The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

Viorel Goleanu

Viorel Goleanu

The Distally Based Superficial Sural Artery Angiosome Flap Concept: Anatomy, Indications, Surgical Technique, Results...

Located between the popliteal fossa and the midportion of the calf, centered over de midline raphe, between the medial and lateral heads of the gastrocnemius muscle, the sural flap is the best known neurocutaneous flap of the leg. [1,2]
The sural angiosome was first introduced in practice by Ponten in 1981, when he reported the use of 23 fasciocutaneous proximally based flaps for soft tissue defects.[3] Donski and Fogdestam described the anatomy of the distally based sural flap and presented three clinical cases in 1982. [4]

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Therapy Principles in Ischemic Mitral Regurgitation

Ischemic mitral regurgitation (IMG) is the mitral regurgitation that is determined by the ischemic coronary disease and must be differentiated from the mitral regurgitation, which coexists with ischemic coronary disease. It appears secondary to acute myocardial infarction with angiographic or echocardiographic signs of contraction anomaly of left ventricle in a region vascularized by a critically stenosed coronary artery (1-3).
Ischemic mitral regurgitation is determined by an excess of tethering of one or both mitral valves, as a result of displacement of one or both papillary muscles. All patients have anterior acute myocardial infarction with regional anomaly of left ventricle wall contraction. Statistically, approximately 80% display posterior infarction and 20% anterior infarction (4).

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