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 Early and late results of surgical treatment of multifocal epilepsy

2009 ◽  
Vol 8 (1(2)) ◽  
pp. 42-45
Author(s):  
V. R. Kasumov
Keyword(s):  
Surgical Treatment ◽  
Seizure Frequency ◽  
Postoperative Period ◽  
Surgical Outcomes ◽  
Late Results ◽  
Early Postoperative Period ◽  
Early And Late Results ◽  
Group 2 ◽  
Group 1

Studies of surgical outcomes in multifocal epilepsy patients showed them to depend on epileptic foci sites in two groups of the diseased according to J. Engel scale (1993): 92 early postoperative period patients (group 1), and 30 late one patients (group 2). Of 92 group 1 patients unilateral cortical epileptic foci were diagnosed in 62 (51.7%), bitemporal ones in 30 (20.0%) patients. Of 30 group 2 patients – unilateral cortical in 17 (42.5%), and bitemporal in 13 (32.5%) patients. In group 1 remission of the seizures and decrease of their frequency over 80.0% was achieved in 80.4% of the patients, in group 2 – decrease of seizure frequency over 50.0% in 67.7%, and recurrent seizures in 26.7% of the patients.

Retinal morphometric parameters of epiretinal membrane in the early period of surgical treatment

2021 ◽  
pp. 147-149
Author(s):  
I.H. Sabirova ◽  
◽  
I.I. Zainutdinova ◽  
L.N. Sabirova ◽  
E.R. Kokoreva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Epiretinal Membrane ◽  
Optical Tomography ◽  
Early Period ◽  
Early Postoperative Period ◽  
Morphometric Parameters ◽  
Retinal Edema

The analysis of the morphometric of the retina in patients with epiretinalmembrane was carried out using spectral coherent optical tomography and determination of retinal photosensitivity in the early postoperative period. A decrease in retinal edema was revealed due to a decrease in the thickness of the inner layers of the neuroepithelium in patients with vitreoretinal pathology after surgical treatment. Keywords: epiretinal membrane, morphometric parameters of the retina, vitrectomy, membranopilling.

Seizures after evacuation of subdural hematomas: incidence, risk factors, and functional impact

2010 ◽  
Vol 112 (2) ◽  
pp. 455-460 ◽  
Author(s):  
Alejandro A. Rabinstein ◽  
Seung Young Chung ◽  
Leslie A. Rudzinski ◽  
Giuseppe Lanzino
Keyword(s):  
Surgical Treatment ◽  
Functional Outcome ◽  
Functional Impairment ◽  
Postoperative Period ◽  
Strong Association ◽  
Early Postoperative Period ◽  
Acute Subdural Hematoma ◽  
Early Functional Outcome ◽  
Gcs Score

Object The purpose of this study was to evaluate the incidence of seizures or epileptiform abnormalities on electroencephalography (EEG) studies in patients undergoing surgical treatment for acute subdural hematoma (SDH). Methods This was a retrospective study of 134 consecutive patients with acute or acute-on-chronic SDH who underwent surgical treatment at the authors' institution between January 2004 and July 2008. Detailed information was collected regarding baseline clinical data (including preexistent functional impairment); Glasgow Coma Scale (GCS) sum scores before and 24 hours after surgery; presence of clinical seizures; EEG findings; and functional outcome on discharge and up to the 6-month follow-up. All brain CT scans were reviewed to calculate SDH volume and midline shift. The Glasgow Outcome Scale (GOS) score was used for functional assessment, and GOS scores of 1–3 were considered indicative of poor outcome. Univariate and multivariate logistic regression analyses were performed to identify statistical associations. Results Clinical seizures or epileptiform changes on EEG were observed during the acute postoperative period in 33 patients (25%). Preexistent functional impairment and seizures/epileptiform EEG findings after surgery were independently associated with poor functional outcome upon hospital discharge (p < 0.001 for both). Preexistent functional impairment (p < 0.001), lower GCS score before surgery (p = 0.04), and lower GCS score 24 hours after surgery (p = 0.007), but not seizures/epileptiform EEG findings, were independently associated with poor functional recovery at 1- to 6-month follow-up evaluations. Seizures/epileptiform EEG findings had a strong association with lower GCS scores after surgery (p = 0.01), and they were more common in patients who underwent evacuation by craniotomy (p = 0.02). Conclusions Epileptic complications are common after acute SDH evacuation, and should be suspected in patients with an unanticipated depressed level of consciousness after surgery. Seizures worsen early functional outcome, but delayed favorable recovery is possible. Therefore, one should be cautious when discussing prognosis in the early postoperative period of patients with epileptic complications.

scholarly journals SURGICAL TREATMENT OF CAROTID STENOSIS IN PATIENTS WITH CORONARY HEAR+T DISEASE IN ORDER TO PREVENT ISCHEMIC STROKE

2020 ◽  
pp. 124-126
Author(s):  
I. S. Pulyaeva ◽  
V. A. Prasol
Keyword(s):  
Ischemic Stroke ◽  
Surgical Treatment ◽  
Carotid Stenosis ◽  
Postoperative Period ◽  
Stable State ◽  
Length Of Hospital Stay ◽  
Early Postoperative Period ◽  
Main Stage ◽  
Simultaneous Operations ◽  
Ischemic Attack

Summary. Goal. To analyze the results of surgical treatment of carotid stenosis in patients with coronary heart disease in order to prevent ischemic stroke. Materials and methods. The analysis included 18 patients treated in the SI «V. T. Zaitseva IGUS of NAMNU» from 2017 to 2019 in combined atherosclerotic lesions of the coronary and carotid arteries which evaluated the reserve brain. Results and discussion. All patients with two-stage treatment of the first and second groups were discharged in a stable state, one had a clinic of transient ischemic attack in the postoperative period. Conclusions. Simultaneous operations are advisable in patients with a reduced reserve of both coronary and cerebral circulation. The risk of developing cerebral and cardiac postoperative complications is comparable with the results of phased operations, reducing the length of hospital stay of the patient. The results of the hypoxic test serve as an additional criterion for the decision to impose an internal intra-arterial shunt. This allows you to reduce the time of the main stage of carotid endarterectomy and to avoid additional possible complications in the early postoperative period.

scholarly journals One-Stage Repair of Aortic Arch Hypoplasia Associated With Ventricular Septal Defect

2020 ◽  
pp. 52-56
Author(s):  
Y. Truba ◽  
R. Sekelyk ◽  
I. Dzyurii ◽  
L. Prokopovych ◽  
O. Golovenko ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Postoperative Period ◽  
Balloon Dilation ◽  
Early Postoperative Period ◽  
Long Term Results ◽  
One Stage ◽  
The Mean ◽  
Aortic Arch Hypoplasia

  Background. Aortic arch hypoplasia is a congenital anomaly of the development of the aortic arch characterized by ground. Aortic arch hypoplasia is a congenital anomaly of the development of the aortic arch characterized by hemodynamically significant narrowing of one or more segments of the aortic arch. Aortic arch hypoplasia combined ynamically significant narrowing of one or more segments of the aortic arch. Aortic arch hypop with ventricular septal defect (VSD) characterizes a special category of children who are in serious condition and need ptal defect (VSD) characterizes a special category immediate surgery. Despite the improvement in the results of surgical treatment of this abnormality in recent years, the gery. Despite the imp issue of choosing treatment tactics remains debatable. g The aim. To analyze immediate and long-term results of one-stage aortic arch hypoplasia repair and VSD repair in infants. Materials and methods. From 2011 to 2019, 55 infants underwent simultaneous aortic arch hypoplasia repair in ypoplasia rep conjunction with VSD repair at the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine and junction with VSD repair at the National Amosov Institute of Cardiovascular Surgery Ukrainian Children’s Cardiac Center. There were 30 (55%) male patients and 25 (45%) female patients. The mean age of (55%) male patients and 25 (45%) female patients. The mean ag the patients was 1.3 ± 1.2 months (from 0.1 to 9.1 months), the average body weight was 3.9 ± 1.3 kg (from 2.4 to 8.7 patients was 1.3 ± 1.2 months (from 0.1 to 9.1 months), the average body weight was 3.9 ± 1.3 kg ( kg). The mean body surface area was 0.27 ± 0.1 m2. Antegrade selective cerebral perfusion was performed in 23 (42%) g). The mean body patients during the aortic arch reconstruction. g Results.The hospital mortality rate was 1.8% (n = 1). The average duration of artificial circulation was 108.5 ± 38.6 minpital mortality rate was 1.8% (n = 1). The averag utes (from 55 to 204 minutes), aortic clamping time was 56.9 ± 36.4 minutes (from 21 to 126 minutes), the time of selec(from 55 to 204 minutes), aortic clamping time was 56.9 ± 36.4 minutes (from 21 to 126 minutes) tive cerebral perfusion was 26.4 ± 11.5 minutes (14 to 49 minutes). In eight patients (14.5%) the sternum was spread perfusion was 26.4 ± 11.5 minutes (14 to 49 minutes). In eight patients (14.5%) the sternum was sp apart in the early postoperative period. Echocardiography before discharge revealed the average pressure gradient at the part in the early postoperative period. Echocardiograp site of plasticity of the aortic arch of 20.5 ± 14.9 mm Hg. plasticity of the aortic arch of 20.5 ± 14.9 mm Hg. The mean long-term follow-up was 2.6 ± 2.1 years (from two months to 8.1 years). There were no fatal cases in the reg-term follow-up was 2.6 ± 2.1 years (from two months to 8.1 years) mote period. In 5 (9.1%) patients aortic arch restenosis occurred in the postoperative period; it was successfully treated period. In 5 (9.1%) patients aortic arch restenosis occurred in the postoperative period; it was successfully endovascularly by balloon dilation in 3 patients, the other 2 of them underwent repeated aortic arch repair. Long-term y by balloon dilation in 3 patients, the other 2 of them underwent repeated aortic arch repair. Long follow-up of other patients showed good results with respect to the pressure gradient at the aortic arch. There were p of other patients showed good results with respect to the pressure g no hemodynamically significant gradient after VSD closure. There were no neurological complications in the long-term follow-up. p Conclusions. One-stage complete repair is an effective and safe treatment for infants which provides good immedige complete repair is an effective and safe treatment for infants which provides g ate and long-term results. This surgical strategy may be an acceptable alternative to two-stage surgical treatment of this g complex pathology.

scholarly journals Secondary neurological outcomes in patients with brachiocephalic and coronary artery disease in the early postoperative period after simultaneous and hybrid surgical treatment

2021 ◽  
Vol 10 (4) ◽  
pp. 58-67
Author(s):  
O. V. Maleva ◽  
O. A. Trubnikova ◽  
I. V. Таrasova ◽  
S. V. Ivanov ◽  
O. L. Barbarash
Keyword(s):  
Coronary Artery ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Postoperative Cognitive Dysfunction ◽  
Early Postoperative Period ◽  
Brachiocephalic Artery ◽  
Neurological Outcomes ◽  
Simultaneous Surgery ◽  
Artery Disease ◽  
Hybrid Group

Aim. To compare secondary neurological outcomes in patients with brachiocephalic and coronary artery disease in the early postoperative period after different surgical treatment strategies (simultaneous and hybrid).Methods. Secondary neurological outcomes were evaluated in 43 patients with coronary and brachiocephalic artery disease in the early postoperative period after (1) carotid endarterectomy and on-pump coronary artery bypass surgery; (2) percutaneous coronary intervention and carotid endarterectomy. Demographic, clinical, instrumental data were collected. Neuropsychological assessment was performed using the Mini-Mental State Examination and Frontal Assessment Battery. Memory, attention and neurodynamics were measured using the “Status-PF” software at days 2–3 before the surgery and at days 5–7 after it. The presence of postoperative cognitive dysfunction was estimated on the basis of criteria defined as a 20% decline on 20% of the tests. Statistical analysis was performed using the software package “Statistica 10.0”.Results. Patients who underwent hybrid intervention demonstrated improved attention and memory in the early postoperative period. Complex visual-motor reaction significantly increased in patients after simultaneous surgery. Attention differed significantly in both groups. Thus, patients from the hybrid group processed more characters per 1 and 4 minutes while completing the Bourdon proof reading test. The total number of processed characters prevailed in the hybrid group. Cognitive processing speed was higher in the hybrid group according to the brain performance test. The incidence of early postoperative cognitive dysfunction was 60% in patients after simultaneous surgery and 11% in patients after hybrid surgery (p = 0.006, OR±SE 12.5±3.2).Conclusion. Hybrid intervention has shown its superiority over simultaneous intervention in terms of low rate of early cognitive impairment, thereby confirming the necessity to take into account the obtained results while selecting the optimal surgical treatment in patients with coronary and brachiocephalic artery disease present with cognitive deficits at baseline.

scholarly journals Iatrogenic Supraclavicular Nerve Injuries in Surgical Treatment of Clavicle Fractures

2015 ◽  
Vol 22 (2) ◽  
pp. 50-54
Author(s):  
A. S Zolotov ◽  
M. S Feshchenko ◽  
O. I Pak
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Early Postoperative Period ◽  
Surgical Approaches ◽  
Nerve Injuries ◽  
Clavicle Fractures ◽  
Traumatic Damage

Incidence and pattern of disturbed sensitivity in the zone of surgical intervention was studied in 24 patients with clavicle fractures. Traumatic damage of supraclavicular nerve (not related to surgery) was observed only in 1 case. Disturbance of sensitivity in the zone of surgical intervention was noted in 21 (87.5%) patients. Mean area of anesthesia made up 44.5±29.3 cm2 (from 8.0 to 125.5 cm2). That complication developed at both horizontal and vertical surgical approaches. Intraoperatively supraclavicular nerves were visualized and preserved in 6 patients however disturbed sensitivity in early postoperative period was observed in 4 cases. Preventive isolation of supraclavicular nerves does not always ensure the preservation of sensitivity in early postoperative period.

New Potentialities in Surgical Treatment of Proximal Humerus

2011 ◽  
Vol 18 (1) ◽  
pp. 21-27
Author(s):  
Eduard Ivanovich Solod ◽  
A F Lazarev ◽  
Ya G Gudushauri ◽  
M G Kakabadze ◽  
A S Roskidaylo ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Surgical Treatment ◽  
General Condition ◽  
Postoperative Period ◽  
Proximal Humerus ◽  
Original Method ◽  
Early Postoperative Period ◽  
Early Rehabilitation ◽  
Control Group ◽  
Stable Fixation

Original method of stressed osteosynthesis for the treatment of proximal humerus is proposed. Primary tension of Y-shaped pin fixative and secondary tension that is created at its intramedullar insertion and blocking enable to achieve stable fixation of fragments without inflicting additional intraoperative injury in patients of any age and independently of their general condition. Preservation of blood supple in fragments, low traumatic osteosynthesis, and possibility of patients' early rehabilitation define the prospective of this technique for the treatment of patients with fractures on the background of osteoporosis. The importance of drug therapy for osteoporosis in the early postoperative period is shown. Experience in treatment of 62 patients aged from 23 to 78 years is presented. Control group included 30 patients with similar fractures who were treated using osteosynthesis. In the main group good results were achieved in 82.3% of patients, satisfactory - in 17.7%, no poor results were observed. In control group good results made up 40%, satisfactory - 56.7%, poor 0 3.3%.

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