Displaying publications 321 - 340 of 981 in total

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  1. Lim YP, Yahya N, Izaham A, Kamaruzaman E, Zainuddin MZ, Wan Mat WR, et al.
    Turk J Med Sci, 2018 Dec 12;48(6):1219-1227.
    PMID: 30541250 DOI: 10.3906/sag-1802-126
    Background/aim: Regional anesthesia for surgery is associated with increased anxiety for patients. This study aimed to compare the
    effect of propofol and dexmedetomidine infusion on perioperative anxiety during regional anesthesia.

    Materials and methods: Eighty-four patients were randomly divided into two groups receiving either study drug infusion. Anxiety
    score, level of sedation using the Bispectral Index and Observer’s Assessment of Alertness and Sedation, hemodynamic stability, and
    overall patient’s feedback on anxiolysis were assessed.

    Results: Both groups showed a significant drop in mean anxiety score at 10 and 30 min after starting surgery. Difference in median
    anxiety scores showed a significant reduction in anxiety score at the end of the surgery in the dexmedetomidine group compared to the
    propofol group. Dexmedetomidine and propofol showed a significant drop in mean arterial pressure in the first 30 min and first 10 min
    respectively. Both drugs demonstrated a significant drop in heart rate in the first 20 min from baseline after starting the drug infusion.
    Patients in the dexmedetomidine group (76.20%) expressed statistically excellent feedback on anxiolysis compared to patients in the
    propofol group (45.20%).

    Conclusion: Dexmedetomidine infusion was found to significantly reduce anxiety levels at the end of surgery compared to propofol
    during regional anesthesia.

    Matched MeSH terms: Heart Rate
  2. Steffens S, Schröder K, Krüger M, Maack C, Streckfuss-Bömeke K, Backs J, et al.
    Clin Res Cardiol, 2024 May;113(5):672-679.
    PMID: 37847314 DOI: 10.1007/s00392-023-02303-3
    The sharing and documentation of cardiovascular research data are essential for efficient use and reuse of data, thereby aiding scientific transparency, accelerating the progress of cardiovascular research and healthcare, and contributing to the reproducibility of research results. However, challenges remain. This position paper, written on behalf of and approved by the German Cardiac Society and German Centre for Cardiovascular Research, summarizes our current understanding of the challenges in cardiovascular research data management (RDM). These challenges include lack of time, awareness, incentives, and funding for implementing effective RDM; lack of standardization in RDM processes; a need to better identify meaningful and actionable data among the increasing volume and complexity of data being acquired; and a lack of understanding of the legal aspects of data sharing. While several tools exist to increase the degree to which data are findable, accessible, interoperable, and reusable (FAIR), more work is needed to lower the threshold for effective RDM not just in cardiovascular research but in all biomedical research, with data sharing and reuse being factored in at every stage of the scientific process. A culture of open science with FAIR research data should be fostered through education and training of early-career and established research professionals. Ultimately, FAIR RDM requires permanent, long-term effort at all levels. If outcomes can be shown to be superior and to promote better (and better value) science, modern RDM will make a positive difference to cardiovascular science and practice. The full position paper is available in the supplementary materials.
    Matched MeSH terms: Heart
  3. Cimr D, Busovsky D, Fujita H, Studnicka F, Cimler R, Hayashi T
    Comput Methods Programs Biomed, 2023 Sep;239:107623.
    PMID: 37276760 DOI: 10.1016/j.cmpb.2023.107623
    BACKGROUND AND OBJECTIVES: Prediction of patient deterioration is essential in medical care, and its automation may reduce the risk of patient death. The precise monitoring of a patient's medical state requires devices placed on the body, which may cause discomfort. Our approach is based on the processing of long-term ballistocardiography data, which were measured using a sensory pad placed under the patient's mattress.

    METHODS: The investigated dataset was obtained via long-term measurements in retirement homes and intensive care units (ICU). Data were measured unobtrusively using a measuring pad equipped with piezoceramic sensors. The proposed approach focused on the processing methods of the measured ballistocardiographic signals, Cartan curvature (CC), and Euclidean arc length (EAL).

    RESULTS: For analysis, 218,979 normal and 216,259 aberrant 2-second samples were collected and classified using a convolutional neural network. Experiments using cross-validation with expert threshold and data length revealed the accuracy, sensitivity, and specificity of the proposed method to be 86.51 CONCLUSIONS: The proposed method provides a unique approach for an early detection of health concerns in an unobtrusive manner. In addition, the suitability of EAL over the CC was determined.

    Matched MeSH terms: Heart Rate
  4. Sapapsap B, Srisawat C, Suthumpoung P, Luengrungkiat O, Leelakanok N, Saokaew S, et al.
    Medicine (Baltimore), 2022 Sep 09;101(36):e30388.
    PMID: 36086772 DOI: 10.1097/MD.0000000000030388
    BACKGROUND: Patients who had mechanical heart valves and an international normalized ratio (INR) of >5.0 should be managed by temporary cessation of vitamin K antagonist. This study aimed to investigate the safety of low-dose vitamin K1 in patients with mechanical heart valves who have supratherapeutic INR.

    METHODS: CINAHL, Cochran Library, Clinical trial.gov, OpenGrey, PubMed, ScienceDirect, and Scopus were systematically searched from the inception up to October 2021 without language restriction. Studies comparing the safety of low-dose vitamin K1 treatment in patients with placebo or other anticoagulant reversal agents were included. We used a random-effect model for the meta-analysis. Publication bias was determined by a funnel plot with subsequent Begg's test and Egger's test.

    RESULTS: From 7529 retrieved studies, 3 randomized control trials were included in the meta-analysis. Pooled data demonstrated that low-dose vitamin K was not associated with thromboembolism rate (risk ratio [RR] = 0.94; 95% CI: 0.19-4.55) major bleeding rate (RR = 0.58; 95% CI: 0.07-4.82), and minor bleeding rate (RR = 0.60; 95% CI: 0.07-5.09). Subgroup and sensitivity analysis demonstrated the nonsignificant effect of low-dose vitamin K on the risk of thromboembolism. Publication bias was not apparent, according to Begg's test and Egger's test (P = .090 and 0.134, respectively).

    CONCLUSION: The current evidence does not support the role of low-dose vitamin K as a trigger of thromboembolism in supratherapeutic INR patients with mechanical heart valves. Nevertheless, more well-designed studies with larger sample sizes are required to justify this research question.

    Matched MeSH terms: Heart Valves
  5. Tromp J, Teng TH, Tay WT, Hung CL, Narasimhan C, Shimizu W, et al.
    Eur J Heart Fail, 2019 01;21(1):23-36.
    PMID: 30113120 DOI: 10.1002/ejhf.1227
    BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a global public health problem. Unfortunately, little is known about HFpEF across Asia.

    METHODS AND RESULTS: We prospectively studied clinical characteristics, echocardiographic parameters and outcomes in 1204 patients with HFpEF (left ventricular ejection fraction ≥50%) from 11 Asian regions, grouped as Northeast Asia (Hong Kong, Taiwan, China, Japan, Korea, n = 543), South Asia (India, n = 252), and Southeast Asia (Malaysia, Thailand, Singapore, Indonesia, Philippines, n = 409). Mean age was 68 ±12 years (37% were heart failure within 1 year. Southeast Asians were at higher risk for adverse outcomes, independent of co-morbidity burden and cardiac geometry.

    CONCLUSION: These first prospective multinational data from Asia show that HFpEF affects relatively young patients with a high burden of co-morbidities. Regional differences in types of co-morbidities, cardiac remodelling and outcomes of HFpEF across Asia have important implications for public health measures and global HFpEF trial design.
    Matched MeSH terms: Heart Failure/diagnosis; Heart Failure/epidemiology*; Heart Failure/physiopathology
  6. Tomitani N, Hoshide S, Buranakitjaroen P, Chia YC, Park S, Chen CH, et al.
    J Clin Hypertens (Greenwich), 2021 03;23(3):606-613.
    PMID: 33694262 DOI: 10.1111/jch.14239
    Increased heart rate is a predictor of cardiovascular disease, heart failure, and all-cause mortality. In those with high heart rates, interventions for heart rate reduction have been associated with reductions in coronary events. Asia is a diverse continent, and the prevalences of hypertension and cardiovascular disease differ among its countries. The present analysis of AsiaBP@Home study data investigated differences among resting heart rates (RHRs) in 1443 hypertensive patients from three Asian regions: East Asia (N = 595), Southeast Asia (N = 680), and South Asia (N = 168). This is the first study to investigate self-measured RHR values in different Asian countries/regions using the same validated home BP monitoring device (Omron HEM-7130-AP/HEM-7131-E). Subjects in South Asia had higher RHR values compared with the other two regions, and the regional tendency found in RHR values was different from that found in BP values. Even after adjusting for age, sex, BMI, habitual alcohol consumption, current smoking habit, shift worker, hyperlipidemia, diabetes, chronic kidney disease, history of heart failure, and beta-blocker use, both office and home RHR values in South Asia were the highest among Asia (mean values ± SE of office: East Asia [E] 75.2 ± 1.5 bpm, Southeast Asia [Se] 76.7 ± 1.5 bpm, South Asia [S] 81.9 ± 1.4 bpm; home morning: [E] 69.0 ± 1.2 bpm, [Se] 72.9 ± 1.2 bpm, [S] 74.9 ± 1.1 bpm; home evening: [E] 74.6 ± 1.2 bpm, [Se] 78.3 ± 1.2 bpm, [S] 83.8 ± 1.1 bpm). Given what is known about the impact of RHR on heart disease, our findings suggest the possible benefit of regionally tailored clinical strategies for cardiovascular disease prevention.
    Matched MeSH terms: Heart Rate
  7. Jeevaratnam K, Chadda KR, Huang CL, Camm AJ
    J Cardiovasc Pharmacol Ther, 2018 03;23(2):119-129.
    PMID: 28946759 DOI: 10.1177/1074248417729880
    The development of novel drugs specifically directed at the ion channels underlying particular features of cardiac action potential (AP) initiation, recovery, and refractoriness would contribute to an optimized approach to antiarrhythmic therapy that minimizes potential cardiac and extracardiac toxicity. Of these, K+ channels contribute numerous and diverse currents with specific actions on different phases in the time course of AP repolarization. These features and their site-specific distribution make particular K+ channel types attractive therapeutic targets for the development of pharmacological agents attempting antiarrhythmic therapy in conditions such as atrial fibrillation. However, progress in the development of such temporally and spatially selective antiarrhythmic drugs against particular ion channels has been relatively limited, particularly in view of our incomplete understanding of the complex physiological roles and interactions of the various ionic currents. This review summarizes the physiological properties of the main cardiac potassium channels and the way in which they modulate cardiac electrical activity and then critiques a number of available potential antiarrhythmic drugs directed at them.
    Matched MeSH terms: Heart Diseases/drug therapy; Heart Diseases/metabolism*; Heart Diseases/physiopathology
  8. Kunasegaran K, Ismail AMH, Ramasamy S, Gnanou JV, Caszo BA, Chen PL
    PeerJ, 2023;11:e15744.
    PMID: 37637168 DOI: 10.7717/peerj.15744
    Mental fatigue has shown to be one of the root causes of decreased productivity and overall cognitive performance, by decreasing an individual's ability to inhibit responses, process information and concentrate. The effects of mental fatigue have led to occupational errors and motorway accidents. Early detection of mental fatigue can prevent the escalation of symptoms that may lead to chronic fatigue syndrome and other disorders. To date, in clinical settings, the assessment of mental fatigue and stress is done through self-reported questionnaires. The validity of these questionnaires is questionable, as they are highly subjective measurement tools and are not immune to response biases. This review examines the wider presence of mental fatigue in the general population and critically compares its various detection techniques (i.e., self-reporting questionnaires, heart rate variability, salivary cortisol levels, electroencephalogram, and saccadic eye movements). The ability of these detection tools to assess inhibition responses (which are sensitive enough to be manifested in a fatigue state) is specifically evaluated for a reliable marker in identifying mentally fatigued individuals. In laboratory settings, antisaccade tasks have been long used to assess inhibitory control and this technique can potentially serve as the most promising assessment tool to objectively detect mental fatigue. However, more studies need to be conducted in the future to validate and correlate this assessment with other existing measures of mental fatigue detection. This review is intended for, but not limited to, mental health professionals, digital health scientists, vision researchers, and behavioral scientists.
    Matched MeSH terms: Heart Rate
  9. Yusoff K, Khalid BA
    Ann Acad Med Singap, 1993 Jul;22(4):609-12.
    PMID: 8257070
    Cardiac arrhythmias are common in patients with thyrotoxicosis. Conduction abnormalities have been seen in a few thyrotoxic patients, but these, in particular high grade atrioventricular (AV) block, often occur in the presence of other conditions. Three thyrotoxic patients with conduction abnormalities are described: two were associated with severe hypokalaemia and the third had congestive cardiac failure. Conditions predisposing to conduction abnormality should be identified when this occurs in a thyrotoxic patient as their correction may help resolve or explain the conduction abnormality.
    Matched MeSH terms: Heart Block/physiopathology*; Heart Failure/physiopathology
  10. Chan BT, Abu Osman NA, Lim E, Chee KH, Abdul Aziz YF, Abed AA, et al.
    PLoS One, 2013;8(6):e67097.
    PMID: 23825628 DOI: 10.1371/journal.pone.0067097
    Dilated cardiomyopathy (DCM) is the most common myocardial disease. It not only leads to systolic dysfunction but also diastolic deficiency. We sought to investigate the effect of idiopathic and ischemic DCM on the intraventricular fluid dynamics and myocardial wall mechanics using a 2D axisymmetrical fluid structure interaction model. In addition, we also studied the individual effect of parameters related to DCM, i.e. peak E-wave velocity, end systolic volume, wall compliance and sphericity index on several important fluid dynamics and myocardial wall mechanics variables during ventricular filling. Intraventricular fluid dynamics and myocardial wall deformation are significantly impaired under DCM conditions, being demonstrated by low vortex intensity, low flow propagation velocity, low intraventricular pressure difference (IVPD) and strain rates, and high-end diastolic pressure and wall stress. Our sensitivity analysis results showed that flow propagation velocity substantially decreases with an increase in wall stiffness, and is relatively independent of preload at low-peak E-wave velocity. Early IVPD is mainly affected by the rate of change of the early filling velocity and end systolic volume which changes the ventriculo:annular ratio. Regional strain rate, on the other hand, is significantly correlated with regional stiffness, and therefore forms a useful indicator for myocardial regional ischemia. The sensitivity analysis results enhance our understanding of the mechanisms leading to clinically observable changes in patients with DCM.
    Matched MeSH terms: Heart Ventricles/pathology*; Heart Ventricles/physiopathology*
  11. Nik Muhamad NA, Nidzwani S
    Med J Malaysia, 2012 Jun;67(3):278-83.
    PMID: 23082417 MyJurnal
    Cardiopulmonary resuscitation (CPR) has been standard treatment for all cardiac arrest patients that arrive at the Emergency Department. However it is unclear whether prolonging resuscitation among the elderly victims will provide any benefit or improve outcome. This study is to evaluate factors that can influence outcome of CPR among the elderly, such as time of arrest, duration of CPR, lactate levels and age (among elderly age groups). 89 patients fit the inclusion criteria from January 2007 to January 2009, and all underwent CPR. Lactate levels (p=0.047) and duration of CPR performed (p=0.019) had significant relation to outcome. Time of arrest to CPR and age had no significance. Of 89 patients studied, 4 (4.5%) survived to hospital discharge. The remaining 85 (95.5%) died either in the emergency department, the wards or the Intensive Care Unit. Among the survivors, only 2 (2.3%) functional (independent on activities of daily life) patients were identified. Among the survivors, the mean lactate level was 4.0 mmol/L. The mean lactate levels among the dead were 9.84 mmol/L. The mean length of CPR among the survivors was 5.42 minutes and for the non-survivors, 19.28 minutes. This study reports certain factors such as duration of resuscitation and initial lactate levels that can be valuable tools in decision making when resuscitating an elderly.
    Matched MeSH terms: Heart Arrest/blood; Heart Arrest/therapy*
  12. Azian AA, Roslani AL
    Med J Malaysia, 2011 Dec;66(5):510-2.
    PMID: 22390115 MyJurnal
    An acardiac twin is rare and the diagnosis is commonly achieved from antenatal ultrasound (US) scans. However there have been cases where the appearances of the acardiac twin can be confusing and mimics a mass or tumour, for example, a teratoma. We experienced a case where the findings were unclear from the antenatal ultrasound scans and we had to resort to Magnetic Resonance Imaging (MRI), where we finally made the correct diagnosis based on the identification of two umbilical cords, supplying the normal fetus and the 'mass' (acardiac twin) respectively.
    Matched MeSH terms: Heart Defects, Congenital/diagnosis*; Heart Defects, Congenital/ultrasonography
  13. Sadiq MA, Azman W, Abidin IZ
    J Invasive Cardiol, 2012 Jan;24(1):E13-5.
    PMID: 22210591
    Permanent complete heart block (CHB) secondary to the loss of first septal perforator after percutaneous coronary intervention (PCI) of the left descending artery (LAD) is an extremely rare complication. We describe a case report where a patient underwent PCI of proximal LAD, complicated by loss of first septal perforator, septal infarction, and bifasicular block, which progressed to symptomatic delayed CHB. One week later, the patient required implantation of a permanent pacemaker following failure to wean off the transvenous temporary pacing maker.
    Matched MeSH terms: Heart Block/etiology*; Heart Block/therapy
  14. Moein S
    Adv Exp Med Biol, 2010;680:109-16.
    PMID: 20865492 DOI: 10.1007/978-1-4419-5913-3_13
    In this paper, application of Artificial Neural Network (ANN) for electrocardiogram (ECG) signal noise removal has been investigated. First, 100 number of ECG signals are selected from Physikalisch-Technische Bundesanstalt (PTB) database and Kalman filter is applied to remove their low pass noise. Then a suitable dataset based on denoised ECG signal is configured and used to a Multilayer Perceptron (MLP) neural network to be trained. Finally, results and experiences are discussed and the effect of changing different parameters for MLP training is shown.
    Matched MeSH terms: Heart Diseases/diagnosis; Heart Diseases/physiopathology
  15. Ngow HA, Wan Khairina WM
    Pathol Oncol Res, 2011 Sep;17(3):771-4.
    PMID: 21213128 DOI: 10.1007/s12253-010-9328-9
    A 15 year-old adolescent was referred with 2 month history of worsening of breathlessness and haemoptysis. He also reported constitutional symptoms of fever, poor appetite and weight loss. The chest roentgenogram showed a massive right pleural effusion with apparent cardiomegaly. The cardiac silhouette over the right heart border was obliterated and the mediastinum was widened. Computed tomogram of the thorax showed a bulky heterogeneous mass in the right lung with extension to the heart. Subsequent CT guided lung biopsy revealed Primitive Neuroectodermal tumour (PNET). Here, we illustrate the clinical course of an aggressive pulmonary PNET with lethal cardiac metastasis.
    Matched MeSH terms: Heart Neoplasms/secondary*; Heart Neoplasms/therapy
  16. Bilgen M
    Australas Phys Eng Sci Med, 2010 Dec;33(4):357-66.
    PMID: 21110236 DOI: 10.1007/s13246-010-0039-z
    Homogenous strain analysis (HSA) was developed to evaluate regional cardiac function using tagged cine magnetic resonance images of heart. Current cardiac applications of HSA are however limited in accurately detecting tag intersections within the myocardial wall, producing consistent triangulation of tag cells throughout the image series and achieving optimal spatial resolution due to the large size of the triangles. To address these issues, this article introduces a harmonic phase (HARP) interference method. In principle, as in the standard HARP analysis, the method uses harmonic phases associated with the two of the four fundamental peaks in the spectrum of a tagged image. However, the phase associated with each peak is wrapped when estimated digitally. This article shows that special combination of wrapped phases results in an image with unique intensity pattern that can be exploited to automatically detect tag intersections and to produce reliable triangulation with regularly organized partitioning of the mesh for HSA. In addition, the method offers new opportunities and freedom for evaluating myocardial function when the power and angle of the complex filtered spectra are mathematically modified prior to computing the phase. For example, the triangular elements can be shifted spatially by changing the angle and/or their sizes can be reduced by changing the power. Interference patterns obtained under a variety of power and angle conditions were presented and specific features observed in the results were explained. Together, the advanced processing capabilities increase the power of HSA by making the analysis less prone to errors from human interactions. It also allows strain measurements at higher spatial resolution and multi-scale, thereby improving the display methods for better interpretation of the analysis results.
    Matched MeSH terms: Heart/anatomy & histology*; Heart/physiology*
  17. Abdullah HN, Khairina WW
    South. Med. J., 2008 Oct;101(10):1035-7.
    PMID: 18791521 DOI: 10.1097/SMJ.0b013e31817fbeb8
    Atrial myxoma is rarely seen in practice. We report a 67-year-old female who presented with acute cardiac insufficiency and pulmonary edema. Cardiac murmur was not detected on precordial examination. Urgent echocardiography, however, revealed atrial myxoma causing mitral valve obstruction. We point out that a normal cardiac examination does not exclude atrial myxoma. The diagnosis may be delayed until significant myocardial dysfunction occurs, as reported here. The clinical presentation of cardiac myxoma is discussed, along with appropriate investigations and treatment.
    Matched MeSH terms: Heart Neoplasms/complications*; Heart Neoplasms/ultrasonography
  18. Lean QY, Shamsuddin N, Wan Ahmad WA
    Med J Malaysia, 2008 Aug;63(3):216-21.
    PMID: 19248693 MyJurnal
    There are well-established guidelines regarding the use of Angiotensin converting enzyme inhibitors (ACEI) in the management of heart failure (HF). In-spite of that, many studies has documented underutilization of ACEI. Thus, this retrospective observational study aimed to evaluate the utilization of ACEI, to identify the pattern of ACEI use and the factors that might contribute to underutilization of ACEI. The target population was hospitalized HF patients in University Malaya Medical Centre (UMMC). Of 321 hospitalized HF patients, only 57% of them were treated with ACEI. 51.2% of the patients treated with ACEI received low dose (< or = 25% from target dose) at discharge. Factors that have significant association with the underutilization of ACEI included serum potassium and creatinine, chronic renal failure and other concurrent medications used (frusemide, aspirin, potassium chloride, calcium channel blockers and angiotensin receptor blockers). The findings indicated that the utilization of ACEI in the management of HF in UMMC is considerably low.
    Matched MeSH terms: Heart Failure/complications; Heart Failure/drug therapy*
  19. Alwi M
    Ann Pediatr Cardiol, 2008 Jan;1(1):38-45.
    PMID: 20300236 DOI: 10.4103/0974-2069.41054
    Ductal stenting is an attractive alternative to conventional shunt surgery in duct dependent congenital heart disease as it avoids thoracotomy and its related problems. With today's generation of coronary stents which have better profile, flexibility and trackability, ductal stenting may be achieved safely and with considerably less difficulty than previously described.As in Blalock-Taussig (BT) shunt, ductal stenting is indicated mainly in duct-dependent cyanotic lesions chiefly in the neonatal period. Unlike the Patent ductus arteriosus (PDA) as an isolated lesion, the ductus in cyanotic heart disease has a remarkable morphologic variability. The ductus tends to arise more proximally under the aortic arch, giving rise to a vertical ductus or occasionally it may arise from the subclavian artery. It also tends to be long and sometimes very tortuous, rendering stent implantation technically impossible. The ductus in these patients may also insert onto one of the branch pulmonary arteries with some stenosis at the site of insertion. The ductus in Tetralogy of Fallot with pulmonary atresia (TOF-PA) tend to exhibit these morphologic features and to a lesser degree in transposition of great arteries with ventricular septal defect and pulmonary atresia (TGA-VSD-PA) and the more complex forms of univentricular hearts. In the preliminary angiographic evaluation, it is important to delineate these morphologic features as the basis for case selection.Ductal stenting may be done by the retrograde femoral artery route or the antegrade transvenous route depending on the ductus morphology and the underlying cardiac lesion. The detailed techniques and essential hardware are described. Finally, major potential complications of the procedure are described. Acute stent thrombosis is the most serious and potentially catastrophic. Emergent treatment with thrombolytic therapy and mechanical disruption of thrombus are required. With proper case selection, appropriate technique and the right hardware ductal stenting provides reasonable short-medium term palliation in duct-dependent cyanotic heart disease.
    Matched MeSH terms: Heart Defects, Congenital; Heart Septal Defects; Heart Septal Defects, Ventricular
  20. Loch A, Sadiq MA, Wan Ahmad WA
    Eur Heart J, 2013 Apr;34(13):981.
    PMID: 23391585 DOI: 10.1093/eurheartj/eht021
    Matched MeSH terms: Heart Atria; Heart Valve Prosthesis*
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