RESUMO
PURPOSE: There are many causes of heart failure, one of them being valvular heart disease. In this case, the stage and type of the disease can significantly affect the hemodynamic parameters of the left ventricle of the heart. In turn, these parameters can significantly influence the mode, type and strategy of clinical treatment. The aim of the study was to analyze and map the hydrodynamic conditions of the heart using a hybrid-digital model of the circulatory system. METHODS: The tests performed using the circulatory system model allowed for the simulation of the failure of both heart's left ventricle and a set of arteries in the systemic circulation. Furthermore, the changes in hemodynamic parameters for valvular anomalies at various heartbeats were obtained. RESULTS: The results suggested that a higher heartbeat should be sustained in such cases of complex mitral-aortic anomalies in the clinical practice. When observing low aortic pressures, heartbeat should be increased to compensate for the valvular insufficiencies. CONCLUSIONS: Extending the already conducted research could result in constituting a wide database for clinicians who are treating the insufficiency of the left ventricle of the heart. Moreover, the information included in this paper may be used for a comparison of the clinical anomalies, which facilitates a correct diagnosis. The test-stand used in the research can be applied to predict the anomalies of the circulation system for a quick and precise analysis of a clinical anomaly of a patient without physical presence.
RESUMO
OBJECTIVE: To describe the successful, clinical use of the Angel(®) Catheter, a device used for the prevention of pulmonary embolism (PE) and central venous access in a critically ill, multi-trauma patient. METHODS: Authors report the case of a 35-year-old man, in critical condition with multiple trauma injuries sustained from a fall, who was admitted to the Department of Rescue Medicine and Multiorgan Trauma in Krakow, Poland. RESULTS: Anticoagulation was interrupted due to the risk of intraoperative bleeding. Due to the continued presence of multiple VTE risk factors, the Angel(®) Catheter was placed at the bedside for the prevention of PE. At the time of removal, a CT scan demonstrated a filling defect, consistent with a fine emboli caught inside the filter. After removal, thrombus was found lodged in the tip of the catheter filter. CONCLUSIONS: The Angel(®) Catheter protected this critically ill, multi-trauma patient from PE at a time when current methods otherwise used for the prevention of venous thromboembolism (VTE), specifically antithrombotic pharmacologic agents and mechanical compression, were contraindicated due to the patient's complex clinical condition. Unlike other invasive techniques used for the prevention of PE, the Angel(®) Catheter also provided the convenience and expedience of bedside placement, eliminating the mandatory involvement of interventional radiologists or vascular surgeons, the need for specialised equipment, and movement of the patient which delay the procedure, increasing the risk of thromboembolic events.
