Biomedical subjects

A Eisenschenk

Publications and source records attributed to A Eisenschenk.

24 records · Page 2Linked to original sources

PubMed1986

[Valve replacement in patients over 70 years of age].

The extension of cardiac diagnostics by invasive and non invasive, imaging procedures results in an extension of indication for cardiac surgery of patients over 70 years. From August 1977 to July 1985 a total of 212 patients over 70 years were operated upon with extracorporeal circulation for different heart diseases. The mean age was 73.2 years (from 70 to 84 years). In almost 57% (121) of the patients with coronary heart disease (CHD) an aortocoronary venous-bypass (ACVB) was performed, with a mean of 3.3 grafts (ranged from 1 to 5). In 84 patients an isolated or combined heart valve replacement was carried out: Aortic valve replacement (AVR) in 51, mitral valve replacement (MVR) in 11, AVR and MVR in 4, AVR and ACVB in 16 and AVR and aortic ascendens replacement in 2 patients. The overall mortality was 8.5%, with isolated AVR 7.8%, with isolated ACVB it was at the lowest with 5.2%. Postoperative complications could be observed in 48% of patients: low output syndrome (LOS) in 4, arrhythmia in 11, respiratory insufficiency (5%) or stroke in 2, mental confusion in 5. The long-term results after heart valve operation in patients over 70 years emphasize the indication for surgery, despite the higher rate of postoperative complications. The hospital mortality does not differ from that of younger patients. Especially with extreme valvular aortic stenosis after acute AVR one can expect a quick improvement of the cardiac situation after unloading of the left ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMedDate not supplied

[Osteomyelitis of the carpus and metacarpus].

AIM: Because of the low prevalence, there is poor evidence on the effective management of bone and joint infections of the carpus and metacarpus. We therefore studied the outcomes of patients undergoing surgical treatment at our department. METHOD: We conducted a retrospective study on all patients operated on because of osteomyelitis of the carpus and metacarpus between January 1998 and June 2004. Main study endpoint were the infection control rate at end of treatment and at time of follow-up. RESULTS: Of eleven subjects (nine men, two women) with a median age of 43 years (range, 19 to 79 years) serial débridement with temporary wound closure and surgical fixation proved successful in ten cases. We identified causative pathogens in ten cases (S. aureus: n = 3, P. aeruginosa: n = 3, mixed: n = 4) by intraoperative biopsy. Eight subjects received local or free tissue flaps. A 73 year old man died in hospital. Follow-up information was available for eight patients after a median of 19.5 months (range: 3 to 61 months). Seven of them did not show signs of recurrent infection. CONCLUSION: Adhering to accepted standards of treating osteomyelitis, satisfactory control rates in carpal and metacarpal infection can be achieved while salvaging the hand.

Adult↗

PubMedDate not supplied

[An algorithm for reconstruction of soft tissue defects of the distal lower leg, ankle and heel].

AIM: The purpose of the study was to establish an algorithm for the reconstruction of soft tissue defects of the distal lower leg, ankle and heel. METHOD: 81 patients presenting with soft tissue defects in these regions underwent flap coverage. The average age was 44.1 years. Small defects (up to 4 x 4 cm) were covered by local flaps. The neurovascular sural flap was the predominant flap procedure for medium size defects (up to 10 x 15 cm). Free flaps were used for larger defects or in cases of stenosis or occlusion of the peroneal artery. Femoro-crural bypasses were performed in three cases to improve peripheral arterial perfusion. RESULTS: The reconstructive goals were achieved in 95% of the cases by performing reconstruction according to the established algorithm. Minor complications occurred in 29.6% of the cases. CONCLUSION: The results appear to be very good considering a patient population with complex and predominantly contaminated wounds. A preoperative angiography represents an important part of the algorithm for flap reconstruction to detect abnormal arterial vascular conditions and thus to plan vascular reconstruction prior to or simultaneously with free flap coverage. Additionally, a non-patency of the peroneal artery represents a contraindication for sural flaps.

Adolescent↗

PubMedDate not supplied

Free vascularized muscle flap transplantation in the treatment of chronic osteomyelitis.

We are reporting our experience with the efficacy of free tissue transfer in treatment of chronic lower-extremity osteomyelitis; 23 latissimus dorsi flaps and 11 rectus abdominis flaps were used. In our series, success was achieved after a mean follow-up of 36.1 months in 79% and after additional wound debridement in 94%. Indications, methods, results and complications are reported.

Adult↗

PubMedDate not supplied

Sensory recovery following total and subtotal amputations distal to the wrist and digital replantations.

Apart from the basic aim of revascularization, other criteria for the success of digital replantation are functional and sensory recovery. Tactile gnosis can only be restored in cases of replantation distal to the wrist by paying great attention to the technical details for nerve repair. Of 253 patients who underwent 312 digital replantations, after total or subtotal amputations, over 16 years, 162 with 215 successful replantations and 377 nerve reconstructions returned for follow-up evaluations. Of 320 patients who underwent 395 nerve repairs after isolated severed digital nerves, 198 with 249 nerve reconstructions returned for follow-up. Our aim was to determine in both groups, the level of sensory recovery for primary nerve repair as well as for primary and secondary nerve grafting by evaluating the results according to the score of Highet. The majority of the patients in both groups reached stage S3 to S4 on the sensory recovery score of Highet. Patients with isolated severed nerve reached stage S3+ more often than the patients with nerve reconstruction after replantation. The evaluation of results takes into consideration factors influencing digital sensibility such as the level and type of injury, the length nerve grafts, cold intolerance and the patient's age.

Adolescent↗

PubMedDate not supplied

Indications, results and complications in connection with free vascularized bone transplants for extremity preservation.

A report is presented on 5 years experience with 33 cases of free vascularized bone transplants for extremity preservation. The indications, results and complications will be demonstrated. The successful results so far were achieved not only by careful indications but by virtue of a strict postoperative treatment scheme extending from direct postoperative blood-flow monitoring through the raising of a skin flap and angiographic control of anastomosis patency to immobilisation/mobilisation and orthotic management.

Adult↗