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Hystopathological Changes of Ascending Aorta and Serum Concentration of Transforming Growth Factor in Patients with Proven Aortopathy
Karalko, Mikita ; Pojar, Marek (advisor) ; Špaček, Miroslav (referee) ; Kurfirst, Vojtěch (referee)
- ENG Histopathological changes of ascending aorta and serum concentration of transforming growth factor in patients with proven aortopathy The etiology of ascending aorta dilation in patients with nonsyndromic ascending aortic aneurysm is not clearly defined and may be multifactorial. Haemodynamic or genetic factors are involved. Determination of the etiology and eventual markers of progression of aortic wall dilatation is important because it is the etiology that determines the risk of catastrophic vascular complications, such as aortic dissection (AD). However, publications on this topic are scarce and their results are contradictory. A total of 376 patients from the clinical database of our institution were included in the retrospective analysis. These patients underwent either elective surgery for dilatation of the ascending aorta (DAA) or emergency surgery for AD. This was an isolated procedure on the ascending aorta or in combination with an aortic valve procedure. After excision, samples of the ascending aorta were histologically examined. On histological examination, we found significantly higher degree of involvement in samples from patients with TAV compared with patients with BAV (P <0.001). However, the correlation was weak for all variables when aortic diameter and histological...
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Impact of Minimally Invasive Approach on Pulmonary Function in Patients Undergoing Aortic Valve Replacement
Gofus, Ján ; Pojar, Marek (advisor) ; Rohn, Vilém (referee) ; Šantavý, Petr (referee)
of the dissertation Impact of minimally invasive approach on pulmonary function in patients undergoing aortic valve replacement MUDr. Ján Gofus The most common minimally invasive approach to aortic valve replacement is upper hemisternotomy, which has been implemented at our department, as well. Preserving the lower half of thoracic cage could lead to lower postoperative drop of pulmonary function, apart from other benefits. Nevertheless, publications on this topic are insufficient and controversial. Our aim was to perform a prospective randomized trial comparing upper hemisternotomy with standard (median) sternotomy in terms of pulmonary function changes perioperatively. We also added a novel exercise tolerance test, one-minute sit-to-stand test, and a quality of life evaluation to the study. We included patients indicated for elective isolated aortic valve replacement with bioprosthesis who were older than 65 years, signed informed consent, and in which both surgical approaches were technically feasible. Exclusion criteria were re-do surgery and concomitant cardiac surgery. Patients were randomized to minimally invasive and standard group in 1:1 ratio. On the day of admission, on the 7th postoperative day and 3 months postoperatively, the patients underwent pulmonary function testing and one-minute...
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