Combination of Bacteriophages and Antibiotics for Prevention of Vascular Graft Infections-An In Vitro Study.

(1) Background: Implant-associated bacterial infections are usually hard to treat conservatively due to the resistance and tolerance of the pathogens to conventional antimicrobial therapy. Bacterial colonization of vascular grafts may lead to life-threatening conditions such as sepsis. The objective of this study is to evaluate whether conventional antibiotics and bacteriophages can reliably prevent the bacterial colonization of vascular grafts.

A functioning Björk-Shiley aortic valve after 36 years without anticoagulation.

There is a broad consensus among all clinical guidelines that lifelong oral anticoagulation is mandatory after mechanical valve prosthesis implantation. However, in rare cases, patients do not receive anticoagulation or anticoagulation therapy is withdrawn over time. We present a case of an exceptionally durable Björk-Shiley mechanical aortic valve prosthesis still functioning 49 years after implantation.

Open surgical replacement of the descending aorta: single-center experience.

Background: This study presents a single center's experience and analyzes clinical outcomes following elective open surgical descending aortic replacement.

Methods: Between January 2000 and August 2019, 96 patients with mean age 64 years (range, 49.5-71 years) (62.

Single-center experience with thoracoabdominal aortic replacement in patients with Marfan syndrome.

Objectives: Patients with Marfan syndrome are usually not suitable for endovascular repair of the thoracoabdominal aorta. This study was designed to analyze our center's experience with open surgical thoracoabdominal aortic replacement in Marfan patients.

Methods: This was a retrospective study with prospective follow-up.

Valve-sparing David procedure minimally invasive access does not compromise outcome.

Objectives: Aortic valve sparing-aortic root replacement (David procedure) has not been routinely performed minimally invasive access due to its complexity. We compared our results of elective David procedure minimally invasive access to those a full sternotomy.

Methods: Between 1993 and 2019, a total of 732 patients underwent a valve sparing root replacement (David) procedure.

A Hyperdynamic Arteriovenous Fistula Aneurysm After Long Time Renal Transplantation.

Closure of arteriovenous fistula should be considered in patients who underwent successful renal transplantation to avoid potential complications that may result from the presence of unused fistula especially, in patients who are predisposed to aneurysm formation in the future.

Chronic unilateral arm lymphedema correlates with increased intima-media thickness in the brachial artery.

Drainage of the arterial wall via adventitial lymphatic vessels has been shown to play a pivotal role for vessel wall homeostasis. Also, retrograde cholesterol transport is ensured via this route, but no studies exist to demonstrate that lymphatic stasis would represent a mechanism to initiate atherosclerotic lesion formation in human arteries. To test this hypothesis, we embarked on a simple clinical experiment, assessing wall thickness in limb arteries with lymphedema after surgical intervention, with the contralateral limb serving as control.

Vascular procedures in patients with left ventricular assist devices: single-center experience.

Objective: A growing number of patients suffering from heart failure is living with a left ventricular assist device (LVAD) and is in the need for non-cardiac surgery. Vascular procedures due to ischemia, bleeding, or other device-related complications may be required and pose a challenge to the caregivers in terms of monitoring and management of these patients. Therefore, we reviewed our experience with LVAD patients undergoing vascular surgery.

Routine Stent Bridging to the Supraaortic Vessels in Aortic Arch Replacement: 10-Year-Experience.

Background: The supraaortic vessel anastomosis stent bridging (SAVSTEB) technique simplifies the reattachment of the supraaortic vessels in aortic arch surgery; however, follow-up data are limited. The study aimed to investigate the stent-related performance and complications.

Methods: Between February 2009 and September 2020, 112 patients underwent total arch replacement with a tetrabranched graft and using the SAVSTEB technique.

Native and prosthetic graft infections of the thoracic aorta: surgical management.

Objectives: Infection of the native aorta or after previous open or endovascular repair of the thoracic aorta is associated with high risks for morbidity and mortality. We analysed the outcome after surgical management of a native mycotic aneurysm or of prosthetic graft infection of the descending aorta.

Methods: From June 2000 to May 2019, a total of 39 patients underwent surgery in our centre for infection of the native descending aorta (n = 19 [49%], group A) or a prosthetic descending aorta [n = 20 (51%), group B].

Prospective evaluation of preoperative lung ultrasound for prediction of perioperative outcome and myocardial injury in adult patients undergoing vascular surgery (LUPPO study).

Background: Myocardial injury after non-cardiac surgery (MINS) is a frequent perioperative event in vascular surgery, associated both with worse outcome and subsequent cardiovascular events. Current guidelines advocate troponin (hs-cTnT) and NT-proBNP measurements in selected patients before surgery, but accurate preoperative identification of patients at risk for MINS is an unmet clinical need. Focused lung ultrasound (LUS) might help to select patients at increased risk for MINS, because it can visualize B-line artifacts correlating to cardiopulmonary disease.

Sequential Surgical Procedures in Vascular Surgery Patients Are Associated With Perioperative Adverse Cardiac Events.

Patients at elevated cardiovascular risk are prone to perioperative cardiovascular complications, like myocardial injury after non-cardiac surgery (MINS). We have demonstrated in a mouse model of atherosclerosis that perioperative stress leads to an increase in plaque volume and higher plaque vulnerability. Regulatory T cells (Tregs) play a pivotal role in development and destabilization of atherosclerotic plaques.

Conventional culture diagnostics vs. multiplex PCR for the detection of causative agents of vascular graft infections - results of a single centre observational pilot study.

Timely diagnosis of vascular graft infections is of major importance in vascular surgery. The detection of causative microorganisms is needed for specific medical treatment, but conventional culture is often slow, insensitive and inconclusive due to antibiotic pre-treatment. Detection of bacterial DNA by polymerase chain reaction (PCR) might bypass these problems.

Axillary Artery Dissection and Thrombosis after Closed Proximal Humerus Fracture - a Rare Interdisciplinary Challenge.

Background: Proximal humerus fractures account for 4 - 6% of all fractures and are a common result of low-energy trauma in the elderly. Concomitant neurovascular injury of the neighboring axillary artery and brachial plexus is a rarity, but has enormous impact on therapy, rehabilitation and prognosis. Diagnosis of axillary artery injury may be delayed due to its varied clinical presentation and lead to prolonged ischemia, distal necrosis and even loss of limb.

Surgical treatment of coronary artery aneurysms.

Introduction: Coronary artery aneurysms (CAA) are rare. We present our experience with the surgical treatment of patients with CAAs.

Methods: Between March 2000 and October 2016, 15 patients with CAA underwent surgery.

Is the frozen elephant trunk procedure superior to the conventional elephant trunk procedure for completion of the second stage?

Objectives: Our goal was to compare the results and outcomes of second-stage completion in patients who had previously undergone the elephant trunk (ET) or the frozen elephant trunk (FET) procedure for the treatment of complex aortic arch and descending aortic disease.

Methods: Between August 2001 and December 2014, 53 patients [mean age 61 ± 13 years, 64% (n = 34) male] underwent a second-stage completion procedure. Of these patients, 32% (n = 17) had a previous ET procedure and 68% (n = 36) a previous FET procedure as a first-stage procedure.

Coronary artery bypass grafting in young patients--insights into a distinct entity.

Objectives: Coronary artery bypass grafting (CABG) is the 'Gold Standard' for patients with multiple vessel coronary artery disease (CAD). Younger patients presenting with coronary artery disease requiring surgery may represent a distinct subgroup with the main goal for coronary revascularization being long term patency of the performed grafts to improve outcome.

Methods: Between January 2010 and August 2013, 126 patients below the age of 50 years underwent CABG for CAD in our hospital.

Renal function interferes with copeptin in prediction of major adverse cardiac events in patients undergoing vascular surgery.

Objective: Precise perioperative risk stratification is important in vascular surgery patients who are at high risk for major adverse cardiovascular events (MACE) peri- and postoperatively. In clinical practice, the patient's perioperative risk is predicted by various indicators, e.g.

Unusual Case of an Arterial Thoracic Outlet Syndrome due to Srb Anomaly.

A thoracic outlet syndrome (TOS) is caused by arterial or nervous obstruction because of skeletal or muscular anomalies and hypertrophies. Congenital rib anomalies occur with low incidences (0.15-0.

Perioperative levels and changes of high-sensitivity troponin T are associated with cardiovascular events in vascular surgery patients.

Objectives: Myocardial infarction after major surgery is frequent, drives outcome, and consumes health resources. Specific prediction and detection of perioperative myocardial infarction is an unmet clinical need. With the widespread use of high-sensitive cardiac troponin T assays, positive tests become frequent, but their diagnostic or prognostic impact is arguable.

Left-sided mini-maze procedure via the left atrial appendage.

This study presents a novel way to perform the mini-maze procedure through the left atrial appendage. By this way, the usual additional incision of the intra-atrial groove is avoided, especially in patients receiving coronary artery bypass grafting (CABG) or aortic valve replacement without mitral valve disease. We retrospectively analysed 23 consecutive patients who received this novel mini-maze procedure between 2009 and 2011.