ABSTRACT
Mechanical circulatory support (MCS) with short-term ventricular assist devices has been used as a bridge to high-risk percutaneous coronary interventions (PCI), as well as during interventions and in the post-procedural recovery period. Percutaneous extracorporeal membrane oxygenation (ECMO) is used when full cardiopulmonary support is necessary due to severe biventricular and pulmonary dysfunction. Prompted by two cases of high-risk rotablation of heavily calcified coronary arteries where ECMO was used as a bridge to intervention and post-intervention recovery, we reviewed the bibliography and the new guidelines on cardiac revascularization with regard to the utility of MCS devices in high-risk PCI cases.
Subject(s)
Calcinosis/complications , Calcinosis/surgery , Coronary Artery Bypass/methods , Coronary Artery Disease/etiology , Coronary Artery Disease/surgery , Extracorporeal Circulation/methods , Heart-Assist Devices , Combined Modality Therapy/methods , Humans , Male , Middle Aged , Risk FactorsABSTRACT
Tobacco is able to accumulate cadmium and reduction of cadmium content can reduce health hazards to smokers. Soil pH and form of N fertilizers are among the factors affecting Cd uptake by tobacco. This hypothesis was tested in an acid soil in northern Greece by a four year field experiment. The variability of Cd uptake by tobacco was attributed to the variation of soil Cd availability as affected by soil pH. Liming with 3000 kg Ca(OH)(2) ha(-1) increased soil pH by 0.8 units and decreased extractable with DTPA soil and leaf Cd by 40% and 35%, respectively. The ammonium fertilizer caused the opposite, but weaker, effects. Liming reduced soil Cd more in the ammonium treatment than in nitrate or combined N treatments. The year of cultivation strongly affected soil and leaf Cd. Four years after tobacco cultivation, soil pH was reduced by 0.5 units, whereas soil and leaf Cd reduction was more than 60% in the limed treatments. Liming affected Cd uptake only in the first three years of cultivation.
