RESUMEN
The authors describe the algorithm of examination and methods of operation on 24 patients. It allowed shortening the time of compression of the aorta, of acute ischemia of the lower extremities, less operation blood loss, exclusion of postoperative lethality.
Asunto(s)
Angiografía/métodos , Aneurisma de la Aorta Abdominal/diagnóstico , Procedimientos Quirúrgicos Cardiovasculares/métodos , Aneurisma Cardíaco/diagnóstico , Ventrículos Cardíacos , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía Doppler Dúplex/métodos , Aneurisma de la Aorta Abdominal/complicaciones , Aneurisma de la Aorta Abdominal/cirugía , Diagnóstico Diferencial , Estudios de Seguimiento , Aneurisma Cardíaco/etiología , Aneurisma Cardíaco/cirugía , Humanos , Infarto del Miocardio/complicaciones , Guías de Práctica Clínica como Asunto , Pronóstico , Estudios RetrospectivosRESUMEN
Examinations and operations on 36 ischemic heart disease patients with postinfarction aneurysm of the left ventricle (PIALV) in combination with hemodynamically significant obliterating atherosclerosis of the lower extremity arteries were performed in the clinic during the period from 1995 through 2005. The first stage of the treatment included resection of PIALV and myocardium revascularization. Positive results were obtained in all 36 patients at the first stage of surgical treatment, without ischemia of the myocardium being observed in the postoperative period. The contractive function of the left ventricle as an ejection fraction due to resection of PIALV and its plasty was on average 17% greater, which created favorable conditions for the following stage of surgical treatment. At the second stage of surgery an individual approach was used for patients with generalized atherosclerotic lesions of the lower extremities with special reference to specific clinical picture, as well as non-standard surgical methods. Among the nonstandard surgical methods there were transprosthetic aortotomic shunts and the method of a reverse formation of anastomoses.
Asunto(s)
Arteriosclerosis Obliterante/cirugía , Procedimientos Quirúrgicos Cardíacos/métodos , Aneurisma Cardíaco/cirugía , Ventrículos Cardíacos , Arteria Ilíaca , Infarto del Miocardio/complicaciones , Procedimientos Quirúrgicos Vasculares/métodos , Angiografía , Arteriosclerosis Obliterante/complicaciones , Arteriosclerosis Obliterante/diagnóstico por imagen , Estudios de Seguimiento , Aneurisma Cardíaco/complicaciones , Aneurisma Cardíaco/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico por imagen , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The authors made operations on 131 patients with aneurysms of the abdominal aorta (AAA). Most severe patients were operated on using a modified resection or "exclusion" of the AAA and aorto-iliac bifurcation prosthesis with reverse formation of anastomoses. It was found that the proposed method increases safety of the operative treatment of AAA and is preferable for patients with a severe coexisting pathology.
Asunto(s)
Aneurisma de la Aorta Abdominal/complicaciones , Aneurisma de la Aorta Abdominal/cirugía , Arteriosclerosis/complicaciones , Anciano , Humanos , Persona de Mediana Edad , Resultado del Tratamiento , Procedimientos Quirúrgicos Vasculares/métodosRESUMEN
An experience with transprosthetic aortotomy in 8 patients is analyzed. There were no lethal outcomes. The technique of the operation is described.
Asunto(s)
Arteritis de Takayasu/cirugía , Procedimientos Quirúrgicos Vasculares/métodos , Aorta Torácica/cirugía , Implantación de Prótesis Vascular , Tronco Braquiocefálico/cirugía , Humanos , Resultado del TratamientoRESUMEN
A 62-year-old patient with Leriche's syndrome and critical ischemia of the low extremities has undergone the surgery of aortofemoral grafting. A patient has developed the severe ARDS on the second day of reperfusion (bilateral diffuse infiltrates, PO2/FiO2 < 100, lung injury score was 3). Different ways of administration of bovine surfactant (SURFACTANT BL, Russia) were used during the treatment. Total application time was 84 hours, total dose was 4000 mg (50 mg/kg). Considerable improvement of lung function occurred after start of the continuous inhalation of surfactant with a constant rate of 63 mg/h. Two hours after this step PO2/FiO2 reached 400 mm Hg and remained stable 12 hours more, up to the end of surfactant administration. The patient was soon successfully extubated and discharged on the 25th day after surgery. It is supposed that in spite of a small total dose of bovine surfactant the success was achieved due to an early start of the surfactant replacement, continuous inhalation and its definite rate.