Minimally invasive coronary-artery bypass surgery.
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Coronary Artery Bypass↗
Biomedical subjects
V Gulielmos
Publications and source records attributed to V Gulielmos.
[Comparative stability evaluation of dynamic hip screw and gamma-nail osteosyntheses in unstable pertrochanteric femoral osteotomies].
In 24 human cadaver femora standardized instable pertrochanteric osteotomies were created. The right and left femur of each pair were alternately selected for osteosyntheses with the gamma nail and the dynamic hip screw. Afterwards an examination of stability was performed. Cyclical loads were increased in 500 N increments to the maximum loading capacity, while the deformation rate was continuously measured. Radiographs were taken to prove the results of loading. The mean deformation was much greater in the DHS group than for the gamma nail, the maximum load to failure was significantly lower. Femoral shaft fractures caused by the loading occurred five times as often in the gamma nail osteosyntheses than in the DHS.
Aged↗
[Results before and after introduction of perioperative antibiotic prophylaxis in hip joint prostheses treatment of geriatric patients].
In a retrospective analysis the clinical history of 202 geriatric patients with vast morbidity who had received hip prosthesis were reviewed. The age of the patients at the time of operation was calculated to a mean of 82.9 years. Hundred and three cases who had underwent cefazolin application as an antibiotic prophylactic therapy were compared to 99 patients who had not received any antibiotics (control group). In comparison wound infections after surgery were less common among the cefazolin group (13.6%) than in the control group (26.3%). Additionally the incidences of reoperations, decubital ulcers and urinary tract infections were statistically significant lower in the cefazolin group as well.
Aged↗
[Experimental studies of the load capacity of DHS osteosyntheses after various kinds of osteotomy in the area of the femoral trochanter].
Standardized osteotomies were performed to mimic fractures classified as (a) stable, (b) partly unstable and (c) complete unstable (according to Evans) in 32 postmortem femoral bones. The stability of all preparations was examined after the performance of an osteosynthesis with a dynamic hip screw. Cycled loadings were increased stepwise every 500 N to the maximum loading capacity (load of fracture). In addition, the distortion at 2000 N was measured. There were no statistically significant differences between the three groups (a), (b), and (c). The average maximum load capacity was significantly lower in group (c) than in groups (a) and (b). Nevertheless, the lowest value (2275 N) recorded for the maximum loading capacity in our study means that in a normal weight person full weight-bearing can be allowed postoperatively.
Aged↗
[The clinical course of surgically managed para-articular femoral fractures in geriatric surgery].
246 patients (average 82.4 years) with proximal femur fractures treated with bipolar endoprosthesis, sliding lag screw or Ender nailing, related to the fracture type were analysed in a retrospective study. Pre-existing diseases, duration of operation, postoperative complications, transfusions, hospital stay, mobility achieved and mortality were noted. In result we found a high multimorbidity related to the age, the highest requirement of transfusions in patients undergoing Ender nailing, a long period to achieve postoperative mobility, a long hospital stay and increasing mortality with average age and average hospital stay.
Aged↗
Three-year follow-up after port-access mitral valve surgery.
INTRODUCTION: After the promising early results with Port-Access mitral valve (MV) surgery, the mid-term results were evaluated. METHODS: Among 31 patients receiving this surgery, there were two subgroups (A and B). The 14 patients in group A (7 men, 7 women, 64.0 +/- 12.8 years, LVEF 0.62 +/- 0.118) received the procedure exactly as proposed by Heartport. The 17 patients in group B (6 men, 11 women, 63.0 +/- 11.48 years, LVEF 0.61 +/- 0.117) received a modified technique for a less complex procedure. The underlying diseases were MV insufficiency (n = 14), MV stenosis (n = 9), and combined MV disease (n = 8). One female patient had a partial atrial ventricular canal. RESULTS: Perioperative mortality was 3.2%. Survival at 39.0 +/- 6.3 months (median +/- SEM) was 93.5%. Two patients required intraoperative inotropic and mechanical support (intra-aortic balloon pump [IABP]). One of these two patients died on postoperative day 3 due to low cardiac output syndrome. All ther patients survived the procedure. Twenty-four patients underwent MV replacement, 7 patients received MV repair, and 1 patient received, in addition, ASD repair. In group B, operative time, ICU stay, and hospitalization was shorter. CONCLUSIONS: Good early results after Port-Access MV surgery were confirmed by equal mid-term results. The patients are satisfied with the surgical and the cosmetic results, however, Port-Access MV surgery still has to prove superior outcome compared to conventional MV surgery. In selected cases a true reduction of the surgical trauma is possible.
Adult↗