1,721,022 research outputs found
The evaluation of results and efficiency after the mitral valve repair operation
No full textAuthor : Robertas Pranevičius LSMU MA MF 20gr. Objective. To evaluate early post-operative outcome after (MV) annulus annuloplasty for degenerative MV insufficiency. Tyrimo uždaviniai : 1. To evaluate and compare the mitral valve operations results in early post-operative outcomes. 2. To evaluate the effectiveness of mitral valve operation and complications. Methods. The study was conducted in Lithuanian University of Health Sciences Kaunas Clinics Hospital Cardiothoracic and Vascular Surgery. Between 2015 and 2016, 140pts underwent MV repair annuloplasty. From 140, 61 pts underwent MV repair procedure because of degenerative factors which caused MV insufficiency. The study involved surgery patients with hemodynamically significant degenerative mitral regurgitation and mitral valve repair surgery was performed. For each patient before the operation the cardiac ultrasound was performed and repeated immediately after surgery to evaluate mitral valve regurgitation degree, regurgitation type. Mitral regurgitation grade was evaluated on the basis of standardized hospital adopted a scale from 1 to 4. All patient surveys and descriptions of operations has been collected and entered into the overall hospital system from which data was collected. The study was to evaluate the mitral valve echocardiographic examination data before surgery (valve condition), postoperative valve tightness in the early postoperative period and the operation-related data. Results. In-hospital mortality was 6,55 % (4/61), 1 patients (1,6 % ) had to undergo reoperation. From 140, 61 pts (24 male; 36 female; mean age 63±1,6) pts were included. Analyzed group of patients had arterial hypertension (AH) 43/61 (71,7 % ), arrhythmias 36/61 (60 % ), diabetes mellitus 7/61 (11.7 % ), smoking patients 15/61 (25 % ). Preoperative MV regurgitation grade was IVo in 24/61; 40 % patients, IIIo 27/61; 45 % , IIo -9/61; 15 % Early postoperatively (up to 2 weeks after operation): Io regurgitation - 54/61; 96,4 % , IIo - 2/61; 3,6 % (p<0,05). Mean preoperative LVEDD 54,67±7,68mm and 49,34±7,63mm (p<0,05), LVEF 47,8±11,5 % and 44,92±11,44 % (p<0,05). Conclusions. This study demonstrates annuloplasty to be an effective treatment for degenerative mitral valve disease
The aortic valve operations under David early and late results
No full textDavid procedure in tricuspid aortic valve patients is well established, but in bicuspid aortic valve it is less widely adopted. We assesed wheather valve type affects early and long term outcomes with valve sparing root reimplantation
Hypertrophic obstructive cardiomyopathy cardioechoscopy results analysis after surgical treatment
No full textM. Raičinskis. Hypertrophic obstructive cardiomyopathy cardioechoscopy results analysis after surgical treatment, Master's thesis - scientific leader prof. dr. R. Benetis; Lithuanian University Of Health Sciences, the Academy of Medicine, Faculty of Medicine, Department of Cardiac, Thoracic and Vascular Surgery – Kaunas, 2017. The aim: to analyze patients with hypertrophic obstructive cardiomyopathy preoperative and postoperative treatment outcomes. Work tasks: 1. Review literature of hypertrophic obstructive cardiomyopathy, etiological factors, clinical expression, surgical treatment. 2. Assess patients‘ with hypertrophic obstructive cardiomyopathy preoperative and postoperative treatment cardioechoscopy results. 3. Compare IVS resection treatment outcomes with foreign survey. Research group: Lithuanian University Of Health Sciences, Carciac, Thoracic and Vascular Surgery Department patients who underwent surgery on hypertrophic obstructive cardiomyopathy. Methods: evaluation of collected information from medical records, assessing cardioechoscopy data before and after surgery. Valued cardioechoscopy data: LVEDD, LVEDDi, IVS, LVPW, MMI, LVEF, LVOT grad. Results: the study involved 44 patients with subvalvular hypertrophic obstructive cardiomyopathy who underwent surgery. After surgery LVEDD increased 0,75 (SD 6,39) mm, LVEDDi increased 1,09 (SD 4,82) mm/m2, IVS decreased 4,29 (SD 3,84) mm, LVPW decreased 1,82 (SD 3,65) mm, MMI decreased 37,58 (SD 51,82) g/m2, LVEF decreased 2,49 (SD 6,20) proc., LVOT grad. decreased 55,67 (SD 37,11) mmHg. Conclusions: HOCM is a disease that manifests with nonspecific symptoms. Decreased cardioechoscopic results shows the effectiveness of the operation. Operation results, comparing this analysis and foreign data, are very similar - positive treatment effect is observed
Evaluation of subintimal angioplasty treatment of superficial femoral artery chronical occlusion
No full textThe Aim The aim of this study is to compare the results of subintimal angioplasty (SA), the bypass surgery and percutaneus transluminal angioplasty (PTA) in treatment of the chronic occlusion of superficial femoral artery (SFA) and determine risk factors of subintimal angioplasty. The objectives: 1. To evaluate peculiarity of subintimal and percutaneus transluminal angioplasty and arterial bypass surgery in treatment the chronic occlusion of superficial femoral artery. 2. To evaluate the primary results of subintimal and percutaneus transluminal angioplasty and arterial bypass surgery in treatment the chronic occlusion of superficial femoral artery. 3. To evaluate the early results of subintimal and percutaneus transluminal angioplasty and arterial bypass surgery in treatment the chronic occlusion of superficial femoral artery. 4. To determine risk factors predicting the primary and the early results of chronic superficial femoral artery occlusion treatment by means of subintimal and percutaneus transluminal angioplasty and the arterial bypass surgery. 2.1. Patients The prospective clinical study is being performed at the Department of Vascular Surgery of the Clinic of Cardiac, Thoracic and Vascular Surgery of Kaunas University of Medicine. The study was started in November 2002 and ended on December 2006. We had 255 patients admitted to the clinic during this period of time due to the occlusion of SFA, which matched the criteria of the study. The patients were split into 3 groups according to the method of treatment that was applied: 1. The SA group – 73 patients. 2. Femoro – poplitael bypass surgery group – 81 patients. 3. The PTA group – 75 patients. 4. CONCLUSIONS 1. The mean of SFA occlusion length in subintimal angioplasty group was bigger than that in the bypass (p=0.024) and percutaneus transluminal angioplasty (p0.05). 2. The technical success rate in subintimal angioplasty group was lower than in the bypass grafting group (p=0.02) and higher then in percutaneus transluminal angioplasty group, but there were not statistically significant (p=0.3). The symptomatic improvement among the patients after subintimal angioplasty was not different then in bypass grafting and percutaneus transluminal angioplasty groups (p>0.05), even if statistically significant difference between the bypass grafting and percutaneus transluminal angioplasty group patients has been evaluated (p=0.003). The mean of the days spent in the hospital among subintimal angioplasty patients is statistically significantly less than that among the patients after bypass grafting (p<0.001) and those of percutaneus transluminal angioplasty group (p=0.025). The complications rate was lower in subintimal angioplasty group then in the bypass grafting (p=0.52) and percutaneus transluminal angioplasty groups (p=0.75), but there were not statistically significant. 3. The probabilities of primary (p<0.001) and primary assisted (p<0.001) patencies in subintimal angioplasty patients were statistically significantly higher than in percutaneus transluminal angioplasty group (p=0.002), yet significantly lower then in the bypass group patients (p=0.007). 4. The initial outcomes in subintimal angioplasty group were negatively influenced calcification at the superficial femoral artery occlusion (p=0.002), in case of the bypass surgery risk factor was the occlusion of all three tibial arteries (p=0.026), in percutaneus transluminal angioplasty group - the length of occlusion of superficial femoral artery ≥10 cm (p=0.007) and the presence of calcification (p=0.003). We did not find any factors that predicted short – term outcomes in subintimal angioplasty and bypass groups, while the short – term outcomes in percutaneus transluminal angioplasty group were negatively influenced by the length of occlusion of superficial femoral artery ≥10 cm (p=0.005) and the calcification at the superficial femoral artery occlusion (p=0.033)
The influence of early reinfusion of autologous shed mediastinal blood on the postoperative course after cardiac surgery
No full textPerioperative bleeding, anaemia, allogeneic blood trans¬fusions and transfusion associated complications – all these factors are closely interrelated and contribute to the increase in the cost of treat¬ment, thereby remain the relevant problem in cardiac surgery. The appropriate alternative to allogeneic blood transfusion is the use of autologous blood. The aim of the study: to evaluate the influence of early reinfusion of collected autologous shed mediastinal blood on a patient’s postoperative course after cardiac surgery. The objectives of the study: 1.To evaluate the workflow features of early postoperative course of patients who underwent reinfusion of shed mediastinal blood after heart surgery. To determine the effects of collected and reinfused autologous shed blood: on the intensity of postoperative bleeding; on the changes in haemoglobin concentration, haematocrit value, number of blood formed elements; on the changes in indices of blood coagulation and fibrinolysis; on the changes in blood inflammatory markers; on the intensity of haemolysis and renal function; on mechanical lung ventilation time and postoperative requirement for catecholamines. 2. To evaluate the effect of reinfusion of autologous shed blood on the postoperative requirement for donor blood components. 3. To evaluate the effect of reinfusion of autologous shed blood on the risk of postoperative complications and length of hospital stay. 4. To determine prognostic value of early reinfusion of collected shed mediastinal blood on the patients postoperative course
Evaluation of endovascular treatment results of long chronic occlusions in iliac arteries
No full textUp to date, no research studies analysing long (longer than 3 cm) atherosclerotic lesion stenting results of iliac arteries have been conducted in Lithuania. No results of iliac artery stenting (IAS) have been analysed in association with stent localisation, implanted stent length, arterial runoff and primary limb ische¬mia degree. Literature sources on these questions provide relatively diffe¬rent results worldwide. We performed a prospective clinical study, evaluated the results of iliac artery stenting after 1 and 2 years and compared them with the results of synthetic vascular prostheses used in iliac artery bypass surgery, as well as determining factors thereof. Our results reveal that patients with atherosclerotic iliac artery lesions (TASC II types B, C and D) can be equally successfully treated by way of iliac artery stenting or bypass. Stent localisation in both iliac arteries and poor femoral arterial runoff statistically significantly reduce primary patency of iliac artery stents. Primary lower limb ischemia level does not influence iliac artery stenting results at 24 months. Primary patency in the iliac artery stent group at 24 months does not depend on the types of lesions according to TASC II stratification. The number of periprocedural complications in the stent group is significantly greater in comparison with the prosthesis group
Relation of postoperative atrial fibrillation to serum electrolyte concentration and urinary electrolyte excretion after myocardial revascularization
No full textEarly and long term results of aortic valve sparing aortic root reimplantation surgery for patients with leaking bicuspid and tricuspid valves
No full textAim of study: in the present, retrospective study, we evaluate our single centre experience focusing on early and long term clinical outcomes of aortic valve sparing aortic root reimplantation surgery in patients with leaking bicuspid or tricuspid aortic valves. Objectives of study: 1) To evaluate aortic cup repair application rates for different aorticroot and ascending aorta phenotypes among the patients with leakingbicuspid or tricuspid aortic valves; 2) To evaluate early outcomes and functional status following aortic valve sparing aortic root reimplantation surgery among the patients with leaking bicuspid or tricuspid aortic valves; 3) To evaluate long-term survival, major adverse valve-related and aortic events of the aortic valve sparing aortic root reimplantation surgery among the patients with leaking bicuspid or tricuspid aortic valves; 4. To assess left ventricle remodelling by echocardiographic examination among the patients with leaking bicuspid or tricuspid aortic valves during follow up period; 5) To identify prognostic factors of recurrent severe aortic regurgitation (> 2+) after the aortic valve sparing aortic root reimplantation surgery. We believe that our data supplement existing outcomes and support the current trend towards extention of the indications for the aortic valve sparing aortic root reimplantation surgery
Impairment of cerebrovascular autoregulation during cardiac surgery and its relation with the postoperative cognitive dysfunction
No full text[...]. The aim was to evaluate the impairment of cerebrovascular autoregulation during cardiac surgery with cardiopulmonary bypass and to find its correlation with the increase in concentration of brain injury biomarkers and postoperative cognitive disorders. [...]. The goals of the study were: 1. to detect changes in cerebovascular autoregulation (CA) during cardiac surgery with CPB. 2. to assess the relation between CA impairment and mean arterial blood pressure (MAP); 3. to evaluate the relation of POCD with the observed CA impairment during the surgery; 4. to evaluate the relation of the concentration of brain injury biomarkers changes with CA impairment during the surgery. [...]
Rbot - The Intelligent Agent in Unreal Game Environment
No full textThis project presents an intelligent agent called Rbot. The Rbot is an Unreal Tournament game opponent, which uses the Bayesian Networks for making decisions. The agent is implemented using the Java language. Two design approaches of creating influence diagrams presented. The performance results against a built-in Unreal Tournament bot and human player are presented. Conclusions about usability and performance of Bayesian networks in real-time game environment presented
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