8 research outputs found
Transcatheter treatment of failed mitral bioprosthesis and tricuspid annuloplasty – a case report
Our experience with aortic valve repair with a remodeling technique, extraaortic ring implantation and root replacement
Objective: Aortic valve replacement (AVR) is still the most commonly used therapeutic option for patients
suffering from AR. Aortic valve repair (AVRep) is an attractive alternative method, since it avoids
the risks of prosthesis-related complications.1-3 We would like to present our experience with the Yacoub
root remodeling, valve sparing technique with the extraaortic expansible ring.
Patients and Methods: Between November 2014 and July 2019, a total of 79 patients (52.6±13.3 years;
15.2% female, EuroScore II of 3.15%±2) underwent AVRep, 12 due to isolated cusp malcoaptation and 67
associated with aortic root dilatation. Reconstruction was done with the Coroneo Extraaortic Ring (27
(25-31)), and the Gelweave graft (28 (26-32)). 44 patients had a tricuspid valve, 33 patients had a bicuspid
valve, and 2 patients had an unicuspid valve. Concomitant procedures included Mvrep and TVrep in 4
patients, CABG in two patents. Aortic arch was replaced in two patients, two patients underwent hemiarch
replacement, and two patients had aortic arch replacement with stented conduit and placement
of stent in descending thoracic aorta (EVITA stent graft Jotec GmbH). Echocardiography was used to
determine AR severity grade preoperatively, during immediate post-operative period (within 7 days
from operation) and at early follow-up.
Results: In postoperative follow-up no patients died. Freedom from reoperation was 88% (10/79) and
there were 2 patients reoperated due to early postoperative regurgitation, one patient was reoperated
due to AI after two years, and one was operated due to pseudoaneurysm formation after 2.5 years. A
significant decrease in LV end-diastolic diameter was observed (LVEDD) (60mm preoperatively, 53 mm
postoperatively) with further decrease at early follow-up. At follow up none of the patients had major
AR (AR0=61, AR1+=14, AR2+=4).
Conclusions: We have proved that AVRep is a good alternative for patients with aortic insufficiency
and leads to LV reverse remodeling with comparable results in terms of LVEDD and LVEF immediately
post-operatively and at early follow up. It is feasible to use this technique in tricuspid, bicuspid, as well
as unicuspid valves with excellent results
Managment of poststernotomy complications by vacuum therapy
UVOD: Terapija rane podtlakom (eng. „Negative pressure wound therapy“ ; „NPWT“
ili „Vacuum assisted closure“; V.A.C.) široko je rasprostranjena terapijska metoda
koja, različitim mehanizmima potiče cijeljenje akutnih i kroničnih rana. Terapija rane
negativnim tlakom svestrana je metoda te je primjenjiva kod različitih rana, od
dijabetičkog ulkusa, dekubitalnih rana, zbrinjavanja abdominalnih compartment
sindroma do zbrinjavanja sternalnih rana u kardiokirurškim operacijama. Prilikom
kardiokirurških operacija izvođenjem medijalne sternotomije moguća je komplikacija
duboke ili površinske infekcije sternalne regije. Komplicirane duboke sternalne
infekcije povezane su visokim morbiditetom i mortalitetom te se suvremena metoda
terapije negativnim tlakom pokazala kao kvalitetan način liječenja. ---- METODE: Pretražili smo PubMed literaturu koristeći ključne riječi „Vaccum assisted
closure“ , „Negative pressure wound therapy“ , „Poststernotomy wound
complications“ , „sternal wound infections“, „Poststernotomy wound dehiscence“.
Pretežno smo koristili članke u prethodnih 15 godina. ----- REZULTATI: Brojni radovi su objavljeni na temu zbrinjavanja komplikacija medijalne
sternotomije kod kardiokirurških operacija. Danas se ta metoda pokazala
najučinkovitijom u zbrinjavanju dubokih sternalnih infekcija gdje je zabilježen
značajno smanjen mortalitet i morbiditet, uz smanjenje broja reinfekcija a samim
time i potrebe za hospitalizacijom te uštedom novčanih sredstava u zdravstvu. ----- ZAKLJUČAK: Zbrinjavanje komplikacija sternalnih rana terapijom negativnim tlakom
se pokazala vrlo učinkovitom metodom. U usporedbi s prijašnjim metodama
zbrinjavanja zbog svog specifičnog načina djelovanja, jednostavne upotrebe i
umanjenih troškova u odnosu na konvencionalne metode terapija negativnim tlakom
se nametnula kao terapija izbora zbrinjavanja poststernotomijskih komplikacija.BACKGROUND: Negative pressure wound therapy (NPWT) is widely used
method which promotes healing of acute and chronic wounds. It is a versatile
method used for treating all kinds of wounds from diabetic ulcers, bedsores,
management of abdominal compartment syndrome to poststernotomy complications
in cardiac surgery. Complications after median sternotomy include superficial and
deep sternal wound infections. Complicated deep sternal infections are associated
with high morbidity and mortality and the NWPT has been showing great results. ----- METHODS: We searched PubMed literature using the following key words:
„Vacuum assisted closure“, „Negative pressure wound therapy“, „Poststernotomy
wound complications“ , „Sternal wound infections“, „Poststernotomy wound
dehiscence“. We mainly used articles in the past fifteen years. ----- RESULTS: There are numerous papers published regarding NPWT use in
management medial sternotomy complications after cardiac surgery. Today this
method has been shown to be efficient in management of poststernotomy
complications where it showed significant reduction in mortality and morbidity,and
reduced reinfections which reduced hospital treatment costs. ----- CONCLUSION: Management of poststernotomy complications by vacuum
therapy has been shown to be very efficient. In comparison to conventional methods
because of its specific mode of action, simple use and cost reduction compared to
other methods it has imposed as the therapy of choice for management of
poststernotomy complications
Managment of poststernotomy complications by vacuum therapy
UVOD: Terapija rane podtlakom (eng. „Negative pressure wound therapy“ ; „NPWT“
ili „Vacuum assisted closure“; V.A.C.) široko je rasprostranjena terapijska metoda
koja, različitim mehanizmima potiče cijeljenje akutnih i kroničnih rana. Terapija rane
negativnim tlakom svestrana je metoda te je primjenjiva kod različitih rana, od
dijabetičkog ulkusa, dekubitalnih rana, zbrinjavanja abdominalnih compartment
sindroma do zbrinjavanja sternalnih rana u kardiokirurškim operacijama. Prilikom
kardiokirurških operacija izvođenjem medijalne sternotomije moguća je komplikacija
duboke ili površinske infekcije sternalne regije. Komplicirane duboke sternalne
infekcije povezane su visokim morbiditetom i mortalitetom te se suvremena metoda
terapije negativnim tlakom pokazala kao kvalitetan način liječenja. ---- METODE: Pretražili smo PubMed literaturu koristeći ključne riječi „Vaccum assisted
closure“ , „Negative pressure wound therapy“ , „Poststernotomy wound
complications“ , „sternal wound infections“, „Poststernotomy wound dehiscence“.
Pretežno smo koristili članke u prethodnih 15 godina. ----- REZULTATI: Brojni radovi su objavljeni na temu zbrinjavanja komplikacija medijalne
sternotomije kod kardiokirurških operacija. Danas se ta metoda pokazala
najučinkovitijom u zbrinjavanju dubokih sternalnih infekcija gdje je zabilježen
značajno smanjen mortalitet i morbiditet, uz smanjenje broja reinfekcija a samim
time i potrebe za hospitalizacijom te uštedom novčanih sredstava u zdravstvu. ----- ZAKLJUČAK: Zbrinjavanje komplikacija sternalnih rana terapijom negativnim tlakom
se pokazala vrlo učinkovitom metodom. U usporedbi s prijašnjim metodama
zbrinjavanja zbog svog specifičnog načina djelovanja, jednostavne upotrebe i
umanjenih troškova u odnosu na konvencionalne metode terapija negativnim tlakom
se nametnula kao terapija izbora zbrinjavanja poststernotomijskih komplikacija.BACKGROUND: Negative pressure wound therapy (NPWT) is widely used
method which promotes healing of acute and chronic wounds. It is a versatile
method used for treating all kinds of wounds from diabetic ulcers, bedsores,
management of abdominal compartment syndrome to poststernotomy complications
in cardiac surgery. Complications after median sternotomy include superficial and
deep sternal wound infections. Complicated deep sternal infections are associated
with high morbidity and mortality and the NWPT has been showing great results. ----- METHODS: We searched PubMed literature using the following key words:
„Vacuum assisted closure“, „Negative pressure wound therapy“, „Poststernotomy
wound complications“ , „Sternal wound infections“, „Poststernotomy wound
dehiscence“. We mainly used articles in the past fifteen years. ----- RESULTS: There are numerous papers published regarding NPWT use in
management medial sternotomy complications after cardiac surgery. Today this
method has been shown to be efficient in management of poststernotomy
complications where it showed significant reduction in mortality and morbidity,and
reduced reinfections which reduced hospital treatment costs. ----- CONCLUSION: Management of poststernotomy complications by vacuum
therapy has been shown to be very efficient. In comparison to conventional methods
because of its specific mode of action, simple use and cost reduction compared to
other methods it has imposed as the therapy of choice for management of
poststernotomy complications
Managment of poststernotomy complications by vacuum therapy
UVOD: Terapija rane podtlakom (eng. „Negative pressure wound therapy“ ; „NPWT“
ili „Vacuum assisted closure“; V.A.C.) široko je rasprostranjena terapijska metoda
koja, različitim mehanizmima potiče cijeljenje akutnih i kroničnih rana. Terapija rane
negativnim tlakom svestrana je metoda te je primjenjiva kod različitih rana, od
dijabetičkog ulkusa, dekubitalnih rana, zbrinjavanja abdominalnih compartment
sindroma do zbrinjavanja sternalnih rana u kardiokirurškim operacijama. Prilikom
kardiokirurških operacija izvođenjem medijalne sternotomije moguća je komplikacija
duboke ili površinske infekcije sternalne regije. Komplicirane duboke sternalne
infekcije povezane su visokim morbiditetom i mortalitetom te se suvremena metoda
terapije negativnim tlakom pokazala kao kvalitetan način liječenja. ---- METODE: Pretražili smo PubMed literaturu koristeći ključne riječi „Vaccum assisted
closure“ , „Negative pressure wound therapy“ , „Poststernotomy wound
complications“ , „sternal wound infections“, „Poststernotomy wound dehiscence“.
Pretežno smo koristili članke u prethodnih 15 godina. ----- REZULTATI: Brojni radovi su objavljeni na temu zbrinjavanja komplikacija medijalne
sternotomije kod kardiokirurških operacija. Danas se ta metoda pokazala
najučinkovitijom u zbrinjavanju dubokih sternalnih infekcija gdje je zabilježen
značajno smanjen mortalitet i morbiditet, uz smanjenje broja reinfekcija a samim
time i potrebe za hospitalizacijom te uštedom novčanih sredstava u zdravstvu. ----- ZAKLJUČAK: Zbrinjavanje komplikacija sternalnih rana terapijom negativnim tlakom
se pokazala vrlo učinkovitom metodom. U usporedbi s prijašnjim metodama
zbrinjavanja zbog svog specifičnog načina djelovanja, jednostavne upotrebe i
umanjenih troškova u odnosu na konvencionalne metode terapija negativnim tlakom
se nametnula kao terapija izbora zbrinjavanja poststernotomijskih komplikacija.BACKGROUND: Negative pressure wound therapy (NPWT) is widely used
method which promotes healing of acute and chronic wounds. It is a versatile
method used for treating all kinds of wounds from diabetic ulcers, bedsores,
management of abdominal compartment syndrome to poststernotomy complications
in cardiac surgery. Complications after median sternotomy include superficial and
deep sternal wound infections. Complicated deep sternal infections are associated
with high morbidity and mortality and the NWPT has been showing great results. ----- METHODS: We searched PubMed literature using the following key words:
„Vacuum assisted closure“, „Negative pressure wound therapy“, „Poststernotomy
wound complications“ , „Sternal wound infections“, „Poststernotomy wound
dehiscence“. We mainly used articles in the past fifteen years. ----- RESULTS: There are numerous papers published regarding NPWT use in
management medial sternotomy complications after cardiac surgery. Today this
method has been shown to be efficient in management of poststernotomy
complications where it showed significant reduction in mortality and morbidity,and
reduced reinfections which reduced hospital treatment costs. ----- CONCLUSION: Management of poststernotomy complications by vacuum
therapy has been shown to be very efficient. In comparison to conventional methods
because of its specific mode of action, simple use and cost reduction compared to
other methods it has imposed as the therapy of choice for management of
poststernotomy complications