scholarly journals Surgical Interventions Are Effective for Treating Unruptured Sinus of Valsalva Aneurysms

2021 ◽  
Vol 8 ◽  
Author(s):  
Juntao Qiu ◽  
Enzehua Xie ◽  
Yuetang Wang ◽  
Wei Wang ◽  
Cuntao Yu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Coronary Sinus ◽  
Surgical Repair ◽  
Heart Function ◽  
Early Death ◽  
Sinus Of Valsalva ◽  
Surgical Interventions ◽  
The Right

Background: This study investigates the optimal management for unruptured sinus of Valsalva aneurysms (USVAs) combined with other cardiovascular lesions.Methods: This retrospective study examined 33 USVA patients who underwent surgical repair from February 1, 2007 to January 31, 2012. We analyzed the surgical procedures and the patients' quality of life after surgery. Additionally, echocardiography follow-up was performed before and after the operation.Results: Most USVAs (87.8%) originated in the right coronary sinus. Aside from one patient who was preoperatively misdiagnosed as having a ruptured sinus of Valsalva aneurysm (SVA). USVAs of the right coronary sinus were addressed by reinforcing this sinus with a Dacron patch through the right ventricle. USVAs were corrected by aortotomy using an autogenous pericardium patch when they originated in the non-coronary or left coronary sinus. Thirty patients (90.9%) were followed up for 22–119 months. No early death, residual fistula or SVA recurrence were found during the follow-up period. They all had a good quality of life and good heart function (New York Heart Association class I–II).Conclusions: Active surgical repair of an USVA can be achieved with satisfactory results in patients combined with other cardiovascular lesions.

Advantages of a mini right axillary thoracotomy for congenital heart defect repair in children

2021 ◽  
pp. 1-6
Author(s):  
Jannika Dodge-Khatami ◽  
Ali Dodge-Khatami
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Global Health ◽  
Congenital Heart ◽  
Surgical Repair ◽  
Median Sternotomy ◽  
Axillary Approach ◽  
Post Operative Pain ◽  
The Right

Abstract Objectives: The mini right axillary thoracotomy is an alternative surgical approach to repair certain congenital heart defects. Quality-of-life metrics and clinical outcomes in children undergoing either the right axillary approach or median sternotomy were compared. Methods: Patients undergoing either approach for the same defects between 2018 and 2020 were included. Demographic details, operative data, and outcomes were compared between both groups. An abbreviated quality of life questionnaire based on the Infant/Toddler/Child Health Questionnaires focused on the patient’s global health, physical activity, and pain/discomfort was administered to all parents/guardians within two post-operative years. Results: Eighty-seven infants and children underwent surgical repair (right axillary thoracotomy, n = 54; sternotomy, n = 33) during the study period. There were no mortalities in either group. The right axillary thoracotomy group experienced significantly decreased red blood cell transfusion, intubation, intensive care, and hospital durations, and earlier chest tube removal. Up to 1 month, parents’ perception of their child’s degree and frequency of post-operative pain was significantly less after the right axillary thoracotomy approach. No difference was found in the patient’s global health or physical activity limitations beyond a month between the two groups. Conclusions: With the mini right axillary approach, surrogates of faster clinical recovery and hospital discharge were noted, with a significantly less perceived degree and frequency of post-operative pain initially, but without the quality of life differences at last follow-up. While providing obvious cosmetic advantages, the minimally invasive right axillary thoracotomy approach for the surgical repair of certain congenital heart lesions is a safe alternative to median sternotomy.

scholarly journals Surgical repair of aortic coarctation in adults: half a century of a single centre clinical experience

2019 ◽  
Vol 56 (6) ◽  
pp. 1178-1185 ◽  
Author(s):  
Djamila Abjigitova ◽  
Mostafa M Mokhles ◽  
Maarten Witsenburg ◽  
Pieter C van de Woestijne ◽  
Jos A Bekkers ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Repair ◽  
Coarctation Of The Aorta ◽  
Surgical Reconstruction ◽  
Refractory Hypertension ◽  
Tertiary Referral Centre ◽  
Related Quality ◽  
Hospital Morbidity

Abstract OBJECTIVES Coarctation of the aorta (CoA) is rarely diagnosed and treated in adults and nowadays mostly treated with percutaneous techniques. The objective of this study is to report the long-term outcomes and health-related quality of life in a unique cohort of patients treated with an open surgical repair for their primary adult CoA. METHODS Ninety adult patients underwent primary surgical repair of CoA at our tertiary referral centre between 1961 and 2008 when the treatment strategy for adult CoA was exclusively surgical. RESULTS The median age at surgery was 24 years (interquartile range 20–36 years), and 39 patients (43%) were asymptomatic at presentation. CoA was located paraductally in most patients (64%), and bicuspid aortic valve was present in 39 (43%) patients. Surgical reconstruction of CoA with an end-to-end anastomosis was performed in majority of the patients (57%). Overall, in-hospital mortality occurred in 1 patient (1%). There was no in-hospital stroke, spinal cord ischaemia, renal replacement therapy or respiratory failure. The cumulative survival was 97.7%, 89.5%, 82.6%, 70.9% and 61.4% at 10, 20, 30, 40 and 50 years, respectively. Thirty-one patients (34%) required an additional cardiac surgery during follow-up. The majority of patients (77%) suffered from refractory hypertension even after decades of surgery. Compared with the matched Dutch population, patients reported a lower social functioning, mental health, vitality and general health with a higher body pain. CONCLUSIONS Patients with native adult CoA have low in-hospital morbidity and mortality when treated with an open surgical reconstruction. However, refractory hypertension and impaired quality of life remain important challenges during follow-up.

Surgical Repair of Pelvic-Floor Prolapse: Lessons Learned from Longitudinal Follow-Up of Quality-of-Life Survey

2010 ◽  
Vol 41 (S 01) ◽  
pp. S30-S33
Author(s):  
H. Matsuyama ◽  
T. Tomimatsu ◽  
M. Tatsumura ◽  
N. Sugino ◽  
K. Naito
Keyword(s):  
Quality Of Life ◽  
Pelvic Floor ◽  
Surgical Repair ◽  
Lessons Learned ◽  
Pelvic Floor Prolapse

scholarly journals Management of Lipedema with Ketogenic Diet: 22-Month Follow-Up

Life ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1402
Author(s):  
Roberto Cannataro ◽  
Sandro Michelini ◽  
Lorenzo Ricolfi ◽  
Maria Cristina Caroleo ◽  
Luca Gallelli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ketogenic Diet ◽  
Nutritional Intervention ◽  
Significant Weight Loss ◽  
State Present ◽  
Unclear Etiology ◽  
Body Circumferences ◽  
The Right

Lipedema is a pathology of adipose tissue, still of unclear etiology and challenging to diagnose. For these reasons, a therapeutic approach is also complex and sometimes controversial. The inflammation state present in lipedema can be limited by controlling the glycemic peaks. Specifically, the ketogenic diet (KD) seems to have the right conditions to be effective. Herein, we reported a subject diagnosed with lipedema who, with only KD nutritional intervention, achieved a significant weight loss (−41 Kg), with a net decrease in body circumferences, and also reporting an improvement in pain, and therefore in the overall quality of life. She refused other types of intervention and kept KD for two years. This case could represent the first step to organize a KD nutritional protocol specifically applied to lipedema.

scholarly journals Endovascular Treatment of Pelvic Congestion Syndrome: Visual Analog Scale Follow-Up

2021 ◽  
Vol 8 ◽  
Author(s):  
Quentin Senechal ◽  
Perrine Echegut ◽  
Marine Bravetti ◽  
Marie Florin ◽  
Lamia Jarboui ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lower Limb ◽  
Iliac Vein ◽  
Pelvic Vein ◽  
Internal Iliac Vein ◽  
Internal Iliac ◽  
The Right ◽  
Pelvic Congestion

Purpose: To evaluate medium-term clinical outcomes of transcatheter embolization and stenting in women with several pelvic venous disorders responsible for chronic pelvic pain and varicose veins of the lower limbs.Materials and Methods: The study population included 327 consecutively recruited patients referred to the interventional radiology unit from January 2014 to December 2019 due to chronic pelvic congestion (91; 27.83%), lower limb varices (15; 4.59%), or a combination of both the symptoms (221; 67.58%). Preprocedural pelvic, transvaginal Doppler ultrasound (US), and MRI were conducted in all the patients and revealed anatomical varicosities and incompetent pelvic veins in 312 patients. In all the patients, selective catheterization demonstrated uterine venous engorgement, ovarian plexus congestion, or pelvic vein filling. Retrograde flow was detected on catheter venography in the left ovarian vein (250; 78%), the right ovarian vein (85; 26%), the left internal iliac vein (222; 68%), and the right internal iliac vein (185; 57%). Patients were followed-up at 1, 6, and 12 months, and years thereafter systematically by the referring angiologist and the interventional radiologist of center. They were contacted by telephone in November and December 2020 to assess pain perception and quality of life by using the visual analog scales from 0 to 10 with assessments made at the baseline and last follow-up. Of the 327 patients (mean age, 42 ± 12 years), 312 patients were suffering from pelvic congestion syndrome and 236 patients was suffering from lower limb varices. All underwent embolization by using ethylene vinyl alcohol copolymer (Onyx®). Eighty-five right ovarian veins, 249 left ovarian veins, 510 tributaries of the right internal iliac vein, and 624 tributaries of the left internal iliac vein were embolized. A cohort of patients also underwent nutcracker syndrome angioplasty (6.7%) and May–Thurner syndrome angioplasty (14%) with a stent placement.Results: The initial technical success rate was 80.9% for embolization of pathological veins and 100% for stenting of stenoses. Overall, 307 patients attended 12-month follow-up visits and 288 (82%) patients completed the telephone survey at mean 39 (±18)-month postintervention. Main pelvic pain significantly improved from 6.9 (±2.4) pre- to 2.0 (±2.4) postembolization (p < 0.001), as did specific symptoms in each category. Improvement or disappearance of pain was achieved in 266/288 (92.36%) patients with improved quality of life in 276/288 (95.8%) patients. There were 16 minor and 4 major adverse events reported on the follow-up.Conclusion: Pelvic vein embolization (Onyx®) is an effective and safe procedure with high clinical success and quality of life improvement rates.

scholarly journals Ruptured and Non-Ruptured Sinus of Valsalva Aneurysms: Five Case Studies

2002 ◽  
Vol 30 (4) ◽  
pp. 457-462 ◽  
Author(s):  
A Ateş ◽  
İ Yekeler ◽  
A Özyazicioğlu ◽  
Ü Vural ◽  
M Yilmaz
Keyword(s):  
Coronary Sinus ◽  
Ductus Arteriosus ◽  
Outlet Obstruction ◽  
Left Ventricular ◽  
Sinus Of Valsalva ◽  
Septal Defects ◽  
Double Approach ◽  
The Mean ◽  
The Right

Between 1987 and 2000, we observed retrospectively a series of five cases of surgically treated sinus of Valsalva aneurysms (SVAs) at the Department of Cardiovascular Surgery, Atatürk University, Erzurum, Turkey. The mean age of the five patients was 32.6 years (range, 18–48 years). Three were male and two were female. Aneurysms originated from the right coronary sinus in four patients, and from the non-coronary sinus in one. Three aneurysms fistulized to the right ventricle, one to the right atrium and the last, originating from the right coronary sinus, was non-ruptured. Two aortic insufficiencies, two ventricular septal defects, one patent ductus arteriosus and one left ventricular outlet obstruction were found as concomitant lesions. All cases were symptomatic. Ruptured SVAs were repaired by double approach involving both the chamber and aortic root. There was no late mortality either in the hospital or during the follow-up period (mean 40.4 months, range 13–66 months). No patient required re-operation.

scholarly journals O42 SURGICAL REPAIR OF DIASTASIS RECTI ABDOMINIS (DRA) PROVIDES LONG-TERM IMPROVEMENT OF ABDOMINAL CORE FUNCTION AND QUALITY OF LIFE: A THREE-YEAR FOLLOW-UP

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Anders Olsson ◽  
Olivia Kiwanuka ◽  
Sofia Wilhelmsson ◽  
Gabriel Sandblom ◽  
Otto Stackelberg
Keyword(s):  
Quality Of Life ◽  
Surgical Repair ◽  
Post Partum ◽  
Diastasis Recti ◽  
Sf 36 ◽  
Core Function ◽  
One Year ◽  
The One

Abstract Aim Diastasis Recti Abdominis (DRA) is a condition affecting many post-partum women. The aim of this study was to evaluate long-term results of surgical repair of DRA in a cohort of post-partum women. Material and Methods Sixty post-partum women with DRA and training-resistant core dysfunctions were included. Surgical repair was performed with suture plication of the linea alba. Abdominal core function was evaluated with the Abdominal Trunk Function Protocol (ATFP) including a self-report questionnaire and seven functional tests. Urinary incontinence and Quality of Life was evaluated with the Urogenital Distress Inventory (UDI-6), the Incontinence Impact Questionnaire (IIQ-7) and the SF-36 questionnaire. Follow-up was performed at one year and three years’ post-operatively. Results Response rate at the three-year follow-up was 86.7 % for the DRI questionnaire; and 71.7% for ATFP, the UDI-6, IIQ-7, and SF-36 questionnaires. All DRI-parameters were improved (p < 0,05) after three-years of follow-up compared to preoperative values. The functional tests in the ATFP showed an improvement (p < 0.05) in core muscle strength and stability, persisting back and abdominal muscle strength compared to preoperative values as well as an improvement compared to the one-year follow-up values (p < 0.05). UDI-6 and IIQ-7 results were improved (p < 0.05) compared to preoperative values and showed consistent values compared to the one-year follow-up. Quality of life measured with SF-36 were improved compared to preoperative values and showed consistent values compared to the one-year follow-up (p < 0.05). Conclusions The functional improvement of surgical reconstruction of the DRA persisted for three years in this series of post-partum women with DRA.

scholarly journals Results of Prompt Surgical Intervention in Hemodialysis Radiocephalic Fistula Secondary Dysfunction

2019 ◽  
Vol 104 (5-6) ◽  
pp. 217-225
Author(s):  
Iyad Fansa ◽  
Mesut Kösem ◽  
Celalettin Karatepe ◽  
Adem Sezen ◽  
Hilal Kuşcu Karatepe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Intervention ◽  
Catheter Placement ◽  
Proximal Anastomosis ◽  
Common Procedure ◽  
Surgical Interventions ◽  
Mean Time ◽  
Early Surgical Intervention

Radiocephalic fistula (RCF) dysfunction is a common problem due to low maturation and patency rates of these fistulas. The most common procedure in such cases is to place a temporary catheter for the dialysis. Temporary catheter placement and undergoing dialysis with this catheter cause complications, reduce the chance for fistula, and deteriorate the quality of life. The aim of this study was to demonstrate that immediate intervention in RCF dysfunctions can increase fistula success for the patient and can reduce the need for a catheter. Furthermore, the hemodialysis treatment can continue without affecting the quality of life. A total of 295 patients who were admitted for RCF dysfunction and who underwent early surgical intervention without any catheter placement were evaluated for postoperative complications, patency rates, and rates and durations of temporary catheter use over a mean time of 47 months of follow-up (range: 4–79 months). Of the patients, 77.2% (n = 228) underwent new proximal anastomosis (NEO; the radial artery and cephalic vein were reached with an incision created proximal to the previous anastomosis), 14.2% (n = 42) underwent brachiocephalic arteriovenous fistula (AVF), 8.4% (n = 25) underwent side-to-side brachiobasilic AVF + superficialization of the basilic vein. In 88.8% (n = 262) of the patients, successful cannulations were performed within the first 24 to 48 hours without any catheter requirement or complications. Temporary catheter was used for 15.1 ± 10.7 days in 11.2% (n = 33) of the patients. In RCF dysfunctions, early surgical interventions performed in the forearm and elbow provide early cannulation and thus decrease the catheter requirement, also prevent the complications of temporary catheters (infection, decreasing the fistula success, vascular injuries, etc.), increase the autogenous fistula success, and allow for the continuation of dialysis without disturbing the quality of life.

Impact of Angioplasty and Arterial Reconstructive Surgery on the Quality of Life of Claudicants

1997 ◽  
Vol 42 (2) ◽  
pp. 47-48 ◽  
Author(s):  
J.P. Pell ◽  
A.J. Lee
Keyword(s):  
Quality Of Life ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Case Mix ◽  
Arterial Reconstruction ◽  
Surgical Interventions ◽  
The Impact ◽  
Percutaneous Transluminal

Claudicants usually die from concomitant conditions. Therefore, surgical interventions are aimed at improving quality of life, rather than survival. This study compared the impact of percutaneous transluminal angioplasty (PTA), arterial reconstruction and conservative management on quality of life. SF36 questionnaires were completed by 201 newly referred claudicants prior to treatment andsix months later. Multiple regression was used to compare the quality of life scores following the three treatments after adjustment for baseline scores, age, sex, site of disease and disease severity. Follow-up data were available on 81% of the 195 patients alive. Nineteen (10%) of these had undergone PTA and 19 (10%) reconstruction. All aspects of quality of lif e deteriorated following conservative treatment. PTA and arterial reconstruction produced significant improvements in both pain and physical functioning after adjustment for case-mix. Although unlikely to improve survival, PTA and arterial reconstruction are associated with significant improvements in quality of life.

scholarly journals Lágyéksérvet utánzó gigantikus méretű myxoid leiomyoma

2016 ◽  
Vol 157 (10) ◽  
pp. 392-395
Author(s):  
Orsolya Huszár ◽  
Attila Zaránd ◽  
Gyöngyi Szántó ◽  
Viktória Juhász ◽  
Eszter Székely ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Smooth Muscle ◽  
Soft Tissue Mass ◽  
Smooth Muscle Tumour ◽  
Tissue Mass ◽  
Abdominal Symptoms ◽  
History Of ◽  
The Right

Leiomyoma is a rare, smooth muscle tumour that can occur everywhere in the human body. The authors present the history of a 60-year-old female, who had a giant, Mullerian type myxoid leiomyoma in the inguinal region mimicking acute abdominal symptoms. After examination the authors removed the soft tissue mass in the right femoral region reaching down in supine position to the middle third of the leg measuring 335 × 495 × 437 mm in greatest diameters in weight 33 kg. Reconstruction of the tissue defect was performed using oncoplastic guidelines. During the follow-up time no tumour recurrence was detected and the quality of life of the patient improved significantly. Orv. Hetil., 2016, 157(10), 392–395.

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