Expert review of medical devices
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Expert Rev Med Devices · Nov 2012
ReviewEdwards SAPIEN and Edwards SAPIEN XT transcatheter heart valves for the treatment of severe aortic stenosis.
Aortic stenosis is the most common heart valve lesion, with aortic valve replacement being the most common type of valve surgery in the Western world. With the aging population, more and more patients are declined for surgical aortic valve replacement owing to age and comorbidities. ⋯ The Edwards SAPIEN and Edwards SAPIEN XT transcatheter heart valves are currently in widespread use, with promising outcomes in terms of short-to-medium-term mortality and valve durability in high-risk patients or patients not eligible for surgical valve replacement. Randomized trials are currently underway to assess transcatheter aortic valve replacement in lower risk surgical candidates, while long-term mortality data are keenly awaited.
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Fecal incontinence (FI), which can severely affect a person's quality of life, is a difficult problem to treat. For some patients, limited management options exist. ⋯ During the first stage, a temporary lead is inserted into the S3 sacral foramen and the patient can monitor improvement before a permanent device is implanted. While this procedure has proven to be effective for treating FI, it is also attractive owing to the low morbidity and low infection risk reported in the literature.
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Expert Rev Med Devices · Sep 2012
ReviewNeonatal hemodynamics: monitoring, data acquisition and analysis.
Monitoring of cardiovascular function is critical to both clinical care and research as the use of sophisticated monitoring systems enable us to obtain accurate, reliable and real-time information on developmental hemodynamics in health and disease. Novel approaches to comprehensive hemodynamic monitoring and data acquisition will undoubtedly aid in developing a better understanding of developmental cardiovascular physiology in neonates. In addition, development and use of state-of-the-art, comprehensive hemodynamic monitoring systems enable the recognition of signs of cardiovascular compromise in its early stages, and provide information on the hemodynamic response to treatment in critically ill patients.
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Expert Rev Med Devices · Jul 2012
ReviewBalloon kyphoplasty in patients with osteoporotic vertebral compression fractures.
Balloon kyphoplasty (BKP) is a minimally invasive surgical procedure indicated for treatment of painful vertebral compression fractures. During BKP, cannulae are placed percutaneously into the vertebral body, allowing insertion of inflatable balloons. Inflating the balloons partially restores vertebral body height, compacts the bone and creates a cavity for placement of bone cement after balloon removal. ⋯ Clinically significant adverse events have been rarely reported. These findings were confirmed in randomized and nonrandomized prospective controlled studies. The objective of this review is to describe the surgical procedures involved in BKP and to review the evidence supporting its use.
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Expert Rev Med Devices · Jul 2012
ReviewTransforaminal percutaneous endoscopic lumbar discectomy: technical tips to prevent complications.
Transforaminal percutaneous endoscopic lumbar discectomy is regarded as an effective alternative to open discectomy. Remarkable technical evolution now enables selective endoscopic removal of an epidurally extruded disc fragment. As a result, the surgical indications for this technique are becoming broader. ⋯ Initial landing should be as close to the target as possible. Complete herniotomy after thorough release of annular anchorage is a key to success. The definitive end point of the procedure is free mobilization of neural tissues, not direct exposure of neural tissues.