Abstract
The nonresectional posterior leaflet remodeling technique through free margin running suture (FMRS) has been recently introduced for the management of complex degenerative lesions of the posterior mitral leaflet. It aims at providing a novel tool in the mitral surgeon's armamentarium to improve the reproducibility and durability of repair, namely in cases characterized by more severe degenerative disease (Barlow and extensive fibroelastic deficiency lesions). Although FMRS can be performed through any surgical access, its features render it particularly adapted to minimally invasive mitral surgery. We describe for the first time the characteristics of FMRS in the context of robotic-assisted mitral repair. A stepwise approach is employed for presentation. The diffusion of robotic-assisted mitral repair has been limited by both economic and reproducibility issues; we hypothesize that FMRS may be helpful in improving the reproducibility of minimally invasive and robotic-assisted mitral surgery. We also discuss the initial clinical results of FMRS.
Highlights
This study deals with CO2 accumulation in confined spaces
CO2 accumulation in the case corresponding to the imposed breathing frequency of 12 breaths/min, is higher than in the Resting state despite the corresponding breathing frequency being higher (17 breaths/min)
It is assumed that the test subject has difficulty breathing normally while striving to maintain the required breathing frequency, leading to deeper inhalation/exhalations and a larger Tidal Volume, affecting CO2 accumulation
Summary
This study deals with CO2 accumulation in confined spaces. Staying in confined spaces with insufficient or ineffective ventilation, presents risks for human health due to CO2 accumulation around the human, a fact of significant importance in the environment of the International Space Station where, in the absence of gravity and natural convective flows, pockets of CO2 form around humans’ heads [1,2,3].Measuring the CO2 accumulation around a person’s head raises several questions. One of the frequently used estimation methods is based on the base metabolic rate (BMR) of each individual and their level of physical activity at the time of estimation [4] Another possibility of estimating the CO2 generation rate is based on the concept of the Tidal Volume – which is the air circulated during regular breathing [5,6] and the number of breaths each minute. Knowing that the human body strives to maintain the same level of CO2 in the exhaled air (4% CO2 per volume) it is possible to estimate the CO2 generation rate. This method has been previously used in studies focusing on the ISS astronauts [7]
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