Mainz because of a striking increase in demand for such interventions in recent years. The advantage of the new heart valve unit: All relevant steps in the course of a heart valve implantation – from patient admission to planning and aftercare on the intensive care unit until to the discharge of patients – take place at one ward.
Mainz University Medical Center https://tinyurl.com/y4y75dvs

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