48 results on '"Morjan M"'
Search Results
2. Is Less More? Outcomes of Reoperative Surgery after Type A Acute Aortic Dissection Repair
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Morjan, M., additional, Mestres, C. A., additional, Savic, V., additional, Mustafa, G., additional, Mathias, V. H., additional, Sromicki, J., additional, Vogt, P. R., additional, and Reser, D., additional
- Published
- 2023
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3. Mapping out a future for ungulate migrations : Limited mapping of migrations hampers conservation
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Kauffman, M.J., Cagnacci, F., Chamaillé-Jammes, S., Hebblewhite, M., Hopcraft, J.G.C., Merkle, J.A., Mueller, T., Mysterud, A., Peters, W., Roettger, C., Steingisser, A., Meacham, J.E., Abera, K., Adamczewski, J., Aikens, E.O., Bartlam-Brooks, H., Bennitt, E., Berger, J., Boyd, C., Côté, S.D., Debeffe, L., Dekrout, A.S., Dejid, N., Donadio, E., Dziba, L., Fagan, W.F., Fischer, C., Focardi, S., Fryxell, J.M., Fynn, R.W.S., Geremia, C., González, B.A., Gunn, A., Gurarie, E., Heurich, M., Hilty, J., Hurley, M., Johnson, A., Joly, K., Kaczensky, P., Kendall, C.J., Kochkarev, P., Kolpaschikov, L., Kowalczyk, R., van Langevelde, F., Binbin V, L., Lobora, A.L., Loison, A., Madiri, T.H., Mallon, D., Marchand, P., Medellin, R.A., Meisingset, E., Merrill, E., Middleton, A.D., Monteith, K.L., Morjan, M., Morrison, T.A., Mumme, S., Naidoo, R., Novaro, A., Ogutu, J.O., Olson, K.A., Oteng-Yeboah, A., Ovejero, R.J.A., Owen-Smith, N., Paasivaara, A., Packer, C., Panchenko, D., Pedrotti, L., Plumptre, A.J., Rolandsen, C.M., Said, S., Salemgareyev, A., Savchenko, A., Savchenko, P., Sawyer, H., Selebatso, M., Skroch, M., Solberg, E., Stabach, J.A., Strand, O., Suitor, M.J., Tachiki, Y., Trainor, A., Tshipa, A., Virani, M.Z., Vynne, C., Ward, S., Wittemyer, G., Wenjing, X., and Zuther, S.
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Settore BIO/07 - ECOLOGIA - Published
- 2021
4. Do all roads lead to Rome? Treatment of malposition pacemaker lead in the left ventricle
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Schmiady MO, Hofmann M, Maisano F, Morjan M, Schmiady, Mo, Hofmann, M, Maisano, F, and Morjan, M
- Published
- 2020
5. Outcomes of patients operated for acute type A aortic dissection requiring preoperative cardiopulmonary resuscitation
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Reser D, Morjan M, Savic V, Pozzoli A, Maisano F, Mestres CA, Reser, D, Morjan, M, Savic, V, Pozzoli, A, Maisano, F, and Mestres, Ca
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- 2020
6. Attracting investment for Africa's protected areas by creating enabling environments for collaborative management partnerships
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Lindsey, P., primary, Baghai, M., additional, Bigurube, G., additional, Cunliffe, S., additional, Dickman, A., additional, Fitzgerald, K., additional, Flyman, M., additional, Gandiwa, P., additional, Kumchedwa, B., additional, Madope, A., additional, Morjan, M., additional, Parker, A., additional, Steiner, K., additional, Tumenta, P., additional, Uiseb, K., additional, and Robson, A., additional
- Published
- 2021
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7. 3.4 - Integration organischer Leuchtdioden auf einem Sensorchip zur Messung der Sauerstoffkonzentration in Gasen und Flüssigkeiten
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Fehse, K., primary, Schlebusch, D., additional, Wartenberg, P., additional, Ulbricht, S., additional, Bunk, G., additional, Brenner, S., additional, Schober, M., additional, Schmidt, C., additional, Richter, B., additional, Vogel, U., additional, Lau, M., additional, Czihal, S., additional, and Morjan, M., additional
- Published
- 2019
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8. 2nd International Symposium on Minimal Invasive Extracorporeal Technologies Athens, Greece, 9-11 June 2016001SAFETY IN THE EVOLVING MINIATURIZED EXTRACORPOREAL SYSTEM002THE CHALLENGE OF CLOSED CIRCUIT SYSTEM FOR ALL CARDIOPULMONARY BYPASS CASES003THE USE OF A MINIMAL INVASIVE EXTRACORPOREAL CIRCUIT FOR REWARMING PATIENTS FROM ACCIDENTAL HYPOTHERMIA: A PROSPECTIVE STUDY004WHAT ARE THE LIMITATIONS OF MINIATURIZED ADULT CARDIOPULMONARY BYPASS? OUR FINDINGS005AORTIC VALVE SURGERY AND CORONARY BYPASS SURGERY IN DIALYZED PATIENTS. MAY MINIMAL EXTRACORPOREAL CIRCULATION BE HELPFUL IN GETTING BETTER RESULTS?006IMPACT OF MINIMAL EXTRACORPOREAL CIRCULATION IN OCTOGENARIANS UNDERGOING CORONARY ARTERY BYPASS GRAFTING. HAVE WE BEEN LOOKING IN THE WRONG DIRECTION?007CORONARY ARTERY BYPASS GRAFTING ON BEATING HEART, ON CARDIOPULMONARY BYPASS OR ON MINIMAL EXTRACORPOREAL CIRCULATION008MINIMAL INVASIVE EXTRACORPOREAL CIRCULATION IMPROVES QUALITY OF LIFE AFTER CORONARY ARTERY BYPASS GRAFTING009MINIMAL INVASIVE DETERMINATIONS OF OXYGEN DELIVERY (DO2) AND CONSUMPTION (VO2) IN CARDIAC SURGERY010CONTINUOUS MONITORING OF PERFUSION INDEX AND PULSE OXIMETRY DURING WARM PULSATILE PERFUSION IN PAEDIATRICS011CEREBRAL MICROEMBOLIZATION IN PATIENTS UNDERGOING SURGICAL AORTIC VALVE REPLACEMENT ON MINIMAL INVASIVE OR CONVENTIONAL EXTRACORPOREAL CIRCULATION012ASSESSMENT OF AUTOMATED SOMATOSENSORY EVOKED POTENTIALS FOR DETECTION OF INTRAOPERATIVE POSITIONAL NEUROPRAXIA IN CARDIAC SURGERY013MINIMAL INVASIVE EXTRACORPOREAL CIRCULATION IN MINIMALLY INVASIVE AORTIC VALVE SURGERY014MINIMAL INVASIVE EXTRACORPOREAL CIRCULATION IN ENDOSCOPIC MITRAL VALVE SURGERY015AIR HANDLING CAPABILITY OF A CONVENTIONAL CARDIOPULMONARY BYPASS VERSUS MINIMIZED EXTRACORPOREAL CIRCUIT USING THE FUSION OXYGENATOR016DOES MINIMALLY INVASIVE EXTRACORPOREAL CIRCULATION AND CELL SALVAGE REDUCE INFLAMMATION AFTER CORONARY ARTERY BYPASS GRAFTING SURGERY?
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Bell, J., primary, Yamamoto, Y., primary, Jenni, H., primary, Mclean, L.A., primary, Chiarella, G., primary, El-Essawi, A., primary, Glendza, D., primary, Antonitsis, P., primary, Boer, C., primary, Durandy, Y., primary, Erdoes, G., primary, Murkin, J.M., primary, Starinieri, P., primary, Spriel, A., primary, Bauer, A., primary, McLean, L., additional, Medlam, W., additional, Bennett, R.T., additional, Bennett, R.V., additional, Turner, E., additional, Wallhead, A., additional, Winkler, B., additional, Erdös, G., additional, Eberle, B., additional, Carrel, T., additional, Bell, J., additional, Benvenuto, D., additional, Ciano, M., additional, Losito, G., additional, Mazzei, V., additional, Breitenbach, I., additional, Haupt, B., additional, Morjan, M., additional, Brower, R., additional, Harringer, W., additional, Dedieu, F., additional, Crispin, V., additional, Aunac, S., additional, Guennaoui, T., additional, Van Ruyssevelt, P., additional, Kostarellou, G., additional, Argiriadou, H., additional, Kleontas, A., additional, Deliopoulos, A., additional, Grosomanidis, V., additional, Anastasiadis, K., additional, Stolze, A., additional, Vonk, A., additional, Burtman, D., additional, Basciani, R., additional, Kröninger, F., additional, Gygax, E., additional, Jenni, H., additional, Reineke, D., additional, Stucki, M., additional, Hagenbuch, N., additional, Turkstra, T., additional, Mayer, R., additional, Robic, B., additional, Wen, W., additional, Yilmaz, A., additional, Nguyen-Vu, M., additional, Serrick, C., additional, Hausmann, H., additional, Eberle, T., additional, Troitzsch, D., additional, Johansen, P., additional, Nygaard, H., additional, and Hasenkam, J.M., additional
- Published
- 2016
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9. Diagnosi non invasiva di rigetto miocardico acuto: l'analisi armonica dell'ecg coadiuva la valutazione clinica
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Fabbri F, Fabbri S, Morjan M, Coccolo F, Magnani G, Fallani F, POTENA, LUCIANO, CORAZZA, IVAN, CARIGI, SAMUELA, MUSURACA, ANNA CHIARA, BIGLIARDI, MAURO, LEONE, ORNELLA, GRIGIONI, FRANCESCO, MAGELLI, CARLO, ZANNOLI, ROMANO, BRANZI, ANGELO, NICOLOSI GL, Fabbri F, Fabbri S, Morjan M, Potena L, Corazza I, Carigi S, Musuraca AC, Bigliardi M, Leone O, Grigioni F, Coccolo F, Magnani G, Fallani F, Magelli C, Zannoli R, and Branzi A.
- Published
- 2005
10. S-Nitroso Human Serum Albumin (S-NO-HSA) Attenuates Pulmonary Hypertension, Improves Right Ventricular-arterial Coupling and Reduces Oxidative Stress in a Chronic Right Ventricle Volume Overload Model
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Rungatscher, A, Hallstrom, S, Morjan, M, Linardi, D, Gasser, H, Podesser, Bruno Karl, Luciani, Gb, Mazzucco, A, and Faggian, G.
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nitric oxide ,pulmonary hypertension ,congenital ,ventricular arterial coupling ,oxidative stress ,left to right shunt ,nitric oxide, S-nitroso albumin, pulmonary hypertension, congenital, left to right shunt, ventricular arterial coupling, oxidative stress ,S-nitroso albumin - Published
- 2011
11. Descending Aorta to Coronary Artery Bypass in a Patient with a Tracheostomy: Columbus´s Egg?
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Ali, K., primary, Morjan, M., additional, Breitenbach, I., additional, Harringer, W., additional, and El-Essawi, A., additional
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- 2015
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12. Symptomatic Anomalous Origin of a Right Coronary Artery Treated by Surgical Correction
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Morjan, M., primary, Breitenbach, I., additional, Ali, K., additional, Brouwer, R., additional, Harringer, W., additional, and El-Essawi, A., additional
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- 2015
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13. Late prosthetic graft infection after frozen elephant trunk presenting by hemoptysis and positive FDG PET/CT
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Morjan, M., primary, Breitenbach, I., additional, Anssar, M., additional, Ali, K., additional, Harringer, W., additional, and El-Essawi, A., additional
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- 2014
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14. Theoretische und experimentelle Entwicklung eines optischen Wasserstoffsensors
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Morjan, M. (Martin), Cammann, K. (Karl), and Universitäts- und Landesbibliothek Münster
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ddc:540 ,Chemischer Sensor ,optischer Sensor ,Wasserstoff ,optische Schicht ,Palladium ,Plasmawelle ,Chemistry and allied sciences - Abstract
Im Rahmen der vorliegenden Arbeit wurden die Grundlagen für einen optischen Wasserstoffsensor für Konzentrationen im Bereich der unteren Explosionsgrenze von 4 Vol. % auf Basis der Oberflächen-Plasmawellen-Resonanz-Spektroskopie entwickelt. Hierbei wurde gezielt der Einfluss von Wasserstoff auf die Anregung von Plasmawellen in Palladium ausgenutzt. Die Entwicklung der Sensoren erfolgte in zwei Schritten. Zuerst wurden durch theoretische Berechnungen mögliche Sensordesigns zur Anregung von Plasmawellen in Palladium in Kretschmann- und Otto-Konfiguration erarbeitet und die Sensoraufbauten mit Hilfe eines Simulationsprogramms bezüglich der Schichtparameter optimiert. Anschließend erfolgte die Herstellung und eine experimentelle Charakterisierung der Sensoren. Die hierbei gewonnen experimentellen Daten wurden mit den berechneten Ergebnissen verglichen. Es konnte gezeigt werden, dass mit dem entwickelten Sensor Wasserstoffkonzentrationen im Bereich der unteren Explosionsgrenze mit einer Auflösung von (0,4 Vol. % detektiert werden können. Darüber hinaus konnten auftretende Temperatureffekte erfolgreich kompensiert werden.
- Published
- 2002
15. ChemInform Abstract: Synthesis of Substituted Benzoins and the Corresponding Bis‐1,2‐ enedithiol Complexes of Nickel, Platinum, and Palladium.
- Author
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ONICIU, D. C., primary, NEGOITA, N., additional, MORJAN, M., additional, GHEORGHIU, M. D., additional, and BALABAN, A. T., additional
- Published
- 1991
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16. Grafting antioxidants; Part VI-grafting kinetics of ^3^5S-Bridged aromatic diamines to rubbers
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Negoita, N., Morjan, M., Giurginca, M., and Herdan, J. M.
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- 1994
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17. Model for End-Stage Liver Disease Including Na, Age, and Sex Is Powerful Predictor of Survival in COVID-19 Patients on Extracorporeal Membrane Oxygenation.
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Jenkins FS, Morjan M, Minol JP, Yilmaz E, Dalyanoglu I, Immohr MB, Korbmacher B, Boeken U, Lichtenberg A, and Dalyanoglu H
- Abstract
Aim: Extracorporeal membrane oxygenation (ECMO) is resource-intensive, is associated with significant morbidity and mortality, and requires careful patient selection. This study examined whether the model for end-stage liver disease (MELD) score is a suitable predictor of in-hospital mortality in patients with COVID-19., Materials and Methods: We retrospectively assessed patients with COVID-19 on ECMO at our institution from March 2020 to May 2021. MELD scoring was performed using laboratory values recorded prior to ECMO initiation. A multiple logistic regression model was established., Results: A total of 66 patients with COVID-19 on ECMO were included (median age of 58.5 years; 83.3% male). The in-hospital mortality was 74.2%. In relation to mortality, patients with MELD Na scores >13.8 showed 6.5-fold higher odds, patients aged >53.5 years showed 18.4-fold higher odds, and male patients showed 15.9-fold higher odds. The predictive power of a model combining the MELD Na with age and sex was significant (AUC = 0.883, p < 0.001). The findings in the COVID-19 patients were not generalizable to a group of non-COVID-19 patients on ECMO., Conclusions: A model combining the MELD Na, age, and sex has high predictive power for in-hospital mortality in patients with COVID-19 on ECMO, and it may be clinically useful for guiding patient selection in critically ill COVID-19 patients both now and in the future, should the virus widely re-emerge.
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- 2024
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18. Hydrogel-coated and active clearance chest drains in cardiac surgery: real-world results of a single-center study.
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Jenkins FS, Morjan M, Minol JP, Farkhondeh N, Dalyanoglu I, Yilmaz E, Immohr MB, Korbmacher B, Boeken U, Lichtenberg A, and Dalyanoglu H
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- Humans, Male, Female, Middle Aged, Hydrogels, Aged, Prospective Studies, Postoperative Complications prevention & control, Cardiac Surgical Procedures methods, Drainage methods, Chest Tubes
- Abstract
Purpose: Cardiac surgery patients require chest drains for postoperative fluid drainage. Innovations in this field include chemical drain coating and manual clot extraction systems, aiming to provide reduced clotting and improved patient comfort. This study compares outcomes using hydrogel-coated, active clearance and conventional chest drains., Methods: Patients with cardiac surgery at our institution from January 2023 to September 2023 were included. Drain allocation was based on surgeon's choice, with either a combination of hydrogel-coated and conventional, active clearance and conventional, or conventional drains alone. Drain data and clinical outcomes were recorded prospectively., Results: One hundred seventy-eight patients (62.9 ± 11.7 years, 67.4% male) received a total of 512 chest drains intraoperatively. Hydrogel-coated and active clearance drains showed higher drainage volumes than conventional drains (p < 0.001, respectively). Patency was lowest in conventional drains (36.7% vs. 98.8% for hydrogel-coated, p < 0.001, and vs. 96.6% for active clearance drains, p < 0.001). Conventional drains showed 5.9 times the odds (95% CI 2.0-25.2) of large pleural effusions compared to hydrogel-coated and 12.0 times the odds (95% CI 1.9-504.1) compared to active clearance drains. Patients with hydrogel-coated drains had the shortest length of stay (p < 0.001)., Conclusion: Hydrogel-coated and active clearance drains show improved outcomes compared to conventional drains in cardiac surgery., (© 2024. The Author(s).)
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- 2024
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19. Transverse testicular ectopia with an inguinal hernia: A rare case report.
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Sattout H, Jabra M, Malahefji H, and Morjan M
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Introduction: Transverse testicular ectopia (TTE) is a rare congenital condition characterized by migration of both testes through the same inguinal canal and often presents with an inguinal hernia. TTE is associated with various genitourinary anomalies., Case Presentation: A three-year-old boy presented with a non-palpable right testis and a palpable undescended left testis in the left inguinal area. Ultrasound (US) indicated the presence of both testes in the left inguinal canal. In surgery, the two testes were found with separated cord and one hernia sac which was dissected and ligated thus the two cords freed. Next, subdartos pouches were created on both scrotum sides, so that testes placed into the left side first, and then a window created in the scrotal septum which allowed the right testis to be translocated and secured in the right subdartos pouch without tension., Discussion: TTE is a rare condition and the etiology is not definitively known. TTE usually presents with an inguinal hernia and contralateral cryptorchidism. The diagnosis is made during surgery, but some radiological methods can help in diagnosis. Management is usually surgical and involves interventions such as hernia repair, reduction of the testis and orchiopexy. Continuous monitoring is essential for ensuring postoperative testes health and evaluating the risk of malignancy., Conclusion: TTE should be suspected in cases with unilateral empty scrotum and family history of genital disorders. US is critical for accurately localizing the testes, along with surgical exploration, to proceed with the appropriate surgical intervention., Competing Interests: Conflict of interest statement No conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2024
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20. The role of BioFire Joint Infection Panel in diagnosing periprosthetic hip and knee joint infections in patients with unclear conventional microbiological results.
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Gardete-Hartmann S, Mitterer JA, Sebastian S, Frank BJH, Simon S, Huber S, Löw M, Sommer I, Prinz M, Halabi M, and Hofstaetter JG
- Abstract
Aims: This study aimed to evaluate the BioFire Joint Infection (JI) Panel in cases of hip and knee periprosthetic joint infection (PJI) where conventional microbiology is unclear, and to assess its role as a complementary intraoperative diagnostic tool., Methods: Five groups representing common microbiological scenarios in hip and knee revision arthroplasty were selected from our arthroplasty registry, prospectively maintained PJI databases, and biobank: 1) unexpected-negative cultures (UNCs), 2) unexpected-positive cultures (UPCs), 3) single-positive intraoperative cultures (SPCs), and 4) clearly septic and 5) aseptic cases. In total, 268 archived synovial fluid samples from 195 patients who underwent acute/chronic revision total hip or knee arthroplasty were included. Cases were classified according to the International Consensus Meeting 2018 criteria. JI panel evaluation of synovial fluid was performed, and the results were compared with cultures., Results: The JI panel detected microorganisms in 7/48 (14.5%) and 15/67 (22.4%) cases related to UNCs and SPCs, respectively, but not in cases of UPCs. The correlation between JI panel detection and infection classification criteria for early/late acute and chronic PJI was 46.6%, 73%, and 40%, respectively. Overall, the JI panel identified 12.6% additional microorganisms and three new species. The JI panel pathogen identification showed a sensitivity and specificity of 41.4% (95% confidence interval (CI) 33.7 to 49.5) and 91.1% (95% CI 84.7 to 94.9), respectively. In total, 19/195 (9.7%) could have been managed differently and more accurately upon JI panel evaluation., Conclusion: Despite its microbial limitation, JI panel demonstrated clinical usefulness by complementing the traditional methods based on multiple cultures, particularly in PJI with unclear microbiological results., Competing Interests: S. Gardete Hartmann reports financial support from BioFire Diagnostics, bioMérieux for attendance with oral presentation and poster presentation at 40th Annual Meeting of the European Bone and Joint Infection Society (EBJIS), and the Interdisciplinary Course on Antibiotics and Resistance (ICARe) 2022, respectively. J. G. Hofstaetter and S. Gardete Hartmann report payment for expert testimonial by BioFire Diagnostics, bioMérieux, unrelated to this study. The remaining co-authors report no conflict of interest., (© 2024 Gardete-Hartmann et al.)
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- 2024
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21. Adrenocortical tumor manifesting as virilizing in a female child: Adenoma or carcinoma? A rare case report.
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Breim F, Jaweesh A, Sleibi A, Kanaa L, Sattout H, and Morjan M
- Abstract
Introduction: Adrenocortical tumors (ACTs) are rare endocrine neoplasms in children, with functional ACTs being more prevalent than non-functional types. Clinical manifestations typically include virilization, Cushing's syndrome, and hyperaldosteronism. Surgical intervention is the primary treatment for ACTs, with a significant risk of recurrence in adrenocortical carcinoma even after complete resection., Presentation of Case: This case presentation describes a 3.5-year-old female with generalized hirsutism and clitoral hypertrophy, leading to the discovery of a left adrenal tumor. The child underwent adrenalectomy, revealing a benign adrenal cortical adenoma. Unfortunately, due to loss of follow-up, the child later presented with pulmonary metastases and passed away, preventing further investigation into the source of metastases., Discussion: Adrenocortical tumors are uncommon in children, with the classification of ACTs into adenomas and carcinomas. To our knowledge, this is the third case of an adrenocortical tumor in a child in Syria. We highlight the challenges in managing pediatric ACTs and emphasize the importance of timely intervention and close monitoring to improve outcomes. Regular follow-up is crucial to detect complications early and optimize treatment strategies, especially considering the unpredictable behavior of these tumors., Conclusion: This case confirms that distinguishing between adrenocortical adenoma and carcinoma can be challenging even histologically. Therefore, it is necessary to follow up after treating each case of adenoma in a child to prevent major complications., Competing Interests: Declarations of interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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22. A rare case of cervical myofibroma in an infant: A case report.
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Breis A, Dordi Y, Kawas H, Abbas W, AlKhamisy A, and Morjan M
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Introduction: A solitary infantile myofibroma tumor arises as a hard, painless cutaneous or subcutaneous nodule and is defined as an uncommon soft tissue neoplasm that is usually seen in childhood., Case Presentation: A nine-month-old female infant presented with a solid mass that appeared one month ago. The mass gradually increased in size within the right posterior triangle of the neck, without any local or systemic accompanying symptoms. Laboratory tests were normal. Ultrasonography revealed a homogeneous tissue mass measuring 1.5 × 3 cm, with blood flow within it. Multislice CT scan accurately localized the isolated tumor. The mass was surgically excised and found within the sternocleidomastoid muscle, without any adhesions to adjacent tissues. Histological examination of the tumor and immunohistochemical tests confirmed infantile myofibroma., Clinical Discussion: IM is one of the most common soft tissue tumors in children and mainly consists of myofibroblasts. 90 % of IM cases are diagnosed before the age of two years. Possible therapeutic measures for this tumor include conservative management, surgical resection, chemotherapy, radiation therapy, and steroid injections into the tumor. Surgical removal of the tumor is often performed, and if it is single and completely removed, the prognosis is good with a recurrence rate of less than 10 %., Conclusion: Infantile myofibroma is considered a benign tumor, but it may be fatal in some cases. Each case is treated individually according to the number (single or multicentric), size, location, symptoms, and visceral involvement. Surgical resection remains the therapeutic procedure of choice in most cases., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2024
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23. Sleep quality and mental health differences following Syria-Turkey earthquakes: A cross-sectional study.
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Ataya J, Soqia J, Ataya J, AlMhasneh R, Batesh D, Alkhadraa D, Albokaai H, and Morjan M
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- Humans, Female, Cross-Sectional Studies, Male, Adult, Syria, Middle Aged, Turkey epidemiology, Surveys and Questionnaires, Depression epidemiology, Anxiety epidemiology, Young Adult, Sleep Wake Disorders epidemiology, Longitudinal Studies, Adolescent, Aged, Disasters, Stress Disorders, Post-Traumatic epidemiology, Earthquakes, Survivors psychology, Mental Health, Sleep Quality
- Abstract
Background: This study explores the lasting mental health impact of the Syria-Turkey earthquakes in 2023 on a population affected by conflict and trauma. It analyzes pre- and post-event mental health and sleep quality differences, identifying predictors of outcomes., Aims: Studying the 2023 Syria-Turkey earthquakes' enduring mental health impact on conflict-affected individuals, this research informs better support and interventions for disaster survivors., Methods: This longitudinal, cross-sectional study examined the enduring mental health impact of the Syria-Turkey earthquakes. The present study involved N = 1,413 Syrian survivors, aged 18 years or older, who actively participated by contributing both pre- and post-earthquake data. A meticulously designed digital questionnaire with established metrics assessed sleep disturbances, depressive symptoms, and anxiety levels. Stratification variables (age, gender, education, marital status) were used for subgroup analysis. Arabic versions of PHQ-9, PSQI, and GAD-2 proved reliable for measuring depression, sleep quality, and anxiety., Results: The majority of participants were female (73.6%) with tertiary education (83.3%). Post-earthquake, a higher percentage reported poor sleep quality (67.7% vs. 59.7%, p < .001) and increased prevalence of MDE (66.1% vs. 56%, p < .001). GAD did not differ significantly. Post-earthquake, women had a higher likelihood of poor sleep quality (OR: 1.58, 95% CI [1.19, 2.10], p < .001) and MDE (OR: 1.55, 95% CI [1.18 to 2.04], p = .003). Predictors varied before and after earthquakes; age and education were significant predictors of poor sleep quality, MDE, and GAD., Conclusion: This study reveals higher rates of poor sleep quality and major depressive episodes among earthquake-affected individuals, especially women. Age, education, and gender contribute to these outcomes. Targeted interventions and comprehensive mental health support are crucial for post-earthquake recovery., Competing Interests: Conflict of interestThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- Published
- 2024
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24. Indications and outcomes of second aortic procedures after acute type A dissection repair.
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Morjan M, Mestres CA, Savic V, Gerçek M, Van Hemelrijck M, Sromicki J, Dzemali O, and Reser D
- Abstract
Objectives: Aortic arch or aortic root replacement is not performed in all cases of acute type A aortic dissection (ATAD), and a second aortic procedure will become necessary over time for some patients. Indications and outcomes, of second aortic procedures have not been studied extensively., Methods: Characteristics and in-hospital outcomes of all patients undergoing surgical repair for type A acute aortic dissection were analysed and patients needing second aortic procedure during follow-up were identified. The latter group was divided in 2 subgroups: on-pump includes patients operated on using cardiopulmonary bypass and off-pump without cardiopulmonary bypass., Results: A total of 638 patients underwent surgery for ATAD; 8% required a second aortic procedure. The most frequent indication for the second aortic procedure was dehiscence of suture lines (44%), followed by arch dilatation (24%). In-hospital mortality was 12%. Isolated ascending aorta replacement at the first surgery was associated with higher incidence of second aortic procedure (P = 0.006). Most patients in the on-pump group underwent a proximal reoperation (75%), with a mortality rate of 14.2%. In-hospital mortality of patients in the off-pump group was 7.7%. Long-term survival analysis showed no difference between groups (P = 0,526), Off-pump patients have greater likelihood of a second intervention during follow-up (P = 0.004)., Conclusions: Extended aortic root surgery and customized aortic arch repair in ATAD could be reasonable to reduce the incidence and mortality of high-risk second aortic procedures., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)
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- 2024
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25. Influence of minimal invasive extracorporeal circuits on dialysis dependent patients undergoing cardiac surgery.
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Nguyen TD, Morjan M, Ali K, Breitenbach I, Harringer W, and El-Essawi A
- Abstract
Introduction: Cardiac surgery in patients on chronic renal dialysis is associated with significant morbidity and mortality. Minimally invasive extracorporeal circuits (MiECC) have shown a positive impact on patient outcome in different high-risk populations. This retrospective study compares the outcome of these high-risk patients undergoing heart surgery either with a MiECC or a conventional extracorporeal circulation (CECC)., Methods: This is a single-center experience including 131 consecutive dialysis dependent patients undergoing cardiac surgery between January 2006 and December 2016. A propensity score matching was employed leaving 30 matched cases in each group., Results: After propensity score matching the 30-day mortality was significantly lower in the MiECC group ( n = 3 (10%) vs n = 10 (33%) in the CECC group, p = .028). Further, intraoperative transfused units of packed red blood cells were lower in the MiECC group (1.4 ± 1.8 units vs 2.8 ± 1.7, p < .001)., Conclusions: There are evident advantages to using MiECC in dialysis dependent patients, especially regarding mortality. These findings necessitate additional research in MiECC usage in high-risk populations., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2023
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26. Successful surgical treatment of congenital chylous ascites co-existed with congenital hypothyroidism: A rare case report.
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Roumi Jamal B, Breim F, Souleman S, Maarawi G, and Morjan M
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Introduction and Importance: Chylous ascites is a rare condition in children wherein milky fluid accumulates in the abdomen. It is caused by various factors and presents with abdominal distension. Diagnosis involves imaging and fluid analysis obtained through paracentesis. Treatment options range from conservative measures to surgery. The association with congenital hypothyroidism is not well-established., Case Presentation: A 3-week-old male infant presented with abdominal distention. Diagnosis revealed congenital chylous ascites and congenital hypothyroidism. Initially, he was treated conservatively with medium-chain triglycerides and total parenteral nutrition, paracentesis, and thyroid hormone supplementation. The patient's condition worsened, necessitating octreotide therapy, blood transfusion, and antibiotics. The conservative treatment failed, and the patient underwent surgery; however, the exact source of fluid leakage could not be identified. Follow-up ultrasound examinations showed no ascitic fluid in the subsequent months., Clinical Discussion: Congenital chylous ascites can be caused by congenital malformations or idiopathic factors. Symptoms include abdominal distension and respiratory difficulties. Diagnosis involves imaging and fluid analysis through paracentesis. To our knowledge, this represents the third case of congenital chylous ascites in the associated with congenital hypothyroidism described in the literature and the first one to be treated with surgery., Conclusion: Treatment options range from conservative measures such as diet management and paracentesis to somatostatin therapy. Surgery is considered in refractory cases. An association between congenital hypothyroidism and congenital chylous ascites has been reported in few cases., Competing Interests: Declaration of competing interest There are none to declare., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2023
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27. Successful excision of a large congenital vallecular cyst in a female newborn: A case report.
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Al-Kurdi MA, Razzouk Q, Hussein OS, Sawas R, and Morjan M
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Introduction and Importance: Congenital laryngeal cysts are a rare cause of stridor in infants, and vallecular cysts account for 10.5-20.1% of all congenital laryngeal cysts. Large cysts can lead to airway obstruction and death. Nasopharyngolaryngoscopy is needed to confirm the diagnosis. Surgical treatment relieves symptoms and prevent serious complications. We report a congenital laryngeal cyst on the lingual surface of the epiglottis in a female newborn that was successfully excised without any complications., Case Presentation: A 15-day-old female newborn presented with stridor, dysphagia and dyspnea that worsened and eventually led to a diagnosis of a large serous cyst on the epiglottis's lingual surface, compressing the entrance to the larynx. Surgery was performed under general anesthesia and the entire cyst was excised using rigid endoscopy. After the surgery, the infant made a quick recovery with no complications or recurrence., Clinical Discussion: Vallecular cysts are a rare type of laryngeal cysts and an uncommon cause of congenital stridor that requires immediate diagnosis and management to prevent upper airway obstruction and death. Clinical features vary depending on the patient's and cyst's characteristics. Laryngoscope can help in confirming the final diagnosis. Complete excision is a better than aspiration, as it has a lower recurrence rate., Conclusion: Vallecular cysts are a life-threatening condition that requires early diagnosis and immediate management to avoid any potential complications. It must be taken into account in the presence of congenital stridor. Marsupialization and excision (extirpation) have equal effectiveness and low recurrence rate, making them definitive surgical treatments for vallecular cysts., Competing Interests: Declaration of competing interest N/A., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2023
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28. A pleuropulmonary blastoma type III in a 4-month-old infant: First case report in Syria.
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AlKhamisy A, Abbas W, Barakat A, Ghabreau L, Khanji K, and Morjan M
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Introduction: Pleuropulmonary blastoma is a rare, aggressive intrathoracic neoplasm of early childhood., Case Presentation: We report a case of a 4-month-old male baby who has presented with recurrent respiratory infections since birth. A surgical team was consulted due to abnormal opacification observed on a chest X-ray. An enhanced-contrast CT scan of the chest revealed a heterogenous, well-delineated mass measuring about 3,8 × 6 cm in the posterior mediastinum. A left posterolateral thoracotomy was performed. The mass was separated from the lung parenchyma, located behind the parietal pleura, and adherent to the chest wall and superior ribs. The lesion was totally removed. Histologically, the lesion was a pleuropulmonary blastoma type III. Currently, the patient is on a 6-month course of chemotherapy., Clinical Discussion: The aggressive, insidious behavior of PPB requires a high index of suspicion for diagnosis. The clinical manifestations and imaging modalities are atypical and nonspecific. However, PPB should be kept in mind when a huge solid or cystic mass is observed in the lung field on imaging., Conclusion: Extrapulmonary pleuropulmonary blastoma is a very rare entity characterized by highly aggressive behavior and a poor prognosis. Early excision of thoracic cystic lesions in children is warranted regardless of the symptoms to avoid future mishaps., Competing Interests: Conflict of interest statement No conflicts., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2023
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29. Midterm outcomes of minimally invasive mitral valve surgery in a heterogeneous valve pathology cohort: respect or resect?
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Passos L, Aymard T, Biaggi P, Morjan M, Emmert MY, Gruenenfelder J, and Reser D
- Abstract
Background: Minimally invasive mitral valve surgery (MIV) through a right lateral thoracotomy has become the standard of care at specialized centers and might soon will be the only acceptable surgical treatment option in the future era of interventional procedures. The aim of our study was to analyze the outcomes of our MIV-specialized, single-center, mixed valve pathology cohort with regard to morbidity, mortality and midterm outcomes comparing two different repair techniques (respect versus resect)., Methods: Baseline and operative variables, postoperative outcomes and follow-up information about survival, valve competence and freedom from reoperation were retrospectively collected and analyzed. The repair cohort was divided into three groups (resection, neo-chordae and both) and compared for outcomes., Results: Between July 22
nd 2013 and May 31st 2022 a total of 278 consecutive patients underwent MIV. Out of those, we identified 165 eligible patients for the three repair groups: 82 patients (29.5%) had "resection", 66 "neo-chordae" (23.7%) and 17 "both" (6.1%). All preoperative variables were comparable between the groups. The predominant valve pathology of the entire cohort was degenerative disease with 20.5% Barlow's, 20.5% bi-leaflet and 32.4% double segment pathology. Bypass time was 164±47, cross-clamp time 106±36 minutes. All valves planned for repair (85.6%) were successfully repaired except for 13 resulting in a repair rate of 94.5%. Only 1 patient (0.4%) had to be converted to clamshell and 2 (0.7%) needed rethoracotomy for bleeding. Mean intensive care unit (ICU) stay was 1.8 days and hospital stay 10.6±1.3 days. In-hospital mortality was 1.1% and the incidence of stroke (1.8%). All in-hospital outcomes were comparable between the groups. Follow up was complete in 86.2% (n=237) for a mean of 3.7±0.8, up to 9 years. Five-year survival was 92.6% (P=0.5) and freedom from re-intervention 96.5% (P=0.1). All but 10 patients had mitral regurgitation less than grade 2 (95.8%, P=0.2) and all but two had less than New York Heart Association (NYHA) II (99.2%, P=0.1)., Conclusions: Despite a heterogeneous cohort with mixed valve pathologies, there is a high reconstruction rate, low short- and midterm morbidity, mortality and need for re-intervention with comparable outcomes of the resect and respect technique in a specialized MIV center., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-22-1796/coif). The authors have no conflicts of interest to declare., (2023 Journal of Thoracic Disease. All rights reserved.)- Published
- 2023
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30. Propensity Matched Outcomes of Minimally Invasive Mitral Surgery: Does a Heart-Team Approach Eliminate Female Gender as an Independent Risk Factor?
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Passos L, Lavanchy I, Aymard T, Morjan M, Kapos I, Corti R, Gruenenfelder J, Biaggi P, and Reser D
- Abstract
Background: There is increasing evidence that female gender is an independent risk factor for cardiac surgery. Minimally invasive mitral surgery (MIV) has proven to have excellent long-term results, but little is known about gender-dependent outcomes. The aim of our study was to analyze our heart team's decision-based MIV-specialized cohort., Methods: In-hospital and follow-up data were retrospectively collected. The cohort was divided into gender groups and propensity-matched groups., Results: Between 22 July 2013 and 31 December 2022, 302 consecutive patients underwent MIV. Before matching, the total cohort showed that women were older, had a higher EuroSCORE II, were more symptomatic, and had more complex valve pathology and tricuspid regurgitation resulting in more valve replacements and tricuspid repairs. Intensive and hospital stays were longer. In-hospital deaths (n = 3, all women) were comparable, with more atrial fibrillation in women. The median follow-up time was 3.44 (0.008-8.9) years. The ejection fraction, NYHA, and recurrent regurgitation were low and comparable and atrial fibrillation more frequent in women. The calculated 5-year survival and freedom from re-intervention were comparable ( p = 0.9 and p = 0.2). Propensity matching compared 101 well-balanced pairs; women still had fewer resections and more atrial fibrillation. During the follow-up, women had a better ejection fraction. The calculated 5-year survival and freedom from re-intervention were comparable ( p = 0.3 and p = 0.3)., Conclusions: Despite women being older and sicker, with more complex valve pathology and subsequent replacement, early and mid-term mortality and the need for reoperation were low and comparable before and after propensity matching, which might be the result of the MIV setting combined with our patient-tailored decision-making. We believe that a multidisciplinary heart team approach is crucial to optimize patient outcomes in MIV, and it might also reduce the widely reported increased surgical risk in female patients. Further studies are needed to prove our findings.
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- 2023
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31. Thoracic spinal tuberculosis in a 2.5-year-old child treated by surgical procedure with a transthoracic approach: a case report.
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Kitaz MN, Alosman MA, Jawish A, Alothman F, Alali K, Wereekia M, Abbas W, Kadi M, and Morjan M
- Abstract
Pott's disease is a form of extrapulmonary tuberculosis (TB) and has a global increase in incidence. The diagnosis should be made early to avoid neurological deficiency or deformity of the spine., Case Presentation: A 2-year-old and 6-month-old boy was admitted with fever and unspecific generalized pain, the examination revealed mild hyperreflexia in the lower extremities, isotope scan showed increased uptake in the T8 vertebra. MRI demonstrated destruction in the T8 vertebra with kyphotic deformity and abscess anterior to T7, T8, and T9 levels with an epidural abscess at the T8 level extending to the spinal canal and compressing the spinal cord. The patient underwent a surgical procedure with a transthoracic approach, the decompression of the spinal canal was performed through T8 corpectomy, the reduction of kyphosis was performed and the internal fixation with a dynamic cylinder and lateral titanium plate was carried out. Microbiologic examination suggests Mycobacterium tuberculosis ., Clinical Discussion: Pott's disease (spinal TB) is extremely rare in the young children population, and surgical treatment is reported only in a few reports, and it is considered a technical challenge. There are several surgical approaches during childhood, for upper thoracic spinal TB, the posterior approach is easy, minimally invasive, safe, reliable, and effective. But it had the worst outcomes. In contrast, the anterior approach provides direct access to the lesions., Conclusion: More research are needed to detect the best choice in the management of thoracic spinal TB in children., Competing Interests: The authors declare that they have no financial conflict of interest with regard to the content of this report., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2023
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32. Once in a Blue Moon: Iatrogenic Coronary Dissection in Anomalous Coronary Artery.
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Gerçek M, Skuljevic T, Morjan M, and Börgermann J
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- 2023
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33. Surgical technique for acute retrograde type A aortic dissection after zone 2 TEVAR for complicated type B dissection in a 63-year-old patient.
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Schurr P, Morjan M, Fellmer P, and Börgermann J
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- Aorta, Thoracic diagnostic imaging, Aorta, Thoracic surgery, Blood Vessel Prosthesis adverse effects, Humans, Middle Aged, Retrospective Studies, Stents adverse effects, Treatment Outcome, Aortic Dissection etiology, Aortic Aneurysm, Thoracic complications, Blood Vessel Prosthesis Implantation methods, Endovascular Procedures methods
- Abstract
Patients suffering retrograde type A aortic dissection after TEVAR for type B dissection are at higher risk of mortality than their spontanous counterparts and the kind of optimal therapy remains obscure. We present a case of successful open surgical repair where distal open anastomosis was accomplished by cutting off the un-covered stent portion and suturing a vascular prosthesis to the dissected distal aortic arch including the covered stent part. The clinical course was regular. Immediate and radical repair in the aortic arch may be the adequate response in such instances., (© 2022 Wiley Periodicals LLC.)
- Published
- 2022
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34. Prior intake of new oral anticoagulants adversely affects outcome following surgery for acute type A aortic dissection.
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Sromicki J, Van Hemelrijck M, Schmiady MO, Krüger B, Morjan M, Bettex D, Vogt PR, Carrel TP, and Mestres CA
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- Administration, Oral, Anticoagulants therapeutic use, Female, Hemorrhage chemically induced, Humans, Male, Retrospective Studies, Warfarin therapeutic use, Aortic Dissection diagnostic imaging, Aortic Dissection surgery, Atrial Fibrillation complications
- Abstract
Objectives: Oral anticoagulation prior to emergency surgery is associated with an increased risk of perioperative bleeding, especially when this therapy cannot be discontinued or reversed in time. The goal of this study was to analyse the impact of different oral anticoagulants on the outcome of patients who underwent emergency surgery for acute type A aortic dissection (ATAAD)., Methods: This was a single-centre retrospective study of patients treated with oral anticoagulation at the time of surgery for ATAAD. Outcomes of patients on new oral anticoagulant (NOAC) therapy were compared to respective outcomes of patients on Coumadin. Additionally, a survival analysis was performed comparing these 2 groups with patients who were operated on with no prior anticoagulation., Results: Between January 2013 and April 2020, a total of 437 patients (63.8 ± 11.8 years, 68.4% male) received emergency surgery for ATAAD; 35 (8%) were taking oral anticoagulation at the time of hospital admission: 20 received phenprocoumon; 14, rivaroxaban; and 1, dabigatran. Compared to Coumadin, NOAC was associated with a greater need for blood-product transfusions and haemodynamic compromise. Operative mortality was 53% in the NOAC group and 30% in the Coumadin group. A 5-year survival analysis showed no significant difference between the NOAC and the Coumadin group (P = 0.059). Compared to 402 patients treated during the study period without anticoagulation, patients taking NOAC had significantly worse survival (P = 0.001), whereas that effect was not observed in patients undergoing surgery who were taking Coumadin (P = 0.99)., Conclusions: Emergency surgery for ATAAD in patients taking NOAC is associated with high morbidity and mortality. NOAC are a major risk factor for uncontrollable bleeding and haemodynamic compromise. New treatment strategies must be defined to improve surgical outcomes in these high-risk patients., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)
- Published
- 2022
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35. The impact of age and sex on in-hospital outcomes in acute type A aortic dissection surgery.
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Morjan M, Mestres CA, Lavanchy I, Gerçek M, Van Hemelrijck M, Sromicki J, Vogt P, and Reser D
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Background: Older age and female sex are thought to be risk factors for adverse outcomes after repair of acute type A aortic dissection (AAAD). The aim of this study is to analyze age- and sex-related outcomes in patients undergoing AAAD repair., Methods: Retrospective analysis of patients undergoing emergency AAAD repair. Patients were divided in Group A, patients aged ≥75 years and Group B <75. Intraoperative and postoperative data were compared between groups before and after propensity score matching. Sex differences were analyzed by age group., Results: Between January 2006 and December 2018, 638 patients underwent emergency AAAD repair. Group A included 143 patients (22.4%), Group B 495 (77.6%). More patients in Group A presented with circulatory collapse (Penn C 26.6% vs. 9.7%, P=0.001) while Group B presented with circulatory collapse-branch malperfusion (Penn BC 29.3% vs. 15.4% P=0.001). After propensity score matching, Group B patients received more complex aortic root (33.6% vs. 23.2%, P=0.019) and concomitant bypass surgery (12.3% vs. 6.3%, P=0.042). There was no significant difference in in-hospital mortality between age groups (18% vs. 12% P=0.12). In Group B, in-hospital mortality was significantly higher in females (22.2% vs. 8.2%, P=0.028). Differences in mortality disappeared after the age of 75 (18.3% vs. 19.4% P=0.87)., Conclusions: Morbidity and mortality are comparable between patients under and over 75 years after AAAD repair. Female patients <75 had higher in-hospital mortality than their male counterparts., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-21-1863/coif). CAM reports that he received consulting fees from CytoSorbent for online presentation. The other authors have no conflicts of interest to declare., (2022 Journal of Thoracic Disease. All rights reserved.)
- Published
- 2022
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36. Concomitant Coronary Artery Bypass in Patients with Acute Type A Aortic Dissection.
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Morjan M, Reser D, Savic V, Sromicki J, Maisano F, and Mestres CA
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- Aged, Coronary Artery Bypass adverse effects, Female, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Aortic Dissection diagnostic imaging, Aortic Dissection surgery, Heart Failure
- Abstract
Coronary Artery Bypass Grafting (CABG) is sometimes necessary in acute Type A Aortic Dissection (AAAD) repair. The aim of this study is to analyze the incidence, indications and influence in-hospital outcomes of AAAD repair requiring concomitant CABG in a high-volume single-center experience. Retrospective study of all consecutive AAAD patients. Those who underwent concomitant CABG were identified. Preoperative, intraoperative, postoperative and follow-up data were collected and analyzed. Between January 1, 2010 and December 31, 2016, 382 patients underwent emergency surgery for AAAD. Forty-one (10.7%) underwent concomitant CABG. In this group, mean age was 64 ± 14 years, 32 were male (78%). Indication for CABG was coronary dissection in 28 patients (68.3%), post-cardiopulmonary bypass (CPB) right heart failure in 7 (17.1%), post CPB left heart failure in (7.3%) and native coronary pathology in 3 (7.3%). In 33 (80.5%) one graft was needed, in 7 (17%) two were performed and in 1 patient (2.4%) 3 were necessary. The right coronary artery (RCA) was the only revascularized vessel in 26 cases (63.4%), the left coronary artery (LCA) alone in 11 (26.8%), and both coronary systems in 4 (9.8%). In-hospital mortality was 51.2% (N = 21); eight (19.5%) patients had postoperative myocardial infarction (MI) and 11 (26.8%) had a major neurological event. Multivariable logistic regression identified concomitant CABG as a predictor of in-hospital mortality (Odds Ratio (OR) = 3.8115, 95% CI= 0.514-2.138, p = 0.001). In our study, concomitant CABG was performed in 10.7% of AAAD repair surgery and it was associated with high in-hospital mortality., (Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
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37. Fracture of the humeral surgical neck and shoulder dislocation following an epileptic seizure: Case report .
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Alibrahim H, Wahedi M, Almohammed MR, Swed S, and Morjan M
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Epilepsy is a pathological condition characterized by seizures of muscle tension and convulsions in which the patient is unable to control himself, resulting in various complications and injuries. In this paper we talk about a rare case that combines a shoulder dislocation with a fracture of the surgical neck of the humerus after an epileptic seizure. The patient came to the hospital with clinical symptoms directed at dislocating the shoulder after an epileptic seizure, but careful examination and radiography revealed the presence of a fracture of the surgical neck of the humerus, so the management needed experience to repair two serious traumatic injuries. In the light of the foregoing, the need for clinical knowledge regarding such injuries in terms of diagnosis and methods of management and treatment is very necessary especially that neglect or wrong diagnosis will lead to very bad results, the most important of which are chronic pain, disability and stiffness., Competing Interests: All authors declared no conflict of interest., (© 2022 The Authors.)
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- 2022
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38. First reported congenital lumbar hernia with lumbo-costo-vertebral syndrome in the Middle-East: a case report.
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Danial AK, Morjan M, Assi A, Raslan H, Bedon M, Khalil H, and Kalaji N
- Abstract
Congenital lumbar hernia is a rare disease affecting mainly infants. Its association with lumbo-costo-vertebral syndrome (LCVS) is hardly seen in the literature. We present a case of LCVS in a 1-month-old female infant presenting with a soft bulge in left lumbar region. Abdominal X-ray revealed absence of multiple ribs with a mild lumbar scoliosis and defective ninth vertebra. Ultrasonography showed absence lateral abdominal wall muscles in left lumbar region and 2.5 cm diameter lumbar hernia. Primary repair of the adnominal wall defect was performed without meshplasty and no recurrence was reported. We hope to enhance the literature of this rare disease with our case., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2021.)
- Published
- 2021
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39. Attitudes towards organ donation in Syria: a cross-sectional study.
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Tarzi M, Asaad M, Tarabishi J, Zayegh O, Hamza R, Alhamid A, Zazo A, and Morjan M
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- Attitude, Cross-Sectional Studies, Female, Health Knowledge, Attitudes, Practice, Humans, Male, Surveys and Questionnaires, Syria, Tissue Donors, Organ Transplantation, Tissue and Organ Procurement
- Abstract
Background: The perception of organ donation and brain death among Syrian population has not been previously explored. The goal of this study is to evaluate the attitude and knowledge of organ donation among Syrians and the willingness of this population to donate their organs., Methods: We conducted a survey-based cross-sectional study in four hospitals in Aleppo, Syria in November 2019. Patient demographic, awareness of brain death; and attitude toward organ donation were collected and analyzed., Results: A total of 350 individuals were invited to participate in the survey among whom 303 (197 females, 106 males) agreed to participate in the study (87% response rate). The majority of our participants (n = 249, 82%) heard about organ donation with television (n = 166, 55%), social media (n = 77, 25%), and the internet (n = 77, 25%) being the most common sources of information. When assessing knowledge about brain death, only 40% (n = 116) answered 3 or more questions (out of 5) correctly. Fifty-eight percent (n = 176) of respondents agreed with the idea of organ donation and 183 (62%) would like to donate their organs one day. The leading motivation to organ donation was the desire to help (n = 234, 77%), while the most common reason to refuse donation was the refusal to disfigure a dead body by removing an organ (n = 125, 41%). Religious reasons were cited as motivation for organ donation by 43% of participants (n = 130), and a reason for refusing to donate organs by 24% (n = 71). Most respondents (n = 261, 88%) were unaware of the laws and legislations related to organ donation in Syria. When asked if religion and law were encouraging organ donation, 76% of respondents (n = 226) would donate their organs. Although more positive attitude was found in those with better brain death knowledge (score ≥ 3), this did not translate into more willingness to donate organs in this group of participants., Conclusions: The promotion of organ donations from deceased donors is a necessity given the rising shortage of organs. The information provided by this study could help policy makers build future strategies to promote deceased organ donation programs and overcome current obstacles preventing such initiatives from achieving their goals.
- Published
- 2020
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40. Aortic valve replacement with or without myocardial revascularization in octogenarians. Can minimally invasive extracorporeal circuits improve the outcome?
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El-Essawi A, Breitenbach I, Haupt B, Brouwer R, Morjan M, and Harringer W
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- Aged, Aged, 80 and over, Coronary Artery Bypass instrumentation, Coronary Artery Bypass methods, Equipment Design, Female, Heart Valve Prosthesis, Humans, Male, Minimally Invasive Surgical Procedures instrumentation, Minimally Invasive Surgical Procedures methods, Propensity Score, Retrospective Studies, Treatment Outcome, Aortic Valve surgery, Heart Valve Prosthesis Implantation instrumentation, Heart Valve Prosthesis Implantation methods, Myocardial Revascularization instrumentation, Myocardial Revascularization methods
- Abstract
Objective: The positive impact of minimally invasive extracorporeal circuits (MiECC) on patient outcome is expected to be most evident in patients with limited physiologic reserves. Nevertheless, most studies have limited their use to low-risk patients undergoing myocardial revascularization. As such, there is little evidence to their benefit outside this patient population. We, therefore, set out to explore their potential benefit in octogenarians undergoing aortic valve replacement (AVR) with or without concomitant myocardial revascularization., Methods: Based on the type of the utilized ECC, we performed a retrospective propensity score-matched comparison among all octogenarians (n = 218) who received a primary AVR with or without concomitant coronary artery bypass grafting in our institution between 2003 and 2010., Results: A MiECC was utilized in 32% of the patients. The propensity score matching yielded 52 matched pairs. The 30-day postoperative mortality (2% vs. 10%; p=0.2), the incidence of low cardiac output (0% vs. 6%; p=0.2) and the Intensive Care Unit (ICU) stay (2.5 ± 2.6 vs. 3.8 ± 4.7 days; p=0.06) were all in favour of the MiECC group, but failed to reach statistical significance while the 90-day postoperative mortality did (2% vs. 16%; p=0.02)., Conclusion: MiECCs have a positive influence on the outcome of octogenarians undergoing AVR with or without concomitant coronary artery bypass grafting. Their use should, therefore, be extended beyond isolated coronary artery bypass graft (CABG) surgery.
- Published
- 2019
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41. Modular minimal invasive extracorporeal circuits: another step toward universal applicability?
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El-Essawi A, Morjan M, Breitenbach I, Bechri A, Brouwer R, and Harringer W
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- Aged, Female, Humans, Male, Treatment Outcome, Coronary Artery Bypass methods, Extracorporeal Membrane Oxygenation methods
- Abstract
Introduction: Safety concerns have been one of the main reasons opposing a wider acceptance of minimal invasive extracorporeal circuits (MiECC). Following an extensive experience and a multitude of modifications, we have set out to employ a modular MiECC as a universal extracorporeal circuit., Methods: A total of 129 cardiac surgical procedures were performed by a single surgeon in 2013. Excluding procedures done under circulatory arrest or with the potential need of such, the MiECC was utilized in almost 90% of surgeries. Of sixty-two (simple procedures) patients who underwent coronary artery bypass grafting (CABG), aortic valve replacement (AVR) or CABG + AVR, 82% were non-elective, 10% had a left ventricular ejection fraction (EF) <30% and most had an impaired renal function. Thirty-eight patients had more complex surgeries (complex procedures), 37% of which were urgent, 15% had an EF <30% and the majority had renal dysfunction., Results: The 30-day mortality was 5% in simple procedures and 2.5% in complex procedures. The incidence of postoperative atrial fibrillation was 13% and 16%, respectively. Optimum outcome was defined as a freedom from all complications and blood transfusions and was achieved in 52% and 42%, respectively., Conclusions: This report shows that modular MiECC can be employed with a high safety margin in cardiac surgery. Furthermore, it emphasizes the impact that minimal invasive philosophy could have in improving patient care.
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- 2017
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42. Ventricular and pulmonary vascular remodeling induced by pulmonary overflow in a chronic model of pretricuspid shunt.
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Linardi D, Rungatscher A, Morjan M, Marino P, Luciani GB, Mazzucco A, and Faggian G
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- Animals, Aorta, Abdominal physiopathology, Cardiac Catheterization, Disease Models, Animal, Echocardiography, Doppler, Heart Ventricles pathology, Hypertension, Pulmonary diagnosis, Hypertension, Pulmonary etiology, Hypertension, Pulmonary pathology, Magnetic Resonance Imaging, Male, Predictive Value of Tests, Pulmonary Artery pathology, Pulmonary Circulation, Rats, Sprague-Dawley, Stroke Volume, Time Factors, Vena Cava, Inferior physiopathology, Aorta, Abdominal surgery, Heart Ventricles physiopathology, Hypertension, Pulmonary physiopathology, Pulmonary Artery physiopathology, Vascular Remodeling, Vena Cava, Inferior surgery, Ventricular Function, Left, Ventricular Function, Right, Ventricular Remodeling
- Abstract
Objectives: Current preclinical models of pulmonary arterial hypertension do not reproduce the clinical characteristics of congenital heart anomalies. Aortocaval shunt is relevant to a variety of clinical conditions. The pathophysiology and possible determination of pulmonary hypertension in this model are still undefined., Methods: A method to create a standardized and reproducible aortocaval shunt was developed in rats. After creation of the shunt, the animals were followed up for 20 weeks and a sham laparotomy was used as a control. The chronic effects of volume overload on the right and left ventricles and pulmonary hemodynamic modifications were evaluated by biventricular catheterization, echocardiography, and magnetic resonance. Pulmonary vascular changes were defined by histology., Results: An increased right ventricular end-diastolic area was confirmed by echocardiography. Left ventricular overload and decreased biventricular ejection fraction were demonstrated by magnetic resonance after 20 weeks in the shunt group compared with the controls (left ventricle, 50% ± 5% vs 62% ± 3%, P = .029; right ventricle, 53% ± 2% vs 65% ± 2%, P = .036). Preload recruitable stroke work of left and right ventricles decreased after 20 weeks in shunt rats (left ventricle: 36 ± 7 vs 98 ± 5, P = .004; right ventricle: 19 ± 2 vs 32 ± 9, P = .047). At the same time point, catheterization showed that effective pulmonary arterial elastance was increased only in the shunt group (1.29 ± 0.20 vs 0.14 ± 0.06 mm Hg/μL; P = .004). Histology showed medial hypertrophy, small artery luminal narrowing, and occlusion., Conclusions: The aortocaval shunt model reliably produces right ventricular volume overload and secondary pulmonary hypertension. Due to a combination of left ventricular dysfunction and pulmonary overflow, the pulmonary hypertension produced shows features similar to those found in patients with chronic atrial-level shunt., (Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
43. Late prosthetic graft infection after frozen elephant trunk presenting by haemoptysis and positive ¹⁸F-fluorodeoxyglucose-positron emission tomography/computed tomography.
- Author
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Morjan M, Ali K, Harringer W, and El-Essawi A
- Subjects
- Aged, Aortic Aneurysm, Thoracic diagnosis, Blood Vessel Prosthesis microbiology, Diagnosis, Differential, Echocardiography, Transesophageal, Female, Follow-Up Studies, Hemoptysis diagnosis, Humans, Prosthesis-Related Infections diagnosis, Radiopharmaceuticals, Aortic Aneurysm, Thoracic surgery, Blood Vessel Prosthesis adverse effects, Fluorodeoxyglucose F18, Hemoptysis etiology, Positron-Emission Tomography methods, Prosthesis-Related Infections complications, Tomography, X-Ray Computed methods
- Abstract
In cardiothoracic surgery, prosthetic graft infection represents a diagnostic and therapeutic challenge. Although clinical assessment, imaging techniques and microbiological investigations are helpful, late graft infection can be difficult to identify using classical diagnostic tools. An aggressive surgical approach involving removal and replacement of all prosthetic materials is technically demanding but remains the best strategy to eradicate infection. Herein, we report a case of a late aortic graft infection, after frozen elephant trunk implantation with atypical presentation, diagnosed with (18)F-fluorodeoxyglucose-positron emission tomography and treated successfully through a radical surgical strategy. This case emphasizes the emerging diagnostic role of positron emission tomography and encourages the adoption of an aggressive surgical approach., (© The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
44. Left ventricular pseudoaneurysm following transfemoral aortic valve implantation.
- Author
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Morjan M, El-Essawi A, Anssar M, and Harringer W
- Subjects
- Aged, 80 and over, Cardiac Surgical Procedures, Female, Heart Aneurysm diagnosis, Humans, Postoperative Complications diagnosis, Aortic Valve surgery, Aortic Valve Stenosis surgery, Cardiac Catheterization methods, Endovascular Procedures methods, Femoral Vein, Heart Aneurysm surgery, Heart Valve Prosthesis Implantation methods, Heart Ventricles, Postoperative Complications surgery
- Abstract
In spite of being a less-invasive technique, transcatheter aortic valve implantation (TAVI) remains associated with potential serious complications. Left ventricular pseudoaneurysm (LVP) is a known, serious complication of transapical TAVI. However, this complication has not been described after the trans-femoral approach. We describe a case of LVP after transfemoral TAVI, emphasizing the importance of an immediate diagnosis of this potential life-threatening complication., (© 2013 Wiley Periodicals, Inc.)
- Published
- 2013
- Full Text
- View/download PDF
45. Life-threatening isometric-exertion related cardiac perforation 5 years after Amplatzer atrial septal defect closure: should isometric activity be limited in septal occluder holders?
- Author
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Santini F, Morjan M, Onorati F, Morando G, Faggian G, and Mazzucco A
- Subjects
- Heart Septal Defects, Atrial surgery, Humans, Isometric Contraction, Male, Middle Aged, Time Factors, Valsalva Maneuver, Heart Atria injuries, Heart Injuries etiology, Physical Exertion physiology, Postoperative Complications etiology, Septal Occluder Device adverse effects, Shock, Cardiogenic etiology
- Published
- 2012
- Full Text
- View/download PDF
46. Sternocleidomastoid muscle hematoma due to sternal wire migration.
- Author
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Rungatscher A, Morjan M, and Faggian G
- Subjects
- Aged, Clavicle, Device Removal methods, Diagnosis, Differential, Foreign-Body Migration diagnosis, Foreign-Body Migration surgery, Hematoma diagnosis, Hematoma surgery, Humans, Imaging, Three-Dimensional, Male, Mastoid, Muscle, Skeletal blood supply, Muscular Diseases diagnosis, Muscular Diseases surgery, Sternum, Tomography, X-Ray Computed methods, Bone Wires adverse effects, Foreign-Body Migration complications, Hematoma etiology, Muscle, Skeletal injuries, Muscular Diseases etiology
- Published
- 2011
- Full Text
- View/download PDF
47. Repair of quadricuspid aortic valve by bicuspidization: a novel technique.
- Author
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Luciani GB, Morjan M, Faggian G, and Mazzucco A
- Subjects
- Aged, Aortic Valve abnormalities, Aortic Valve diagnostic imaging, Aortic Valve physiopathology, Aortic Valve Insufficiency etiology, Aortic Valve Insufficiency surgery, Cardiac Valve Annuloplasty, Echocardiography, Transesophageal, Heart Defects, Congenital complications, Heart Defects, Congenital diagnostic imaging, Heart Defects, Congenital physiopathology, Humans, Male, Suture Techniques, Treatment Outcome, Aortic Valve surgery, Cardiac Surgical Procedures, Heart Defects, Congenital surgery
- Abstract
Quadricuspid aortic valve (QAV) is a rare congenital lesion, generally manifesting with valve regurgitation. Standard treatment involves valve replacement, though anecdotal cases of successful repair by means of valve tricuspidization have been reported. Here, the successful application of a repair technique previously unreported in the setting of QAV is described.
- Published
- 2010
- Full Text
- View/download PDF
48. Surgical treatment of postinfarction left ventricular free wall rupture.
- Author
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Haddadin S, Milano AD, Faggian G, Morjan M, Patelli F, Golia G, Franchi P, and Mazzucco A
- Subjects
- Aged, Aged, 80 and over, Cardiopulmonary Resuscitation, Cause of Death, Early Diagnosis, Echocardiography, Female, Heart Rupture, Post-Infarction diagnosis, Heart Rupture, Post-Infarction mortality, Hospital Mortality, Humans, Male, Middle Aged, Multiple Organ Failure mortality, Pericardial Effusion diagnosis, Pericardial Effusion surgery, Shock, Cardiogenic diagnosis, Shock, Cardiogenic mortality, Shock, Cardiogenic surgery, Suture Techniques, Heart Rupture, Post-Infarction surgery, Heart Ventricles surgery
- Abstract
Background: Left ventricular free wall rupture (LVFWR) is still one of the often fatal complications of acute myocardial infarction. Surgical repair is mandatory even with high operative mortality. The optimal surgical technique is controversial since the results depend on type of rupture. We present our mid-term surgical experience according to the status of the left ventricular tear and type of surgical repair., Methods: From January 1997 to December 2007, 19 consecutive patients with LVFWR were treated at our institution. The mean age was 72 +/- 8 ranging from 53 to 81 years; there were eight males and 11 females. According to the intraoperative findings, patients were divided into two groups: group 1 (eight patients), where no macroscopic tear of the LVFW could be detected with blood oozing from infarcted zone (Oozing type LVFWR); and group 2 (11 patients), where a macroscopic defect of the epicardium, with free communication between left ventricular cavity and pericardial space, was identified (Blow-out type LVFWR). The patch covering and glue technique was applied for group 1 patients, while closure of the ventricular tear either by direct suture or by patch repair was used for group 2 patients., Results: The interval between diagnosis of LVFWR and surgery was 2.9 +/- 1.1 hours. However, reevaluation of echocardiographic studies showed an early missed diagnosis of LVFWR in three patients of group 1 and in eight of group 2. Thus, the mean interval between initial signs of rupture and surgery was 9 +/- 8 hours and 21 +/- 15 hours, respectively, for oozing and blow-out type rupture. On arrival in the operating room, four patients were on cardiopulmonary resuscitation, while four were in cardiogenic shock. The hospital mortality was 12% (one death) in group 1 and 36% (four deaths) in group 2 mainly due to multiorgan failure. Fourteen patients were discharged with a mean follow-up of 3.8 +/- 3.5 years. During follow-up, one patient in group 1 died after 7.5 years. No recurrence of free wall rupture or aneurysm formation was demonstrated in all cases. At last follow-up, all survivors showed excellent clinical results with a preserved left ventricular function. Patients with oozing type LVFWR and patch covering technique repair showed an absence of left ventricular-restricted motion at the echocardiographic study., Conclusion: In patients with LVFWR, early diagnosis and surgical treatment are crucial for successful outcome when excellent results can be achieved with a simple glued patch covering technique.
- Published
- 2009
- Full Text
- View/download PDF
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