{"id":34579,"date":"2023-08-01T09:47:18","date_gmt":"2023-08-01T09:47:18","guid":{"rendered":"https:\/\/cardiacinstitute.bg\/?p=34579"},"modified":"2023-08-01T09:47:41","modified_gmt":"2023-08-01T09:47:41","slug":"vascular-surgeons-from-heart-and-brain-saved-a-patient-by-performing-bulgarias-first-emergency-implantation-of-a-fenestrated-endograft","status":"publish","type":"post","link":"https:\/\/cardiacinstitute.bg\/ro\/2023\/08\/01\/vascular-surgeons-from-heart-and-brain-saved-a-patient-by-performing-bulgarias-first-emergency-implantation-of-a-fenestrated-endograft\/","title":{"rendered":"Chirurgii vasculari de la &#8222;Inim\u0103 \u0219i Creier&#8221; au salvat un pacient, realiz\u00e2nd prima implantare de urgen\u021b\u0103 din Bulgaria a unei endoproteze fenestrate"},"content":{"rendered":"<p>Un pacient \u00een v\u00e2rst\u0103 de 74 de ani din Gabrovo, cu dureri abdominale severe \u0219i deficien\u021be generale, a fost internat de urgen\u021b\u0103 la Departamentul de Chirurgie Vascular\u0103 de la &#8216;Heart and Brain&#8217;. \u00cen urma unei scan\u0103ri cu substan\u021b\u0103 de contrast, s-a constatat o ruptur\u0103 (ruptur\u0103) a unui anevrism aortic abdominal. Aceasta este o afec\u021biune care pune \u00een pericol via\u021ba, \u00een care o cantitate mare de s\u00e2nge se vars\u0103 \u00een cavitatea abdominal\u0103, iar singurul tratament este interven\u021bia chirurgical\u0103.<\/p>\n<p>Riscul unui rezultat fatal \u00een cazul unei interven\u021bii chirurgicale clasice deschise pentru anevrismul rupt este de peste 90%. Repararea endovascular\u0103 a anevrismului aortic (EVAR) este efectuat\u0103 \u00een mod obi\u0219nuit la Spitalul Inimii \u0219i Creierului din Pleven, at\u00e2t la pacien\u021bii electivi, c\u00e2t \u0219i la cei de urgen\u021b\u0103. Provocarea \u00een acest caz este c\u0103 anevrismul implic\u0103 ambele artere renale \u0219i artera principal\u0103 care alimenteaz\u0103 intestinul \u0219i, prin urmare, chirurgia endovascular\u0103 standard nu poate fi aplicat\u0103. Singura op\u021biune este introducerea unei endoproteze fenestrate, care nu este disponibil\u0103 \u00een aceast\u0103 \u021bar\u0103 \u0219i al c\u0103rei cost dep\u0103\u0219e\u0219te 70 000 BGN.<\/p>\n<p>Dup\u0103 o analiz\u0103 \u00eendelungat\u0103 \u0219i un consiliu \u00eentre medici din diferite domenii, speciali\u0219tii au decis s\u0103 aplice o abordare nou\u0103 pentru \u021bara noastr\u0103 &#8211; o protez\u0103 personalizat\u0103 \u0219i modelat\u0103 fiziologic. Aceast\u0103 tehnic\u0103 a mai fost aplicat\u0103 o singur\u0103 dat\u0103 \u00een Bulgaria, dar nu \u00een condi\u021bii de urgen\u021b\u0103.<\/p>\n<p>Cu ajutorul unei serii de m\u0103sur\u0103tori \u0219i calcule precise, chirurgii vasculari modific\u0103 implantul pentru nevoile specifice ale pacientului prin imagistic\u0103 3D, urmat\u0103 de fabricarea, \u00eentr-un mediu steril, a fenestr\u0103rilor (orificiilor) endoprotezelor, prin care se asigur\u0103 alimentarea cu s\u00e2nge a organelor vitale. Urmeaz\u0103 procesul extrem de delicat de inserare a stenturilor \u00een arterele renale \u0219i \u00een artera mezenteric\u0103 (artera care alimenteaz\u0103 cu s\u00e2nge intestinele). Opera\u021bia este minim invaziv\u0103 \u0219i dureaz\u0103 10 ore. Printr-o mic\u0103 incizie \u00een arterele femurale, sub control cu raze X \u00eentr-o sal\u0103 de opera\u021bie hibrid\u0103, echipa de chirurgie vascular\u0103 a reu\u0219it s\u0103 salveze via\u021ba pacientului. Aceast\u0103 procedur\u0103 extrem de complex\u0103, complex\u0103 \u0219i \u00een mai multe etape necesit\u0103 o preg\u0103tire prealabil\u0103 atent\u0103, multe cuno\u0219tin\u021be \u0219i abilit\u0103\u021bi suplimentare ale medicilor.<\/p>\n<p>&#8222;Putem num\u0103ra pe degetele de la m\u00e2ini centrele spitalice\u0219ti din \u00eentreaga lume care au implementat cu succes acest tip de interven\u021bie chirurgical\u0103. Fabricarea unei proteze personalizate finite ar necesita mult timp \u0219i bani. Mul\u021bumit\u0103 echipelor de la &#8216;Heart and Brain&#8217; \u0219i colegilor mei din capital\u0103 &#8211; Dr. Nikola Kolev \u0219i Dr. Dimitar Nikolov, am reu\u0219it s\u0103 modific\u0103m cu succes o gref\u0103 existent\u0103, care este acoperit\u0103 de NHIF. Pacientul era \u00een stare general\u0103 bun\u0103, \u00een picioare chiar a doua zi&#8221;, a declarat chirurgul vascular Dr. Todor Samardzhiev, care a supervizat opera\u021bia.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Un pacient \u00een v\u00e2rst\u0103 de 74 de ani din Gabrovo, cu dureri abdominale severe \u0219i deficien\u021be generale, a fost internat de urgen\u021b\u0103 la Departamentul de Chirurgie Vascular\u0103 de la &#8216;Heart and Brain&#8217;. \u00cen urma unei scan\u0103ri cu substan\u021b\u0103 de contrast, s-a constatat o ruptur\u0103 (ruptur\u0103) a unui anevrism aortic abdominal. Aceasta este o afec\u021biune care [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[183],"tags":[],"class_list":["post-34579","post","type-post","status-publish","format-standard","hentry","category-stiri"],"_links":{"self":[{"href":"https:\/\/cardiacinstitute.bg\/ro\/wp-json\/wp\/v2\/posts\/34579","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiacinstitute.bg\/ro\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiacinstitute.bg\/ro\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiacinstitute.bg\/ro\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiacinstitute.bg\/ro\/wp-json\/wp\/v2\/comments?post=34579"}],"version-history":[{"count":3,"href":"https:\/\/cardiacinstitute.bg\/ro\/wp-json\/wp\/v2\/posts\/34579\/revisions"}],"predecessor-version":[{"id":34582,"href":"https:\/\/cardiacinstitute.bg\/ro\/wp-json\/wp\/v2\/posts\/34579\/revisions\/34582"}],"wp:attachment":[{"href":"https:\/\/cardiacinstitute.bg\/ro\/wp-json\/wp\/v2\/media?parent=34579"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiacinstitute.bg\/ro\/wp-json\/wp\/v2\/categories?post=34579"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiacinstitute.bg\/ro\/wp-json\/wp\/v2\/tags?post=34579"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}