A different technique for sutureless coronary bypass grafting.

Introduction: Many coronary anastomotic devices have been designed to replace manual stitching in coronary surgery; however, interestingly, none of them became widespread. Our aim was to work out an easy and fast endoluminal vessel-to-vessel stent bridge distal anastomotic technique.

Materials And Methods: Ten coronary arteries of eight fresh human hearts were used in this study.

Introducing the craniocervical Y-ligament.

Purpose: We examined the accessory atlantoaxial ligaments and found them to be a part of a complex ligamentous structure, which we named craniocervical Y-ligament with respect to its shape.

Methods: The ligaments of the upper cervical spine were dissected in ten Thiel embalmed human cadavers. Origin and attachment of the Y-ligament were described and a detailed photo and video-documentation was carried out with the head in the neutral position, flexion, extension and rotation to study the ligament during these movements.

Primary Obstruction of the Foramen of Luschka: Anatomy, Histology, and Clinical Significance.

Background: The foramen of Luschka is a natural aperture between the fourth ventricle and the subarachnoid space at the cerebellopontine angle. Membranous closure of this foramen is referred to as primary obstruction. Available information about this variant and its role in the development of the cysts of the posterior fossa is contradictory.

Morphometry and microsurgical anatomy of Bochdalek's flower basket and the related structures of the cerebellopontine angle.

Background: Bochdalek's flower basket (Bfb) is the distal part of the horizontal segment of the fourth ventricle's choroid plexus protruding through the lateral aperture (foramen of Luschka). The microsurgical anatomy of the cerebellopontine angle, fourth ventricle and its inner choroid plexus is well described in the literature, but only one radiological study has investigated the Bfb so far. The goal of the present study was to give an extensive morphometric analysis of the Bfb for the first time and discuss the surgically relevant anatomical aspects.

Endoscopic approach-routes in the posterior fossa cisterns through the retrosigmoid keyhole craniotomy: an anatomical study.

Endoscopy in cerebellopontine angle surgery is an increasingly used technique. Despite of its advantages, the shortcomings arising from the complex anatomy of the posterior fossa are still preventing its widespread use. To overcome these drawbacks, the goal of this study was to define the anatomy of different endoscopic approaches through the retrosigmoid craniotomy and their limitations by surgical windows.

Experimental transapical endoscopic ventricular visualization and mitral repair.

Background: An increasing number of experimental beating heart animal studies describe simple transapical mitral valve repairs based on the direct endoscopic visualization of the left ventricle. The aim of our human cadaveric study was to develop a method for more complex transapical endoscopic procedures by on-pump heart operations.

Materials And Methods: After preparation of 20 human fresh cadavers, a standard left anterolateral minithoracotomy was performed in the fifth intercostal space and the pericardium was entered.

Applied anatomy of a minimally invasive muscle-splitting approach to posterior C1-C2 fusion: an anatomical feasibility study.

Purpose: To describe the applied anatomy of a minimally invasive muscle-splitting approach used to reach the posterior aspect of the C1-C2 complex. Atlantoaxial fusion using a midline posterior approach and polyaxial screw and rod system is widely used. Although minimally invasive variations of this technique have been recently reported, the complex applied anatomy of these approaches has not been described.

Comparative endoscopic anatomic description of the mitral valvular complex: a cadaveric study.

Background: We compared the aortic, left atrial, and apical approaches to visualize the mitral valve with the goal to investigate the endoscopic anatomy and give exact step-by-step descriptions of these views.

Materials And Methods: The mitral valvular complex of human cadaveric fresh hearts was investigated from three approaches using 0, 30, and 70 degrees rigid endoscopic optics. In 30 cases after the removal of the hearts, the endoscopes were introduced directly into the aortic root through an aortotomy, left atrium through a standard atriotomy, and apex of the heart through a transmural incision.

Intraosseous territory of the facial artery in the maxilla and anterior mandible: implications for allotransplantation.

Aim: The aim of this anatomical study was to define the intraosseous vascular territory of the facial artery. The clinical issue is whether ipsilateral facial artery anastomosis will guarantee blood supply to the ipsi- and contralateral mandibular symphyses and maxillae in allotransplantation.

Material And Methods: Of 10 human cadaveric heads, the left facial artery was injected with a positive contrast agent.

Histamine and H1 -histamine receptors faster venous circulation.

The study has analysed the action of histamine in the rabbit venous system and evaluated its potential role in contraction during increased venous pressure. We have found that a great variety exists in histamine sensitivity and H(1) -histamine receptor expression in various types of rabbit veins. Veins of the extremities (saphenous vein, femoral vein, axillary vein) and abdomen (common iliac vein, inferior vena cava) responded to histamine by a prominent, concentration-dependent force generation, whereas great thoracic veins (subclavian vein, superior vena cavas, intrathoracic part of inferior vena cava) and a pelvic vein (external iliac vein) exhibited slight sensitivity to exogenous histamine.

[Excision of the calcified mitral valve with ultrasound scalpel].

Mitral valve excision using ultrasound device has not been a routine procedure yet. We used an ultrasonic scalpel for the excision of the calcified mitral valves, which shorten operation time. Further, this technique permits an excision of the valve without applying traction or elevation of the valve from the level of the annulus.

Surgical anatomy of the cochlea for cochlear implantation.

The anatomy of the cochlea was investigated to obtain precise data for surgical cochlear implantation. The aim of this study has been to find the optimal site for cochleostomy, to determine the course of the basal turn and to define the relationship of the cochlea to the middle ear. Our study is the first to depict the cochlea in a classical coordinate system, to compare the anatomical situation to the surgical approaches, and, consequently, to offer firm anatomical basis for minimal invasive intervention.

Development of the protympanum.

The protympanum, the only opening of the tympanic cavity, has enormous significance in the pathogenesis of middle ear inflammation. In our study, we analyzed 70 macerated temporal bones stereomicroscopically to understand the development of the protympanum. Details of this embryonic process were attained using histological sections made in frontal and horizontal planes.

Hand perfusion with 99mTc-HSA in patients expecting to undergo coronary bypass surgery: elaboration of a new complex diagnostic protocol for the safe removal of a radial artery graft.

Background: The Allen test is used worldwide for radial artery graft removal. The postoperative examination of our patients' hand function and circulation proved that beside the transient neurological complications chronic hand circulatory disorders may arise.

Aim: To develop a non-invasive method suitable for an objective evaluation of the hand's circulation to make it possible to use radial arteries safely for the revascularization of coronary arteries.

Development and surgical anatomy of the round window niche.

The round window niche is a bony pouch of the tympanic cavity and clinically frequently explored, therefore its topography has fundamental impact on microsurgery. A total of 783 macerated and formalin-fixed temporal bones were used to study the normal anatomy of the round window and its development. The ossification of the niche starts in the 16th fetal week and is complete at birth.

Development of the anterior chordal canal.

Resent advances have led to the reexamination of the intraosseous pathway of the chorda tympani a few years ago and they stated that the nerve never enters the mandibular fossa and its exit the skull base in the sphenopetrosal fissure. In our report, 58 temporal bones were investigated after maceration and formalin fixation in order to understand the development of the anterior chordal canal. Our study revealed that the chorda tympani leaves the tympanic cavity through the tympanosquamosal fissure before formation of the anterior chordal canal of Huguier.

Geometrical model of the pulmonary root.

Background And Aim Of The Study: The renaissance of the Ross procedure has attracted much attention to the clinical anatomy of the pulmonary valve. Within the reviewed literature which emphasizes the morphology of the pulmonary root, no detailed anatomy has been reported. The study aim was to describe the cardiosurgical-orientated anatomy of the pulmonary valve.

A new classification of the mitral papillary muscle.

Background: Mitral valve homograft implantation and reconstruction of the left ventricular subvalvular apparatus requires a good knowledge of the morphology of the left papillary muscles. A comprehensive description of the left ventricular subvalvular apparatus is presented to aid in this procedure and to support conventional and endoscope-assisted reconstruction of the chordae tendineae.

Material/methods: The subvalvular apparatuses of 100 unfixed human hearts were investigated.

The clinical anatomy of the sinus node artery.

Background: Our basic aim was to describe the topographic relation between the sinus node artery and the superior posterior border of the interatrial septum with regard to the sinus node dysfunction that follows the superior transseptal approach to the mitral valve.

Methods: During our study 50 human hearts without previous pathologic alterations were analyzed. The position of the sinus node and the course of the sinus node artery were investigated.

[Biportal neuroendoscopy of the prepontine cisterns].

Introduction: While bi- or multiportal approaches have been adopted in different fields of surgery including abdominal and spine surgery, the uniportal access into the skull is a traditional principle in neurosurgery. In this preclinical cadaver study the authors developed combinations of biportal endoneurosurgical dissections in the prepontine subarachnoid space to test the safety of this technique.

Methods: In 34 fresh post-mortem adult human cadavers and 14 formaldehyde-fixed adult human head specimen a total of 48 biportal endoscopical dissections were carried out.

The anatomy of the aortic root.

Objective: Since the aortic root preserving methods are spreading in heart surgery, the importance of aortic root anatomy is increasing. The surgical and anatomical descriptions of the aortic root are not always congruent. Therefore, the present study focuses on the surgical aspects of the aortic root anatomy.

Topographic microsurgical anatomy of the paraclinoid carotid artery.

In this publication, the authors describe the microanatomic topography of the entire paraclinoid area with respect to the paraclinoid segment of the internal carotid artery and its surrounding anatomical structures. Special attention was given to the borders of the paraclinoid area, cavernous sinus, arterial vessels, and cranial nerves passing through the region. The paraclinoid region was defined as a pyramid-formed space formed by the dural covering of the anterior clinoid process.