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  • Breast Surgery  (1)
  • Catheter Ablation  (1)
  • Congenital heart disease  (1)
  • 1
    ISSN: 1572-8595
    Keywords: Radiofrequency Energy ; PSVT ; Catheter Ablation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Temperature monitoring may be helpful for ablation of accessory pathways, however its role in ablation of atrioventricular nodal reentrant tachycardia (AVNRT) using the slow pathway approach is unclear. Therefore, the purpose of this study was to prospectively compare slow pathway ablation for AVNRT using fixed power or temperature monitoring. The study included 120 patients undergoing ablation for AVNRT. Patients were randomly assigned to receive either fixed power at 32 watts, or to temperature monitoring with a target temperature of 60°C. The primary success rate was 72% in the fixed power group and 95% in the temperature monitoring group (p=0.001). The ablation procedure duration (35±29 min vs 35±30 min; p=0.9), fluoroscopic time (32±17 vs 35±19 min; p=0.4), mean number of applications (10.2±8.1 vs 8.4±7.9; p=0.2), and coagulum formation per application (0.2% vs 0.5%; p=0.6) were statistically similar in the fixed power and temperature monitoring groups, respectively. The mean temperature (47.3±4.8°C vs 48.6±3.8°C; p〈0.01), and the temperature associated with junctional ectopy (48.2±3.8°C vs 49.3±3.6°C, p〈0.01) were less for the fixed power than the temperature monitoring group. In the temperature monitoring group, only 31% of applications achieved an electrode temperature of 60°C. During follow up of 6.6±3.6 months there were two recurrences in the fixed power group and one in the temperature monitoring group (p=1.0). In summary, power titration directed by temperature monitoring was associated with an improved primary procedural success rate. Applications of energy were associated with a temperature of approximately 50°C with both techniques, suggesting that there is a low efficiency of heating in the posterior septum.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric cardiology 2 (1982), S. 245-250 
    ISSN: 1432-1971
    Keywords: Hypercarbia ; Infancy ; Congenital heart disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Three infants are described who illustrate 3 distinct mechanisms by which cardiac disease may cause carbon dioxide retention: 1) hypoventilation 2) large alveolar dead space and 3) decreased effective pulmonary blood flow. These mechanisms are illustrated here in patients with problems commonly encountered in the infant with symptomatic congenital heart disease. The physiologic basis of their carbon dioxide retention is also discussed.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-5241
    Keywords: Mammaplasty ; Breast Surgery ; Outpatient ; Breast Reduction ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Traditionally, reduction mammaplasty has been performed on an inpatient basis with a one to two day hospitalization. Many procedures once commonly performed on an inpatient basis have been shown to be safe and effective when performed in an outpatient setting. The purpose of this study was to determine if reduction mammaplasty could be performed safely on an outpatient basis and to compare findings between inpatient and outpatient groups. An outcome based retrospective review of patients who had bilateral reduction mammaplasty from 1989 to 1993 was performed at two centers. Minimum follow-up was nine months. Of 331 patients, 161 were outpatients and 170 were inpatients. Seventy-six percent of the surgeries were performed in the hospital and 24 percent at a free-standing surgical facility. There were no statistical differences between the two groups when comparing age, marital status, preoperative health status, operative technique, and resection weight. Evaluation of patient body weights, use of antibiotics, and complications did reveal statistical differences between the two groups. The inpatients were heavier, more likely to experience a complication, and less likely to receive antibiotics. There was, however, no difference between the two groups for incidence of rehospitalization, return to the emergency department, or reoperation. A patient satisfaction survey was conducted with both out-patient and inpatient groups reporting high satisfaction with their results. Over 95 percent of patients in both groups felt the experience was a positive one. The survey indicated high patient acceptance of breast reduction on an outpatient basis for the outpatient population. The data confirms that reduction mammaplasty is a safe and effective procedure when performed on an outpatient basis. The cost savings associated with outpatient surgery is significant and an important consideration in this era of health care reform.
    Type of Medium: Electronic Resource
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