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Osswald B, Thomas G, Tochtermann U, Gegouskov V, Badowski-Zyla D, Thielmann M, Massoudy P, Jakob H, Hagl S. Risk score – valuable tool for individual risk assessment? Thorac Cardiovasc Surg 2008. [DOI: 10.1055/s-2008-1037864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Loukanov T, Sebening C, Springer W, Khalil M, Ulmer H, Hagl S, Karck M, Gorenflo M. Replacement of valved right ventricular (RV) to pulmonary artery (PA) conduits – an observational study with focus on right ventricular geometry. Thorac Cardiovasc Surg 2008. [DOI: 10.1055/s-2008-1037723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Loukanov T, Sebening C, Hagl S, Karck M, Springer W, Gorenflo M. Pulmonary artery sling syndrom – reoperations for untreated tracheal stenosis. Thorac Cardiovasc Surg 2008. [DOI: 10.1055/s-2008-1037961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Osswald B, Gegouskov V, Badowski-Zyla D, Tochtermann U, Thomas G, Jakob H, Hagl S. Venous graft – always a worse choice? Thorac Cardiovasc Surg 2008. [DOI: 10.1055/s-2008-1037778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Loukanov T, Gorenflo M, Sebening C, Springer W, Eichhorn J, Ulmer H, Hagl S. Surgical Treatment of Long-Segment Tracheal Anomalies in Infants and Children. Thorac Cardiovasc Surg 2007; 55:375-9. [PMID: 17721847 DOI: 10.1055/s-2007-965381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Tracheal stenosis in combination with vascular and/or cardiac anomalies is a life-threatening condition in infants and children presenting with severe symptoms of airway obstruction. The optimal surgical treatment of these cases remains controversial. OBJECTIVES We present here a group of infants and children with combined tracheal malformations and vascular and/or cardiac anomalies. More than 30 % of the stenotic trachea was resected in a subgroup of the patients. A reconstruction with end-to-end anastomosis was achieved on the basis of extensive mobilization of the whole tracheobronchial tree and use of CPB. METHODS The clinical outcome in 37 children with a median age of 8 (1 - 72) months was analyzed retrospectively. The patients presented with severe airway obstruction in combination with congenital heart defects and/or vascular anomalies. Cardiac catheterization, bronchoscopy and thoracic computer tomography were performed prior to operation. The operations were performed under CPB and consisted of tracheal resection with end-to-end anastomosis or external stabilization. Associated intracardiac and vascular anomalies were repaired simultaneously. RESULTS All but 1 patient survived and had a straightforward recovery. The patients were extubated under bronchoscopic control with a median intubation time after airway repair of 12.2 days. The average follow-up was 8.4 years (1 - 14 years) and the surviving patients did not show signs of restenosis clinically. A segment longer than 30 % of the tracheal length was resected and reconstructed with end-to-end anastomosis in 57 % of the patients (12 of 21 patients). CONCLUSIONS Our experience demonstrates that resection of tracheal stenosis and end-to-end anastomosis can be achieved successfully even in cases with stenosis of more than 30 % of the total tracheal length. The use of CBP allowed extensive mobilization of the tracheobronchial tree and resection with end-to-end tension-free anastomotic reconstruction.
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Gegouskov V, Tochtermann U, Badowski-Zyla D, Thomas G, Hagl S, Osswald B. Long-Term Results after Coronary Artery Reconstructive Surgery. Thorac Cardiovasc Surg 2007; 55:293-7. [PMID: 17629858 DOI: 10.1055/s-2007-965061] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Diffuse coronary artery disease, multiple consecutive stenoses and complex lesions are a common finding in coronary surgery. Coronary reconstructive surgery in terms of extended anastomoses with or without thromboendarterectomy is still controversially discussed. The aim of this study was to evaluate the long-term results of patients who underwent coronary reconstruction. METHODS Between January 1995 and June 2004, 640 consecutive, unselected patients underwent isolated CABG with coronary reconstructive surgery of the LAD at a single institution. A cross-sectional long-term follow-up was performed with a completeness of 99.2 %. Questionnaires were sent to all patients with a response rate of 83.2 % (n = 533). RESULTS 147 of the 640 patients (22.9 %) died during up the follow-up period which was up to 10 years. Of the 371 patients who responded to the questionnaires, the status of 54 patients (15.9 %), predominantly those with a preoperative lower NYHA class, remained unchanged, while 294 patients (79.2 %) improved by at least one NYHA class. Repeat angiography was performed in 80 patients (15.7 %). Indications for percutaneous coronary intervention for the LAD arose in 4 cases (0.8 %); the interventions were performed in the proximal (n = 2) or distal (n = 1) LAD and one intervention affected the anastomotic area. Redo CABG was necessary in 3 patients (0.5 %). CONCLUSIONS Coronary reconstruction in patients with complex coronary morphology and advanced diffuse CAD is in an additionally investigated subgroup of patients associated with a satisfying graft patency and excellent long-term results in terms of survival, NYHA class and reintervention rate.
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Koch A, Schmidt CI, Dengler TJ, Remppis A, Sack FU, Schirmacher P, Hagl S, Karck M, Schnabel PA. Differentiated expression patterns of growth factors in routine formalin-fixed endomyocardial biopsies in the early postoperative phase after heart transplantation. Transplant Proc 2007; 39:554-7. [PMID: 17362780 DOI: 10.1016/j.transproceed.2006.12.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Platelet-derived growth factor (PDGF) and fibroblast growth factor (FGF) seem to play a key role in immunological reactions shortly after heart transplantation (HTx). The aim of this study was to analyze the time course of the expression of PDGF A and B, PDGF-receptor alpha (PDGF-Ralpha) and beta, aFGF, and bFGF on formalin-fixed routine endomyocardial biopsies. PATIENTS AND METHODS Right ventricular endomyocardial biopsies were obtained from 36 heart transplant recipients up to 2 weeks after HTx. According to the clinical course in the first postoperative year, 3 groups were formed: (1) clinically uneventful course (n = 12); (2) cardiac/systemic infections (n = 12); (3) acute rejection (n = 12). The growth factor expression was examined immunohistochemically. RESULTS In the early phase after HTx, PDGF A, PDGF B, PDGF-Ralpha, and PDGF-Rbeta were predominantly expressed in endothelial cells. The main expression of PDGF-Ralpha and bFGF was found in cardiomyocytes, endothelial cells, and smooth muscle cells. During the first 2 postoperative weeks, PDGF A, PDGF B, and PDGF-Rbeta showed a similar time course of expression: A significantly elevated expression in the first week was followed by a decrease in the second week. In the rejection group, PDGF A was significantly elevated after the first week. CONCLUSIONS The increased expression of PDGF in the first postoperative week can be interpreted as an unspecific reaction to peritransplant injury. The prolonged expression of PDGF A, PDGF B, and PDGF-Rbeta showed that there were ongoing immunological reactions in the transplant during week 2. The persistence of elevated PDGF A expression might be of prognostic value in terms of a risk factor for either infection or rejection.
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Szabó G, Heger U, Michel-Gröschel C, Szabó C, Hagl S, Bährle S. 141: Inhibition of poly (ADP-ribose) polymerase improves endothelial and myocardial function after brain death. J Heart Lung Transplant 2007. [DOI: 10.1016/j.healun.2006.11.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Tochtermann U, Keller S, Badowski-Zyla D, Gegouskov V, Thomas G, Hagl S, Osswald BR. Is CABG in acute myocardial infarction justified? Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Szabó G, Beller CJ, Seres L, Gorenflo M, Sonnenberg K, Hagl S. Tetrahydrobiopterin improves cardiac and pulmonary function after cardiopulmonary bypass. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Loganathan S, Radovits T, Wiratonseng I, Veres G, Hütter J, Hagl S, Szabó G. Effects of Vardenafil, a selective phosphodiesterase-5-inhibitor, on cardiovascular function in a rat model. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Szabó G, Heger U, Miesel-Gröschel C, Radovits T, Bährle S, Weigang E, Szabó C, Hagl S. Inhibition of poly (ADP-Ribose) polymerase improves endothelial and myocardial function after brain death. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Szabó G, Bulut C, Hagl S. Constrictive pericarditis: pre-operative risk adjusted survival after total pericardiectomy. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Szabó G, Veres G, Radovits T, Miesel-Gröschel C, Hagl S. Is cardiopulmonary bypass responsible for systemic infalammation and cardiovascular dysfunction after cardiac surgery? Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Szabó G, Radovits T, Koch A, Beller CJ, Veres G, Hagl S. FP15, a novel peroxynitrite decomposition catalyst reduces reperfusion injury in a rat heart transplantation model. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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De Simone R, Hoda R, Wolf I, Mottl-Link S, Mikhail B, Meinzer HP, Karck M, Hagl S. Study of different patterns of left ventricular remodeling in patients with functional mitral regurgitation and coronary artery disease. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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De Simone R, Hoda R, Mottl-Link S, Wolf I, Meinzer HP, Karck M, Hagl S. Comparison of three methods for quantitative assessment of left ventricular volume and ejection fraction by three-dimensional echocardiography and magnetic resonance imaging. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Denk K, Kayhan N, Peivandi AA, Hagl S, Vahl CF. Left Ventricular Force production in 3 vessel disease in patients with and without preceeding intracoronary stent procedures. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Osswald BR, Blackstone EH, Tochtermann U, Badowski-Zyla D, Gegouskov V, Hagl S. Neutralization of risk factors – a silent process of high impact. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kayhan N, Peivandi AA, Stumpf NA, Gaffga U, Hagl S, Vahl CF. Is the optimal temperature for weaning from extracorporeal circulation different in failing compared to normal human myocardium? Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hoda MR, Wolf I, Mottl-Link S, Seidel M, Meinzer HP, Hagl S, De Simone R. A new multimodal imaging technique for virtual planning of mitral valve repair. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Beller CJ, Radovits T, Kosse J, Becker A, Berger I, Hagl S, Szabó G. Different effects of statin treatment on endothelial dysfunction in the coronary and carotid arteries of hypercholesterolemic pigs. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kayhan N, Edler K, Albers J, Wahn B, Peivandi AA, Hagl S, Vahl CF. Frank Starling Mechanisms: Dangerous one-way road in failing human myocardium? Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Radovits T, Zotkina J, Lin LN, Gerő D, Veres G, Hagl S, Szabó C, Szabó G. Single dose treatment with PARP-inhibitor INO-1001 improves cardiovascular dysfunction associated with advanced aging. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hoda MR, Vetter HO, Hagl S, De Simone R. Kinetics of systemic stress hormone release during open heart surgery. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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