[Surgical treatment of infective endocarditis: Surgical indications, complications, intrahospital and long-term mortality]. / Endocardites infectieuses opérées : indications chirurgicales, complications, mortalité intrahospitalière et à long terme.

BACKGROUND: In addition to medical treatment, half of the patients with infective endocarditis (IE) receive surgical treatment. Despite clear recommendations on the indications and the operating delays, the decision remains difficult and must take into consideration several factors. METHODS: A retrospective study was performed at Foch Hospital. All patients operated for IE between 2005 and 2018 were included. Patient characteristics, indications and operating delays, as well as intrahospital mortality, were noted. Patient follow-up was provided by phone calls. RESULTS: Fifty-two patients were operated on for IE between 2005 and 2018. The most frequent surgical indications were the presence of a massive symptomatic regurgitation, an uncontrolled infection and large vegetations with embolism. The average operative delay was 13.2 days with 56.5% of patients operated within the first 10 days. The most common postoperative complications were acute kidney injury (AKI) in 57.7% of cases, with 9.6% of dialysis, shock in 50% of cases, rhythm disorders in 40.4% of cases, infectious complications in 19.2% of cases, conductive disorders in 25% of cases, of which 17.3% require a definitive pacemaker implementation. The intrahospital mortality was 7.7% and the average length of hospital stay was 35 days. Survival at one year and 5 years was 95% and 85%, respectively. CONCLUSION: The indications and the operating delays were conformed to international recommendations. Intrahospital and long-term mortality rate was low.

An autonomous low-power management system for energy harvesting from a miniaturized spherical piezoelectric transducer.

A new spherical vibrational energy harvesting device with an additional low power management circuit for optimizing the power transfer from the mechanical vibrations to a storage capacitor is presented. The device is devoted to underwater wireless sensor network applications due to its broadband vibrational energy harvesting, sensing, and communicating facilities. The sensing node container consists of two acrylic glass (PMMA) half-spherical shells and a Pz26 piezoelectric ring clamped between the shells. The energy harvesting, the management circuit, and communication electronics were fitted within the hollow portion of the sphere. A simulation model of the energy extraction and management system using spice has been developed. This simulation shows the feasibility and efficiency of the low power extraction circuit; a level of the necessary stored voltage was set at 3 V. The numerical model was validated by underwater experimental measurements; a voltage of 3 V was obtained at the terminals of a storage capacitor (47 µF) which was sufficient to supply the communication electronics. Power harvesting performances were measured relative to the transmitter/sensor distance and the incident acoustical field excitation voltage. Finally, 175 µW of harvested power has been measured with an excitation voltage of 8 Vpp at 5 cm distance from the emitter.