1. Complications on the feeding artery after an arterio-venous fistula closure in patients after kidney transplantation : a national cohort studyMatej Zrimšek, Barbara Vajdič Trampuž, Matija Jelenc, Juš Kšela, Jakob Gubenšek, 2025, izvirni znanstveni članek Povzetek: Background: Arteriovenous fistulas (AVFs) in kidney transplant recipients are sometimes closed, either as a policy or due to complications. We collected data on the incidence of complications after AVF closure in a national cohort of transplanted patients. Methods: Patients who received a kidney transplant between 2000 and 2015 and had a functional AVF that was later ligated or extirpated were included. Medical records were searched for arterial complications on the arm with the closed AVF. Furthermore, all patients who were still alive in January 2023 were invited for a follow-up arterial ultrasound exam. Results: Sixty patients were included; mean follow-up was 9.3 ± 3.8 years. There were five (8% cumulative incidence) patients with symptomatic arterial thrombosis and three (5% incidence) with a symptomatic feeding artery aneurysm. Prospective ultrasound exams were performed in 50 patients; the mean diameter of the brachial artery was almost doubled on the arm with the closed AVF (8.1 ± 3.2 versus 4.7 ± 0.7 mm; P < .001). Additional asymptomatic complications were found in nine patients (18% incidence): seven cases (14% incidence) of arterial thrombosis, some extending up to the axillary artery, and three (6% incidence) brachial artery aneurysms. All patients in whom the thrombosis spread to the brachial artery had large brachial arteries (>10 mm) or an aneurysm. Conclusion: We observed a high cumulative incidence of arterial thrombosis (20%) and brachial artery aneurysms (10%), sometimes developing several years after AVF closure. These complications should be taken into account when contemplating closure of a well-developed AVF and an AVF-preserving approach with flow reduction surgery might be preferred in some cases.
Ključne besede: kidney transplantation, arterial thrombosis, arteriovenous fistula, complications, true brachial artery aneurysm, ultrasound exam
Objavljeno v DiRROS: 01.12.2025; Ogledov: 490; Prenosov: 94
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2. Segmental analysis of aortic basal ring dimensions in normal and dilated tricuspid aortic rootsMatija Jelenc, Blaž Jelenc, Sara Habjan, Christian Giebels, Peter Fries, Hector I. Michelena, Thomas Foley, Hans Joachim Schäfers, 2024, izvirni znanstveni članek Povzetek: Objectives: In patients with aortic root aneurysm, the aortic basal ring is frequently dilated. It has been speculated that the muscular part of the basal ring dilates most. The purpose of this study was to analyse the segmental dilatation of the basal ring, comparing normal and dilated roots in patients with tricuspid aortic valves. Methods: Retrospective analysis of computed tomography studies in patients with normal and dilated aortic roots was performed. Lengths of segments of the basal ring corresponding to each of the 3 sinuses, and to the muscular and fibrous parts were measured. Fractions of these segments relative to the total basal ring perimeter were calculated. Results: We analysed 152 normal and 126 dilated aortic roots and 86 propensity-matched pairs. Basal ring dilatation was present in all segments of dilated aortic roots with subtle differences between the segments corresponding to the 3 sinuses. The muscular part of the basal ring dilated proportionately to its fibrous part, with no difference in fractions of measured muscular part in normal and dilated roots [42.2% (interquartile range 4.3%) vs 42.1% (interquartile range 6.3%)]. CONCLUSIONS: Basal ring dilatation was present in all segments corresponding to the 3 sinuses in dilated aortic roots. Both muscular and fibrous parts dilated equally, supporting the need to stabilize the entire basal ring when performing aortic valve repair surgery.
Ključne besede: aortic root dilatation, aortic valve anatomy, computed tomography angiography, tricuspid aortic valve, propensity score matching, aortic valve annulus
Objavljeno v DiRROS: 26.11.2025; Ogledov: 431; Prenosov: 84
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3. Comparison of pulmonary and aortic root and cusp dimensions in normal adults using computed tomography : potential implications for Ross procedure planningMatija Jelenc, Blaž Jelenc, Sara Habjan, Karen B. Abeln, Peter Fries, Hector I. Michelena, Hans Joachim Schäfers, 2024, izvirni znanstveni članek Povzetek: Objectives: The Ross procedure is currently receiving renewed interest. Its function and durability depend on preservation of pulmonary valve anatomy; limited data exist on normal pulmonary valve geometry. The objective was to compare aortic and pulmonary root and cusp dimensions in adults with normal tricuspid aortic and pulmonary valves. Methods: We reviewed 507 coronary computed tomography studies, selecting those with adequate visibility of both pulmonary and aortic roots for further analysis. Diastolic aortic and pulmonary root and cusp dimensions were measured. Root dimensions at different phases of the cardiac cycle were measured in 3 patients. Results: We analysed studies of 50 patients with the mean age of 54 years [standard deviation (SD): 16]. In end-diastole, pulmonary root had a smaller sinutubular to basal ring ratio than the aortic root [0.82 (SD: 0.09) vs 1.14 (SD: 0.12), P<0.001]. Aortic and pulmonary cusps had similar dimensions; however, pulmonary cusp effective height was lower [5.9 mm (SD: 1.6) vs 8.4 mm (SD: 1.2), P<0.001]. Pulmonary basal ring perimeter was largest at end-diastole and smallest at end-systole, with the relative difference of 23.5% (SD: 2.7). Conclusions: The pulmonary root has a similar cusp size compared to the aortic root, but a different shape, resulting in a lower pulmonary cusp effective height. The perimeter of the pulmonary basal ring changes during the cardiac cycle. These findings suggest that stabilizing the autograft to normal aortic, rather than pulmonary, root dimensions should result in normal autograft cusp configuration. Computed tomography angiography could become a tool for personalized planning of the Ross procedure.
Ključne besede: computed tomography angiography, pulmonary valve anatomy, ross procedure, aortic valve anatomy, cardiac cycle
Objavljeno v DiRROS: 26.11.2025; Ogledov: 271; Prenosov: 103
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5. Transplantacija srca 28 let po končanem zdravljenju ne-Hodgkinovega limfoma v otroštvuLorna Zadravec-Zaletel, Peter Rakovec, Matija Jelenc, Zvezdana Dolenc-Stražar, Berta Jereb, 2014, drugi znanstveni članki Povzetek: Pri bolnikih, ki so se zdravili zaradi raka v otroštvu, so okvare kardiovaskularnega sistema med poglavitnimi vzroki pozne umrljivosti, ki je sedem-krat večja kot pri splošni populaciji. Najpogostejši vzrok komplikacij na srcu pri bolnikih z rakom so antraciklini ki sodijo med najučinkovitejša zdravila neoplastičnih bolezni. Pri opisu primera našega bolnika želimo opozoriti na napredujočo okvaro srčne mišice po zdravljenju ne-Hodgkinovega limfoma s kemoterapijo, ki je vsebovala antracikline in alkilirajoče agense, in je 28 let po končanem zdravljenju privedla do odpovedi srca, zaradi katere je bila potrebna transplantacija srca. Pri bolnikih, zdravljenih z antracikini, je zelo pomembno doživljenjsko sledenje funkcije srca, da vsako motnjo (tudi klinično nemo) na srcu čim prej odkrijemo in ustrezno zdravimo. Ehokardiografija je najpogosteje uporabljena diagnostična metoda za ocenjevanje delovanja srca v okviru sledenja poznih posledic zdravljenja s citostatiki in/ali obsevanjem. Zelo pomembno je morebitne okvare najti v fazi, ko je bolnik še asimptomatski, saj lahko z ustreznim zdravljenjem (predvsem ACE inhibitorji in beta-blokatorji) in ustreznim načinom življenja in zmanjševanjem drugih dejavnikov tveganja za razvoj kardiovaskularnih obolenj preprečimo oz. upočasnimo razvoj življenje ogrožujoče okvare srca.
Ključne besede: pozne posledice raka, otroci, ne-Hodgkinov limfom, kardiovaskularni sistem, odpoved srca
Objavljeno v DiRROS: 31.08.2018; Ogledov: 4649; Prenosov: 1161
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