Publications by authors named "Bas Mochtar"
Cardiac surgery with cardiopulmonary bypass (CPB) is associated with blood loss and post-surgery thrombotic complications. The process of thrombin generation is disturbed during surgery with CPB because of haemodilution, coagulation factor consumption and heparin administration. We aimed to investigate the changes in thrombin generation during cardiac surgery and its underlying pro- and anticoagulant processes, and to explore the clinical consequences of these changes using in silico experimentation.
View Article and Find Full Text PDFBackground: In thoracic stent graft repair, the importance of segmental artery (SA) occlusion and the role of blood pressure management during the intraoperative and directly postoperative period are not clear. To study these aspects in relation to spinal cord ischemia, our protocol in the endovascular treatment of descending thoracic aneurysms covering segmental arteries T8 and lower includes preoperative assessment of the spinal cord circulation using magnetic resonance angiography, intraoperative cerebrospinal fluid drainage, and spinal cord function monitoring using motor evoked potentials (MEPs).
Methods: Thirteen patients with thoracic aortic aneurysms and dissections needing stent graft coverage of T8 and lower were included.
Objective: Paraplegia after thoracoabdominal aortic aneurysm (TAAA) repair mainly occurs in patients with Crawford extent I and II. We assessed the impact of monitoring spinal cord integrity and the subsequent adjusted surgical maneuvers on neurologic outcome in repairs of type I and II TAAAs.
Methods: Surgical repair of TAAAs was performed in 112 consecutive patients with extent type I (n = 42) and type II (n = 70) aneurysms.
Objective: Renal failure is a potential complication after thoracoabdominal aortic aneurysm (TAAA) repair and is a significant risk factor for postoperative mortality. We assessed the results of distal aortic perfusion and continuous volume-controlled and pressure-controlled blood perfusion of the kidneys during TAAA repair in patients with preoperative normal and impaired renal function.
Methods: Surgical repair of TAAA was performed in 279 consecutive patients (type I, n = 90; type II, 117; type III, 42; type IV, 30).
Background And Aim Of The Study: Preoperative left ventricular (LV) function is the strongest predictor of outcome after valve replacement for aortic stenosis (AS). Although pressure-volume analysis with the conductance catheter technique can provide detailed information on LV systolic and diastolic function, this technique has not yet been used in AS patients. The present study examined the potential use of LV function measurements using pressure-volume analysis with a conductance catheter during surgery for AS.
View Article and Find Full Text PDFBackground: Monitoring motor-evoked potentials (MEPs) is an accurate technique to assess spinal cord integrity during thoracoabdominal aortic aneurysm (TAAA) repair, guiding surgical strategies to prevent paraplegia.
Methods: In 210 consecutive patients with type I (n = 75), type II (n = 103), and type III (n = 32) TAAA surgical repair was performed using left heart bypass, cerebrospinal fluid drainage, and MEPs monitoring.
Results: Reliable MEPs were registered in all patients.
Background: In this feasibility study, early results are presented of our first series of patients with microwave ablation for atrial fibrillation (AF) on the beating heart.
Methods: From June 2001 until December 2001, a total of 24 patients underwent beating-heart epicardial ablation for AF. With a microwave antenna, the left and right pulmonary veins were isolated and connected to each other followed by amputation of the left atrial appendage.
Objective: In patients with thoracoabdominal aortic aneurysms (TAAAs), the blood supply to the spinal cord is highly variable and unpredictable because of obstructed intercostal and lumbar arteries. This study was performed for the prospective documentation of patent segmental arteries during TAAA repair and the assessment of their functional contribution to the spinal cord blood supply.
Methods: TAAA repair was performed in 184 consecutive patients (68 with type I aneurysm, 91 with type II, and 25 with type III) according to a protocol that included left heart bypass grafting, cerebrospinal fluid drainage, and the monitoring of motor-evoked potentials (MEPs).