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279 results on '"Turina, M. I."'

7. Herz- und Thoraxchirurgie

Author

Pallua, N., Rugo, E., Voss, A., Bücherl, E. S., Kleine, P., Schröder, P., Glogaza, P., Struck, E., Dapunt, O., Zukriegel, M., Ghosh, P. K., Unger, F., Hetzer, R., Warnecke, H., Schiessler, A., Hennig, E., Christof, K., Wilde, E., Bauer, E. Ph., von Segesser, L. K., Turina, M. I., Kulka, F., Rau, H. G., Jung, A. J., Hohlbach, G., Schildberg, F. W., Bauer, Peter C., Hermes-Husemann, E., Freitag, L., Greschuchna, D., Rolle, A., Thetter, O., Unsöld, E., Eitinger, G., Elfeldt, R., Schröder, D., Beske, Ch., Hamelmann, H., Liewald, F., Valet, G., Dienemann, H., Wirsching, R., Sunder-Plassmann, L., Hamelmann, H., and Ungeheuer, E., editor

Published
1989
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12. Incidence and pathophysiology of atrioventricular block following mitral valve replacement and ring annuloplasty

Author

Berdajs, D, Schurr, U P, Wagner, A, Seifert, Burkhardt; https://orcid.org/0000-0002-5829-2478, Turina, M I, Genoni, M, Berdajs, D, Schurr, U P, Wagner, A, Seifert, Burkhardt; https://orcid.org/0000-0002-5829-2478, Turina, M I, and Genoni, M

Abstract

BACKGROUND: In this retrospective study we evaluate the causative mechanisms underlying postoperative atrioventricular block (AVB) following mitral valve replacement and mitral valve annuloplasty. METHODS: Between January 1990 and December 2003, 391 patients underwent mitral valve replacement or ring annuloplasty and quadrangular resection. Exclusion criteria were preoperative AV block, two or three valvular procedures, reoperations and procedures combined with coronary artery bypass grafting. The presence of the postoperative AVB was compared with preoperative and intraoperative variables. On 55 post-mortem specimens the relationship between the AV node, AV node artery and mitral valve annulus was investigated. RESULTS: The mean age was 59+/-14 years and 44% of patients were female. Postoperatively AVB occurred in 92 (23.5%) patients. AVB III was found in 17 (4%) patents, in whom a pacemaker was implanted within median interval of 4 days. Second degree AVB occurred and first degree AVB in five (1.3%) and in 70 (18%) patients respectively. In dry dissected human hearts in 23% of investigated cases the AV node artery was discovered to run close to the annulus of the mitral valve. CONCLUSIONS: Data collected in this study showed that, sotalol and amiodarone as well as a prolonged cross-clamp time may slightly influence the 23% incidence of postoperative AVB. The morphological investigation showed that the AV node artery runs in close proximity to the annulus in 23% of cases. We speculate that damage of the AV node artery may play a role in development of AVB.

Published
2008

13. Cryopreserved arterial allografts in the treatment of major vascular infection: a comparison with conventional surgical techniques

Author

Vogt, P R, Brunner-La Rocca, H P, Carrel, T, von Segesser, L K, Ruef, C, Debatin, J, Seifert, Burkhardt, Kiowski, W, Turina, M I, University of Zurich, and Vogt, P R

Subjects
2740 Pulmonary and Respiratory Medicine, 610 Medicine & health, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), 2705 Cardiology and Cardiovascular Medicine, 2746 Surgery
Published
1998

14. Future of heart valve surgery

Author

Turina, M I and Turina, M I

Abstract

In highly developed nations, valve surgery will be increasing applied in older people, with more co-morbidities and a higher incidence of concomitant coronary artery disease. Valve surgeons will be facing increased competition from the catheter-based procedures, both for valve repair and replacement; these are already applied clinically, and their numbers will rise in near future. Early mortality in double valve procedures and in combined CABG and valve operations remains substantial, and there is ample room for improvement of surgical results. New valve prostheses are slow in development, due to financial restraints and exceeding cost of certification. Tissue-engineered valves are being developed, but are not ready for larger clinical trials. Cardiac surgery is undergoing a rapid transformation; radical changes both in scope and workload of cardiosurgical units in Europe can be expected in near future. Socio-economic factors and recent advances in medical technology contribute to these changes.

Published
2004

15. Low-dose heparin versus full-dose heparin with high-dose aprotinin during cardiopulmonary bypass. A preliminary report

Author

von Segesser, L K, Garcia, E, and Turina, M I

Subjects
Adult, Male, Cardiopulmonary Bypass, Dose-Response Relationship, Drug, Heparin, Blood Loss, Surgical, Blood Component Transfusion, Middle Aged, Aprotinin, Myocardial Revascularization, Humans, Female, Research Article, Aged
Abstract

Perfusion during cardiopulmonary bypass with low-dose heparin (activated clotting time, > 180 sec) versus full-dose heparin (activated clotting time, > 480 sec) combined with high-dose aprotinin was evaluated prospectively. Fifteen patients undergoing elective myocardial revascularization were randomly assigned to 1 of 2 groups. No significant differences between the groups were found for age, sex, body surface area, preoperative hematocrit level, duration of cardiopulmonary bypass, aortic cross-clamp time, mean number of bypasses per patient, or mean number of arterial grafts per patient. In all patients, heparin-coated cardiopulmonary bypass equipment was used, including heparinized hollow-fiber membrane oxygenators and tubing sets. In each group, protamine sulfate was given equivalent to the heparin loading dose; additional doses were administered according to the ACT. The mean total dosage of heparin was 9.5 +/- 1.4 x 10(3) IU for the group given low systemic heparinization (Group 1) compared with 34.6 +/- 3.4 x 10(3) IU for the group given full systemic heparinization in combination with high-dose aprotinin (Group 2) (p < 0.0001). The mean amount of aprotinin administered in Group 2 was 5.6 +/- 0.3 x 10(6) KIU; aprotinin was not used in Group 1. The mean protamine dosage necessary in Group 1, 7.0 +/- 0.9 x 10(3) IU, was significantly less than the 22.9 +/- 3.2 x 10(3) IU needed in Group 2 (p < 0.0001). In Group 1, shed blood recovery was achieved by a red-cell spinning device; in Group 2, cardiotomy suction was used. The total chest tube drainage (i.e., postoperative blood loss) per patient in Group 1 totaled 432 +/- 162 mL/m2; in Group 2, it was 311 +/- 111 mL/m2 (difference not significant). Transfusion requirements comprised a mean volume of 143 +/- 165 mL/m2 concentrated homologous red blood cells per patient in Group 1 and 416 +/- 128 mL/m2 in Group 2 (p < 0.01). Heparin-coated perfusion equipment allowed a significantly lower dosage of systemic heparin and protamine in Group 1 than that in Group 2, and a lower dosage in Group 2 than that in previous studies. Postoperative blood loss appeared to be similar between groups. The combination of heparin-coated perfusion equipment with low systemic heparinization and a red-cell spinning device provides promising results.

Published
1993

39. Dorsocranial Liver Resection and Direct Hepatoatrial Anastomosis for Hepatic Venous Outflow Obstruction: Long-Term Outcome and Functional Results.

Author

Vogt, P. R., Anderson, L. C., B., Risti, Von Segesser, L. K., Turina, M. I., and Jenni, R.

Subjects
ABDOMINAL pain, EDEMA, HEMATEMESIS, ESOPHAGEAL varices, BILIRUBIN, ASCITES, LIVER surgery, VENA cava inferior, THROMBOSIS
Abstract

Objectives: The management of hepatic venous out-flow obstruction, usually known as Budd-Chiari syndrome, remains complex despite a variety of treatments. Methods: We present the results from 16 patients with Budd-Chiari syndrome who underwent dorsocranial liver resection and direct hepatoatrial anastomosis over a 10-yr period. The inferior caval vein was occluded in 10 patients. Results: Operative mortality was 12.5% (2/16). During a mean follow-up of 7.2 yr, three patients required reoperation two of whom had veno-occlusive disease. The late mortality was 14% (2/14). Clinical status improved in terms of: abdominal pain, 81 versus 14%; lower limb edema, 56 versus 14%; hematemesis, 19 versus 0%; hepatomegaly, 94 versus 36%; esophageal varices, 56 versus 7%; splenomegaly, 56 versus 21%; and ascites, 87 versus 29%. Mean serum bilirubin (μmol/l) fell from 40.2 to 27.1 (p = 0.005), and serum albumin remained unchanged. A patent hepatoatrial anastomosis was demonstrated in 10/12 survivors. The actuarial survival rate was 74.2% at 5 and 10 yr. Conclusions: Thus, in patients with outflow obstruction of the major hepatic veins, transcaval dorsocranial liver resection and direct hepatoatrial anastomosis recreate an adequate hepatic runoff. Moreover, this procedure is appropriate for patients with occlusion of the inferior caval vein, obviates or defers the need for liver transplantation, and prevents recurrence of thrombosis. [ABSTRACT FROM AUTHOR]

Published
1996

40. Endovascular Repair with Bifurcated Stent-Grafts under Local Anaesthesia to Improve Outcome of Ruptured Aortoiliac Aneurysms

Author

Lachat, M. L., Pfammatter, Th., Witzke, H. J., Bettex, D., Künzli, A., Wolfensberger, U., and Turina, M. I.

Abstract

Introduction: acute haemodynamic changes and/or loss of abdominal muscle tone can occur during induction of general anaesthesia and may be the Achilles' tendon in endovascular aneurysm repair (EVAR) of ruptured aortoiliac aneurysms (rAIA). The purpose of this study was to evaluate the use of local anaesthesia (LA) for EVAR to overcome these limitations. Methods: twenty-one consecutive patients with rAIA are included in this study. Twenty patients underwent EVAR under LA, and 1 patient was treated under general anaesthesia. Haemodynamics were stabilised during assessment of EVAR feasibility by CT-scan and during the procedure itself by controlled hypotension (MAP 50–60 mmHg) and moderate fluid resuscitation. Results: median procedure time was 120 min. Haemodynamics remained stable in all but 3 patients who required transfemoral balloon occlusion of the supra-renal aorta. Perioperative intubation was necessary in 5 patients because of respiratory distress (n=3), or retroperitoneal access (n=2). Temporary deterioration of renal function occurred in 6 patients, with 2 requiring hemofiltration. CT-scan confirmed sealing of the rAIA in all patients at discharge. 30-day mortality was 9.5% (2 deaths). In the median follow-up of 19 months, there were no deaths, but 3 endovascularre-interventions, 1 crossover femoro-femoral bypass, and 1 open surgical graft repair. Discussion: our series is the first to show that EVAR for rAIA can be safely performed under LA. This approach allows implantation of commercially available bifurcated SG and improves patient outcome. Copyright 2002 Elsevier Science Ltd

Published
2002
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41. Tissue engineering of small caliber vascular grafts.

Author

Hoerstrup, S P, Zünd, G, Sodian, R, Schnell, A M, Grünenfelder, J, and Turina, M I

Abstract

Previous tissue engineering approaches to create small caliber vascular grafts have been limited by the structural and mechanical immaturity of the constructs. This study uses a novel in vitro pulse duplicator system providing a 'biomimetic' environment during tissue formation to yield more mature, implantable vascular grafts.

Published
2001
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43. Explanted cryopreserved allografts: a morphological and immunohistochemical comparison between arterial allografts and allograft heart valves from infants and adults.

Author

Vogt, P R, Stallmach, T, Niederhäuser, U, Schneider, J, Zünd, G, Lachat, M, Künzli, A, and Turina, M I

Abstract

Life expectancy of cryopreserved allografts implanted in infants is different from those implanted in adults. A morphological study of explanted allograft heart valves was performed to determine the mechanism of deterioration and to compare cryopreserved arterial and heart valve allografts from adult patients with those explanted from infants.

Published
1999
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