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PubMed1978

Submergence of roots for alveolar bone preservation. II. Reimplanted endodontically treated roots.

Root canal therapy was accomplished on the mandibular premolars of four dogs. These premolars were then extracted, contoured, reimplanted, and submerged. Resorption occurred up to 60 days; healing progressed satisfactorily, with some evidence of coronal osseous regeneration. Root canal sealer was expressed out the coronal orifice after the roots were submerged. This sealer appeared to affect normal healing over the coronal surface of the roots.

Alveolar Process↗
PubMed1982

Left renal venous hypertension "nutcracker" syndrome. Managed by direct renocaval reimplantation.

Since 1978 a diagnosis of left renal venous hypertension has been established in 3 patients. All 3 had otherwise unexplained left flank and abdominal pain, 2 had left renal gross hematuria, and 2 were found to have ureteral and peripelvic varices demonstrated by selective renal venography. All were found to have mild to moderate pressure gradients between the left renal vein and vena cava, presumably due to compression of the left renal vein between the aorta and overlying superior mesenteric artery. Direct left renocaval reimplantation was performed in all cases, with resection of the collateral varices that were present in 2 cases. Severe unrelenting pain was the primary indication for surgery in all cases, rather than hematuria. All remain asymptomatic one to four years after surgery.

Adult↗
PubMed1985

Removal and reimplantation of the parietal cortex of the neonatal mouse: consequences for the barrelfield.

The barrelfield, i.e., the cortical representation of the contralateral whiskerpad, develops in the mouse between postnatal days 4 and 6 (P4 and P6). The pattern of barrels in the barrelfield is dependent on that of the whiskers on the whiskerpad. We removed (unilaterally) and reimplanted, with normal orientation (n = 23) or after 180 degrees rotation (n = 23), that part of the pallium where the barrelfield is to develop. These operations were made at birth (PO), at P1 or at P3. Our aim was to know whether a homeomorphic representation of the periphery would be established, by regeneration or by retarded growth of surviving thalamic fibers into the cortex, and if so, whether it could be modified in its orientation. Of group (i) 16 animals survived of which 14 killed between P26 and P29 could be analyzed. We operated 11 at PO and 4 of these had a normal barrelfield, two a rotated one (by about 30 degrees) with some barrels in odd positions, one a wildly disorganized one and 4 no barrels at all. Three mice operated at P3 presented a normal barrelfield. In group (ii) operated at PO, the 17 survivors, killed between P13 and P68, had no barrels. The results indicate that a homeomorphic representation of the periphery may be established in the somatosensory cortex after an early, complete and massive interruption not only of all its afferent and efferent fibers, but also of its vascularization. With respect to animals of group (ii) we cannot rule out the ingrowth of thalamic afferents into the implant.(ABSTRACT TRUNCATED AT 250 WORDS)

Afferent Pathways↗
PubMed1994

Successful extracorporeal circulatory support after aortic reimplantation of anomalous left coronary artery.

The development of severe heart failure is the main cause of postoperative mortality after the surgical treatment of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). Two patients with ALCAPA who developed low cardiac output and could not be weaned from cardiopulmonary bypass (CPB) after aortic reimplantation of the anomalous left coronary artery were successfully treated with a centrifugal left ventricular assist device (LVAD) and extracorporeal membrane oxygenation (ECMO). The circulation of a 10-month-old infant with severe left ventricular dysfunction was supported 192 h postoperatively with a LVAD and a 9-year-old boy with severe right ventricular failure received ECMO support for 99 h following surgery. Both patients survived and, 4 and 9 months after surgery, are asymptomatic and have normal ventricular function. If CPB (up to 3 h) is not effective in improving ventricular function after surgery for ALCAPA, ECMO or LVAD must be used since myocardial recovery in these patients can occur only after prolonged extracorporeal circulatory support.

Cardiopulmonary Bypass↗
PubMed2006

Reimplantation technique (David operation) for multiple sinus of valsalva aneurysms.

Sinus of Valsalva aneurysms are relatively uncommon, and surgical repair is indicated at the time of diagnosis whether or not symptoms are present. This generally entails closure using a patch technique because usually only one sinus is involved. We report here the successful treatment of multiple sinus of Valsalva aneurysms using a David reimplantation valve-sparing root replacement.

Aortic Aneurysm↗
PubMed2006

Thoracic and thoracoabdominal aneurysm repair: is reimplantation of spinal cord arteries a waste of time?

BACKGROUND: The impact of different strategies for management of intercostal and lumbar arteries during repair of thoracic and thoracoabdominal aortic aneurysms (TAA/A) on the prevention of paraplegia remains poorly understood. METHODS: One hundred consecutive patients with intraoperative monitoring of motor evoked potentials (MEP) and somatosensory evoked potentials (SSEP) during TAA/A repair involving serial segmental artery sacrifice (October 2002 to December 2004) were reviewed. RESULTS: Operative mortality was 6%. The median intensive care unit stay was 2.5 days (IQ range: 1-4 days), and the median hospital stay 10.0 days (IQ range: 8-17 days). Potentials remained unchanged during the course of serial segmental artery sacrifice, or could be returned to baseline levels by anesthetic and blood pressure manipulation, in 99 of 100 cases. An average of 8.0 +/- 2.6 segmental artery pairs were sacrificed overall, with an average of 4.5 +/- 2.1 segmental pairs sacrificed between T7 and L1, where the artery of Adamkiewicz is presumed to arise. Postoperative paraplegia occurred in 2 patients. In 1, immediate paraplegia was precipitated by an intraoperative dissection, resulting in 6 hours of lower body ischemia. A second ambulatory patient had severe paraparesis albeit normal cerebral function after resuscitation from a respiratory arrest. CONCLUSIONS: With monitoring of MEP and SSEP, sacrifice--without reimplantation--of as many as 15 intercostal and lumbar arteries during TAA/A repair is safe, resulting in acceptably low rates of immediate and delayed paraplegia. This experience suggests that routine surgical implantation of segmental vessels is not indicated, and that, with evolving understanding of spinal cord perfusion, endovascular repair of the entire thoracic aorta should ultimately be possible without spinal cord injury.

Adult↗
PubMed2005

A simple method to adapt the height of the sinotubular junction of the De Paulis Valsalva graft to the height of the patient's sinuses in David reimplantation procedure.

De Paulis and associated introduced a new aortic root conduit for valve-sparing operation. The use of this prosthesis for David I (reimplantation) procedure occasionally may be problematic when the top of the commissures, do not match the new sinotubular junction of the graft. We propose a simple method that allows to create a new sinotubular junction at the desired level in the skirt portion of the Valsalva prosthesis.

Aorta↗
PubMed2005

Successful reimplantation of a phrenic nerve stimulator after traumatic exteriorisation.

A quadriplegic patient experienced post-traumatic exteriorisation of the subcutaneous receiver of a phrenic pacemaker. In the absence of infection and stimulation dysfunction in the patient, the device was reimplanted with full success at 1 year. This strategy can, exceptionally, be considered if removal and subsequent implantation is impossible or refused.

Diaphragm↗
PubMed2005

A technique to reposition sinotubular junction in aortic valve reimplantation procedures with the De Paulis Valsalva graft.

Sinotubular junction reconstruction in reimplantation type of valve-sparing aortic procedure can present some problem when a Valsalva graft is used. Since in the Valsalva graft the sinotubular junction height is predetermined, correct matching with native commissures height can be difficult. We propose a method by which it is possible to create a new sinotubular junction in Valsalva graft without altering its original configuration.

Aortic Aneurysm↗
PubMed2006

A simple modification of 'David-V' aortic root reimplantation.

Valve-sparing aortic root reimplantation with creation of Dacron graft pseudosinuses is a popular and promising surgical choice for annuloaortic ectasia or ascending aortic aneurysm. We have developed a simple modification of the David-V technique, which facilitates free adjustment of the size of the new aortic annulus and the pseudosinus of each patient, as well as the creation of pseudosinuses of excellent shape, with only one Dacron graft.

Aorta↗
PubMed2006

Ureteral reimplantation for management of ureteral strictures: a retrospective comparison of laparoscopic and open techniques.

OBJECTIVES: To compare the results of laparoscopic ureteral reimplantation with a previous series of open surgery. MATERIALS AND METHODS: We compared ten patients who underwent laparoscopic vesicopsoas-hitch with (n=4) or without Boari-flap (n=6) technique for ureteral obstructions with ten patients treated by open ureteroneocystostomy for similar pathologies. Patient demographics, preoperative symptoms, radiologic imaging, and postoperative outcomes were analyzed. Postoperative observation time averaged 17 mo (range: 9-23) in the laparoscopic and 65 mo (range: 18-108) in the open group. Success was defined as relief of obstruction in postoperative imaging studies and relief of pain. RESULTS: Mean length of stricture (28.5 vs. 25 mm) was comparable in both groups. In laparoscopy versus open surgery, mean operative time (228 vs. 187 min) was longer, blood loss (370 vs. 610 ml) and analgesic requirement (4.9 vs. 21.5mg) were significantly lower, and mean time to oral intake (1.5 vs. 2.9 d), hospital stay (9.2 vs. 19.1 d), and convalescence time (2.3 vs. 4.2 wk) were significantly shorter. Success rates yielded 10 of 10 after laparoscopy and 8 of 10 after open surgery. No intra- or postoperative major complications occurred in the laparoscopic series. After open surgery, two patients had major postoperative complications, including urinary extravasation with abdominal haematoma and anastomostic stricture, respectively. CONCLUSIONS: Laparoscopic ureteroneocystostomy is feasible, providing functional outcomes comparable to open surgery while offering the advantages of a minimal invasive technique (e.g., less postoperative analgesics, and shorter hospitalization and convalescence). Nevertheless, it requires a high level of laparoscopic expertise and should be carried out only in specialist centers.

Adult↗
PubMed2004

Rescue and sprouting of motoneurons following ventral root avulsion and reimplantation combined with intraspinal adeno-associated viral vector-mediated expression of glial cell line-derived neurotrophic factor or brain-derived neurotrophic factor.

Following avulsion of a spinal ventral root, motoneurons that project through the avulsed root are axotomized. Avulsion between, for example, L2 and L6 leads to denervation of hind limb muscles. Reimplantation of an avulsed root directed to the motoneuron pool resulted in re-ingrowth of some motor axons. However, most motoneurons display retrograde atrophy and subsequently die. Two neurotrophic factors, glial cell line-derived neurotrophic factor (GDNF) and brain-derived neurotrophic factor (BDNF), promote the survival of motoneurons after injury. The long-term delivery of these neurotrophic factors to the motoneurons in the ventral horn of the spinal cord is problematic. One strategy to improve the outcome of the neurosurgical reinsertion of the ventral root following avulsion would involve gene transfer with adeno-associated viral (AAV) vectors encoding these neurotrophic factors near the denervated motoneuron pool. Here, we show that AAV-mediated overexpression of GDNF and BDNF in the spinal cord persisted for at least 16 weeks. At both 1 and 4 months post-lesion AAV-BDNF- and -GDNF-treated animals showed an increased survival of motoneurons, the effect being more prominent at 1 month. AAV vector-mediated overexpression of neurotrophins also promoted the formation of a network of motoneuron fibers in the ventral horn at the avulsed side, but motoneurons failed to extent axons into the reinserted L4 root towards the sciatic nerve nor to improve functional recovery of the hind limbs. This suggests that high levels of neurotrophic factors in the ventral horn promote sprouting, but prevent directional growth of axons of a higher number of surviving motoneurons into the implanted root.

Animals↗
PubMed2004

Reimplantation, bone augmentation, and implantation procedures for impacted maxillary canines: a clinical report.

Single tooth implant-supported restorations have become a common procedure for the restoration of missing teeth. This clinical report describes the treatment and long-term follow-up of 2 maxillary implant-supported crowns in the canine region placed after unsuccessful reimplantation and successful bone augmentation procedures. In spite of the complicated procedures presented, a good long-term clinical result was achieved.

Adolescent↗
PubMed2006

A corner-saving ureteral reimplantation technique without stenting.

In this study we present our new technique, which will simplify reconstruction of even a small-caliber ureter. Our transplantation team has performed 1523 renal transplantation since 1975. From 1975 to 1983, we performed 300 ureteroneocystostomies using the modified Politano-Leadbetter technique. Since 1983, the extravesical Lich-Gregoir technique was used in combination with temporary ureteral stenting in 1141 patients. After September 2003, we began a corner-saving technique. Eighty-two (62 living related, 20 cadaver) renal transplantations have been performed since September 2003. The mean recipient age was 32.2 +/- 10.9 years (range, 7 to 63). Mean donor age was 38.9 +/- 13.1 years. For ureteral reimplantation, a running suture is started from 3 mm ahead from the middle of the posterior wall and finished 3 mm afterward. After the last stitch, both ends of the suture material are pulled and the posterior wall of the ureter and bladder are approximated tightly. The anterior wall is sewn either with the same suture or another running suture. Since using this technique, we have not employed a double J or any other stent to prevent ureteral complications at the anastomosis side. We have seen only two (2.4%) ureteral complications. In conclusion, due to the low complication rate, we believe that our new technique is the safest way to perform a ureteroneocyctostomy.

Adolescent↗
PubMed2004

Ureteral reimplantation for vesicoureteral reflux: comparison of minimally invasive extravesical with transvesical and conventional extravesical techniques.

OBJECTIVES: To analyze and compare the different ureteral reimplantation techniques to clarify the decision making for surgical treatment of vesicoureteral reflux. METHODS: From July 1995 to December 2000, 218 patients underwent antireflux surgery. The first 92 cases (143 ureters) were performed with the transvesical technique of Cohen (group 1), the next 37 cases (49 ureters) with the conventional extravesical technique (group 2), and the last 89 cases (113 ureters) with the new minimally invasive technique (group 3). The surgical time, length of hospital stay, postoperative side effects, frequency of pain control, and voiding cystogram findings to ensure the cessation of reflux for all patients were retrospectively analyzed. RESULTS: The success rates were similar among the different procedures. All patients in group 1 required a suprapubic cystostomy, and three had blood clot retention. Four patients in group 2 had bladder inefficiency. The surgical time ranged from 139 to 181 minutes in group 1, 58 to 94 minutes in group 2, and 40 to 61 minutes in group 3. The length of hospital stay ranged from 2.8 to 5.5 days in groups 1 and 2, and no hospital stay was needed in group 3. The frequency of analgesic administration was significantly less in group 2 compared with group 1; however, no analgesia was required in group 3. CONCLUSIONS: The results from our comparison show that the minimally invasive technique can be used as a simple and highly effective interventional procedure with less morbidity for the patient.

Analgesics↗