The authors present their initial experience with the use of the intraluminal double-ring prosthesis in the surgical treatment of thoracic aorta aneurysms. To date, they have performed this procedure in a total of 7 patients. Five had dissecting aneurysms of the ascending and descending aorta, one had a false aneurysm of the aortic arch, and one was operated on for a traumatic aneurysm of the descending aorta. Five patients recovered without any severe complications. Two patients died. Of these, one underwent surgery on an emergency basis for ruptured dissecting aneurysm of the ascending aorta while another died from intestinal gangrene due to occlusion of the upper mesenteric artery, caused by dissection. The benefits of the new technique of vascular reconstruction are discussed, and the potential for expanded indicational criteria is mentioned.
Infection in cardiovascular surgery invariably constitutes a very serious complication that cannot be controlled by antibiotics in all cases. Improved blood supply to the tissue affected by infection largely helps to control these complications. The article reports on three cases in which mobilized muscle and omental flaps helped essentially to heal infectious complications following heart transplantation, aortic valve replacement, and reconstruction of arteries of the lower limb.
In experiments in dogs we studied the effect of antiaggregating agents on the patency of prosthetic vascular grafts (4 mm in diameter) and vein grafts, both placed in areas with a rate of flow ranging between 50-60 ml/min. All 6 prosthetic grafts became occluded in the nonmedicated controls, 1 of 5 prosthetic grafts remained patent for a prolonged period of time in dogs receiving 250 mg acetylsalicylic acid 3 times a day, while 5 of 6 prosthetic grafts remained patent in animals receiving an antiaggregating mixture. Follow-up studies showed that antiaggregating medication had no effect on the patency of vein grafts, but it prevented the formation of mural thrombi and subendothelial proliferation.
The case of a 60-year-old man with a large aneurysm of the common carotid artery, which manifested five months after puncture angiography, is described. This was successfully managed by aneurysm exclusion and aortocarotid bypass. The etiology of the aneurysm is discussed.
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