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M Perić

Publications and source records attributed to M Perić.

25 records · Page 2Linked to original sources
PubMedDate not supplied

Partial left ventriculectomy and limited heart transplantation availability.

BACKGROUND AND AIM: Partial left ventriculectomy, a novel cardiac volume reduction operation, is applied in countries without a developed heart transplantation program. We sought to determine its impact in our population of patients. METHODS: Partial left ventriculectomy was performed in 38 patients during the last 4 years. Basic inclusion criteria were nonischemic dilated cardiomyopathy and poor response to medical therapy for heart failure. Hemodynamic evaluation was carried out before and after operation. A modified surgical technique of mitral valve repair and ventricle suturing was applied. RESULTS: Thirty-day, 6-month, and 2-year survival rates were 82% +/- 7%, 65% +/- 8%, and 61% +/- 9%, respectively. Duration of heart failure symptoms was the only predictor of survival (p = 0.042). A high proportion of noncardiac causes of death was noted. Functional capacity in surviving patients improved at every successive measurement up to 1 year postoperatively. CONCLUSIONS: The introduction of partial left ventriculectomy in a country with limited heart transplantation availability had a great impact on the management of end-stage heart failure and may represent the only surgical option for some patients. The average cost per patient was substantially lower when compared to heart transplantation.

Adult↗
PubMedDate not supplied

[Use of the internal thoracic artery in patients with stenosis of the left main branch of the coronary artery].

UNLABELLED: Internal thoracic artery (ITA) is the graft of choice in myocardial revascularization. However, superiority of the ITA graft in patients (pts) with left main coronary artery disease is still a matter of debate. PATIENTS: In the period from November 1986 through February 1999, ITA graft was used for myocardial revascularization in 2860 pts. Stenosis of the left main stem was present in 229 patients (8.0%); there were 39 women (17.0%) and 26 diabetics (11.4%). Severely depressed left ventricular function was present in 32 pts (14.0%), while the average age was 56.4 +/- 7.2 years. RESULTS: Operative mortality was 1.3% and postoperative morbidity was 5.2%. Average postoperative hospital stay was 7.9 days (6-29). There were no differences in analyzed parameters between patients who received ITA graft and similar group of 240 patients who received vein grafts only, during the same period of time. All 16 patients operated on in the period 1986-1992 (6-12 years follow-up) are alive. CONCLUSION: It is safe to use ITA graft for myocardial revascularization in patients with left main coronary artery stenosis. Early operative results are favorable and these patients should not be denied the benefit of the ITA graft, since long-term results are proved to be good as well.

Aged↗
PubMedDate not supplied

[Angiographic characteristics of the internal thoracic artery--anatomic variations and their surgical importance].

INTRODUCTION: The internal thoracic artery is considered the graft of choice for surgical revascularization of the ischemic myocardium. The real incidence of anatomic variations of the internal thoracic artery is not known, although it is an extremely important issue, considering surgical strategy, as well as immediate and long-term outcome. MATERIAL AND METHODS: During a period of three months (Jun. 1st-Aug. 31st 1998) we have evaluated the left internal thoracic artery (ITA) in 80 randomly selected patients (62 men, average age being 57.4 +/- 5.2). RESULTS: Typical take-off, side branches, terminal division and absence of any atherosclerotic lesions were noted in 69 patients (86.25%). Angiographically apparent atherosclerotic lesions were not noted; anomalous take-off from the left subclavian artery was noted in 9 cases (11.25%--including one case of aneurysmatic proximal portion of the ITA); there were two cases where the lateral thoracic artery was present (2.5%) and three cases where the distal division was of a trifurcation type, which is not of surgical importance (3.75%). Average diameter of the left ITA was 2.19 +/- 0.24 mm for the entire group (2.20 +/- 0.19 mm for men, and 2.10 +/- 0.21 mm for women, p = NS). DISCUSSION: Results that we have obtained are in accordance with previously published data. We did not find significant (angiographically visible) atherosclerotic lesions of the ITA, however variations in the take-off and branching were found to be frequent (11.25%). Aneurysmatic left ITA is an extremely rare finding in the literature. Angiographically found variations (capable of causing coronary steal) are impossible to be detected during operation. This raises a question of a need for routine angiographic evaluation of the ITA before operation. For some patients, routine angiographic evaluation of the ITA before myocardial revascularization is mandatory: in pts with previous myocardial revascularization, in whom ITA was not used, but could have been damaged; in pts with atherosclerotic lesions of the supraaortic vessels; in pts with previous irradiation of the anterior mediastinum (ITA could be fibrotic); in pts with actual or corrected coarctation of aorta (ITA could be aneurysmatic). CONCLUSION: The incidence of anatomic variations of the ITA (that may be of surgical importance) is not negligible (13.25%). These data indicate that routine angiographic evaluation of the ITA should be considered in all patients in need for myocardial revascularization.

Aneurysm↗
PubMedDate not supplied

[Intracranial complications of sinusitis].

A rare case of cerebral abscess is presented. Sinusitis was identified as a predisposing factor. Rhinogenous endocranial complications are almost ten times less frequent than the otogenous ones. Despite great progress in the treatment of infections of different localizations, the lethality from cerebral abscess has remained relatively high ranging between 30 and 60%. We report on one of our patients and give a critical review of the contemporary diagnostic and therapeutical possibilities in the treatment of cerebral abscess. The case is interesting since brain abscess has been completely cured inoperatively. Although the treatment of cerebral abscess has been considerably improved, this remains one of the most severe diseases, requiring further improvement of diagnostic and therapeutical methods.

Adolescent↗
PubMedDate not supplied

[Etiology and incidence of amaurosis in war injuries of the eye].

Retrospective analysis of the medical documentation of 506 wounded treated at the Ophtalmological Clinic of the Military Medical Academy, was used to separate the cases where, due to the injury, the eyesight was destroyed or reduced to "the sense and projection of the light". The groups were formed according to the mechanism of injury and etiological factor. In 41.03% of eyes described sight impairment was established on admission, and the perforative injury of the eye was the basic etiological factor in 64.26% of the cases.

Blindness↗