Early and late outcomes of complex aortic root surgery in patients with aortic root abscesses

Leontyev, Sergey; Davierwala, Piroze; Krögh, Günther; Feder, Stefan; Oberbach, Andreas; Bakhtiary, Farhad; Misfeld, Martín; Borger, Michael A.; Mohr, Friedrich W.

doi:10.1093/ejcts/ezv138

Cited by 45 publications

(53 citation statements)

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“…Surgical correction is commonly required in these cases. Several papers investigated patient outcomes after such complex procedures and a high inhospital mortality rate has been reported (3,4). Comparison of surgical results is difficult because of the general lack of anatomic details depicting the degree of the severity of annulus and aortic root involvement.…”

Section: Discussionmentioning

confidence: 99%

“…This heterogeneity is further underlined by the inclusion of different types of surgical procedures from aortic valve replacement (AVR)with or without patch reconstruction, to extensive repair and full root replacement. In this regard, the studies presenting precise data of location and extension of periannular complications invariably report the need for complex root surgery in case of larger abscess cavities, involvement of aorto-mitral continuity or circular detachment of the aorta (3,4,13). An early mortality rate around 20% can be expected in these cases (3)(4)(5)7,(13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

“…The progression of the pathology may further complicate the scenario, with fistulisation in other cardiac structures or the development of a pseudoaneurysm (3). Surgical therapy is invariably required in these cases and represents the only therapeutic option, but it is associated with high postoperative mortality and morbidity (2,4,5). In this paper, we describe our experience in the treatment of aortic valve/aortic root endocarditis complicated by extensive annular and periannular tissue disruption.…”

Section: Introductionmentioning

confidence: 99%

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Aortic valve endocarditis complicated by proximal false aneurysm

Malvindi

Mikus

Caprili³

et al. 2019

Ann. Cardiothorac. Surg.

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Background: Aortic valve endocarditis remains a life-threatening condition, especially in cases of periannular complications. Aorto-ventricular discontinuity associated with proximal false aneurysm represents a severe picture caused by extensive tissue disruption and is usually associated with prosthetic valve infection. Complex surgical repair is required in these cases and continues to be associated with high mortality and morbidity rates.Methods: We retrieved information for 32 patients undergoing operation for infective aortic valve/ prosthetic valve endocarditis complicated by pseudoaneurysm arising from aorto-ventricular discontinuity.Patients were relatively young, mostly male and most of them had a prior cardiac operation. Aortic root replacement with valve graft conduit was performed in all cases; it was associated with other procedures in seven patients: CABG (n=2), MV surgery (n=3), MV surgery + CABG (n=1) and pulmonary valve replacement (n=1). We reported and analysed patient outcomes at early and mid-term follow-up.Results: Pre-discharge mortality was 22% (n=7). The postoperative course was complicated in 24 (75%) cases. Eighteen patients (56%) sustained low cardiac output resulting in multiple organ failure syndrome and death in five cases. One patient (3%) experienced a major neurologic deficit with a permanent cerebral stroke. Acute kidney injury complicated the course in 12 cases (37%), continuous renal replacement therapy was necessary in four patients (12%). Overall survival and freedom from endocarditis and reoperation at 5-year was 59% and 89%, respectively. Conclusions:Patients with complicated aortic valve endocarditis presented generally in a poor preoperative state. Surgical treatment poses a non-negligible risk of postoperative mortality and morbidity but provides an acceptable survival rate and a satisfactory recovery at mid-term.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Aortic valve endocarditis complicated by proximal false aneurysm

Malvindi

Mikus

Caprili³

et al. 2019

Ann. Cardiothorac. Surg.

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“…Согласно исследованию Kumar N . et al высокие кишечные свищи с обшир -ной зоной повреждения рекомендовано разрешать открытым хирургическим путем [20]. Однако и тра-диционная активная хирургическая тактика со мно-жеством открытых операций связана с длительным пребыванием в стационаре, увеличением расходов и до 60% летальностью [21].…”

Section: Discussionunclassified

Analysis of Early Complications After Using Permacol Bioimplant in Combination With Selective Administration of the Nicergolin in Case of Intestinal Fistulas

Иштуков¹,

Пантелеев²,

Дорофеев³

2017

Kreat. hir. onkol.

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Введение. В современной хирургии кишечные свищи по сей день остаются одной из нерешенных хирургических задач. Если при низких кишечных свищах тактика ве-дения больных условно совпадает у большинства авторов, то наиболее эффективное лечение кишечных свищей высокой локализации остается спорным. В этой связи це-лью работы явилось совершенствование лечения пациентов с несформированными дуоденальными и высокими тонкокишечными свищами путем местного применения коллагенового покрытия с селективным ангиотропным воздействием.Материалы и методы. Было проведено открытое проспективное рандомизиро-ванное исследование, включающее 109 пациентов, поступивших в отделение гной-ной хирургии Республиканской клинической больницы им. Г.Г. Куватова (г. Уфа) для оперативного лечения в период 2000-2016 гг. Основным критерием включения па-циентов в исследование являлось наличие дуоденальных и/или других тонкокишеч-ных свищей. Все пациенты случайным образом были распределены на две основные группы: группа традиционной терапии (68 пациентов), где после ушивания кишечных свищей выполнялась стандартная медикаментозная терапия; исследуемая группа (41 пациент), где для укрепления швов на кишке применялся коллаген с последующим селективным введением ангиопротекторов и лазероантибиотикотерапией.Результаты. По результатам проведенного исследования установлено, что при-менение оригинально разработанной схемы приводило к снижению несостоятель-ности швов с 39,5 до 17,0% и летальности с 37,5 до 19,5%.Заключение. Местное применение коллагена в сочетании с селективным дли-тельным введением ангиопротекторов позволяет снизить частоту ранних послеопера-ционных осложнений и тем самым улучшить результаты лечения пациентов с несфор-мированными дуоденальными и высокими тонкокишечными свищами.Ключевые слова: свищ кишечника, двенадцатиперстной кишки болезни, тонкая кишка, послеоперационные осложнения, коллаген, ницерголин Для цитирования: Иштуков Р.Р., Пантелеев В.С., Дорофеев В.Д. Анализ ранних осложнений применения биоимпланта permacol в комбинации с селективным введе-нием препарата ницерголина при кишечных свищах. Креативная хирургия и онколо-гия. 2017;7(4):27-31. DOI:10.24060/2076DOI:10.24060/ -3093-2017. : 10.24060/2076-3093-2017-7-4-27-31 28 Introduction. Intestinal fistulas to date remain one of the unresolved surgical problems. If patients with low intestinal fistulas are treated roughly the same way by the majority of authors, then the most effective treatment of intestinal fistula of high localization remains controversial. In this context, the objective of the work was to improve the treatment of patients with unformed duodenal and high enteric fistulas by local administration of collagen coating with selective angiotropic effect. AnALYSIS oF eARLY CoMPLICAtIonS AFteR Materials and methods.The work involved open prospective randomized study including 109 patients admitted in purulent surgery Department of the Republican State Clinical Hospital named after G.G. Kuvatov (city of Ufa) for surgical treatment in the period 2000-2016. The main criterio...

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“…Анализ доступной литературы свидетельс-твует, что экстренная повторная операция и рефрак-терный шок являются независимыми предикторами летальности независимо от типа хирургической па-тологии [15].…”

Section: таблица 4 -структура оперированных пациентов со спаечной болunclassified

Early and Long-Term Results of Surgical Treatment of Peritoneal Adhesions. Retrospective Analysis

Sufiyarov¹,

Нуртдинов²,

Yamalova³

et al. 2017

Kreat. hir. onkol.

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Early and late outcomes of complex aortic root surgery in patients with aortic root abscesses

Abstract: The surgical treatment of aortic root abscess is a challenging operation and is associated with a high early morbidity and mortality. However, the long-term survival and freedom from reoperation is satisfactory.

Cited by 45 publications

References 23 publications

Aortic valve endocarditis complicated by proximal false aneurysm

Aortic valve endocarditis complicated by proximal false aneurysm

Analysis of Early Complications After Using Permacol Bioimplant in Combination With Selective Administration of the Nicergolin in Case of Intestinal Fistulas

Early and Long-Term Results of Surgical Treatment of Peritoneal Adhesions. Retrospective Analysis

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