The Experts below are selected from a list of 312 Experts worldwide ranked by ideXlab platform
Hendrik Bonnemeier - One of the best experts on this subject based on the ideXlab platform.
-
Abstract 17088: Bleeding Complications After Implantation of Pacemakers and Defibrillators in an Era of Triple Therapy and Novel Antithrombotic Drugs
Circulation, 2013Co-Authors: G. Senel, Lukas Heimbacher, Hendrik BonnemeierAbstract:Introduction: Bleeding complications (eg. pocket hematoma) are still common complications after implantation of active cardiovascular implantable devices (CIEDs). We investigated the influence of the type of CIED, the implantation strategy, and the underlying antiplatelet- and anticoagulation-therapy on bleeding complication. Methods: Between 2006 and 2012, a total of 3,082 CIEDs (Pacemakers: n=1,689; ICD/CRT/CCM: n= 1393) were implanted at our institution. There was no perioperative anticoagulation in 17.7%, ASA or thienopyridine monotherapy in 33.5%, anticoagulation with phenprocoumon, heparins or novel oral anticoagulants (NOAKs) monotherapy in 16.3%, and a dual- or triple-combination of different antithrombotic drugs in 32.5% of the patients. HAS-BLED-score was >3 in 17.5% of the patients. Bleeding complications were defined as pocket hematoma, pericardial effusion, Hematothorax, drop of hemoglobin >2mg/dl, and transfusion of >2 erythrocyte concentrates. Results: No patient died due to bleeding complications. The overall incidence of bleeding complications was 7,2%. Reoperation for pocket hematoma or Hematothorax was required in 1.26%. Patients with HAS-BLED-Score >3, patients on dual- or triple combination of antithrombotic drugs, patients on low molecular weight heparins (LMWHs), and patients on dabigatran, ticagrelor or prasugrel exhibited a higher incidence for bleeding complications. Conclusions: Even in an era of novel antithrombotic drugs and dual-/triple-anticoagulation, the rate of bleeding complications is comparable to published data of the last decade. The use of bridging therapy with LMWHs and especially its combination with ASA/thienopyridine treatment are highly predictive for bleeding complications during or after CIEDs-surgery.
-
Bleeding complications after implantation of active cardiovascular implantable devices in an era of triple therapy and novel antithrombotic drugs
European Heart Journal, 2013Co-Authors: L. Heimbaecher, G. Senel, S. Sandrock, T. Demming, Hendrik BonnemeierAbstract:Introduction: Bleeding complications (eg. pocket hematoma) are still common complications after implantation of active cardiovascular implantable devices (CIEDs). We investigated the influence of the type of CIED, the implantation strategy, and the underlying antiplatelet- and anticoagulation-therapy on bleeding complication. Methods: Between 2006 and 2012, a total of 3,082 CIEDs (Pacemakers: n=1,689; ICD/CRT/CCM: n= 1393) were implanted at our institution. There was no perioperative anticoagulation in 17.7%, ASA or thienopyridine monotherapy in 33.5%, anticoagulation with phenprocoumon, heparins or novel oral anticoagulants (NOAKs) monotherapy in 16.3%, and a dual- or triple-combination of different antithrombotic drugs in 32.5% of the patients. HAS-BLED-score was >3 in 17.5% of the patients. Bleeding complications were defined as pocket hematoma, pericardial effusion, Hematothorax, drop of hemoglobin >2mg/dl, and transfusion of >2 erythrocyte concentrates. Results: No patient died due to bleeding complications. The overall incidence of bleeding complications was 7,2%. Reoperation for pocket hematoma or Hematothorax was required in 1.26%. Patients with HAS-BLED-Score >3, patients on dual- or triple combination of antithrombotic drugs, patients on low molecular weight heparins (LMWHs), and patients on dabigatran, ticagrelor or prasugrel exhibited a higher incidence for bleeding complications. Conclusions: Even in an era of novel antithrombotic drugs and dual-/triple-anticoagulation, the rate of bleeding complications is comparable to published data of the last decade. The use of bridging therapy with LMWHs and especially its combination with ASA/thienopyridine treatment are highly predictive for bleeding complications during or after CIEDs-surgery.
D.r. Nellensteijn - One of the best experts on this subject based on the ideXlab platform.
-
Thoraxtrauma – drainage voor decompensatio cordis
Nederlands Tijdschrift voor Traumachirurgie, 2015Co-Authors: I.s. Bakker, D.r. NellensteijnAbstract:Een 65-jarige man met blanco voorgeschiedenis werd binnengebracht op de Spoedeisende Hulp, na een hoogenergetisch thoraxtrauma. Patient had een maximale EMV-score, een saturatie van 82% met 15 L zuurstof. Over de longen werd basaal crepiteren gehoord. Aanvullende diagnostiek middels X-thorax en CT-abdomen toonde het beeld van basaal vocht beiderzijds, maar tevens werden aanwijzingen voor preexistent pleuravocht bij decompensatio cordis gezien. Onder verdenking van Hematothorax werd een thoraxdrain geprikt. Deze produceerde echter helder pleuravocht, passend bij de diagnose decompensatio cordis.
-
Thoraxtrauma – drainage voor decompensatio cordis
Nederlands Tijdschrift voor Traumachirurgie, 2015Co-Authors: I.s. Bakker, D.r. NellensteijnAbstract:Een 65-jarige man met blanco voorgeschiedenis werd binnengebracht op de Spoedeisende Hulp, na een hoogenergetisch thoraxtrauma. Patiënt had een maximale EMV-score, een saturatie van 82% met 15 L zuurstof. Over de longen werd basaal crepiteren gehoord. Aanvullende diagnostiek middels X-thorax en CT-abdomen toonde het beeld van basaal vocht beiderzijds, maar tevens werden aanwijzingen voor preexistent pleuravocht bij decompensatio cordis gezien. Onder verdenking van Hematothorax werd een thoraxdrain geprikt. Deze produceerde echter helder pleuravocht, passend bij de diagnose decompensatio cordis. A 65 year old man without medical history presented himself at the emergency department after a high-energy chest trauma. Patient had a maximum EMV-score, a saturation of 82% with 15 L oxygen. Auscultation of the lungs indicated basal crepitations. Additional examination with x-thorax and CT scan of the thorax, showed bilateral basal fluid, but also evidence of preexisting pleural effusions as seen in congestive heart failure. Under suspicion of hemathothorax a chest drain was inserted, however, the drain produced clear pleural fluid, fitting the diagnosis of congestive heart failure.
F Eckersberger - One of the best experts on this subject based on the ideXlab platform.
-
lung wedge resection improves outcome in stage i primary spontaneous pneumothorax
The Annals of Thoracic Surgery, 2004Co-Authors: Martin Czerny, Andreas Salat, Tatjana Fleck, Wolfgang Hofmann, Daniel Zimpfer, F Eckersberger, Walter Klepetko, E Wolner, M R MuellerAbstract:Abstract Background To evaluate the role of apical lung wedge resection in patients with recurrent primary spontaneous pneumothorax with no endoscopic abnormalities at surgery as compared with simple apical pleurectomy. Methods We performed a retrospective analysis on 126 consecutive video-assisted thoracoscopic surgery (VATS) procedures in 113 patients treated for stage I recurrent PSP between January 1994 and December 2001. Two surgical strategies were applied: simple apical pleurectomy (57 procedures, 45.2%: group A) and apical pleurectomy together with an apical lung wedge resection (69 procedures, 54.8%: group B). Results Mean duration of chest tubes was 1.4 days (range, 1 to 7), mean hospital stay was 2.4 days. Three patients (2.4%) required redo VATS, 2 in group A (3.5%) for persistent air leak and 1 (1.4%) in group B for apical Hematothorax. Mean follow-up was 38.7 months. Overall recurrence rate was 3.2%. Four patients in group A (7%) experienced recurrent ipsilateral pneumothoraces 4 to 73 weeks (mean, 30.2) after surgery. No recurrences were observed in group B ( p = 0.009). Conclusions In this selected group of patients without endoscopical abnormalities, VATS offers low recurrence rates. However, these data suggest that apical pleurectomy should be accompanied by apical lung wedge resection even for this favorable category of patients.
-
Thorakoskopische Chirurgie — videoassistierte Thoraxchirurgie
Acta Chirurgica Austriaca, 2000Co-Authors: F EckersbergerAbstract:Background: Video-assisted thoracoscopic surgery has taken a firm place in thoracic surgery. Nearly every type of thoracic surgery operation has been performed in video-assisted technique (VATS). Based on experiences commonly accepted indications and nowadays relative indications for use of VATS have been yielded. Methods: By means of available reports of the literature and personal experiences the current status is pointed out for indication, technical procedure, conversion rate as well as an overview of cost analysis. Results: Commonly accepted indications are nowadays: Spontaneous pneumothorax, biopsies in pleural and mediastinal diseases of tumors, cysts and emphysema, peripheral coin lesions, lung biopsies in interterstitial lung diseases, sympathectomy and pericardial windows. VATS is used not routinely in metastasectomy, decortication after empyema and Hematothorax, treatment in lung cancer for lobectomy or pneumoectomy and in oncological esophageal surgery. Conclusions: VATS has become a standard procedure in a wide field of diagnosis and therapy. The debate between proponents of the thoracoscpic procedure and an open approach has largely focused on: technical feasibility, pain reduction, relative costs both procedural and in-patient, safety und the adequacy of resection in malignant diseases. Grundlagen: Videoassistierte thorakoskopische Operationen haben in der Thoraxchirurgie einen festen Stellenwert eingenommen. Beinahe alle thoraxchirurgischen Eingriffe sind mit dieser videoassistierten Technik (VATS) schon durchgeführt worden. Mit der Erfahrung haben sich gesicherte und derzeit relative Indikationen zur Anwendung von VATS ergeben. Methodik: Aus eigener Erfahrung und an Hand der Literatur wird versucht, den aktuellen Stand in bezug auf Indikation, Operationstechnik, Konversionsrate sowie Ausbildung darzulegen und einen Überblick über Kostenrechnungen zu geben. Ergebnisse: Als gesicherte Indikationen sind aus heutiger Sicht anzusehen: Spontanpneumothorax, Biopsie mediastinaler und pleuraler Prozesse und Raumforderungen, der periphere Rundherd der Lunge, Lungenbiopsie bei interstitiellen Gerüsterkrankungen, Lungenzysten und Emphysem, Sympatektomie, Perikardfenster, Pleurodese. Fraglich und nicht routinemäßig wird VATS angewendet zur: Dekortikation beim Empyem und Hämatothorax, Metastasektomie, Behandlung des Bronchuskarzinoms mit Lobektomie und Pneumonektomie und bei malignen Erkrankungen des Ösophagus. Schlußfolgerungen: In der Diagnostik und Therapie thorakaler Erkrankungen gilt VATS heute unumstritten als wertvolle Standardmethode. Den tatsächlichen Vorteil der VATS gegenüber der offenen Methoden versucht man nun durch Vergleich von technischer Durchführbarkeit. Schmerzreduktion, Kosten-Nutzen-Kalkulation, Sicherheit und Risiko sowie durch die Anwendbarkeit in der Malignomchirurgie objektiv zu evaluieren.
-
Minimal invasive Thoraxchirurgie
Acta chirurgica Austriaca, 1999Co-Authors: F Eckersberger, Daniela Kandioler-eckersbergerAbstract:Background: This year marks the tenth anniversary of the beginning of the new era of video-assisted thoracic surgery. During that time, nearly every type of thoracic surgical operation has been performed “through the scope”. Video-assisted technique (VATS) has taken a firm place in thoracic surgery. Methods: By means of available reports of the literature and personal experiences the current status is pointed out for indications, technical procedure, conversion rate as well as training and education to identify areas of potential development. Results: Nowadays commonly accepted indications include: Spontaneous pneumothorax, biopsies in pleural and mediastinal diseases or tumors, peripheral coin lesions, biopsies in interstitial lung diseases, cysts and emphysema, sympathectomy and pericardial windows. VATS is used not routinely in metastasectomy, decortication after empyema and Hematothorax, treatment in lung cancer for lobectomy or pneumonectomy and in oncological esophageal surgery. Conclusions: In a wide field VATS has become a standard procedure in diagnosis and therapy. The debate between proponents of the thoracoscope and an open approach has largely focused on: technical feasibility, pain reduction, relative costs both procedural and in — patient, safety issues and the adequacy of resection in malignant diseases. Grundlagen: Vor 10 Jahren hat man begonnen, die minimal invasive Methode auch in die Thoraxchirurgie einzuführen, und seither wurden schon beinahe alle thoraxchirurgischen Eingriffe mit dieser videoassistierten Technik (VATS) durchgeführt. So hat die thorakoskopische Chirurgie einen festen Stellenwert eingenommen. Methodik: Anhand der eigenen Erfahrungen und Berichte aus der Literatur wird versucht, den aktuellen Stand in bezug auf Indikation, Operationstechnik, Konversionsrate sowie Ausbildung darzulegen und mögliche Entwicklungen aufzuzeigen. Ergebnisse: Als gesicherte Indikationen sind aus heutiger Sicht anzusehen: Spontanpneumothoarax, Biopsie mediastinaler und pleuraler Prozesse und Raumforderungen, der periphere Rundherd der Lunge, Lungenbiopsie bei interstitiellen Gerüsterkrankungen, Lungenzysten und Emphysem, Sympathektomie, Perikardfenster, Pleurodese. Fraglich und nicht routinemäßig wird VATS angewendet zur: Dekortikation beim Empyem und Hämatothorax, Metastasektomie, Behandlung des Bronchuskarzinoms zur Lobektomie bzw. Pneumonektomie und bei malignen Erkrankungen des Oesophagus. Schlußfolgerungen: VATS gilt heute unumstritten als wertvolle Standardmethode in der Diagnostik und Therapie thorakaler Erkrankungen. Den tatsächlichen Vorteil gegenüber den offenen Methoden versucht man nun durch Vergleich von technischer Durchführbarkeit, Schmerzreduktion, Kosten-Nutzen-Analysen, Sicherheit und Risiko sowie die Anwendbarkeit in der Malignomchirurgie herauszuarbeiten.
I.s. Bakker - One of the best experts on this subject based on the ideXlab platform.
-
Thoraxtrauma – drainage voor decompensatio cordis
Nederlands Tijdschrift voor Traumachirurgie, 2015Co-Authors: I.s. Bakker, D.r. NellensteijnAbstract:Een 65-jarige man met blanco voorgeschiedenis werd binnengebracht op de Spoedeisende Hulp, na een hoogenergetisch thoraxtrauma. Patient had een maximale EMV-score, een saturatie van 82% met 15 L zuurstof. Over de longen werd basaal crepiteren gehoord. Aanvullende diagnostiek middels X-thorax en CT-abdomen toonde het beeld van basaal vocht beiderzijds, maar tevens werden aanwijzingen voor preexistent pleuravocht bij decompensatio cordis gezien. Onder verdenking van Hematothorax werd een thoraxdrain geprikt. Deze produceerde echter helder pleuravocht, passend bij de diagnose decompensatio cordis.
-
Thoraxtrauma – drainage voor decompensatio cordis
Nederlands Tijdschrift voor Traumachirurgie, 2015Co-Authors: I.s. Bakker, D.r. NellensteijnAbstract:Een 65-jarige man met blanco voorgeschiedenis werd binnengebracht op de Spoedeisende Hulp, na een hoogenergetisch thoraxtrauma. Patiënt had een maximale EMV-score, een saturatie van 82% met 15 L zuurstof. Over de longen werd basaal crepiteren gehoord. Aanvullende diagnostiek middels X-thorax en CT-abdomen toonde het beeld van basaal vocht beiderzijds, maar tevens werden aanwijzingen voor preexistent pleuravocht bij decompensatio cordis gezien. Onder verdenking van Hematothorax werd een thoraxdrain geprikt. Deze produceerde echter helder pleuravocht, passend bij de diagnose decompensatio cordis. A 65 year old man without medical history presented himself at the emergency department after a high-energy chest trauma. Patient had a maximum EMV-score, a saturation of 82% with 15 L oxygen. Auscultation of the lungs indicated basal crepitations. Additional examination with x-thorax and CT scan of the thorax, showed bilateral basal fluid, but also evidence of preexisting pleural effusions as seen in congestive heart failure. Under suspicion of hemathothorax a chest drain was inserted, however, the drain produced clear pleural fluid, fitting the diagnosis of congestive heart failure.
D. B. Poddie - One of the best experts on this subject based on the ideXlab platform.
-
Video-assisted thoracic surgery (VATS) lobectomy for typical bronchopulmonary carcinoid tumors
Surgical Endoscopy, 2000Co-Authors: L. Solaini, P. Bagioni, F. Prusciano, F. Di Francesco, D. B. PoddieAbstract:Background: Indications for the use of video-assisted thoracic surgery (VATS) lobectomy are a controversial matter. This study aims to provide a retrospective evaluation of VATS lobectomy in typical bronchopulmonary carcinoids. Methods: Patient selection criteria for VATS lobectomy were as follows: (a) typical carcinoids with clear diagnosis; (b) centrally located lung tumors not amenable to bronchial resection with bronchoplastic procedures, or tumors located in peripheral lung tissues; (c) no hilar or mediastinal lymph node enlargement; and (d) normal respiratory function. Between January 1995 and December 1999, 12 patients (eight men and four women with a mean age of 57 years) were treated, seven with a peripheral and five with a centrally located tumor. Preoperative examination included chest roentgenograms, computed tomography (CT) of the chest, bronchoscopy, and spirometry; diagnosis was established by direct bronchoscopy in five cases, transbronchial biopsy in two cases, transthoracic biopsy in two cases, and videothorascopic wedge resection in three cases. Eleven VATS lobectomies and one VATS bilobectomy were performed. All patients underwent hilar lymphadenectomy and mediastinal sampling. Results: There were no intraoperative complications. The only postoperative complication, Hematothorax (8.3%), required VATS reoperation. Mean postoperative hospital stay was 5.33 days. Pathological examination of the resected specimens confirmed that the procedure was radical in all 12 patients and revealed eight T1N0 and four T2N0. At a mean follow-up of 30 months, no signs of recurrence were recorded. Conclusion: VATS lobectomy in the treatment of selected typical carcinoids, both central and peripheral, seems to yield favorable results and is therefore preferable to thoracotomy since it is less invasive.