University College Hospital at Westmoreland Street, named The Heart Hospital until refurbished and renamed in 2015, was a specialist cardiac hospital located in London, United Kingdom until 2015. It is part of the University College London Hospitals NHS Foundation Trust and is closely associated with University College London (UCL). After the 2015 refurbishment the hospital now provides thoracic surgery, and urology services.Before the 2015 refurbishment the Heart Hospital conducted over 1,000 surgical heart operations each year, had 95 in-patient beds, and was one of the largest cardiac centres in the UK. It treated around 1,700 new outpatients, 5,500 follow-up outpatients and 1,200 inpatients each year. It was a centre for cardiac research, home to the UCL Centre for Cardiology in the Young, and part of the UCLH/UCL Biomedical Research Centre and the UCL Partners academic health science centre.
Bearings play a critical role in rotating machinery, making it essential to monitor their operational states to ensure machine reliability and safety. Performance degradation assessment is a key aspect of condition based maintenance (CBM) and predictive maintenance strategies. Predicting the Remaining Useful Life (RUL) of a bearing is crucial for effective health management and ensuring the safety and reliability of rotating machinery systems. With stringent demands on performance, cost, and safety, there is a growing need to develop and enhance techniques for predicting RUL. To enhance the accuracy of RUL prediction, this study presents a data-driven approach for RUL prediction, demonstrating superior performance compared to existing methods. The novelty of the proposed model lies in the fusion of entropy-based statistical features with energy-based wavelet features, a combination that remains underexplored in the context of RUL estimation. This feature integration strategy effectively captures both the statistical complexity and spectral energy distribution of the vibration signals, leading to incremental improvements in prediction accuracy, as validated by our experimental results. Specifically, employing two types of features from wavelet transform, first localized energy distribution through reconstructed wavelet packets and second statistical descriptors from multi-level wavelet decomposition, enabling comprehensive signal characterisation for degradation tracking along. Furthermore, a long short-term memory (LSTM) is employed to effectively capture and analyze fault propagation dynamics for improved bearing perfor- mance degradation assessment. To validate the effectiveness of the proposed approach, experimental evaluations are performed using two widely recognized run-to-failure bearing datasets: PRONOSTIA and XJTU-SY.
Advanced heart failure (HF) remains a growing clinical challenge, while the limited availability of donor organs has increased the importance of mechanical circulatory support (MCS) as a therapeutic option. Patient selection for MCS implantation, together with decisions regarding the optimal timing and choice of device, has become one of the most critical issues in contemporary heart failure management. Despite robust evidence demonstrating significant improvements in survival and quality of life following implantation of durable mechanical circulatory support (dMCS) devices, only a small proportion of eligible patients receive this therapy in many countries, including Bulgaria. The reasons are multifactorial and include death before referral, advanced irreversible end-organ dysfunction, socioeconomic barriers, and patient refusal. Decision-making is highly complex because every candidate presents unique clinical characteristics requiring comprehensive diagnostic evaluation and preoperative optimization. Final patient selection should be based on structured multidisciplinary discussion within a specialized advanced heart failure team, following clearly defined principles and evidence-based recommendations. The aim of this review is to provide a practical framework for clinicians involved in the management of advanced heart failure, enabling appropriate assessment of individual patient characteristics, definition of the therapeutic intent of durable mechanical circulatory support, and determination of the optimal timing for device implantation.
Primary mediastinal tumors in children are extremely rare, consisting of under 0.1% of neoplasms in this age group. Of these, teratomas represent 8%–16% of the cases. Clinical presentation depends primarily on the tumor’s size, location, malignancy, and growth rate. Large tumor masses may compress structures in the thorax and cause respiratory distress syndrome, superior vena cava syndrome, or cardiac tamponade. This report describes a neonate with respiratory distress and heart failure shortly after birth due to a large mediastinal tumor mass. The child underwent successful surgery and has no signs of relapse during the 2-year follow-up. A complex approach and a multidisciplinary team are the cornerstone in the treatment of neonates with mediastinal tumors. Complete tumor resection is the gold standard treatment.
We report the case of a boy diagnosed at age 9 with a large aortopulmonary septal defect and Eisenmenger syndrome, highlighting the challenges of late diagnosis and management of fixed pulmonary hypertension. Over the course of six years (2018–2024), the patient underwent several follow-ups, including invasive hemodynamic assessments and echocardiography, revealing progressive pulmonary vascular disease. Despite the administration of medical therapy with sildenafil, bosentan, and antiplatelets, the patient’s condition remained unfavorable due to fixed pulmonary vascular obstructive disease. This case underscores the importance of early diagnosis and the complexities of managing advanced pulmonary hypertension in congenital heart defects.
Drug therapy is a mandatory component of the treatment of patients with acute and chronic aortic syndromes, regardless of the chosen therapeutic approach (surgical, endovascular, or conservative). In the acute phase, it aims to control pain, heart rate, and arterial blood pressure, while in the long-term it seeks to slow disease progression and potentially prevent aortic rupture. This review focuses on the therapeutic goals in aortic diseases, the medications used, and the evidence currently available. Attention is also given to the importance of lifestyle modifi cations, as well as recommendations for follow-up using various imaging modalities.
