Thirty-three years old modified senning operation.

Numerous technical modifications and various complications of the Senning procedure have been described in the literature. We describe the excellent clinical status and anatomic result of a 33-year-old patient who underwent a modified Senning operation using the left atrial appendage for reconstruction more than 30 years prior to presentation.

Neurohormonal activity and vascular properties late after aortic coarctation repair.

BACKGROUND: Coarctation of aorta (CoA) patients present cardiovascular complications late after repair the causes of which are not fully understood. Our study investigates the neurohormonal and immune activation and the elastic properties of the aorta and peripheral vessels in adult patients with coarctation of aorta (CoA), late after repair. METHODS: Nineteen adult patients with repaired CoA and 29 matched healthy controls underwent aortic distensibility, stiffness index, a study of the elastic properties of peripheral vessels proximal to the coarctation site and measurement of plasma cytokine and neurohormone levels. RESULTS: Distensibility index was reduced (p=0.02) and stiffness index was increased (p=0.005) in CoA patients compared to control. Augmentation index (p=0.0007) and augmented pressure (p=0.001) were higher in CoA patients and Forearm Blood Flow (FBF) index was reduced (p=0.009). Plasma levels of sICAM-1 (p=0.01), sVCAM-1 (p=0.05), E-selectin (p=0.01), sFas-ligand (p=0.02) and IL-10 (p=0.01) were also elevated in CoA patients vs control. TNF-a, IL-6, Endothelin-1 and NT-pro-BNP levels were not. CONCLUSIONS: Adults with repaired CoA seem to develop a late inflammatory reaction, which reflects a functional problem in all vessels, regardless of the initial lesion. This may explain the late complications of the disease despite early repair and improved surgical procedures.

Differences in the efficiency between the grab and track starts for both genders in greek young swimmers.

The aim of this study was to determine the differences in the kinematic parameters between the grab and track starts and the differences in these two starts between genders. A total of 27 swimmers at the competitive level participated in the study, 13 boys (mean ± SD: age 15.8 ± 0.8 years, body mass 67.7 ± 7.7 kg and body height 178.6 ± 5.7 cm) and 14 girls (mean ± SD: age 16 ± 0.8 years, body mass 59.2 ± 6.6 kg and body height 166.2 ± 6.7 cm). Each swimmer performed three attempts for both start techniques. The best attempt of the grab start and the track start was taken for further analysis. The following kinematic parameters were analysed: flight distance, flight time, flight velocity, entry angle and reaction time. The males had greater numeric values for the results in all kinematic parameters for the grab start compared with the track start, except for flight velocity and entry angle (flight time 0.42 vs. 0.41 s, flight distance 3.21 vs. 3.14 m, flight velocity 7.76 vs. 7.83 m/s, entry angle 44.22 vs. 43.85 degrees and reaction time 0.86 vs. 0.81 s). The females also had greater numeric values for the results in all kinematic parameters for the grab start compared with the track start, except for flight time (flight time 0.38 vs. 0.38 s, flight distance 2.82 vs. 2.73 m, flight velocity 7.47 vs. 7.31 m/s, entry angle 45.18 vs. 44.79 degrees and reaction time 0.88 vs. 0.82 s). These results indicate that the males had significantly better results for flight time and flight distance compared with the females for the grab start (flight time 0.42 vs. 0.38 s, flight distance 3.21 vs. 2.82 m). In the case of the track start, the males had significantly better results for flight distance (3.14 vs. 2.73 m). Exploring the characteristics of the two starts did not lead to any significant kinematic differences. Therefore, a conclusion that demonstrates the superiority of one of the techniques cannot be reached. The coach, together with each swimmer individually, should devote some time to decide after some tests what type of start is better for the body type and general qualifications of the swimmer.