We analyzed the postoperative short- and mid-term outcomes of a series of patients with annuloaortic ectasia who underwent a modified Bentall operation in our clinic from September 2000 through March 2006. The study included 44 patients. Their average age was 53.4 +/- 14.1 years. The underlying disease was degenerative aortic aneurysm in 42 patients (95.5%) and acute aortic dissection in 2 patients (4.5%). Six patients (13.6%) had Marfan phenotype. Aortic insufficiency was moderate in 30 patients (68.2%) and severe in 14 patients (31.8%). In our modification of the Bentall technique, we completed the resection of the aortic root while leaving 5 to 10 mm of native aortic wall tissue to support the anastomosis. A long piece of Teflon felt (width, 0.5-1 cm) was laid on the annulus, and nonpledgeted 2-0 polyester sutures were passed in turn through the Teflon felt, the preserved aortic tissue, and the aortic annulus. A thin piece of Teflon felt was also used in the coronary artery reimplantation sites. Fibrin glue was routinely applied to all anastomoses. There were no intraoperative deaths. One patient died in the hospital after surgery for acute type I aortic dissection. Another patient died 1 year after the operation from prosthetic-valve endocarditis. No patient required surgical correction of excessive postoperative bleeding. Kaplan-Meier curves showed overall survival of 0.94 (95% confidence intervals, 0.9-0.99). We consider our approach an easy, effective way to minimize bleeding from the anastomoses and at the aortic root--a common challenge in aortic surgery.
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In surgery for acute type A aortic dissection, controlling bleeding from the posterior wall of the proximal anastomosis is particularly challenging. To address this, we use the "reversed turn-up technique." For the reinforcement of the proximal aortic stump, Teflon felt strips were placed inside and outside the suture line with 4-0 polypropylene continuous transverse mattress sutures, and BioGlue was applied to the false lumen.
View Article and Find Full Text PDFKyobu Geka
September 2024
Department of Cardiovascular Surgery, Iwate Medical University, Iwate, Japan.
J Clin Med
November 2024
Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.
Type A aortic dissection repair using Polytetrafluorethylene (PTFE) felt inlay and tissue glue has been proposed as a treatment modality. It remains unclear, if this method performs superiorly to tissue glue only. Between January 2011 and December 2015, 139 patients underwent surgical repair for type A aortic dissection, and 48 patients were excluded ( = 29 after receiving a composite graft, = 18 in which no tissue glue was used, and = 1 due to missing data).
View Article and Find Full Text PDFJ Neurosurg
September 2024
1Department of Neurosurgery, Konkuk University Medical Center, Seoul; and.
Objective: The lateral spread response (LSR) is an important electrophysiological sign that predicts successful decompression in patients undergoing microvascular decompression (MVD) for hemifacial spasm (HFS). However, LSRs do not consistently correlate with clinical outcomes, and there are cases in which LSRs are absent. In this study, the authors identified a unique pattern on facial nerve electromyography (EMG) when the root exit zone (REZ) is touched.
View Article and Find Full Text PDFHeliyon
July 2024
Xingtai Key Laboratory of New Energy Optoelectronic Devices and Energy Storage Technology, Xingtai, 054000, China.
All-vanadium redox flow batteries (VRFB) have the advantages of high safety and long life, and have broad application prospects in the field of large-scale power energy storage. Low energy density is the main factor restricting its development. In this study, the carbon felt used as the electrode was pretreated in various ways to improve the performance of the vanadium redox flow battery.
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