ABSTRACT
An artificial vessel replacement, which is athrombogenic and impermeable for a migration from the adjacent tissue, was implanted end to end into the thoracic aorta of 10 sheep. The center of this tube has a Dacron surface, which is known to trap blood elements. We examined the tissue samples built up by blood derived cells between 2 and 84 days morphologically by means of light microscopy as well as by SEM and TEM. We checked the thrombus fragments of 7 cases for their PGI2-generation using MONCADA's bioassay. In our specimens we found an average activity of 4, 7 pg PGI2 mg/min. The morphological examination revealed different stages of thrombosis and organization consisting of a large number of cells. Macrophages, fibroblast like cells, myofibroblasts as well as endothelial cells and foreign body giant cells around the Dacron fibers could be found. Our experimental design excludes the ingrowth of mesenchymal elements, which suggests that blood derived cells are able to produce PGI2.
Subject(s)
Blood Cells , Blood Coagulation , Epoprostenol/biosynthesis , Prostaglandins/biosynthesis , Aging , Animals , Aorta , Endothelium/ultrastructure , Female , Fibroblasts/ultrastructure , Histiocytes/ultrastructure , Phagocytes/ultrastructure , SheepABSTRACT
Extra-anatomical grafting (axillo-femoral and femoro-femoral bypass) seems to present a possibility of saving the lower limbs from amputation in high-risk patients with severe decompensation from arterial occlusive diseases of the legs. A case description is given of 20 patients, in whom 21 bypass procedures were carried out. The results with axillo-femoral bypass proved satisfactory and this method of intervention can be recommended as an emergency operation in high-risk patients.
Subject(s)
Arterial Occlusive Diseases/surgery , Axillary Artery/surgery , Femoral Artery/surgery , Aged , Blood Vessel Prosthesis , Collateral Circulation , Female , Humans , Male , Middle AgedABSTRACT
51 cases of pathological fracture, mostly due to metastatic malignant tumours, are reviewed in respect to the methods and results of operative treatment. These results are compared with those of other authors. It is found that resection of the tumour and osteosynthesis combined with the use of bone cement is the best way of treatment to relieve the patients of pain, mobilize them as soon as possible and improve the quality of their short, remaining lifespan. Despite the positive approach towards operative treatment there are some limiting findings which indicate that an operation should not be undertaken in those patients whose estimated survival time is less than the time of recovery and mobilization.
Subject(s)
Fracture Fixation, Internal/methods , Fractures, Spontaneous/therapy , Adult , Aged , Bone Neoplasms/secondary , Breast Neoplasms/complications , Carcinoma, Bronchogenic/complications , Female , Fractures, Spontaneous/etiology , Hip Fractures/therapy , Hip Prosthesis , Humans , Humeral Fractures/therapy , Male , Middle AgedABSTRACT
The experimental and clinical results are presented of the research programme "Artificial Heart" carried out by the 2nd Department of Surgery, University of Vienna. In particular, an assessment of the clinical experience in 177 patients with the intra-aortic balloon pump is documented and it is concluded that only limited cardiac support is possible by this pump. In view of this fact more efficient methods of mechanical circulatory support, such as the interaortic auxilliary ventricle, the aortic "Windkessel" ventricle with guiding balloon, and two types of ventriculo-aortic bypass ventricle were tested with regard to their haemodynamic and long-time efficacy. The transatrio-aortic auxilliary ventricle (E-LVAD) was also clinically tested in 11 patients. In conclusion the problems of total mechanical heart replacement are discussed.
Subject(s)
Heart, Artificial/instrumentation , Animals , Arrhythmias, Cardiac/therapy , Blood Pressure , Cardiac Surgical Procedures/instrumentation , Coronary Disease/therapy , Electrocardiography , Heart Failure/therapy , Hemodynamics , Humans , Intra-Aortic Balloon Pumping/instrumentation , Myocardial Infarction/therapy , Research , Stroke VolumeABSTRACT
22 cases of arterial occlusion below the branching of the popliteal artery and 1 case of traumatic subtotal amputation of the calf were revascularized by autogenous femoro-crural vein bypasses. All patients had pain at rest and/or gangrene. So far, with an average bypass patency of 15 months in two of three equal parts of the operated legs, the decision to try reconstruction instead to amputate has met with successful results. The operative technique is described in detail and the speical problems of this group of patients and the particular difficulties of this technically sophisticated bypass procedure are discussed.
