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Background Randomized trials show high long-term patency for no-touch saphenous vein grafts in coronary artery bypass grafting. The patency rate in off-pump coronary bypass surgery for these grafts has not been investigated. Our center participated in the CORONARY randomized trial, NCT00463294. This is a study aimed to assess the patency of no-touch saphenous veins in on- versus off-pump coronary bypass surgery at five-year follow-up. Methods Fifty-six patients were included. Forty of 49 patients, alive at 5 years, participated in this follow-up. There were 21 and 19 patients in the on- and off-pump groups respectively. No-touch saphenous veins were used to bypass all targets and in some cases the left anterior descending artery. Graft patency according to distal anastomosis was evaluated with computed tomography angiography. Results The five-year patency rate was 123/139 (88.5%). The patency for the no-touch vein grafts was 57/64 (89.1%) in the on-pump versus 37/45 (82.2%) in the off-pump group. All left internal thoracic arteries except for one, 29/30 (96.6%), were patent. All vein grafts used to bypass the left anterior descending and the diagonal arteries were patent 32/32. The lowest patency rate for the saphenous veins was to the right coronary territory, particularly in off-pump surgery (80.0% vs. 62.5% for the on- respective off-pump groups). Conclusions Comparable 5-year patency for the no-touch saphenous veins and the left internal thoracic arteries to the left anterior descending territory in both on- and off-pump coronary artery bypass grafting. Graft patency in off-pump CABG is lower to the right coronary artery.

The concept of a direct association between coronary graft patency and clinical status is generally accepted. However, the relationship is more complex and variable than usually thought. Key issues are the lack of a common definition of graft occlusion and of a standardized imaging protocol for patients undergoing coronary bypass surgery. Factors like the type of graft, the timing of the occlusion, and the amount of myocardium at risk, as well as baseline patients' characteristics, modulate the patency-to-clinical status association. Available evidence suggests that graft occlusion is more often associated with non-fatal events rather than death. Also, graft failure due to competitive flow is generally a benign event, while graft occlusion in a graft-dependent circulation is associated with clinical symptoms. In this systematic review, we summarize the evidence on the association between graft status and clinical outcomes.

BACKGROUND: Randomized trials show high long-term patency for no-touch saphenous vein grafts in coronary artery bypass grafting. The patency rate in off-pump coronary bypass surgery for these grafts has not been investigated. Our center participated in the CORONARY randomized trial, NCT00463294. This is a study aimed to assess the patency of no-touch saphenous veins in on- versus off-pump coronary bypass surgery at five-year follow-up. METHODS: Fifty-six patients were included. Forty of 49 patients, alive at 5 years, participated in this follow-up. There were 21 and 19 patients in the on- and off-pump groups respectively. No-touch saphenous veins were used to bypass all targets and in some cases the left anterior descending artery. Graft patency according to distal anastomosis was evaluated with computed tomography angiography. RESULTS: The five-year patency rate was 123/139 (88.5%). The patency for the no-touch vein grafts was 57/64 (89.1%) in the on-pump versus 37/45 (82.2%) in the off-pump group. All left internal thoracic arteries except for one, 29/30 (96.6%), were patent. All vein grafts used to bypass the left anterior descending and the diagonal arteries were patent 32/32. The lowest patency rate for the saphenous veins was to the right coronary territory, particularly in off-pump surgery (80.0% vs. 62.5% for the on- respective off-pump groups). CONCLUSIONS: Comparable 5-year patency for the no-touch saphenous veins and the left internal thoracic arteries to the left anterior descending territory in both on- and off-pump coronary artery bypass grafting. Graft patency in off-pump CABG is lower to the right coronary artery., Funding agency:Region Örebro län OLL-689991

Saphenous veins used for coronary artery bypass surgery are subjected to considerable vascular trauma when harvested by conventional methods. This vascular damage is responsible, at least in part, for the inferior patency of the saphenous vein when compared with the internal thoracic artery. The performance of saphenous vein grafts is improved when this conduit is harvested atraumatically using the no-touch technique. There is growing evidence that the success of the no-touch technique is due to the preservation of a number of vascular structures including the endothelium, vasa vasorum and perivascular fat. There is conflicting evidence regarding the degree of endothelial damage to the endothelium of conventional versus no-touch saphenous vein grafts. In general, it has been shown that this single layer of cells lining the lumen exhibits considerable damage associated with a combination of vascular trauma and high pressure intraluminal distension. Increased platelet aggregation and thrombus formation at the exposed subendothelial membrane is due to a local reduction of endothelium-derived factors including nitric oxide. In addition, damage to the vasa vasorum of conventionally-harvested veins will reduce transmural blood flow, a condition shown to promote neointimal hyperplasia and atheroma formation. By stripping off the perivascular fat during conventional harvesting, mechanical support of the graft is reduced and the source of adipocyte-derived factors potentially beneficial for graft patency removed. While most agree that endothelial damage to the saphenous vein affects graft patency, the contribution of other tissue-derived factors affected by vascular damage at harvesting need to be considered.

Background: In 2004, a prospective randomized trial demonstrated that after 3 years, saphenous veins (SVs) harvested with a no touch (NT) technique had a greater patency than radial grafts for coronary bypass surgery. Here we report the 8-year follow-up data of this trial. Methods: The trial included 108 patients undergoing coronary artery bypass grafting (CABG). Each patient was assigned to receive 1 NT SV and 1 radial artery (RA) graft to either the left or right coronary territory to complement the left internal thoracic artery (LITA). Sequential grafting was common, so overall graft patency as well as the patency of each anastomosis were assessed. Results: Angiography was performed in 84 patients (78%) at mean of 97 months postoperatively. Graft patency were high and similar for both NT and RA: 86% for NT versus 79% for RA (P = .22). The patency of coronary anastomoses was significantly higher with the NT SV grafts (91% vs 81%; P = .046). The NT grafts also had excellent patency in coronary arteries with <90% stenosis (93% patency) and in coronary arteries of small diameter (87% patency) or with mild calcification (88% patency). Patency for the LITA was 92%. Conclusions: NT SV grafts have excellent patency similar to that of RA grafts after 8 years. In addition, NT SV grafts can be used in situations that are not ideal for RA grafts., Funding Agencies:Nyckelfonden Regional Research Committee, University Hospital, Örebro, Sweden

Periferna arterijska okluzivna bolest (PAOB) je zastupljena izmeĊu 3% i 20% opšte populacije, a aorto-ilijaĉni segment je pogoĊen do 30% bolesnika sa PAOB. Tradicionalno, aorto-ilijaĉna okluzivna bolest leĉena je otvoreno hirurškim pristupom, ali se poslednjih decenija endovaskularni tretman sve više primenjuje kao terapijska opcija za uglavnom sve tipove aorto-ilijaĉne okluzivne bolesti prema TASC II (Trans-Atlantic Inter-Society Consensus) klasifikaciji. CILJ: Cilj ove studije bio je proceniti uspešnost endovaskularnog leĉenja aorto-ilijaĉne okluzivne bolesti sa aspekta ranih i kasnih rezultata, kao i uporediti rezultate razliĉitih tipova okluzivnih lezija prema TASC II klasifikaciji. MATERIJAL I METODE: Retrospektivna-prospektivna bicentriĉna studija sprovedena je na 100 pacijenata (proseĉna starost 59.14 ± 8.53; 64 muškarca) sa aorto-ilijaĉnom okluzivnom bolešću koji su leĉeni endovaskularno izmeĊu januara 2013. i novembra 2017. godine. Ispitivani su preproceduralni podaci (pedo-brahijalni indeksi, multidetektorska kompjuterizovana tomografija angiografija), proceduralni (pristup, lokalizacija i dužina okluzivne lezije, tip procedure, karakteristike stenta, periproceduralne komplikacije) i postproceduralni podaci (primarna, primarna asistirana i sekundarna protoĉnost). Analizirali smo rane i kasne rezultate za celu grupu, i prema tipu okluzivne lezije po TASC II klasifikaciji. REZULTATI: Prema TASC II klasifikaciji, 56 (56%) pacijenata imalo je okluziju TASC B, 28 bolesnika TASC C, a 16 bolesnika TASC D. Većina pacijenata (60%) leĉena je zbog onesposobljavajućih klaudikacija..., Peripheral artery disease affects between 3% and 20% of the general population, and the aorto-iliac segment is affected in up to 30% of PAD patients. Traditionally, aorto-iliac occlusive disease was managed with open surgery, but during the last decades endovascular treatment has been increasingly applied as a therapeutic option for many of the Trans-Atlantic Inter-Society Consensus document II (TASC II) categories. OBJECTIVES: The aim of this study was to evaluate early and long-term results of endovascular therapy on the treatment of aorto-iliac occlusions, as well as to compare the results of different types of aorto-iliac occlusive lesions according to the TASC II classification. MATERIAL AND METHODS: A bi-center retrospective-prospective study was conducted on 100 patients (mean age 59.14 ± 8.53; 64 men) who underwent endovascular treatment of aorto-iliac occlusive disease between January 2013 and November 2017. Preprocedural data (ankle-brachial pressure index, multidetector computed tomography angiography), procedural data (access, location and length of occlusive lesions, type of procedure, stent characteristics, and periprocedural complications) and postprocedural data (primary patency, primary assisted patency and secondary patency) were examined. We analyzed early and late results for the entire group, and according to the type of occlusive lesion according to the TASC II classification. RESULTS: According to TASC II classification, 56 (56%) patients had TASC B occlusions, 28 patients TASC C, and 16 patients TASC D. The majority of patients (60%) were treated for severe claudication...

Introduction and Aim: Peripheral arterial disease is a serious global healthcare concern with a subgroup of patients requiring revascularisation for chronic limb-threatening ischaemia. Open bypass surgery remain a valuable tool in the armamentarium of revascularisation options and several factors are known to affect the patency of a bypass procedure. Literature in this regard is, however, lacking in the South African population. Methods: This was a retrospective cohort analytic study of infrainguinal reverse vein bypasses performed at a central academic hospital in South Africa between January 2012 and December 2016 for the indication of chronic limb-threatening ischaemia. 211 patients with a total of 219 bypass procedures were included. Patency data was assessed for 138 bypasses with 79 patients (36.1%) lost to follow-up and 2 patients (0.9%) who demised. Results: 156 (73.9%) were males and 55 (26.1%) were females. The median age was 61 years. The majority of the patients (78.2%) had hypertension and were known smokers (83.4%), whereas only 32.2% had diabetes mellitus and 11.4% had renal impairment. The human immunodeficiency virus status was unknown in the majority (70.6%) of patients. 83.1% of bypasses were performed for the indication of tissue loss in addition to rest pain. The proximal anastomosis was performed from the common femoral artery in 47.9% of cases and the distal anastomosis to the tibialis posterior artery in 27.9% of cases. Most patients (26.9%) had a single vessel runoff. The median diameter of greater saphenous vein utilised was 2.7mm. 26.1% of grafts demonstrated early graft failure within 30 days compared to 45.7% demonstrating patency beyond 12 months. Age, race, hypertension, diabetes, renal failure, the presence of tissue loss, level of the proximal and distal anastomoses and number of runoff vessels had no significant effect on graft patency. Female gender, a small greater saphenous diameter as well as a single anterior tibial vessel runof

Objectives: To evaluate outcomes after endovascular treatment of abdominal aortic aneurysms (AAA) involving the renovisceral arteries and to compare outcomes after fenestrated/branched endovascular aortic repair (f/b-EVAR), chimney/periscope EVAR (ch-EVAR), and bailout ch-EVAR. Methods: A retrospective multicenter study including all patients with AAA involving the renovisceral segment, treated with f/b-EVAR, ch-EVAR, or bailout ch-EVAR, between 1 January 2005 and 30 June 2015, in three Swedish vascular centers. Patient charts were reviewed for data. Renovisceral stent graft patency was assessed on follow-up CT. Mortality was cross-checked against the Swedish Population Registry. Bailout ch-EVAR was defined as a perioperative decision of renovisceral endografting, as the artery was accidentally covered, or as the aneurysm neck sealing zone was considered inadequate. Results: Of the 99 identified patients (76 men; mean age 74 years (range 58-89 years)), 68 underwent f/b-EVAR, 18 ch-EVAR, and 13 bailout ch-EVAR. Follow-up lasted for a median of 3.2 years (Q1, Q3 (2.1, 4.7 years)). Elective surgery comprised 87.9% (n = 87) of the cases. Six patients died within 30 days, and the 30-day mortality after elective surgery was 4.6% (95% CI, 1.3%-11.4%) overall, 1.6% after f/b-EVAR (95% CI, 0.0%-11.4%), 15.4% after ch-EVAR (95% CI, 1.9%-45.4%), and 10.0% (95% CI, 0.3%-44.5%) after bailout ch-EVAR. During follow-up, there were 16 secondary interventions, of which 75% (n = 12) were performed within six months after the primary intervention. Compared with f/b-EVAR, ch-EVAR was associated with a higher degree of type 1 endoleaks (1.5% vs. 22.2%, P = 0.001) and re-interventions during follow-up (13.2% vs. 33.3%, P = 0.046). The overall assisted target vessel patency was 96.1% (95% CI, 91.7%-98.6%) at one year and 95.2% (95% CI, 89.2%-98.4%) at two years. Conclusions: Results after EVAR involving endografting of renovisceral arteries from three centers in Sweden with medium volumes

Ischemic heart disease is currently the leading cause of death globally, with coronary artery bypass grafting among the most common operations performed worldwide. More extensive use of arterial grafts has been advocated because of their high long-term patency, long-term survival benefit, and freedom from reinterventions. Despite this, the saphenous vein is the most frequently used conduit in patients undergoing coronary artery bypass surgery since its introduction over 50 years ago. Consequently, the saphenous vein remains an indispensable conduit in coronary artery bypass grafting and maintaining its long-term patency is one of the most crucial challenges in cardiovascular surgery. This situation led to the development of the no-touch saphenous vein harvesting technique, where the vein is harvested completely with its pedicle of surrounding tissue. Several studies report a superior long-term patency rate, slower progression of atherosclerosis, and better clinical outcomes whilst employing no-touch harvesting technique. The success of the technique is multifactorial, including the decreased risk for graft spasm-and the need for manual distension-preservation of the vaso vasorum and an intact endothelium, reducing neointimal hyperplasia and subsequent atherosclerosis. Furthermore, the intact perivascular tissue, including the surrounding cushion of fat, may act as a "natural external stem", providing mechanical support preventing the graft from kinking. We arc convinced that the use of arterial grafts, in combination with the no-touch saphenous vein graft, will significantly improve the results of coronary artery bypass grafting. This is important for achieving a comprehensive and evidence-based balance between the major treatment strategies of ischemic heart disease, explicitly coronary artery bypass grafting and percutaneous coronary intervention. The no-touch technique is becoming increasingly popular among surgeons, with further studies to be initiated worldwide

OBJECTIVES: We investigated the patency rates of no-touch saphenous vein grafts anastomosed to the left anterior descending artery compared with the left internal thoracic artery. Further, we compared the patency of no-touch vein grafts to the left anterior descending artery with the patency of no-touch vein grafts to other coronary arteries. METHODS: Of 2635 consecutive patients undergoing coronary artery bypass grafting between 2003 and 2008, 168 (6.3%) were given at least a saphenous vein graft to the left anterior descending artery to avoid harvesting complications in high-risk patients or in response to a left internal thoracic artery injury. A total of 97 patients were consecutively included after informed consent. A clinical examination and computed tomography angiography were performed on 91 patients at a mean of 6 (4-9) years. RESULTS: The mean age of patients was 75.6 ± 8.5 years. Postoperatively, 88.7% of patients (86/97) were free of angina. The 91 examined patients had 163 grafts with 286 distal anastomoses. Crude patency, according to distal anastomoses, was 94.4% (270/286). The patency of single versus sequential no-touch vein grafts to the left anterior descending artery was 98% (50/51) versus 92.5% (37/40). The total patency rate was 95.6% (87/91), similar to the reported patency rate for the left internal thoracic artery. The no-touch grafts to the left anterior descending artery versus other coronaries had a patency of 95.6% (87/91) versus 93.8% (183/195), a high similarity confirmed by an equivalence analysis. CONCLUSIONS: In elderly coronary bypass patients with multiple comorbidities, a no-touch saphenous vein graft is a promising substitute for the left internal thoracic artery., Funding Agencies:Örebro County Council through the regional research board Nyckelfonden 11-029

Ischemic heart disease is currently the leading cause of death globally. Coronary artery bypass grafting (CABG) is considered the best treatment for many patients and its success depends on the long-term patency of the conduits. Greater use of arterial grafts has been advocated because of their higher long-term patency compared to saphenous vein grafts (SVGs). Despite this, SVGs account for up to 80% of all grafts used in CABG. Consequently, the long-term patency of the saphenous vein (SV) is one of the most crucial challenges in cardiovascular surgery. The no-touch (NT) SV in CABG has shown a superior patency rate, slower progression of atherosclerosis, and better clinical outcome compared to conventional veins up to 8.5 years postoperatively. The aim of this thesis was to study the long-term angiographic, echocardiographic, and clinical aspects of CABG patients receiving either NT or conventional vein grafts and to investigate the health-related quality of life (HRQoL) in this patient group. Studies I-II report a randomized trial between NT and conventional veins where 74 patients were followed-up at a mean of 16 years postoperatively. Study III is a prospective cohort trial in which 97 patients with NT vein grafts anastomosed to the left anterior descending artery (LAD) were included and followed-up at a mean of 6 years postoperatively. Study IV included 257 patients in whom HRQoL and graft patency were studied during the same follow-up visit. Overall, NT vein grafts showed a higher patency compared to conventional veins at a mean of 16 years, 83% vs. 64% (p=0.03), which was similar to the patency of the left internal thoracic artery, 88%. The NT group had a better left ventricular ejection fraction compared to the conventional group, 57.9% vs. 49.4% (p=0.011). After a mean of 6 years, the patency rate of NT SVs to the LAD was 95.6% and to non-LAD targets, 93.9%. Graft patency was an independent predictor of HRQoL in CABG patients. These patients reported a funct

Purpose: The radiocephalic arteriovenous fistula (RC-AVF) has significant failure rates due to occlusions and failure to mature. The size and quality of the veins are considerable limiting factors for the procedure. The aim of this pilot study was to describe the No-Touch technique (NTT) to create RC-AVF and present the results up to 1 year of follow-up. Methods: Thirty-one consecutive patients who were referred for surgery for a RC-AVF were included (17 men, mean age 63 years, range 35-84) and operated by NTT where the vein and artery were dissected with a tissue cushion around it. Twenty-two patients had small veins or arteries (<= 2 mm), 12 patients had a small cephalic vein (<= 2 mm), and the mean distal cephalic vein diameter was 2.4 mm (range 1.0-4.1 mm). Results: Technical surgical success and immediate patency were obtained in all patients. Clinical success was achieved in 23 of the 27 (85%) patients who required hemodialysis. The proportion of primary patency at 30 days and 6 months was 84% and 64%, respectively. Secondary patency at 30 days and 6 months was 97% and 83%, respectively. At 1-year follow-up, primary patency was 54% and secondary patency was 80%. There was no major difference in patency due to preoperative vein diameter. Conclusions: The results of this study indicate that NTT can be used for primary radio-cephalic fistula surgery with very good results. This method offers the potential to create a RC-AVF in patients who are not usually considered appropriate for a distal arm fistula due to a small cephalic vein.

Purpose: The radiocephalic arteriovenous fistula (RC-AVF) has significant failure rates due to occlusions and failure to mature. The size and quality of the veins are considerable limiting factors for the procedure. The aim of this pilot study was to describe the No-Touch technique (NTT) to create RC-AVF and present the results up to 1 year of follow-up. Methods: Thirty-one consecutive patients who were referred for surgery for a RC-AVF were included (17 men, mean age 63 years, range 35-84) and operated by NTT where the vein and artery were dissected with a tissue cushion around it. Twenty-two patients had small veins or arteries (<= 2 mm), 12 patients had a small cephalic vein (<= 2 mm), and the mean distal cephalic vein diameter was 2.4 mm (range 1.0-4.1 mm). Results: Technical surgical success and immediate patency were obtained in all patients. Clinical success was achieved in 23 of the 27 (85%) patients who required hemodialysis. The proportion of primary patency at 30 days and 6 months was 84% and 64%, respectively. Secondary patency at 30 days and 6 months was 97% and 83%, respectively. At 1-year follow-up, primary patency was 54% and secondary patency was 80%. There was no major difference in patency due to preoperative vein diameter. Conclusions: The results of this study indicate that NTT can be used for primary radio-cephalic fistula surgery with very good results. This method offers the potential to create a RC-AVF in patients who are not usually considered appropriate for a distal arm fistula due to a small cephalic vein.

Ischemic heart disease is currently the leading cause of death globally. Coronary artery bypass grafting (CABG) is considered the best treatment for many patients and its success depends on the long-term patency of the conduits. Greater use of arterial grafts has been advocated because of their higher long-term patency compared to saphenous vein grafts (SVGs). Despite this, SVGs account for up to 80% of all grafts used in CABG. Consequently, the long-term patency of the saphenous vein (SV) is one of the most crucial challenges in cardiovascular surgery. The no-touch (NT) SV in CABG has shown a superior patency rate, slower progression of atherosclerosis, and better clinical outcome compared to conventional veins up to 8.5 years postoperatively. The aim of this thesis was to study the long-term angiographic, echocardiographic, and clinical aspects of CABG patients receiving either NT or conventional vein grafts and to investigate the health-related quality of life (HRQoL) in this patient group. Studies I-II report a randomized trial between NT and conventional veins where 74 patients were followed-up at a mean of 16 years postoperatively. Study III is a prospective cohort trial in which 97 patients with NT vein grafts anastomosed to the left anterior descending artery (LAD) were included and followed-up at a mean of 6 years postoperatively. Study IV included 257 patients in whom HRQoL and graft patency were studied during the same follow-up visit. Overall, NT vein grafts showed a higher patency compared to conventional veins at a mean of 16 years, 83% vs. 64% (p=0.03), which was similar to the patency of the left internal thoracic artery, 88%. The NT group had a better left ventricular ejection fraction compared to the conventional group, 57.9% vs. 49.4% (p=0.011). After a mean of 6 years, the patency rate of NT SVs to the LAD was 95.6% and to non-LAD targets, 93.9%. Graft patency was an independent predictor of HRQoL in CABG patients. These patients reported a funct

Ischemic heart disease is currently the leading cause of death globally. Coronary artery bypass grafting (CABG) is considered the best treatment for many patients and its success depends on the long-term patency of the conduits. Greater use of arterial grafts has been advocated because of their higher long-term patency compared to saphenous vein grafts (SVGs). Despite this, SVGs account for up to 80% of all grafts used in CABG. Consequently, the long-term patency of the saphenous vein (SV) is one of the most crucial challenges in cardiovascular surgery. The no-touch (NT) SV in CABG has shown a superior patency rate, slower progression of atherosclerosis, and better clinical outcome compared to conventional veins up to 8.5 years postoperatively. The aim of this thesis was to study the long-term angiographic, echocardiographic, and clinical aspects of CABG patients receiving either NT or conventional vein grafts and to investigate the health-related quality of life (HRQoL) in this patient group. Studies I-II report a randomized trial between NT and conventional veins where 74 patients were followed-up at a mean of 16 years postoperatively. Study III is a prospective cohort trial in which 97 patients with NT vein grafts anastomosed to the left anterior descending artery (LAD) were included and followed-up at a mean of 6 years postoperatively. Study IV included 257 patients in whom HRQoL and graft patency were studied during the same follow-up visit. Overall, NT vein grafts showed a higher patency compared to conventional veins at a mean of 16 years, 83% vs. 64% (p=0.03), which was similar to the patency of the left internal thoracic artery, 88%. The NT group had a better left ventricular ejection fraction compared to the conventional group, 57.9% vs. 49.4% (p=0.011). After a mean of 6 years, the patency rate of NT SVs to the LAD was 95.6% and to non-LAD targets, 93.9%. Graft patency was an independent predictor of HRQoL in CABG patients. These patients reported a funct

Ischemic heart disease is currently the leading cause of death globally. Coronary artery bypass grafting (CABG) is considered the best treatment for many patients and its success depends on the long-term patency of the conduits. Greater use of arterial grafts has been advocated because of their higher long-term patency compared to saphenous vein grafts (SVGs). Despite this, SVGs account for up to 80% of all grafts used in CABG. Consequently, the long-term patency of the saphenous vein (SV) is one of the most crucial challenges in cardiovascular surgery. The no-touch (NT) SV in CABG has shown a superior patency rate, slower progression of atherosclerosis, and better clinical outcome compared to conventional veins up to 8.5 years postoperatively. The aim of this thesis was to study the long-term angiographic, echocardiographic, and clinical aspects of CABG patients receiving either NT or conventional vein grafts and to investigate the health-related quality of life (HRQoL) in this patient group. Studies I-II report a randomized trial between NT and conventional veins where 74 patients were followed-up at a mean of 16 years postoperatively. Study III is a prospective cohort trial in which 97 patients with NT vein grafts anastomosed to the left anterior descending artery (LAD) were included and followed-up at a mean of 6 years postoperatively. Study IV included 257 patients in whom HRQoL and graft patency were studied during the same follow-up visit. Overall, NT vein grafts showed a higher patency compared to conventional veins at a mean of 16 years, 83% vs. 64% (p=0.03), which was similar to the patency of the left internal thoracic artery, 88%. The NT group had a better left ventricular ejection fraction compared to the conventional group, 57.9% vs. 49.4% (p=0.011). After a mean of 6 years, the patency rate of NT SVs to the LAD was 95.6% and to non-LAD targets, 93.9%. Graft patency was an independent predictor of HRQoL in CABG patients. These patients reported a funct

Ischemic heart disease is currently the leading cause of death globally. Coronary artery bypass grafting (CABG) is considered the best treatment for many patients and its success depends on the long-term patency of the conduits. Greater use of arterial grafts has been advocated because of their higher long-term patency compared to saphenous vein grafts (SVGs). Despite this, SVGs account for up to 80% of all grafts used in CABG. Consequently, the long-term patency of the saphenous vein (SV) is one of the most crucial challenges in cardiovascular surgery. The no-touch (NT) SV in CABG has shown a superior patency rate, slower progression of atherosclerosis, and better clinical outcome compared to conventional veins up to 8.5 years postoperatively. The aim of this thesis was to study the long-term angiographic, echocardiographic, and clinical aspects of CABG patients receiving either NT or conventional vein grafts and to investigate the health-related quality of life (HRQoL) in this patient group. Studies I-II report a randomized trial between NT and conventional veins where 74 patients were followed-up at a mean of 16 years postoperatively. Study III is a prospective cohort trial in which 97 patients with NT vein grafts anastomosed to the left anterior descending artery (LAD) were included and followed-up at a mean of 6 years postoperatively. Study IV included 257 patients in whom HRQoL and graft patency were studied during the same follow-up visit. Overall, NT vein grafts showed a higher patency compared to conventional veins at a mean of 16 years, 83% vs. 64% (p=0.03), which was similar to the patency of the left internal thoracic artery, 88%. The NT group had a better left ventricular ejection fraction compared to the conventional group, 57.9% vs. 49.4% (p=0.011). After a mean of 6 years, the patency rate of NT SVs to the LAD was 95.6% and to non-LAD targets, 93.9%. Graft patency was an independent predictor of HRQoL in CABG patients. These patients reported a funct

Background - Up to 85% of hospital in-patients will require some form of vascular access device to deliver essential fluids, drug therapy, nutrition and blood products, or facilitate sampling. The failure rate of these devices is unacceptably high, with 20–69% of peripheral intravenous catheters and 15–66% of central venous catheters failing due to occlusion, depending on the device, setting and population. A range of strategies have been developed to maintain device patency, including intermittent flushing. However, there is limited evidence informing flushing practice and little is known about the current flushing practices. Objective - The aim of the study was to improve our understanding of current flushing practices for vascular access devices through a survey of practice. Method - A cross-sectional survey of nurses and midwives working in the State of Queensland, Australia was conducted using a 25-item electronic survey that was distributed via the local union membership database. Results - A total of 1178 surveys were completed and analysed, with n = 1068 reporting peripheral device flushing and n = 584 reporting central device flushing. The majority of respondents were registered nurses (55%) caring for adult patients (63%). A large proportion of respondents (72% for peripheral, 742/1028; 80% for central, 451/566) were aware of their facility’s policy for vascular access device flushing. Most nurses reported using sodium chloride 0.9% for flushing both peripheral (96%, 987/1028) and central devices (75%, 423/566). Some concentration of heparin saline was used by 25% of those flushing central devices. A 10-mL syringe was used by most respondents for flushing; however, 24% of respondents used smaller syringes in the peripheral device group. Use of prefilled syringes (either commercially prepared sterile or prefilled in the workplace) was limited to 10% and 11% respectively for each group. The frequency of flushing varied widely, wit

Introduction: Open repair of the aorta carries a high risk for morbidity and mortality especially in the elderly population and in patients unfit for major surgery. Endovascular aortic repair is safe, durable and effective when there is adequate proximal and distal sealing zone for the aortic stent graft. Fenestrated and branched stent grafts have made the repair possible for complex but elective cases that do not have an adequate sealing zone. Urgent complex cases and patients with midaortic occlusive diseases do not have any therapeutic alternative if they are not fit for open repair. Chimney graft technique fills this gap and allows the sealing zones for aortic stent graft to be extended as required. The aim of the present thesis is to study the applicability, safety and durability of CG technique in urgent cases with complex lesions in the thoracic and abdominal aorta including the midaortic occlusive diseases. Patients and Methods: All patients who received CG were treated urgently or semi-urgently. The majority of the treated aortic lesions were aneurysms, dissections, pseudoaneurysms, infection, and accidental overstented vital aortic side branches. The median age of all patients was 75 years (IQR, 69-78), of them 32% were female except for the first study where all ten patients were female with midaortic occlusive diseases. The second study evaluated the mid to long-term efficacy and durability of the CG technique in 29 patients with urgent and complex lesions of the thoracic aorta. The third study examined the long-term results of CG in preserving the visceral flow of 51 patients with urgent complex aortic lesions. The fourth study evaluated the CTA images of 206 patients with ruptured abdominal aortic aneurysm. The study measured the applicability of CG in patients for whom standard EVAR was contraindicated because of a short aneurysmal neck. Results: The results showed that CG is applicable and safe for midaortic occlusive diseases with high technical suc

Background: Hemodialysis patients who are subject to increased risk of hemorrhage may need specific dialysis regimes to avoid bleeding. The aim of this study was to determine in vitro which of various anticoagulation options were most beneficial. Materials and method: 60 in vitro hemodialyses (HD) were performed in parallel using blood from healthy donors. The dialysis circuits were rinsed with either 1 L of 0.9% NaCl alone (n = 6), or with 1 L saline and the addition of either 5 mL 20% albumin (Alb, n = 6), 5,000 U of heparin (Hep, n = 6), Hep and Alb in combination (HA, n = 30), 20,000 U of Hep and Alb (4H-A, n = 6), and finally Hep and 20 mL 20% albumin (H-4A, n = 6). The blood was recirculated for a maximum of 192 min. Clotting was graded. Results: A 192 min dialysis was completed with all series of HA, 4H-A, and H-4A, all with a slight grade of clotting. In contrast to the above settings (p = 0.002, Fisher's test), a total clotting of the dialysis circuit occurred for all series using the NaCl rinsing alone (median time to stop: 21, range: 18-27 min, p = 0.026 compared to the HA setting) and for the Alb rinsing (median 26, range: 19-35 min, p = 0.028). Conclusions: Priming using HA, Hep, 4H-A, and H-4A reduced clotting and allowed 192 min of HD. Clinical studies need to confirm these data in vivo.

Background : Radial artery occlusion is one of the transradial vascular complications post cardiac catheterization. To minimize the effect of vascular problem related to local compression by using compression methods after cardiac catheterization would be decrease vascular complication such as radial artery occlusion (RAO). This research was conducted to determine the comparison between the Barbeau test method and the clinical observation method carried out by the researcher in order to examine the patency of radial artery during compression, post procedure cardiac catheterization at the Angiography Coroner Unit and the Cardiac Intensive Care Unit, Hasan Sadikin Bandung General Hospital, Indonesia. Methods : This research was a quantitative research using the comparative study design. The subjects of this research were 20 patients who took cardiac catheterization procedure using radial artery access site at the Angiography Coroner Unit and checked in pairs. The measurement was conducted gradually in three hours using compression band, namely the Stepty-P. The statistical test, specifically the McNemar test, was used to analyze the comparasion between the Barbeau test method and the clinical observation method, meanwhile the single variable data were analyzed by the distribution frequency. Result : According to the research result, it depicts that the distribution frequency of subjects who suffer from radial artery blood flow during compression period based on Barbeau Test at the first fifteen minutes were 7 patients (35%), the number of patients declined negligibly after 3 hours to 5 patients (25%), whereas the result from the clinical observation methods was 1 patient (5%) at the first fifteen minutes, it then raise marginally after 3 hours to 2 patients (10%). The statistical result shows that there wsere a significant difference in radial artery evaluation during compression period between two methods, in which at the first fifteen minutes (p=0,035) and the first

Background: Systemic anticoagulation during hemodialysis (HD) increases the risk for bleeding complications pre- or post-operatively. Based on the concept of blood-membrane interaction, we developed a heparin-albumin solution to rinse the dialysis circuit before start. The aim of this study was to investigate if this method was a valuable tool for our patients at risk for bleeding complications. Material and methods: This retrospective, comparative, quality assessment study included 248 HD in 68 patients; Group 1: 178 treatments were performed at patients for risk of bleeding using heparin-albumin-priming and Group 2: 70 acute HD were performed on patients without increased risk of bleeding using a bolus of heparin at start and a continuous infusion of heparin. In Group 1 additional heparin was given upon suspicion of progressive clotting. One L saline contained albumin (1 g/I) and heparin (5000 U/I) used for priming. Excess priming solution was removed by filling the circuit with blood at start of treatment. Results: In Group 1, a mean total dose of 2000 U of heparin was given during the HD (18% performed HD without any heparin) and Group 2 used a mean total dose of 5500 U (p<0.001). There was no increased incidence of clotting in Group 1 versus Group 2 compared to standard HD. No bleeding complications were reported during any of the HA-priming treatments. Conclusions: Heparin-albumin priming resulted in a reduced total dose of heparin. There was no increased clotting and no incidence of bleeding was reported in either group.

Na+, K+-ATPases is a heterodimer protein consisting of α- and β-subunits that control the ion transport through cell membranes. In insects the β-subunit of the Na+, K+-ATPase, known as Nervana, was characterized as a nervous system-specific glycoprotein antigen from adult Drosophila melanogaster heads. Nervana is expressed ubiquitously in all insect tissues, and in epithelial cells appeared located in a basolateral position as part of the septate junctions. Herein we study two Nervana isoforms from Blattella germanica, a cockroach species with panoistic ovaries. The sequencing and the phylogenetic analysis results suggest that these two isoforms are orthologs of D. melanogaster Nervana 1 and Nervana 2, respectively. Nervana 1 is highly expressed in the ovary of B. germanica, and depleting its expression results in changes in oocyte shape that do not impair oviposition. However, the resulting embryos show different defects and never hatch. These findings highlight the importance of this type of membrane pump in insect oogenesis as well as in embryo development, and its possible regulation by juvenile hormone. © 2012 Elsevier Ltd.

Objectives: Small-diameter synthetic vascular graft performance is inferior to autologous vein grafts. This study tested the hypotheses that local in vivo administration of plasmids encoding for human vascular endothelial. growth factor (VEGF), or co-administration of plasmids encoding for human vascular endothelial growth factor/plasmids encoding for fibroblast growth factor-2 in the tissues surrounding a porous synthetic vascular graft would enhance graft endothelialisation and, consecutively, graft patency. Methods: First, optimal gene for small-diameter synthetic graft endothelialisation was studied in rat abdominal aorta model (n = 132): plasmids encoding for human vascular endothelial growth factor; co-administration of plasmids encoding for human vascular endothelial growth factor/plasmids encoding for fibroblast growth factor-2; or control plasmids were injected around 60 mu m ePTFE graft. Second, optimal small-diameter synthetic graft design for endothelialisation was explored in rabbit abdominal aorta model (n = 90). Various ePTFE grafts or pre-clotted polyester grafts were used with/without plasmids encoding for human vascular endothelial growth factor. Third, clinically used medium-size synthetic grafts were investigated with/without plasmids encoding for human vascular endothelial growth factor in dog carotid (n = 20) and femoral. arteries (n = 15). Endothelialisation was assessed in midgraft area with scanning electron microscopy. Results: In rats, plasmids encoding for human vascular endothelial growth factor enhanced endothelialisation; whereas co-administration of plasmids encoding for human vascular endothelial growth factor/plasmids encoding for fibroblast growth factor-2 had worst outcome at 1 week (NS), 2 weeks (P = 0.01) and 4 weeks (P = 0.02). In rabbits, pre-clotted polyester grafts had a trend for faster endothelialisation than ePTFE grafts (P = 0.08); whereas plasmids encoding for human vascular endothelial growth factor enhanced endothelia

Objective: To study whether locally administered recombinant inactivated human coagulation factor VIIa (FFR-rFVIIa) would reduce the thrombus formation and improve patency in an experimental venous thrombosis model without inducing systematic changes in the coagulation. Design: Experimental double-dummy randomised study. Materials: In 20 healthy New Zealand White rabbits both juguIar veins were exposed under general anaesthesia. Methods: The thrombi were induced in a 10 mm long jugular vein segment with a combination of chemical destruction of the intima and a restriction of the bloodflow. Each segment was treated with either FFR-rFVIIa or placebo injected directly into the vein. Results: 1.5 mg topically applied FFR-rFVIIa significantly reduced the thrombus weight (p < 0.001). The 30 and the 120 min patency tests were significantly improved (p < 0.05 and p < 0.001, respectively). Plasma analyses (APTT, dilute-TF time, FVII protein) were evaluated as baseline, 3 min after declamping and at sacrifice. No prolongation of the clotting times were seen. FFR-rFVIIa protein was detected in minute amounts (ng/ml); however, this was not enough to prolong the dilute-TF time. Conclusions: Local application of recombinant active-site inhibited human FVIIa reduced both thrombus weight and improved patency significantly in an experimental venous thrombosis model without affecting the systematic clotting times.

Objective: To study whether locally administered recombinant inactivated human coagulation factor VIIa (FFR-rFVIIa) would reduce the thrombus formation and improve patency in an experimental venous thrombosis model without inducing systematic changes in the coagulation. Design: Experimental double-dummy randomised study. Materials: In 20 healthy New Zealand White rabbits both juguIar veins were exposed under general anaesthesia. Methods: The thrombi were induced in a 10 mm long jugular vein segment with a combination of chemical destruction of the intima and a restriction of the bloodflow. Each segment was treated with either FFR-rFVIIa or placebo injected directly into the vein. Results: 1.5 mg topically applied FFR-rFVIIa significantly reduced the thrombus weight (p < 0.001). The 30 and the 120 min patency tests were significantly improved (p < 0.05 and p < 0.001, respectively). Plasma analyses (APTT, dilute-TF time, FVII protein) were evaluated as baseline, 3 min after declamping and at sacrifice. No prolongation of the clotting times were seen. FFR-rFVIIa protein was detected in minute amounts (ng/ml); however, this was not enough to prolong the dilute-TF time. Conclusions: Local application of recombinant active-site inhibited human FVIIa reduced both thrombus weight and improved patency significantly in an experimental venous thrombosis model without affecting the systematic clotting times.

Objective: To study whether locally administered recombinant inactivated human coagulation factor VIIa (FFR-rFVIIa) would reduce the thrombus formation and improve patency in an experimental venous thrombosis model without inducing systematic changes in the coagulation. Design: Experimental double-dummy randomised study. Materials: In 20 healthy New Zealand White rabbits both juguIar veins were exposed under general anaesthesia. Methods: The thrombi were induced in a 10 mm long jugular vein segment with a combination of chemical destruction of the intima and a restriction of the bloodflow. Each segment was treated with either FFR-rFVIIa or placebo injected directly into the vein. Results: 1.5 mg topically applied FFR-rFVIIa significantly reduced the thrombus weight (p < 0.001). The 30 and the 120 min patency tests were significantly improved (p < 0.05 and p < 0.001, respectively). Plasma analyses (APTT, dilute-TF time, FVII protein) were evaluated as baseline, 3 min after declamping and at sacrifice. No prolongation of the clotting times were seen. FFR-rFVIIa protein was detected in minute amounts (ng/ml); however, this was not enough to prolong the dilute-TF time. Conclusions: Local application of recombinant active-site inhibited human FVIIa reduced both thrombus weight and improved patency significantly in an experimental venous thrombosis model without affecting the systematic clotting times.

In order to investigate the nerve-mediated response of vas deferens subjected to autotransposition, muscular strips were taken from various segments of rat vas. Electrical field stimulation (EFS) was applied and frequency-response curves were determined. After autotransposition the neural function was preserved, albeit the amplitude of the contractile response to EFS was smaller than in controls. Further, a reduced contractile response was noted in the vas segments proximal, as well as distal, to the transposed segment, probably due to secondary reactions to the surgical trauma. Noradrenaline and ATP seem to act as transmitter substances in the transposed vas segments because the results show a reduction of the contraction after pretreatment with prazosin or α,β-methylene ATP. However, the reduction recorded was less pronounced in transposed segments of vas compared with controls, indicating that other transmitter substances may contribute. No difference in contractile response could be seen between segments from fertile rats and segments from infertile animals and it is concluded that factors other than the intrinsic neural response determine fertility after autotransposition of vas.

Diplomová práce se zabývá rehabilitací přilehlého okolí historického jádra města Kyjov a zaměřuje se na oživení veřejných prostorů. Součástí práce jsou analýzy současného stavu řešeného a dotčeného území, následné vyhodnocení problémů a hodnot území a návrh nové struktury zástavby spolu s fungujícím dopravním řešením. Hlavním kritériem pro výběr řešeného území pro mne byla problematika této lokality spojená s velkou plochou fungujícího výrobního areálu mlýnů a velmi malé procento kvalitního zastavění území. Areál zabírá téměř čtvrtinu řešeného území a v současnosti spolu s okolními stavbami tvoří velkou neprůchozí bariéru ve městě. Návrh se snaží reagovat na fungující stav areálu a rehabilitovat okolní prostředí. Dalším faktorem pro výběr území byl nevyužitý potenciál nábřeží řeky Kyjovky, která územím protéká. Řešená lokalita ukrývá spoustu problémů a zároveň ojediněle disponuje kvalitní architekturou. Mým úkolem bylo skloubit všechny aspekty území a maximálně je využít pro svůj návrh. Na území vzniká nová funkční čtvrť bydlení s veřejnými prostory a občanskou vybaveností. Celkem navrhuji 2 nové ulice, 4 veřejné prostory, pěší zónu, nábřeží řeky Kyjovky, 45 nových objektů a 10 rekonstruovaných objektů, které začleňuji do nové struktury. Konceptu území se týká také přesun stávajícího hlavního nádraží. Při navrhování je kladen důraz na řešení současných problémů města Kyjov – nedostatek bytové zástavby, úbytek a rostoucí věkový průměr obyvatel, nekvalitní služby a dojížďka obyvatel za prací., This diploma thesis is focused on the rehabilitation of adjacent surroundings of the historical center of Kyjov and revitalizing public spaces. Part of the thesis are the analysis of the current condition of the solved and affected area, problems evaluation and values of the territory and draft of a new building structure along with a working transport solution. The main criterion for the choice of the area to be solved for me was the problem of this locality with conjunction to industry area of the mills and a very small percentage of the quality of the territory. The mill site occupies almost a quarter of the area and together with surrounding buildings, makes a large impassable barrier in the city. The draft seeks to respond to the functioning state of the site and to rehabilitate the surrounding environment. Another factor for the selection of the territory was the unused potential of the river side Kyjovka flowing through the area. This area hides many other problems and there is no quality architecture. My task was to combine all aspects of the area and make the most of it for the draft. A new functional neighborhood of housing with public spaces and amenities is being designed on the area. The draft include 2 new streets, 4 public spaces, pedestrian zone, Kyjovka riverside, 45 new buildings and 10 reconstructed buildings. The concept of the area also concerns the transfer of the existing main railway station. The draft is also aimed on the main problem of Kyjov, as a growing age population, the poor quality of services and commuting to work.

Diplomová práce se zabývá rehabilitací přilehlého okolí historického jádra města Kyjov a zaměřuje se na oživení veřejných prostorů. Součástí práce jsou analýzy současného stavu řešeného a dotčeného území, následné vyhodnocení problémů a hodnot území a návrh nové struktury zástavby spolu s fungujícím dopravním řešením. Hlavním kritériem pro výběr řešeného území pro mne byla problematika této lokality spojená s velkou plochou fungujícího výrobního areálu mlýnů a velmi malé procento kvalitního zastavění území. Areál zabírá téměř čtvrtinu řešeného území a v současnosti spolu s okolními stavbami tvoří velkou neprůchozí bariéru ve městě. Návrh se snaží reagovat na fungující stav areálu a rehabilitovat okolní prostředí. Dalším faktorem pro výběr území byl nevyužitý potenciál nábřeží řeky Kyjovky, která územím protéká. Řešená lokalita ukrývá spoustu problémů a zároveň ojediněle disponuje kvalitní architekturou. Mým úkolem bylo skloubit všechny aspekty území a maximálně je využít pro svůj návrh. Na území vzniká nová funkční čtvrť bydlení s veřejnými prostory a občanskou vybaveností. Celkem navrhuji 2 nové ulice, 4 veřejné prostory, pěší zónu, nábřeží řeky Kyjovky, 45 nových objektů a 10 rekonstruovaných objektů, které začleňuji do nové struktury. Konceptu území se týká také přesun stávajícího hlavního nádraží. Při navrhování je kladen důraz na řešení současných problémů města Kyjov – nedostatek bytové zástavby, úbytek a rostoucí věkový průměr obyvatel, nekvalitní služby a dojížďka obyvatel za prací., This diploma thesis is focused on the rehabilitation of adjacent surroundings of the historical center of Kyjov and revitalizing public spaces. Part of the thesis are the analysis of the current condition of the solved and affected area, problems evaluation and values of the territory and draft of a new building structure along with a working transport solution. The main criterion for the choice of the area to be solved for me was the problem of this locality with conjunction to industry area of the mills and a very small percentage of the quality of the territory. The mill site occupies almost a quarter of the area and together with surrounding buildings, makes a large impassable barrier in the city. The draft seeks to respond to the functioning state of the site and to rehabilitate the surrounding environment. Another factor for the selection of the territory was the unused potential of the river side Kyjovka flowing through the area. This area hides many other problems and there is no quality architecture. My task was to combine all aspects of the area and make the most of it for the draft. A new functional neighborhood of housing with public spaces and amenities is being designed on the area. The draft include 2 new streets, 4 public spaces, pedestrian zone, Kyjovka riverside, 45 new buildings and 10 reconstructed buildings. The concept of the area also concerns the transfer of the existing main railway station. The draft is also aimed on the main problem of Kyjov, as a growing age population, the poor quality of services and commuting to work.

Diplomová práce se zabývá rehabilitací přilehlého okolí historického jádra města Kyjov a zaměřuje se na oživení veřejných prostorů. Součástí práce jsou analýzy současného stavu řešeného a dotčeného území, následné vyhodnocení problémů a hodnot území a návrh nové struktury zástavby spolu s fungujícím dopravním řešením. Hlavním kritériem pro výběr řešeného území pro mne byla problematika této lokality spojená s velkou plochou fungujícího výrobního areálu mlýnů a velmi malé procento kvalitního zastavění území. Areál zabírá téměř čtvrtinu řešeného území a v současnosti spolu s okolními stavbami tvoří velkou neprůchozí bariéru ve městě. Návrh se snaží reagovat na fungující stav areálu a rehabilitovat okolní prostředí. Dalším faktorem pro výběr území byl nevyužitý potenciál nábřeží řeky Kyjovky, která územím protéká. Řešená lokalita ukrývá spoustu problémů a zároveň ojediněle disponuje kvalitní architekturou. Mým úkolem bylo skloubit všechny aspekty území a maximálně je využít pro svůj návrh. Na území vzniká nová funkční čtvrť bydlení s veřejnými prostory a občanskou vybaveností. Celkem navrhuji 2 nové ulice, 4 veřejné prostory, pěší zónu, nábřeží řeky Kyjovky, 45 nových objektů a 10 rekonstruovaných objektů, které začleňuji do nové struktury. Konceptu území se týká také přesun stávajícího hlavního nádraží. Při navrhování je kladen důraz na řešení současných problémů města Kyjov – nedostatek bytové zástavby, úbytek a rostoucí věkový průměr obyvatel, nekvalitní služby a dojížďka obyvatel za prací., This diploma thesis is focused on the rehabilitation of adjacent surroundings of the historical center of Kyjov and revitalizing public spaces. Part of the thesis are the analysis of the current condition of the solved and affected area, problems evaluation and values of the territory and draft of a new building structure along with a working transport solution. The main criterion for the choice of the area to be solved for me was the problem of this locality with conjunction to industry area of the mills and a very small percentage of the quality of the territory. The mill site occupies almost a quarter of the area and together with surrounding buildings, makes a large impassable barrier in the city. The draft seeks to respond to the functioning state of the site and to rehabilitate the surrounding environment. Another factor for the selection of the territory was the unused potential of the river side Kyjovka flowing through the area. This area hides many other problems and there is no quality architecture. My task was to combine all aspects of the area and make the most of it for the draft. A new functional neighborhood of housing with public spaces and amenities is being designed on the area. The draft include 2 new streets, 4 public spaces, pedestrian zone, Kyjovka riverside, 45 new buildings and 10 reconstructed buildings. The concept of the area also concerns the transfer of the existing main railway station. The draft is also aimed on the main problem of Kyjov, as a growing age population, the poor quality of services and commuting to work.

Diplomová práce se zabývá rehabilitací přilehlého okolí historického jádra města Kyjov a zaměřuje se na oživení veřejných prostorů. Součástí práce jsou analýzy současného stavu řešeného a dotčeného území, následné vyhodnocení problémů a hodnot území a návrh nové struktury zástavby spolu s fungujícím dopravním řešením. Hlavním kritériem pro výběr řešeného území pro mne byla problematika této lokality spojená s velkou plochou fungujícího výrobního areálu mlýnů a velmi malé procento kvalitního zastavění území. Areál zabírá téměř čtvrtinu řešeného území a v současnosti spolu s okolními stavbami tvoří velkou neprůchozí bariéru ve městě. Návrh se snaží reagovat na fungující stav areálu a rehabilitovat okolní prostředí. Dalším faktorem pro výběr území byl nevyužitý potenciál nábřeží řeky Kyjovky, která územím protéká. Řešená lokalita ukrývá spoustu problémů a zároveň ojediněle disponuje kvalitní architekturou. Mým úkolem bylo skloubit všechny aspekty území a maximálně je využít pro svůj návrh. Na území vzniká nová funkční čtvrť bydlení s veřejnými prostory a občanskou vybaveností. Celkem navrhuji 2 nové ulice, 4 veřejné prostory, pěší zónu, nábřeží řeky Kyjovky, 45 nových objektů a 10 rekonstruovaných objektů, které začleňuji do nové struktury. Konceptu území se týká také přesun stávajícího hlavního nádraží. Při navrhování je kladen důraz na řešení současných problémů města Kyjov – nedostatek bytové zástavby, úbytek a rostoucí věkový průměr obyvatel, nekvalitní služby a dojížďka obyvatel za prací., This diploma thesis is focused on the rehabilitation of adjacent surroundings of the historical center of Kyjov and revitalizing public spaces. Part of the thesis are the analysis of the current condition of the solved and affected area, problems evaluation and values of the territory and draft of a new building structure along with a working transport solution. The main criterion for the choice of the area to be solved for me was the problem of this locality with conjunction to industry area of the mills and a very small percentage of the quality of the territory. The mill site occupies almost a quarter of the area and together with surrounding buildings, makes a large impassable barrier in the city. The draft seeks to respond to the functioning state of the site and to rehabilitate the surrounding environment. Another factor for the selection of the territory was the unused potential of the river side Kyjovka flowing through the area. This area hides many other problems and there is no quality architecture. My task was to combine all aspects of the area and make the most of it for the draft. A new functional neighborhood of housing with public spaces and amenities is being designed on the area. The draft include 2 new streets, 4 public spaces, pedestrian zone, Kyjovka riverside, 45 new buildings and 10 reconstructed buildings. The concept of the area also concerns the transfer of the existing main railway station. The draft is also aimed on the main problem of Kyjov, as a growing age population, the poor quality of services and commuting to work.

Diplomová práce se zabývá rehabilitací přilehlého okolí historického jádra města Kyjov a zaměřuje se na oživení veřejných prostorů. Součástí práce jsou analýzy současného stavu řešeného a dotčeného území, následné vyhodnocení problémů a hodnot území a návrh nové struktury zástavby spolu s fungujícím dopravním řešením. Hlavním kritériem pro výběr řešeného území pro mne byla problematika této lokality spojená s velkou plochou fungujícího výrobního areálu mlýnů a velmi malé procento kvalitního zastavění území. Areál zabírá téměř čtvrtinu řešeného území a v současnosti spolu s okolními stavbami tvoří velkou neprůchozí bariéru ve městě. Návrh se snaží reagovat na fungující stav areálu a rehabilitovat okolní prostředí. Dalším faktorem pro výběr území byl nevyužitý potenciál nábřeží řeky Kyjovky, která územím protéká. Řešená lokalita ukrývá spoustu problémů a zároveň ojediněle disponuje kvalitní architekturou. Mým úkolem bylo skloubit všechny aspekty území a maximálně je využít pro svůj návrh. Na území vzniká nová funkční čtvrť bydlení s veřejnými prostory a občanskou vybaveností. Celkem navrhuji 2 nové ulice, 4 veřejné prostory, pěší zónu, nábřeží řeky Kyjovky, 45 nových objektů a 10 rekonstruovaných objektů, které začleňuji do nové struktury. Konceptu území se týká také přesun stávajícího hlavního nádraží. Při navrhování je kladen důraz na řešení současných problémů města Kyjov – nedostatek bytové zástavby, úbytek a rostoucí věkový průměr obyvatel, nekvalitní služby a dojížďka obyvatel za prací., This diploma thesis is focused on the rehabilitation of adjacent surroundings of the historical center of Kyjov and revitalizing public spaces. Part of the thesis are the analysis of the current condition of the solved and affected area, problems evaluation and values of the territory and draft of a new building structure along with a working transport solution. The main criterion for the choice of the area to be solved for me was the problem of this locality with conjunction to industry area of the mills and a very small percentage of the quality of the territory. The mill site occupies almost a quarter of the area and together with surrounding buildings, makes a large impassable barrier in the city. The draft seeks to respond to the functioning state of the site and to rehabilitate the surrounding environment. Another factor for the selection of the territory was the unused potential of the river side Kyjovka flowing through the area. This area hides many other problems and there is no quality architecture. My task was to combine all aspects of the area and make the most of it for the draft. A new functional neighborhood of housing with public spaces and amenities is being designed on the area. The draft include 2 new streets, 4 public spaces, pedestrian zone, Kyjovka riverside, 45 new buildings and 10 reconstructed buildings. The concept of the area also concerns the transfer of the existing main railway station. The draft is also aimed on the main problem of Kyjov, as a growing age population, the poor quality of services and commuting to work.