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Biomedical subjects

B J Messmer

Publications and source records attributed to B J Messmer.

At least 145 records · Page 8Linked to original sources
PubMed1980

Improved technique in permanent atrial pacing.

At the present time, the relatively high atrial stimulation threshold and the low and often unstable P wave amplitude are the main concerns in atrial pacing. As a further contribution to the solution of this problem we used a screw-in atrial lead in 16 patients. During the implantation, atrial mapping was performed in order to establish the position with the best electrical performance. The acute threshold for voltage at a pulse duration of 1 ms averaged 0.49 +/- 0.18 Volt. The acute peak-to-peak P wave amplitude averaged 4.6 mV +/- 1.3. No complication occurred at the time of the implantation. Follow-up periods averaged 12 months. No dislocation or bleeding was observed during a follow-up period of up to 28 months. Using this lead together with intraoperative atrial mapping, it is possible to achieve an acute strength-duration relationship in the atrium at a level similar to that in the ventricle. The results of this study demonstrate that intraoperative mapping is an important stein in enhancing the safety margins and long-term performance of atrial pacing.

Action Potentials↗
PubMed1978

[Special diagnostic procedures in atrial tumours of the heart (author's transl)].

A vascular myxoma which prolapsed into the mitral valve was found in the left atrium of a 47-year old man. Two-dimensional ultrasonic tomography yielded relevant non-invasive diagnostic information on the pattern of movement of the pedunculated tumour. Highly accurate determination of the tumour volume was achieved via angiocardiography and videometry. Coronography of the tumour vessels allowed identification of an unusual point of insertion of the myxoma. The risk of obstruction of the mitral orifice was documented haemodynamically by a steep gradient above the mitral valve when holding breath during the expiratory phase.

Angiocardiography↗
PubMed1977

[Hemolysis after aortic valve replacement (author's transl)].

Hemolysis after isolated aortic valve replacement using Björk-Shiley and Starr-Edwards (series 1260) prostheses as well as unstented Fascia-lata valves has been determined in 50 patients. A battery of hemathologic and blood-chemical tests were performed in all patients but LDH has proved to be the most reliable parameter. Survival of erythrocytes was measured in a small group of patients. Patients with Björk-Shiley prosthesis have shown lower average rate of hemolysis (LDH 201 IU, Haptoglobin 45 mg %) than patients with Starr-Edwards prosthesis (LDH 273 IU, Haptoglobin 35 mg %). When functioning regularly neither prosthesis results, however, in clinically significant hemolysis. In patients with unstented Fascia-lata valve the degree of hemolysis reflects directly the functional status of the valve.

Adult↗
PubMed1976

Psychomotor and intellectual development after deep hypothermia and circulatory arrest in early infancy.

Somatic, psychomotor, and intellectual development were studied in 11 patients who had total correction of congenital cardiac malformation in early infancy by the method of surface-induced deep hypothermia and circulatory arrest up to 43 minutes. Time between operation and re-evaluation ranged from 3 to 11 years (average 7 years). Somatic development was normal in all children. Psychomotor and intellectual behavior, measured by a battery of specially adapted test methods, failed to show a statistically significant difference when compared between the study group, a matched control group, and the normal population. Normal scores in psychomotor tests and normal intelligence quotients (I.Q.) were present in 8 patients; mental retardation was found in 2 patients: and unstable behavior, evident from different tests, was present in one. Except for the last case, in none of the patients was the method was found to be the primary cause of the abnormal behavior. Deep hypothermia and circulatory arrest in early infancy does not appear to have a negative influence on somatic, psychomotor, or intellectual development.

Anthropometry↗
PubMed1975

[Proceedings: Results of early surgery in infectious endocarditis].

23 patients with infective endocarditis have been treated surgically during the period 1965 to 1975. 20 patients underwent operation for intractable heart failure, complicated in 4 instances by systemic embolization and in 4 others by intractable infection. Two patients were operated upon only for intractable infection and one patient for severe hemolysis. There were 5 early deaths within 12 days and 2 late deaths 2 and 21 months after operation. Four months to 9 1/2 years after operation 16 patients were alive, only one of whom had mild heart failure. The best prognosis (1 death) was apparent in the 12 patients who underwent operation for intractable heart failure only.

Adult↗
PubMed1975

[Transportation of great arteries: possibilities and problems of surgical treatment (author's transl)].

The principle of atrial inversion clinically introduced by Senning in 1958 remains the method of choice for total correction of isolated transposition. Simplifactions and refinement of the original technique resulted in a lower operative mortality and in significant reduction of late complications such as life threatening arrhythmias and venous inflow stenoses especially found after the original Mustard operation. Transposition complicated by ventricular septum defect with or without pulmonic stenosis remains a surgical challenge. In these cases the anatomic and hemodynamic corection with the Rastelli procedure may be of advantage. Palliative operations have a high operative risk (17% in the present series). Today, their indication is restricted to patients who are not improved after balloon-septostomy or to patients with inadequate pulmonary flow urging for pulmonary artery banding and aorto-pulmonary shunt, respectively. In isolated transposition of the great arteries primary balloon-septostomy followed by early total correction in infancy after the age of six months seems to be the most appropriate treatment today.

Adolescent↗
PubMed1975

[Mitral valve surgery: 10 years follow-up of 501 patients (author's transl)].

The results of mitral surgery between 1961 and 1971 are presented. Pure or predominant mitral stenosis outnumbered combined mitral valve disease and mitral incompetence by two to one. Surgical treatment comprised 291 closed mitral commissurotomies, 145 open reconstructions and 81 replacements of the mitral valve. One month mortality was 2,4% for commissurotomy, 4,8% for reconstruction, and 25% for replacement. Early mortality of the latter operation decreased to 7% since 1971. For patients with no more than slight preoperative symptoms life expectany remained unaffected for 10 years after closed commissurotomy. For patients with significant preoperative limitation or symptoms at rest 5 and 10 years life expectancy after successful surgery was 93 and 79% resp. for commissurotomy, 94 and 73% for reconstruction and 79 and 53% resp. for mitral valve replacement. In spite of a higher rate of reoperations and late deterioration of valve function the reparative operations deserve preference to the replacement of the mitral valve whenever feasible.

Adult↗