Gefäßchirurgie

Abdominal Aortic Aneurysm (AAA) is the most common type of true aneurysm and have a high incidence to rupture. The introduction of endovascular grafting was a milestone in the treatment of patients with AAA as it provided a treatment option for those patients with large aneurysms with inoperable conditions because of the presence of significant medical co-morbidities. By this innovation, an early benefit in quality of life can be achieved, as it relates to reducing hospital stay and recovery period in comparison with open surgery. In our study, we enrolled 20 patients to describe initial and midterm results of Endovascular Aortic Aneurysm Repair (EVAR) in patients with infra-renal abdominal Aortic Aneurysm.

Die zukünftige gefäßchirurgische Versorgung des Tiroler Unterlandes ist ein hochaktuelles Thema in der Gesundheitspolitik. Orientierende Sitzungen mit den ärztlichen Leitern sowie dem chirurgischen Fachpersonal der einzelnen Krankenhäuser unter der Leitung von Dr. Schöch und Landesrat DI Dr. Tilg loten die Möglichkeiten aus. Diese wissenschaftliche Arbeit soll anhand einer Bedarfsanalyse und Darstellung der Ressourcen des BKH Schwaz diesen Entscheidungsprozess unterstützen. Ausgehend von einer zukünftigen Steigerung der Patientenzahl mit peripherer arterieller Verschlusserkrankung (pAVK) im Rahmen des demografischen Wandels soll diese bis zum Jahr 2030 ausgelegte Bedarfsanalyse aufzeigen, ob das BKH Schwaz ausreichende Kapazitäten zur Versorgung des Bezirkes vorhält oder, ob strukturelle Anpassungen erforderlich sind. Auch die möglichen Auswirkungen eines überregionalen Versorgungsauftrages wurden analysiert und die entstehenden Steigerungen abgeschätzt. Weiters wurde eine wirtschaftliche Evaluierung der gefäßchirurgischen Therapieoptionen am BKH Schwaz durchgeführt.

Studienarbeit aus dem Jahr 2015 im Fachbereich Pädagogik - Berufsbildung, Weiterbildung, Note: 1,3, FernUniversität Hagen, Sprache: Deutsch, Abstract: Diese reflektierende Dokumentation fasst ein dreiwöchiges Unterrichtspraktikum zusammen. Die Aufgabe während des Praktikums besteht in der Planung, Durchführung und Evaluation von gefäßchirurgischen Unterrichtseinheiten im Rahmen der Ausbildung zum/r Operationstechnischen Assistenten/in (OTA).Anschließend an diesen Überblick über die Reflektierende Dokumentation wird die Praktikumsstelle vorgestellt. Dazu werden die Struktur der Einrichtung, die Rahmenbedingungen des Praktikums und die Analyse der Zielgruppe näher erläutert. So kann sich der Leser einen Eindruck über die institutionellen Rahmenbedingungen schaffen.Im darauf folgenden Kapitel der bildungstheoretischen Rahmung wird beschrieben, auf welche Art und Weise die Planung des Unterrichts abläuft. Neben erläuternden Worten zu Unterrichtshospitationen, Materialrecherche und Zusammenarbeit mit der Bezugslehrerin wird die Planung anhand des Berliner Modells dargestellt. Zudem kann die Durchführung und Evaluation der Unterrichtseinheiten nachvollzogen werden. Daran anschließend wird erörtert, was man unter Projektmanagement versteht und welchen Stellenwert dieses für die konkrete Praktikumssituation einnimmt. Im weiteren Verlauf der Reflektierenden Dokumentation wird auf die Qualitätssicherung innerhalb des Praktikums eingegangen. Dabei wird u.a. erläutert, wie eine Qualitätssicherung zu erzielen ist.Parallel zum dreiwöchigen Praktikum wir ein WordPress-Blog in Form eines Lerntagebuchs geführt. Die Erfahrungen und Eindrücke dieses Blogs werden im weiteren Verlauf dargestellt. Zuletzt beschäftigt sich die reflektierende Dokumentation mit der Evaluation des Projekts, ehe das Fazit, welches sich mit der bildungswissenschaftlichen Profession im Spannungsfeld zwischen Theorie und Praxis beschäftigt, einen Abschluss dieser Ausarbeitung bildet.

The technique of angioplasty and some other methods employed in vascular stenosis have been elucidated in this book. The area of operating transcatheter interventions for treating vascular lesions has multiplied manifolds over the past 20 years, and not only has the technology transformed, particularly in the field of balloon/stent devices, but the techniques of approaching intricate lesions has advanced over the last decade. Lesions that no one would have thought of diagnosing back in the 1990's are now being diagnosed frequently in the catheterization suite. This book presents an up-to-date account on the present techniques and devices used to treat a diverse variety of lesions. Though, at first, the outward appearance of these subjects appears to be diverse, they are all connected by the basic thread of treating vascular lesions. Through this book, we aim to offer awareness from experts in their areas to treat, both medically and procedurally, complex vascular lesions that we so commonly encounter and to promote increased communication between areas of medicine that usually does not happen between adult interventional cardiologists, pediatric interventional cardiologists, interventional radiologists, and neurosurgeons. A lot could be learned from respective colleagues in these fields which can further the world of interventions.

Written by internationally acclaimed specialists, Cardio-Thoracic, Vascular, Renal and Transplant Surgery provides pertinent and concise procedure descriptions spanning benign and malignant problems and minimally invasive procedures. Complications are reviewed when appropriate for the organ system and problem, creating a book that is both comprehensive and accessible. Stages of operative approaches with relevant technical considerations are outlined in an easily understandable manner.  Forming part of the series, Surgery: Complications, Risks and Consequences, this volume Cardio-Thoracic, Vascular, Renal and Transplant Surgery provides a valuable resource for all general surgeons and residents in training. Other healthcare providers will also find this a useful resource.

One of the most outstanding achievements in contemporary surgery has been the development ofmicrosurgery and its c1inical application. Early in 1960s, the Shanghai Sixth People's Hospital began to research and practise the replant­ ation of severed limbs and has hence been acc1aimed as the cradle of replant­ ation surgery in China. Succeeding Dr. Chen Zhong-wei, Dr. Yu Zhong-jia has led the Department of Orthopaedic Surgery to continue ploughing and weeding diligently in the field of microsurgery of the extremities and has made, in both reconstructive and reparative microsurgery, great advances that have attracted world attention. I used to be the scientific advisor of this hospital and have therefore followed c1ose1y what has been achieved there. A well-known orthopaedist and microsurgeon, Dr. Yu Zhong-jia is adept in using the present advanced techniques to solve difficult problems which re­ mained unsettled in spite of predecessors' repeated earlier attempts, and his own scientific research is always directed by the imperative needs of his patients. The results of his research thus not only attain a high technical standard, but are also rich in practical value. Dr. Yu was the the first surgeon in the world to trans plan ted autogenous toes to the amputated forearm stump, with a metallic artificial metacarpus as the connection, reconstructing a new hand with sensibil­ ity and movability afterwards eulogized by foreign friends as the "China Hand".

The 6th International Symposium on Artificial Heart and Assist Devices met in Tokyo in July 1996, bringing together researchers and specialists from around the world. The symposiums proceedings in this volume comprise papers from nine sessions, each opening with contributions by leading scientists: TAH, heart transplantation, biomaterials, VAS, clinical application, pathophysiology, engineering, new approaches, and special sessions. Of special note is the inclusion, for the first time, of pathophysiology related to clinical use of assist devices. The clinical application section includes a paper by Dr. Michael DeBakey on the progress made in recent years. With descriptions of the scientific exhibition, accompanied by photographs of all artificial heart devices and systems displayed by major laboratories and manufacturers, Artificial Heart 6 presents the latest information on developments in the field of artificial heart, biomaterials, and heart transplantation.

Vascular care has evolved from conservative therapy and open surgical therapy to a minimally invasive approach using endovascular techniques, laparoscopic or thoracoscopic techniques as well as hybrids of open and endovascular techniques. New technological developments continue to arise allowing surgeons to be more creative and adding to the treatment options available.   Vascular Surgery provides up-to-the-minute information and details new developments and procedures in the field of vascular surgery. With an authorship of international acclaim, this comprehensive text is a highly valuable resource for surgeons and trainees.

Since the advent of microsurgery, there has always been a need for a systematic presentation of relevant anatomical biometry. In view of this urgent demand, this monograph has been compiled on the basis of recent research done by Chinese colleagues in the fields of microsurgery and related anatomical sciences from more than fourteen medical colleges in the hope of providing a complete set of anatomical data covering most areas of modern microsurgery. This volume presents thirteen chapters dealing with the applied anatomy of free skin flap, muscle, bone and omental grafting and of intestinal and small organ transplantation including reconstruction of the thumb using toes. Space is also devoted to the microsurgical anatomy of the central and peripheral nervous systems, the lymphatic system and the middle ear. To help under­ standing, 212 illustrations, involving 21 photographic plates, are included. The authors are particularly indebted to Professors He Guangchi and Zhao Minxue for their valuable suggestions and revision of the manuscript, and also to the late Professor Yang Dongyue for his personal contribution in the field of microsurgery and everlasting inspiration. The authors also wish to express their gratitude to the publishers for their great enthusiasm in producing this first edition.

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Advances made in microsurgical techniques during the last three decades have dramatically improved the treatment of complex limb injuries, such as a closed fracture covered by healthy tissue and a complex open fracture of the tibia. Microvascular transfers from the foot have revolutionized the treatment of digital amputations, and vascularized bone transfers are used in various indications.The microvascular techniques are still evolving. Many imaginative new flaps are being proposed to meet precisely the functional requirements of the various defects. Alternative anastomotic techniques are being investigated and the no-flow phenomenon has been extensively studied. Allotransplantation may be feasible in the future.This unique book is a result of the exchange of ideas among clinicians of various specialties noted for their innovations and basic researchers involved with the problems of microvascular reconstruction of upper and lower extremities. While most of the chapters are invited contributions, some are based on presentations made during an international symposium held in Brussels, Belgium, in 1997.

In der Buchreihe "Fortschritte der Herz-, Thorax- und Gefiillchirurgie" konnten mit der freundlichen Unterstiitzung der Gesellschaft der Freunde des Deutschen Herz­ zentrums Berlin e. Y. regeimaBig Habilitationsarbeiten mit ihrem ungekiirzten Text veroffentlicht werden. Die vorliegende Dissertationsarbeit von Herrn Christoph Knosalla, die von der Freien Universitat Berlin mit dem Pradikat "summa cum laude" bewertet wurde, ist die erste ihrer Art, welche die Buchreihe fortsetzt. Auch in Zukunft sollen herausra­ gende Promotionsarbeiten in dieser Form erscheinen. Herr Dr. Knosalla hat einen wichtigen experimentellen Beitrag zum Verstandnis und zur Bewertung des "Intramyokardialen Elektrogramms", kurz "IMEG" ge­ nannt, zur AbstoBungserkennung und -verfolgung, geliefert. Dieses IMEG, von meinen Mitarbeitern Drs. Henning Warnecke und Johannes Miiller erarbeitet und zur klinischen Anwendungsreife gebracht, gilt heute in unserer Nachbehandlung nach Herztransplantation als verlaBlichste Methode, AbstoBungsreaktionen an transplantierten Herzen friihzeitig zu erkennen, ihren Verlauf und damit den Thera­ pieerfolg zu beobachten. Die regeimaBige Herzmuskelbiopsie zur Gewinnung von Partikeln des transplantierten Herzens fUr die histologische Untersuchung, bisher die zumeist gebrauchte Methode, wurde damit weitgehend obsolet. Auch humorale, d. h. vorwiegend durch Antikorper vermittelte AbstoBungsreaktionen, die der Er­ kennung in der herkommlichen Histologie entgehen, konnen mit dem IMEG erfaBt werden.

Microcirculation is a rather new field which has been of predominant interest to basic scientists, linking togeth~r technical, hemodynamic, and biochemical aspects. The fmdings elaborated, however, are not only of theoretical interest, but bear in addition great clinical implications. In clinical cardiology this became quite evident by the use of tracers in order to study myocardial perfuSion and by the deSCription of certain clinical entities - such as angina with normal coro­ nary arteries - which are best explained by "disturbed microcirculation". With respect to this new developing theoretical and clinical field of cardiac microcirculation it was the aim of the Microcirculation Working Group of the European Society of Cardiology to have a symposium on which all different but clinically relevant aspects of cardiac microcirculation will be covered. This symposium, held in Heidelberg in January 1980, was planned not only for the exchange of concepts and ideas, but was expected to be in addition partially a teaching session; the basic scientists should be directed toward a better under­ standing of the clinical problems, and the clinicians should learn more about the basic mechanisms regulating substrate and ion exchange in such an impor­ tant organ as the heart, and furthermore the theoretical limitations of some of the diagnostic and therapeutical procedures should be taught. Without a lot of help we would never have succeeded in organizing the sym­ posium and editing its results.