(J Vasc Surg 2012; 55: 1187-95.)”
“Probability

theory has long been taken as the self-evident norm against which to evaluate inductive reasoning, and classical demonstrations MDV3100 in vivo of violations of this norm include the conjunction error and base-rate neglect. Many of these phenomena require multiplicative probability integration, whereas people seem more inclined to linear additive integration, in part, at least, because of well-known capacity constraints on controlled thought. In this article, the authors show with computer simulations that when based on approximate knowledge of probabilities, as is routinely the case in natural environments, linear additive integration can yield as accurate estimates, and as good average decision returns, as estimates based on probability theory. It is proposed that in natural environments people have little opportunity or incentive to induce the normative rules of probability theory and, given their cognitive constraints, linear additive integration may often offer superior bounded rationality.”
“Objective: Controlled hypotension is critical for precise deployment of endografts in the thoracic aorta and for safe balloon dilation after deployment. We describe a novel approach to rapid right ventricular pacing using a pulmonary artery catheter (PAC) that is placed during the procedure

Selleck Danusertib for hemodynamic monitoring.

Methods: The study included 27 patients (20 men and seven women), with a mean age of 74 years, who underwent endograft placement in the thoracic aorta with PAC-directed rapid right ventricular pacing. Hemodynamic parameters, accuracy of deployment, complications related to rapid right ventricular pacing and PAC placement, presence of endoleaks, and postoperative complications were evaluated.

Results: PAC-directed rapid right ventricular pacing was performed during endograft deployment and balloon dilation after deployment without technical difficulty.

Each patient underwent a median of two pacing episodes (range, 1-4). The length of each pacing episode was a mean of 11 seconds (range, 8-14 seconds). Mean pacing rate ALOX15 was 170 +/- 15 beats/min, which achieved an average mean arterial pressure (MAP) of 42 +/- 8 mm Hg. After pacing cessation, the recovery time of MAP to prepacing levels was <5 seconds (mean, 2 seconds) in all but one patient. All endografts were precisely deployed at a mean of 2 mm from the intended placement site, and there was no unintentional branch vessel coverage. One patient with severe valvular heart disease died. There were nine endoleaks, one postoperative stroke (4%), and one access wound hematoma (4%).

Conclusions: PAC-directed rapid right ventricular pacing is an effective method of inducing hypotension, enabling precise thoracic endograft deployment and safe balloon dilation after deployment.