scholarly journals The aortal arch plasty in a new-born babies, using “end-to-side” anastomosis

2020 ◽  
Vol 87 (11-12) ◽  
pp. 19-22
Author(s):  
Ya. P. Truba ◽  
І. V. Dzyurii ◽  
O. O. Motrechko ◽  
O. S. Golovenko ◽  
V. V. Lazoryshynets
Keyword(s):  
Pediatric Cardiology ◽  
Late Results ◽  
Neurological Complications ◽  
Reconstructive Procedure ◽  
New Born ◽  
Average Body Mass ◽  
Cardio Vascular ◽  
Scientific Practical ◽  
Average Body

Objective. To analyze the immediate and late follow-up results of the aortal arch plasty, using anastomosis «end to side». Materials and methods. In 2010 - 2019 yrs period in Amosov National Institute of Cardio-Vascular Surgery and Scientific-Practical Medical Centre of Pediatric Cardiology and Cardiosurgery in 75 new-born babies, suffering coarctation and hypoplasia of one or several segments of aortal arch its reconstruction was done, using ‘end-to-side” anastomosis. Into the investigation only the patients with a two-ventricular physiology and further two-ventricular correction were included. There were 41 (54.6%) boys and 34 (45.4%) girls. Average age of the patients was (2,5 ± 1,2) mo, and average body mass - (3.3 ± 0.6) kg. The main diagnostic method for the failure determination and immediate and late results studying was echocardiographic investigation. Results. Hospital lethality have constituted 6.6% (5 patients died). The lethality causes were not connected with the aortal arch reconstructive procedure, using anastomosis «end to side». Duration of follow-up was 1 mo - 9.3 yrs, (2.8 ± 2.5) yrs at average. In late follow-up period 1 patient died. In 11 (14.6%) patients in postoperative period the aortal arch restenosis have developed. In 7 patients restenosis was eliminated endovascularly, using balloon dilatation. In 4 patients the aortal arch surgical replasty was done. Tracheal and the main bronchi compression, neurological complications in late follow-up period were not observed. Conclusion. After plasty for the aortal arch hypoplasia, using anastomosis «end to side» in new-born babies good immediate and late follow-up results were noted, what witnesses its efficacy. In accordance to results of the investigation accomplished such kind of anastomosis applied may be used in patients, suffering hypoplasia of proximal aorta or in tubular hypoplasia of all aortal arch.

scholarly journals Cartilage Surgery in Overweight Patients: Clinical and MRI Results after the Autologous Matrix-Induced Chondrogenesis Procedure

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Matthias Lahner ◽  
Christopher Ull ◽  
Marco Hagen ◽  
Christoph von Schulze Pellengahr ◽  
Kiriakos Daniilidis ◽  
...  
Keyword(s):  
Orthopaedic Surgery ◽  
Lesion Size ◽  
Single Step ◽  
Lysholm Score ◽  
Cartilage Defects ◽  
Knee Cartilage ◽  
Average Body Mass Index ◽  
Average Body Mass ◽  
Average Body

Modern orthopaedic surgery provides a variety of techniques for cartilage repair. The Autologous Matrix-Induced Chondrogenesis (AMIC) procedure is a single-step technique with a collagen I/III scaffold for the treatment of full-thickness cartilage lesions. The aim of the study was to analyze the outcome of the AMIC procedure in overweight patients with knee cartilage defects. Overweight patients treated with AMIC surgery were followed up by clinical and MRI examination. 9 patients with a cartilage defect of the knee with a mean lesion size of 2.1±1.2 cm2 and an average body mass index (BMI) of 29.3 were available for the follow-up. The Lysholm Score was significantly improved by the AMIC procedure (38 to 67, p≤0.008). The VAS Score was significantly lower after the procedure (9 to 3, p≤0.018). In the postoperative MOCART Scale, the scaffold reached defect covering of 80%. However, 2 patients had to be revised due to persisting knee pain. The AMIC procedure enhances pain reduction and gain of knee function for cartilage defects of overweight patients. However, in cases of an increased BMI, the patient had to be informed that success rate is reduced despite good defect covering.

Weight and weight change and risk of atrial fibrillation: the HUNT study

2019 ◽  
Vol 40 (34) ◽  
pp. 2859-2866 ◽  
Author(s):  
Tingting Feng ◽  
Malmo Vegard ◽  
Linn B Strand ◽  
Lars E Laugsand ◽  
Bjørn Mørkedal ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Weight Change ◽  
Normal Weight ◽  
Hazard Ratios ◽  
Hunt Study ◽  
Average Body Mass ◽  
Average Body ◽  
Over Time

Abstract Aims Although obesity has been associated with risk of atrial fibrillation (AF), the associations of long-term obesity, recent obesity, and weight change with AF risk throughout adulthood are uncertain. Methods and results An ambispective cohort study was conducted which included 15 214 individuals. The cohort was created from 2006 to 2008 (the baseline) and was followed for incident AF until 2015. Weight and height were directly measured at baseline. Data on previous weight and height were retrieved retrospectively from measurements conducted 10, 20, and 40 years prior to baseline. Average body mass index (BMI) over time and weight change was calculated. During follow-up, 1149 participants developed AF. The multivariable-adjusted hazard ratios were 1.2 (95% confidence interval 1.0–1.4) for average BMI 25.0–29.9 kg/m2 and 1.6 (1.2–2.0) for average BMI ≥30 kg/m2 when compared with normal weight. The association of average BMI with AF risk was only slightly attenuated after adjustment for most recent BMI. In contrast, current BMI was not strongly associated with the risk of AF after adjustment for average BMI earlier in life. Compared with stable BMI, both loss and gain in BMI were associated with increased AF risk. After adjustment for most recent BMI, the association of BMI gain with AF risk was largely unchanged, while the association of BMI loss with AF risk was weakened. Conclusion Long-term obesity and BMI change are associated with AF risk. Obesity earlier in life and weight gain over time exert cumulative effects on AF development even after accounting for most recent BMI.

Isolated Gastrocnemius Recession for the Treatment of Achilles Tendinopathy

2017 ◽  
Vol 11 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Kenneth S. Smith ◽  
Caleb Jones ◽  
Zachariah Pinter ◽  
Ashish Shah
Keyword(s):  
Achilles Tendinopathy ◽  
Treatment Modalities ◽  
Gastrocnemius Recession ◽  
Foot Function ◽  
Vas Scores ◽  
Average Body Mass ◽  
Equinus Contracture ◽  
Student’S T ◽  
Average Body

Background: Various treatment modalities have been described for Achilles tendinopathy with varying degrees of success. The rationale for the gastrocnemius recession procedure is to decrease the mechanical overload of the Achilles tendon arising from an equinus contracture. Methods: We retrospectively reviewed 25 patients who underwent an isolated gastrocnemius recession procedure at our institution between May 2013 and April 2015 by a single surgeon. Clinical outcome was evaluated on the basis of pain, utilizing visual analog scale (VAS) scores and the Foot Function Index (FFI) by telephonic interview. Student’s t test and one-way analysis of variance were used for statistical analysis. Results: The average age of patients was 53.2 years with an average body mass index of 35.8 kg/m2. The average follow-up was 13.1 months. All 25 patients had a decrease in VAS scores from an average of 8.9 preoperatively to 2.0 at the 6-week visit. The average FFI went from 73.5 preoperatively to 27.4 at final follow-up. Two out of 25 patients had a postoperative sural neuritis with a total complication rate of 12%. Twenty-one of 25 patients (84%) reported total or significant pain relief. Conclusion: The medium-term results of our study suggest that an isolated gastrocnemius recession is a simple, effective, and safe surgical procedure for the treatment of Achilles tendinopathy. Levels of Evidence: Therapeutic, Level IV: Retrospective

scholarly journals Temporal subsidence patterns of cemented polished taper-slip stems: a systematic review

2021 ◽  
Vol 6 (5) ◽  
pp. 331-342
Author(s):  
Kwaku Baryeh ◽  
Jeewaka Mendis ◽  
David H. Sochart
Keyword(s):  
Clinical Outcomes ◽  
Implant Design ◽  
Radiological Findings ◽  
Exclusion Criteria ◽  
Patient Demographics ◽  
Average Body Mass ◽  
Method Of Measurement ◽  
Average Body ◽  
Methods Of Measurement

The literature was reviewed to establish the levels of stem subsidence for both double and triple-tapered implants in order to determine whether there were any differences in subsidence levels with regard to the methods of measurement, the magnitude and rate of subsidence and clinical outcomes. All studies reporting subsidence of polished taper-slip stems were identified. Patient demographics, implant design, radiological findings, details of surgical technique, methods of measurement and levels of subsidence were collected to investigate which factors were related to increased subsidence. Following application of inclusion and exclusion criteria, 28 papers of relevance were identified. The studies initially recruited 3090 hips with 2099 being available for radiological analysis at final follow-up. Patient age averaged 68 years (42–70), 60.4% were female and the average body mass index (BMI) was 27.4 kg/m2 (24.1–29.2). Mean subsidence at one, two, five and 10 years was 0.97 mm, 1.07 mm, 1.47 mm and 1.61 mm respectively. Although double-tapered stems subsided more than triple-tapered stems at all time points this was not statistically significant (p > 0.05), nor was the method of measurement used (p > 0.05). We report the levels of subsidence at which clinical outcomes and survivorship remain excellent, but based on the literature it was not possible to determine a threshold of subsidence beyond which failure was more likely. There were relatively few studies of triple-tapered stems, but given that there were no statistically significant differences, the levels presented in this review can be applied to both double and triple-tapered designs. Cite this article: EFORT Open Rev 2021;6:331-342. DOI: 10.1302/2058-5241.6.200086

Reconstruction of aortal arch in patients with transposition of the main arteries: results of a one-stage correction

2020 ◽  
Vol 87 (5-6) ◽  
pp. 41-45
Author(s):  
Ya. P. Truba ◽  
M. P. Radchenko ◽  
I. V. Dzyurii ◽  
O. S. Golovenko ◽  
V. V. Lazoryshynets
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Cerebral Perfusion ◽  
Late Results ◽  
Early Postoperative Period ◽  
One Stage ◽  
Echocardiographic Examination ◽  
Average Body Mass ◽  
Scientific Practical

Objective. To analyze immediate and late results of a one-stage surgical treatment of the main arteries transposition in conjunction with obstruction on the level of aortal arch. Materials and metods. For the period 2010 - 2019 yrs in Amosov National Institute of Cardiovascular Surgery and Scientific-Practical Medical Centre of Pediatric Cardiology and Cardio-Surgery in 52 newborn babies a one-stage correction of the main arteries transposition with obstruction on the level of aortal arch was conducted. In the investigation were included only the patients with a two-ventricle physiology and further two-ventricle correction. There were 35 (67.3%) boys and 17 (32.7%) girls. Average age of the patients was (0.6 ± 0.3) mo, average body mass - (3.6 ± 0.8) kg. The main method of diagnosis in determination of the failure and estimation of immediate and late results was echocardiographic examination. In 24 (46.2%) of the patients while doing reconstruction of the aortal arch a selective antegrade cerebral perfusion was conducted. Results. Hospital mortality have constituted 3.8% (n=2). Duration of artificial blood circulation have constituted (194.3 ± 73.1) min, aortal clamping - (108.5 ± 35.6) min, selective cerebral perfusion - (19.6 ± 7.2) min. In early postoperative period 6 (11.5%) patients have been with desintegrated sternum. Average duration of observation have constituted (3.7 ± 2.8) yr (from 1 no to 9.yrs). In late period one child died. In 5 (9.6%) patients in postoperative period restenosis in aortal arch have developed, who was successfully curated endovascularly, using balloon dilatation in 3 patients, In two secondary plasty of aortal arch was done surgically. Tracheal or the main bronchi compression, neurologic complications were not observed in remote period. Conclusion. One-stage correction of the main arteries transposition together with the aortal arch hypoplasia - an effective and secure method of treatment of a newborn children with good immediate and late results. The investigation conducted gives a background to conclude, that this surgical strategy constitutes the affordable alternative to two-staged surgical treatment of this complex pathology.

scholarly journals Correction of the aortic arch hypoplasia in newborn babies, suffering complete form of atrio-ventricular septal defect

2020 ◽  
Vol 87 (7-8) ◽  
pp. 29-32
Author(s):  
Ya. P. Тruba ◽  
А. А. Dovhaliuk ◽  
І. V. Dzyurii ◽  
P. А. Danchenko ◽  
О. S. Golovenko ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Aortic Arch ◽  
Septal Defect ◽  
Late Results ◽  
Neurological Complications ◽  
Aortic Arch Reconstruction ◽  
Complete Form ◽  
Staged Approach ◽  
Arch Reconstruction

Objective. Tactics of treatment and results of the hypoplasia of the aortic arch correction in newborn babies with complete form of atrio-ventricular septal defect were studied. Маterials and methods. During period from 2011 tо 2019 yrs in 21 patients correction of hypoplasia of aortic arch and atrio-ventricular septal defect were performed. The investigated group consisted of patients with a two-ventricular physiology. The patients, suffering imbalanced form of atrio-ventricular septal defect and with variants of hypoplasia in left parts of the heart, were excluded from the investigation. There were 9 (42.9%) boys and 12 (57.1%) girls. Average age of the patients have constituted (2.3 ± 1.1) mo (from 0.06 до 7.7 mo). Average body mass of the patients have constituted (3.8 ± 1.0) kg (from 2.0 до 5.9 kg). The aortic arch segment was considered a hypoplastic one if a Z-score (Standard Score - standard estimation) shift have constituted lesser than 2.0. Results. Hospital lethality have constituted 14.2%. Three newborn babies died: 2 - after first stage of correction, and 1 - after second stage of correction. All the patients, to whom a one-staged correction was done, have survived. The causes of lethality were not connected with method of the aortic arch reconstruction. While performance of echocardiography before discharge from the hospital the pressure gradient on place of the aortic arch plasty have constituted (13.6 ± 6.8) mm Hg at average. Average follow-up period have constituted (2.6 ± 2.1) yrs (from 2 mo tо 8.1 yr). In late follow-up period lethality was absent. In 2 (9.5%) patients in postoperative period reoperations on aortic arch and mitral valve were performed. Tracheal compression as well as the main bronchi compression, neurological complications in late follow-up period were absent. Conclusion. For the patients, suffering complete form of atrio-ventricular septal defect in conjunction with hypoplasia of aortic arch the staged correction constitutes a more favorable option, owing good immediate and late results. A staged approach in the treatment is indicated for newborn babies, suffering hypoplasia of distal aortic arch and competent atrio-venticular valves or with small regurgitation. Оne-stage correction is indicated in hypoplasia of aortic arch, pronounced regurgitation on common atrio-ventricular valve and pronounced heart failure.

The PAP Flap Breast Reconstruction: A Practical Option for Slim Patients

2021 ◽  
Author(s):  
Taehee Jo ◽  
Dong Nyeok Jeon ◽  
Hyun Ho Han
Keyword(s):  
Donor Site ◽  
Wound Dehiscence ◽  
Diep Flap ◽  
Separate Analysis ◽  
Flap Reconstruction ◽  
Average Body Mass Index ◽  
Deep Inferior Epigastric Perforator ◽  
Average Body Mass ◽  
Artery Perforator ◽  
Average Body

Abstract Background The posterior thigh-based profunda artery perforator (PAP) flap has been an emerging option as a secondary choice in breast reconstructions. However, whether a PAP flap could consistently serve as the secondary option in slim patients has not been investigated. Methods Records of immediate unilateral breast reconstructions performed from May 2017 to June 2019 were reviewed. PAP flap breast reconstructions were compared with standard deep inferior epigastric perforator (DIEP) flap breast reconstructions, and were grouped into single or stacked PAP flaps for further analysis. Results Overall, 43 PAP flaps were performed to reconstruct 32 breasts. Eleven patients underwent stacked PAP flap reconstruction, while 17 patients underwent 21 single PAP flap reconstruction. The average body mass index (BMI) of the patients was 22.2 ± 0.5 kg/m2. The results were as follows: no total loss, one case of venous congestion (2.3%), two donor site wound dehiscence cases (4.7%), and one case of fat necrosis from partial flap loss (2.3%). When compared with 192 DIEP flap reconstructions, the final DIEP flap supplied 98.1 ± 1.7% of mastectomy weight, while the final PAP flap supplied 114.1 ± 6.2% of mastectomy weight (p < 0.005), demonstrating that PAP flaps can successfully supply final reconstruction volume. In a separate analysis, single PAP flaps successfully supplied 104.2% (84.2-144.4%) of mastectomy weights, while stacked PAP flaps supplied 103.7% (98.8-115.2%) of mastectomy weights. Conclusion In our series of PAP flap reconstructions performed in low-to-normal BMI patients, we found that PAP flaps, as single or stacked flaps, provide sufficient volume to reconstruct mastectomy defects.

Reduced Efficacy of the Pipeline Embolization Device in the Treatment of Posterior Communicating Region Aneurysms with Fetal Posterior Cerebral Artery Configuration

Neurosurgery ◽  
2017 ◽  
Vol 82 (5) ◽  
pp. 695-700 ◽  
Author(s):  
Anil K Roy ◽  
Brian M Howard ◽  
Diogo C Haussen ◽  
Joshua W Osbun ◽  
Sameer H Halani ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Clinical Symptoms ◽  
Posterior Cerebral Artery ◽  
Neurological Complications ◽  
Class I ◽  
Class Iii ◽  
Pipeline Embolization Device ◽  
Independent Association ◽  
Incomplete Occlusion

Abstract BACKGROUND Aneurysms at the origin of the posterior communicating artery (PcommA) have been demonstrated to be effectively treated with the pipeline embolization device (PED). Much less is known about the efficacy of the PED for aneurysms associated with a fetal posterior cerebral artery (fPCA) variant. OBJECTIVE To study PED treatment efficacy of PcommA aneurysms, including fPCA aneurysms. METHODS A prospectively maintained university database of aneurysm patients treated with the PED was retrospectively reviewed. Demographics, treatment details, and imaging were reviewed for all PcommA and fPCA aneurysms. RESULTS Out of a total of 285 patients treated with PED, 50 patients (mean age 57.5 ± 12.2 yr, 42 females) with unruptured PcommA (9 fPCA) aneurysms were identified. Mean follow-up duration was 14.0 ± 11.6 mo (48 patients). Roy-Raymond class I occlusion on follow-up magnetic resonance or catheter angiography (mean time 11.7 ± 6.8 mo) was achieved in 30 patients (62.5%), class II occlusion in 11 patients (22.9%) and class III occlusion in 7 patients (14.5%). The PcommA was occluded in 56% of patients without any clinical symptoms. No deaths or permanent neurological complications occurred. In fPCA aneurysms, class I occlusion was seen in 1 patient, class 2 occlusion in 2 patients, and class III occlusion in 6 patients. Multivariate analysis revealed an independent association between incomplete occlusion and fPCA configuration (OR 73.65; 95% CI: 5.84-929.13; P = .001). CONCLUSION The PED is a safe and effective treatment for PcommA aneurysms, although fetal anatomy should increase consideration of traditional endovascular techniques or surgical clipping.

scholarly journals 306 20 years of follow-up in 132 Senning procedures: late results

2011 ◽  
Vol 3 (1) ◽  
pp. 101
Author(s):  
Francois Roubertie ◽  
Pierre Oses ◽  
Laurent Seban ◽  
Xavier Iriart ◽  
Nadine Laborde ◽  
...  
Keyword(s):  
Late Results
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