Biomedical subjects
Publications and source records attributed to A S Nadjafi.
A modified technique of jejunum-reservoir after total gastrectomie for gastric cancer is recommended. The advantages of this method are the simplicity of technique, the preservation of duodenal passage, the avoiding of reflux and the normal emptying time of reservoir.
Explore the source record for details and available documents.
Carotid artery insufficiency is caused by an abnormal kinked or coiled internal carotid artery in 15-20 per cent of symptomatic patients. Surgical correction should be considered if other causes for the neurological signs are excluded, a pronounced kinked or coiled area is demonstrated and if there is not a severe neurological deficit. As well as eliminating the elongation, surgical correction should include intraluminal inspection of the artery as, in 38-5 per cent of cases, a concomitant arteriosclerotic stenosis requires simultaneous correction.
Special problems in the surgical treatment of aortic coarctation may be caused by unusual morphological findings as a long hypoplastic segment, the combination with pre- or poststenotic aneurysms or by atypical localisation of the stenosis in the aortic arch, the decreasing or abdominal aorta. A bypass procedure is considered as the method of choice for the repair of coarctation in the aortic arch or the "critical zone" of the abdominal aorta (renal- and suprarenal segment). The bypass-principle allows many variations of branching and avoids cross-clamping of the aorta. The involvement of important branches as is the left common carotid, the superior mesenteric or the renal artery, necessitates a vascular reconstruction in the same session. Probably the first report about a very rare combined lesions is presented: the combination of an aortic arch coarctation in association with a complete situs inversus (right descending aorta), a common carotid trunc, an aneurysm of the left subclavian artery (first branch of the arch) and congenital cysts of the right upper lobe of the lung (Case No. 1). Usually concomitant aneurysms are found in the pre- or poststenotic aortic segment. Some of the infrarenal fusiform aneurysms (Case No. 4 and 5) are occasionally of poststenotic origin, secondary to a longstanding infrarenal coarctation. In these cases the procedure of choice is the total exstirpation and the interposition of a Dacrongraft. Important branches (as the subclavian or renal artery) can be some times inserted directly in the vascular protheses. Using the bypass technic or the patch graftplastic of Vosschulte the risk of late operation (beyond the age of 30 years) may be remarkably reduced.
The validity of invasive preoperative diagnostic procedures in patients with unilateral renovascular hypertension was assessed. A significant lowering of blood pressure following reconstructive surgery can be predicted if following stimulation with Dihydralazine the renal-venous renin ratio of the involved to the noninvolved kidney is at least 2.0. Furthermore, it is of importance to determine the renal perfusion rate in the contralateral non-stenotic kidney which should be within normal limits. If these two criteria are met then in the majority of cases surgical intervention in unilateral hypertension is meaningful.
In all vascular surgery the technic and quality of the first operation is a factor of decisive importance for the long-term results. The need to perform a second or third operation considerably reduces the chances of success. Routine use of an intra-operative control method like arteriography or vascular endoscopy, makes a decisive contribution in the peripheral circulation of the limbs to the immediate detection of errors of operative technic and their correction during the same operation. A change of indication for occlusive processes in the femoropopliteal branch is evident: patients with claudication should be treated with profunda revascularisation combined with lumbal sympathectomy and patients with rest-pain and necrosis should be treated with venous autografts using a microsurgical technic. To avoid deep wound infections the selection of an incision line which does not damage the lymphatic channels, particularly in the groin, the short duration of operations and the use of a purely instrumental operative technic with minimal damage to the tissues are of decisive importance. Examples are used to illustrate errors of indication and technic and the post-operative sequelae of such errors.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.