M Turina

Zürcher Höhenklinik Wald, Zürich, Zurich, Switzerland

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Publications (558)1834.32 Total impact

  • The Thoracic and Cardiovascular Surgeon 01/2008; 56. DOI:10.1055/s-2008-1038067 · 1.08 Impact Factor
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    Gefässchirurgie 10/2005; 10(5):341-346. DOI:10.1007/s00772-005-0411-6 · 0.24 Impact Factor
  • The Thoracic and Cardiovascular Surgeon 01/2005; 53(S 01). DOI:10.1055/s-2005-861893 · 1.08 Impact Factor
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    ABSTRACT: Most cardiac tumors are benign, whereas up to 50 % of the diagnosed cases are histologically myxomas. The common clinical signs are rhythm disturbances, myocardial ischemia, pulmonary edema, syncope and cardiac arrest. They do normally lead to the diagnostic hypothesis of an intracardiac mass. The primary modality for imaging is echocardiography which usually confirms the suspected diagnosis. But in rare cases there are masses which cannot be exactly identified by this technique. Here we present a patient with an atypical echocardiography of an unusual intracardiac tumor.
    The Thoracic and Cardiovascular Surgeon 11/2004; 52(5):302-4. DOI:10.1055/s-2004-821167 · 1.08 Impact Factor
  • Indian Journal of Thoracic and Cardiovascular Surgery 01/2004; 20(1):26-26. DOI:10.1007/s12055-004-0372-5
  • European Journal of Anaesthesiology 01/2004; 21:46-47. DOI:10.1097/00003643-200406002-00169 · 3.01 Impact Factor
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    ABSTRACT: To evaluate the feasibility of robotically enhanced preparation of internal mammary arteries (IMA). Via three trocars in left thoracic wall the left, right or both IMA were skeletonized under CO(2) insufflation and single lung ventilation using electrocautery. In 12 months, 26 LIMA, five BIMA and one RIMA were dissected. In five patients, the procedure had to be determined (IMA injury (two), respiratory insufficiency (two), and heart penetration (one)). Mean intrathoracic pressure was 9.7+/-1.5 mmHg. Mean time for LIMA and RIMA dissection was 66.7+/-21.1 and 99.2+/-8.7 min, respectively. In 10 patients, pericardium was incised and course of LAD assessed. However, in two patients, this coronary did not correlate with LAD. Time for instrument change depended on type of tool (cautery blade: 24.9+/-13.1 s, clip applier 72.8+/-28.4 s). Robotic dissection of IMA is reasonable. However, life-threatening complications can barely be managed due to inadequate tools and excessive time for instrument change. Incorrect determination of coronaries can result in misplaced anastomoses.
    Cardiovascular Surgery 01/2004; 11(6):483-7. DOI:10.1016/S0967-2109(03)00114-5
  • European Journal of Anaesthesiology 01/2004; 21:21-22. DOI:10.1097/00003643-200406001-00056 · 3.01 Impact Factor
  • Indian Journal of Thoracic and Cardiovascular Surgery 01/2004; 20(1):24-24. DOI:10.1007/s12055-004-0367-2
  • European Journal of Anaesthesiology 01/2004; 21. DOI:10.1097/00003643-200406001-00057 · 3.01 Impact Factor
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    ABSTRACT: Objective: The MicroMed DeBakey left ventricular assist device (LVAD) axial blood flow pump was used as bridge to heart transplantation (HTx) in patients with terminal heart failure. The aim was to evaluate this novel mechanical circulatory support system in regard to overall outcome. Methods: Prospective study in 15 HTx candidates (mean age 40 +/- 7 years) with terminal heart failure and maximal medical treatment due to ischemic cardiomyopathy (CMP, it = 5), dilated CMP (n = 3), restrictive CMP (n = 2), unclassified CMP (n = 1), metabolic CMP (n = 1), valvutar CMP (n = 1) and congenital CMP (n = 2). All patients were implanted with a MicroMed DeBakey LVAD. A rescue procedure was necessary in eight critical patients, while seven underwent elective LVAD implantation. Procedures were performed via median sternotomy, in normotherm femoro-femoral CPB (mean duration 59 +/- 1 min). Oral Marcoumaro(
    European Journal of Cardio-Thoracic Surgery 08/2003; 24(1):113-8. DOI:10.1016/S1010-7940(03)00179-9 · 2.81 Impact Factor
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    ABSTRACT: Bilateral common iliac artery (CIA) aneurysms are rare, but more frequently symptomatic than abdominal aortic aneurysms (AAA). In elderly patients with coexisting medical problems, transluminal and/or endovascular procedures are preferred to avoid the risk of morbidity and mortality associated with further general anesthesia and surgery. However, bilateral internal iliac artery (IIA) occlusion during endovascular repair might be associated with significant morbidity, including gluteal claudicatio, and ischemia of the sigmoid colon and perineum. In the presented case report we describe the successful repair of bilateral CIA aneurysms by a total transluminal and endovascular approach. The potentially reversible embolisation of the less diseased IIA with detachable latex balloons preceded the implantation of a bilateral endovascular Y-stent. Both CIA aneurysms were successfully excluded from circulation. No complications were noted and the patient could be discharged four days after surgery. Probationary detachable balloon embolisation of the IIA followed by implantation of an endovascular bifurcated stentgraft is a safe technique. It allows clinical monitoring of acute ischemic complications before bilateral IIA occlusion by the stentgraft. In comparison to coil embolisation these balloons may be easier to remove if for instance, an external-internal iliac artery bypass is needed. Percutaneous balloon puncture might be another option to reverse acute ischemia.
    VASA.: Zeitschrift für Gefässkrankheiten. Journal for vascular diseases 06/2003; 32(2):103-7. DOI:10.1024/0301-1526.32.2.103 · 1.21 Impact Factor
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    ABSTRACT: Coronary artery bypass grafting (CABG) and combined stent-grafting (SG) were evaluated to reduce morbidity and mortality of patients with descending or infrarenal aortic aneurysm. CABG and SG (thoracic n=6, infrarenal n=36) were performed during the same hospitalization in 42 patients (mean age of 73+/-14 years). In 29 patients (mean Euroscore: 9), SG was performed under local anesthesia 9+/-3 days after coronary surgery (simultaneous) and in 13 patients (mean Euroscore: 7) during the same anesthesia (synchronous). In the latter group, 11 out of 13 patients underwent off-pump CABG. All aneurysms were treated by implantation of commercially available self-expanding grafts. CABG was successful in all, but one patient with left internal mammary artery hypoperfusion syndrome, requiring an additional distal saphenous graft to the left anterior descending coronary artery. SG was uneventful in 98% (41/42 patients). Postoperative computerized tomography showed incomplete sealing in seven patients (17%), but only the two attachment endoleaks had to be treated by one proximal and one distal SG extension. Overall hospital stay for the synchronous repair was 12.5+/-6 days and that of the simultaneous group 17.5+/-7 days. Thirty-day mortality was 5% (2/42) as one patient of the simultaneous group experienced a lethal cerebral embolism during SG and one patient of the synchronous group developed an untreatable infection. In the follow-up of 4 years, there were two vascular reinterventions but no additional procedure-related morbidity or mortality. This experience shows that combined CABG and SG of thoracic or infrarenal aortic aneurysm is a safe and less-invasive alternative to the open graft repair, especially in the older patients or patients with severe comorbidities.
    European Journal of Cardio-Thoracic Surgery 05/2003; 23(4):532-6. DOI:10.1016/S1010-7940(02)00838-2 · 2.81 Impact Factor
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    ABSTRACT: With the DaVinci Robot only recently in clinical use, limitations of video-assisted thoracoscopy could disappear due to Endo-Wrist features, tremor cancellation and three-dimensional view. This report describes the total endoscopic pericardiectomy successfully achieved with robotic assistance in a 50-year-old man suffering from effusive pericarditis.
    Interactive Cardiovascular and Thoracic Surgery 01/2003; 1(2):102-4. DOI:10.1016/S1569-9293(02)00063-4 · 1.11 Impact Factor
  • The Journal of Heart and Lung Transplantation 01/2003; 22(1). DOI:10.1016/S1053-2498(02)00854-9 · 5.61 Impact Factor
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    ABSTRACT: Our aim was to evaluate the occurrence of implanted cardioverter-defibrillator (ICD) shock and antitachycardia pacing (ATP), the effect of ICD therapies on mortality and the impact of revascularisation strategies on arrhythmic events. We investigated 130 CAD patients undergoing ICD implantation between 1984 and 1999. Freedom of shock was 66 +/- 7 %, 48 +/- 9 % and 48 +/- 9 % after 1, 3 and 5 years in patients with revascularisation and 62 +/- 8 %, 43 +/- 8 % and 23 +/- 11 % in patients without revascularisation, respectively; p = n. s. Freedom from ATP was similar in both groups - in patients with revascularisation, 64 +/- 6 %, 58 +/- 7 % and 58 +/- 7 % and without revascularisation 56 +/- 8 %, 51 +/- 9 % and 38 +/- 10 %, respectively; p = n. s. There were no significant differences in cumulative survival between patients with and without revascularisation; p = n. s. CAD patients with VT/VF and with implanted ICD have, despite successful revascularisation, the same rate of device therapy and mortality as patients without an indication of revascularisation. This implies that patients with chronic ischemic heart disease and ventricular tachyarrhythmias continue to be at risk of sudden death after CABG/PTCA; evaluation for ICD implantation is warranted.
    The Thoracic and Cardiovascular Surgeon 01/2003; 50(6):333-6. DOI:10.1055/s-2002-35741 · 1.08 Impact Factor
  • The Journal of Heart and Lung Transplantation 01/2003; 22(1). DOI:10.1016/S1053-2498(02)01101-4 · 5.61 Impact Factor
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    ABSTRACT: Coronary artery surgery with beating heart technique is gaining increasing popularity. However, it is a challenging technique even for well-trained cardiac surgeons. Thus, a training model for beating heart surgery was developed to increase safety and accuracy of this procedure. The model consists of differentially hardened polyurethane resembling mechanical properties of the human heart. The covering used in this model is a 1:1 replica of the human thoracic wall with optionally embedded skeletal structures. Sternotomy, lateral thoracotomy or trocar placement is possible to access the lungs, the pericardium and the heart with adjacent vessels. Disposable artificial coronaries variable in size, wall quality or wall thickness are embedded in the synthetic myocardium. Two-layer vessels, which can simulate dissection, are available. Bypass conduits utilize the same material. Coronaries/bypasses as well as part of the ascending aorta are water-tight and can be rinsed with saline. Lungs can be inflated. A purpose-built pump induces heart movement with adjustable or randomized stroke volume, heart rate and arrhythmia induction. The model was tested in a recent 'Wet-Lab' course attended by 30 surgeons. All conventional instruments and stabilizers with standard techniques can be used. Training with beating or non-beating heart was possible. Time needed for an anastomosis was similar to clinical experience. Each artificial tissue showed its individual nature-like qualities. Various degrees of difficulty can be selected, according to stroke volume, heart rate, arrhythmia, vessel size and vessel quality. The model can be quickly and easily set up and is fully reusable. The similarity to human tissue and the easy set-up make this completely artificial model an ideal teaching tool to increase the confidence of cardiac surgeons dealing with beating heart and minimally invasive surgery.
    European Journal of Cardio-Thoracic Surgery 09/2002; 22(2):244-8. DOI:10.1016/S1010-7940(02)00269-5 · 2.81 Impact Factor
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    ABSTRACT: Medical treatment is generally advocated for patients with acute type B aortic dissection without complications. The objective of this retrospective analysis was to determine whether there are any initial findings that can help predict the long-term course of the disease. Case records of the 130 patients treated for type B aortic dissection between 1988 and 1997 were reviewed; 41 (31%) were operated on in the acute phase (<14 days), 31 (24%) were operated on in the chronic phase and 58 (45%) were treated medically. Overall acute mortality was 10.8%; 22% for patients operated on in the early phase and 5.6% for medically treated patients. Age (P=0.002), persistent pain (P=0.01) and malperfusion (P=0.001) were significant independent predictors of the need for surgery. Paraplegia/para paresis (P=0.0001), leg ischaemia (P=0.003), pleural effusion (P=0.003), rupture (P=0.0001), shock (P=0.0001), age (P=0.003), cardiac failure (P=0.002) and aortic diameter >4.5 cm (P=0.002) were significant predictors of poor survival. Age and shock also emerged as independent risk factors. Patients without malperfusion (P=0.0001), pleural effusion (P=0.003), rupture (P=0.0001) and shock (P=0.0001) had a significantly better event-free survival (freedom from repeat surgery and death). The actuarial survival rate for high-risk patients (malperfusion, rupture, shock) was 62% at 1 year and 40% at 5 years; the corresponding values for low-risk patients were 94 and 84%, respectively. Rupture, shock and malperfusion are significant predictors of poor survival in patients with acute type B aortic dissection.
    European Journal of Cardio-Thoracic Surgery 08/2002; 22(1):59-63. DOI:10.1016/S1010-7940(02)00203-8 · 2.81 Impact Factor

Publication Stats

5k Citations
1,834.32 Total Impact Points

Institutions

  • 1991–2004
    • Zürcher Höhenklinik Wald
      Zürich, Zurich, Switzerland
  • 2003
    • University of Oxford
      Oxford, England, United Kingdom
  • 1991–2002
    • University Hospital Zürich
      Zürich, Zurich, Switzerland
  • 2001
    • Deutsches Herzzentrum München
      München, Bavaria, Germany
  • 1999–2001
    • Triemli City Hospital
      Zürich, Zurich, Switzerland
  • 1996–1999
    • University Hospital of Lausanne
      Lausanne, Vaud, Switzerland
  • 1989–1999
    • University of Zurich
      • • Internal Medicine Unit
      • • Department of Cardiovascular Surgery
      Zürich, ZH, Switzerland
  • 1982–1999
    • Schulthess Klinik, Zürich
      Zürich, Zurich, Switzerland
  • 1998
    • Heinrich-Heine-Universität Düsseldorf
      Düsseldorf, North Rhine-Westphalia, Germany
  • 1967–1997
    • Psychiatrische Universitätsklinik Zürich
      Zürich, Zurich, Switzerland
  • 1995
    • Inselspital, Universitätsspital Bern
      Berna, Bern, Switzerland
  • 1989–1991
    • Universitätsspital Basel
      • Clinical Trial Unit
      Bâle, Basel-City, Switzerland