Endoscopic Vessel Harvesting
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Endoscopic Vessel Harvesting
Endoscopic vessel harvesting (EVH) is a surgical technique that may be used in conjunction with coronary artery bypass surgery (commonly called a "bypass"). For patients with coronary artery disease, a physician may recommend a bypass to reroute blood around blocked arteries to restore and improve blood flow and oxygen to the heart. To create the bypass graft, a surgeon will remove or "harvest" healthy blood vessels from another part of the body, often from the patient's leg or arm. This vessel becomes a graft, with one end attaching to a blood source above and the other end below the blocked area, creating a "conduit" channel or new blood flow connection across the heart. The success of coronary artery bypass graft surgery (CABG) may be influenced by the quality of the conduit and how it is handled or treated during the vessel harvest and preparation steps prior to grafting. Success can be measured in terms of: * The need for repeat revascularization to treat a new blockage * ...
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Surgery
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pathological condition such as a disease or injury, to help improve bodily function, appearance, or to repair unwanted ruptured areas. The act of performing surgery may be called a surgical procedure, operation, or simply "surgery". In this context, the verb "operate" means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments or surgical nurse. The person or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who practices surgery and a surgeon's assistant is a person who practices surgical assistance. A surgical team is made up of the surgeon, the surgeon's assistant, an anaesthetist, a circulating nurse and a surgical technologist. Surgery usually spa ...
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Clinical Trial
Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, dietary choices, dietary supplements, and medical devices) and known interventions that warrant further study and comparison. Clinical trials generate data on dosage, safety and efficacy. They are conducted only after they have received health authority/ethics committee approval in the country where approval of the therapy is sought. These authorities are responsible for vetting the risk/benefit ratio of the trial—their approval does not mean the therapy is 'safe' or effective, only that the trial may be conducted. Depending on product type and development stage, investigators initially enroll volunteers or patients into small pilot studies, and subsequently conduct progressively larger scale comparative studies. Clinical trials can vary i ...
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Smooth Muscle
Smooth muscle is an involuntary non-striated muscle, so-called because it has no sarcomeres and therefore no striations (''bands'' or ''stripes''). It is divided into two subgroups, single-unit and multiunit smooth muscle. Within single-unit muscle, the whole bundle or sheet of smooth muscle cells contracts as a syncytium. Smooth muscle is found in the walls of hollow organs, including the stomach, intestines, bladder and uterus; in the walls of passageways, such as blood, and lymph vessels, and in the tracts of the respiratory, urinary, and reproductive systems. In the eyes, the ciliary muscles, a type of smooth muscle, dilate and contract the iris and alter the shape of the lens. In the skin, smooth muscle cells such as those of the arrector pili cause hair to stand erect in response to cold temperature or fear. Structure Gross anatomy Smooth muscle is grouped into two types: single-unit smooth muscle, also known as visceral smooth muscle, and multiunit smooth muscle. ...
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Direct Current
Direct current (DC) is one-directional flow of electric charge. An electrochemical cell is a prime example of DC power. Direct current may flow through a conductor such as a wire, but can also flow through semiconductors, insulators, or even through a vacuum as in electron or ion beams. The electric current flows in a constant direction, distinguishing it from alternating current (AC). A term formerly used for this type of current was galvanic current. The abbreviations ''AC'' and ''DC'' are often used to mean simply ''alternating'' and ''direct'', as when they modify ''current'' or ''voltage''. Direct current may be converted from an alternating current supply by use of a rectifier, which contains electronic elements (usually) or electromechanical elements (historically) that allow current to flow only in one direction. Direct current may be converted into alternating current via an inverter. Direct current has many uses, from the charging of batteries to large power sup ...
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Coagulation
Coagulation, also known as clotting, is the process by which blood changes from a liquid to a gel, forming a blood clot. It potentially results in hemostasis, the cessation of blood loss from a damaged vessel, followed by repair. The mechanism of coagulation involves activation, adhesion and aggregation of platelets, as well as deposition and maturation of fibrin. Coagulation begins almost instantly after an injury to the endothelium lining a blood vessel. Exposure of blood to the subendothelial space initiates two processes: changes in platelets, and the exposure of subendothelial tissue factor to plasma factor VII, which ultimately leads to cross-linked fibrin formation. Platelets immediately form a plug at the site of injury; this is called ''primary hemostasis. Secondary hemostasis'' occurs simultaneously: additional coagulation (clotting) factors beyond factor VII ( listed below) respond in a cascade to form fibrin strands, which strengthen the platelet plug. Disorders of ...
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Vaporization
Vaporization (or vaporisation) of an element or compound is a phase transition from the liquid phase to vapor. There are two types of vaporization: evaporation and boiling. Evaporation is a surface phenomenon, whereas boiling is a bulk phenomenon. Evaporation is a phase transition from the liquid phase to vapor (a state of substance below critical temperature) that occurs at temperatures below the boiling temperature at a given pressure. Evaporation occurs ''on the surface''. Evaporation only occurs when the partial pressure of vapor of a substance is less than the equilibrium vapor pressure. For example, due to constantly decreasing pressures, vapor pumped out of a solution will eventually leave behind a cryogenic liquid. Boiling is also a phase transition from the liquid phase to gas phase, but boiling is the formation of vapor as bubbles of vapor ''below the surface'' of the liquid. Boiling occurs when the equilibrium vapor pressure of the substance is greater than or equa ...
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Alternating Current
Alternating current (AC) is an electric current which periodically reverses direction and changes its magnitude continuously with time in contrast to direct current (DC) which flows only in one direction. Alternating current is the form in which electric power is delivered to businesses and residences, and it is the form of electrical energy that consumers typically use when they plug kitchen appliances, televisions, fans and electric lamps into a wall socket. A common source of DC power is a battery cell in a flashlight. The abbreviations ''AC'' and ''DC'' are often used to mean simply ''alternating'' and ''direct'', as when they modify ''current'' or ''voltage''. The usual waveform of alternating current in most electric power circuits is a sine wave, whose positive half-period corresponds with positive direction of the current and vice versa. In certain applications, like guitar amplifiers, different waveforms are used, such as triangular waves or square waves. Audio a ...
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Cauterization
Cauterization (or cauterisation, or cautery) is a medical practice or technique of burning a part of a body to remove or close off a part of it. It destroys some tissue in an attempt to mitigate bleeding and damage, remove an undesired growth, or minimize other potential medical harm, such as infections when antibiotics are unavailable. The practice was once widespread for treatment of wounds. Its utility before the advent of antibiotics was said to be effective at more than one level: *To prevent exsanguination *To close amputations Cautery was historically believed to prevent infection, but current research shows that cautery actually increases the risk for infection by causing more tissue damage and providing a more hospitable environment for bacterial growth. Actual cautery refers to the metal device, generally heated to a dull red glow, that a physician applies to produce blisters, to stop bleeding of a blood vessel, and for other similar purposes., page 16. The main forms ...
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Endothelium
The endothelium is a single layer of squamous endothelial cells that line the interior surface of blood vessels and lymphatic vessels. The endothelium forms an interface between circulating blood or lymph in the lumen and the rest of the vessel wall. Endothelial cells form the barrier between vessels and tissue and control the flow of substances and fluid into and out of a tissue. Endothelial cells in direct contact with blood are called vascular endothelial cells whereas those in direct contact with lymph are known as lymphatic endothelial cells. Vascular endothelial cells line the entire circulatory system, from the heart to the smallest capillaries. These cells have unique functions that include fluid filtration, such as in the glomerulus of the kidney, blood vessel tone, hemostasis, neutrophil recruitment, and hormone trafficking. Endothelium of the interior surfaces of the heart chambers is called endocardium. An impaired function can lead to serious health issues throug ...
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Propensity Score Matching
In the statistical analysis of observational data, propensity score matching (PSM) is a statistical matching technique that attempts to estimate the effect of a treatment, policy, or other intervention by accounting for the covariates that predict receiving the treatment. PSM attempts to reduce the bias due to confounding variables that could be found in an estimate of the treatment effect obtained from simply comparing outcomes among units that received the treatment versus those that did not. Paul R. Rosenbaum and Donald Rubin introduced the technique in 1983. The possibility of bias arises because a difference in the treatment outcome (such as the average treatment effect) between treated and untreated groups may be caused by a factor that predicts treatment rather than the treatment itself. In randomized experiments, the randomization enables unbiased estimation of treatment effects; for each covariate, randomization implies that treatment-groups will be balanced on average ...
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Cardiac Surgery
Cardiac surgery, or cardiovascular surgery, is surgery on the heart or great vessels performed by cardiac surgeons. It is often used to treat complications of ischemic heart disease (for example, with coronary artery bypass grafting); to correct congenital heart disease; or to treat valvular heart disease from various causes, including endocarditis, Rheumatic fever, rheumatic heart disease, and atherosclerosis. It also includes heart transplantation. History 19th century The earliest operations on the pericardium (the sac that surrounds the heart) took place in the 19th century and were performed by Francisco Romero (surgeon), Francisco Romero (1801) in the city of Almería (Spain), Dominique Jean Larrey (1810), Henry Dalton (1891), and Daniel Hale Williams (1893). The first surgery on the heart itself was performed by Axel Cappelen on 4 September 1895 at Rikshospitalet in Kristiania, now Oslo. Cappelen ligature (medicine), ligated a bleeding coronary circulation, coronary ...
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Circulation (journal)
''Circulation'' is a scientific journal published by Lippincott Williams & Wilkins for the American Heart Association. The journal publishes articles related to research in and the practice of cardiovascular diseases, including observational studies, clinical trials, epidemiology, health services and outcomes studies, and advances in applied (translational) and basic research. Its 2020 impact factor is 29.690, ranking it third among journals in the Cardiac and Cardiovascular Systems category and first in the Peripheral Vascular Disease category.2020 Journal Citation Reports (Clarivate Analytics, 2021) Articles become open access after a 12-month embargo period. 2008 saw the appearance of six subspecialty journals. The first edition of ''Circulation: Arrhythmia and Electrophysiology'' appeared in April 2008, followed by an edition dedicated to heart failure in May titled ''Circulation: Heart Failure''. The remaining four journals launched once per month from July through October ...
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