Author: Zivojin Jonjev

ReReDo surgery due to acute aortic dissection

Zivojin Jonjev
72 y/o Caucasian male was admitted to the hospital due to acute aortic dissection (De Bakey typ I), after physical exertion (Figure 1 and 2). Pt was previously operated on 19 y/a after sever anterior MI (LAD-lima) and 3 y/a was operated on as a ReDo case (3xCABG: LIMA was recycled to the LAD, and SV grafts were implanted to RCA and CxOM1). In ReReDo surgery ascending aorta was replaced with prosthetic graft, and RCA SF graft was re-implanted to prosthesis (Figure 3). Pt was discharged on the PO day#8 w/o complications.

Acute aortic dissection (hemiarch repair in deep hypothermia)

Zivojin Jonjev

Caucasian female 73 y/o was admitted to the hospital with acute aortic dissection. Transthoracic eco indicated that MR 4 and TR 3 were also present. After quick preop set up PT was urgently operated on. The dissected aorta was resected and hemiarch procedure was performed with implantation of the Vascutek #30 prosthesis. PT was in deep hypothermia (T=28C) and total circulatory arrest was established for 57 minutes. Brain was protected with cerebral anterograde perfusion through brachiocephalic trunk. MR and TR were also corrected by annuloplasty. The patient was discharged on the PO day #13 w/o complication. PT was doing well 3 month after surgery.

  • Preop view of the Aortic Dissection
  • Arrangement of the proximal anastomosis with aortic cross clamp
  • Tailoring of the graft and preparation for open distal anastomosis
  • Final view after surgey

Papillary muscle rupture after acute myocardial infarction

Zivojin Jonjev

The patient was admitted to the hospital soon after diagnosis of the acute myocardial infarction, complicated with cardiogenic shock. The patiend was former Olimpic Champion in hanball and was in an excelent physical condition. The cath. lab confirmed triple vessel disease and the patient was transferred to the operating room. The patient was operated on with triple CABG. RCA was grafted with saphenous venin and LAD/D1 was grafted with LIMA in a “jumping” fashion. Mitral valve was replaced with Carbomedics 27 bileaflet prosthesis, and the tricuspid valve was reconstructed with stitch annuloplasty. The patient did well after surgery and was discharged on the PO 11 in a good health condition.

Papillary muscle rupture (anterior head of the posteromedial PM) after MI

ReDo surgery of the ascending aorta 15 years after primary aortic valve replacement

Zivojin Jonjev
  • 55 y/o Caucasian man was admitted for elective surgical treatment.
  • 15 y/a he was operated on due to aortic valve replacement .
  • St Jude mechanical valve #27 (AV) was implanted.
  • Acs.Ao (AA) was estimated as slightly elevated and left intact.
  • MSCT scan measured 64mm in ascending aorta and 43mm in the region of the ST junction.
  • Other surgical structures including previously implanted mechanical valve were normal.
  • ReDo surgery was scheduled. Asc.Ao was resected and replaced with Gelwave straight woven vascular graft (Vascutek prosthesis #32).
  • Pt was released from the hospital on PO day#10 w/o complications.

Resekcija gigantske koronarne aneurizme

Zivojin Jonjev
Pacijent star 68 godina primljen je zbog ishemijske bolesti srca. Koronarografijom je dijagnostikovana višesudovna koronarna okluzivna bolest i gigantska kornarna aneurizma desne koronarne arterije.
  • Pacijent star 68 godina primljen je zbog ishemijske bolesti srca
  • Dijagnostičkom koronarografijom utvrđeno je postojanje višesudovne koronarne bolesti i gigantske koronarne aneurizme desne koronarne arterije
  • CT koronarografijom potvrđeno je postojanje koronarne aneurizme i određena je njena topografija u odnosu na ostale srčane strukture.
  • Urađena je hirurška revaskularizacija miokarda (3xCABG-ACDpd, LAD-lima, CxOM1) uz totalnu resekciju koronarne aneurizme.
  • Pacijent je otpušten na dalji kućni oporavak 7. PO dana u dobrom opštem stanju i bez komplikacija.

68th ESCVS kongres, Groningen, Holandija

Zivojin Jonjev

Od 22. do 25. maja 2019. godine, održan je 68. kongres Evropskog društva za kardiovaskularnu i endovaskularnu hirurgiju (ESCVS) u Groningenu, u Holandiji. Događaj je organizovan u saradnji sa Institutom Venckebach Univerzitetskog medicinskog centra Groningen (UMCG).

ESCVS je najstarije društvo u Evropi na polju kardiohirurške i vaskularne hirurgije, a osnovali su ga Rene Leriche i R. Dos Santos 1950. godine. Poznati stručnjaci iz celog sveta predstavili su najnovija dostignuća u ovoj oblasti. ESCVS 2019 imalo je preko 1000 učesnika.

Disfunkcionalni kvadrivelarni aortni zalistak

Zivojin Jonjev

Pacijent star 68 godina primljen je u bolnicu zbog zakazane kardiohirurške operacije zamene aortnog zaliska i revaskularizacije miokarda. Tokom operacije registrovana je kvadrivelarna, disfunkcionalna aortna valvula sa centralnom insuficijencijom. Urađena je zamena aortnog zaliska implantacijom mehaničke St Jude proteze i revaskularizacija miokarda trostrukim bypass-om (LAD-lima, RIM, Cx). Pacijent je otpušten 7 p.o. dana na dalji kućni oporavak bez komplikacija