The influence of the hot isostatic pressing (HIP) post-processing step on structural and phase changes, porosity healing and mechanical strength in a powder metallurgy Ti35Nb2Sn alloy was studied. Powders were pressed at room temperature at 750 MPa, and then sintered at 1,350°C in a vacuum for 3 h. The standard HIP process at 1,200°C and 150 MPa for 3 h was performed to study its effect on a Ti35Nb2Sn powder metallurgy alloy. The influence of the HIP process and cold rate on density, microstructure, the quantity of interstitial elements, mechanical strength and Young's modulus was investigated. HIP post-processing for 2 h at 1,200°C and 150 MPa led to greater porosity reduction and a marked retention of the β phase at room temperature. The slow cooling rate during the HIP process affected phase stability, with a large amount of α”-phase precipitate, which decreased the titanium alloy’s yield strength.

Aims: The objective of this study was to assess the cost-effectiveness of the CardioMEMS HF system in a HF Clinic in Spain by evaluating the real-time remote monitoring of pulmonary artery pressures, which has shown to reduce heart failure (HF) related hospitalizations and improve the quality of life for selected HF patients. Particularly, the study aimed to determine the value of CardioMEMS in Southern Europe, where healthcare costs are significantly lower and its effectiveness remains uncertain. Methods: This single-centre study enrolled all consecutive HF patients who had been implanted with a pulmonary artery pressure sensor (CardioMEMS-HF system, Abbott Laboratories, Abbott Park, IL, USA). The number of HF hospitalizations in the year before and the year after the sensor implantation was compared and quality-adjusted life years (QALY) gained based on a literature review of previous studies was calculated. Results: The rate of HF hospitalisations was significantly lower at 1 year compared with the year before CardioMEMS implantation (0.25 versus 1.10 events/patient-years, HR 0.22, p=0.001). At the end of first year, the usual management outperformed the CardioMEMS HF system, resulting in a net monetary value difference of 2,540€ per patient and a benefit-cost ratio of 0.38. However, by the end of the second year, the CardioMEMS system is estimated to reduce costs compared to usual management. Conclusions: Based on the results, we suggest that remote monitoring of pulmonary artery pressure with the CardioMEMS HF system represents a long-term cost-effective strategy in a healthcare setting in Southern Europe.