Author: "LACHAT, M." / Database: OAIster - Searchworks@Jio Institute Digital Library Search Results

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51 results on '"LACHAT, M."'

1. First joint oscillation analysis of Super-Kamiokande atmospheric and T2K accelerator neutrino data

Author: Super-Kamiokande, collaborations, T2K, Abe, S., Abe, K., Akhlaq, N., Akutsu, R., Alarakia-Charles, H., Ali, A., Hakim, Y. I. Alj, Monsalve, S. Alonso, Amanai, S., Andreopoulos, C., Anthony, L. H. V., Antonova, M., Aoki, S., Apte, K. A., Arai, T., Arihara, T., Arimoto, S., Asada, Y., Asaka, R., Ashida, Y., Atkin, E. T., Babu, N., Barbi, M., Barker, G. J., Barr, G., Barrow, D., Bates, P., Batkiewicz-Kwasniak, M., Beauchêne, A., Berardi, V., Berns, L., Bhadra, S., Bhuiyan, N., Bian, J., Blanchet, A., Blondel, A., Bodur, B., Bolognesi, S., Bordoni, S., Boyd, S. B., Bravar, A., Bronner, C., Bubak, A., Avanzini, M. Buizza, Burton, G. T., Caballero, J. A., Calabria, N. F., Cao, S., Carabadjac, D., Carter, A. J., Cartwright, S. L., Casado, M. P., Catanesi, M. G., Cervera, A., Chakrani, J., Chalumeau, A., Chen, S., Cherdack, D., Choi, K., Chong, P. S., Chvirova, A., Cicerchia, M., Coleman, J., Collazuol, G., Cook, L., Cormier, F., Cudd, A., Dalmazzone, C., Daret, T., Dasgupta, P., Davis, C., Davydov, Yu. I., De Roeck, A., De Rosa, G., Dealtry, T., Delogu, C. C., Densham, C., Dergacheva, A., Dharmapal, R., Di Lodovico, F., Lopez, G. Diaz, Dolan, S., Douqa, D., Doyle, T. A., Drapier, O., Duffy, K. E., Dumarchez, J., Dunne, P., Dygnarowicz, K., D'ago, D., Edwards, R., Eguchi, A., Elias, J., Emery-Schrenk, S., Erofeev, G., Ershova, A., Eurin, G., Fannon, J. E. P., Fedorova, D., Fedotov, S., Feltre, M., Feng, J., Feng, L., Ferlewicz, D., Fernandez, P., Finch, A. J., Aguirre, G. A. Fiorentini, Fiorillo, G., Fitton, M. D., Patiño, J. M. Franco, Friend, M., Fujii, Y., Fujisawa, C., Fujita, S., Fukuda, Y., Furui, Y., Gao, J., Gaur, R., Giampaolo, A., Giannessi, L., Giganti, C., Glagolev, V., Goldsack, A., Gonin, M., Rosa, J. González, Goodman, E. A. G., Gorin, A., Gorshanov, K., Gousy-Leblanc, V., Grassi, M., Griskevich, N. J., Guigue, M., Hadley, D., Haigh, J. T., Han, S., Harada, M., Harris, D. A., Hartz, M., Hasegawa, T., Hassani, S., Hastings, N. C., Hayato, Y., Heitkamp, I., Henaff, D., Hill, J., Hino, Y., Hiraide, K., Hogan, M., Holeczek, J., Holin, A., Holvey, T., Van, N. T. Hong, Honjo, T., Horiuchi, S., Hosokawa, K., Hu, Z., Hu, J., Iacob, F., Ichikawa, A. K., Ieki, K., Ikeda, M., Iovine, N., Ishida, T., Ishino, H., Ishitsuka, M., Ishizuka, T., Ito, H., Itow, Y., Izmaylov, A., Izumiyama, S., Jakkapu, M., Jamieson, B., Jang, M. C., Jang, J. S., Jenkins, S. J., Jesús-Valls, C., Ji, J. Y., Jia, M., Jiang, J., Jonsson, P., Joshi, S., Jung, C. K., Jung, S., Kabirnezhad, M., Kaboth, A. C., Kajita, T., Kakuno, H., Kameda, J., Kanemura, Y., Kaneshima, R., Karpova, S., Kasetti, S. P., Kashiwagi, Y., Kasturi, V. S., Kataoka, Y., Katori, T., Kawamura, Y., Kawaue, M., Kearns, E., Khabibullin, M., Khotjantsev, A., Kikawa, T., Kim, S. B., King, S., Kiseeva, V., Kisiel, J., Kneale, L., Kobayashi, H., Kobayashi, T., Kobayashi, M., Koch, L., Kodama, S., Kolupanova, M., Konaka, A., Kormos, L. L., Koshio, Y., Koto, T., Kowalik, K., Kudenko, Y., Kudo, Y., Kuribayashi, S., Kurjata, R., Kurochka, V., Kutter, T., Kuze, M., Kwon, E., La Commara, M., Labarga, L., Lachat, M., Lachner, K., Lagoda, J., Lakshmi, S. M., LamersJames, M., Langella, A., Laporte, J. -F., Last, D., Latham, N., Laveder, M., Lavitola, L., Lawe, M., Learned, J. G., Lee, Y., Lee, S. H., Silverio, D. Leon, Levorato, S., Lewis, S., Li, X., Li, W., Lin, C., Litchfield, R. P., Liu, S. L., Liu, Y. M., Long, K. R., Longhin, A., Moreno, A. Lopez, Lu, X., Ludovici, L., Lux, T., Machado, L. N., Maekawa, Y., Magaletti, L., Mahn, K., Mahtani, K. K., Malek, M., Mandal, M., Manly, S., Marino, A. D., Martens, K., Marti, Ll., Martin, D. G. R., Martin, J. F., Martin, D., Martini, M., Maruyama, T., Matsubara, T., Matsumoto, R., Mattiazzi, M., Matveev, V., Mauger, C., Mavrokoridis, K., Mazzucato, E., McCauley, N., McElwee, J. M., McFarland, K. S., McGrew, C., McKean, J., Mefodiev, A., Megias, G. D., Mehta, P., Mellet, L., Menjo, H., Metelko, C., Mezzetto, M., Migenda, J., Mijakowski, P., Miki, S., Miller, E., Minamino, A., Mine, S., Mineev, O., Mirabito, J., Miura, M., Bueno, L. Molina, Moon, D. H., Mori, M., Moriyama, S., Morrison, P., Muñoz, A., Mueller, Th. A., Munford, D., Munteanu, L., Nagai, Y., Nagai, K., Nakadaira, T., Nakagiri, K., Nakahata, M., Nakajima, Y., Nakamura, A., Nakamura, K., Nakamura, K. D., Nakamura, T., Nakanishi, F., Nakano, Y., Nakaya, T., Nakayama, S., Nakayoshi, K., Naseby, C. E. R., Ngoc, T. V., Nguyen, V. Q., Nguyen, D. T., Nicholson, M., Niewczas, K., Ninomiya, K., Nishijima, K., Nishimori, S., Nishimura, Y., Noguchi, Y., Nosek, T., Nova, F., Novella, P., Nugent, J. C., Odagawa, T., Okazaki, R., Okazawa, H., Okinaga, W., Okumura, K., Okusawa, T., Ommura, Y., Onda, N., Ospina, N., Osu, L., Oyama, Y., O'Flaherty, M., O'Keeffe, H. M., O'Sullivan, L., Périssé, L., Paganini, P., Palladino, V., Paolone, V., Pari, M., Park, R. G., Parlone, J., Pasternak, J., Payne, D., Penn, G. C., de Perio, P., Pershey, D., Pfaff, M., Pickering, L., Pintaudi, G., Pistillo, C., Pointon, B. W., Popov, B., Yrey, A. Portocarrero, Porwit, K., Posiadala-Zezula, M., Prabhu, Y. S., Prasad, H., Pronost, G., Prouse, N. W., Pupilli, F., Quilain, B., Quyen, P. T., Raaf, J. L., Radermacher, T., Radicioni, E., Radics, B., Ramirez, M. A., Ramsden, R. M., Ratoff, P. N., Reh, M., Riccio, C., Richards, B., Rogly, R., Rondio, E., Roth, S., Roy, N., Rubbia, A., Russo, L., Rychter, A., Saenz, W., Sakai, S., Sakashita, K., Samani, S., Santos, A. D., Sato, Y., Sato, K., Schefke, T., Schloesser, C. M., Scholberg, K., Scott, M., Seiya, Y., Sekiguchi, T., Sekiya, H., Seo, J. W., Sgalaberna, D., Shaikhiev, A., Shi, W., Shiba, H., Shibayama, R., Shigeta, N., Shima, S., Shimamura, R., Shimizu, K., Shinoki, M., Shiozawa, M., Shiraishi, Y., Shvartsman, A., Skrobova, N., Skwarczynski, K., Smy, M. B., Smyczek, D., Sobczyk, J. T., Sobel, H. W., Soler, F. J. P., Sonoda, Y., Speers, A. J., Spina, R., Stroke, Y., Suslov, I. A., Suvorov, S., Suzuki, S., Suzuki, A., Suzuki, S. Y., Suzuki, Y., Sánchez, F., Tada, T., Tada, M., Tairafune, S., Takagi, Y., Takeda, A., Takemoto, Y., Takeuchi, Y., Takhistov, V., Takifuji, K., Tanaka, H., Tanaka, H. K., Tanigawa, H., Taniuchi, N., Tano, T., Tarrant, A., Tashiro, T., Teklu, A., Terada, K., Tereshchenko, V. V., Thamm, N., Thiesse, M. D., Thompson, L. F., Toki, W., Tomiya, T., Touramanis, C., Tsui, K. M., Tsukamoto, T., Tzanov, M., Uchida, Y., Vagins, M. R., Vargas, D., Varghese, M., Vasseur, G., Villa, E., Vinning, W. G. S., Virginet, U., Vladisavljevic, T., Wachala, T., Wakabayashi, D., Wallace, H. T., Walsh, J. G., Walter, C. W., Wan, L., Wang, X., Wang, Y., Wark, D., Wascko, M. O., Watanabe, E., Weber, A., Wendell, R. A., Wester, T., Wilking, M. J., Wilkinson, C., Wilson, S. T., Wilson, J. R., Wood, K., Wret, C., Wu, Y., Xia, J., Xie, Z., Xu, B. D., Xu, Y. -H., Yamamoto, K., Yamamoto, T., Yamauchi, K., Yanagisawa, C., Yang, G., Yang, B. S., Yang, J. Y., Yankelevich, A., Yano, T., Yasutome, K., Yershov, N., Yevarouskaya, U., Yokoyama, M., Yoo, J., Yoshida, T., Yoshida, S., Yoshimoto, Y., Yoshimura, N., Yoshioka, Y., Yu, M., Yu, I., Zaki, R., Zaldivar, B., Zalewska, A., Zalipska, J., Zaremba, K., Zarnecki, G., Zhang, J., Zhang, A. Q., Zhang, B., Zhao, X. Y., Zhong, H., Zhu, T., Ziembicki, M., Zimmerman, E. D., Zito, M., Zsoldos, S., Super-Kamiokande, collaborations, T2K, Abe, S., Abe, K., Akhlaq, N., Akutsu, R., Alarakia-Charles, H., Ali, A., Hakim, Y. I. Alj, Monsalve, S. Alonso, Amanai, S., Andreopoulos, C., Anthony, L. H. V., Antonova, M., Aoki, S., Apte, K. A., Arai, T., Arihara, T., Arimoto, S., Asada, Y., Asaka, R., Ashida, Y., Atkin, E. T., Babu, N., Barbi, M., Barker, G. J., Barr, G., Barrow, D., Bates, P., Batkiewicz-Kwasniak, M., Beauchêne, A., Berardi, V., Berns, L., Bhadra, S., Bhuiyan, N., Bian, J., Blanchet, A., Blondel, A., Bodur, B., Bolognesi, S., Bordoni, S., Boyd, S. B., Bravar, A., Bronner, C., Bubak, A., Avanzini, M. Buizza, Burton, G. T., Caballero, J. A., Calabria, N. F., Cao, S., Carabadjac, D., Carter, A. J., Cartwright, S. L., Casado, M. P., Catanesi, M. G., Cervera, A., Chakrani, J., Chalumeau, A., Chen, S., Cherdack, D., Choi, K., Chong, P. S., Chvirova, A., Cicerchia, M., Coleman, J., Collazuol, G., Cook, L., Cormier, F., Cudd, A., Dalmazzone, C., Daret, T., Dasgupta, P., Davis, C., Davydov, Yu. I., De Roeck, A., De Rosa, G., Dealtry, T., Delogu, C. C., Densham, C., Dergacheva, A., Dharmapal, R., Di Lodovico, F., Lopez, G. Diaz, Dolan, S., Douqa, D., Doyle, T. A., Drapier, O., Duffy, K. E., Dumarchez, J., Dunne, P., Dygnarowicz, K., D'ago, D., Edwards, R., Eguchi, A., Elias, J., Emery-Schrenk, S., Erofeev, G., Ershova, A., Eurin, G., Fannon, J. E. P., Fedorova, D., Fedotov, S., Feltre, M., Feng, J., Feng, L., Ferlewicz, D., Fernandez, P., Finch, A. J., Aguirre, G. A. Fiorentini, Fiorillo, G., Fitton, M. D., Patiño, J. M. Franco, Friend, M., Fujii, Y., Fujisawa, C., Fujita, S., Fukuda, Y., Furui, Y., Gao, J., Gaur, R., Giampaolo, A., Giannessi, L., Giganti, C., Glagolev, V., Goldsack, A., Gonin, M., Rosa, J. González, Goodman, E. A. G., Gorin, A., Gorshanov, K., Gousy-Leblanc, V., Grassi, M., Griskevich, N. J., Guigue, M., Hadley, D., Haigh, J. T., Han, S., Harada, M., Harris, D. A., Hartz, M., Hasegawa, T., Hassani, S., Hastings, N. C., Hayato, Y., Heitkamp, I., Henaff, D., Hill, J., Hino, Y., Hiraide, K., Hogan, M., Holeczek, J., Holin, A., Holvey, T., Van, N. T. Hong, Honjo, T., Horiuchi, S., Hosokawa, K., Hu, Z., Hu, J., Iacob, F., Ichikawa, A. K., Ieki, K., Ikeda, M., Iovine, N., Ishida, T., Ishino, H., Ishitsuka, M., Ishizuka, T., Ito, H., Itow, Y., Izmaylov, A., Izumiyama, S., Jakkapu, M., Jamieson, B., Jang, M. C., Jang, J. S., Jenkins, S. J., Jesús-Valls, C., Ji, J. Y., Jia, M., Jiang, J., Jonsson, P., Joshi, S., Jung, C. K., Jung, S., Kabirnezhad, M., Kaboth, A. C., Kajita, T., Kakuno, H., Kameda, J., Kanemura, Y., Kaneshima, R., Karpova, S., Kasetti, S. P., Kashiwagi, Y., Kasturi, V. S., Kataoka, Y., Katori, T., Kawamura, Y., Kawaue, M., Kearns, E., Khabibullin, M., Khotjantsev, A., Kikawa, T., Kim, S. B., King, S., Kiseeva, V., Kisiel, J., Kneale, L., Kobayashi, H., Kobayashi, T., Kobayashi, M., Koch, L., Kodama, S., Kolupanova, M., Konaka, A., Kormos, L. L., Koshio, Y., Koto, T., Kowalik, K., Kudenko, Y., Kudo, Y., Kuribayashi, S., Kurjata, R., Kurochka, V., Kutter, T., Kuze, M., Kwon, E., La Commara, M., Labarga, L., Lachat, M., Lachner, K., Lagoda, J., Lakshmi, S. M., LamersJames, M., Langella, A., Laporte, J. -F., Last, D., Latham, N., Laveder, M., Lavitola, L., Lawe, M., Learned, J. G., Lee, Y., Lee, S. H., Silverio, D. Leon, Levorato, S., Lewis, S., Li, X., Li, W., Lin, C., Litchfield, R. P., Liu, S. L., Liu, Y. M., Long, K. R., Longhin, A., Moreno, A. Lopez, Lu, X., Ludovici, L., Lux, T., Machado, L. N., Maekawa, Y., Magaletti, L., Mahn, K., Mahtani, K. K., Malek, M., Mandal, M., Manly, S., Marino, A. D., Martens, K., Marti, Ll., Martin, D. G. R., Martin, J. F., Martin, D., Martini, M., Maruyama, T., Matsubara, T., Matsumoto, R., Mattiazzi, M., Matveev, V., Mauger, C., Mavrokoridis, K., Mazzucato, E., McCauley, N., McElwee, J. M., McFarland, K. S., McGrew, C., McKean, J., Mefodiev, A., Megias, G. D., Mehta, P., Mellet, L., Menjo, H., Metelko, C., Mezzetto, M., Migenda, J., Mijakowski, P., Miki, S., Miller, E., Minamino, A., Mine, S., Mineev, O., Mirabito, J., Miura, M., Bueno, L. Molina, Moon, D. H., Mori, M., Moriyama, S., Morrison, P., Muñoz, A., Mueller, Th. A., Munford, D., Munteanu, L., Nagai, Y., Nagai, K., Nakadaira, T., Nakagiri, K., Nakahata, M., Nakajima, Y., Nakamura, A., Nakamura, K., Nakamura, K. D., Nakamura, T., Nakanishi, F., Nakano, Y., Nakaya, T., Nakayama, S., Nakayoshi, K., Naseby, C. E. R., Ngoc, T. V., Nguyen, V. Q., Nguyen, D. T., Nicholson, M., Niewczas, K., Ninomiya, K., Nishijima, K., Nishimori, S., Nishimura, Y., Noguchi, Y., Nosek, T., Nova, F., Novella, P., Nugent, J. C., Odagawa, T., Okazaki, R., Okazawa, H., Okinaga, W., Okumura, K., Okusawa, T., Ommura, Y., Onda, N., Ospina, N., Osu, L., Oyama, Y., O'Flaherty, M., O'Keeffe, H. M., O'Sullivan, L., Périssé, L., Paganini, P., Palladino, V., Paolone, V., Pari, M., Park, R. G., Parlone, J., Pasternak, J., Payne, D., Penn, G. C., de Perio, P., Pershey, D., Pfaff, M., Pickering, L., Pintaudi, G., Pistillo, C., Pointon, B. W., Popov, B., Yrey, A. Portocarrero, Porwit, K., Posiadala-Zezula, M., Prabhu, Y. S., Prasad, H., Pronost, G., Prouse, N. W., Pupilli, F., Quilain, B., Quyen, P. T., Raaf, J. L., Radermacher, T., Radicioni, E., Radics, B., Ramirez, M. A., Ramsden, R. M., Ratoff, P. N., Reh, M., Riccio, C., Richards, B., Rogly, R., Rondio, E., Roth, S., Roy, N., Rubbia, A., Russo, L., Rychter, A., Saenz, W., Sakai, S., Sakashita, K., Samani, S., Santos, A. D., Sato, Y., Sato, K., Schefke, T., Schloesser, C. M., Scholberg, K., Scott, M., Seiya, Y., Sekiguchi, T., Sekiya, H., Seo, J. W., Sgalaberna, D., Shaikhiev, A., Shi, W., Shiba, H., Shibayama, R., Shigeta, N., Shima, S., Shimamura, R., Shimizu, K., Shinoki, M., Shiozawa, M., Shiraishi, Y., Shvartsman, A., Skrobova, N., Skwarczynski, K., Smy, M. B., Smyczek, D., Sobczyk, J. T., Sobel, H. W., Soler, F. J. P., Sonoda, Y., Speers, A. J., Spina, R., Stroke, Y., Suslov, I. A., Suvorov, S., Suzuki, S., Suzuki, A., Suzuki, S. Y., Suzuki, Y., Sánchez, F., Tada, T., Tada, M., Tairafune, S., Takagi, Y., Takeda, A., Takemoto, Y., Takeuchi, Y., Takhistov, V., Takifuji, K., Tanaka, H., Tanaka, H. K., Tanigawa, H., Taniuchi, N., Tano, T., Tarrant, A., Tashiro, T., Teklu, A., Terada, K., Tereshchenko, V. V., Thamm, N., Thiesse, M. D., Thompson, L. F., Toki, W., Tomiya, T., Touramanis, C., Tsui, K. M., Tsukamoto, T., Tzanov, M., Uchida, Y., Vagins, M. R., Vargas, D., Varghese, M., Vasseur, G., Villa, E., Vinning, W. G. S., Virginet, U., Vladisavljevic, T., Wachala, T., Wakabayashi, D., Wallace, H. T., Walsh, J. G., Walter, C. W., Wan, L., Wang, X., Wang, Y., Wark, D., Wascko, M. O., Watanabe, E., Weber, A., Wendell, R. A., Wester, T., Wilking, M. J., Wilkinson, C., Wilson, S. T., Wilson, J. R., Wood, K., Wret, C., Wu, Y., Xia, J., Xie, Z., Xu, B. D., Xu, Y. -H., Yamamoto, K., Yamamoto, T., Yamauchi, K., Yanagisawa, C., Yang, G., Yang, B. S., Yang, J. Y., Yankelevich, A., Yano, T., Yasutome, K., Yershov, N., Yevarouskaya, U., Yokoyama, M., Yoo, J., Yoshida, T., Yoshida, S., Yoshimoto, Y., Yoshimura, N., Yoshioka, Y., Yu, M., Yu, I., Zaki, R., Zaldivar, B., Zalewska, A., Zalipska, J., Zaremba, K., Zarnecki, G., Zhang, J., Zhang, A. Q., Zhang, B., Zhao, X. Y., Zhong, H., Zhu, T., Ziembicki, M., Zimmerman, E. D., Zito, M., and Zsoldos, S.
Abstract: The Super-Kamiokande and T2K collaborations present a joint measurement of neutrino oscillation parameters from their atmospheric and beam neutrino data. It uses a common interaction model for events overlapping in neutrino energy and correlated detector systematic uncertainties between the two datasets, which are found to be compatible. Using 3244.4 days of atmospheric data and a beam exposure of $19.7(16.3) \times 10^{20}$ protons on target in (anti)neutrino mode, the analysis finds a 1.9$\sigma$ exclusion of CP-conservation (defined as $J_{CP}=0$) and a preference for the normal mass ordering., Comment: 10 pages, 3 figures
Published: 2024

2. Akute Gefäßerkrankungen in der Gastroenterologie

Author: Grubhofer, F., Pecoraro, F., Gilhofer, T.S., Gubler, C., Lurje, G., Schneider, P.M., Lachat, M., Grubhofer, F., Pecoraro, F., Gilhofer, T.S., Gubler, C., Lurje, G., Schneider, P.M., and Lachat, M.
Abstract: Zusammenfassung: Vaskulär-gastroenterologische Notfälle zählen zu den häufigen Krankheitsbildern auf internistischen und chirurgischen Notfallstationen. Die klinischen Konsequenzen reichen von trivialen bis zu lebensbedrohlichen Situationen. Nur eine frühzeitige Erkennung der Symptomenkomplexe und die Anwendung der adäquaten diagnostischen Mittel führen zur korrekten Diagnosestellung mit nachfolgend - möglicherweise lebensrettender - Therapie. Um die hohen Mortalitätsraten der akuten Mesenterialischämien (50%), aortoenterischen Fisteln (30-40%), Aneurysmen viszeraler Arterien (10-100%) sowie des Budd-Chiari-Syndroms weiter senken zu können, gewinnen neue Strategien mit endovaskulärem Therapieansatz zunehmend an Bedeutung und ersetzen teilweise über viele Jahrzehnte etablierte Diagnose- und Therapiealgorithmen. Diese Übersichtsarbeit soll einen Überblick über aktuelle Diagnostik- und Therapiekonzepte häufiger vaskulär-gastroenterologischer Notfälle verschaffen
Published: 2018

3. Periskop-, Kamin- und Sandwichtechnik sowie VORTEC zur Vereinfachung der Behandlung von Aneurysmen der Aorta abdominalis und thoracoabdominalis

Author: Pecoraro, F., Rancic, Z., Pfammatter, T., Veith, F.J., Donas, K.P., Frauenfelder, T., Mayer, D., Lachat, M., Pecoraro, F., Rancic, Z., Pfammatter, T., Veith, F.J., Donas, K.P., Frauenfelder, T., Mayer, D., and Lachat, M.
Abstract: Zusammenfassung: VORTEC (Viabahn Open Revascularisation TEChnique) und die Kaminprothesentechnik sind Verfahren zur Erhaltung oder Wiederherstellung des Blutflusses von Aortenästen, die geplant oder als Notlösung bei offener Operation oder endovaskulärem Vorgehen eingesetzt werden können. VORTEC ist eine stentbasierte vaskuläre Verbindungstechnik zur Herstellung einer End-zu-End-Anastomose, die insbesondere geeignet ist, wenn die herkömmliche Nahttechnik schwierig ist (sein könnte). Es handelt sich um ein schnelles Verfahren, das praktisch ohne Blutflussunterbrechung und ohne Anastomosenblutung ist, die Durchgängigkeitsraten sind ähnlich gut wie bei Nahtanastomosen. Die Kamin-Periskop-Sandwich-Prothesentechnik ("chimney/periscope and sandwich graft technique”, CHIMPES) ist ein endovaskuläres Verfahren, bei dem parallele Endoprothesen zur Erhaltung oder Wiederherstellung des Blutflusses von Aortenästen verwendet werden, während ein herkömmlicher Aortenstent oberhalb ihres Ursprungs platziert wird. Es ist ein relativ schnelles Verfahren mit der Möglichkeit, selbst in Notfällen handelsübliche Produkte zu verwenden. Bei der Sandwichtechnik verlaufen parallele Prothesen zwischen 2Aortenstents. Publizierten Erfahrungen zufolge scheinen diese beiden Techniken besonders für die Behandlung von Aneurysmen der Aortenäste und der Aorta thoracoabdominalis geeignet zu sein, vor allem in Hochrisiko- oder Akutfällen. Die englische Volltextversion dieses Beitrags ist über SpringerLink (unter "Supplemental") verfügbar
Published: 2018

4. Simultane Behandlung von obliterativen Karotispathologien und koronarer Herzkrankheit: Aktuelles Konzept und Resultate der letzten 5Jahre

Author: Mayer, D., Lachat, M., Wilhelm, M., Künzli, A., Amann-Vesti, B., Baumgartner, R., Turina, M., Mayer, D., Lachat, M., Wilhelm, M., Künzli, A., Amann-Vesti, B., Baumgartner, R., and Turina, M.
Abstract: Zusammenfassung: Einführung: Die kombinierte Karotisendarteriektomie und aorto-coronare Baypassoperation (C-CABG) weisen ein hohes peri-operatives Risiko auf. Als Alternative wird in letzter Zeit das Stenting der Artera carotis interna propagiert. Das Fehlen von Level I Evidenz hat uns motiviert, die Resultate unserer C-CABG der letzten 5 Jahre zu evaluieren. Methoden und Patienten: Retrospektive Monozenterstudie von 113C-CABG, durchgeführt zwischen Januar 2000 und Dezember 2004. Das mediane Alter der Patienten betrug 65Jahre (22Patienten waren 80Jahre alt oder älter). Die Karotisendarteriektomie wurde vor der aortokoronaren Bypassoperation in derselben Narkose durchgeführt. Resultate: Die 30-Tages-Mortalität war ausschließlich kardial bedingt und betrug 4,4% (5/113). Die neurologischen Komplikationen waren ein Schlaganfall, der innerhalb von 30Tagen vollständig regredient war, und 3TIA (3,5%, 4/113). Schlussfolgerung: C-CABG mit initial durchgeführter Karotisendarteriektomie ist ein sicheres Verfahren mit niedriger neurologischer Komplikationsrate. Der riskante Anteil des kombinierten Eingriffs ist nicht die Karotisendarteriektomie, sondern die aortokoronare Revaskularisation. Demzufolge scheint das Stenting beim kombinierten Eingriff als Alternative nicht gerechtfertigt, solange keine klaren Vorteile hinsichtlich der Früh- und Langzeitresultate gegenüber der alleinigen Karotisendarteriektomie vorliegen
Published: 2018

5. Teicoplanin-Induced Complete AV-Block in a Heart Transplant Recipient

Author: Enseleit, F., Mueller, N., Duru, F., Lachat, M., Noll, G., Ruschitzka, F., Enseleit, F., Mueller, N., Duru, F., Lachat, M., Noll, G., and Ruschitzka, F.
Published: 2018

6. Minimal-invasiver Zugang für EVAR: Chirurgisch oder rein interventionell?

Author: Mayer, D., Rancic, Z., Wilhelm, M., Veith, F.J., Lachat, M., Mayer, D., Rancic, Z., Wilhelm, M., Veith, F.J., and Lachat, M.
Abstract: Zusammenfassung: Komplikationen kommen sowohl beim rein chirurgischen als auch rein interventionellen (perkutanen) Gefäßzugang nicht selten vor. Sie beinhalten eine nicht zu unterschätzende Morbidität und können sogar zum Tod führen. Wir beschreiben eine Technik, die die Vorteile der chirurgisch offenen mit den rein perkutanen Zugangsmethoden kombiniert: die minimale chirurgische Freilegung des Zugangsgefäßes, gefolgt von einer schnellen und sicheren Punktion mittels einer modifizierten, offenen Seldinger-Technik unter direkter taktiler und visueller Kontrolle. Diese einzigartige Kombination verschiedener Techniken erhöht die Sicherheit des Gefäßzugangs derart, dass lokale Komplikationen fast vollständig vermieden werden können. Ökonomische und sicherheitsrelevante Betrachtungen werden diskutiert, abgerundet durch einen ausgewogenen Überblick über die Vorteile der verschiedenen Techniken
Published: 2018

7. Reverse Chimney or Periscope: Some Issues have to be Addressed 'Re: Endovascular Aneurysm Repair Using a Reverse Chimney Technique in a Patient with Marfan Syndrome and Contained Ruptured Chronic Type B Dissection”

Author: Rančić, Z., Mayer, D., Veith, F., Lachat, M., Rančić, Z., Mayer, D., Veith, F., and Lachat, M.
Published: 2018

8. Editor's Choice - Management of Descending Thoracic Aorta Diseases : Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS).

Author: Writing Committee, Riambau, V, Böckler, D, Brunkwall, J, Cao, P, Chiesa, R, Coppi, G, Czerny, M, Fraedrich, G, Haulon, S, Jacobs, M J, Lachat, M L, Moll, F L, Setacci, C, Taylor, P R, Thompson, M, Trimarchi, S, Verhagen, H J, Verhoeven, E L, Esvs Guidelines Committee, Kolh, P, de Borst, G J, Chakfé, N, Debus, E S, Hinchliffe, R J, Kakkos, S, Koncar, I, Lindholt, J S, Vega de Ceniga, M, Vermassen, F, Verzini, F, Document Reviewers, Black, J H, Busund, R, Björck, Martin, Dake, M, Dick, F, Eggebrecht, H, Evangelista, A, Grabenwöger, M, Milner, R, Naylor, A R, Ricco, J-B, Rousseau, H, Schmidli, J, Writing Committee, Riambau, V, Böckler, D, Brunkwall, J, Cao, P, Chiesa, R, Coppi, G, Czerny, M, Fraedrich, G, Haulon, S, Jacobs, M J, Lachat, M L, Moll, F L, Setacci, C, Taylor, P R, Thompson, M, Trimarchi, S, Verhagen, H J, Verhoeven, E L, Esvs Guidelines Committee, Kolh, P, de Borst, G J, Chakfé, N, Debus, E S, Hinchliffe, R J, Kakkos, S, Koncar, I, Lindholt, J S, Vega de Ceniga, M, Vermassen, F, Verzini, F, Document Reviewers, Black, J H, Busund, R, Björck, Martin, Dake, M, Dick, F, Eggebrecht, H, Evangelista, A, Grabenwöger, M, Milner, R, Naylor, A R, Ricco, J-B, Rousseau, H, and Schmidli, J
Published: 2017
Full Text: View/download PDF

9. Editor's Choice – Management of Descending Thoracic Aorta Diseases : Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Author: Writing Committee, Committee, Riambau, V., Böckler, D., Brunkwall, J., Cao, P., Chiesa, R., Coppi, G., Czerny, M., Fraedrich, G., Haulon, S., Jacobs, M. J., Lachat, M. L., Moll, F. L., Setacci, C., Taylor, P. R., Thompson, M., Trimarchi, S., Verhagen, H. J., Verhoeven, E. L., ESVS Guidelines Committee, Guidelines Committee, Kolh, P., de Borst, G. J., Chakfé, N., Debus, E. S., Hinchliffe, R. J., Kakkos, S., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Vermassen, F., Verzini, F., Document Reviewers, Reviewers, Black, J. H., Busund, R., Björck, M., Dake, M., Dick, F., Eggebrecht, H., Evangelista, A., Grabenwöger, M., Milner, R., Naylor, A. R., Ricco, J. B., Rousseau, H., Schmidli, J., Writing Committee, Committee, Riambau, V., Böckler, D., Brunkwall, J., Cao, P., Chiesa, R., Coppi, G., Czerny, M., Fraedrich, G., Haulon, S., Jacobs, M. J., Lachat, M. L., Moll, F. L., Setacci, C., Taylor, P. R., Thompson, M., Trimarchi, S., Verhagen, H. J., Verhoeven, E. L., ESVS Guidelines Committee, Guidelines Committee, Kolh, P., de Borst, G. J., Chakfé, N., Debus, E. S., Hinchliffe, R. J., Kakkos, S., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Vermassen, F., Verzini, F., Document Reviewers, Reviewers, Black, J. H., Busund, R., Björck, M., Dake, M., Dick, F., Eggebrecht, H., Evangelista, A., Grabenwöger, M., Milner, R., Naylor, A. R., Ricco, J. B., Rousseau, H., and Schmidli, J.
Published: 2017

10. Editor's Choice – Management of Descending Thoracic Aorta Diseases : Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Author: Writing Committee, Committee, Riambau, V., Böckler, D., Brunkwall, J., Cao, P., Chiesa, R., Coppi, G., Czerny, M., Fraedrich, G., Haulon, S., Jacobs, M. J., Lachat, M. L., Moll, F. L., Setacci, C., Taylor, P. R., Thompson, M., Trimarchi, S., Verhagen, H. J., Verhoeven, E. L., ESVS Guidelines Committee, Guidelines Committee, Kolh, P., de Borst, G. J., Chakfé, N., Debus, E. S., Hinchliffe, R. J., Kakkos, S., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Vermassen, F., Verzini, F., Document Reviewers, Reviewers, Black, J. H., Busund, R., Björck, M., Dake, M., Dick, F., Eggebrecht, H., Evangelista, A., Grabenwöger, M., Milner, R., Naylor, A. R., Ricco, J. B., Rousseau, H., Schmidli, J., Writing Committee, Committee, Riambau, V., Böckler, D., Brunkwall, J., Cao, P., Chiesa, R., Coppi, G., Czerny, M., Fraedrich, G., Haulon, S., Jacobs, M. J., Lachat, M. L., Moll, F. L., Setacci, C., Taylor, P. R., Thompson, M., Trimarchi, S., Verhagen, H. J., Verhoeven, E. L., ESVS Guidelines Committee, Guidelines Committee, Kolh, P., de Borst, G. J., Chakfé, N., Debus, E. S., Hinchliffe, R. J., Kakkos, S., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Vermassen, F., Verzini, F., Document Reviewers, Reviewers, Black, J. H., Busund, R., Björck, M., Dake, M., Dick, F., Eggebrecht, H., Evangelista, A., Grabenwöger, M., Milner, R., Naylor, A. R., Ricco, J. B., Rousseau, H., and Schmidli, J.
Published: 2017

11. Editor's Choice – Management of Descending Thoracic Aorta Diseases : Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Author: Writing Committee, Committee, Riambau, V., Böckler, D., Brunkwall, J., Cao, P., Chiesa, R., Coppi, G., Czerny, M., Fraedrich, G., Haulon, S., Jacobs, M. J., Lachat, M. L., Moll, F. L., Setacci, C., Taylor, P. R., Thompson, M., Trimarchi, S., Verhagen, H. J., Verhoeven, E. L., ESVS Guidelines Committee, Guidelines Committee, Kolh, P., de Borst, G. J., Chakfé, N., Debus, E. S., Hinchliffe, R. J., Kakkos, S., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Vermassen, F., Verzini, F., Document Reviewers, Reviewers, Black, J. H., Busund, R., Björck, M., Dake, M., Dick, F., Eggebrecht, H., Evangelista, A., Grabenwöger, M., Milner, R., Naylor, A. R., Ricco, J. B., Rousseau, H., Schmidli, J., Writing Committee, Committee, Riambau, V., Böckler, D., Brunkwall, J., Cao, P., Chiesa, R., Coppi, G., Czerny, M., Fraedrich, G., Haulon, S., Jacobs, M. J., Lachat, M. L., Moll, F. L., Setacci, C., Taylor, P. R., Thompson, M., Trimarchi, S., Verhagen, H. J., Verhoeven, E. L., ESVS Guidelines Committee, Guidelines Committee, Kolh, P., de Borst, G. J., Chakfé, N., Debus, E. S., Hinchliffe, R. J., Kakkos, S., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Vermassen, F., Verzini, F., Document Reviewers, Reviewers, Black, J. H., Busund, R., Björck, M., Dake, M., Dick, F., Eggebrecht, H., Evangelista, A., Grabenwöger, M., Milner, R., Naylor, A. R., Ricco, J. B., Rousseau, H., and Schmidli, J.
Published: 2017

12. Editor's Choice – Management of Descending Thoracic Aorta Diseases: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Author: Zorgeenheid Vaatchirurgie Medisch, Circulatory Health, Writing Committee, Committee, Riambau, V., Böckler, D., Brunkwall, J., Cao, P., Chiesa, R., Coppi, G., Czerny, M., Fraedrich, G., Haulon, S., Jacobs, M. J., Lachat, M. L., Moll, F. L., Setacci, C., Taylor, P. R., Thompson, M., Trimarchi, S., Verhagen, H. J., Verhoeven, E. L., ESVS Guidelines Committee, Guidelines Committee, Kolh, P., de Borst, G. J., Chakfé, N., Debus, E. S., Hinchliffe, R. J., Kakkos, S., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Vermassen, F., Verzini, F., Document Reviewers, Reviewers, Black, J. H., Busund, R., Björck, M., Dake, M., Dick, F., Eggebrecht, H., Evangelista, A., Grabenwöger, M., Milner, R., Naylor, A. R., Ricco, J. B., Rousseau, H., Schmidli, J., Zorgeenheid Vaatchirurgie Medisch, Circulatory Health, Writing Committee, Committee, Riambau, V., Böckler, D., Brunkwall, J., Cao, P., Chiesa, R., Coppi, G., Czerny, M., Fraedrich, G., Haulon, S., Jacobs, M. J., Lachat, M. L., Moll, F. L., Setacci, C., Taylor, P. R., Thompson, M., Trimarchi, S., Verhagen, H. J., Verhoeven, E. L., ESVS Guidelines Committee, Guidelines Committee, Kolh, P., de Borst, G. J., Chakfé, N., Debus, E. S., Hinchliffe, R. J., Kakkos, S., Koncar, I., Lindholt, J. S., Vega de Ceniga, M., Vermassen, F., Verzini, F., Document Reviewers, Reviewers, Black, J. H., Busund, R., Björck, M., Dake, M., Dick, F., Eggebrecht, H., Evangelista, A., Grabenwöger, M., Milner, R., Naylor, A. R., Ricco, J. B., Rousseau, H., and Schmidli, J.
Published: 2017

13. Predictors of complications in acute type B aortic dissection

Author: Genoni, M., Paul, M., Tavakoli, R., Künzli, A., Lachat, M., Graves, K., Seifert, B., Turina, M., Genoni, M., Paul, M., Tavakoli, R., Künzli, A., Lachat, M., Graves, K., Seifert, B., and Turina, M.
Abstract: Objectives: Medical treatment is generally advocated for patients with acute type B aortic dissection without complications. The objective of this retrospective analysis was to determine whether there are any initial findings that can help predict the long-term course of the disease. Methods: Case records of the 130 patients treated for type B aortic dissection between 1988 and 1997 were reviewed; 41 (31%) were operated on in the acute phase (≪14 days), 31 (24%) were operated on in the chronic phase and 58 (45%) were treated medically. Results: Overall acute mortality was 10.8%; 22% for patients operated on in the early phase and 5.6% for medically treated patients. Age (P=0.002), persistent pain (P=0.01) and malperfusion (P=0.001) were significant independent predictors of the need for surgery. Paraplegia/para paresis (P=0.0001), leg ischaemia (P=0.003), pleural effusion (P=0.003), rupture (P=0.0001), shock (P=0.0001), age (P=0.003), cardiac failure (P=0.002) and aortic diameter ≫4.5cm (P=0.002) were significant predictors of poor survival. Age and shock also emerged as independent risk factors. Patients without malperfusion (P=0.0001), pleural effusion (P=0.003), rupture (P=0.0001) and shock (P=0.0001) had a significantly better event-free survival (freedom from repeat surgery and death). The actuarial survival rate for high-risk patients (malperfusion, rupture, shock) was 62% at 1 year and 40% at 5 years; the corresponding values for low-risk patients were 94 and 84%, respectively. Conclusions: Rupture, shock and malperfusion are significant predictors of poor survival in patients with acute type B aortic dissection
Published: 2017

14. Aortic stent-grafting: successful introduction into the combined procedure for coronary artery bypass grafting and aortic aneurysm repair

Author: Lachat, M., Witzke, H., Pfammatter, T., Bettex, D., Slankamenac, K., Wolfensberger, U., Turina, M., Lachat, M., Witzke, H., Pfammatter, T., Bettex, D., Slankamenac, K., Wolfensberger, U., and Turina, M.
Abstract: Objectives: Coronary artery bypass grafting (CABG) and combined stent-grafting (SG) were evaluated to reduce morbidity and mortality of patients with descending or infrarenal aortic aneurysm. Methods: CABG and SG (thoracic n=6, infrarenal n=36) were performed during the same hospitalization in 42 patients (mean age of 73±14 years). In 29 patients (mean Euroscore: 9), SG was performed under local anesthesia 9±3 days after coronary surgery (simultaneous) and in 13 patients (mean Euroscore: 7) during the same anesthesia (synchronous). In the latter group, 11 out of 13 patients underwent off-pump CABG. All aneurysms were treated by implantation of commercially available self-expanding grafts. Results: CABG was successful in all, but one patient with left internal mammary artery hypoperfusion syndrome, requiring an additional distal saphenous graft to the left anterior descending coronary artery. SG was uneventful in 98% (41/42 patients). Postoperative computerized tomography showed incomplete sealing in seven patients (17%), but only the two attachment endoleaks had to be treated by one proximal and one distal SG extension. Overall hospital stay for the synchronous repair was 12.5±6 days and that of the simultaneous group 17.5±7 days. Thirty-day mortality was 5% (2/42) as one patient of the simultaneous group experienced a lethal cerebral embolism during SG and one patient of the synchronous group developed an untreatable infection. In the follow-up of 4 years, there were two vascular reinterventions but no additional procedure-related morbidity or mortality. Conclusions: This experience shows that combined CABG and SG of thoracic or infrarenal aortic aneurysm is a safe and less-invasive alternative to the open graft repair, especially in the older patients or patients with severe comorbidities
Published: 2017

15. Acute traumatic aortic rupture: early stent-graft repair

Author: Lachat, M., Pfammatter, T., Witzke, H., Bernard, E., Wolfensberger, U., Künzli, A., Turina, M., Lachat, M., Pfammatter, T., Witzke, H., Bernard, E., Wolfensberger, U., Künzli, A., and Turina, M.
Abstract: Objective: Prospective evaluation of early stent-graft repair of acute traumatic aortic rupture. Methods: Twelve patients with acute traumatic aortic rupture of the descending aorta, out of a series of 337 endovascular aortic procedures, were treated by implantation of self-expanding stent-grafts. The procedures were performed within a mean post-injury time-period of 5±7 days (median: 1 day). The feasibility of stent-grafting was assessed by CT scanning and echography. Implantation was performed under local (n=6), or general anesthesia (n=6) if patients were already intubated (n=5) or required a common iliac artery access (n=1). Results: The immediate technical success rate was 100%. There were no post-procedure complications in all but one patient, who died 12 h postoperatively (8% mortality). Complete sealing of the aortic rupture in the remaining 11 patients was confirmed by postoperative CT scans. There were no intervention-related morbidity or mortality during the mean follow-up of 17 months. One patient with peri-graft leakage was successfully repaired with an additional stent-graft 12 months postoperatively. Conclusion: Non-delayed or early stent-grafting in acute traumatic rupture of the descending aorta is feasible. This technique seems to be a valuable option, in particular when associated lesions may interfere with the surgical outcome. Immediate post-procedural CT scanning and/or echography should be performed, in order to rule out residual leakage
Published: 2017

16. Electrical and mechanical support in advanced heart failure. Rationale and feasibility of a combined management strategy

Author: Duru, F., Candinas, R., Lachat, M., Rahn, M., Noll, G., Lüscher, T.F., Turina, M., Duru, F., Candinas, R., Lachat, M., Rahn, M., Noll, G., Lüscher, T.F., and Turina, M.
Published: 2017

17. Advanced training model for beating heart coronary artery surgery: the Zurich heart-trainer

Author: Reuthebuch, O., Lang, A., Groscurth, P., Lachat, M., Turina, M., Zünd, G., Reuthebuch, O., Lang, A., Groscurth, P., Lachat, M., Turina, M., and Zünd, G.
Abstract: Objective: Coronary artery surgery with beating heart technique is gaining increasing popularity. However, it is a challenging technique even for well-trained cardiac surgeons. Thus, a training model for beating heart surgery was developed to increase safety and accuracy of this procedure. Methods: The model consists of differentially hardened polyurethane resembling mechanical properties of the human heart. The covering used in this model is a 1:1 replica of the human thoracic wall with optionally embedded skeletal structures. Sternotomy, lateral thoracotomy or trocar placement is possible to access the lungs, the pericardium and the heart with adjacent vessels. Disposable artificial coronaries variable in size, wall quality or wall thickness are embedded in the synthetic myocardium. Two-layer vessels, which can simulate dissection, are available. Bypass conduits utilize the same material. Coronaries/bypasses as well as part of the ascending aorta are water-tight and can be rinsed with saline. Lungs can be inflated. A purpose-built pump induces heart movement with adjustable or randomized stroke volume, heart rate and arrhythmia induction. Results: The model was tested in a recent ‘Wet-Lab' course attended by 30 surgeons. All conventional instruments and stabilizers with standard techniques can be used. Training with beating or non-beating heart was possible. Time needed for an anastomosis was similar to clinical experience. Each artificial tissue showed its individual nature-like qualities. Various degrees of difficulty can be selected, according to stroke volume, heart rate, arrhythmia, vessel size and vessel quality. The model can be quickly and easily set up and is fully reusable. Conclusions: The similarity to human tissue and the easy set-up make this completely artificial model an ideal teaching tool to increase the confidence of cardiac surgeons dealing with beating heart and minimally invasive surgery
Published: 2017

18. Left ventricular assist device as bridge to heart transplantation - lessons learned with the MicroMed DeBakey axial blood flow pump

Author: Salzberg, S., Lachat, M., Zünd, G., Oechslin, E., Schmid, E.R., DeBakey, M., Turina, M., Salzberg, S., Lachat, M., Zünd, G., Oechslin, E., Schmid, E.R., DeBakey, M., and Turina, M.
Abstract: Objective: The MicroMed DeBakey left ventricular assist device (LVAD) axial blood flow pump was used as bridge to heart transplantation (HTx) in patients with terminal heart failure. The aim was to evaluate this novel mechanical circulatory support system in regard to overall outcome. Methods: Prospective study in 15 HTx candidates (mean age 40±7 years) with terminal heart failure and maximal medical treatment due to ischemic cardiomyopathy (CMP, n=5), dilated CMP (n=3), restrictive CMP (n=2), unclassified CMP (n=1), metabolic CMP (n=1), valvular CMP (n=1) and congenital CMP (n=2). All patients were implanted with a MicroMed DeBakey LVAD. A rescue procedure was necessary in eight critical patients, while seven underwent elective LVAD implantation. Procedures were performed via median sternotomy, in normotherm femoro-femoral CPB (mean duration 59±1 min). Oral Marcoumar© (INR 2.0-3.0) and Aspirin© (100 mg daily) were started as soon as possible. Patients were discharged into a specialized rehabilitation clinic from which it was possible to release them home after a few weeks. Results: Successful implantation and discharge from ICU (mean stay 10±7 days) was possible in 11 patients. Seven were transplanted (mean support 50.7 days) and one is awaiting HTx (support >310 days) in the comfort of his home (NYHA I). Survival was 100% among the transplanted patients. Of the seven elective implants, five, and of the eight rescue procedures three patients underwent successful HTx. Four patients died early, while three patients died late on pump support due to intracranial hemorrhage (n=2, 73 and 76 days) and chest infection (n=1, 124 days). All survivors were discharged from hospital, with significant decrease in NYHA class (mean 3.8-2.4 (n=11)). Treadmill testing showed increased exercise tolerance, from 35 to 71 W (n=4). Plasma BNP values (mean 950-162 ng/l (n=4)) and pulmonary resistance (mean 316-194.5 dyne s/cm5 (n=3)) decreased significantly during LVAD support. Conclusion
Published: 2017

19. Preoperative predictors of recurrent atrial fibrillation late after successful mitral valve reconstruction

Author: Vogt, P.R., Brunner-LaRocca, H.P., Rist, M., Zünd, G., Genoni, M., Lachat, M., Niederhäuser, U., Turina, M.I., Vogt, P.R., Brunner-LaRocca, H.P., Rist, M., Zünd, G., Genoni, M., Lachat, M., Niederhäuser, U., and Turina, M.I.
Abstract: Objective: Late outcome after mitral valve repair was examined to define preoperative predictors of recurrent atrial fibrillation late after successful mitral valve reconstruction. Methods: One hundred and eighty-nine patients, 112 with preoperative sinus rhythm and 72 with preoperative chronic or intermittent atrial fibrillation, were followed for 12.2±10 years after valve repair. Clinic, hemodynamic end echocardiographic data were entered into Cox-regression and Kaplan-Meyer analysis to assess predictors for recurrent atrial fibrillation late after successful mitral valve repair. Results: Univariate and multivariate predictors for recurrent atrial fibrillation late after successful mitral valve reconstruction were preoperative atrial fibrillation (P=0.0001), preoperative antiarrhythmic drug treatment (P=0.005), heart rate (P=0.01), left ventricular ejection fraction (P=0.01) and increased left ventricular posterior wall thickness (P=0.05). Patients>57.5 years with a mean pulmonary artery pressure ≥23mm Hg and a history of preoperative antiarrhythmic drug treatment had an odds ratio of 53.33 (95% confidence limits 6.12-464.54) for atrial fibrillation late after successful mitral valve repair. Conclusion: Older patients with a history of atrial fibrillation, antiarrhythmic treatment or an elevated pulmonary artery pressure may present atrial fibrillation late after successful mitral valve repair. They could be considered for combined mitral valve reconstruction and surgery for atrial fibrillation even though sinus rhythm is present preoperatively
Published: 2017

20. Editor's choice - management of descending thoracic aorta diseases clinical practice guidelines of the European Society for Vascular Surgery (ESVS)

Author: Writing Committee, Riambau, V, Böckler, D, Brunkwall, J, Cao, P, Chiesa, R, Coppi, G, Czerny, M, Fraedrich, G, Haulon, S, Jacobs, M J, Lachat, M L, Moll, F L, Setacci, C, Taylor, P R, Thompson, M, Trimarchi, S, Verhagen, H J, Verhoeven, E L, Esvs Guidelines Committee, Kolh, P, de Borst, G J, Chakfé, N, Debus, E S, Hinchliffe, R J, Kakkos, S, Koncar, I, Lindholt, J S, Vega de Ceniga, M, Vermassen, F, et al, Writing Committee, Riambau, V, Böckler, D, Brunkwall, J, Cao, P, Chiesa, R, Coppi, G, Czerny, M, Fraedrich, G, Haulon, S, Jacobs, M J, Lachat, M L, Moll, F L, Setacci, C, Taylor, P R, Thompson, M, Trimarchi, S, Verhagen, H J, Verhoeven, E L, Esvs Guidelines Committee, Kolh, P, de Borst, G J, Chakfé, N, Debus, E S, Hinchliffe, R J, Kakkos, S, Koncar, I, Lindholt, J S, Vega de Ceniga, M, Vermassen, F, and et al
Published: 2017

21. Editor's Choice - Durability of Endovascular Repair in Blunt Traumatic Thoracic Aortic Injury : Long-Term Outcome from Four Tertiary Referral Centers

Author: Steuer, Johnny, Björck, Martin, Sonesson, B., Resch, T., Dias, N., Hultgren, R., Tunesi, R., Wanhainen, Anders, Lachat, M., Pfammatter, T., Steuer, Johnny, Björck, Martin, Sonesson, B., Resch, T., Dias, N., Hultgren, R., Tunesi, R., Wanhainen, Anders, Lachat, M., and Pfammatter, T.
Abstract: Objectives: To analyze the early and long-term survival and re-intervention rate in patients undergoing TEVAR for blunt traumatic thoracic aortic injury. Methods: This was a consecutive case series. Between the years 2001 and 2010, a total of 74 patients underwent TEVAR for blunt traumatic thoracic aortic injury at four tertiary referral centers, three in Sweden and one in Switzerland. The median age of the patients was 41 years, and 16% were women. Demographic, procedural, and outcome data were collected and reviewed retrospectively. The patients were followed up during 2013-2014. Results: Early (30 day) mortality was 9% (7 patients), with only two cases directly related to the aortic injury; in hospital mortality was 14% as three patients died during the primary hospital admission within the first 6 months. Most patients had sustained severe injuries to other organ systems, and among all in hospital deaths brain injury was the predominant cause. Five year survival in the whole group was 81%. Re-intervention was needed in 16% (12 patients) during the first year, half of them within the first month. Only one patient underwent re-intervention more than 1 year after the initial procedure. Infolding and partial stentgraft collapse was the reason for the secondary procedure in five of the 13 patients; in three it occurred within 3 weeks of the acute TEVAR. Conclusion: TEVAR allows rapid and effective therapy in trauma patients with blunt aortic injury. The outcome is dependent on the severity of the concomitant injuries. The treatment is durable during the first decade after the procedure, but even longer follow up is needed to determine the impact of TEVAR in young patients on the degenerative changes that take place in the aging aorta.
Published: 2015
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22. A 12-year experience with chimney and periscope grafts for treatment of type i endoleaks

Author: Montelione, Nunzio, Pecoraro, Felice, Puippe, Gilbert, Chaykovska, Lyubov, Rancic, Zoran, Pfammatter, Thomas, Mayer, Dieter, Amann-Vesti, Beatrice, Husmann, Marc J, Veith, Frank J, Mangialardi, Nicola, Lachat, M, Montelione, Nunzio, Pecoraro, Felice, Puippe, Gilbert, Chaykovska, Lyubov, Rancic, Zoran, Pfammatter, Thomas, Mayer, Dieter, Amann-Vesti, Beatrice, Husmann, Marc J, Veith, Frank J, Mangialardi, Nicola, and Lachat, M
Abstract: PURPOSE: To evaluate the midterm outcomes of chimney and/or periscope grafts (CPGs) in patients presenting type I endoleak after a previous endovascular aneurysm repair (EVAR). METHODS: Between June 2002 and April 2014, 24 consecutive patients (mean age 73.9±9.2 years; 23 men) presenting a type I endoleak were addressed with CPGs to extend the proximal and/or distal landing zone and to maintain side branch perfusion. Indication for treatment was a type Ia endoleak in 23 (96%) patients and a type Ib endoleak in one. Median interval from the previous EVAR to endoleak treatment with CPGs was 52.2±48.9 months (range 0.2-179). All patients had proximal/distal landing zones precluding any standard endovascular reintervention. Measured outcomes included technical success and perioperative mortality and morbidity. Technical success was defined as a procedure completed as intended, with no secondary procedures within 30 days. Midterm outcomes included survival, CPG patency, endoleaks, and freedom from reintervention. RESULTS: Technical success was 96%; a single patient required an additional procedure to seal a recurrent type Ia endoleak. Intraoperative revascularization of all 55 target vessels (2.3/patient) with CPGs was successful. One (4%) patient died within 30 days. Estimated survival at 12, 24, and 36 months was 83%; estimated CPG patency at the same intervals was 94%. Over a mean follow-up of 23.4±29 months, 6 (25%) reinterventions were performed; of these, 4 were secondary to type I endoleak. Aneurysm diameters reduced from 88.3±26 to 85.5±33 mm (p=0.49) over the mean follow-up. CONCLUSION: The CPG technique is a safe and effective tool for treatment of type I endoleak after previous EVAR. The CPG technique is feasible even in nonelective patients, with excellent outcomes in terms of patency. Close imaging follow-up is warranted to rule out recurrent or de novo endoleaks.
Published: 2015

23. Distinction between Acute and Chronic Type B Aortic Dissection : Is there a Sub-acute Phase?

Author: Steuer, Johnny, Björck, Martin, Mayer, D, Wanhainen, Anders, Pfammatter, T, Lachat, M, Steuer, Johnny, Björck, Martin, Mayer, D, Wanhainen, Anders, Pfammatter, T, and Lachat, M
Abstract: OBJECTIVES: This study aims to assess the relevance of the definition of acute dissection, to analyse whether there is a sub-acute phase and to determine early outcome of thoracic endovascular aortic repair (TEVAR) in acute complicated type B aortic dissection. DESIGN: Dual-centre consecutive case series. MATERIALS: Between 1999 and 2011, 102 patients underwent TEVAR for non-traumatic acute complicated type B dissection in Zurich, Switzerland, and Uppsala, Sweden. In addition, 22 patients treated for an acute dissection-related complication occurring >14 days after onset of symptoms were included. Median age was 68 years, 35% were women. METHODS: Demographic, procedural and outcome data were collected prospectively. The patients were followed up on 1 January 2012. RESULTS: In the 22 sub-acute patients (18%), there were no early deaths or neurological complications. The predominant complication in these patients was rapid aortic enlargement, whereas rupture was more prevalent in patients treated within 14 days. In total, there were nine (7%) early deaths, three (2%) post-intervention paraplegias and six cases of stroke (5%). CONCLUSIONS: TEVAR was performed with low early mortality and few neurological complications. A significant proportion of patients presented with acute complications >14 days after onset of symptoms, indicative of a sub-acute phase in the transition between acute and chronic dissection, questioning the relevance of the current definition.
Published: 2013
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24. Periskop-, Kamin- und Sandwichtechnik sowie VORTEC zur Vereinfachung der Behandlung von Aneurysmen der Aorta abdominalis und thoracoabdominalis

Author: Pecoraro, F, Rancic, Z, Pfammatter, T, Veith, F J, Donas, K P, Frauenfelder, T, Mayer, D, Lachat, M, Pecoraro, F, Rancic, Z, Pfammatter, T, Veith, F J, Donas, K P, Frauenfelder, T, Mayer, D, and Lachat, M
Abstract: VORTEC (Viabahn Open Revascularisation TEChnique) und die Kaminprothesentechnik sind Verfahren zur Erhaltung oder Wiederherstellung des Blutflusses von Aortenästen, die geplant oder als Notlösung bei offener Operation oder endovaskulärem Vorgehen eingesetzt werden können. VORTEC ist eine stentbasierte vaskuläre Verbindungstechnik zur Herstellung einer End-zu-End-Anastomose, die insbesondere geeignet ist, wenn die herkömmliche Nahttechnik schwierig ist (sein könnte). Es handelt sich um ein schnelles Verfahren, das praktisch ohne Blutflussunterbrechung und ohne Anastomosenblutung ist, die Durchgängigkeitsraten sind ähnlich gut wie bei Nahtanastomosen. Die Kamin-Periskop-Sandwich-Prothesentechnik ("chimney/periscope and sandwich graft technique”, CHIMPES) ist ein endovaskuläres Verfahren, bei dem parallele Endoprothesen zur Erhaltung oder Wiederherstellung des Blutflusses von Aortenästen verwendet werden, während ein herkömmlicher Aortenstent oberhalb ihres Ursprungs platziert wird. Es ist ein relativ schnelles Verfahren mit der Möglichkeit, selbst in Notfällen handelsübliche Produkte zu verwenden. Bei der Sandwichtechnik verlaufen parallele Prothesen zwischen 2Aortenstents. Publizierten Erfahrungen zufolge scheinen diese beiden Techniken besonders für die Behandlung von Aneurysmen der Aortenäste und der Aorta thoracoabdominalis geeignet zu sein, vor allem in Hochrisiko- oder Akutfällen. Die englische Volltextversion dieses Beitrags ist über SpringerLink (unter "Supplemental") verfügbar
Published: 2012

25. Complete replacement of open repair for ruptured abdominal aortic aneurysms by endovascular aneurysm repair : a two-center 14-year experience

Author: Mayer, D., Aeschbacher, S., Pfammatter, T., Veith, F. J., Norgren, Lars, Magnuson, A., Rancic, Z., Lachat, M., Larzon, Thomas, Mayer, D., Aeschbacher, S., Pfammatter, T., Veith, F. J., Norgren, Lars, Magnuson, A., Rancic, Z., Lachat, M., and Larzon, Thomas
Abstract: Objective: To present the combined 14-year experience of 2 university centers performing endovascular aneurysm repair (EVAR) on 100% of noninfected ruptured abdominal aortic aneurysms (RAAA) over the last 32 months. Background: : Endovascular aneurysm repair for RAAA feasibility is reported to be 20% to 50%, and EVAR for RAAA has been reported to have better outcomes than open repair. Methods: We retrospectively analyzed prospectively gathered data on 473 consecutive RAAA patients (Zurich, 295; Örebro, 178) from January 1, 1998, to December 31, 2011, treated by an "EVAR-whenever-possible" approach until April 2009 (EVAR/OPEN period) and thereafter according to a "100% EVAR" approach (EVAR-ONLY period).Straightforward cases were treated by standard EVAR. More complex RAAA were managed during EVAR-ONLY with adjunctive procedures in 17 of 70 patients (24%): chimney, 3; open iliac debranching, 1; coiling, 8; onyx, 3; and chimney plus onyx, 2. Results: Since May 2009, all RAAA but one have been treated by EVAR (Zurich, 31; Örebro, 39); 30-day mortality for EVAR-ONLY was 24% (17 of 70). Total cohort mortality (including medically treated patients) for EVAR/OPEN was 32.8% (131 of 400) compared with 27.4% (20 of 73) for EVAR-ONLY (P = 0.376). During EVAR/OPEN, 10% (39 of 400) of patients were treated medically compared with 4% (3 of 73) of patients during EVAR-ONLY. In EVAR/OPEN, open repair showed a statistically significant association with 30-day mortality (adjusted odds ratio [OR] = 3.3; 95% confidence interval [CI], 1.4-7.5; P = 0.004). For patients with no abdominal decompression, there was a higher mortality with open repair than EVAR (adjusted OR = 5.6; 95% CI, 1.9-16.7). In patients with abdominal decompression by laparotomy, there was no difference in mortality (adjusted OR = 1.1; 95% CI, 0.3-3.7). Conclusions: The "EVAR-ONLY" approach has allowed EVAR treatment of nearly all incoming RAAA with low mortality and turndown rates. Although the observed association of
Published: 2012
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26. Collected world and single center experience with endovascular treatment of ruptured abdominal aortic aneurysms.

Author: Veith, F.J., Lachat, M., Mayer, D., Malina, M., Holst, J., Mehta, M., Verhoeven, E.L., Larzon, T., Gennai, S., Coppi, G., Lipsitz, E.C., Gargiulo, N.J., Vliet, J.A. van der, Blankensteijn, J.D., Buth, J., Lee, W.A., Biasiol, G., Deleo, G., Kasirajan, K., Moore, R., Soong, C.V., Cayne, N.S., Farber, M.A., Raithel, D., Greenberg, R.K., Sambeek, M.R. van, Brunkwall, J.S., Rockman, C.B., Hinchliffe, R.J., Veith, F.J., Lachat, M., Mayer, D., Malina, M., Holst, J., Mehta, M., Verhoeven, E.L., Larzon, T., Gennai, S., Coppi, G., Lipsitz, E.C., Gargiulo, N.J., Vliet, J.A. van der, Blankensteijn, J.D., Buth, J., Lee, W.A., Biasiol, G., Deleo, G., Kasirajan, K., Moore, R., Soong, C.V., Cayne, N.S., Farber, M.A., Raithel, D., Greenberg, R.K., Sambeek, M.R. van, Brunkwall, J.S., Rockman, C.B., and Hinchliffe, R.J.
Abstract: Contains fulltext : 81133.pdf (publisher's version ) (Closed access), BACKGROUND: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. OBJECTIVE: To clarify these we examined a collected experience with use of EVAR for RAAA treatment from 49 centers. METHODS: Data were obtained by questionnaires from these centers, updated from 13 centers committed to EVAR treatment whenever possible and included treatment details from a single center and information on 1037 patients treated by EVAR and 763 patients treated by open repair (OR). RESULTS: Overall 30-day mortality after EVAR in 1037 patients was 21.2%. Centers performing EVAR for RAAAs whenever possible did so in 28% to 79% (mean 49.1%) of their patients, had a 30-day mortality of 19.7% (range: 0%-32%) for 680 EVAR patients and 36.3% (range: 8%-53%) for 763 OR patients (P < 0.0001). Supraceliac aortic balloon control was obtained in 19.1% +/- 12.0% (+/-SD) of 680 EVAR patients. Abdominal compartment syndrome was treated by some form of decompression in 12.2% +/- 8.3% (+/-SD) of these EVAR patients. CONCLUSION: These results indicate that EVAR has a lower procedural mortality at 30 days than OR in at least some patients and that EVAR is better than OR for treating RAAA patients provided they have favorable anatomy; adequate skills, facilities, and protocols are available; and optimal strategies, techniques, and adjuncts are employed.
Published: 2009

27. The heart of patients with aortic aneurysms: evidence from cardiac computed tomography.

Author: Stolzmann, P., Phan, C., Desbiolles, L., Lachat, M., Pfammatter, T., Marincek, B., Prokop, M., Alkadhi, H., Stolzmann, P., Phan, C., Desbiolles, L., Lachat, M., Pfammatter, T., Marincek, B., Prokop, M., and Alkadhi, H.
Abstract: Contains fulltext : 81282.pdf (publisher's version ) (Open Access), To determine in patients with abdominal aortic aneurysm (AAA) the coronary calcium burden and prevalence of coronary artery disease (CAD) in relation to cardiovascular risk factors, and to assess the left ventricular (LV) function using cardiac computed tomography (CT). Sixty consecutive patients (six females; 72.2+/-9.0 years) with AAA underwent dual-source CT calcium scoring and coronary angiography prior to AAA repair. In the 60 patients, the Framingham risk score (FRS) ranged from 5-43%. Twenty patients (33%) were at low, 16 (27%) at intermediate, and 24 (40%) at high risk for cardiovascular disease. The median Agatston score (AS) was 393 (0-3538). No significant correlation was found between AS and FRS (P=0.76). 846/851 coronary segments (99%) in 57/60 patients (95%) were depicted with a diagnostic image quality. Significant stenoses were found in 132/846 segments (16%) in 33/60 patients (55%). Five patients (8%) with significant coronary artery stenosis showed reduced LV function [ejection fraction (EF)<50%]. The extent of CAD was significantly correlated with AS (r=0.43, P<0.01), whereas no correlation was found for FRS (P=0.55). Cardiac CT is feasible in patients with AAA and allows for the assessment of coronary calcium, coronary stenoses, and LV function. The calcium burden and coronary stenoses assessment with cardiac CT provides incremental information beyond traditional cardiovascular risk factors alone.
Published: 2009

28. Collected world and single center experience with endovascular treatment of ruptured abdominal aortic aneurysms.

Author: Veith, F.J., Lachat, M., Mayer, D., Malina, M., Holst, J., Mehta, M., Verhoeven, E.L., Larzon, T., Gennai, S., Coppi, G., Lipsitz, E.C., Gargiulo, N.J., Vliet, J.A. van der, Blankensteijn, J.D., Buth, J., Lee, W.A., Biasiol, G., Deleo, G., Kasirajan, K., Moore, R., Soong, C.V., Cayne, N.S., Farber, M.A., Raithel, D., Greenberg, R.K., Sambeek, M.R. van, Brunkwall, J.S., Rockman, C.B., Hinchliffe, R.J., Veith, F.J., Lachat, M., Mayer, D., Malina, M., Holst, J., Mehta, M., Verhoeven, E.L., Larzon, T., Gennai, S., Coppi, G., Lipsitz, E.C., Gargiulo, N.J., Vliet, J.A. van der, Blankensteijn, J.D., Buth, J., Lee, W.A., Biasiol, G., Deleo, G., Kasirajan, K., Moore, R., Soong, C.V., Cayne, N.S., Farber, M.A., Raithel, D., Greenberg, R.K., Sambeek, M.R. van, Brunkwall, J.S., Rockman, C.B., and Hinchliffe, R.J.
Abstract: Contains fulltext : 81133.pdf (publisher's version ) (Closed access), BACKGROUND: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. OBJECTIVE: To clarify these we examined a collected experience with use of EVAR for RAAA treatment from 49 centers. METHODS: Data were obtained by questionnaires from these centers, updated from 13 centers committed to EVAR treatment whenever possible and included treatment details from a single center and information on 1037 patients treated by EVAR and 763 patients treated by open repair (OR). RESULTS: Overall 30-day mortality after EVAR in 1037 patients was 21.2%. Centers performing EVAR for RAAAs whenever possible did so in 28% to 79% (mean 49.1%) of their patients, had a 30-day mortality of 19.7% (range: 0%-32%) for 680 EVAR patients and 36.3% (range: 8%-53%) for 763 OR patients (P < 0.0001). Supraceliac aortic balloon control was obtained in 19.1% +/- 12.0% (+/-SD) of 680 EVAR patients. Abdominal compartment syndrome was treated by some form of decompression in 12.2% +/- 8.3% (+/-SD) of these EVAR patients. CONCLUSION: These results indicate that EVAR has a lower procedural mortality at 30 days than OR in at least some patients and that EVAR is better than OR for treating RAAA patients provided they have favorable anatomy; adequate skills, facilities, and protocols are available; and optimal strategies, techniques, and adjuncts are employed.
Published: 2009

29. The heart of patients with aortic aneurysms: evidence from cardiac computed tomography.

Author: Stolzmann, P., Phan, C., Desbiolles, L., Lachat, M., Pfammatter, T., Marincek, B., Prokop, M., Alkadhi, H., Stolzmann, P., Phan, C., Desbiolles, L., Lachat, M., Pfammatter, T., Marincek, B., Prokop, M., and Alkadhi, H.
Abstract: Contains fulltext : 81282.pdf (publisher's version ) (Open Access), To determine in patients with abdominal aortic aneurysm (AAA) the coronary calcium burden and prevalence of coronary artery disease (CAD) in relation to cardiovascular risk factors, and to assess the left ventricular (LV) function using cardiac computed tomography (CT). Sixty consecutive patients (six females; 72.2+/-9.0 years) with AAA underwent dual-source CT calcium scoring and coronary angiography prior to AAA repair. In the 60 patients, the Framingham risk score (FRS) ranged from 5-43%. Twenty patients (33%) were at low, 16 (27%) at intermediate, and 24 (40%) at high risk for cardiovascular disease. The median Agatston score (AS) was 393 (0-3538). No significant correlation was found between AS and FRS (P=0.76). 846/851 coronary segments (99%) in 57/60 patients (95%) were depicted with a diagnostic image quality. Significant stenoses were found in 132/846 segments (16%) in 33/60 patients (55%). Five patients (8%) with significant coronary artery stenosis showed reduced LV function [ejection fraction (EF)<50%]. The extent of CAD was significantly correlated with AS (r=0.43, P<0.01), whereas no correlation was found for FRS (P=0.55). Cardiac CT is feasible in patients with AAA and allows for the assessment of coronary calcium, coronary stenoses, and LV function. The calcium burden and coronary stenoses assessment with cardiac CT provides incremental information beyond traditional cardiovascular risk factors alone.
Published: 2009

30. Collected world and single center experience with endovascular treatment of ruptured abdominal aortic aneurysms.

Author: Veith, F.J., Lachat, M., Mayer, D., Malina, M., Holst, J., Mehta, M., Verhoeven, E.L., Larzon, T., Gennai, S., Coppi, G., Lipsitz, E.C., Gargiulo, N.J., Vliet, J.A. van der, Blankensteijn, J.D., Buth, J., Lee, W.A., Biasiol, G., Deleo, G., Kasirajan, K., Moore, R., Soong, C.V., Cayne, N.S., Farber, M.A., Raithel, D., Greenberg, R.K., Sambeek, M.R. van, Brunkwall, J.S., Rockman, C.B., Hinchliffe, R.J., Veith, F.J., Lachat, M., Mayer, D., Malina, M., Holst, J., Mehta, M., Verhoeven, E.L., Larzon, T., Gennai, S., Coppi, G., Lipsitz, E.C., Gargiulo, N.J., Vliet, J.A. van der, Blankensteijn, J.D., Buth, J., Lee, W.A., Biasiol, G., Deleo, G., Kasirajan, K., Moore, R., Soong, C.V., Cayne, N.S., Farber, M.A., Raithel, D., Greenberg, R.K., Sambeek, M.R. van, Brunkwall, J.S., Rockman, C.B., and Hinchliffe, R.J.
Abstract: Contains fulltext : 81133.pdf (publisher's version ) (Closed access), BACKGROUND: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. OBJECTIVE: To clarify these we examined a collected experience with use of EVAR for RAAA treatment from 49 centers. METHODS: Data were obtained by questionnaires from these centers, updated from 13 centers committed to EVAR treatment whenever possible and included treatment details from a single center and information on 1037 patients treated by EVAR and 763 patients treated by open repair (OR). RESULTS: Overall 30-day mortality after EVAR in 1037 patients was 21.2%. Centers performing EVAR for RAAAs whenever possible did so in 28% to 79% (mean 49.1%) of their patients, had a 30-day mortality of 19.7% (range: 0%-32%) for 680 EVAR patients and 36.3% (range: 8%-53%) for 763 OR patients (P < 0.0001). Supraceliac aortic balloon control was obtained in 19.1% +/- 12.0% (+/-SD) of 680 EVAR patients. Abdominal compartment syndrome was treated by some form of decompression in 12.2% +/- 8.3% (+/-SD) of these EVAR patients. CONCLUSION: These results indicate that EVAR has a lower procedural mortality at 30 days than OR in at least some patients and that EVAR is better than OR for treating RAAA patients provided they have favorable anatomy; adequate skills, facilities, and protocols are available; and optimal strategies, techniques, and adjuncts are employed.
Published: 2009

31. Collected world and single center experience with endovascular treatment of ruptured abdominal aortic aneurysms

Author: Veith, F, Lachat, M, Mayer, D, Malina, M, Holst, J, Mehta, M, Verhoeven, E, Larzon, T, Gennai, S, Coppi, G, Lipsitz, E, Gargiulo, N, van der Vliet, J, Blankensteijn, J, Buth, J, Lee, W, Biasi, G, Deleo, G, Kasirajan, K, Moore, R, Soong, C, Cayne, N, Farber, M, Raithel, D, Greenberg, R, van Sambeek, M, Brunkwall, J, Rockman, C, Hinchliffe, R, RAAA Investigators: Adiseshiah, M, Alimi, Y, Bekkema, F, Bell, P, Becquemin, J, Benatti, C, Braithwaite, B, Camesasca, W, Cao, P, Casali, R, Castellani, L, Chester, J, Criado, F, Cuypers, P, Dake, M, Darling, R, Eliasson, K, Fillinger, M, Froio, A, Gloviczki, P, Goode, S, Gruber, G, Hopkinson, B, Hodgson, K, Ivancev, K, Kapma, M, Koskas, F, Liapis, C, Long, J, Loan, W, Macsweeney, S, Makaroun, M, Matsumura, J, Matyas, L, May, J, Moore, W, Pamler, R, Parodi, J, Paty, P, Sunder Plassmann, L, Pfammatter, T, Peppelenbosch, N, Piglionica, M, Ross, J, Resch, T, Roddy, S, Rubin, B, Saitta, G, Sales, C, Sanchez, L, Silingardi, R, Sonesson, B, Taggert, J, Sternbach, Y, Toivola, A, van den Berg, J, van Dijk, L, Vermassen, F, Villa, V, White, R, Zipfel, B, Veith, F. J, Verhoeven, E. L. G, Lipsitz, E. C, Gargiulo, N. J, van der Vliet, J. A, Lee, W. A, Soong, C. V, Cayne, NS, Farber, MA, Greenberg, RK, van Sambeek, MRHM, Brunkwall, JS, Rockman, CB, Hinchliffe, RJ, Becquemin, JP, Darling, RC, MacSweeney, S, Zipfel, B., BIASI, GIORGIO MARIA, FROIO, ALBERTO, Veith, F, Lachat, M, Mayer, D, Malina, M, Holst, J, Mehta, M, Verhoeven, E, Larzon, T, Gennai, S, Coppi, G, Lipsitz, E, Gargiulo, N, van der Vliet, J, Blankensteijn, J, Buth, J, Lee, W, Biasi, G, Deleo, G, Kasirajan, K, Moore, R, Soong, C, Cayne, N, Farber, M, Raithel, D, Greenberg, R, van Sambeek, M, Brunkwall, J, Rockman, C, Hinchliffe, R, RAAA Investigators: Adiseshiah, M, Alimi, Y, Bekkema, F, Bell, P, Becquemin, J, Benatti, C, Braithwaite, B, Camesasca, W, Cao, P, Casali, R, Castellani, L, Chester, J, Criado, F, Cuypers, P, Dake, M, Darling, R, Eliasson, K, Fillinger, M, Froio, A, Gloviczki, P, Goode, S, Gruber, G, Hopkinson, B, Hodgson, K, Ivancev, K, Kapma, M, Koskas, F, Liapis, C, Long, J, Loan, W, Macsweeney, S, Makaroun, M, Matsumura, J, Matyas, L, May, J, Moore, W, Pamler, R, Parodi, J, Paty, P, Sunder Plassmann, L, Pfammatter, T, Peppelenbosch, N, Piglionica, M, Ross, J, Resch, T, Roddy, S, Rubin, B, Saitta, G, Sales, C, Sanchez, L, Silingardi, R, Sonesson, B, Taggert, J, Sternbach, Y, Toivola, A, van den Berg, J, van Dijk, L, Vermassen, F, Villa, V, White, R, Zipfel, B, Veith, F. J, Verhoeven, E. L. G, Lipsitz, E. C, Gargiulo, N. J, van der Vliet, J. A, Lee, W. A, Soong, C. V, Cayne, NS, Farber, MA, Greenberg, RK, van Sambeek, MRHM, Brunkwall, JS, Rockman, CB, Hinchliffe, RJ, Becquemin, JP, Darling, RC, MacSweeney, S, Zipfel, B., BIASI, GIORGIO MARIA, and FROIO, ALBERTO
Abstract: BACKGROUND: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. OBJECTIVE: To clarify these we examined a collected experience with use of EVAR for RAAA treatment from 49 centers. METHODS: Data were obtained by questionnaires from these centers, updated from 13 centers committed to EVAR treatment whenever possible and included treatment details from a single center and information on 1037 patients treated by EVAR and 763 patients treated by open repair (OR). RESULTS: Overall 30-day mortality after EVAR in 1037 patients was 21.2%. Centers performing EVAR for RAAAs whenever possible did so in 28% to 79% (mean 49.1%) of their patients, had a 30-day mortality of 19.7% (range: 0%-32%) for 680 EVAR patients and 36.3% (range: 8%-53%) for 763 OR patients (P < 0.0001). Supraceliac aortic balloon control was obtained in 19.1% +/- 12.0% (+/-SD) of 680 EVAR patients. Abdominal compartment syndrome was treated by some form of decompression in 12.2% +/- 8.3% (+/-SD) of these EVAR patients. CONCLUSION: These results indicate that EVAR has a lower procedural mortality at 30 days than OR in at least some patients and that EVAR is better than OR for treating RAAA patients provided they have favorable anatomy; adequate skills, facilities, and protocols are available; and optimal strategies, techniques, and adjuncts are employed.
Published: 2009

32. Simultane Behandlung von obliterativen Karotispathologien und koronarer Herzkrankheit

Author: Mayer, D, Lachat, M, Wilhelm, M, Künzli, A, Amann-Vesti, B, Baumgartner, R, Turina, M, Mayer, D, Lachat, M, Wilhelm, M, Künzli, A, Amann-Vesti, B, Baumgartner, R, and Turina, M
Abstract: Einführung: Die kombinierte Karotisendarteriektomie und aorto-coronare Baypassoperation (C-CABG) weisen ein hohes peri-operatives Risiko auf. Als Alternative wird in letzter Zeit das Stenting der Artera carotis interna propagiert. Das Fehlen von Level I Evidenz hat uns motiviert, die Resultate unserer C-CABG der letzten 5 Jahre zu evaluieren. Methoden und Patienten: Retrospektive Monozenterstudie von 113C-CABG, durchgeführt zwischen Januar 2000 und Dezember 2004. Das mediane Alter der Patienten betrug 65Jahre (22Patienten waren 80Jahre alt oder älter). Die Karotisendarteriektomie wurde vor der aortokoronaren Bypassoperation in derselben Narkose durchgeführt. Resultate: Die 30-Tages-Mortalität war ausschließlich kardial bedingt und betrug 4,4% (5/113). Die neurologischen Komplikationen waren ein Schlaganfall, der innerhalb von 30Tagen vollständig regredient war, und 3TIA (3,5%, 4/113). Schlussfolgerung: C-CABG mit initial durchgeführter Karotisendarteriektomie ist ein sicheres Verfahren mit niedriger neurologischer Komplikationsrate. Der riskante Anteil des kombinierten Eingriffs ist nicht die Karotisendarteriektomie, sondern die aortokoronare Revaskularisation. Demzufolge scheint das Stenting beim kombinierten Eingriff als Alternative nicht gerechtfertigt, solange keine klaren Vorteile hinsichtlich der Früh- und Langzeitresultate gegenüber der alleinigen Karotisendarteriektomie vorliegen
Published: 2005

33. Emergency stent-graft placement for hemorrhage control in acute thoracic aortic rupture

Author: Melnitchouk, S, Pfammatter, T, Kadner, A, Dave, H, Witzke, H, Trentz, O, Turina, M, Lachat, M, Melnitchouk, S, Pfammatter, T, Kadner, A, Dave, H, Witzke, H, Trentz, O, Turina, M, and Lachat, M
Abstract: Objective: To report mid-term results of stent-graft (SG) implantation in acute thoracic aortic rupture as alternative to conventional open surgery with its associated high morbidity and mortality rates. Methods: Out of a series of 69 patients undergoing thoracic aortic SG implantation since 1998, 24 (mean age 57±19 years, range 20-85-years-old) patients were treated on an emergency basis for hemorrhage control. The indication for SG placement was acute traumatic aortic rupture in 15 patients, type B dissection with contained rupture in 3 patients, penetrating aortic ulcer with periaortic hematoma in 3 patients, and thoracic aortic aneurysm rupture in 3 patients. Preoperative assessment was done by computed tomography (CT) scanning and echography. Patients were treated in the angiography suite by implantation of Excluder (n=18), Talent (n=4), Corvita (n=1), and Vanguard (n=1) self-expanding grafts. Local anesthesia was the most frequently used anaesthesiologic technique. Results: Technical success rate of SG deployment was 100%. The early postoperative mortality was 12.5% (3 of 24). One patient suffered temporary paraplegia (4%). There was no intervention-related mortality during the mean follow-up of 34.1 months. Two secondary endoleaks were successfully treated with additional SG placement at 2 and 12 months postoperative, respectively. Conclusions: Emergency SG repair to control hemorrhage in patients with an acute thoracic aortic rupture is a less-invasive attractive and rational treatment option, especially if associated lesions or co-morbidity may interfere with the surgical outcome. Long-term follow-up results will be helpful to clarify procedure durability bounded by material failure and postoperative aneurysm or aortic wall remodelling
Published: 2004

34. Frühzeitige endovaskuläre Stenteinlage bei schwerverletzten Patienten mit traumatischer thorakaler Aortenruptur.

Author: Labler, L, Hitendu, D, Lachat, M, Pfammatter, T, Keel, M, Trentz, O, Labler, L, Hitendu, D, Lachat, M, Pfammatter, T, Keel, M, and Trentz, O
Published: 2003

35. Frühzeitige endovaskuläre Stenteinlage bei schwerverletzten Patienten mit traumatischer thorakaler Aortenruptur.

Author: Labler, L, Hitendu, D, Lachat, M, Pfammatter, T, Keel, M, Trentz, O, Labler, L, Hitendu, D, Lachat, M, Pfammatter, T, Keel, M, and Trentz, O
Published: 2003

36. Aortic stent-grafting: successful introduction into the combined procedure for coronary artery bypass grafting and aortic aneurysm repair

Author: Lachat, M, Witzke, H, Pfammatter, T, Bettex, D, Slankamenac, K, Wolfensberger, U, Turina, M, Lachat, M, Witzke, H, Pfammatter, T, Bettex, D, Slankamenac, K, Wolfensberger, U, and Turina, M
Abstract: Objectives: Coronary artery bypass grafting (CABG) and combined stent-grafting (SG) were evaluated to reduce morbidity and mortality of patients with descending or infrarenal aortic aneurysm. Methods: CABG and SG (thoracic n=6, infrarenal n=36) were performed during the same hospitalization in 42 patients (mean age of 73±14 years). In 29 patients (mean Euroscore: 9), SG was performed under local anesthesia 9±3 days after coronary surgery (simultaneous) and in 13 patients (mean Euroscore: 7) during the same anesthesia (synchronous). In the latter group, 11 out of 13 patients underwent off-pump CABG. All aneurysms were treated by implantation of commercially available self-expanding grafts. Results: CABG was successful in all, but one patient with left internal mammary artery hypoperfusion syndrome, requiring an additional distal saphenous graft to the left anterior descending coronary artery. SG was uneventful in 98% (41/42 patients). Postoperative computerized tomography showed incomplete sealing in seven patients (17%), but only the two attachment endoleaks had to be treated by one proximal and one distal SG extension. Overall hospital stay for the synchronous repair was 12.5±6 days and that of the simultaneous group 17.5±7 days. Thirty-day mortality was 5% (2/42) as one patient of the simultaneous group experienced a lethal cerebral embolism during SG and one patient of the synchronous group developed an untreatable infection. In the follow-up of 4 years, there were two vascular reinterventions but no additional procedure-related morbidity or mortality. Conclusions: This experience shows that combined CABG and SG of thoracic or infrarenal aortic aneurysm is a safe and less-invasive alternative to the open graft repair, especially in the older patients or patients with severe comorbidities
Published: 2003

37. Acute traumatic aortic rupture: early stent-graft repair

Author: Lachat, M, Pfammatter, T, Witzke, H, Bernard, E, Wolfensberger, U, Künzli, A, Turina, M, Lachat, M, Pfammatter, T, Witzke, H, Bernard, E, Wolfensberger, U, Künzli, A, and Turina, M
Abstract: Objective: Prospective evaluation of early stent-graft repair of acute traumatic aortic rupture. Methods: Twelve patients with acute traumatic aortic rupture of the descending aorta, out of a series of 337 endovascular aortic procedures, were treated by implantation of self-expanding stent-grafts. The procedures were performed within a mean post-injury time-period of 5±7 days (median: 1 day). The feasibility of stent-grafting was assessed by CT scanning and echography. Implantation was performed under local (n=6), or general anesthesia (n=6) if patients were already intubated (n=5) or required a common iliac artery access (n=1). Results: The immediate technical success rate was 100%. There were no post-procedure complications in all but one patient, who died 12 h postoperatively (8% mortality). Complete sealing of the aortic rupture in the remaining 11 patients was confirmed by postoperative CT scans. There were no intervention-related morbidity or mortality during the mean follow-up of 17 months. One patient with peri-graft leakage was successfully repaired with an additional stent-graft 12 months postoperatively. Conclusion: Non-delayed or early stent-grafting in acute traumatic rupture of the descending aorta is feasible. This technique seems to be a valuable option, in particular when associated lesions may interfere with the surgical outcome. Immediate post-procedural CT scanning and/or echography should be performed, in order to rule out residual leakage
Published: 2002

38. Advanced training model for beating heart coronary artery surgery: the Zurich heart-trainer

Author: Reuthebuch, O, Lang, A, Groscurth, P, Lachat, M, Turina, M, Zünd, G, Reuthebuch, O, Lang, A, Groscurth, P, Lachat, M, Turina, M, and Zünd, G
Abstract: Objective: Coronary artery surgery with beating heart technique is gaining increasing popularity. However, it is a challenging technique even for well-trained cardiac surgeons. Thus, a training model for beating heart surgery was developed to increase safety and accuracy of this procedure. Methods: The model consists of differentially hardened polyurethane resembling mechanical properties of the human heart. The covering used in this model is a 1:1 replica of the human thoracic wall with optionally embedded skeletal structures. Sternotomy, lateral thoracotomy or trocar placement is possible to access the lungs, the pericardium and the heart with adjacent vessels. Disposable artificial coronaries variable in size, wall quality or wall thickness are embedded in the synthetic myocardium. Two-layer vessels, which can simulate dissection, are available. Bypass conduits utilize the same material. Coronaries/bypasses as well as part of the ascending aorta are water-tight and can be rinsed with saline. Lungs can be inflated. A purpose-built pump induces heart movement with adjustable or randomized stroke volume, heart rate and arrhythmia induction. Results: The model was tested in a recent ‘Wet-Lab' course attended by 30 surgeons. All conventional instruments and stabilizers with standard techniques can be used. Training with beating or non-beating heart was possible. Time needed for an anastomosis was similar to clinical experience. Each artificial tissue showed its individual nature-like qualities. Various degrees of difficulty can be selected, according to stroke volume, heart rate, arrhythmia, vessel size and vessel quality. The model can be quickly and easily set up and is fully reusable. Conclusions: The similarity to human tissue and the easy set-up make this completely artificial model an ideal teaching tool to increase the confidence of cardiac surgeons dealing with beating heart and minimally invasive surgery
Published: 2002

39. Periskop-, Kamin- und Sandwichtechnik sowie VORTEC zur Vereinfachung der Behandlung von Aneurysmen der Aorta abdominalis und thoracoabdominalis

Author: Pecoraro, F., Rancic, Z., Pfammatter, T., Veith, F.J., Donas, K.P., Frauenfelder, T., Mayer, D., Lachat, M., Pecoraro, F., Rancic, Z., Pfammatter, T., Veith, F.J., Donas, K.P., Frauenfelder, T., Mayer, D., and Lachat, M.
Abstract: Zusammenfassung: VORTEC (Viabahn Open Revascularisation TEChnique) und die Kaminprothesentechnik sind Verfahren zur Erhaltung oder Wiederherstellung des Blutflusses von Aortenästen, die geplant oder als Notlösung bei offener Operation oder endovaskulärem Vorgehen eingesetzt werden können. VORTEC ist eine stentbasierte vaskuläre Verbindungstechnik zur Herstellung einer End-zu-End-Anastomose, die insbesondere geeignet ist, wenn die herkömmliche Nahttechnik schwierig ist (sein könnte). Es handelt sich um ein schnelles Verfahren, das praktisch ohne Blutflussunterbrechung und ohne Anastomosenblutung ist, die Durchgängigkeitsraten sind ähnlich gut wie bei Nahtanastomosen. Die Kamin-Periskop-Sandwich-Prothesentechnik ("chimney/periscope and sandwich graft technique”, CHIMPES) ist ein endovaskuläres Verfahren, bei dem parallele Endoprothesen zur Erhaltung oder Wiederherstellung des Blutflusses von Aortenästen verwendet werden, während ein herkömmlicher Aortenstent oberhalb ihres Ursprungs platziert wird. Es ist ein relativ schnelles Verfahren mit der Möglichkeit, selbst in Notfällen handelsübliche Produkte zu verwenden. Bei der Sandwichtechnik verlaufen parallele Prothesen zwischen 2Aortenstents. Publizierten Erfahrungen zufolge scheinen diese beiden Techniken besonders für die Behandlung von Aneurysmen der Aortenäste und der Aorta thoracoabdominalis geeignet zu sein, vor allem in Hochrisiko- oder Akutfällen. Die englische Volltextversion dieses Beitrags ist über SpringerLink (unter "Supplemental") verfügbar

40. Simultane Behandlung von obliterativen Karotispathologien und koronarer Herzkrankheit: Aktuelles Konzept und Resultate der letzten 5Jahre

Author: Mayer, D., Lachat, M., Wilhelm, M., Künzli, A., Amann-Vesti, B., Baumgartner, R., Turina, M., Mayer, D., Lachat, M., Wilhelm, M., Künzli, A., Amann-Vesti, B., Baumgartner, R., and Turina, M.
Abstract: Zusammenfassung: Einführung: Die kombinierte Karotisendarteriektomie und aorto-coronare Baypassoperation (C-CABG) weisen ein hohes peri-operatives Risiko auf. Als Alternative wird in letzter Zeit das Stenting der Artera carotis interna propagiert. Das Fehlen von Level I Evidenz hat uns motiviert, die Resultate unserer C-CABG der letzten 5 Jahre zu evaluieren. Methoden und Patienten: Retrospektive Monozenterstudie von 113C-CABG, durchgeführt zwischen Januar 2000 und Dezember 2004. Das mediane Alter der Patienten betrug 65Jahre (22Patienten waren 80Jahre alt oder älter). Die Karotisendarteriektomie wurde vor der aortokoronaren Bypassoperation in derselben Narkose durchgeführt. Resultate: Die 30-Tages-Mortalität war ausschließlich kardial bedingt und betrug 4,4% (5/113). Die neurologischen Komplikationen waren ein Schlaganfall, der innerhalb von 30Tagen vollständig regredient war, und 3TIA (3,5%, 4/113). Schlussfolgerung: C-CABG mit initial durchgeführter Karotisendarteriektomie ist ein sicheres Verfahren mit niedriger neurologischer Komplikationsrate. Der riskante Anteil des kombinierten Eingriffs ist nicht die Karotisendarteriektomie, sondern die aortokoronare Revaskularisation. Demzufolge scheint das Stenting beim kombinierten Eingriff als Alternative nicht gerechtfertigt, solange keine klaren Vorteile hinsichtlich der Früh- und Langzeitresultate gegenüber der alleinigen Karotisendarteriektomie vorliegen

41. Teicoplanin-Induced Complete AV-Block in a Heart Transplant Recipient

Author: Enseleit, F., Mueller, N., Duru, F., Lachat, M., Noll, G., Ruschitzka, F., Enseleit, F., Mueller, N., Duru, F., Lachat, M., Noll, G., and Ruschitzka, F.

42. Minimal-invasiver Zugang für EVAR: Chirurgisch oder rein interventionell?

Author: Mayer, D., Rancic, Z., Wilhelm, M., Veith, F.J., Lachat, M., Mayer, D., Rancic, Z., Wilhelm, M., Veith, F.J., and Lachat, M.
Abstract: Zusammenfassung: Komplikationen kommen sowohl beim rein chirurgischen als auch rein interventionellen (perkutanen) Gefäßzugang nicht selten vor. Sie beinhalten eine nicht zu unterschätzende Morbidität und können sogar zum Tod führen. Wir beschreiben eine Technik, die die Vorteile der chirurgisch offenen mit den rein perkutanen Zugangsmethoden kombiniert: die minimale chirurgische Freilegung des Zugangsgefäßes, gefolgt von einer schnellen und sicheren Punktion mittels einer modifizierten, offenen Seldinger-Technik unter direkter taktiler und visueller Kontrolle. Diese einzigartige Kombination verschiedener Techniken erhöht die Sicherheit des Gefäßzugangs derart, dass lokale Komplikationen fast vollständig vermieden werden können. Ökonomische und sicherheitsrelevante Betrachtungen werden diskutiert, abgerundet durch einen ausgewogenen Überblick über die Vorteile der verschiedenen Techniken

43. Reverse Chimney or Periscope: Some Issues have to be Addressed 'Re: Endovascular Aneurysm Repair Using a Reverse Chimney Technique in a Patient with Marfan Syndrome and Contained Ruptured Chronic Type B Dissection”

Author: Rančić, Z., Mayer, D., Veith, F., Lachat, M., Rančić, Z., Mayer, D., Veith, F., and Lachat, M.

44. Predictors of complications in acute type B aortic dissection

Author: Genoni, M., Paul, M., Tavakoli, R., Künzli, A., Lachat, M., Graves, K., Seifert, B., Turina, M., Genoni, M., Paul, M., Tavakoli, R., Künzli, A., Lachat, M., Graves, K., Seifert, B., and Turina, M.
Abstract: Objectives: Medical treatment is generally advocated for patients with acute type B aortic dissection without complications. The objective of this retrospective analysis was to determine whether there are any initial findings that can help predict the long-term course of the disease. Methods: Case records of the 130 patients treated for type B aortic dissection between 1988 and 1997 were reviewed; 41 (31%) were operated on in the acute phase (≪14 days), 31 (24%) were operated on in the chronic phase and 58 (45%) were treated medically. Results: Overall acute mortality was 10.8%; 22% for patients operated on in the early phase and 5.6% for medically treated patients. Age (P=0.002), persistent pain (P=0.01) and malperfusion (P=0.001) were significant independent predictors of the need for surgery. Paraplegia/para paresis (P=0.0001), leg ischaemia (P=0.003), pleural effusion (P=0.003), rupture (P=0.0001), shock (P=0.0001), age (P=0.003), cardiac failure (P=0.002) and aortic diameter ≫4.5cm (P=0.002) were significant predictors of poor survival. Age and shock also emerged as independent risk factors. Patients without malperfusion (P=0.0001), pleural effusion (P=0.003), rupture (P=0.0001) and shock (P=0.0001) had a significantly better event-free survival (freedom from repeat surgery and death). The actuarial survival rate for high-risk patients (malperfusion, rupture, shock) was 62% at 1 year and 40% at 5 years; the corresponding values for low-risk patients were 94 and 84%, respectively. Conclusions: Rupture, shock and malperfusion are significant predictors of poor survival in patients with acute type B aortic dissection

45. Aortic stent-grafting: successful introduction into the combined procedure for coronary artery bypass grafting and aortic aneurysm repair

Author: Lachat, M., Witzke, H., Pfammatter, T., Bettex, D., Slankamenac, K., Wolfensberger, U., Turina, M., Lachat, M., Witzke, H., Pfammatter, T., Bettex, D., Slankamenac, K., Wolfensberger, U., and Turina, M.
Abstract: Objectives: Coronary artery bypass grafting (CABG) and combined stent-grafting (SG) were evaluated to reduce morbidity and mortality of patients with descending or infrarenal aortic aneurysm. Methods: CABG and SG (thoracic n=6, infrarenal n=36) were performed during the same hospitalization in 42 patients (mean age of 73±14 years). In 29 patients (mean Euroscore: 9), SG was performed under local anesthesia 9±3 days after coronary surgery (simultaneous) and in 13 patients (mean Euroscore: 7) during the same anesthesia (synchronous). In the latter group, 11 out of 13 patients underwent off-pump CABG. All aneurysms were treated by implantation of commercially available self-expanding grafts. Results: CABG was successful in all, but one patient with left internal mammary artery hypoperfusion syndrome, requiring an additional distal saphenous graft to the left anterior descending coronary artery. SG was uneventful in 98% (41/42 patients). Postoperative computerized tomography showed incomplete sealing in seven patients (17%), but only the two attachment endoleaks had to be treated by one proximal and one distal SG extension. Overall hospital stay for the synchronous repair was 12.5±6 days and that of the simultaneous group 17.5±7 days. Thirty-day mortality was 5% (2/42) as one patient of the simultaneous group experienced a lethal cerebral embolism during SG and one patient of the synchronous group developed an untreatable infection. In the follow-up of 4 years, there were two vascular reinterventions but no additional procedure-related morbidity or mortality. Conclusions: This experience shows that combined CABG and SG of thoracic or infrarenal aortic aneurysm is a safe and less-invasive alternative to the open graft repair, especially in the older patients or patients with severe comorbidities

46. Acute traumatic aortic rupture: early stent-graft repair

Author: Lachat, M., Pfammatter, T., Witzke, H., Bernard, E., Wolfensberger, U., Künzli, A., Turina, M., Lachat, M., Pfammatter, T., Witzke, H., Bernard, E., Wolfensberger, U., Künzli, A., and Turina, M.
Abstract: Objective: Prospective evaluation of early stent-graft repair of acute traumatic aortic rupture. Methods: Twelve patients with acute traumatic aortic rupture of the descending aorta, out of a series of 337 endovascular aortic procedures, were treated by implantation of self-expanding stent-grafts. The procedures were performed within a mean post-injury time-period of 5±7 days (median: 1 day). The feasibility of stent-grafting was assessed by CT scanning and echography. Implantation was performed under local (n=6), or general anesthesia (n=6) if patients were already intubated (n=5) or required a common iliac artery access (n=1). Results: The immediate technical success rate was 100%. There were no post-procedure complications in all but one patient, who died 12 h postoperatively (8% mortality). Complete sealing of the aortic rupture in the remaining 11 patients was confirmed by postoperative CT scans. There were no intervention-related morbidity or mortality during the mean follow-up of 17 months. One patient with peri-graft leakage was successfully repaired with an additional stent-graft 12 months postoperatively. Conclusion: Non-delayed or early stent-grafting in acute traumatic rupture of the descending aorta is feasible. This technique seems to be a valuable option, in particular when associated lesions may interfere with the surgical outcome. Immediate post-procedural CT scanning and/or echography should be performed, in order to rule out residual leakage

47. Advanced training model for beating heart coronary artery surgery: the Zurich heart-trainer

Author: Reuthebuch, O., Lang, A., Groscurth, P., Lachat, M., Turina, M., Zünd, G., Reuthebuch, O., Lang, A., Groscurth, P., Lachat, M., Turina, M., and Zünd, G.
Abstract: Objective: Coronary artery surgery with beating heart technique is gaining increasing popularity. However, it is a challenging technique even for well-trained cardiac surgeons. Thus, a training model for beating heart surgery was developed to increase safety and accuracy of this procedure. Methods: The model consists of differentially hardened polyurethane resembling mechanical properties of the human heart. The covering used in this model is a 1:1 replica of the human thoracic wall with optionally embedded skeletal structures. Sternotomy, lateral thoracotomy or trocar placement is possible to access the lungs, the pericardium and the heart with adjacent vessels. Disposable artificial coronaries variable in size, wall quality or wall thickness are embedded in the synthetic myocardium. Two-layer vessels, which can simulate dissection, are available. Bypass conduits utilize the same material. Coronaries/bypasses as well as part of the ascending aorta are water-tight and can be rinsed with saline. Lungs can be inflated. A purpose-built pump induces heart movement with adjustable or randomized stroke volume, heart rate and arrhythmia induction. Results: The model was tested in a recent ‘Wet-Lab' course attended by 30 surgeons. All conventional instruments and stabilizers with standard techniques can be used. Training with beating or non-beating heart was possible. Time needed for an anastomosis was similar to clinical experience. Each artificial tissue showed its individual nature-like qualities. Various degrees of difficulty can be selected, according to stroke volume, heart rate, arrhythmia, vessel size and vessel quality. The model can be quickly and easily set up and is fully reusable. Conclusions: The similarity to human tissue and the easy set-up make this completely artificial model an ideal teaching tool to increase the confidence of cardiac surgeons dealing with beating heart and minimally invasive surgery

48. Electrical and mechanical support in advanced heart failure. Rationale and feasibility of a combined management strategy

Author: Duru, F., Candinas, R., Lachat, M., Rahn, M., Noll, G., Lüscher, T.F., Turina, M., Duru, F., Candinas, R., Lachat, M., Rahn, M., Noll, G., Lüscher, T.F., and Turina, M.

49. Left ventricular assist device as bridge to heart transplantation - lessons learned with the MicroMed DeBakey axial blood flow pump

Author: Salzberg, S., Lachat, M., Zünd, G., Oechslin, E., Schmid, E.R., DeBakey, M., Turina, M., Salzberg, S., Lachat, M., Zünd, G., Oechslin, E., Schmid, E.R., DeBakey, M., and Turina, M.
Abstract: Objective: The MicroMed DeBakey left ventricular assist device (LVAD) axial blood flow pump was used as bridge to heart transplantation (HTx) in patients with terminal heart failure. The aim was to evaluate this novel mechanical circulatory support system in regard to overall outcome. Methods: Prospective study in 15 HTx candidates (mean age 40±7 years) with terminal heart failure and maximal medical treatment due to ischemic cardiomyopathy (CMP, n=5), dilated CMP (n=3), restrictive CMP (n=2), unclassified CMP (n=1), metabolic CMP (n=1), valvular CMP (n=1) and congenital CMP (n=2). All patients were implanted with a MicroMed DeBakey LVAD. A rescue procedure was necessary in eight critical patients, while seven underwent elective LVAD implantation. Procedures were performed via median sternotomy, in normotherm femoro-femoral CPB (mean duration 59±1 min). Oral Marcoumar© (INR 2.0-3.0) and Aspirin© (100 mg daily) were started as soon as possible. Patients were discharged into a specialized rehabilitation clinic from which it was possible to release them home after a few weeks. Results: Successful implantation and discharge from ICU (mean stay 10±7 days) was possible in 11 patients. Seven were transplanted (mean support 50.7 days) and one is awaiting HTx (support >310 days) in the comfort of his home (NYHA I). Survival was 100% among the transplanted patients. Of the seven elective implants, five, and of the eight rescue procedures three patients underwent successful HTx. Four patients died early, while three patients died late on pump support due to intracranial hemorrhage (n=2, 73 and 76 days) and chest infection (n=1, 124 days). All survivors were discharged from hospital, with significant decrease in NYHA class (mean 3.8-2.4 (n=11)). Treadmill testing showed increased exercise tolerance, from 35 to 71 W (n=4). Plasma BNP values (mean 950-162 ng/l (n=4)) and pulmonary resistance (mean 316-194.5 dyne s/cm5 (n=3)) decreased significantly during LVAD support. Conclusion

50. Preoperative predictors of recurrent atrial fibrillation late after successful mitral valve reconstruction

Author: Vogt, P.R., Brunner-LaRocca, H.P., Rist, M., Zünd, G., Genoni, M., Lachat, M., Niederhäuser, U., Turina, M.I., Vogt, P.R., Brunner-LaRocca, H.P., Rist, M., Zünd, G., Genoni, M., Lachat, M., Niederhäuser, U., and Turina, M.I.
Abstract: Objective: Late outcome after mitral valve repair was examined to define preoperative predictors of recurrent atrial fibrillation late after successful mitral valve reconstruction. Methods: One hundred and eighty-nine patients, 112 with preoperative sinus rhythm and 72 with preoperative chronic or intermittent atrial fibrillation, were followed for 12.2±10 years after valve repair. Clinic, hemodynamic end echocardiographic data were entered into Cox-regression and Kaplan-Meyer analysis to assess predictors for recurrent atrial fibrillation late after successful mitral valve repair. Results: Univariate and multivariate predictors for recurrent atrial fibrillation late after successful mitral valve reconstruction were preoperative atrial fibrillation (P=0.0001), preoperative antiarrhythmic drug treatment (P=0.005), heart rate (P=0.01), left ventricular ejection fraction (P=0.01) and increased left ventricular posterior wall thickness (P=0.05). Patients>57.5 years with a mean pulmonary artery pressure ≥23mm Hg and a history of preoperative antiarrhythmic drug treatment had an odds ratio of 53.33 (95% confidence limits 6.12-464.54) for atrial fibrillation late after successful mitral valve repair. Conclusion: Older patients with a history of atrial fibrillation, antiarrhythmic treatment or an elevated pulmonary artery pressure may present atrial fibrillation late after successful mitral valve repair. They could be considered for combined mitral valve reconstruction and surgery for atrial fibrillation even though sinus rhythm is present preoperatively

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