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- Szabó, Zoltán, et al.
(author)
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Kiegészítő klinikai módszer a nyitott szívműtéteknél fellépő légembolisatio csökkentésére : [A complementary clinical method to minimize air embolism during open-heart surgery]
- 2008
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In: Magyar Sebeszet. - : Akademiai Kiado. - 0025-0295 .- 1789-4301. ; 61, s. 57-59
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Journal article (peer-reviewed)abstract
- Air from the left heart is ejected even up to several hours after cardiopulmonary bypass (CPB) despite the use of CO 2 . The following method is complementary in addition to surgical de-airing in order to further reduce the chance of air embolism, especially from the pulmonary veins. After re-expanding the lungs with standard bag inflation, the ventilation is restarted in consultation with the surgeon. The ventilator is set to the respiratory minute volume used before the CPB but at a respiratory frequency of 10/minutes whereas the regularly beating heart is filled from the heart lung machine. Transoesophageal echocardiography (TEE) reliably controls the effect.
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| 4. |
- Ferencz, S., et al.
(author)
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[A new method for prothetisation of vascular patients with lower limb amputation: initial experiences with osseointegration technique.]
- 2009
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In: Magyar Sebészet. - 0025-0295. ; 62:5, s. 293-7
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Journal article (peer-reviewed)abstract
- Introduction/Aims: Prostheses use for lower limb amputees is difficult, while the socket is hard, the prosthesis is heavy. Drawbacks of conventional prosthesis are mainly associated with the socket, therefore osseointegration technique is a promising solution, since it doesn't require a socket. Our aim was to introduce this technique in Hungary and extend indication for vascular patients. Methods: The method includes two operative and one rehabilitation phases: during first operation a titanium screw is fixed into the femoral bone marrow cavity, this connects to an abutment, which also penetrates the skin, making a direct connection between the femur and the prosthesis during the second intervention. During rehabilitation the patient makes loading exercises and learns to walk with new prosthesis. Results: This method was launched in Hungary in 2005. Two female amputees were operated on initially, their second surgery was performed in 2006 (when titanium screw was applied in the male patients, as well). Incorporation of titanium screw was exquisite, and rehabilitation was successful. One of our male patients died eight months after his first operation due to myocardial infarction. Conclusion: Based on our experiences, the osseointegration technique facilitates rehabilitation of vascular patients for prostheses use. Adequate follow-up and stable vascular diseases are not contraindications, although further clinical trials are needed to determine its indication.
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| 5. |
- Szentgyörgyi, Lajos, et al.
(author)
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Intraoperative fires caused by alcoholic skin antiseptic and diathermy
- 2008
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In: Magyar sebészet. - 0025-0295. ; 61, s. 71-73
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Journal article (peer-reviewed)abstract
- UNLABELLED: The authors describe two intraoperative fires during cardiac surgery. In both cases, in addition to the usual disinfection and isolation of the operating field, they wanted to reduce the infection hazard and to restore the partly ruined isolation by 70% alcoholic skin antiseptic solution. Soon after the disinfection, but before the evaporation of alcohol, diathermy was used and caused fire. In case of the first patient the fire spread over the isolation film and resulted second grade (5%) and third-grade (1%) burn injury which required plastic surgery. In the second case the patient's beard caught fire causing second-grade (1%) burn that was treated locally. Despite these burn injuries both patients recovered after the heart surgery. These two intraoperative fires are 0.003-0.004% of all surgical procedures.CONCLUSION: Fires during surgery are rare and might have serious consequences. They can be prevented by keeping the discipline of work and instructions of fire protection. The best way of prevention is regular education of all the staff (doctors, nurses, etc.) working in the operating theatre.
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| 6. |
- Tamas, Eva, et al.
(author)
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[Simple surgical method for intraoperative evaluation of adequacy of tricuspid annuloplasty].
- 2008
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In: Magyar sebészet. - 0025-0295. ; 61:1, s. 49-52
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Journal article (peer-reviewed)abstract
- In tricuspid annuloplasty intraoperative "real time" evaluation using transoesophageal echocardiography requires normal flow to get reliable result. It means that the patient has to be already weaned from the cardiopulmonary bypass by the time of evaluation. In the authors' experience a well functioning tricuspid annuloplasty prevents back-flow through the valve. It can be observed on on-pump beating heart. If the tricuspid valve is competent, it is unnecessary to suck the blood flowing back through the coronary sinus while closing the right atrium. This observation seems to correlate well with post cardiopulmonary bypass transoesophageal echocardiography measurements and the control transthoracic echocardiography right before discharging the patients. These statements are based on a group of 72 patients. Sixty-nine patients (95.8%) were discharged (early mortality 4.2%). Only in one case we could observe a discrepancy between the intraoperative surgical observation and the postoperative echocardiographic finding. Development of functional tricuspid regurgitation in left-sided heart disease is a warning sign for myocardial impairment, which is an indication for surgery. Tricuspid annuloplasty can be performed even with moderate to medium grade regurgitation because it improves the early and late outcome. The described method is an adequate method for intraoperative evaluation of the repaired tricuspid valve competency.
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