Objective:To define the in-hospital and 6-month post-discharge resource use, following Transcatheter Aortic Valve Implantation (TAVI) and conventional Aortic Valve Replacement (AVR) surgery within a single UK hospital.Methods:A local service evaluation of patients undergoing TAVI or AVR between January 2011 and May 2012 captured data until 6-months post-procedure, collected from hospital records and via a General Practitioner questionnaire. The main end-points were mortality, time in ITU/HDU, hospital length of stay (LoS), discharge destination, re-admission, and post-discharge primary/secondary care resource use. Sub-group analyses were performed for AVR patients aged ≥80 (AVR ≥ 80) and with EuroSCORE of ≥10 (AVR ES ≥ 10) to allow more direct comparison with ‘TAVI type’ patients.Results:Results are given as means (standard deviation) for TAVI (n = 51), AVR (n = 188), AVR ≥ 80 (n = 48), and AVR ES ≥ 10 (n = 47), respectively, unless otherwise stated. Age in years was 83.0 (8.1), 71.2 (13.1), 84.1 ...

Comparing post-operative resource consumption following transcatheter aortic valve implantation (TAVI) and conventional aortic valve replacement in the UK

As transcatheter aortic valve implantation (TAVI) becomes a standardised procedure with reproducible and excellent periprocedural, early and medium-term outcomes, it is opportune to question whether the time has come to simplify the TAVI procedure. In some centres, a minimalist approach to TAVI is already the standard of care. In this perspective, we share our experience and opinions on how and when we can simplify the TAVI procedure.

Is it time to simplify the TAVI procedure? "Make it simple but not too simple".

Optical coherence tomography (OCT) uses low coherence interferometry to obtain depth‐resolved tissue reflectivity profiles (M‐mode) and transverse beam scanning to create images of two‐dimensional tissue morphology (B‐mode). Endoscopic OCT imaging probes typically employ proximal or distal mechanical beam scanning mechanisms that increase cost, complexity, and size. Here, we demonstrate in the gastrointestinal (GI) tracts of unsedated human patients, that a passive, single‐fiber probe can be used to guide device placement, conduct device−tissue physical contact sensing, and obtain two‐dimensional OCT images via M‐to‐B‐mode conversion.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/lsm.23576

Passively scanned, single‐fiber optical coherence tomography probes for gastrointestinal devices

Minimally-invasive diagnosis and therapy have gradually become the trend and research hotspot of current medical applications. The integration of intraoperative diagnosis and treatment is a development important direction for real-time detection, minimally-invasive diagnosis and therapy to reduce mortality and improve the quality of life of patients, so called minimally-invasive theranostics (MIT). Light is an important theranostic tool for the treatment of cancerous tissues. Light-mediated minimally-invasive theranostics (LMIT) is a novel evolutionary technology that integrates diagnosis and therapeutics for the less invasive treatment of diseased tissues. Intelligent theranostics would promote precision surgery based on the optical characterization of cancerous tissues. Furthermore, MIT also requires the assistance of smart medical devices or robots. And, optical multimodality lay a solid foundation for intelligent MIT. In this review, we summarize the important state-of-the-arts of optical MIT or LMIT in oncology. Multimodal optical image-guided intelligent treatment is another focus. Intraoperative imaging and real-time analysis-guided optical treatment are also systemically discussed. Finally, the potential challenges and future perspectives of intelligent optical MIT are discussed.

pdf/the-lmit-light-mediated-minimally-invasive-theranostics-in-4k1qju47eh.pdf

The LMIT: Light-mediated minimally-invasive theranostics in oncology

Abstract To explore the clinical application value of optical coherence microscopy (OCM) in Hirschsprung’s disease. 109 HSCR patients were recuited in a Chinese hospital from January 2018 to July 2021. All the recruited patients underwent barium enema angiography preoperatively and the resected diseased intestinal tubes were evaluated intraoperatively. The OCM and the histopathological examination were performed successively on the surgical specimens, and the OCM images were compared with the relevant tissue sections to characterize different lesions. 10 non-HSCR fetal colorectal tissues at the same period were retained for OCM, the characteristics of which with and without HSCR under OCM imaging were analyzed. In the OCM images of in vitro tissue, it can be clearly observed that the scattering degree of HSCR narrow segment mucosal is high, glands and crypt structures are reduced or even atrophy, and the scattering degree of submucosal and intermuscular is low; In the dilated segment, the low scattering and high scattering are complex, and the muscle layer is obviously hypertrophy and structural disorder. Compared with the pathological findings, the OCM sensitivity, Kappa value, and AUC area reached 92.66%, 0.63, and 0.91, respectively. OCM can quickly and clearly display the structure of all layers of colorectal tissue, which is highly consistent with the corresponding histopathological examination results and has high sensitivity. which will provide a more reliable basis for OCM diagnosis of early HSCR, targeted biopsy and location of operative treatment, and has a certain potential for clinical application. 

/pdf/study-on-the-application-of-optical-coherence-microscopy-in-1lxjaqxw.pdf

Study on the application of optical coherence microscopy in Hirschsprung's disease

A Multidisciplinary, Multimodality But Minimalist (3M) Approach to Transfemoral Transcatheter Aortic Valve Replacement Facilitates Safe Next Day Discharge in High Risk Patients

We have previously demonstrated a miniaturized transnasal introduction tube (TNIT) for transnasal endomicroscopy (TNEM) with optical coherence tomography (OCT) for clinical imaging of the small intestine of infants and adults in vivo. Although the TNIT is a convenient and effective way to implement TNEM, OCT probes for imaging through the TNIT had long manufacturing times and low yields, and its multiple cylindrical surfaces caused severe optical aberrations, degrading OCT image quality. Here we introduce a new optical design for 3D-printed microoptics that correct TNIT-induced astigmatism. Preliminary results show that the lens improves resolution and can be reliably manufactured. 

3D printed micro-optics for astigmatism correction in catheter-based endoscopic imaging

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Passively scanned, single‐fiber optical coherence tomography probes for gastrointestinal devices

A Multidisciplinary, Multimodality But Minimalist (3M) Approach to Transfemoral Transcatheter Aortic Valve Replacement Facilitates Safe Next Day Discharge in High Risk Patients

3D printed micro-optics for astigmatism correction in catheter-based endoscopic imaging