26
|
Gedik N, Thielmann M, Kottenberg E, Peters J, Jakob H, Heusch G, Kleinbongard P. P423No evidence for activated autophagy in left ventricular myocardium with protection by remote ischemic preconditioning in patients undergoing coronary artery bypass grafting. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu091.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
27
|
Wendt D, Plicht B, Kahlert P, Hartmann K, Al-Rashid F, Price V, Konorza T, Erbel R, Jakob H, Thielmann M. A novel calcium scoring system accurately predicts likelihood and location of post-TAVI paravalvular leak. THE JOURNAL OF CARDIOVASCULAR SURGERY 2014; 55:423-433. [PMID: 24189518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM Sclerosis distribution, topography and morphology in aortic stenosis may have an impact on the localisation of post-procedural paravalvular leakage (PVL) following transcatheter aortic valve implantation (TAVI). METHODS Between 05/2005 and 03/2011 a total of 208 patients underwent either transapical (TA) or transvascular (TV) TAVI using the Edwards-SAPIEN(TM), or CoreValve(TM) system. Aortic cusp and annular sclerosis distribution and aortic valve sclerosis symmetry were evaluated by preoperative transesophageal echocardiography (TOE). Mild, moderate and severe PVL after TAVI (group 1, N.=117) were analysed and compared to those patients with no signs of postprocedural PVL (group 2, N.=91). Commercial available image processing and analysing software were used to evaluate all relevant calcific sections (aortic sclerosis score 0-66; symmetry score 0-5) and were matched with the localization of the PVLs. RESULTS A total of 117 patients (83±6 years, mean logistic EuroSCORE 20.1±12.7%) were identified with a mild-moderate PVL (TV, N.=102; TA, N.=15). Mean aortic sclerosis score was 38.7±7.6 in group 1 compared to 33.7±8.3 in group 2 (P<0.001) showing highest calcification in the non-coronary part for both groups. The mean symmetry score was 1.9±1.0 group 1 compared to 1.7±1.0 in group 2 (P=0.12). Regression analysis showed a significant relation of preoperative cusp localisation to the corresponding paravalvular leakage (P<0.001). CONCLUSION The present study shows that a aortic sclerosis score constructed by TOE enables prediction of postoperative PVL and moreover, the localisation of PVL after TAVI correlates with the corresponding preoperative amount of sclerosis for each cusp.
Collapse
|
28
|
Dohle DS, Tsagakis K, Liubov P, Kühl H, Lieder H, Benedik J, Wendt D, Thielmann M, Jakob H. Aortic remodeling in acute aortic dissection after frozen elephant trunk. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
29
|
Thielmann M, Liakopoulos O, Slottosch I, Welp H, Wendt D, Schiller W, Martens S, Welz A, Wahlers T, Neuhäuser M, Jakob H. Surgical outcomes of patients with acute coronary syndromes undergoing coronary artery bypass grafting: a current report of the North-Rhine-Westphalia surgical myocardial infarction registry. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
30
|
Ross B, Steinmann J, Buer J, Dusse F, Jakob H, Schneemann H, Hugo-Hanke S, Bräutigam S, Sanewski A, Kundt R, Parohl N, Weidler K, Witzke O, Popp W. [Outbreak with Ralstonia pickettii caused by contaminated magnesium vials]. Dtsch Med Wochenschr 2014; 139:323-6. [PMID: 24496893 DOI: 10.1055/s-0033-1360059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
HISTORY In February 2013, 5 patients in an intensive care unit (ICU) were found to have positive blood cultures with Ralstonia pickettii within one week. Because all patients got intravenous therapy, improper work of a staff member was suspected. Some days later, a 6th patient was found with a positive blood culture of Ralstonia pickettii in another department of the hospital. INVESTIGATIONS Hygienic investigations showed no evidence of failures in preparation of intravenous therapy. All patients were on different intravenous drugs, but every patient had received glucose 5 % and magnesium. We examined samples of glucose and magnesia as well as samples from environment. RESULTS AND COURSE: Glucose and magnesium samples were examined by membrane filter method. Ralstonia pitteckii was detected in some Magnesium vials. We concluded, that contamination of Magnesium vials might have been the reason for blood stream infection of patients. Pharmacists and authorities were informed and all vials were collected and replaced by vials from another company. Later a nationwide recall of Magnesium vials was performed by the producing company. No further Ralstonia pickettii was found in blood cultures in our hospital. CONCLUSION Unusual pathogens in blood cultures should lead to reflection of rarer causes such as contamination of medicines.
Collapse
|
31
|
Yan TD, Tian DH, LeMaire SA, Misfeld M, Elefteriades JA, Chen EP, Chad Hughes G, Kazui T, Griepp RB, Kouchoukos NT, Bannon PG, Underwood MJ, Mohr FW, Oo A, Sundt TM, Bavaria JE, Di Bartolomeo R, Di Eusanio M, Roselli EE, Beyersdorf F, Carrel TP, Corvera JS, Della Corte A, Ehrlich M, Hoffman A, Jakob H, Matalanis G, Numata S, Patel HJ, Pochettino A, Safi HJ, Estrera A, Perreas KG, Sinatra R, Trimarchi S, Sun LZ, Tabata M, Wang C, Haverich A, Shrestha M, Okita Y, Coselli J. The ARCH Projects: design and rationale (IAASSG 001). Eur J Cardiothorac Surg 2013; 45:10-6. [DOI: 10.1093/ejcts/ezt520] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
32
|
Benedik J, Pilarczyk K, Mourad F, Wendt D, Tsagakis K, Baba HA, Jakob H. Comparison of aortic wall quality between patients with coronary artery disease, aortic valve disease and aortic aneurysms. J Cardiothorac Surg 2013. [PMCID: PMC3844533 DOI: 10.1186/1749-8090-8-s1-o10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
|
33
|
El Chilali K, Al-Rashid F, Patsalis P, Plicht B, Wendt D, Thielmann M, Jakob H, Erbel R, Kahlert P. Elevated plasma B-type natriuretic peptide level predicts 30-day and 1-year mortality after transapical but not transfemoral transcatheter aortic valve implantation. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
34
|
Dohle DS, Petrat F, Tsagakis K, Bestendonk C, Pilarczyk K, Broecker-Preuss M, Thielmann M, Jakob H, de Groot H. Early detection of Mesenteric Ischemia by serum markers in cardiac surgery patients. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
35
|
Avner PR, Dove WF, Dubois P, Gaillard JA, Guénet JL, Jacob F, Jakob H, Shedlovsky A. The genetics of teratocarcinoma transplantation: tumor formation in allogeneic hosts by the embryonal carcinoma cell lines F9 and PCC3. Immunogenetics 2012; 7:103-15. [PMID: 21302063 DOI: 10.1007/bf01843995] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/1978] [Revised: 07/27/1978] [Indexed: 11/25/2022]
Abstract
Two cultured lines of murine embryonal carcinoma, F9 and PCC3, have been grafted to a variety of allogeneic hosts. The host strains have been classified by their resistance or sensitivity to these carcinomas. Resistance seems to be immunological in nature.Allograft rejection does not correlate withH-2 haplotype, and seems to be controlled by a limited number of recessive factors, presumably histocompatibility genes. We infer that these factors have limited polymorphism in the mouse species. Recombinational analysis of strain A/He has revealed the presence of a recessive factor linked to theH-2 locus. Tumor resistance of strains C57BL/6 and AKR appears to result from the interaction of dominant or semi-dominant factors in theH-2 region with other recessive elements in the genetic background.Though F(1) hybrids between resistant mouse strains and the syngeneic strain 129 are largely tumor-sensitive, a low level of hybrid resistance to F9 has been observed and shown to be eliminated by X-irradiation.
Collapse
|
36
|
Tsagakis K, Konorza T, Dohle DS, Kottenberg E, Buck T, Thielmann M, Erbel R, Jakob H. Hybrid operating room concept for combined diagnostics, intervention and surgery in acute type A dissection. Eur J Cardiothorac Surg 2012; 43:397-404. [DOI: 10.1093/ejcts/ezs287] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
37
|
Relja B, Lustenberger T, Puttkammer B, Jakob H, Morser J, Gabazza EC, Takei Y, Marzi I. Thrombin-activatable fibrinolysis inhibitor (TAFI) is enhanced in major trauma patients without infectious complications. Immunobiology 2012; 218:470-6. [PMID: 22749979 DOI: 10.1016/j.imbio.2012.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 06/04/2012] [Indexed: 01/13/2023]
Abstract
BACKGROUND Infectious complications frequently occur after major trauma, leading to increased morbidity and mortality. Thrombin-activatable fibrinolysis inhibitor (TAFI), a procarboxypeptidase in plasma, plays a dual role in regulating both coagulation and inflammation. Activated TAFI (TAFIa) has broad anti-inflammatory properties due to its inactivation of active inflammatory mediators (anaphylatoxins C3a and C5a, bradykinin, osteopontin). OBJECTIVES The purpose of this study was to determine if TAFI plays a role in the development of inflammatory complications after major trauma. PATIENTS/METHODS Upon arrival at the emergency department (ED), plasma levels of TAFI and TAFIa were measured in 26 multiple traumatized patients for 10 consecutive days. Systemic levels of inflammatory mediators, including interleukin-6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP) and leukocytes were determined. RESULTS Fifteen patients developed pneumonia and/or sepsis (compl) and 11 had no complications (wo compl). Overall injury severity and age were comparable in both groups. Complications occurred approximately 5 days after trauma. IL-6 increased on day 5, whereas CRP, PCT and leukocytes started to increase on day 6 in the compl-group. Upon arrival at the ED and on days 1 and 4, TAFI levels were significantly lower in the compl-group compared to the wo compl-group (p=0.0215). Similarly, TAFIa was significantly lower on day 4 in the compl-group than in the wo compl-group (p=0.049). CONCLUSIONS This pilot study shows that TAFI levels are inversely correlated with inflammation-associated development of complications after major trauma.
Collapse
|
38
|
Jakob H, Dohle DS, Piotrowski J, Benedik J, Thielmann M, Marggraf G, Erbel R, Tsagakis K. Six-year experience with a hybrid stent graft prosthesis for extensive thoracic aortic disease: an interim balance. Eur J Cardiothorac Surg 2012; 42:1018-25. [DOI: 10.1093/ejcts/ezs201] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
|
39
|
Thielmann M, Pasa S, Wendt D, Price V, Marggraf G, Neuhauser M, Piotrowski A, Jakob H. Prognostic significance of cardiac troponin I on admission for surgical treatment of acute pulmonary embolism: a single-centre experience over more than 10 years. Eur J Cardiothorac Surg 2012; 42:951-7. [DOI: 10.1093/ejcts/ezs122] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
40
|
Jánosi RA, Böse D, Konorza T, Eggebrecht H, Tsagakis K, Jakob H, Erbel R. [Malperfusion in aortic dissection: diagnostic problems and therapeutic procedures]. Herz 2012; 36:531-8. [PMID: 21858546 DOI: 10.1007/s00059-011-3498-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Malperfusion of the thoracoabdominal aorta and its side branches is a common complication of aortic dissection, often proving fatal. Vital organ malperfusion accompanying acute aortic dissection is a major cause of mortality and morbidity and requires timely reperfusion of the ischemic organs as well as adequate management of the aortic dissection. Ischemic damage to vital organs supplied by the thoracoabdominal aorta greatly increases the overall risk of aortic dissection. As initial symptoms may be subtle, malperfusion tends to be recognized late, and therefore accounts for a considerable percentage of fatalities.Effective reperfusion is not readily achieved by central aortic surgery alone in a certain number of patients. Various strategies have been used, including entry closure by central aortic surgery or stent grafting, surgical or catheter fenestration, bypass grafting and percutaneous stenting.Endovascular bare-metal stent placement is an attractive and promising treatment option since it is readily available, is less invasive and presents fewer risks to the patient.
Collapse
|
41
|
Jakob H. Kanülierung des wahren Lumens der Aorta ascendens bei akuter Aortendissektion Typ A. ZEITSCHRIFT FUR HERZ THORAX UND GEFASSCHIRURGIE 2012. [DOI: 10.1007/s00398-011-0903-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
42
|
Thielmann M, Wendt D, Icking K, Pasa S, Tsagakis K, Massoudy P, Piotrowski AJ, Jakob H. Total-arterial revascularization in multivessel coronary artery disease with T-grafting of bilateral internal thoracic artery. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
43
|
Thielmann M, Wendt D, Pasa S, Al-Rashid F, Kahlert P, Konorza T, Kottenberg E, Erbel R, Jakob H. Staged approach in acute decompensated aortic stenosis with bridging percutaneous balloon aortic valvuloplasty before transcatheter aortic valve implantation. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
44
|
Pasa S, Thielmann M, Hösel M, Wendt D, Marggraf G, Piotrowski AJ, Jakob H. Comparison of heart-type fatty acid binding protein and cardiac troponin I for early detection of myocardial infarction after coronary bypass surgery. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
45
|
Thielmann M, Wendt D, Aßmann J, Böhm J, Pasa S, Tsagakis K, Kälsch H, Buck T, Erbel R, Jakob H. Hemodynamic performance and first clinical experience with the TrifectaTM valve in a prospective single-center study. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
46
|
Wendt D, Plicht B, Hartmann K, Kahlert P, Konorza T, Erbel R, Jakob H, Thielmann M. Aortic valve calcium symmetry and distribution to predict localisation of paravalvular leakage after TAVI. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
47
|
Wendt D, Kahlert P, Neuhäuser M, Lenze T, Konorza T, Erbel R, Jakob H, Thielmann M. Aortic stenosis in high-risk patients presenting coronary artery disease: Conventional or transcatheter strategy? A propensity score analysis. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
48
|
Azhari P, Marggraf G, Pilarczyk K, Jakob H. Outcome and health-related quality of life after cardiothoracic surgery of patients with short-term and prolonged mechanical ventilation. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
49
|
Tsagakis K, Dohle DS, Piotrowski J, Benedik J, Wendt D, Thielmann M, Erbel R, Jakob H. Time saving modification of arch replacement in frozen elephant trunk procedure. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
50
|
Geiger EV, Laurer HL, Jakob H, Frank JM, Marzi I. [Treatment costs for anterior cruciate ligament reconstruction: procedure related cost analysis in an university hospital]. Unfallchirurg 2011; 116:517-23. [PMID: 22101778 DOI: 10.1007/s00113-011-2114-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Complex procedures in knee surgery, such as anterior cruciate ligament (ACL) reconstruction with the double bundle technique are not specially recognized within the German diagnosis-related groups (G-DRG) system. Hence, the goal of the present study was to perform a cost unit calculation and evaluate how ACL reconstruction in single versus double bundle techniques is remunerated. PATIENTS AND METHODS In 30 patients ACL reconstruction was performed with the single bundle technique (group A) and in 21 an anatomic double bundle reconstruction (group B) was performed. All costs including those for human resources, implants and materials, as well as general costs for administration and facilities were calculated. RESULTS All cases entered one DRG category, the I30Z "complex procedures at the knee joint". Thus, the revenue in 2008 was 2,996.65 euro per case and in 2009 3,120.35 euro per case. Calculating all costs, the profit contributions in 2008 and 2009 were 592,42 euro and 716,12 euro, respectively for group A. However, in group B the profit contributions were 314,68 euro and 438,38 euro, respectively. CONCLUSION Performing the double bundle technique for ACL reconstruction in a university hospital setting, significant cost reductions are needed to achieve the revenue generated by the single bundle technique. Additional changes of the relative weighting in the DRG are also necessary.
Collapse
|