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.

• Klíčová slova
• Aortic regurgitation, Aortic root aneurysm, Aortic valve repair, Propensity-score matching, Valve-sparing root replacement,
• 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.

• Klíčová slova
• amputation, dog bite injury, flap ischemia, forehead replantation, replantation,
• MeSH
• čelo * chirurgie   MeSH
• kousnutí a bodnutí chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mikrochirurgie * metody   MeSH
• psi MeSH
• replantace * metody   MeSH
• zvířata MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• psi MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• 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.

• Klíčová slova
• ALCAPA, Left coronary artery, Right internal iliac artery, Surgery,
• 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

Loss injuries of the hand are a common trauma primarily encountered by outpatient surgeons on the front lines. The aim of this article is to systematically describe a thorough examination of the hand and the various options for reconstructing loss injuries of the hand, thereby creating an overview that can be utilized in practice. The article focuses on methods ranging from simple healing by secondary intention to basic techniques of flap reconstruction. It describes the coverage of defects with various types of skin grafts, which are a common and effective solution in many cases. Furthermore, the article addresses the use of local flaps, which provide a reliable alternative where simple skin grafts are not suitable. The article also describes the use of axial, distant flaps, and free flaps, which allow the reconstruction of larger and more complicated defects. Finally, the issue of replantation is discussed, which, despite its difficulty and complexity, can offer the best solution for the preservation and restoration of hand function in certain cases. The goal of the article is to provide a clear and practical guide that can facilitate decision-making for outpatient surgeons and improve treatment outcomes for loss of hand injuries.

• Klíčová slova
• fingertip injuries, flap, hand injuries, hand surgery, skin grafts,
• MeSH
• chirurgické laloky * MeSH
• lidé MeSH
• poranění ruky * chirurgie   MeSH
• replantace metody   MeSH
• transplantace kůže MeSH
• zákroky plastické chirurgie * metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy 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.

• MeSH
• amputace MeSH
• kouření tabáku * MeSH
• kouření * škodlivé účinky   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• multivariační analýza MeSH
• replantace MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

Background The aim of this study was to evaluate long-term survival and freedom from coronary artery reintervention after the arterial switch operation (ASO). Methods and Results This single-center nationwide retrospective study included consecutive children who underwent ASO between 1990 and 2016 (n=605). Long-term outcomes were obtained by cross-mapping individual data with the National Death Registry and the National Registry of Cardiovascular Interventions for adults. A control group was randomly retrieved at a 1:10 ratio from the National Birth and Death Registries. Early mortality was 3.3% and late mortality was 1.7% during a median follow-up of 10 (interquartile range, 5-16) years. The probability of overall survival at 20 years after ASO was 94.9% compared with 99.5% in the background population (hazard ratio [HR] 15.6; 95% CI, 8.9-27.5, P<0.001). Independent multivariable predictors of worse survival were an intramural coronary artery (HR, 5.2; 95% CI, 1.8-15.2, P=0.002) and period of ASO 1990 to 1999 (HR, 4.6; 95% CI, 1.5-13.6, P<0.001). Fourteen patients (2.3%) required 16 coronary artery reoperations. Freedom from coronary artery reintervention at 20 years after ASO was 96%. The only independent multivariable predictor associated with a higher hazard for coronary artery reintervention was an intramural coronary artery (HR, 33.9; 95% CI, 11.8-97.5, P<0.001). Conclusions Long-term survival after ASO is excellent. Coronary artery reinterventions are rare. An intramural coronary artery was an independent predictor associated with a higher risk for coronary artery reintervention and death, regardless of the surgical period.

• Klíčová slova
• congenital heart disease, coronary artery anomaly, transposition of great vessels,
• MeSH
• anomálie koronárních cév diagnostické zobrazování   epidemiologie   chirurgie   MeSH
• časové faktory MeSH
• dítě MeSH
• doba přežití bez progrese choroby MeSH
• dospělí MeSH
• hodnocení rizik MeSH
• kojenec MeSH
• korekce transpozice velkých arterií * škodlivé účinky   mortalita   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• novorozenec MeSH
• pooperační komplikace mortalita   chirurgie   MeSH
• předškolní dítě MeSH
• přežívající MeSH
• registrace MeSH
• reoperace MeSH
• replantace * škodlivé účinky   mortalita   MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• transpozice velkých cév diagnostické zobrazování   epidemiologie   chirurgie   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

RATIONALE: The first successful ear replantation was performed by Pennigton in 1980 in Sydney. At least 84 ear replantations have been described in the literature over a period of 37 years since the first case. The authors have not found any previous case of frozen ear replantation in the literature. PATIENT CONCERNS: We report the case of a 38-year-old man, who had an injury to the head while working with a machine. DIAGNOSIS: The patient suffered total traumatic avulsion of the left ear. The ear was wrapped in moistened, sterile gauze and was transported on dry ice. At the time of admission to our department, the amputated ear was frozen to stiff, solid nonelastic matter. INTERVENTIONS: We attempted replantation. Despite repeated arterial thrombosis during surgery, the ear was successfully replanted with arterial and venous anastomosis. OUTCOMES: Venous congestion occurred within 9 h of surgery and was treated using leeches. Freezing cold injury developed during reattachment. The radix and proximal parts of the helix exhibited necrosis and so were reconstructed by contralateral conchal cartilage graft, which was wrapped with a local subauricular skin flap. On completion of treatment, a satisfactory shape was achieved, although the replanted and reconstructed left auricle slightly was smaller than the contralateral auricle. LESSONS LEARNED: Our report confirms that the replantation of a frozen, amputated ear is possible, and we suggest that ear replantation should be the method of choice for the treatment of ear loss even under these conditions.

• MeSH
• dospělí MeSH
• kryoprezervace * MeSH
• lidé MeSH
• pracovní úrazy chirurgie   MeSH
• replantace metody   MeSH
• traumatická amputace chirurgie   MeSH
• zákroky plastické chirurgie metody   MeSH
• zevní ucho zranění   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

• MeSH
• aorta thoracica diagnostické zobrazování   MeSH
• arteria pulmonalis abnormality   diagnostické zobrazování   MeSH
• arteria subclavia abnormality   diagnostické zobrazování   chirurgie   MeSH
• CT angiografie metody   MeSH
• echokardiografie MeSH
• lidé MeSH
• otevřená tepenná dučej diagnostické zobrazování   MeSH
• předškolní dítě MeSH
• replantace metody   MeSH
• zobrazování trojrozměrné metody   MeSH
• Check Tag
• lidé MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

• MeSH
• endoskopie * MeSH
• lidé MeSH
• mladý dospělý MeSH
• penis diagnostické zobrazování   zranění   MeSH
• replantace metody   MeSH
• sebepoškozování diagnostické zobrazování   chirurgie   MeSH
• traumatická amputace diagnostické zobrazování   chirurgie   MeSH
• uretra diagnostické zobrazování   chirurgie   MeSH
• Check Tag
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• dopisy MeSH
• kazuistiky MeSH

The left renal vein (LRV) reimplantation into the distal inferior vena cava is considered to be the gold standard of care for symptomatic nutcracker syndrome (NCS). The vast majority of these surgical procedures are performed by open surgery. Experiences with minimally invasive laparoscopic surgery in this field are very limited. We present a case of a 17-year-old boy with NCS in whom the transposition of the LRV was done laparoscopically. The patient suffered from left flank pain, painful left-sided varicocele, microscopic hematuria, proteinuria, and oligoasthenospermia. There were no intraoperative complications, and the postoperative course was uneventful. At 12-month follow-up, hematuria, left flank pain, and left testicular pain resolved. Duplex ultrasonography revealed patent LRV. Laparoscopic LRV transposition appears to be safe, feasible, and has favorable postoperative course.

• MeSH
• časové faktory MeSH
• duplexní dopplerovská ultrasonografie MeSH
• flebografie metody   MeSH
• laparoskopie * MeSH
• lidé MeSH
• mladiství MeSH
• počítačová rentgenová tomografie MeSH
• průchodnost cév MeSH
• renální louskáčkový syndrom diagnóza   patofyziologie   chirurgie   MeSH
• replantace MeSH
• vena cava inferior chirurgie   MeSH
• venae renales diagnostické zobrazování   patofyziologie   chirurgie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH