Search results for "Operative"
showing 10 items of 2781 documents
Fehlerquellen der Navigation in der lateralen Sch�delbasischirurgie
2003
Die Identifikation moglicher Storfaktoren navigationsunterstutzter Eingriffe an der lateralen Schadelbasis ermoglichen dem Anwender die Vermeidung und Behebung dieser Fehler. Anhand unserer Erfahrungen von 85 navigationsunterstutzten Eingriffen im Bereich der lateralen Schadelbasis werden Fehler der Hard- und Software, der Bildgebung und des -transfers, der Patientenregistrierung, durch den Anwender und solche strategischer Art analysiert. Bei optischen CAS-Systemen fuhrt eine Blockade des Sichtfelds der Kameras zu Funktionsbeschrankungen, wahrend elektromagnetische Systeme durch ferromagnetisch aktive Materialien beeinflusst werden konnen. Die bisherigen Verfahren der Patientenregistrierun…
A case report of a difficult dissection of the iliac vessels conducted by means of the harmonic scalpel during a kidney transplantation
2011
Background. The “difficult” preparation of iliac vessels in the kidney transplant recipient caused by a perivascular fibrosis with satellite lymphadenopathy is sometimes burdened by post-transplant complications (lymphocele, seroma and hematoma). Both iliac vascular adhesions and satellite lymphoadenopaty are often due to reiterate femoral cannulation aimed to hemodialysis. Patients and Methods: The case report concerns a 60 years old female uremic patient, on dialysis for about 4 years with perivascular fibrosis and pelvic lymphadenopathy caused by bilateral femoral artery catheterization. In the course of kidney transplant, preparation of the iliac vessels was performed by ultrasonic scal…
A population-based study relevant to seasonal variations in causes of death in children undergoing surgery for congenital cardiac malformations
2007
AbstractAimsOur objectives were, first, to study seasonal distribution of perioperative deaths within 30 days after surgery, and late death, in children undergoing surgery for congenitally malformed hearts, and second, to study the causes of late death.MethodsWe analysed a retrospective cohort of 1,753 children with congenital cardiac malformations born and undergoing surgery in the period from 1990 through 2002 with a special focus on the causes of late death. The data was obtained from the registry of congenital cardiac malformations at Rikshospitalet, Oslo, and the Norwegian Medical Birth Registry. The mean follow-up from birth was 8.1 years, with a range from zero to 15.2 years.ResultsD…
Cardiac pacing in premature infants and neonates: steroid eluting leads and automatic output adaptation
1999
Abstract Background . Appropriate generator and lead selection as well as techniques of implantation are most important aspects of cardiac pacing in the extremely young patient. Here we report the clinical results using a new technique with automatic output adaptation based on evoked response in combination with steroid-eluting epicardial leads in small children. Methods . One neonate and 2 premature infants underwent permanent pacemaker implantation because of congenital high-degree atrioventricular block or postoperative complete heart block, respectively. Steroid-eluting epicardial leads and a multiprogrammable pacemaker with automatic output adaptation were used. Results . Intermuscular…
The heart in the elderly critically ill patient
2002
Cardiac complications such as myocardial infarction and congestive heart failure are the primary source of perioperative morbidity and mortality in elderly surgical patients. This is the result of structural and functional age-related changes in the heart and the vasculature and an increasing incidence of cardiovascular disorders. Appropriate perioperative management of the elderly patient should be based on the extent of functional compromise, the type and severity of pre-existing disease, and the invasiveness of the surgical procedure. Current studies suggest that appropriately administered medical therapy, particularly beta-adrenergic blockade, may reduce perioperative cardiovascular mor…
Charting a Roadmap for Heart Failure Biomarker Studies
2013
Heart failure is a syndrome with a pathophysiological basis that can be traced to dysfunction in several interconnected molecular pathways. Identification of biomarkers of heart failure that allow measurement of the disease on a molecular level has resulted in enthusiasm for their use in prognostication and selection of appropriate therapies. However, despite considerable amounts of information available on numerous biomarkers, inconsistent research methodologies and lack of clinical correlations have made bench-to-bedside translations rare and left the literature with countless publications of varied quality. There is a need for a systematic and collaborative approach aimed at definitively…
Early cardiac unloading with ImpellaCP™ in acute myocardial infarction with ventricular septal defect
2020
Abstract Despite a relative contraindication, mechanical support with Impella™ left ventricular assist device has already been described for ischaemic ventricular septal defect treatment, either as a bridge to surgery, as intraoperative mechanical haemodynamic support, or to ensure intraprocedural haemodynamic stability during device closure. We describe two cases of ventricular septal defect complicating acute myocardial infarction, where the percutaneous ImpellaCP was implanted early (differently than previously described) with the aim of preventing haemodynamic instability, while deferring surgical repair. We present a report of haemodynamic, echocardiographic, biochemical, and clinical …
What Is the Role of Minimally Invasive Mitral Valve Surgery in High-Risk Patients? A Meta-Analysis of Observational Studies
2016
Background. Minimally invasive valve surgery is related to certain better postoperative outcomes. We aimed to assess the role of minimally invasive mitral valve surgery in high-risk patients. Methods. A systematic literature review identified eight studies of which seven fulfilled criteria for metaanalysis. Outcomes for a total of 1,254 patients (731 were conventional standard sternotomy and 523 were minimally invasive mitral valve surgery) were submitted to meta-analysis using random effects modeling. Heterogeneity and subgroup analysis with quality scoring were assessed. The primary end point was early mortality. Secondary end points were intraoperative and postoperative outcomes and long…
Preoperative evaluation before MitraClip®: present and future perspective.
2014
ABSTRACT Mitral regurgitation (MR) is the second most common heart valve disease worldwide. Currently, the management of MR is based on medical therapy (including biventricular pacing), surgery (mitral valve replacement or repair) and percutaneous therapy. However, in spite of guideline recommendations, 50% of individuals assessed in the Euro Heart Survey were not referred to surgical intervention due to comorbidities or real or perceived high risks for cardiac surgery; thus, in recent years, the focus of research has shifted to the development of percutaneous approaches to treat severe MR in order to restore valve function in a minimally invasive fashion. Among these techniques, the perc…
SYMPTOMATIC ACUTE MYOCARDIAL INFARCTION IN A PATIENT BEARER OF HEART TRANSPLANTATION FOLLOWING ISCHEMIC HEART DISEASE
2008
In 2005 Syeda et al. reported that the major factor limiting the long term of cardiac transplantation is the development of accelerated arteriosclerosis that occurs in the coronary arteries of the cardiac allograft. Transplant arteriosclerosis is characterized by diffuse, uniform, concentric narrowing of the artery by a fibrous proliferation of sub-intima cells. This atherosclerosis was estimate to occur in approximately 50% of patients by 5 years after transplantation. Unfortunately, as a consequence of cardiac denervation, symptoms are often atypical or completely absent. When these are present, the symptoms are those typical of effort angina. Very uncommon is the acute coronary syndrome.…