Modified Warden operation using aortic homograft.
Ontology highlight
ABSTRACT:
SUBMITTER: Kumar TKS
PROVIDER: S-EPMC8305712 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description: Not available
| S-EPMC8304521 | biostudies-literature
Project description:We present a case of acute aortic homograft regurgitation manifesting as a new-onset "cooing" murmur in a patient with congenital heart disease who did not have signs of clinical decompensation or evidence of infective endocarditis. He underwent successful transcatheter aortic valve implantation following a diagnosis of sterile acute valvular degeneration. (Level of Difficulty: Intermediate.).
| S-EPMC8299863 | biostudies-literature
Project description:The advent of the arterial switch operation for the treatment of transposition of great arteries (TGA) made the atrial switch operation largely redundant and its use in the developed world is now confined to the atrial component of the double-switch operation for congenitally corrected TGA. In resource-limited countries, however, it remains relevant as a treatment option for patients presenting late with transposition and a regressed left ventricle. The operation is intricate with many potential pitfalls, and this "how I do it" article describes the operative steps in detail to enable surgeons to learn this procedure and make it a part of their surgical armamentarium.
| S-EPMC8457269 | biostudies-literature
Project description:Introduction and importanceBekhterev's disease, or ankylosing spondylitis (AS), is a chronic inflammatory rheumatic disease closely related to the human leukocyte antigen (HLA)-B27. Cardiac damage in AS occurs in 2-10 % of patients more commonly as aortic insufficiency, aortitis, mitral valve fibrosis, or cardiac conduction abnormalities.Case presentationIn this article we present a clinical case of a 52-year-old female patient with Bekhterev's disease, who underwent aortic valve reconstruction with autopericardium and mitral homograft implantation in mitral position.Clinical discussionThe use of homografts and reconstructive surgeries using autologous materials allow not only avoiding lifelong intake of anticoagulants, but also maintaining hemodynamic profile comparable to that of native valves.ConclusionThis clinical case shows that treatment of patients with rheumatic diseases is a complex treatment problem that requires a personalized approach.
| S-EPMC9988661 | biostudies-literature
Project description:Aortic valve infective endocarditis is a life-threatening condition. Patients frequently present profoundly unwell and extensive surgery may be required to correct the underlying anatomical deficits and control sepsis. Periannular involvement occurs in more than 10% of patients with aortic valve endocarditis. Complex aortic valve endocarditis has a mortality rate of 10 to 40%. Longstanding surgical dogma suggests homografts represent the optimal replacement option in complex aortic valve endocarditis; however, there is a paucity of evidence and lack of consensus on the optimal replacement choice. A systematic review and meta-analysis was performed utilizing EMBASE, PubMed, and the Cochrane databases to review articles describing homografts versus aortic valve replacement and/or valved conduit graft implantation for complex aortic valve endocarditis. The outcomes of interest were mortality, reinfection, and reoperation. Eleven studies were included in this meta-analysis, contributing 810 episodes of complex aortic valve endocarditis. All included reports were cohort studies. There was no statistically significant difference in overall mortality (risk ratio [RR] 0.99; 95% confidence interval [CI], 0.61-1.59; p = 0.95), reinfection (RR 0.89; 95% CI, 0.45-1.78; p = 0.74), or reoperation (RR 0.91; 95% CI, 0.38-2.14; p = 0.87) between the homograft and valve replacement/valved conduit graft groups. Overall, there was no difference in mortality, reinfection, or reoperation rates between homografts and other valve or valved conduits in management of complex aortic endocarditis. However, there is a paucity of high-quality evidence in the area, and comparison of valve types warrants further investigation.
| S-EPMC9357462 | biostudies-literature
Project description:Cardiovascular surgery requires the use of state-of-the-art artificial materials. For example, microporous polytetrafluoroethylene grafts manufactured by Gore-Tex® are used for the treatment of cyanotic heart defects (i.e., modified Blalock-Taussig shunt). Significant mortality during this palliative operation has led surgeons to adopt mathematical models to eliminate complications by performing fluid-solid interaction (FSI) simulations. To proceed with FSI modeling, it is necessary to know either the mechanical properties of the aorta and graft or the rheological properties of blood. The properties of the aorta and blood can be found in the literature, but there are no data about the mechanical properties of Gore-Tex® grafts. Experimental studies were carried out on the mechanical properties vascular grafts adopted for modified pediatric Blalock-Taussig shunts. Parameters of two models (the five-parameter Mooney-Rivlin model and the three-parameter Yeoh model) were determined by uniaxial experimental curve fitting. The obtained data were used for patient-specific FSI modeling of local blood flow in the "aorta-modified Blalock-Taussig shunt-pulmonary artery" system in three different shunt locations: central, right, and left. The anisotropic model of the aortic material showed higher stress values at the peak moment of systole, which may be a key factor determining the strength characteristics of the aorta and pulmonary artery. Additionally, this mechanical parameter is important when installing a central shunt, since it is in the area of the central anastomosis that an increase in stress on the aortic wall is observed. According to computations, the anisotropic model shows smaller values for the displacements of both the aorta and the shunt, which in turn may affect the success of preoperative predictions. Thus, it can be concluded that the anisotropic properties of the aorta play an important role in preoperative modeling.
| S-EPMC9026531 | biostudies-literature
Project description:Introduction: The anti-Nuss procedure has gradually been found to have several shortcomings in clinical practice. Accordingly, our department previously designed and introduced a new steel plate. However, there is limited evidence regarding its safety and efficacy. Thus, we aim to compare the efficacy and safety of the conventional anti-Nuss operation with those of a modified anti-Nuss operation using a flexible plate. Methods: Patients with pectus carinatum who underwent surgery between January 2014 and August 2019 were consecutively enrolled in this single-center, retrospective study. In all, 53 patients underwent the modified procedure using the new steel plate (new procedure group), whereas 43 underwent the conventional anti-Nuss procedure (traditional procedure group). Outcome analysis was performed using SPSS to compare the intraoperative and postoperative short-term outcomes. Results: All patients in the new procedure group had shorter operation duration (75.23 ± 11.90 vs. 82.45 ± 9.30 min, p = 0.008), postoperative hospitalizations (3.42 ± 0.95 vs. 4.64 ± 1.53 days, p = 0.039), and plate removal surgery durations (40.60 ± 3.47 vs. 60.30 ± 9.75 min, p = 0.041) than patients in the traditional procedure group. There were no significant differences in the length of incision, postoperative Haller index, cost, postoperative surgical outcome, and incidence of complications between the two groups. Conclusion: Our data reveal that the main clinical outcomes were similar for after anti-Nuss operation and modified anti-Nuss operation. However, the modified procedure for pectus carinatum had a shorter operation duration, postoperative hospitalization, and plate removal surgery duration.
| S-EPMC7920095 | biostudies-literature
Project description:BackgroundShortcoming of traditional Nuss operation on adults is gradually found in the clinical practice. A new kind of introducer-bar complex was introduced. However, there is limited evidence regarding its safety and efficacy. Therefore, a single center, retrospective study was conducted to address this issue.MethodsPatients with pectus excavatum who underwent surgery between January 2015 and June 2017 were consecutively enrolled in this study. In all, 52 patients underwent the modified procedure using the introducer-bar complex (new procedure group), whereas 48 underwent the traditional anti-Nuss procedure (traditional procedure group). Outcomes analysis of balanced baseline was performed to compare the intraoperative and postoperative short-term outcomes.ResultsAll patients in the new procedure group had shorter operation duration (51.54 ± 20.32 vs. 79.45 ± 13.88 min, p = 0.017), postoperative hospitalizations (4.77 ± 1.62 vs. 6.86 ± 2.18 days, p = 0.028), plate removal surgery durations (39.30 ± 8.97 vs. 60.30 ± 10.49 min, p < 0.001), and less blood loss during operation (6.25 ± 4.88 vs. 10.90 ± 5.75 ml, p = 0.003) than patients in the traditional procedure group. There was no significant difference in the length of incision, postoperative Haller index, cost, number of steel bars, postoperative surgical outcome and incidence of complications between the two groups.ConclusionThrough the main clinical outcome were similar, our results shown that modified procedure may have the shorter operation time, postoperative hospital stay, and operation time for plate removal and less blood loss, which may bring potential clinical benefits to patients.
| S-EPMC8456631 | biostudies-literature
Project description:Faden operation was first described in 1912. It weakens the muscle in its field of action without much slackening and alteration in the primary position. When combined with recession the weakening effect is more. It is a useful surgery in esotropia with high accommodative convergence, nystagmus blockage syndrome, dissociated vertical deviation, Duane's retraction syndrome with up or downshoots, and in sixth nerve paresis, where it is performed on the contralateral normal yoke muscle to increase the field of binocular vision. The conventional procedure is cumbersome due to small working space, entanglement of sutures, and posterior location of Faden site which is not easily accessible. We have modified the Faden operation by using a single 5-0 double-armed polyester suture, which is much easier and simpler to perform, and have done it in a series of small angle esotropias combined with recession. This paper demonstrates the surgical technique so that this surgery can be performed with ease by more surgeons.
| S-EPMC6376826 | biostudies-other