Heart : official journal of the British Cardiac Society
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Growing numbers of public access defibrillators aim to improve the effectiveness of bystander cardiopulmonary resuscitation prior to ambulance arrival. In the UK, however, public access defibrillators are only deployed successfully in 1.7% of out-of-hospital cardiac arrests. We aimed to understand whether this was due to a lack of devices, lack of awareness of their location or a reflection of lack of public knowledge and confidence to use a defibrillator. ⋯ These findings suggest that a lack of public knowledge, confidence in using a defibrillator and the inability to locate a nearby device may be more important than a lack of defibrillators themselves. Underused public access defibrillation is a missed opportunity to save lives, and improving this link in the chain of survival may require these issues to be addressed ahead of investing more funds in actual defibrillator installation.
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Comparative Study
Infective endocarditis of a transcatheter pulmonary valve in comparison with surgical implants.
Melody valved stents (Medtronic Inc, Minneapolis, Minnesota, USA) have become a very competitive therapeutic option for pulmonary valve replacement in patients with congenital heart disease. After adequate prestenting of the right ventricular outflow tract (RVOT) Melody valved stents have a good medium term functional result but are exposed to infective endocarditis (IE). ⋯ The Contegra conduit and Melody valved stents have a significantly higher incidence of IE than homografts. IE is a significant threat for long-term conduit function.
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Multicenter Study Comparative Study
Atrial fibrillation and stroke in adult patients with atrial septal defect and the long-term effect of closure.
To estimate the risk of atrial fibrillation (AF) and stroke and the impact of closure in patients with atrial septal defect (ASD) compared with a general population cohort. ⋯ Patients with ASD had a higher risk of first-time AF after closure than the comparison cohort. There was no effect of closure on the use of AF-related medicine in patients with prevalent AF.
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Following the first reported case of thoracic endovascular aortic repair (TEVAR) in 1987, there has been rapid technological development and widespread uptake of this approach for thoracic aortic disease. TEVAR has particular advantages for acute thoracic syndromes and there is continuing development of TEVAR for use in the elective situation. This is still a young technology and many unknowns remain, including long-term outcomes and the relative advantages and disadvantages versus both conservative treatment and open surgical repair. The current uses of TEVAR in the treatment of aortic dissection, thoracic aortic aneurysm, penetrating aortic ulcer and trauma are discussed.