A Thiem

Universitätsklinikum Schleswig - Holstein, Kiel, Schleswig-Holstein, Germany

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Publications (4)1.21 Total impact

  • A Thiem, T Attmann, J Cremer
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    ABSTRACT: Coronary artery bypass grafting (CABG), a modern and safe procedure, is considered the therapy of choice in the care of patients with multi-vessel disease. The 3-year results of the SYNTAX trial not only showed surgical advantages in terms of repeat revascularisation, but the results also demonstrated significant surgical benefit for myocardial infarction and survival rates. More differentiated analyses showed distinct disadvantages in percutaneous coronary intervention (PCI) associated with the greater complexity of coronary pathology. PCI tends to be a comparable therapeutic option only in certain cases of left main stem lesions or multi-vessel disease. The findings from the SYNTAX study herald a new era in the treatment of coronary heart disease in which, as recommended in the updated guidelines issued by the EACTS/ESC in 2010, the interventionalist and the surgeon, working closely together as a"heart team", provide a sound therapy plan for affected patients.
    Herz 12/2011; 36(8):669-76. · 0.78 Impact Factor
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    ABSTRACT: Minimally invasive direct coronary artery bypass grafting (MIDCAB) offers arterial revascularization of the left anterior descending coronary artery especially in lesions unsuitable for percutaneous coronary interventions. By avoidance of sternotomy and cardiopulmonary bypass its invasivity is less than that of conventional bypass surgery. A literature search of all published minimal invasive direct coronary artery bypass grafting studies was performed for the period from January 1995 through November 2011. Additionally, the authors reviewed their experience in more than one thousand patients treated by minimal invasive direct coronary artery bypass grafting within the last 14 years at their institution. Early mortally ranged from 1.2 to 1.3%. Midterm mortality ranged up to 3.2%. At 6-month follow up 3.6% grafts were occluded and 7.2% had a significant stenosis which resulted in target vessel revascularization in 3.3% of cases. The conversion rate to sternotomy or cardiopulmonary bypass ranged between 1.2 and 6.2%. In the past MIDCAB was predominantly used in patients with isolated lesions of the left anterior descending coronary artery. In combination with percutaneous interventions it provides an attractive option for full revascularization in multi vessel disease especially in older patients with significant comorbidities. Overall minimal invasive direct coronary artery bypass grafting is associated with few perioperative complications and with high graft patency rates in the mid-term and long-term course.
    HSR proceedings in intensive care & cardiovascular anesthesia. 01/2011; 3(4):249-53.
  • Thoracic and Cardiovascular Surgeon - THORAC CARDIOVASC SURG. 01/2007; 55.
  • A Thiem, J Cremer, G Lutter
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    ABSTRACT: Percutaneous treatment of valve diseases has proven to be an effective alternative to open surgery since the early 1980's. For most patients with rheumatic mitral stenosis, use of percutaneous catheter-based techniques as balloon valvuloplasty for the treatment of both congenital pulmonary stenosis as well as trans-septal commissurotomy has become a good therapeutic option. Furthermore in the mid 1990's in vitro studies demonstrated the feasibility of percutaneous catheter-based valve implantation first in pulmonary and subsequently in aortic position. Afterwards initial in vivo implantations were successfully undertaken. Limitations of this new branch of transcatheter-based techniques are: risk of embolization due to pre-dilatation; difficult deployment; migration of valved stent; paravalvular leakage and limited durability of the implanted valve. Hence, many advances and improvements are necessary prior to pronouncing a new real alternative and safe therapeutic option. Up to now the gold standard for the treatment of heart valve disease is still open surgical valve repair and replacement. Percutaneous valve replacement procedures offer substantial advantages both to patients and medical care providers. From a medical point of view, they may help reduce surgical risks, offer a less invasive procedure, lower complication rates and shorten rehabilitation times in future. From an economic standpoint, shorter hospital stays result in overall cost reduction.
    Minerva cardioangiologica 03/2006; 54(1):23-30. · 0.43 Impact Factor

Publication Stats

1 Citation
1.21 Total Impact Points

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Institutions

  • 2011
    • Universitätsklinikum Schleswig - Holstein
      • Klinik für Herz- und Gefäßchirurgie (Kiel)
      Kiel, Schleswig-Holstein, Germany
  • 2006
    • Christian-Albrechts-Universität zu Kiel
      Kiel, Schleswig-Holstein, Germany