Ms. hebr. qu. 1 - Megilat ha-megale

Blattangabe im Katalog fehlerhaft, Blätter nachpaginiert

Sēfer ḥizzûq emûnā

dós da hoṭ (meḥabbēr) giwezn (hab-baqî be-Tôrā Nevî'îm û-Ktûvîm) Yiṣḥāq Ben-Avrāhām ...

Sēfer Tôrat leqaḥ ṭôv

Avrāhām Yāgel B.-... Ḥananyā ... mim-Mônṣîlîṣî

Sēfer Divrê yôšer : hā-lô hem ketûvîm ʿal sifrê yešārîm ...

ḥibbērô Avrāhām Ben ... Menaḥēm Mendelî Šwab ...

Schnidejoch und Lötschenpass. Archäologische Forschungen in den Berner Alpen. Schnidejoch et Lötschenpass. Investigations archéologiques dans les Alpes bernoises.

Archäologie in den Hochalpen: Vom Rückgang der Gletscher sind auch archäologische Objekte betroffen. Über Jahrtausende hinweg haben sie im Eis überdauert, nun kommen sie zum Vorschein. Im Hitzesommer 2003 fand eine Wanderin am Schnidejoch ein fremdartiges Objekt aus Birkenrinde. Es erwies sich als Teil eines 4800 Jahre alten Bogenfutterals. In den Jahren 2004 bis 2011 unternahm der Archäologische Dienst des Kantons Bern über 30 Begehungen der Nordseite und – zusammen mit der Walliser Kantonsarchäologie – auch der Südseite des Schnidejochs. Zahlreiche weitere Funde aus Holz, Leder und Metall konnten geborgen und wissenschaftlich untersucht werden. Einzigartige Funde Zu den spektakulärsten Funden vom Schnidejoch zählt das Bogenfutteral aus Birkenrinde. Weiter stechen aus den rund 900 Funden ein Pfeilbogen, mehrere vollständige Pfeile und Fragmente einer Schale aus Ulmenholz hervor. Es handelt sich dabei um das älteste Holzgefäss der Schweiz. Weitere herausragende Funde sind ein bronzezeitliches Holzgefäss aus Birkenrinde, eine bronzezeitliche Gewandnadel sowie Bekleidung und Schuhe aus Leder. Archéologie dans les Alpes bernoises Le recul des glaciers a aussi un impact sur les découvertes archéologiques. Il fait réapparaître des objets préservés dans les glaces depuis des millénaires. Pendant l’été caniculaire de 2003, une randonneuse a découvert un objet singulier en écorce de bouleau, qui s’est avéré être un morceau de carquois vieux de 4800 ans. De 2004 à 2011, le Service archéologique du canton de Berne s’est rendu plus de trente fois sur le versant nord du Schnidejoch et, en collaboration avec le Service d’archéologie du canton du Valais, sur le versant sud de ce col. De nombreux autres objets en bois, cuir et métal ont pu être mis au jour et étudiés scientifiquement. Des découvertes uniques Le carquois en écorce de bouleau constitue l’une des découvertes les plus sensationnelles du Schnidejoch. Parmi les quelque 900 objets mis au jour figurent un arc, plusieurs flèches complètes et les fragments d’un bol en bois d’orme. Ce bol est le plus ancien récipient en bois de Suisse. D’autres trouvailles spectaculaires ont été faites, notamment un récipient en écorce de bouleau et une épingle à vêtements datant de l’Âge du Bronze ainsi que des vêtements et des chaussures en cuir.

Ms. hebr. oct. 67 - Sefer ha-ʾorah

Vorbesitzer: Abraham Merzbacher

Ms. hebr. oct. 79 - Ḥidushe ha-RITBA

Vorbesitzer: Abraham Merzbacher

Ms. hebr. oct. 80 - Ḥizuḳ emunah

Vorbesitzer: Eljāqīm Carmoly; Abraham Merzbacher

Ms. hebr. oct. 127 - Sodot und Perush ha-Hagadah

Vorbesitzer: Eljāqīm Carmoly; Abraham Merzbacher

Befestigung im Glauben

von Jizchak, Sohn Abrahams. Neu hrsg. mit verbessertem hebr. Texte ... vermehrt mit einer Übers. ins Dt. und begleitet von einigen Anm. von David Deutsch

Clinical and haemodynamic outcomes in 658 patients receiving the Perceval sutureless aortic valve: early results from a prospective European multicentre study (the Cavalier Trial)†.

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.

Sutureless aortic valve replacement: a systematic review and meta-analysis.

BACKGROUND Sutureless aortic valve replacement (SU-AVR) has emerged as an innovative alternative for treatment of aortic stenosis. By avoiding the placement of sutures, this approach aims to reduce cross-clamp and cardiopulmonary bypass (CPB) duration and thereby improve surgical outcomes and facilitate a minimally invasive approach suitable for higher risk patients. The present systematic review and meta-analysis aims to assess the safety and efficacy of SU-AVR approach in the current literature. METHODS Electronic searches were performed using six databases from their inception to January 2014. Relevant studies utilizing sutureless valves for aortic valve implantation were identified. Data were extracted and analyzed according to predefined clinical endpoints. RESULTS Twelve studies were identified for inclusion of qualitative and quantitative analyses, all of which were observational reports. The minimally invasive approach was used in 40.4% of included patients, while 22.8% underwent concomitant coronary bypass surgery. Pooled cross-clamp and CPB duration for isolated AVR was 56.7 and 46.5 minutes, respectively. Pooled 30-day and 1-year mortality rates were 2.1% and 4.9%, respectively, while the incidences of strokes (1.5%), valve degenerations (0.4%) and paravalvular leaks (PVL) (3.0%) were acceptable. CONCLUSIONS The evaluation of current observational evidence suggests that sutureless aortic valve implantation is a safe procedure associated with shorter cross-clamp and CPB duration, and comparable complication rates to the conventional approach in the short-term.

Mechanical versus biological aortic valve replacement strategies.

Aortic valve replacement (AVR) is the most frequently performed procedure in valve surgery. The controversy about the optimal choice of the prosthetic valve is as old as the technique itself. Currently there is no perfect valve substitute available. The main challenge is to choose between mechanical and biological prosthetic valves. Biological valves include pericardial (bovine, porcine or equine) and native porcine bioprostheses designed in stented or stentless versions. Homografts and pulmonary autografts are reserved for special indications and will not be discussed in detail in this review. We will focus on the decision making between artificial biological and mechanical prostheses, respectively. The first part of this article reviews guideline recommendations concerning the choice of aortic prostheses in different clinical situations while the second part is focused on novel strategies in the treatment of patients with aortic valve pathology.

European multicentre experience with the sutureless Perceval valve: clinical and haemodynamic outcomes up to 5 years in over 700 patients†.

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.

Pitfalls and premature failure of the Freedom SOLO stentless valve

Gebiet: Chirurgie Abstract: Objectives This study reports a series of pitfalls, premature failures and explantations of the third generation Freedom SOLO bovine pericardial stentless valve. – – Methods 149 patients underwent aortic valve replacement (AVR) using the FS. Follow-up was 100% complete with an average observation time of 5.5±2.3 years (max. 8.7 years) and a total of 825 patient years. Following intraoperative documentation, all explanted valve prostheses underwent histological examination. – – Results Freedom from structural valve deterioration (SVD) at 5, 6, 7, 8 and 9 years was 92%, 88%, 80% and 70% and 62%, respectively. 14 prostheses required explantation due to valve-independent dysfunction (n=5, i.e. thrombus formation, oversizing, aortic dilatation, endocarditis and suture dehiscence) or valve-dependent failure (acute leaflet tears, n=4, severe stenosis, n=5). Thus freedom from explantation at 5, 6, 7, 8 and 9 years was 95%, 94%, 91% and 81% and 72%, respectively. An acute vertical tear along the non-coronary/right-coronary commissure to the base occurred at a mean of 6.0 years [range 4.3?7.3 years] and affected size 25 and 27 prostheses exclusively. Four FS required explantation after a mean of 7.5 years [range 7.0?8.3 years] due to severe functional stenosis and gross calcification that included the entire aortic root. – – Conclusions The Freedom SOLO stentless valve is safe to implant and shows satisfying mid-term results in our single institution experience. Freedom from SVD and explantation decreased markedly after only 6 ? 7 years, so that patients with FS require close observation and follow-up. Exact sizing, symmetric positioning and observing patient limitations are crucial for optimal outcome.