The impact of type and volume of blood flow restoration on long-term surgical treatment results in patients with obliterating atherosclerosis in stage of chronic critical ischemia of the lower extremities

Background and Aim of the Study: Ischemic mitral valve regurgitation (IMR) in patients undergoing coronary artery bypass grafting (CABG) is associated with worse long-term outcomes. The aim of this study was to assess the impact of mitral valve repair with CABG in patients with moderate IMR. Method: This observational study enrolled 3,215 consecutive patients from the Juntendo CABG registry with moderate IMR and multivessel coronary artery disease who underwent CABG between 2002 and 2017. The CABG alone and CABG with mitral valve surgery (MVs) groups were compared. The propensity score was calculated for each patient. Long-term all-cause death, cardiac death, and major adverse cardiac and cerebrovascular events (MACCEs) were compared between the two groups. Results: A total of 101 patients who underwent CABG had moderate IMR in our database. Propensity score matching selected 40 pairs for final analysis. MVs was associated with increased risks of postoperative atrial fibrillation, blood transfusion, and longer hospitalization. There were no differences between the two groups in long-term outcomes, including all-cause mortality, cardiac mortality, and the incidence of MACCEs. Conclusions: Surgical treatment of moderate IMR combined with CABG was as safe as CABG alone, with no differences in long-term outcomes. Further studies are needed to determine the effects of MVs in patients with moderate IMR and severe coronary artery disease.

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Long-Term Surgical Treatment Results of Critical Lower Limb Ischemia Following Simultaneous Direct and Indirect Revascularization

Novosti Khirurgii ◽

10.18484/2305-0047.2017.2.131 ◽

2017 ◽

Vol 25 (2) ◽

pp. 131-139

Author(s):

V.I. Rusin ◽

◽

V.V. Korsak ◽

P.A. Boldizhar ◽

V.V. Rusin ◽

...

Keyword(s):

Surgical Treatment ◽

Lower Limb ◽

Limb Ischemia ◽

Treatment Results ◽

Lower Limb Ischemia ◽

Indirect Revascularization

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Surgical treatment of «dry» forms of central chorioretinal dystrophy with the use of platelet-rich blood autoplasma

Kazan medical journal ◽

10.17750/kmj2017-390 ◽

2017 ◽

Vol 98 (3) ◽

pp. 390-393

Author(s):

D G Arsjutov

Keyword(s):

Surgical Treatment ◽

Pigment Epithelium ◽

Vitreoretinal Surgery ◽

Internal Limiting Membrane ◽

Hyaline Membrane ◽

The Impact ◽

Observation Period ◽

Subretinal Injection ◽

Sodium Solution

Aim. To study the impact of platelet-rich blood autoplasma on the capability of the retinal regeneration in nonexudative forms of central chorioretinal dystrophy with the use of microinvasive vitreoretinal surgery. Methods. Surgical treatment was performed on 14 patients with central chorioretinal dystrophy aged 29 to 87 years. The surgery technique consisted of 3-port 25+, 27 Ga vitrectomy with posterior hyaline membrane and internal limiting membrane peel with subsequent central retinal exfoliation with 38 Ga cannula and balanced sodium solution and subretinal injection to the formed in macule space 0.1-0.2 ml of platelet-rich autolplasma. Results. As a result of the treatment according to this technique during the long-term period after the surgery (1 to 9 months) thickness of fovea reduced to 85-150 µm in average staying stable during the whole observation period. In 9 patients pigment epithelium thickened from 24 to 38 µm in parafoveolar area and fovea area. Corrected vision in 3 patients reached 0.1, and in the rest it did not exceed 0.06, herewith, all patients noted consistently improved vision. All patients had favorable evolution of photosensitivity according to microperimetry in average from 0.1-0.5 to 8.5-11 dB with a tendency of fixation point movement from periphery to the center. Conclusion. Vitreoretinal surgery 25+, 27 Ga for nonexudative forms of central chorioretinal dystrophy with the use of subretinal injection of platelet-rich autoplasma is a microinvasive, safe, effective method of the treatment of such pathology improving vision characteristics and anatomical and physiological characteristics of the eye involved.

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Possibilities of combined surgical treatment of pyonecrotic lesions in the neuroischemic form of diabetic foot syndrome

Diabetes Mellitus ◽

10.14341/2072-0351-5412 ◽

2009 ◽

Vol 12 (1) ◽

pp. 8-13

Author(s):

Valeriy Afanas'evich Mitish ◽

I A Eroshkin ◽

Gagik Radikovich Galstyan ◽

Lyudmila Petrovna Doronina ◽

Yu S Paskhalova ◽

...

Keyword(s):

Surgical Treatment ◽

Diabetic Foot ◽

Lower Extremities ◽

Lower Leg ◽

Diabetic Foot Syndrome ◽

Diagnostic Tools ◽

Critical Ischemia ◽

Adequate Treatment ◽

Patients With Diabetes ◽

Foot Lesions

Aim. To present results of combined surgical treatment of the ischemic form of diabetic foot syndrome complicated by pyonecrotic process. To show thatthe use of modern diagnostic tools and the choice of adequate treatment strategy permits to substantially reduce the number of above-the-knee amputations. Materials and methods. A total of 140 patients with diabetes mellitus and critical ischemia of lower extremities were under observation during 2004-2008.All of them had purulent and/or necrotic foot lesions. The patients were examined by X-ray, computed and magneto-resonance tomography of the feet,duplex scanning of lower leg vasculature, transcutaneous measurement of PO2, pelvic and lower leg arterial angiography. Results. A strategy of surgical treatment was developed to be used depending on the patients health status, clinical features and severity of pyonecroticprocesses in the foot, and the degree of involvement of the main blood vessels of lower extremities. Conclusion. Combination of endovascular surgery with various methods for plastic wound closure permits to extend the range of possibilities for the treatmentof high-risk patients, such as those with pyonecrotic lesions and neuroischemic form of diabetic foot syndrome. This approach opens up prospects fora significant decrease of percentage of above-the-knee amputations and improves the quality of life in these patients.

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Efficacy evaluation of case-specific approach for surgical treatment of incisional ventral hernia

Polish Journal of Surgery ◽

10.5604/01.3001.0014.9756 ◽

2021 ◽

Vol 93 (5) ◽

pp. 1-5

Author(s):

Svetlana Sokolova ◽

Andrey Sherbatykh ◽

Konstantin Tolkachev ◽

Vladimir Beloborodov ◽

Vadim Dulskiy ◽

...

Keyword(s):

Surgical Treatment ◽

Abdominal Wall ◽

Ventral Hernia ◽

Anterior Abdominal Wall ◽

Abdominal Wall Defect ◽

Long Term Results ◽

Treatment Results ◽

Specific Approach ◽

Incisional Ventral Hernia

The Aim of research is to improve the results of surgical treatment of incisional ventral hernia by applying a case-specific approach and a new method of plastic repair of anterior abdominal wall. The prospective controlled dynamic study is based on incisional ventral hernia treatment results with the use of meshed endoprostheses among 219 patients. On-lay alloplasty was used in patients younger than 60 years of age, without severe concomitant pathology, with small and medium hernias and anterior abdominal wall defect of up to 10 cm (W1 - W2). The article shows a selection algorithm for anterior abdominal wall plastic repair method. It goes through advantages of the author’s proprietary technique. The article displays frequency and patterns of complications, life quality of the patients after various prosthetic plastic repairs. In the main group, positive treatment results were observed in 65.0%, long-term results of the operation were observed in 88.4%, complications occurred in 13.6%, relapse in 4.5%. «On lay» treatment tactics showed positive results in 59.4%, long-term results of the operation were observed in 74.7%, complications occurred in 40%, relapse in 3.1%. After «sub lay» intervention, excellent results were observed in 40.0% of patients, long-term results of the operation were observed in 81.9%, complications occurred in 12%, and relapse in 1.4%.

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Effect of aerobic bacteriology on the clinical presentation and treatment results of chronic suppurative otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215100133535 ◽

1996 ◽

Vol 110 (4) ◽

pp. 315-318 ◽

Cited By ~ 19

Author(s):

Eero Vartiainen ◽

Jukka Vartiainen

Keyword(s):

Surgical Treatment ◽

Otitis Media ◽

Clinical Presentation ◽

Chronic Suppurative Otitis Media ◽

Long Term Results ◽

Treatment Results ◽

Suppurative Otitis Media ◽

Hearing Results ◽

Significant Difference

AbstractThe effect of aerobic bacteriology on the clinical presentation, complications of the disease and long-term results of surgical treatment was assessed in a cohort of 368 patients with chronic suppurative otitis media. Bacteriological findings showed no significant difference between child and adult patients. Staphylococcus aureus was isolated in cholesteatoma ears more frequently than Pseudomonas aeruginosa, in chronic ears without cholesteatoma the situation was reversed. Bacteriological findings had no significant effect on the incidence of complications caused by the disease. Failures after surgical treatment were most common in Pseudomonas ears. The bacteriology had no significant effect on pre-operative hearing levels nor postoperative hearing results. It was concluded that, in order to improve results of chronic ear sugery, more attention should be paid to pre-operative conservative treatment of chronically discharging ears, especially those infected by P. aeruginosa.

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The impact of additional antegrade pulmonary blood flow at bidirectional Glenn shunt on long-term outcomes

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2021.01.022 ◽

2021 ◽

Cited By ~ 1

Author(s):

Jae Suk Baek ◽

Chun Soo Park ◽

Eun Seok Choi ◽

Tae-Jin Yun ◽

Bo Sang Kwon ◽

...

Keyword(s):

Blood Flow ◽

Pulmonary Blood Flow ◽

Long Term Outcomes ◽

Glenn Shunt ◽

Bidirectional Glenn ◽

Bidirectional Glenn Shunt ◽

The Impact

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EFFICACY OF FREE AUTOVENOUS TRANSPLANT IN FEMORAL-POPLITEAL BYPASS BELOW THE JOINT SPACE OF THE KNEE

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2016-175-4-75-79 ◽

2016 ◽

Vol 175 (4) ◽

pp. 75-79

Author(s):

B. S. Sykovatykh ◽

L. N. Belikov ◽

M. B. Sykovatykh ◽

D. V. Sidorov ◽

M. A. Inarkhov ◽

...

Keyword(s):

Blood Flow ◽

Joint Space ◽

Arterial Blood Flow ◽

Control Group ◽

Treatment Technology ◽

Critical Ischemia ◽

Shunt Thrombosis ◽

Atherosclerotic Lesions ◽

Arterial Blood

The article presents an analysis of complex examination and treatment of 60 patients with critical ischemia of the lower extremities due to atherosclerotic lesions of femoral-poplitealtibia segment. Typical traditional autovenous bypass of reverse big saphena was performed for the first (control) group of patients. The operation, which used an original technology by free autovenous transplant with collapsed valves without vein reverse, was completed for the second (experimental) group of patients. An application of original treatment technology allowed an increase of blood flow volume in the extremity in 1,5 times, an arterial blood flow - in 1,6 times, rate of microcirculation - in 1,3 times. An early postoperative complications were decreased on 23,4%, the late shunt thrombosis - on 40%. Long-term shunt passability was improved in 2,6 times and physical component of health - on 10,6%, psychological - on 4,3%. The shunt functioned in 36,7% of the first group and in 83,3% patients of the second group after two years since operation. The extremity was saved in 60% of the first group and 90% patients of the second group.

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