Graft In Conjunction Research Articles

Extraanatoinical Reconstruction for Bilateral Intrathoracic Subclavian Artery Aneurysms

Successful extraanatomical repair of bilateral intrathoracic arteriosclerotic subclavian artery aneurysms is reported. Rupture of the left subclavian aneurysm required emergency thoracotomy for proximal and distal ligation. The right subclavian aneurysm was repaired electively. Because of constraints resulting from the arterial anatomy (origin of aneurysm at innominate artery bifurcation), prior operation (coronary artery bypass grafting and repair of aneurysm of the sinus of Valsalva), and the patient's occupation (young, employed craftsman with dominant right hand), an extraanatomical reconstruction was devised to exclude the aneurysm and revascularize the head and arm. The reconstruction consisted of an external ilioaxillary Gore-Tex bypass graft in conjunction with an end-to-end distal subclavian to distal common carotid Gore-Tex graft. This is believed to represent the first reported successful repair of bilateral intrathoracic arteriosclerotic subclavian aneurysms, and the first application of this extraanatomical reconstruction.

One-Stage Lower Eyelid Reconstruction

SUMMARY A technique for reconstruction of 75% to 90% of the lower eyelid is presented. This procedure utilizes a large tarsoconjunctival graft in conjunction with an advancement skin graft from the cheek. This one-stage approach is valuable in lower eyelid reconstruction in monocular patients.

The Strip Scalp Graft

Hair transplantation for male pattern baldness has been done on many patients by dermatologists and plastic surgeons during the past 20 years. In selected cases, hair transplantation has been successful for adequate replacement of hair in bald areas of the scalp. In most cases, the punch graft technique alone is used. However, in selected cases, especially in younger individuals desiring a dense growth in the frontal area, the strip graft in conjunction with punch grafts can be used. When the strip graft operation is properly executed, the results are very gratifying. My most impressive results have been with those who have had the strip graft operation combined with the punch graft method (Figs. 13 and 14). The strip graft, like the punch graft, has proved to be extremely versatile. It can be transplanted in any conceivable direction and in any area of the scalp. It may be twisted into any desired shape so as to conform to any recipient site. It can also be made short or long and may be cut into smaller strips or even into small square grafts. If careful attention is paid to the simple steps of the operation discussed in this article, a surgeon will usually be rewarded with a good take of the strip graft.

Discussion and management of late failures in reconstructive procedures involving the abdominal aorta

Review of fifty-eight late failures of 326 procedures performed for revascularization of the abdominal aorta over the past six years showed a low overall operative mortality of 9 per cent. Secondary vascular procedures directed at the aorta itself or at its graft substitute proved more effective in relieving symptoms and restoring flow than did secondary procedures directed at more distal problems in the lower extremities. The aortofemoral graft in conjunction with profundaplasty proved to be the most effective means of restoring flow to the lower extermity after graft occlusion in a previous aortoiliac or aortofemoral graft.