Surgical left atrial appendage closure: success rate and its relationship with cerebrovascular accident

Background: Several surgical procedures such as excision or exclusion are recommended for the closure of the left atrial appendage (LAA). This study was conducted with the aim to evaluate the success rate of different surgical techniques for LAA closure, their respective complications, and the rate of post-surgical cerebrovascular accident (CVA). Methods: This retrospective study included 150 consecutive patients who underwent LAA closure most commonly after mitral valve surgery within 3 to 6 months after surgery. An expert echocardiographic fellow collected the data on patients’ surgical LAA closure methods and history of CVA, types of prosthetic valves, mortality, and bleeding. Results: The failure rate for complete LAA closure was 36.7% (55 patients) in our study. The greatest success rate of complete LAA closure was seen in purse-string method (75.5%), followed by resection method (71.4%), while the lowest success rate (≈ 33.3%) was observed in ligation method. A significant relationship was observed between clots on the surface of metallic valve and postoperative CVA (P = 0.001; likelihood ratio: 32). significant relationship between partial LAA closure and the incidence of post-surgical CVA (P > 0.050). Conclusion: We observed the highest success rate of complete LAA closure in purse-string method followed by resection method. Interestingly, our results showed that despite the higher rate of residual LAA clot in cases of partial LAA closure, the occurrence of post-surgical CVA was mostly related to the presence of clots on the surface of metallic mitral prostheses rather than the presence of partial LAA closure.

Vaginal prolapse due to ring womb in a 3-year old Sudanese-Balami cross breed Ewe

This report presented a case of vaginal prolapse complicated with dystocia due to ring womb, the ewe was presented with the chief complaint of protruding mass around the vulva. On physical examination, vaginal prolapse was established and corrected gently by pushing the mass through the vulva opening and stay sutures were placed using buried purse-string method. Two days post-management the ewe was observed to be at term and the sutures were removed but the ewe was unable to deliver. It was then prepared for caesarean operation and two foetuses were removed alive, the foetuses died a day after the caesarean section. The post mortem findings on the foetuses revealed pulmonary atelectasis. The ewe recovered and the sutures were removed 14 days after the surgery.

Tube-Based Taut String Algorithms for Total Variation Regularization

Removing noise from signals using total variation regularization is a challenging signal processing problem arising in many practical applications. The taut string method is one of the most efficient approaches for solving the 1D TV regularization problem. In this paper we propose a geometric description of the linearized taut string method. This geometric description leads to the notion of the “tube”. We propose three tube-based taut string algorithms for total variation regularization. Different weight functionals can be used in the 1D TV regularization that lead to different types of tubes. We consider uniform, vertically nonuniform, vertically and horizontally nonuniform tubes. The proposed geometric approach is used to speed-up TV regularization processing by dividing the tubes into subtubes and using parallel processing. We introduce the concept of a relatively convex tube and describe the relationship between the geometric characteristics of tubes and exact solutions to the TV regularization. The properties of exact solutions can also be used to design efficient algorithms for solving the TV regularization problem. The performance of the proposed algorithms is discussed and illustrated by computer simulation.