{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T09:26:35Z","timestamp":1648632395236},"reference-count":14,"publisher":"Akademiai Kiado Zrt.","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["MaSeb"],"published-print":{"date-parts":[[2012,8,1]]},"abstract":"<jats:title>Absztrakt<\/jats:title>\n        <jats:p>\n          <jats:italic>Esetismertet\u00e9s:<\/jats:italic> A szerz\u0151k 53 \u00e9ves vesetranszplant\u00e1lt f\u00e9rfi betegr\u0151l sz\u00e1molnak be, akin\u00e9l fullad\u00e1s \u00e9s neh\u00e9zl\u00e9gz\u00e9s miatt k\u00e9sz\u00fclt mellkasr\u00f6ntgen, majd mellkasi CT-angiographia bal oldali haemothoraxot okoz\u00f3, ruptur\u00e1lt aorta\u00edv-descendens aneurysm\u00e1t igazolt. Acut m\u0171t\u00e9t sor\u00e1n sternotomi\u00e1b\u00f3l ascendo-anonymo-caroticus Y-\u00e1thidal\u00e1st, majd femoralis felt\u00e1r\u00e1sb\u00f3l stentgraft-implant\u00e1ci\u00f3t v\u00e9geztek. A bal mellkasf\u00e9lben kialakult, a t\u00fcd\u0151 kompresszi\u00f3s atelectasi\u00e1j\u00e1t okoz\u00f3 haematom\u00e1t \u00e9s a szerv\u00fcl\u0151 fibrines felrak\u00f3d\u00e1sokat m\u00e1sodik l\u00e9p\u00e9sben, thoracotomi\u00e1b\u00f3l t\u00e1vol\u00edtott\u00e1k el. A kontroll sor\u00e1n a beteg panaszmentes, a bifurcati\u00f3s prot\u00e9zis \u00e9s a stentgraft j\u00f3 helyzetben r\u00f6gz\u00fclt, az aneurysmazs\u00e1k megkisebbedett, a t\u00fcd\u0151k expand\u00e1ltak. <jats:italic>Megbesz\u00e9l\u00e9s:<\/jats:italic> Az aorta\u00edv-aneurysm\u00e1k ell\u00e1t\u00e1s\u00e1ban a hagyom\u00e1nyos m\u0171t\u00e9t cardiopulmonalis bypass v\u00e9delm\u00e9ben \u00e9s teljes kering\u00e9sle\u00e1ll\u00edt\u00e1s mellett t\u00f6rt\u00e9nik. A m\u0171t\u00e9t alatt kialakul\u00f3 cerebralis sz\u00f6v\u0151dm\u00e9nyek magas kock\u00e1zat\u00e1t \u2013 a m\u00e9ly hypothermia cerebroprotekt\u00edv hat\u00e1s\u00e1n t\u00fal \u2013 \u00fajabban az izol\u00e1lt cerebralis perfusio l\u00e9tes\u00edt\u00e9s\u00e9vel tudt\u00e1k eredm\u00e9nyesen cs\u00f6kkenteni. A tiszt\u00e1n seb\u00e9szi megold\u00e1s alternat\u00edv\u00e1j\u00e1t jelentik a hybrid m\u0171t\u00e9tek, amelyek sor\u00e1n a supraaorticus \u00e1gak kering\u00e9s\u00e9nek biztos\u00edt\u00e1sa (debranching) ut\u00e1n t\u00f6rt\u00e9nik stentgraft-implant\u00e1ci\u00f3. E beavatkoz\u00e1sok kisebb megterhel\u00e9st jelentenek, ugyanakkor \u00e1lland\u00f3 ut\u00e1nk\u00f6vet\u00e9st ig\u00e9nyelnek, \u00e9s hossz\u00fa t\u00e1v\u00fa eredm\u00e9nyek m\u00e9g nem \u00e1llnak rendelkez\u00e9sre. Acut esetben az aorta\u00edv hybrid rekonstrukci\u00f3ja kis sz\u00e1mban v\u00e9gzett beavatkoz\u00e1s, azonban a felt\u00e9telek megl\u00e9te eset\u00e9n a magas kock\u00e1zat\u00fa betegek ell\u00e1t\u00e1s\u00e1nak val\u00f3s alternat\u00edv\u00e1ja. Jelen esetben fontos tov\u00e1bbi szempont, hogy e met\u00f3dus alkalmaz\u00e1s\u00e1val a j\u00f3l m\u0171k\u00f6d\u0151 transzplant\u00e1lt vese kering\u00e9se mindv\u00e9gig biztos\u00edtva volt.<\/jats:p>","DOI":"10.1556\/maseb.65.2012.4.10","type":"journal-article","created":{"date-parts":[[2012,9,2]],"date-time":"2012-09-02T07:41:39Z","timestamp":1346571699000},"page":"230-233","source":"Crossref","is-referenced-by-count":0,"title":["Ruptur\u00e1lt \u00edv-descendens aorta aneurysma hybrid rekonstrukci\u00f3ja vesetranszplant\u00e1lt betegben"],"prefix":"10.1556","volume":"65","author":[{"given":"Zolt\u00e1n","family":"Ol\u00e1h","sequence":"first","affiliation":[{"name":"1 \u00c9rseb\u00e9szeti Klinika, Semmelweis Egyetem, 1122, Budapest, V\u00e1rosmajor u. 68."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zolt\u00e1n","family":"Szabolcs","sequence":"additional","affiliation":[{"name":"2 Sz\u00edvseb\u00e9szeti Klinika, Semmelweis Egyetem, 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