Mechanical Support Systems Research Articles

State of the art treatment with Impella® in cardiac surgery inAustria.

Since 2022, the mechanical left ventricular support system Impella5.5® has been used in Austria for patients with cardiogenic shock, advanced heart failure, post-cardiotomy and low output syndrome. The surgical insertion of the Impella5.5 via the subclavian artery or alternatively via the ascending aorta has become an established procedure for medium-term treatment in patients with cardiogenic shock and bridging scenarios, such as bridge to recovery, bridge to left ventricular assist device (LVAD), bridge to decision, and bridge to heart transplant (HTx) in Austria. All Impella left ventricular heart pumps share the common feature of unloading the left ventricle, with the Impella5.5 achieving afull cardiac output of 5.5l/min. The stable positioning via transaxillary or transaortic insertion enables rapid extubation and mobilization of patients in the intensive care unit (ICU), leading to asignificantly shorter ICU stay. The combined support of Impella5.5 with venoarterial extracorporeal membrane oxygenation (VA-ECMO) has also proven effective in certain scenarios. Several nonrandomized studies demonstrated the effectiveness and safety of the Impella5.5 in practice, which have been included in multiple international guidelines. The advantages of the Impella5.5 in practice include the easy handling with high positional stability, and low complications rates. This article describes the significance of surgical Impella treatment in Austria from the perspective of Austrian clinical experts.

State of the art treatment with Impella® in cardiac surgery in Austria

Since 2022, the mechanical left ventricular support system Impella 5.5® has been used in Austria for patients with cardiogenic shock, advanced heart failure, post-cardiotomy and low output syndrome. The surgical insertion of the Impella 5.5 via the subclavian artery or alternatively via the ascending aorta has become an established procedure for medium-term treatment in patients with cardiogenic shock and bridging scenarios, such as bridge to recovery, bridge to left ventricular assist device (LVAD), bridge to decision, and bridge to heart transplant (HTx) in Austria. All Impella left ventricular heart pumps share the common feature of unloading the left ventricle, with the Impella 5.5 achieving a full cardiac output of 5.5l/min. The stable positioning via transaxillary or transaortic insertion enables rapid extubation and mobilization of patients in the intensive care unit (ICU), leading to a significantly shorter ICU stay. The combined support of Impella 5.5 with venoarterial extracorporeal membrane oxygenation (VA-ECMO) has also proven effective in certain scenarios. Several nonrandomized studies demonstrated the effectiveness and safety of the Impella 5.5 in practice, which have been included in multiple international guidelines. The advantages of the Impella 5.5 in practice include the easy handling with high positional stability, and low complications rates. This article describes the significance of surgical Impella treatment in Austria from the perspective of Austrian clinical experts.

Integrating Pharmacomechanical Treatments for Pulmonary Embolism Management within a Hub-and-Spoke System in the Swiss Ticino Region.

The Swiss Ticino regional pulmonary embolism response team (PERT) features direct access to various pharmacomechanical PE management options within a hub/spoke system, by integrating evidence, guidelines' recommendations and personal experiences. This system involves a collaborative management of patients among the hospitals distributed throughout the region, which refer selected intermediate-high or high PE patients to a second-level hub center, located in Lugano at Cardiocentro Ticino, belonging to the Ente Ospedaliero Cantonale (EOC). The hub provides 24/7 catheterization laboratory activation for catheter-based intervention (CBI), surgical embolectomy and/or a mechanical support system such as extracorporeal membrane oxygenation (ECMO). The hub hosts PE patients after percutaneous or surgical intervention in two intensive care units, one specialized in cardiovascular anesthesiology, to be preferred for patients without relevant comorbidities or with hemodynamic instability and one specialized in post-surgical care, to be preferred for PE patients after trauma or surgery or with relevant comorbidities, such as cancer. From April 2022 to December 2023, a total of 65 patients were referred to the hub for CBI, including ultrasound-assisted catheter-directed thrombolysis (USAT) or large-bore aspiration intervention. No patient received ECMO or underwent surgical embolectomy.

The Design of A Robot for Laser Cladding of Inner Walls of Pipes

This paper presents a design scheme of an adaptive laser cladding robot for the inner wall of variable diameter pipes. The robot is in the shape of a capsule, with an adaptive walking system, a mechanical support and balance system, a laser cladding system and a water cooling system, which can achieve efficient laser cladding and strengthening of the inner walls of different pipes. Among them, innovative designs such as pressure overload protection device and beam focusing lens adjustment motor have significantly improved the stability and accuracy of robot operation. Compared with traditional equipment, the robot is simple in structure, easy to disassemble, reliable in performance, high in automation, easy to maintain, and low in energy consumption. It provides an effective solution for laser cladding of pipe inner wall under complex and changeable working conditions, and helps to promote the wide promotion and application of laser cladding technology.

The efficacy of different torque profiles for weight compensation of the hand.

Orthotic wrist supports will be beneficial for people with muscular weakness to keep their hand in a neutral rest position and prevent potential wrist contractures. Compensating the weight of the hands is complex since the level of support depends on both wrist and forearm orientations. To explore simplified approaches, two different weight compensation strategies (constant and linear) were compared to the theoretical ideal sinusoidal profile and no compensation in eight healthy subjects using a mechanical wrist support system. All three compensation strategies showed a significant reduction of 47-53% surface electromyography activity in the anti-gravity m. extensor carpi radialis. However, for the higher palmar flexion region, a significant increase of 44-61% in the m. flexor carpi radialis was found for all compensation strategies. No significant differences were observed between the various compensation strategies. Two conclusions can be drawn: (1) a simplified torque profile (e.g., constant or linear) for weight compensation can be considered as equally effective as the theoretically ideal sinusoidal profile and (2) even the theoretically ideal profile provides no perfect support as other factors than weight, such as passive joint impedance, most likely influence the required compensation torque for the wrist joint.

Universal fixation system for pad printing of plastic parts.

Pad printing is used in automotive, medical, electrical and other industries, employing diverse materials to transfer a 2D image onto a 3D object with different sizes and geometries. This work presents a universal fixation system for pad printing of plastic parts (UFSP4) in response to the needs of small companies that cannot afford to invest in the latest technological advances. The UFSP4 comprises two main subsystems: a mechanical support system (i.e., support structure, jig matrix and braking system) and a control system (i.e., an electronic system and an electric-hydraulic system). A relevant feature is the combination of a jig matrix and jig pins to fixate complex workpieces with different sizes. Using finite element analysis (FEA), in the mesh convergence, the total displacement converges to 0.00028781 m after 12,000 elements. The maximum equivalent stress value is 1.22 MPa for the polycarbonate plate in compliance with the safety factor. In a functionality test of the prototype performed in a production environment for one hour, the jigs fixed by the plate did not loosen, maintaining the satisfactory operation of the device. This is consistent with the displacement distribution of the creep analysis and shows the absence of the creep phenomenon. Based on FEA that underpinned the structural health computation of the braking system, the prototype was designed and built, seeking to ensure a reliable and safe device to fixate plastic parts, showing portability, low-cost maintenance and adaptability to the requirements of pad printing of automotive plastic parts.

Ambulatory 7-day mechanical circulatory support in sheep model of pulmonary hypertension and right heart failure

Right heart failure is the major cause of death in pulmonary hypertension. Lung transplantation is the only long-term treatment option for patients who fail medical therapy. Due to the scarcity of donor lungs, there is a critical need to develop durable mechanical support for the failing right heart. A major design goal for durable support is to reduce the size and complexity of devices to facilitate ambulation. Toward this end, we sought to deploy wearable mechanical support technology in a sheep disease model of chronic right heart failure. In 6 sheep with chronic right heart failure, a mechanical support system consisting of an extracorporeal blood pump coupled with a gas exchange unit was attached in a right atrium-to-left atrium configuration for up to 7days. Circuit performance, hematologic parameters, and animal hemodynamics were analyzed. Six subjects underwent the chronic disease model for 56 to 71days. Three of the subjects survived to the 7-day end-point for circulatory support. The circuit provided 2.8 (0.5) liter/min of flow compared to the native pulmonary blood flow of 3.5 (1.1) liter/min. The animals maintained physiologically balanced blood gas profile with a sweep flow of 1.2 (1.0) liter/min. Two animals freely ambulated while wearing the circuit. Our novel mechanical support system provided physiologic support for a large animal model of pulmonary hypertension with right heart failure. The small footprint of the circuit and the low sweep requirement demonstrate the feasibility of this technology to enable mobile ambulatory applications.

Prehospital resuscitation : Current status, results and strategies for improvement in Germany

Out-of-hospital cardiac arrest (OHCA) is one of the most frequent causes of death in Europe and is associated with adismal prognosis. The annual incidence in Germany is approximately 100-120 per 100,000 inhabitants (ca. 80,000-100,000 cases). With the use of cardiopulmonary resuscitation (CPR) about 40% of patients have areturn of spontaneous circulation (ROSC); however, after OHCA only 15% of patients survive for 30 days and less than 10% survive with no or only minor neurological deficits. Data from the German Resuscitation Register demonstrate that there was no change in the results over the last 15years, despite all medical innovations, higher rates of coronary interventions, higher use of mechanical support systems and improvement in intensive care treatment. Ahigh proportion of patients with OHCA have acardiac or coronary cause. As shown by the data from the German Cardiac Arrest Register (G-CAR) an early coronary angiography is often carried out after CPR in Germany; however, in randomized clinical studies an immediate coronary angiography in patients with non-ST segment elevation in the electrocardiogram (ECG) was not associated with an improvement in the prognosis. In large randomized studies the use of mechanical CPR systems and the implantation of mechanical circulatory support devices after OHCA also did not lead to a reduction in mortality. The most important impact factor for the success of CPR is the time interval between collapse and start of CPR, if possible also by bystander resuscitation. Therefore, the focus of efforts for improving CPR should be on increasing the rate of patients with early CPR. Experiences from Denmark and The Netherlands indicate that this can be successful by education and training of the general population, telephone resuscitation and apps for alerting lay persons.

Impact of a VA-ECMO in Combination with an Extracorporeal Cytokine Hemadsorption System in Critically Ill Patients with Cardiogenic Shock-Design and Rationale of the ECMOsorb Trial.

Cardiogenic shock and arrest present as critical, life-threatening emergencies characterized by severely compromised tissue perfusion and inadequate oxygen supply. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) serves as a mechanical support system for patients suffering shock refractory to conventional resuscitation. Despite the utilization of VA-ECMO, clinical deterioration due to systemic inflammatory response syndrome (SIRS) resulting from the underlying shock and exposure of blood cells to the artificial surfaces of the ECMO circuit may occur. To address this issue, cytokine adsorbers offer a valuable solution by eliminating blood proteins, thereby controlling SIRS and potentially improving hemodynamics. Consequently, a prospective, randomized, blinded clinical trial will be carried out with ECMOsorb. ECMOsorb is a single-center, controlled, randomized, triple-blinded trial that will compare the hemodynamic effects of treatment with a VA-ECMO in combination with a cytokine adsorber (CytoSorb®, intervention) to treatment with VA-ECMO only (control) in patients with cardiogenic shock (with or without prior cardiopulmonary resuscitation (CPR)) requiring extracorporeal, hemodynamic support. Fifty-four patients will be randomized in a 1:1 fashion to the intervention or control group over a 36-month period. The primary endpoint of ECMOsorb is the improvement of the Inotropic Score (IS) 72 h after the intervention. Prognostic indicators, including mortality rates, hemodynamic parameters, laboratory findings, echocardiographic assessments, quality of life measurements, and clinical parameters, will serve as secondary outcome measures. The safety evaluation encompasses endpoints such as air embolisms, allergic reactions, peripheral ischemic complications, vascular complications, bleeding incidents, and stroke occurrences. The ECMOsorb trial seeks to assess the efficacy of a cytokine adsorber (CytoSorb®; CytoSorbents Europe GmbH, Berlin, Germany) in reducing SIRS and improving hemodynamics in patients with cardiogenic shock who are receiving VA-ECMO. We hypothesize that a reduction in cytokine levels can lead to faster weaning from inotropic and mechanical circulatory support, and ultimately to improved recovery.

Improved lubrication and wear resistance of gallium-matrix liquid metal containing molybdenum diselenide nanoparticles under heavy load conditions

Owing to their advantages of high load-carrying performance, efficient heat conduction, and low friction coefficient, liquid metal-lubricated spiral groove bearings are critical mechanical components in high-speed mechanical support systems including computed tomography X-ray tubes, machine spindles of multi-axis numerical control machining center, etc. Therefore, it is imperative to understand the tribological mechanisms between liquid metal lubricants and tribo-pairs aiming to improve their functional properties and extend the service life of spiral groove bearings. In this study, molybdenum diselenide (MoSe2) nanoparticles, a friction-reducing lubricant, were blended as an additive into the gallium-based liquid metal (LM, Ga64In24Sn12) using mechanical grinding techniques. Following lubrication with MoSe2/Ga64In24Sn12 LM lubricant, friction and wear characteristics of Si3N4 ceramics ball/AISI 52100 steel disk friction pairs were evaluated by a high-frequency linear reciprocating oscillation friction test machine with ball-on-disc configuration under a normal load ranging from 50 N to 1500 N. Experimental results demonstrate that as the MoSe2 dosage increases, the viscosity of MoSe2/Ga64In24Sn12 LM lubricant gradually rises. Both normal load and MoSe2 nanoparticles content have a notable influence on the lubrication properties of MoSe2/Ga64In24Sn12 LM lubricant at a light (50 N) or a heavy load (1500 N). Of all these LM lubricants, the best lubrication performance and wear resistance (f = 0.10, k = 1.93×10−8 mm3/Nm) was achieved for 5.0 wt% MoSe2/Ga64In24Sn12. The improvement in the lubrication characteristics of MoSe2/Ga64In24Sn12 LM lubricant under heavy load conditions originated from the generation of tribo-films from the Tribo-chemical reactions involving MoSe2 nanoparticles. The thickness of Ga-based tribo-films is 1.50 ± 0.10 μm. This kind of tribo-films is rich in various nanocrystals consisting of orthorhombic α-Fe2O3, monoclinic β-Ga2O3, cubic In2O3, tetragonal rutile SnO2, orthorhombic α-MoO3, and noncrystalline SiO2. Friction-induced lubricating films prevent adhesion wear of frictional pairs at heavy loads and consequently increase the load-bearing characteristics of LM lubricant, thereby improving the lubrication characteristics of LM.

Acquired Willberand Syndrome and Acute Coronary Syndrome: Risks and Management

Von willbrand syndrome remains a rare pathology. Its etiologies and clinical manifestations are varied. This syndrome can be inherited or acquired. The acquired form is associated with various pathologies (Gastric, mechanical support system…) including cardiovascular diseases such as aortic stenosis, HCM, and Mitral regurgitation. Nevertheless, the association of acquired Willebrand syndrome with coronary pathology remains a rare association. In this literature review, we have made a review of the various articles addressing this subject. The management of ACS in patients with AvWS follows that of normal patients in terms of interventional procedure, however therapeutic drug management remains delicate given the hemorrhagic risk that these drugs present. The use of DAPT and heparin is possible while thrombolysis remains at very high risk for the patient. The use of desmopressin can be done with caution and also factor VIII and vWF concentrates have their place to reduce the risk of bleeding. Overall, the collaboration of the cardiologist and hematologist remains essential for better management of these patients.

Evaluation of Seismic Acceleration Demands on Mechanical Support Systems

Earthquakes are among the most influential force of nature that affect human life. Reconnaissance after the severe earthquakes pointed out that seismic performance of non-structural members and elements could be as significant as the structural members in lateral force-resisting systems. As such, it is important for design engineers to recognize the seismic demand on the mechanical systems that support the critical non-structural components (e.g., sprinklers, electrical and mechanical equipment, etc.) in terms of the safety during and after an earthquake as well as functionality and retrofitting cost after an earthquake. The primary goal of this study is to systematically investigate the seismic demands on the mechanical support systems of a typical mid-rise steel structure. For this purpose, non-linear time history analyses are carried out using a suite of ground motion acceleration records to evaluate the seismic demands on both seismic force-resisting system and the support system by means of inter-story drift angle and horizontal accelerations, respectively. Results obtained from the analyses are discussed considering the requirements stipulated in the current national and international buildings and recommendations are made.

Predictors of in-Hospital Prognosis after Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction Requiring Mechanical Support Devices

Objectives: The study was designed to identify predictor variables of the hospitalized patient’s primary percutaneous coronary intervention (PPCI) for MI needing mechanical support systems including some intra-aortic balloon-pumping and percutaneous cardiopulmonary. However, these predictors are still unknown. Place and Duration: The research was carried out at National Institute of Cardiovascular Disease with the duration from 5th September 2021 to 5th March 2022. Methodology: Clinical history, angiographic research results, primary PCI outcomes, as well as in hospital prognosis were retroactively evaluated by comparing primary PCI treated acute myocardial infarction patients needing mechanical aid devices (with intra-aortic balloon pump patient populations, n=550) versus those without (IABP patients, n=755). In comparison to individuals without IABP, those with intra-aortic balloon pump were much more inclined to have a greater proportion of diseased vessels, a lower TIMI score in the infarct related artery (IRA), and a considerably high death rate of hospitalized patients. On multivariate analysis, possession of Thrombolysis In Myocardial Infarction greater than or equal to 3 flow in the infarct-related artery right after PPCI was the poor indicator in the without intra-aortic balloon pump patients, in contrast to the patients with IABP. The percentage of diseased vessels or diseased left main trunk at preliminary cardiac catheterization was the impartial predictive factor of the hospitalized patient’s fatalities in the sufferers with IABP, but not in the sufferers without intra-aortic balloon pump. Results: A significant risk factor for fatality in hospitalized patients in PPCI-treated acute myocardial infarction patients needing mechanical assistance devices is the proportion of diseased vessels ≥ 2 or diseased left main trunk at baseline CAG. Keywords: Percutaneous cardiopulmonary support; Intra-aortic balloon pumping, PPCI or primary percutaneous coronary intervention; Multi-vessel disease

Rationale and Design of JenaMACS-Acute Hemodynamic Impact of Ventricular Unloading Using the Impella CP Assist Device in Patients with Cardiogenic Shock.

Introduction: Cardiogenic shock due to myocardial infarction or heart failure entails a reduction in end organ perfusion. Patients who cannot be stabilized with inotropes and who experience increasing circulatory failure are in need of an extracorporeal mechanical support system. Today, small, percutaneously implantable cardiac assist devices are available and might be a solution to reduce mortality and complications. A temporary, ventricular, continuous flow propeller pump using magnetic levitation (Impella®) has been approved for that purpose. Methods and Study Design: JenaMACS (Jena Mechanical Assist Circulatory Support) is a monocenter, proof-of-concept study to determine whether treatment with an Impella CP® leads to improvement of hemodynamic parameters in patients with cardiogenic shock requiring extracorporeal, hemodynamic support. The primary outcomes of JenaMACS are changes in hemodynamic parameters measured by pulmonary artery catheterization and changes in echocardiographic parameters of left and right heart function before and after Impella® implantation at different support levels after 24 h of support. Secondary outcome measures are hemodynamic and echocardiographic changes over time as well as clinical endpoints such as mortality or time to hemodynamic stabilization. Further, laboratory and clinical safety endpoints including severe bleeding, stroke, neurological outcome, peripheral ischemic complications and occurrence of sepsis will be assessed. JenaMACS addresses essential questions of extracorporeal, mechanical, cardiac support with an Impella CP® device in patients with cardiogenic shock. Knowledge of the acute and subacute hemodynamic and echocardiographic effects may help to optimize therapy and improve the outcome in those patients. Conclusion: The JenaMACS study will address essential questions of extracorporeal, mechanical, cardiac support with an Impella CP® assist device in patients with cardiogenic shock. Knowledge of the acute and subacute hemodynamic and echocardiographic effects may help to optimize therapy and may improve outcome in those patients. Ethics and Dissemination: The protocol was approved by the institutional review board and ethics committee of the University Hospital of Jena. Written informed consent will be obtained from all participants of the study. The results of this study will be published in a renowned international medical journal, irrespective of the outcomes of the study. Strengths and Limitations: JenaMACS is an innovative approach to characterize the effect of additional left ventricular mechanical unloading during cardiogenic shock via a minimally invasive cardiac assist system (Impella CP®) 24 h after onset and will provide valuable data for acute interventional strategies or future prospective trials. However, JenaMACS, due to its proof-of-concept design, is limited by its single center protocol, with a small sample size and without a comparison group.

VIRIAL THEOREM LIMITATIONS FOR THE TOROIDAL MAGNETIC ENERGY STORAGE CAUSED BY THE LOCATION OF SUPPORT STRUCTURE ELEMENTS AND THEIR MECHANICAL PROPERTIES

Based on the virial theorem, the influence of the following factors to characteristics of mechanical support systems of toroidal magnetic energy storage is considered: the configuration of the coils, the support system elements location under compressive forces, the mechanical properties of the material, the distribution of the cross-sectional areas of the support rings and the corresponding distribution of radial forces. It is established that the volume of structure requirement depends only on the radii from which the coils transmit forces to the support rings. The found general relation, in contrast to the existing ones, establishes a relationship between all the parameters that determine the volume of the support structures. The characteristics of support systems are analyzed both for identical mechanical stresses and for identical mechanical properties of all support elements. The characteristics for specific examples of toroidal systems with circular coils are found. It is shown that systems with support elements in compression located on the side of the vertical axis of the torus have a significantly smaller volume of structure compared to other locations. The influence of the relative radial size of the torus cross-section and the distribution of the cross-sectional areas of the support rings on the structure requirement is analyzed. The relationship between dimensionless characteristics that determine the volume of elements subjected to mechanical stresses of compression and tension is noted. References 37, figures 8, table 1.

МОДЕЛИРОВАНИЕ СИСТЕМ УПРАВЛЕНИЯ ОРГАНИЗАЦИОННО-ТЕХНОЛОГИЧЕСКИМ ОБЕСПЕЧЕНИЕМ МЕХАНИЧЕСКОЙ СБОРКИ НА ПРЕДПРИЯТИЯХ АВТОМОБИЛЕСТРОИТЕЛЬНОГО КЛАСТЕРА

A system for providing mechanical assembly based on threaded joints used at enterprises of the automotive cluster. This system combines a subsystem of assembly equipment, a subsystem of spare tools. The model of the mechanical assembly support system can be based on a set-theoretic approach as a set of subsystems of organizational and technological support for mechanical assembly at automotive cluster enterprises. Subsystems of organizational and technological support of mechanical assembly for automotive cluster enterprises can be described from the standpoint of management theory. In each control system being formed, an object, a control subject, a feedback mechanism is allocated, and it is also assumed that the PMD will interact with the subsystem of organizational and technological support for mechanical assembly through the information system database being formed. The task of managing the organizational and technological system for providing mechanical assembly involves solving particular problems, including those of managing the subsystem of assembly equipment, also the subsystem of controlling and testing, the subsystem of spare tools, instruments and devices. The criteria of optimal control of the generated control tasks are presented.

Sistem Pendukung Keputusan Penilaian Kinerja Mekanik Menggunakan Metode AHP dan TOPSIS

Decision Support (DSS) is a system that was built to solve problems that are managerial or corporate organization designed to develop the effectiveness and productivity of managers to solve problems. PT. Auto Mobil Prima is one of the most popular Hino dealers in Sampit. This dealer is located in Central Kalimantan, precisely on Jl. General Sudirman Km. 2 Sampit and has branches in Pangkalan Bun and Palangka Raya. This study aims to assess the performance of the mechanical employees at PT. Prime Cars. In the assessment process, it is difficult for management to give weight to each criterion. So that it takes quite a long time, there is no system for decision makers that supports the performance appraisal of employees in the mechanics department. From the problems above and based on previous research, it is necessary to have a decision support system for evaluating the performance of employees in the mechanics department at PT. Auto Mobil Prima, one of the methods that can be used is AHP (Anailitycal Hierarchy Process) and TOPSIS (Technique For Others Reference by Similarity to Ideal Solution). This method was chosen because it is able to complete employee performance appraisals based on predetermined criteria. The results of this study are a website for a mechanical performance appraisal decision support system using the AHP (Anailitycal Hierarchy Process) and TOPSIS (Technique For Others Reference by Similarity to Ideal Solution) methods. So it is hoped that it can help PT. Auto Mobil Prima is a more objective mechanical performance decision maker

Fibers by Electrospinning and Their Emerging Applications in Bone Tissue Engineering

Bone tissue engineering (BTE) is an optimized approach for bone regeneration to overcome the disadvantages of lacking donors. Biocompatibility, biodegradability, simulation of extracellular matrix (ECM), and excellent mechanical properties are essential characteristics of BTE scaffold, sometimes including drug loading capacity. Electrospinning is a simple technique to prepare fibrous scaffolds because of its efficiency, adaptability, and flexible preparation of electrospinning solution. Recent studies about electrospinning in BTE are summarized in this review. First, we summarized various types of polymers used in electrospinning and methods of electrospinning in recent work. Then, we divided them into three parts according to their main role in BTE, (1) ECM simulation, (2) mechanical support, and (3) drug delivery system.

Static and Dynamic Characteristics of Machine Tools with an Adhesive–Mechanical Support System

Static and Dynamic Characteristics of Machine Tools with an Adhesive–Mechanical Support System

Impact of extra-corporeal life support (ECLS) cannulation strategy on outcome after durable mechanical circulation support system implantation on behalf of durable MCS after ECLS Study Group.

The literature on outcomes of patients requiring durable mechanical circulatory support (MCS) after extra-corporeal life support (ECLS) is limited. The aim of this study was to investigate the impact of preoperative ECLS cannulation on postoperative outcome after durable MCS implantation. The durable MCS after ECLS registry is a multicenter retrospective study that gathered data on consecutive patients who underwent durable MCS implantation after ECLS between January 2010 and August 2018 in eleven high volume European centers. Patients who underwent the implantation of total artificial heart, pulsatile pumps, or first-generation pumps after ECLS were excluded from the analysis. The remaining patients were divided into two groups; central ECLS group (cECLS) and peripheral ECLS group (pECLS). A 1:1 propensity score analysis was performed to identify two matched groups. The outcome of these two groups was compared. A total of 531 durable MCS after ECLS were implanted during this period. The ECLS cannulation site was peripheral in 87% (n=462) and central in 13% (n=69) of the patients. After excluding pulsatile pumps and total artificial heart patients, a total of 494 patients remained (pECLS =434 patients, cECLS =60 patients). A 1:1 propensity score analysis resulted in 2 matched groups (each 55 patients) with median age of 54 years (48-60 years) in cECLS group and 54 years (43-60 years) in pECLS group. HeartWare HVAD (Medtronic, Minneapolis, MN) was implanted in the majority of the patients (cECLS =71% vs. pECLS =76%, P=0.67). All postoperative morbidities were comparable between the groups. The thirty-day, one year and long-term survival was comparable between the groups (P=0.73). The cannulation strategy of ECLS appears to have no impact on the post-operative outcome after durable MCS implantation.