Notice bibliographique
Résumé
Sir, Heart failure has a fair share in disease burden worldwide. A very large portion with advanced heart failure has a very poor prognosis despite being on optimized medical therapy. Unfortunately, there is a huge mismatch in demand and supply for heart donors and recipients. For the patients awaiting cardiac transplantation, mechanical circulatory support has been widely utilized in the form of left ventricular assist device (LVAD) or total artificial heart (TAH). Both TAH and LVAD have been approved for the use as a bridge to transplantation; however, only LVAD has been approved for use as the destination therapy.[1] Currently, a trial is underway to support the use of TAH as the destination therapy. Most of the patients benefit from LVADs; however, the use of TAH is more appropriate in the patients who have concurrent right heart failure or other structural abnormalities. Until now, almost 1600 TAHs have been transplanted. SynCardia temporary TAH is currently the only Food and Drug Administration (FDA), and Health Canada approved artificial heart commercially available in the market that is being used in over 50 centers in the world. A trial for Cardio West TAH (now being marketed as SynCardia TAH) was conducted between 1993 and 2002. Eighty-one patients were implanted with the device. At the end of the study, the rate of survival to transplantation was 79%, and 1- and 5-year survival rates after transplantation were 86% and 64%.[2] SynCardia TAH consists of two artificial ventricles, each made of semirigid polyurethane. Each ventricle consists of two single leaflet mechanical valves, which regulate the blood flow. This pulsatile device is capable of generating up to 9.5 L/min of blood flow. Both the ventricles are attached to pneumatic drivelines, which are connected to the back of the external console. The console includes a monitoring computer that provides noninvasive diagnostic information. The device is surgically implanted after the removal of both the ventricles and four valves. It can only be placed in the patients with large enough body habitus that can accommodate its positioning. A study of 47 patients evaluating the safety of device showed that patients who were supported on SynCardia TAH for more than 1 year had the following complications: systemic infections in 25 patients (53%), driveline infections in 13 patients (27%), thromboembolic events in 9 patients (19%), and hemorrhagic events in 7 patients (14%).[3] FDA has already approved a clinical study for 19 patients to evaluate the effectiveness of SynCardia as the destination therapy.[4] Smaller SynCardia has also been designed for the use in patients with smaller body habitus and pediatric population. Moreover, the use of portable freedom driver allows the mobility of the patients and safe discharge from the hospital.[5] More clinical trials are needed to evaluate the efficacy of artificial hearts for their utilization in destination therapy. Awareness is needed about these devices in the medical community that would eventually prompt the government agencies to promote research in this area. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».