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Over the past 2 ​decades, structural heart interventions including procedures like transcatheter aortic valve replacement, transcatheter mitral or tricuspid valve replacement, and transcatheter edge-to-edge mitral or tricuspid valve repair, have emerged as feasible alternatives to traditional surgery for treating valvular heart diseases. Antithrombotic treatment represents a critical aspect of postoperative care, aiming to balance the thromboembolic risk due to the incorporation of prosthetic materials and the consequently altered hemodynamics within the cardiac chambers with the bleeding risk depending on patients’ and procedural factors. This continuously evolving interplay underscores the importance of personalized, evidence-based approaches to ensure optimal outcomes. This review provides a comprehensive examination of the current knowledge on antithrombotic therapies after structural interventions, offering insights into the evolving field and emphasizing the importance of tailored strategies.

Reliable identification and collection of cells from bodily fluids is of growing interest for monitoring patient response to therapy and for early detection of disease or its recurrence. We describe a detection platform that combines microfluidics with surface-enhanced Raman spectroscopy (SERS) for the identification of individual mammalian cells continuously flowing in a microfluidics channel. A mixture of cancerous and noncancerous prostate cells was incubated with SERS biotags (SBTs) developed and synthesized by us, then injected into a flow-focused microfluidic channel, which forces the cells into a single file. The spectrally rich SBTs are based on a silver nanoparticle dimer core labeled with a Raman-active small reporter molecule paired with an affinity biomolecule, providing a unique barcode whose presence in a composite SERS spectrum can be deconvoluted. Individual cancer cells passing through the focused laser beam were correctly identified among a proportionally larger number of other cells by their Raman signatures. We examine two deconvolution strategies: principal component analysis and classical least-squares. The deconvolution strategies are used to unmix the overall spectrum to determine the relative contributions between two SBT barcodes, where one SBT barcode indicates neuropilin-1 overexpression, while a second SBT barcode is more universal and indicates unspecific binding to a cell’s membrane. Highly reliable results were obtained for all of the cell mixture ratios tested, the lowest being 1 in 100 cells.

We present a microfluidic device that detects trace concentrations of drugs of abuse in saliva within minutes using surface-enhanced Raman spectroscopy (SERS). Its operation is demonstrated using methamphetamine. The detection scheme exploits concentration gradients of chemicals, fostered by the laminar flow in the device, to control the interactions between the analyte, silver nanoparticles (Ag-NPs), and a salt. Also, since all species interact while advecting downstream, the relevant reaction coordinates occur with respect to the position in the channel. The system was designed to allow the analyte first to diffuse into the side stream containing the Ag-NPs, on which it is allowed to adsorb, before salt ions are introduced, causing the Ag-NPs to aggregate, and so creating species with strong SERS signal. The device allows partial separation viadiffusion of the analyte from the complex mixture. Also, the reproducible salt-induced NP aggregation decouples the aggregation reaction (necessary for strong SERS) from the analyte concentration or charge. This method enables the creation of a region where detection of the analyte of interest viaSERS is optimal, and dramatically extends the classes of molecules and quality of signals that can be measured using SERS, compared to bulk solution methods. The spatial distribution of the SERS signals was used to map the degree of nanoparticle aggregation and species diffusion in the channel, which, together with numerical simulations, was used to describe the kinetics of the colloid aggregation reaction, and to determine the optimal location in the channel for SERS interrogation.

Background: Age is a strong independent predictor of outcomes after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Whether lower rates of reperfusion success contribute to the poor prognosis in elderly patients is unknown. Methods: A formal ST-segment analysis substudy was performed in 695 patients undergoing primary PCI for AMI in the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) trial. Reperfusion success (determined by the magnitude of ST-segment elevation resolution [STR] after PCI) was evaluated in 4 age groups: <50 years (n = 163), >=50 to <60 years (n = 187), >=60 to <70 years (n = 194), and >=70 years (n = 151). Results: There were no differences in the age groups for angiographic procedural success >91% in all, P = .6), postprocedural Thrombolysis in Myocardial Infarction grade 3 flow >94%, P = .8), and the proportions of patients with complete, partial, or absent STR (P >.8). However, rates of 30-day mortality (0.6%, 1.1%, 3.6%, 6.0%, respectively) and major adverse cardiac events (MACE; 2.5%, 4.8%, 6.2% 9.3%, respectively) increased with age. Rates of mortality and MACE were also inversely related to the magnitude of STR. Absent STR (hazard ratio, 3.00; 95% CI, 1.37-6.58; P = .006) and age (hazard ratio, 1.34; 95% CI, 1.01-1.77; P = .04) were independent predictors of 30-day MACE by using multivariable modeling. Conclusions: Lack of effective myocardial reperfusion is not a contributory mechanism responsible for the high morbidity and mortality rates observed in elderly patients. Nevertheless, advanced age and absent STR are both independent predictors of adverse outcomes after primary PCI, emphasizing the importance of successful reperfusion in the elderly population. .

The Royal College of Physicians and Surgeons of Canada (RCPSC) provides training objectives for cardiac catheterization and hemodynamics for adult cardiology training in Canada. We evaluated current core cardiology trainee perspectives on cardiac catheterization training across Canada and identified potential barriers to pursuing a career in interventional cardiology (IC).

A method for calculating microstrip discontinuities and T junctions is described, and a waveguide model for the microstrip line is defined. With the help of this model and the use of an orthogonal series expansion, a solution of the above problems is found. Numerical results for the scattering matrices of both the discontinuities and the junctions are given.

A new mixer/modulator for millimetre-wave applications is presented. The circuit is implemented with a combination of finlines, coplanar lines and microstrip lines. By applying the described mixer/modulator to millimetre-wave systems a twofold use of active elements such as the Gunn element and Schottky diodes is possible. The size of the whole planar structure is about 4 × 4 cm and there is no need for a variable short.

A planar waveguide model with a frequency-dependent effective relative permittivity and a frequency-dependent effective width is developed for the open microstrip line. The validity of this waveguide model is shown by experimental results from measurements with a resonator and a sliding-load technique.