Forschung und Innovation
Offene und endovaskuläre GefäßchirurgieDas Aortenzentrum am UHZ gehört zu den führenden Einrichtungen der Gefäßforschung in Deutschland. Die Wissenschaft in unserem Aortenzentrum basiert auf der engen Verbindung zwischen Krankenbett, klinischer Forschung und der Grundlagenforschung. Ähnlich wie bei der Patientenversorgung ist eine hohe Interdisziplinarität über Abteilungsgrenzen hinweg charakteristisch für die wissenschaftliche Tätigkeit in unserer Klinik. Das Universitäts-Aortenzentrum Freiburg kooperiert mit vielen anerkannten Zentren weltweit, wie z.B. dem Hospital of the University of Pennsylvania, dem Stanford Hospital & Clinics oder auch dem Herzzentrum Leipzig. Wir verstehen Innovation als Suche nach neuen Behandlungskonzepten. Ziel ist es, die Behandlung unserer Patienten stetig zu verbessern.
Für unsere Patienten wollen wir immer die schonendste und beste Behandlungsmethode finden. Um das zu erreichen, sind wir jederzeit bestrebt, auch neue Behandlungskonzepte zu entwickeln. An unserer Klinik arbeiten die Ärztinnen und Ärzte deshalb an neuen Methoden, die nach der Versuchs- und Erprobungsphase erfolgreich bei Eingriffen angewendet werden.
Abb. Gleichzeitige Behandlung des Aortenverschlusses und der Stenose der Nierenarterien durch einen aorto-bifemoralen Bypass und Revaskularisation der Nierenarterien
Abb. Eine selbst gefertigte Prothese aus dem Rinderperikard zur Behandlung der Aortenfisteln und der infizierten Aortenprothesen
Abb. Neues Konzept der endovaskulären Behandlung der Aorta ascendens. Diese Methode wird aktuell in Tierversuchen untersucht.
Abb. Neue Anastomosentechnik zwischen Hauptschlagader und Aortenprothese. Rylski B, Siepe M, Schoellhorn J, Beyersdorf F. An improved technique for aortic anastomosis: graft telescopic inversion. J Thorac Cardiovasc Surg 2010;140:934-5.
Abb. Computertomographie des Aortenbogens nach total-endovaskulärer Behandlung mit einem 2-fach gebranchten Stentgraft
Thigh compartment syndrome during extracorporeal life support. Kreibich M, Czerny M, Benk C, Beyersdorf F, Rylski B, Trummer G. J Vasc Surg Venous Lymphat Disord. 2017 Nov;5(6):859-863.
The frozen elephant trunk technique for the treatment of acute complicated Type B aortic dissection. Kreibich M, Berger T, Morlock J, Kondov S, Scheumann J, Kari FA, Rylski B, Siepe M, Beyersdorf F, Czerny M. Eur J Cardiothorac Surg. 2017 Aug 2. doi: 10.1093/ejcts/ezx281.
Endovascular repair of acute type A aortic dissection-we have the technology, but where is the courage? Rylski B. Interact Cardiovasc Thorac Surg. 2017 Oct 1;25(4):501-502.
How does descending aorta geometry change when it dissects? Rylski B, Muñoz C, Beyersdorf F, Siepe M, Reser D, Carrel T, Schoenhoff F, Schlensak C, Lescan M, Eckstein HH, Reutersberg B, Erbel R, Janosi RA, Czerny M. Eur J Cardiothorac Surg. 2017 Aug 31. doi: 10.1093/ejcts/ezx292.
Spinal ischaemia after thoracic endovascular aortic repair with left subclavian artery sacrifice: is there a critical stent graft length? Kari FA, Saravi B, Krause S, Puttfarcken L, Wittmann K, Förster K, Rylski B, Maier S, Göbel U, Siepe M, Czerny M, Beyersdorf F. Eur J Cardiothorac Surg. 2017 Aug 24. doi: 10.1093/ejcts/ezx285.
Spinal Ischemia in Thoracic Aortic Procedures: Impact of Radiculomedullary Artery Distribution. Kari FA, Wittmann K, Krause S, Saravi B, Puttfarcken L, Förster K, Rylski B, Maier S, Göbel U, Siepe M, Czerny M, Beyersdorf F. Ann Thorac Surg. 2017 Sep 18. pii: S0003-4975(17)30706-3. doi: 10.1016/j.athoracsur.2017.05.031.
A novel aortic clamp distributing equal pressure along the jaws. Rylski B, Schmid C, Beyersdorf F, Siepe M. J Thorac Cardiovasc Surg. 2017 Nov;154(5):1524-1525. doi: 10.1016/j.jtcvs.2017.04.078.
Fate of the dissected aortic arch after ascending replacement in type A aortic dissection†. Rylski B, Hahn N, Beyersdorf F, Kondov S, Wolkewitz M, Blanke P, Plonek T, Czerny M, Siepe M. Eur J Cardiothorac Surg. 2017. doi: 10.1093/ejcts/ezx062
Acute Non-A Non-B Aortic Dissection: Incidence, Treatment and Outcome Rylski B, Perez M, Beyersdorf F, Reser D, Kari FA, Siepe M, Czerny M. Eur J Cardiothorac Surg. 2017. Accepted for publication-
Descendo-bifemoral bypass grafting and renal artery revascularization to treat complex obliterative arteriopathy. Kondov S, Rylski B, Kari FA, Wobser R, Leschka S, Siepe M, Beyersdorf F, Czerny M. Interact Cardiovasc Thorac Surg. 2017. doi: 10.1093/icvts/ivw388
Technical details making aortic arch replacement a safe procedure using the Thoraflex™ Hybrid prosthesis. Czerny M, Rylski B, Kari FA, Kreibich M, Morlock J, Scheumann J, Kondov S, Südkamp M, Siepe M, Beyersdorf F. Eur J Cardiothorac Surg. 2017 Jan;51(suppl 1):i15-i19
Immediate Spinal Cord Collateral Blood Flow During Thoracic Aortic Procedures: The Role of Epidural Arcades. Kari FA, Wittmann K, Saravi B, Puttfarcken L, Krause S, Förster K, Maier S, Göbel U, Beyersdorf F. Semin Thorac Cardiovasc Surg. 2016 Summer;28(2):378-387.
A Technical Modification for Establishing Selective Antegrade Cerebral Perfusion during Pulmonary Endarterectomy. Czerny M, von Samson P, Passlick B, Beyersdorf F, Kroll J. Thorac Cardiovasc Surg Rep. 2016 Dec;5(1):33-35.
MMP-2 Isoforms in Aortic Tissue and Serum of Patients with Ascending Aortic Aneurysms and Aortic Root Aneurysms. Tscheuschler A, Meffert P, Beyersdorf F, Heilmann C, Kocher N, Uffelmann X, Discher P, Siepe M, Kari FA. PLoS One. 2016 Nov 1;11(11):e0164308
Thoracic endovascular aortic repair for uncomplicated type B aortic dissection. Czerny M, Rylski B, Beyersdorf F. Curr Opin Cardiol. 2016 Nov;31(6):606-610.
Selective Heart, Brain and Body Perfusion in Open Aortic Arch Replacement. Maier S, Kari F, Rylski B, Siepe M, Benk C, Beyersdorf F. J Extra Corpor Technol. 2016 Sep;48(3):122-128.
Characterization of serum matrix metalloproteinase 2/9 levels in patients with ascending aortic aneurysms. Meffert P, Tscheuschler A, Beyersdorf F, Heilmann C, Kocher N, Uffelmann X, Discher P, Rylski B, Siepe M, Kari FA. Interact Cardiovasc Thorac Surg. 2017 Jan;24(1):20-26.
Generalized Malperfusion Due to Systemic Embolization From a Large Thrombosed Pulmonary Vein Aneurysm. Kreibich M, Rylski B, Morlock J, Beyersdorf F, Czerny M. Ann Thorac Surg. 2016 Aug;102(2):e123-4.
Complex aortic arch surgery: Back to the future? Beyersdorf F. J Thorac Cardiovasc Surg. 2016 Jul;152(1):7-8.
Is right axillary artery cannulation safe in type A aortic dissection with involvement of the innominate artery? Rylski B, Czerny M, Beyersdorf F, Kari FA, Siepe M, Adachi H, Yamaguchi A, Itagaki R, Kimura N. J Thorac Cardiovasc Surg. 2016 Sep;152(3):801-807.e1
Spinal near-infrared spectroscopy monitoring in aortic surgery: the beginning of understanding it or already clinical routine? Kari FA, Czerny M. Eur J Cardiothorac Surg. 2016 Oct;50(4):683-684.
A Smart Solution for Solving Acute Angulations during Frozen Elephant Trunk Implantation. Czerny M, Grabenwöger M, von Segesser L. Thorac Cardiovasc Surg. 2016 Mar;64(2):137-8
Two Aortic Ruptures in Two Months-Role of Cross-Clamp-Associated Late Injury. Rylski B, Beyersdorf F, Czerny M, Siepe M. Ann Vasc Surg. 2016 Apr;32:129.e17-9
Endovascular approach to complex aortic arch pathologies: state of the art. Rylski B. Kardiochir Torakochirurgia Pol. 2016 Mar;13(1):1-2
Mobile medical technology: the revolution in medicine is in your smartphone. Rylski B. Eur J Cardiothorac Surg. 2016 Jul;50(1):52.
Serious cardiac compression after ruptured thoraco-abdominal aortic aneurysm and endovascular repair. Pingpoh C, Diab N, Rylski B, Siepe M. Interact Cardiovasc Thorac Surg. 2016. pii: ivw301.
Fenestrated and Branched Aortic Grafts. Rylski B, Czerny M, Südkamp M, Russe M, Siep M, Beyersdorf F. Dtsch Arztebl Int. 2015 Nov 27;112(48):816-22.
Unequal pressure distribution along the jaws of currently available vascular clamps: do we need a new aortic clamp? Rylski B, Schmid C, Beyersdorf F, Kari FA, Kondov S, Lutz L, Werner M, Czerny M, Siepe M. Eur J Cardiothorac Surg. 2016 Jun;49(6):1671-5.
The TEVAR App: a contemporary guide to thoracic endovascular aortic repair†. Rylski B, Czerny M, Südkamp M, Siepe M, Beyersdorf F. Interact Cardiovasc Thorac Surg. 2016 Feb;22(2):228-30.
Secondary organ fistulation after thoracic endovascular aortic repair. Czerny M, Rylski B, Schuster I, Kari F, Siepe M, Beyersdorf F. Minim Invasive Ther Allied Technol. 2015;24(5):305-10.
Outcomes of surgery for chronic type A aortic dissection. Rylski B, Milewski RK, Bavaria JE, Branchetti E, Vallabhajosyula P, Szeto WY, Desai ND. Ann Thorac Surg. 2015 Jan;99(1):88-93.
Bicuspid Aortic Valve Resuspension in Acute Type A Aortic Dissection Patients. Rylski B, Siepe M, Beyersdorf F, Kari FA, Grün L, Desai ND, Szeto WY, Milewski RK, Adachi H, Kimura N, Bavaria JE. Ann Thorac Surg. 2015 Sep;100(3):827-32.
Aortic surgery and spinal collateral flow: A call for structured approaches to functional characterization of the intraspinal collateral system. Kari FA, Beyersdorf F. J Thorac Cardiovasc Surg. 2015 Jun;149(6):1675-80.
Four-dimensional magnetic resonance imaging-derived ascending aortic flow eccentricity and flow compression are linked to aneurysm morphology†. Kari FA, Kocher N, Beyersdorf F, Tscheuschler A, Meffert P, Rylski B, Siepe M, Russe MF, Hope MD. Interact Cardiovasc Thorac Surg. 2015 May;20(5):582-7
Aneurysms of the pulmonary artery. Kreibich M, Siepe M, Kroll J, Höhn R, Grohmann J, Beyersdorf F. Circulation. 2015 Jan 20;131(3):310-6.
Aorto-bronchial and aorto-pulmonary fistulation after thoracic endovascular aortic repair: an analysis from the European Registry of Endovascular Aortic Repair Complications. Czerny M, Reser D, Eggebrecht H, Janata K, Sodeck G, Etz C, Luehr M, Verzini F, Loschi D, Chiesa R, Melissano G, Kahlberg A, Amabile P, Harringer W, Janosi RA, Erbel R, Schmidli J, Tozzi P, Okita Y, Canaud L, Khoynezhad A, Maritati G, Cao P, Kölbel T, Trimarchi S. Eur J Cardiothorac Surg. 2015 Aug;48(2):252-7.
Distal aortic reintervention after surgery for acute DeBakey type I or II aortic dissection: open versus endovascular repair. Rylski B, Beyersdorf F, Desai ND, Euringer W, Siepe M, Kari FA, Vallabhajosyula P, Szeto WY, Milewski RK, Bavaria JE. Eur J Cardiothorac Surg. 2015 Aug;48(2):258-63.
Acute type A aortic dissection extending beyond ascending aorta: Limited or extensive distal repair. Rylski B, Beyersdorf F, Kari FA, Schlosser J, Blanke P, Siepe M. J Thorac Cardiovasc Surg. 2014 Sep;148(3):949-54;
Operative techniques in patients with type A dissection complicated by cerebral malperfusion. Rylski B, Urbanski PP, Siepe M, Beyersdorf F, Bachet J, Gleason TG, Bavaria JE. Eur J Cardiothorac Surg. 2014 Aug;46(2):156-66.
Long-term results of neomedia sinus valsalva repair in 489 patients with type A aortic dissection. Rylski B, Bavaria JE, Milewski RK, Vallabhajosyula P, Moser W, Kremens E, Pochettino A, Szeto WY, Desai ND. Ann Thorac Surg. 2014 Aug;98(2):582-8;
Modeling of predissection aortic size in acute type A dissection: More than 90% fail to meet the guidelines for elective ascending replacement. Rylski B, Branchetti E, Bavaria JE, Vallabhajosyula P, Szeto WY, Milewski RK, Desai ND. J Thorac Cardiovasc Surg. 2014 Sep;148(3):944-8.e1.
Long-term results of aggressive hemiarch replacement in 534 patients with type A aortic dissection. Rylski B, Milewski RK, Bavaria JE, Vallabhajosyula P, Moser W, Szeto WY, Desai ND. J Thorac Cardiovasc Surg. 2014 Dec;148(6):2981-5.
Type A aortic dissection in Marfan syndrome: extent of initial surgery determines long-term outcome. Rylski B, Bavaria JE, Beyersdorf F, Branchetti E, Desai ND, Milewski RK, Szeto WY, Vallabhajosyula P, Siepe M, Kari FA. Circulation. 2014 Apr 1;129(13):1381-6.
Type A aortic dissection after previous cardiac surgery: results of an integrated surgical approach. Rylski B, Desai ND, Bavaria JE, Moser W, Vallabhajosyula P, Pochettino A, Szeto WY, Milewski RK. Ann Thorac Surg. 2014 May;97(5):1582-8;
Gender-related changes in aortic geometry throughout life. Rylski B, Desjardins B, Moser W, Bavaria JE, Milewski RK. Eur J Cardiothorac Surg. 2014 May;45(5):805-11.
Transcatheter aortic valve implantation in patients with ascending aortic dilatation: safety of the procedure and mid-term follow-up†. Rylski B, Szeto WY, Bavaria JE, Walsh E, Anwaruddin S, Desai ND, Moser W, Herrmann HC, Milewski RK. Eur J Cardiothorac Surg. 2014 Aug;46(2):228-33;
Development of a single endovascular device for aortic valve replacement and ascending aortic repair. Rylski B, Szeto WY, Bavaria JE, Branchetti E, Moser W, Milewski RK. J Card Surg. 2014 May;29(3):371-6.
Aortic valve morphology determines the presentation and surgical approach to acute type A aortic dissection. Rylski B, Desai ND, Bavaria JE, Vallabhajosyula P, Moser W, Pochettino A, Szeto WY, Milewski RK. Ann Thorac Surg. 2014 Jun;97(6):1991-6;
Results after thoracic aortic reoperations in Marfan syndrome. Kari FA, Beyersdorf F, Stephens EH, Peter P, Rylski B, Russe M, Blanke P, Siepe M. Ann Thorac Surg. 2014 Apr;97(4):1275-80.
How does the ascending aorta geometry change when it dissects? Rylski B, Blanke P, Beyersdorf F, Desai ND, Milewski RK, Siepe M, Kari FA, Czerny M, Carrel T, Schlensak C, Krüger T, Mack MJ, Brinkman WT, Mohr FW, Etz CD, Luehr M, Bavaria JE. J Am Coll Cardiol. 2014 Apr 8;63(13):1311-1319
New insights regarding the incidence, presentation and treatment options of aorto-oesophageal fistulation after thoracic endovascular aortic repair: the European Registry of Endovascular Aortic Repair Complications. Czerny M, Eggebrecht H, Sodeck G, Weigang E, Livi U, Verzini F, Schmidli J, Chiesa R, Melissano G, Kahlberg A, Amabile P, Harringer W, Horacek M, Erbel R, Park KH, Beyersdorf F, Rylski B, Blanke P, Canaud L, Khoynezhad A, Lonn L, Rousseau H, Trimarchi S, Brunkwall J, Gawenda M, Dong Z, Fu W, Schuster I, Grimm M. Eur J Cardiothorac Surg. 2014 Mar;45(3):452-7.
Controlled reperfusion versus conventional treatment of the acutely ischemic limb: results of a randomized, open-label, multicenter trial. Heilmann C, Schmoor C, Siepe M, Schlensak C, Hoh A, Fraedrich G, Beyersdorf F. Circ Cardiovasc Interv. 2013 Aug;6(4):417-27
Acute aortic dissection type A: age-related management and outcomes reported in the German Registry for Acute Aortic Dissection Type A (GERAADA) of over 2000 patients. Rylski B, Hoffmann I, Beyersdorf F, Suedkamp M, Siepe M, Nitsch B, Blettner M, Borger MA, Weigang E; Multicenter Prospective Observational Study. Ann Surg. 2014 Mar;259(3):598-604.
Modified perfusion strategy and aortic arch debranching in complicated acute aortic dissection type A: a bridge to definitive endovascular therapy. Rylski B, Siepe M, Blanke P, Kari FA, Schoellhorn J, Beyersdorf F. Ann Thorac Cardiovasc Surg. 2014;20(6):1038-41
Iatrogenic acute aortic dissection type A: insight from the German Registry for Acute Aortic Dissection Type A (GERAADA). Rylski B, Hoffmann I, Beyersdorf F, Suedkamp M, Siepe M, Nitsch B, Blettner M, Borger MA, Weigang E. Eur J Cardiothorac Surg. 2013 Aug;44(2):353-9;
Results of high-risk endovascular procedures in patients with non-dissected thoracic aortic pathology: intermediate outcomes. Rylski B, Blanke P, Siepe M, Kari FA, Euringer W, Südkamp M, Beyersdorf F. Eur J Cardiothorac Surg. 2013 Jul;44(1):156-62.
Late complications and distal growth rates of Marfan aortas after proximal aortic repair. Kari FA, Russe MF, Peter P, Blanke P, Rylski B, Euringer W, Beyersdorf F, Siepe M. Eur J Cardiothorac Surg. 2013 Jul;44(1):163-71.
Supracoronary ascending aortic replacement in patients with acute aortic dissection type A: what happens to the aortic root in the long run? Rylski B, Beyersdorf F, Blanke P, Boos A, Hoffmann I, Dashkevich A, Siepe M. J Thorac Cardiovasc Surg. 2013 Aug;146(2):285-90.
Adventitial inversion with graft telescopic insertion for distal anastomosis in acute type a aortic dissection. Rylski B, Siepe M, Blanke P, Euringer W, Schoellhorn J, Beyersdorf F. Ann Thorac Cardiovasc Surg. 2012;18(3):278-80.
Early histological changes in the porcine aortic media after thoracic stent-graft implantation. Scheumann J, Heilmann C, Beyersdorf F, Siepe M, Brenner RM, Böckler D, Griepp RB, Bischoff MS. J Endovasc Ther. 2012 Jun;19(3):363-9.
Chronic critical limb ischemia. Dohmen A, Eder S, Euringer W, Zeller T, Beyersdorf F. Dtsch Arztebl Int. 2012 Feb;109(6):95-101.
Mechanisms of symptomatic spinal cord ischemia after TEVAR: insights from the European Registry of Endovascular Aortic Repair Complications (EuREC). Czerny M, Eggebrecht H, Sodeck G, Verzini F, Cao P, Maritati G, Riambau V, Beyersdorf F, Rylski B, Funovics M, Loewe C, Schmidli J, Tozzi P, Weigang E, Kuratani T, Livi U, Esposito G, Trimarchi S, van den Berg JC, Fu W, Chiesa R, Melissano G, Bertoglio L, Lonn L, Schuster I, Grimm M. J Endovasc Ther. 2012 Feb;19(1):37-43.
Outcome after surgery for acute aortic dissection type A in patients over 70 years: data analysis from the German Registry for Acute Aortic Dissection Type A (GERAADA). Rylski B, Suedkamp M, Beyersdorf F, Nitsch B, Hoffmann I, Blettner M, Weigang E. Eur J Cardiothorac Surg. 2011 Aug;40(2):435-40.