The Infraorbital Artery in Fetuses: Clinical Relevance in Perforator Flap Surgery.

Introduction: The reconstruction of soft tissue detects in mid facial region are highly demanding. Most challenging region are nasal alla. For full thickness nasal alla defects most authors use nasolabial flap based on facial/angular arcade, but for recidivans tumors the infraorbital perforator flap is a good solution.

Single stage turn in perforator infraorbital artery island flap for nasal ala reconstruction.

Background: The reconstruction of fullthickness nasal alla defects is challenging procedure. Use of local flaps is acceptable approach. Flap based on infraorbital artery could be used for primary reconstruction of nasal ala defects.

Vascular rupture-a rare lethal complication of neurofibromatosis v. Recklinghausen.

Neurofibromatosis type 1 (NF-1), a phacomatosis with an incidence of 1:3,000-4,000, is characterized by multiple benign nerve tumors, skin café-au-lait spots and a variety of other dysplastic abnormalities, e.g., of blood vessels.

Behavior of gaseous microemboli in extracorporeal circuits: air versus CO2.

Background: Open heart surgery is associated with serious risk of cerebral and peripheral organ dysfunction, attributed in part to air microbubbles generated in or not eliminated from the extracorporeal circuit (ECC). Venous air leakage leads to increased arterial bubble load. CO2 replacing air in cardiac chambers show faster resorption times, reducing possible cerebral or peripheral organ damage after heart valve interventions.

Clinical experience with the Heartflotrade mark System in coronary surgery.

In coronary artery bypass grafting (CABG), distal graft to coronary anastomoses are currently performed with running sutures or, to a limited extent, interrupted techniques, which are more time-consuming. The Heartflotrade mark anastomotic device, introduced in 2000, automates the suturing process via simultaneous delivery of ten standard polypropylene sutures through the graft and the coronary vessel wall to construct the anastomosis. Clinical testing was performed after extensive animal studies in several centers in Europe and Canada.

Automatic connector devices for proximal anastomoses do not decrease embolic debris compared with conventional anastomoses in CABG.

Objective: Emboli generated during cardiac surgery have been associated with aortic clamping and manipulation. Proximal anastomotic devices are thought to be less traumatic by eliminating partial clamping, potentially resulting in fewer adverse outcomes. Intra-aortic filtration has been shown to effectively capture particulate debris.

Elimination of microbubbles from the extracorporeal circuit: dynamic bubble trap versus arterial filter.

Background: Open heart surgery is associated with important risk of cerebral and peripheral organ dysfunction, attributed in part to microbubbles generated in or not eliminated from the ECC. For elimination of microbubbles, a dynamic bubble trap (DBT) was developed for the arterial line of ECCs.

Methods: Bubble eliminating properties of an arterial filter were evaluated in four CABG patients and compared to the performance of the DBT in four patients.

Improved cerebral protection through replacement of residual intracavital air by carbon dioxide: a porcine model using diffusion-weighted magnetic resonance imaging.

Background: Major risk of central or peripheral organ damage is attributed to air embolism from incompletely de-aired cardiac chambers after cardiac operations. Replacement of air by carbon dioxide insufflation into the thoracic cavity is widely used. Diffusion-weighted magnetic resonance imaging of the brain detects ischemia within minutes after onset.

Ultrafast computed tomography for quality control of automated proximal anastomoses.

Background: The Symmetry aortic connector uses a nitinol implant to create proximal anastomoses with saphenous vein grafts. Multiple detector-row cardiac computed tomography (MDCT) is used as a noninvasive method of quality control at our institution.

Methods: In 50 elective coronary artery bypass grafting patients who participated in a randomized trial comparing automated with conventionally hand-sewn proximal anastomoses, MDC T was performed on postoperative day 5.

The Heartflo device for distal coronary anastomoses: clinical experiences in 60 patients.

Background: The Heartflo anastomotic device automates the suturing process with simultaneous delivery of 10 standard polypropylene sutures through the graft and the coronary vessel wall to construct the anastomosis. We performed clinical testing in 60 patients undergoing coronary artery bypass grafting.

Methods: One automated distal coronary anastomosis was initially placed in each patient, the other anastomoses were created with standard running sutures.

Optimal carbon dioxide application for organ protection in cardiac surgery.

Background: Cardiac surgery is associated with an important risk of central or peripheral organ damage, attributed in part to air embolism from incompletely deaired cardiac chambers. Insufflation of carbon dioxide into the thoracic cavity is widely used for organ protection in cardiac surgery.

Methods: In patients operated on through a sternotomy, the gas was insufflated through a standard cardioplegia line (group I, n = 10) or a Jackson-Pratt drain (group II, n = 10), with flow rates of 2, 4, and 6 L/min.

Conventional carbon dioxide application does not reduce cerebral or myocardial damage in open heart surgery.

Background: Open heart surgery is associated with a significant risk of cerebral and myocardial dysfunction, which is attributed in part to air embolism from incompletely deaired cardiac chambers. To evaluate the impact of carbon dioxide (CO2) insufflation to the thoracic cavity, a prospective randomized study was designed.

Methods: A total of 62 elective patients were randomly assigned to CO2 insufflation (group I, n = 31) or control (group II, n = 31).

Determination of lipoprotein(a): enzyme immunoassay and immunoradiometric assay compared.

Lipoprotein(a) (Lp(a)) concentration in plasma is a strong independent risk factor for pre-mature atherosclerosis. Lp(a) closely resembles LDL. Its protein moiety contains apolipoprotein (apo) B-100 and apo(a).