Surgical therapy can be mostly avoided unless pathomorphological diagnosis remains unclear. In all, the aim was to deploy the stent graft just above the target vessel coeliac trunk, mesenteric superior or renal artery. This ischaemia—reperfusion injury results in local as well as systemic complications. However, it can be reduced or even prevented by controlling pO2 to normoxic 100 mmHg or hypoxic levels 20—30 mmHg when starting cardiopulmonary bypass and by subsequent reoxygenation with normoxic, substrate-enriched, hypocalaemic, alkalotic warm blood cardioplegic introduction controlled reoxygenation. There is an opportunity for intervention to prevent death if controlled reperfusion can be rapidly instituted rather than uncontrolled reperfusion. In der modernen Aortenbogenchirurgie soll die Aortenpathologie und nicht die Verfügbarkeit einer Methode das beste Behandlungskonzept definieren.
Objectives: Our goal was to assess the results after orthotopic branched endovascular aortic arch repair using a new double-branch endoprosthesis in patients with thoracic aortic disease affecting the aortic arch who cannot undergo classical surgery. Results: From 2010 to 2014, a total of 129 patients were enrolled at 17 centers in Germany and the Czech Republic. The closure of the primary entry tear was successfully achieved in all patients. Aortic repair within 2 weeks due to new organ malperfusion, rapid aortic growth, aortic rupture or persisting pain was performed in 43% descending-entry and 36% arch-entry patients 0% in-hospital mortality. Median size of the Siena graft used was 26 mm. Survival after acute coronary occlusion is determined by the infarct size and the capacity of the remote, non-ischaemic myocardium to support the systemic circulation.
Further studies are required to assess the long-term outcome of this approach. Die Indikationsstellung zur indirekten Herzunterstützungstherapie durch eine intraaortale Ballonpumpe ist aktuell Gegenstand kontroverser Diskussionen. Myocardial preservation in the immature heart; J. You can change your cookie settings at any time. Experimentally, we and others have demonstrated that local and systemic complications after normal blood reperfusion following prolonged complete ischaemia can be reduced if the damaged skeletal muscle is managed carefully during the first phase 30 min after restoration of perfusion by the strategy of controlled limb reperfusion. Interdisciplinary plastic-reconstructive flap surgery is a helpful tool for the successful treatment of intrathoracic fistulae. We observed a reduction in the amplitude, prolonged latencies, or complete signal loss in nine procedures.
Cardioplegia with an extracellular formulation; D. Further studies are needed to assess the long-term durability of this new method. Yet, surgical treatment of native and prosthetic aortic infection with xenopericardial tube-grafts shows promising short-term results with regard to durability and freedom from reinfection in any aortic segment. Sped up heart problems is a widespread worry of continual kidney ailment. J Vasc Surg 6: 231- 234, 1987. Correct placement of the cannula should be controlled.
His tireless dedication over the past 23 years has resulted in this becoming a world-class surgical institution. After resection of the aneurysm and after radical local debridement, orthotopic repair was performed with a self-made pericardial tube graft from the brachiocephalic bifurcation to the thoracic outlet. Das ermittelte Überleben nach 10 Jahren betrug um 90 %. The paravertebral and posterior mediastinal abscess was drained. It additionally demonstrates the explanation for the current method of the administration and therapy of hypertensive illnesses and atherosclerosis. Clinical application and results using reperfusion strategies in cardiac surgery 3. Methods: Dissection extension and entry location were analysed in patients with acute aortic dissection admitted between 2001 and 2016 at a tertiary centre.
Three patients required aortic reintervention for a suture-line aneurysm, for graft occlusion, and for the development of a neo-aorto-intestinal fistulation, respectively. The models were subjected to blood pressure 120 mmHg and 160 mmHg and longitudinal systolic aortic stretching 0 mm, 5 mm, 10 mm and 15 mm. Fluorescent microspheres were injected into the left atrium and a reference sample was aspirated from the descending aorta. The overwhelming majority of aortic segments were not dilated in all these patients. Der Hauptkörper hat 2 offene, innere Tunnel als proximale Landungszonen für die supraaortalen Stent-Grafts. Am J Physiol 1994; 266: H1316-21.
The superiority of this perfusion device has still to be proved even though it is an innovative solution to reduce the ischaemic time significantly. Results: One pig in each group could not be successfully resuscitated. Der vorliegende Kommentar fasst die wesentlichen Neuerungen zusammen und erläutert die Hintergründe dafür. Methods: Within a 28-month period, 20 patients were treated with a bovine self-made pericardial tube graft to replace infected vascular grafts after conventional surgical aortic replacement or endovascular stentgraft implantation or to treat a contaminated surgical site. The current trend towards separate reimplantation of supra-aortic branches may expose certain subgroups of patients to an increased risk of stroke, e. Leading groups from Europe, the U. Despite significant innovations and refinements in many aspects of cardiac transplantation, myocardial protection strategies have not changed much in recent decades.
This tutorial illustrates the steps involved in removing an infected stent graft and replacing it with a bovine pericardial tube graft. Angiographic or duplex ultrasound control of adequate limb perfusion and correct placement of the perfusion cannulas is recommended. We compared the aortic geometry before and after the dissection onset. The results of this study may be useful in future patient-specific computational models used to assess the risk of aortic complications. Of all various strategies described to reduce reperfusion injury post- and preconditioning, single-pharmacological interventions, etc.