9 resultados para Perceval

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This paper discusses the manuscript transmission of Chrétien’s Roman de Perceval ou le Conte du Graal and Wolfram’s Parzival in terms of their textual tradition and editorial criticism. It shows that the most recent edition of the Old French Perceval (K. Busby 1993) can be viewed as a landmark of the art of conventional editing that appeared at the peak of the discussion of ‘New Philology’ and took its own position in this context. At the same time, the Perceval was subject of critical studies based on the principle of ‘unrooted trees’ that questioned the genealogical concept of traditional ‘Lachmannian’ stemmatology. Conversely, a new edition of Wolfram’s Parzival, based on all known manuscripts, remained a desideratum for decades in German studies. Specific research on the textual tradition played a rather marginal role for a long time, but has been reinforced in the recent years in the context of a new critical edition presenting the totality of manuscripts as well as different textual versions in electronic form. The concept of ‘unrooted trees’ visualizing relationships of manuscript readings can be integrated in this concept. The article gives an overview of these methods, presents examples of editorial techniques, and develops ideas on how to combine the research on the manuscript tradition of both the German text and its French counterpart.

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This article discusses the manuscript transmission of Chrétien’s Roman de Perceval ou le Conte du Graal and Wolfram’s Parzival in terms of their textual tradition and editorial criticism. It shows that the most recent edition of the Old French Perceval (K. Busby 1993) can be viewed as a landmark of the art of conventional editing that appeared at the peak of the discussion of ‘New Philology’ and took its own position in this context. At the same time, the Perceval was subject of critical studies based on the principle of ‘unrooted trees’ that questioned the genealogical concept of traditional ‘Lachmannian’ stemmatology. Conversely, a new edition of Wolfram’s Parzival, based on all known manuscripts, remained a desideratum for decades in German studies. Specific research on the textual tradition played a rather marginal role for a long time, but has been reinforced in the recent years in the context of a new critical edition presenting the totality of manuscripts as well as different textual versions in electronic form. The concept of ‘unrooted trees’ visualizing relationships of manuscript readings can be integrated in this concept. The article gives an overview of these methods, presents examples of editorial techniques, and develops ideas on how to combine the research on the manuscript tradition of both the German text and its French counterpart.

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BACKGROUND The Perceval (Sorin Group, Milan, Italy) is a self-anchoring sutureless aortic valve prosthesis. We report the short- to midterm results of combined aortic valve replacement (AVR) with concomitant procedures in elderly patients undergoing operation as part of 3 consecutive prospective multicenter European studies. METHODS From April 2007 to February 2013, 243 patients (mean age, 79.7 ± 5.1 years; female patients, 61%; median EuroSCORE, 9%) underwent AVR with concomitant procedures. The concomitant procedures were coronary artery bypass grafting (CABG) (182 cases), septal myectomy (21 cases), CABG + other procedures (18 cases), and 22 other procedures. Primary and secondary end points included implant feasibility and safety (for mortality and morbidity) and efficacy (New York Heart Association [NYHA] class improvement and hemodynamic results) of the prosthesis at the different follow-up periods. Data were expressed as mean ± standard deviation. Kaplan-Meier analysis was performed for survival analysis. RESULTS Mean aortic cross-clamp and extracorporeal circulation (ECC) times were 50.7 ± 22.8 minutes and 78.9 ± 32.3 minutes, respectively. Thirty-day mortality was 2.1%. Mean postoperative gradient and effective orifice area were 10.1 ± 4.7 mm Hg and 1.5 ± 0.4 cm(2) and 8.9 ± 5.6 mm Hg and 1.6 ± 0.4 cm(2), respectively, at 1 year. There were early explantations, 4 of which resulted from paravalvular leaks. One additional valve explantation resulted from aortic root bleeding, probably caused by excessively extensive decalcification. In the late period, there was 1 mild paravalvular leak and no intravalvular insufficiency. No migration, dislodgement, or degeneration of the valve occurred during follow-up. Median follow-up was 444 days. CONCLUSIONS These trials confirm the safety and efficacy of the Perceval sutureless aortic valve, especially in elderly patients requiring AVR + concomitant procedures. In this patient group, sutureless valves may be advantageous compared to transcatheter valve implantations as concomitant procedures other than percutaneous coronary artery angioplasty are not always possible in the latter.

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OBJECTIVES The aim of the Cavalier trial was to evaluate the safety and performance of the Perceval sutureless aortic valve in patients undergoing aortic valve replacement (AVR). We report the 30-day clinical and haemodynamic outcomes from the largest study cohort with a sutureless valve. METHODS From February 2010 to September 2013, 658 consecutive patients (mean age 77.8 years; 64.4% females; mean logistic EuroSCORE 10.2%) underwent AVR in 25 European Centres. Isolated AVRs were performed in 451 (68.5%) patients with a less invasive approach in 219 (33.3%) cases. Of the total, 40.0% were octogenarians. Congenital bicuspid aortic valve was considered an exclusion criterion. RESULTS Implantation was successful in 628 patients (95.4%). In isolated AVR through sternotomy, the mean cross-clamp time and the cardiopulmonary bypass (CPB) time were 32.6 and 53.7 min, and with the less invasive approach 38.8 and 64.5 min, respectively. The 30-day overall and valve-related mortality rates were 3.7 and 0.5%, respectively. Valve explants, stroke and endocarditis occurred in 0.6, 2.1 and in 0.1% of cases, respectively. Preoperative mean and peak pressure gradients decreased from 44.8 and 73.24 mmHg to 10.24 and 19.27 mmHg at discharge, respectively. The mean effective orifice area improved from 0.72 to 1.46 cm(2). CONCLUSIONS The current 30-day results show that the Perceval valve is safe (favourable haemodynamic effect and low complication rate), and can be implanted with a fast and reproducible technique after a short learning period. Short cross-clamp and CPB times were achieved in both isolated and combined procedures. The Perceval valve represents a promising alternative to biological AVR, especially with a less invasive approach and in older patients.

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OBJECTIVES This report summarizes the 5-year clinical and haemodynamic data from three prospective, European multicentre trials with the Perceval sutureless aortic valve. METHODS From April 2007 to August 2012, 731 consecutive patients (mean age: 78.5 years; 68.1% females; mean logistic EuroSCORE 10.9%) underwent AVR with the Perceval valve in 25 European centres. Isolated AVR was performed in 498 (68.1%) patients. A minimally invasive approach was performed in 189 (25.9%) cases. The cumulative follow-up was 729 patients-years. RESULTS In isolated AVR, mean cross-clamp and cardiopulmonary bypass times were 30.8 and 50.8 min in full sternotomy, and 37.6 and 64.4 min in the minimally invasive approach, respectively. Early cardiac-related deaths occurred in 1.9%. Overall survival rates at 1 and 5 years were 92.1 and 74.7%, respectively. Major paravalvular leak occurred in 1.4% and 1% at early and late follow-up, respectively. Significant improvement in clinical status was observed postoperatively in the majority of patients. Mean and peak gradients decreased from 42.9 and 74.0 mmHg preoperatively, to 7.8 and 16 mmHg at the 3-year follow-up. LV mass decreased from 254.5 to 177.4 g at 3 years. CONCLUSIONS This European multicentre experience, with the largest cohort of patients with sutureless valves to date, shows excellent clinical and haemodynamic results that remain stable even up to the 5-year follow-up. Even in this elderly patient cohort with 40% octogenarians, both early and late mortality rates were very low. There were no valve migrations, structural valve degeneration or valve thrombosis in the follow-up. The sutureless technique is a promising alternative to biological aortic valve replacement.

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Aortic stenosis has become the most frequent type of valvular heart disease in Europe and North America and presents in the large majority of patients as calcified aortic stenosis in adults of advanced age. Surgical aortic valve replacement has been recognized to be the definitive therapy which improves considerably survival for severe aortic stenosis since more than 40 years. In the most recent period, operative mortality of isolated aortic valve replacement for aortic stenosis varies between 1–3% in low-risk patients younger than 70 years and between 4 and 8% in selected older adults. Long-term survival following aortic valve replacement is close to that observed in a control population of similar age. Numerous observational studies have consistently demonstrated that corrective surgery in symptomatic patients is invariably followed by a subjective improvement in quality of life and a substantial increase in survival rates. More recently, transcatheter aortic valve implantation (TAVI) has been demonstrated to be feasible in patients with high surgical risk using either a retrograde transfemoral or transsubclavian approach or an antegrade, transapical access. Reported 30-day mortality ranges between 5 and 15%) and is acceptable when compared to the risk predicted by the logistic EuroSCORE (varying between 20 and 35%) and the STS Score, although the EuroScore has been shown to markedly overestimate the effective operative risk. One major concern remains the high rate of paravalvular regurgitation which is observed in up to 85% of the patients and which requires further follow-up and critical evaluation. In addition, long-term durability of these valves with a focus on the effects of crimping remains to be addressed, although 3-5 year results are promising. Sutureless biological valves were designed to simplify and significantly accelerate the surgical replacement of a diseased valve and allow complete excision of the calcified native valve. Until now, there are 3 different sutureless prostheses that have been approved. The 3f Enable valve from ATS-Medtronic received CE market approval in 2010, the Perceval S from Sorin during Q1 of 2011 and the intuity sutureless prosthesis from Edwards in 2012. All these devices aim to facilitate valve surgery and therefore have the potential to decrease the invasivness and to shorten the conventional procedure without compromise in term of excision of the diseased valve. This review summarizes the history and the current knowledge of sutureless valve technology.

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The Codex Biblioteca Casanatense 1409 which has for a long time been neg- lected in Parzival scholarship, transmits German translations of three continuations of Chre ́tien de Troyes‘ Roman de Perceval ou Le Conte du Graal together with the last two books (XV/XVI) of Wolfram von Eschenbach’s Parzival. This article supports the for- merly casually made assumption that the Casanatense manuscript is in fact a direct copy of Codex Donaueschingen 97, the so called Rappoltsteiner Parzifal. As is to be shown, marks in the Donaueschingen codex, as well as significant copying errors in the Casanatense text and its treatment of initials suggest a direct relationship of the two witnesses. The notion of ,writing scene‘ (Schreibszene) with its implications of linguistic semantics, instrumentality, gesture and self reflection, proposed in modern literary scholarship, can help to understand peculiarities of the copying process in the Casanatensis, such as the numerous conceptual abbreviations and the adaptations in the handling of headings. In the final part of the article, the hypothesis is corroborated, that the copy of the Casa- natensis might have been produced in the surroundings of Lamprecht von Brunn (ca. 1320–1399), bishop of Strasburg and Bamberg, and counsellor of the emperor Charles IV.

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Intertextuality imposes vulnerability – unter diesem Motto entwickelt der Renaissance-Forscher Thomas M. Greene die These, dass Texte im Zuge von Prozessen der Übertragung und Aneignung ‚verwundbar’ werden (Thomas M. Greene, The vulnerable text, New York 1986). Die so verstandene ‚Verwundbarkeit’ sei insbesondere ein Symptom vormoderner Textualität, die Texte zumeist ‚aus zweiter Hand’ produziere und den Begriff der ‚Originalität’ noch nicht kenne: „Part of the text’s vulnerability lies in its dependence on second hand signifiers, a vulnerability aggravated in a culture which does not yet fetishize originality.“ Während Greenes Ansatz in der Altgermanistik bereits im Hinblick auf die zwischen der Eigengesetzlichkeit vormoderner Texte und deren philologischer Erschließung bestehende Spannung zur Anwendung gebracht und problematisiert wurde (so von Christian Kiening für den ›Ackermann‹: Schwierige Modernität, Tübingen 1998), harrt er in Bezug auf das Verständnis von Intertextualität noch der altgermanistischen Auseinandersetzung. Diese versucht der eingereichte Vorschlag mit einem Fallbeispiel in Gang zu bringen. Als Textgrundlage werden Chrétiens ›Perceval ou le Conte du Graal‹ und dessen Aneignung durch Wolfram von Eschenbach gewählt, dies im Blick auf die Anfortas- und Sigune-Handlung (was es ermöglicht, den ›Titurel‹ mit einzubeziehen). Der Beitrag geht (im Anschluss an Jean Fourquet, Wolfram d’Eschenbach et le Conte del Graal, Paris 1938, 21966) davon aus, dass Wolfram die Bücher III bis VI des ›Parzival‹ (Jugendgeschichte bis zu Kundries Verfluchung wegen der unterlassenen Mitleidsfrage) nach einer handschriftlichen Vorlage des französischen Textes gestaltete, die ihm nach Abschluss dieses Teils abhanden kam. Für die Anfertigung der übrigen Bücher dürfte Wolfram eine anders geartete handschriftliche Vorlage zur Verfügung gehabt haben, was zur Überarbeitung eines bereits in Umlauf befindlichen deutschsprachigen Textes führte, die sich noch in Fassungsvarianten der Überlieferung wiederspiegelt. Aufgrund veränderter intertextueller Relationen wird also Wolframs eigener Text im Zuge der Redaktion ‚verwundbar’. Dieser Sachverhalt soll an Varianzen der Anfortas-Handlung aufgezeigt werden, wie sie insbesondere zwischen Buch V (Parzivals erster Besuch auf der Gralburg) und Buch IX (Parzivals Aufklärung durch den Einsiedler Trevrizent) fassbar werden. Der wunde Anfortas kann dabei auf Handlungsebene als Prototyp der Verletzbarkeit schlechthin gelten – einer Verletzbarkeit, die mit jener des Textes interagiert. Mit in diese Perspektive einbezogen werden sollen Elemente der Sigune-Handlung. Der Vorlagenwechsel veranlasst Wolfram auch im Hinblick auf den Kampfestod von Sigunes Geliebtem Schionatulander (bei Chrétien sind beide Figuren namenlos) zu den erwähnten Adaptationen und hat wohl seinerseits die Entstehung des ›Titurel‹ motiviert, wo die Verletzbarkeit im Umgang mit textlichen ‚Vorlagen’ sogar thematisiert wird: Sigune zerschürft ihre Hände beim Versuch, das beschriftete Brackenseil zu behalten. Das Paradox der ›Titurel‹-Dichtung besteht dabei darin, dass die erwähnte Szene und die darin beschriebene Verwundbarkeit der Figur eine Vorlage thematisiert, die der Text selbst gerade nicht hat. Denn der ›Titurel‹ dürfte unabhängig von einer konkreten Quelle, wie sie Chrétiens ›Perceval‹ darstellt, entstanden sein und besitzt damit gerade jene ‚Originalität’, die Greene im Rahmen seines Konzepts von ‚vulnerabilty’ vormodernen Texten abspricht.

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OBJECTIVE Sutureless aortic valve replacement (AVR) offers an alternative to standard AVR in aortic stenosis. This prospective, single-arm study aimed to demonstrate safety and effectiveness of a bovine pericardial sutureless aortic valve at 1 year. METHODS From February 2010 to September 2013, 658 patients (mean age 78.3 ± 5.6 years; 40.0% octogenarian; 64.4% female; mean Society of Thoracic Surgeons score 7.2 ± 7.4) underwent sutureless AVR in 25 European centers. Concomitant cardiac procedures were performed in 29.5% and minimally invasive cardiac surgery in 33.3%. RESULTS One-year site-reported event rates were 8.1% for all-cause mortality, 4.5% for cardiac mortality, 3.0% for stroke, 1.9% for valve-related reoperation, 1.4% for endocarditis, and 0.6% for major paravalvular leak. No valve thrombosis, migration, or structural valve deterioration occurred. New York Heart Association class improved at least 1 level in 77.5% and remained stable (70.4% New York Heart Association class I or II at 1 year). Mean effective orifice area was 1.5 ± 0.4 cm(2); pressure gradient was 9.2 ± 5.0 mm Hg. Left ventricular mass decreased from 138.5 g/m(2) before surgery to 115.3 g/m(2) at 1 year (P < .001). Echocardiographic core laboratory findings confirmed that paravalvular leak was rare and remained stable during follow-up. CONCLUSIONS The Perceval sutureless valve resulted in low 1-year event rates in intermediate-risk patients undergoing AVR. New York Heart Association class improved in more than three-quarters of patients and remained stable. These data support the safety and efficacy to 1 year of the Perceval sutureless valve in this intermediate-risk population.