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Biomedical subjects

Emile A Bacha

Publications and source records attributed to Emile A Bacha.

23 records · Page 2Linked to original sources
PubMed2002

Catheter therapy of Swiss cheese ventricular septal defects using the Amplatzer muscular VSD occluder.

The medical and surgical management of patients with multiple muscular ventricular septal defects (VSDs) is associated with morbidity and mortality. Three children with Swiss cheese VSDs were treated with transcatheter occlusion of their multiple defects using the Amplatzer muscular VSD occluder. Seventeen defects were closed in five catheterization procedures. One patient had three devices placed in two procedures, the second had five defects closed in one procedure, and the third had nine defects closed in two procedures. Two patients had previously been treated with pulmonary artery banding and required subsequent surgical band removal. There was immediate reduction in the left-to-right shunting and clinical improvement in all patients. Complications included the need for blood transfusion during the two longest procedures and tricuspid valve regurgitation in one. Transcatheter occlusion of multiple VSDs is an acceptable alternative or adjunct to surgical therapy for these complex patients.

Cardiac Catheterization↗
PubMedDate not supplied

Development of a percutaneous pediatric ventricular assist device.

Remarkable progress has been made on ventricular assist devices for adult patients. Unfortunately, similar devices are not yet available in the United States for pediatric heart patients. The goal of this project is to demonstrate the feasibility of a percutaneous ventricular assist device for pediatric patients above 2 kg. The proposed system consists of an extracorporeal centrifugal blood pump, a transseptal venous cannula that takes blood from the left atrium to the pump, an arterial cannula that returns the blood to the arterial system, and a controller to adjust pump speed/flow. Using an ad hoc pediatric pump prototype and a spectrum of specially designed cannulae of various sizes, benchtop studies showed that the proposed system could deliver blood flow in a range of 0.3 to 3.0 l/min. For smaller patients (2-35 kg), the transseptal cannula was designed to be placed in the internal jugular vein and the arterial cannula in the internal carotid artery. For larger patients (> 35 kg), the femoral vein and artery would be used. Further development effort will be focused on reducing the hemolysis of the pump design, refining the cannula design, and demonstrating the safety and functionality in animal studies.

Adolescent↗
PubMedDate not supplied

Necessity for evaluation of anomalous pulmonary venous return before percutaneous closure of atrial septal defects--a case report.

About 10%-15% of patients with an atrial septal defect will have some form of anomalous pulmonary venous connection. With the advent of percutaneous closure of atrial septal defects, it is imperative that presence of partial anomalous pulmonary venous return be excluded to prevent unnecessary percutaneous closure in patients who would ultimately require a surgical approach. The authors herein report a 29-year-old man who underwent percutaneous closure of 2 atrial septal defects but was later found to have his left upper pulmonary vein draining into the innominate vein via a vertical vein. He subsequently underwent surgical repair of the anomalous pulmonary vein.

Adult↗
PubMedDate not supplied

Single dose of glutamine enhances myocardial tissue metabolism, glutathione content, and improves myocardial function after ischemia-reperfusion injury.

BACKGROUND: Myocardial ischemia and reperfusion (I/R) injury causes significant morbidity and mortality. Protection against I/R injury may occur via preservation of tissue metabolism and ATP content, preservation of reduced glutathione, and stimulation of heat shock protein (HSP) synthesis. Supplementation with glutamine (GLN) has been reported to have beneficial effects on all of these protective pathways. Thus, we hypothesized that GLN pretreatment given to the rat in vivo would protect the myocardium against I/R-induced dysfunction. METHODS: GLN (0.52 g/kg, intraperitoneally, given as alanine-glutamine dipeptide), alanine alone (0.23 g/kg), or a Ringer's lactate solution (control) was administered to Sprague-Dawley rats 18 hours before heart excision, perfusion, exposure to global ischemia (15 minutes) and reperfusion (1 hour). Tissue metabolites were analyzed via magnetic resonance spectroscopy. RESULTS: In control and alanine-treated animals, I/R injury resulted in cardiac dysfunction, indicated by a decrease in cardiac output. Administration of GLN 18 hours before I/R injury preserved cardiac output after reperfusion. Metabolic analysis of the myocardial tissue revealed that [/R injury led to significant diminution of myocardial tissue glutamate, ATP content, accumulation of myocardial lactate, and a reduction in reduced glutathione content in control animals. GLN significantly reduced the deleterious changes in myocardial metabolism and improved reduced glutathione content. No changes in pre- or post-I/R injury HSP expression were observed after GLN administration. CONCLUSIONS: These observations demonstrate that remote in vivo administration of GLN before cardiac I/R injury can improve post-I/R cardiac function. This effect may be mediated via improved myocardial metabolism and enhanced reduced glutathione content.

Adenosine Diphosphate↗