Biomedical subjects

E Jagamos

Publications and source records attributed to E Jagamos.

3 recordsLinked to original sources

PubMed2002

Radial artery grafts: surgical anatomy and harvesting techniques(1).

At present more and more surgeons are using the radial artery as a graft for coronary bypass. The statistics until now show that the patency of radial grafts exceeds that of the venous grafts used up to the present. In our department we used radial artery for coronary bypass in 515 patients between January 1990 and December 2000. The radial artery harvesting with minimally invasive technique developed by us was applied in 50 of these patients while the rest were performed with the traditional method. No ischemic complications occurred in forearm or hand following either of the methods. One year after the operation we carried out control examinations on 197 consecutive patients. Our surveys showed that following the traditional technique of radial artery harvesting neurological complications (temporary dysaesthesia) occurred in 16.5% of the patients. After the minimally invasive procedure, temporary dysaesthesia occurred in one case (2%). These complaints ceased within 1-12 months (an average of 3.8 months). Definitive neurological complications did not occur in any of the patients. In summation, we experienced that both operating techniques can be safely applied. The proportion of temporary neurological complications is higher following the traditional procedure, therefore, further development and application of the minimally invasive procedure should be considered.

Coronary Artery Bypass↗

PubMed1999

[Surgical treatment of mitral insufficiency using annuloplasty suture technic].

In 1991 a simple and cheap technique was introduced for mitral valve repair at our department. After repairing the mitral leaflets, where indicated a posterior leaflet annuloplasty was performed with a semicircular suture and the annulus fixed for the appropriate size by tying the stitch. Between July 1991 and December 1995 86 patients underwent the above procedure (average age 56.8 +/- 10.4 years). 45 patients had primary mitral valve disease (myxomatous degeneration, rheumatoid disease, endocarditis), the other 41 had functional mitral regurgitation secondary to severe aortic valve or coronary artery disease. Echocardiography showed severe mitral regurgitation in 77% of the patients. In 45 cases the mitral valve itself was also repaired (valvotomy, quadrangular resection, wedge resection, etc.) in 29 cases the aortic valve was replaced as well, while 24 patients required additional revascularisation of the myocardium. The 30 day mortality was 3.5%. One week after surgery echocardiography was performed at all patients and showed acceptable mitral valve area (2.28 +/- 0.39 cm2). In 28 cases mild mitral regurgitation was found, the other valves were competent. All but 3 patients were followed up (96.4%). There were 6 late deaths (3 cardiac, 2 non cardiac, 1 embolic, 7.2% late mortality). During the follow up period (31.7 +/- 11.2 months) 5 patients required mitral valve replacement for severe recurrent mitral regurgitation (6.0%). In two cases new chorda rupture caused the recurrence, in an other case the suture had torn out of the annulus due to inadequate surgical technique. In the last two cases the annulus had dilated with intact Prolene annuloplasty stitch present, 86.8% of the survivors were in NYHA class I. or II. Our results suggest that mitral valve repair in selected cases can be performed without using expensive annuloplasty rings. The suture used for annuloplasty should be strong, non absorbable and non stretchable. Since 1994, when we started using GoreTex suture instead of Prolene no more patients required reoperation for annuloplasty failure.

Adult↗

PubMed1997

Mini-sternotomy for aortic valve surgery.

In the recent years more and more efforts have been made widely to introduce new techniques in the minimally invasive cardiac surgery. At our Department and the Linköping University Hospital, Cardiothoracic Surgery Department, from August 1996 to January 1997, aortic valve surgery was performed in 23 adult patients (9 female, 14 male), age 28-86 years (mean age 62.5 years). Twenty-two patients had aortic valve replacement, among these, in 3 cases concomitant aortic annulus dilatation was made and in one case reduction-plasty of the dilated ascending aorta. In another one case resection of a sub-aortic membrane was performed. The operations and postoperative period were free of complications in all patients. Following an average 36 hours intensive care all patients were discharged after an average of 11.2 day hospital stay. The authors introduce the new surgical technique and present its advantages and disadvantages. Mini-sternotomy has less detrimental structural and functional effects on the thorax. Moreover, due to its minimal surgical trauma, this less invasive technique reduces patient morbidity, hospital stay and cost of care. Since mini-sternotomy is a safe and advantageous technique, the authors recommend applying this new technique in most of aortic valve operations.

Adult↗