OBJECTIVES: Both aortic root remodelling and aortic valve (AV) reimplantation have been used for valve-sparing root replacement in patients with aortic root aneurysm with or without aortic regurgitation. There is no clear evidence to support one technique over the another. This study aimed to compare remodelling with basal ring annuloplasty versus reimplantation on a multicentre level with the use of propensity-score matching. METHODS: This was a retrospective international multicentre study of patients undergoing remodelling or reimplantation between 2010 and 2021. Twenty-three preoperative covariates (including root dimensions and valve characteristics) were used for propensity-score matching. Perioperative outcomes were analysed along with longer-term freedom from AV reoperation/reintervention and other major valve-related events. RESULTS: Throughout the study period, 297 patients underwent remodelling and 281 had reimplantation. Using propensity-score matching, 112 pairs were selected and further compared. We did not find a statistically significant difference in perioperative outcomes between the matched groups. Patients after remodelling had significantly higher reintervention risk than after reimplantation over the median follow-up of 6 years (P = 0.016). The remodelling technique (P = 0.02), need for decalcification (P = 0.03) and degree of immediate postoperative AV regurgitation (P < 0.001) were defined as independent risk factors for later AV reintervention. After exclusion of patients with worse than mild AV regurgitation immediately after repair, both techniques functioned comparably (P = 0.089). CONCLUSIONS: AV reimplantation was associated with better valve function in longer-term postoperatively than remodelling. If optimal immediate repair outcome was achieved, both techniques provided comparable AV function.
- MeSH
- anuloplastika srdeční chlopně metody MeSH
- aortální chlopeň * chirurgie MeSH
- aortální insuficience * chirurgie MeSH
- chirurgická náhrada chlopně metody MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- reoperace statistika a číselné údaje MeSH
- replantace * metody MeSH
- retrospektivní studie MeSH
- senioři MeSH
- tendenční skóre * MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- srovnávací studie MeSH
In this article we would like to present, to our best knowledge, the very first published replantation of a forehead/part of a forehead as a single unit. The patient is a 57-year-old male smoker who sustained an avulsion forehead injury after a dog bite. Replantation was performed using microanastomosis of the supratrochlear vessels with restoration of good blood circulation after the procedure. Unfortunately, 5 days after the surgery, ischemia of the flap occurred followed by successful acute revision surgery. Nevertheless, the day after the ischemia reoccurred due to the time that passed, circumstances and unfavorable conditions affecting the sutured vessels, no further revision surgery was indicated. Observation continued and eventual wound necrosis after demarcation was left to be treated with skin grafting or per secundam intentionem. Only partial necrosis of the flap occurred, approximately 50%, which was subsequently treated with a full-thickness skin graft with very good results leading to the satisfaction of the patient.
- MeSH
- anastomóza chirurgická metody škodlivé účinky MeSH
- čelo chirurgie zranění MeSH
- cévy zranění MeSH
- ischemie etiologie terapie MeSH
- kouření škodlivé účinky MeSH
- kousnutí a bodnutí chirurgie patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mikrochirurgie metody MeSH
- nekróza etiologie terapie MeSH
- recidiva MeSH
- replantace * metody MeSH
- skalpační poranění * chirurgie etiologie komplikace patologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Anomalous left coronary artery originating from the pulmonary artery (ALCAPA) is an infrequent congenital anomaly. Presentation of this syndrome is rare in adults. Nevertheless, adult patients are at risk of ischaemia, arrhythmias or sudden cardiac death and always require surgical intervention. At our institution, a specific technique of interposition of the right internal iliac artery as a free-graft for left coronary artery reimplantation was used in adult ALCAPA patients. The aim of this report is to determine long-term results and experiences with this surgical technique.
- MeSH
- anomálie koronárních cév * diagnostické zobrazování chirurgie MeSH
- anomální odstup levé koronární tepny * MeSH
- arteria iliaca diagnostické zobrazování chirurgie MeSH
- arteria pulmonalis diagnostické zobrazování chirurgie abnormality MeSH
- dospělí MeSH
- lidé MeSH
- replantace MeSH
- syndrom Bland-White-Garland * chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Introduction: It is often questioned whether to perform replantation or revision amputation for amputation injuries in elderly patients and smokers. According to the current indication criteria, neither old age nor smoking in the absence of other risk factors are considered to be risk factors for replantation failure. However, many microsurgeons still may make the decision not to perform digital replantation based solely on these factors. Material and methods: In order to evaluate the influence of both factors, we provided univariate and multivariate analyses of patients who underwent replantation at our centre during a 10-year period. We divided patients in two groups according to age (< and ≥ 60 years) and smoking status. Results: In the univariate analysis, there were no differences in immediate results between the two age groups. In the multivariate analysis, no statistical difference was found in neither long-term nor short-term results between the two age groups and between smokers and non-smokers. Conclusion: Smoking and age should not be considered the only risk factors when deciding whether to perform digital replantation.
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- MeSH
- amoxicilin aplikace a dávkování terapeutické užití MeSH
- antibakteriální látky terapeutické užití MeSH
- debridement metody MeSH
- infekce spojené s protézou * chirurgie terapie MeSH
- klindamycin aplikace a dávkování terapeutické užití MeSH
- lidé MeSH
- replantace metody MeSH
- rifampin aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Úvod a cíl: Autotransplantace zubu je v současné době považována za jednu ze spolehlivých terapeutických metod náhrady zubu. Cílem článku je podat ucelený přehled odborných publikací zabývajících se transplantacemi zubů v české odborné literatuře. Metodika: Retrospektivně byla prozkoumána česká odborná literatura z let 1920–2021. Konkrétně se jednalo o časopisy Zubní lékařství, Československá stomatologie, Praktické zubní lékařství, Ortodoncie, LKS a české verze časopisu Quintessenz. Závěr: Celkově bylo do současnosti v české odborné literatuře publikováno 25 prací zabývajících se transplantacemi zubů.
Introduction, aim: Currently, the tooth autotransplantation is considered a reliable method for the tooth substitution. The aim of this article is to give a comprehensive outline of the studies dealing with tooth transplantation in the Czech dental literature. Methods: A retrospective survey of the Czech dental literature of the years 1920–2021 was done. Namely the journals Zubní lékařství, Československá stomatologie, Praktické zubní lékařství, Ortodoncie, LKS and the Czech version of Quintessenz journal. Conclusion: Overall, 25 studies have been published in the Czech dental literature dealing with the tooth transplantation up to now.
- MeSH
- autologní transplantace MeSH
- dějiny zubního lékařství * MeSH
- lidé MeSH
- replantace zubu dějiny MeSH
- zuby * transplantace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- historické články MeSH
- MeSH
- amoxicilin terapeutické užití MeSH
- avulze zubu * etiologie komplikace MeSH
- fokální infekce zubní MeSH
- lidé MeSH
- mladiství MeSH
- replantace zubu * metody MeSH
- resorpce zubního kořene etiologie MeSH
- úrazy pádem MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
