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Biomedical subjects

B Heisig

Publications and source records attributed to B Heisig.

At least 19 recordsLinked to original sources
PubMed1981

Surgical treatment of various types of left ventricular outflow tract stenosis by aortoventriculoplasty--clinical results.

Since 1974 the new concept of aortoventriculoplasty (AVP) has been applied clinically in Göttingen. Out of 1,112 patients with various types of congenital aortic stenosis 502 patients have undergone commissurotomy, resection of a subvalvular ring, myotomy and supravalvular patch plasty. Fifty-seven patients were treated by AVP, in only 11 patients was AVP the first procedure, 46 had had one or more previous operations. Total hospital mortality was 12.2%; in the last 37 cases there was only one death. Two patients suffered permanent AV block. The mean left ventricular-aorta gradient was reduced from 94 +/- 24 mmHg to 14 +/- 15 mmHg after AVP. In our clinical material the indications for AVP (n = 57) have been the following: valvular aortic stenosis with narrow annulus (8 patients), diffuse subaortic stenosis (20) (from collar-like to tunnel-like, out of these patients 6 with Shone-complex), multi-level stenosis (20), outgrown prosthesis (4), hypertrophic obstructive cardiomyopathy (5). In comparison to the apico-aortic conduit procedure and total replacement of the aortic root by homograft, the clinical results indicate AVP to be a simple and easy-to-apply operative technique.

Adolescent↗
PubMed1981

Stabilization of flail chest by compression osteosynthesis--experimental and clinical results.

It has been demonstrated that the impaired ventilatory parameters can be normalized after early stabilization of flail chest. Most methods for operative fixation, however, have given disappointing results and only plate fixation procedures have been effective. The experimental results of osteosynthesis with dynamic compression plates are presented and demonstrate the superiority of compression osteosynthesis in rib fractures. Compression osteosynthesis resulted in a primary fracture healing with stable fragments after 14 days, whereas conventional plate fixation techniques required a much longer time and showed secondary fracture healing. The benefits of compression osteosynthesis could also be demonstrated in 10 patients with traumatic flail chest. Osteosynthesis resulted in marked pain relief, immediate stabilization of the chest wall, and a shorter time of intubation. Not all fractured ribs need stabilization, dorsal fractures are well fixed by the strong erector muscles, and in the lateral position only ribs III to VII need to be considered. Reasonable stabilization may be achieved with fixation of every second rib. In patients with bilateral rib serial fractures subcutaneous implantation of one or 2 rib struts is recommended--good results were obtained in 12 patients. The indication for operative stabilization of flail chest should be restricted to: 1. Patients with severe ventilatory restriction due to chest wall paradox alone. 2. Flail chest combined with intra-thoracic lesions which require thoracotomy. 3. Flail chest combined with lesions which require a prone position for surgical exploration. 4. Respiratory distress patients when the unstable chest wall interferes with mechanical ventilation or with underlying organs.

Adolescent↗
PubMed1981

Early and long-term results after surgical treatment of abdominal aortic aneurysm.

From 1959 to July 1981, 121 patients underwent surgery for abdominal aortic aneurysm. One hundred-nine patients were male and 12 female. Ninety-one patients had an elective operation, 30 patients were operated on an emergency basis. Among the electively treated there were 32 asymptomatic patients. Early mortality of electively operated patients was 13.2% in period I (1959 to 1974), and 8.8% in period II (1975 to 1981). The early death rate of asymptomatic patients decreased from 9.4% to 4.8%. The prognosis of emergency patients remained unchanged: 50% died in both periods. Cardiac complications were the major cause of early death. The late complication rate related to the aneurysmectomy was 18.1%. Four patients died of rupture of the proximal anastomosis. Aneurysm-related reoperations were necessary in 19.1% of the patients. The mortality rate for patients under 65 years was 6.1% in period II, and 16.7% in patients over 70 years. Another severe risk factor is coronary artery disease (16.0% mortality in period II), especially in combination with advanced age (21.4% mortality in period II). The results indicate that the abdominal aortic aneurysm should be treated electively; however, poor risk patients should not undergo surgery if the aneurysm is asymptomatic. In younger patients with coronary artery disease, coronary artery bypass surgery should be considered prior to aneurysmectomy.

Adult↗
PubMed1978

Results of aortoventriculoplasty in 21 consecutive patients with left ventricular outflow tract obstruction.

Results of aortoventriculoplasty (AVP) are reported in 21 patients with various types of left ventricular outflow tract obstruction (LVOTO). The concept of AVP is based on creating a surgical aortoseptal defect which is patched to provide the largest possible outflow tract to the left ventricle. Lesions consisted of isolated diffuse fibromuscular subaortic stenosis in six patients, diffuse subaortic stenosis and associated other cardiovascular anomalies in five, hypoplastic aortic anulus in two, idiopathic hypertrophic subaortic stenosis (IHSS) in two, and stenosis of a previously implanted aortic valvular prosthesis in three patients. Ten patients had had at least one unsuccessful previous surgical attempt to relieve the LVOTO. The coexisting mitral incompetence in IHSS disappeared after AVP alone. Immediate postoperative hemodynamic results were excellent in all cases. Postoperative death in five patients was due to advance myocardial failure in two, brain damage in one, transection of a dominant septal artery in one, and severe acidosis with renal failure in the last case. However, in the last 16 patients (17 operations) the only death (5.8 percent) was that caused by uncontrollable acidosis. Follow-up results indicate that 16 patients are clinically doing well, and hemodynamic studies in 14 patients are rated as excellent or good from 1 to 25 months postoperatively. It is concluded that AVP is an effective operation for managing all types of LVOTO and can be used routinely with an acceptably low mortality rate.

Aorta↗
PubMed1976

[The portacaval anastomosis (author's transl)].

All patients treated in the authors' clinic for portal hypertension from 1958 to 1975 are reviewed and the problems encountered with portacaval anastomoses are explained with special reference to encephalopathy and hepatic failure. Intrahepatic block was recorded in 88% of 722 patients. Portacaval anastomoses were constructed in 292 cases, splenorenal anastomoses in 175, and mesenterico-caval anastomoses in 12. Among the patients with stationary cirrhosis, the 6-year survival was unrelated to the type of operation performed and amounted to approximately 70%, while 6-year survival was only 40% in patients with progressive cirrhosis of the liver, whether they received surgical or conservative treatment.

Esophageal and Gastric Varices↗
PubMed1975

[Glucose and lactate concentration in tears of rabbits following mechanical stress and wearing of contact lenses].

The concentration of glucose and lactat in tears is significantly different after slight or strong irritation of the eye. More glucose and lactat can be washed out of alterated tissue compared to normal one, although we estimate that the metabolits are primary more secreted after irritation. Under soft contact-lenses the concentration of both metabolits increase continiously during a certain period. Under hard contact-lenses the single measurements are very different. We have to estimate many disturbing factors.

Animals↗