| 1. |
- Offstad, Jon, et al.
(författare)
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The Scandinavian multicenter hemodynamic evaluation of the SJM Regent aortic valve
- 2011
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Ingår i: Journal of Cardiothoracic Surgery. - : Springer Science and Business Media LLC. - 1749-8090. ; 6:163
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Tidskriftsartikel (refereegranskat)abstract
- Background: 112 patients who received small and medium sized St.Jude Regent heart valves (19-25 mm) at 7 Scandinavian centers were studied between January 2003 and February 2005 to obtain non-invasive data regarding the hemodynamic performance at rest and during Dobutamine stress echocardiography (DSE) testing one year after surgery. Material and methods: 46 woman and 66 men, aged 61.8 +/- 9.7 (18-75) years, were operated on for aortic regurgitation (17), stenosis (65), or mixed dysfunction (30). Valve sizes were 19 mm (6), 21 mm (33), 23 mm (41), 25 mm (30). Two patients receiving size 27 valves were excluded from the hemodynamic evaluation. Pledgets were used in 100 patients, everted mattress in 66 and simple interrupted sutures in 21. Valve orientation varied and was dependent on the surgeons' choice. 34 patients (30.4%) underwent concomitant coronary artery surgery. Results: There were two early deaths (1.8%) and three late deaths, one because of pancreatic cancer. Late events during follow-up were: non structural dysfunction (1), bleeding (2), thromboembolism (2). At one year follow up 93% of the patients were in NYHA classes 1-2 versus 47.8% preoperatively. Dobutamine stress echocardiography (DSE) was performed in a total of 66 and maximal peak stress was reached in 61 patients. During DSE testing, the following statistically significant changes took place: Heart rate increased by 73.0%, cardiac output by 85.5%, left ventriclular ejection fraction by 19.6%, and maximal mean prosthetic transvalvular gradient by 133.8%, whereas the effective orifice area index did not change. Left ventricular mass fell during one year from 215 +/- 63 to 197 +/- 62 g (p < 0.05). Conclusion: The Dobutamine test induces a substantial stress, well suitable for echocardiographic assessment of prosthesis valve function and can be performed in the majority of the patients. The changes in pressure gradients add to the hemodynamic characteristics of the various valve sizes. In our patients the St. Jude Regent valve performed satisfactory at rest and under pharmacological stress situation.
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| 2. |
- Palmskog, Karl, et al.
(författare)
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ABS-NET: Fully Decentralized Runtime Adaptation for Distributed Objects
- 2013
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Ingår i: Proceedings 6th Interaction and Concurrency Experience. - : Open Publishing Association. ; , s. 85-100
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Konferensbidrag (refereegranskat)abstract
- We present a formalized, fully decentralized runtime semantics for a core subset of ABS, a language and framework for modelling distributed object-oriented systems. The semantics incorporates an abstract graph representation of a network infrastructure, with network endpoints represented as graph nodes, and links as arcs with buffers, corresponding to OSI layer 2 interconnects. The key problem we wish to address is how to allocate computational tasks to nodes so that certain performance objectives are met. To this end, we use the semantics as a foundation for performing network-adaptive task execution via object migration between nodes. Adaptability is analyzed in terms of three Quality of Service objectives: node load, arc load and message latency. We have implemented the key parts of our semantics in a simulator and evaluated how well objectives are achieved for some application-relevant choices of network topology, migration procedure and ABS program. The evaluation suggests that it is feasible in a decentralized setting to continually meet both the objective of a node-balanced task allocation and make headway towards minimizing communication, and thus arc load and message latency.
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