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Biomedical subjects

U Hvass

Publications and source records attributed to U Hvass.

At least 91 records · Page 5Linked to original sources
PubMed1981

[Coarctation of the thoracic aorta with extensive segmental hypoplasia. A new surgical approach (author's transl)].

The authors describe a new surgical technique used for the repair of coarctations of the aorta with extensive segmental hypoplasia. The technique is divided into four stages: enlargement of part of the hypoplastic segment by arterioplasty, using a flap from the subclavian artery; the extent of possible enlargement is governed by the length of subclavian artery available; resection of the residual hypoplasia and of the coarctation area proper; end-to-end anastomosis of the two aortic segments; revascularization of the arm by direct implantation of the subclavian artery into the left common carotid artery.

Aorta, Thoracic↗
PubMed1981

Recurrent coarctation of the thoracic aorta: subclavian flap arterioplasty with carotid reimplantation of the distal subclavian artery.

Combining a subclavian flap procedure and reimplantation of the distal subclavian artery into the left carotid artery was used in 2 patients with recurrent coarctation of the thoracic aorta. One of the patients was 12 years old and the other, 6 years old. The operation has several advantages. (1) It is very efficient in relieving recurrent gradients. (2) The use of prosthetic material is avoided. (3) Minimal dissection is required. (4) It prevents subsequent subclavian steal syndrome and long-term ischemia of the left upper limb.

Aorta, Thoracic↗
PubMed1981

Tandem coarctation of the thoracic aorta. An unusual congenital anomaly.

The coarctation involving the aortic isthmus, with hypoplasia of the upper aortic segment, was satisfactorily repaired in a 15-year-old girl. The technique used was subclavian flap arterioplasty followed by reimplantation of the distal subclavian artery into the left carotid artery. Suprisingly weak femoral pulses were noted postoperatively and prompted a control angiogram. This showed an intraluminal diaphragm 2 cm below the site of the previous repair, with a 100 mm Hg gradient. At reoperation, a centrally performed fibrous diaphragm was excised, and the aorta was enlarged with a small Dacron patch. The postoperative course was uneventful.

Adolescent↗
PubMed1980

[Complete correction of the tetralogy of Fallot without right ventriculotomy].

The authors present an improved technique for operative treatment of tetralogy of Fallot. Developed by Edmund's technique it complets and improves it in several ways making it suitable for nearly all forms of tetralogy of Fallot. The transatrial approach is intended by it's author to only selected cases of the malformation, namely with large pulmonary arteries a correct pulmonary annulus and moderate infundibular hypertrophy. The combined approach which we propose (transatrial and transpulmonary) gives us very good post-operative and short term results.

Heart Ventricles↗
PubMed1980

[Exclusive approach through the pulmonary artery or r. atrium in the surgical treatment of stenoses of the r. ventricle ejection channel (author's transl)].

In the light of their experience of surgical treatment of right ventricle muscular stenoses, the authors have gradually abandoned the classical approach (ventriculotomy) and now exclusively use a new one through the tricuspid and pulmonary rings. The new approach considerably reduces the number and extent of enlargement patches in the infundibulum and should result in better preservation of the right ventricular function.

Adolescent↗
PubMed1980

Reoperation for massively calcified pulmonary valve heterografts. Surgical considerations.

Calcifications of pulmonary valve heterografts inserted in children are more frequently recognized with increasing follow-up periods and may lead to reoperation. This complication is common with our non-industrially prepared procine valves and may also be observed with Hancock porcine heterografts. Reoperation is rendered difficult by incrustation of the massively calcified heterograft into the posterior aspect of the sternum and because of the need of adequate exposure of the pulmonary bifurcation. Four patients were successfully reoperated on by the authors. The valves were not replaced. An improved surgical technique used in the last three cases is described.

Adolescent↗
PubMed1980

Long segment coarctation of the thoracic aorta in a young adult. An alternative treatment.

To avoid using an interposition Dacron graft in a 17-year-old female for repair of a long segment coarctation of the aorta, the authors combined reconstructing the thoracic aorta using a left subclavian arterial flap, and reimplanting the distal segment of the subclavian artery into the left carotid artery. coarctation repair was done through a left side thoracotomy and the subclavian artery reimplantation via a short vertical cervicotomy. This operation restores a practically normal anatomy without the inconvenience of the long-term hazards due to using prosthetic material.

Adolescent↗
PubMed1980

Tetralogy of Fallot with type C complete atrioventricular canal: surgical repair in three cases.

The successful repair of three consecutive cases of tetralogy of Fallot associated with complete atrioventricular canal type C is reported. The correct preoperative diagnosis was established by right and left ventriculography. Operative repair in the first two patients involved division of both hemivalves above the crest of the ventricular septal defect and closure of the septal defects with a single large Dacron patch. In the third patient, the septal defects were closed with two separate patches. The undivided hemivalves were attached to the patches by interrupted sutures placed more to the right side of the midline, so that tricuspid tissue was used to reconstitute the mitral valve. Right ventricular outflow tract obstruction was relieved by infundibulectomy, pulmonary valvulotomy, and placement of a Darcon patch on the infundibulum in Cases 1 and 3. A valved tube was used in Case 2. Six months postoperatively, the condition of the patient is satisfactory. The first patient is receiving digitalis; the second, digitalis and diuretics; and the third patient is well without treatment.

Blood Vessel Prosthesis↗
PubMed1979

[Pulmonary stenosis with intact ventricular septum. Surgical experience in 200 cases, excluding the neonatal period].

Experience over 10 years, studying two groups of patients (group I: 79 cases aged between 2 months and 2 years, group II: 151 cases aged over 2 years) has shown that the operative prognosis of severe forms is now the same as in simple forms. Interest is now focused on the long term function of the right ventricle with regard to the surgical procedure. The main discussion in management is between isolated pulmonary commissurotomy, whatever the anatomical form, and operations such as we perform which associate ventricular resection with or without an infundibular patch in severe cases. The possible causes of late ventricular dysfunction are discussed, especially the muscular resection, the operative myocardial protection and the preoperative myocardial sclerosis. The good results observed in this series as opposed to the doubt as to the cause and variability of late ventricular dysfunction do not justify a change in our management at present.

Adolescent↗
PubMed1979

[Complete correction of Fallot's tetralogy with a Waterston shunt].

The influence of a Waterston shunt on the mortality in complete correction of Fallot's tetralogy varies from series to series. Some authors believe that it has no influence and others, on the contrary, believe it plays an important role to the point of recognising a particular premonitory syndrome of pulmonary hypertension and a low output state. This divergence of opinion in patients with comparable lesions is surprising, and cannot always be explained by poor surgical indications (irreversible pulmonary hypertension) or by problems of surgical technique. In our experience the conditions of cardiopulmonary bypass are of prime importance and we believe that the common factor in surgical failure is poor myocardial protection. This point of view is suggested by our present results in the correction of moderate and severe forms of Fallot's tetralogy under cardioplegia and seems to be reinforced by the results of extensive repair in forms with a Waterston shunt, said to be high risk procedures, that is to say with considerable asymmetry of the pulmonary vascularisation by stenosis of the right main pulmonary artery.

Adolescent↗