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Biomedical subjects

B Reichart

Publications and source records attributed to B Reichart.

At least 361 records · Page 20Linked to original sources
PubMed1983

[Global and regional left ventricular myocardial function following aorto-coronary multiple (5-, 6-, 7-) bypass. Non-invasive determination with technetium 99m-pertechnetate scintigraphy].

In 19 patients (mean age 55.3 years) with severe, diffuse coronary artery disease and stable angina pectoris, coronary artery bypass surgery was performed with an average of 5.36 anastomoses per patient. At 15.5 +/- 8 months postoperatively, radionuclide ventriculograms were obtained in the RAO projection (first-pass-technique) at rest and during maximal exercise by means of a multicrystal camera. To assess the effects of revascularization on the myocardial function, analysis was performed for global ejection fraction (GEF) as well as three regional ejection fraction (GEF) as well as three regional ejection fractions (REF) corresponding to the vascular beds of the three major coronary arteries. During exercise global ejection fraction increased in 13 patients (68.4%) an average of 9.5%-points from 51.5 to 61.0%, in one patient (5.2%) remained unchanged and in five patients (26.3%) decreased an average of 9.6% %-points from 62.6 to 53.0% (all changes p less than 0.05). The classification of the various myocardial regions was based on the preoperative coronary angiogram as well as intraoperative in-situ findings according to the status of the coronary vessels, the extent of revascularization and the presence of remote myocardial infarctions. Regions of group I had a significantly higher fraction of complete revascularizations, that is 79.9%. 61.1% of group-II-territories were incompletely revascularized. The weighted balance of the three regions supplied by the left anterior descending artery, the circumflex and the right coronary artery explains the postoperative response of the global ejection fraction to exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗
PubMed1983

[Heart transplantation--2 years' experience in the Grosshadern Clinic of the University of Munich].

Between August 1981 and August 1983 11 heart transplantations were carried out at the Klinikum Grosshadern of the University of Munich. The recipients were 10 men and 1 women. The age of the patients at the time of the operation ranged from 20 to 45 years. The diagnosis was: congestive cardiomyopathy (4 cases), coronary heart disease (5 cases), Uhl's disease (1 case), valvular heart disease (1 case). Cyclosporin A was used as the main immunosuppressive agent in all cases. 3 patients died (1., 10. and 73. postop. day). 8 patients survived now since 2 to 25 months. The survival time exceeds 0.5 years in 5 cases and 1 year in 3 cases.

Adult↗
PubMed1983

[Heart surgery].

Explore the source record for details and available documents.

Bioprosthesis↗
PubMed1983

Penetration of ceftazidime into human tissue in patients undergoing cardiac surgery.

The penetration of ceftazidime into human heart muscle, skeletal muscle, skin, fat and bone was measured in 39 patients undergoing cardiac surgery. Mean serum levels of 70 mg/l were measured 1.5 h after dosing with mean levels of 27 mg/l after 4 h and 5.5 mg/l after 12 h. Tissue levels of ceftazidime were measured up to 280 min after dosing. These levels were high with mean corrected levels after 120 min of 20.0 mg/l in bone, 7.1 mg/l in skin (after 100 min), 9.2 mg/l in fat, 12.7 mg/l in heart muscle and 9.4 mg/l in skeletal muscle. Serum and tissue levels were sufficient to prevent infection by all likely pathogens, including Staphylococcus aureus, 98% of which have a ceftazidime minimum inhibitory concentration of 8 mg/l or less. There were no post-surgical infections.

Adipose Tissue↗
PubMed1982

[Report on a successful orthotopic cardiac transplantation in Germany].

The first successful heart-transplantation carried out in the Department for Cardiovascular Surgery of the University of Munich, Klinikum Grosshadern is reported. The recipient, 32 years old at the time of operation, had sustained a large antero-lateral-septal myocardial infarction in June 1980; thereafter the left ventricular ejection fraction was severely impaired (e.f. = 19%). Yet, the operation was definitely planned some year later, after the patient had survived an embolus to the right lung, an acute left heart failure and a small ulcer of the stomach. The operation was performed on 8-19-1981. The donor was a 23 year old young man, who had met a fatal motorcycle accident 10 days ago. The man was pronounced dead in the afternoon of the preoperative day according to the criterions of the German Society for Surgery by means of a carotid angiogram. Donor and recipient were well matched in regard to blood group, HLA-A2-System and finally cross-match-test. Transplantation was carried out according to the technique of Lower and Shumway. Immediately p.o., immunosuppressive therapy was started using azathioprine, cortisone and antihuman thymocyte globulin. Two acute rejections were noted, the first from p.o. day 6 to 15, the second from p.o. day 22 to 34. The second acute rejection was complicated by a pneumatosis cystoides intestinii, which caused a change of the immunosuppressive therapy to Cyclosporin A. No further complications were registered in the following p.o. course, the patient is discharged since Christmas 1981.

Adrenal Cortex Hormones↗
PubMed1982

Regional left ventricular function in the three main coronary artery territories at rest and during exercise.

Twenty consecutive patients (mean age 51.6 years) with persistent severe angina pectoris underwent aorto-coronary bypass surgery receiving an overall of 60 anastomosis. On an average, 9.4 +/- 1.5 months p.o. first pass radionuclide ventriculograms (18 to 24 mCi 99m Technetium-Pertechnetate i.v.) were performed at rest and after exercise. Besides measurement of global ejection fraction (GEF), regional ejection fraction (REF) was assessed employing for the first time a new technique: each RAO-view of p.o. radionuclide left ventriculogram was subdivided into three regions according to supply of the three main coronary arteries and their branches as visualized on pre-operative coronary angiogram. GEF improved after maximum exercise in 13 cases by 8.1% points (from 50.4 to 58.5%), remained unchanged three times and decreased four times by 7.1 points (from 51.6 to 44.5%; all changes p less than 0.05). In completely revascularized regions (n = 35) REF improved 24 times by 9.7 points (from 51.1 to 60.8%), did not differ from rest REF six times and decreased in three case by 7.3 points (from 48.6 to 41.3%; all changes p less than 0.05). completely revascularized regions responded to exercise like normally perfused areas (increase 7.8 points (from 50.6 to 58.4%; n = 7; p less than 0.05). REF deteriorated in incompletely revascularized regions (n = 9) six times by 12.8 points (from 58.0 to 45.2%), remained unchanged twice and improved once by 4.5 points. Total group's REF decreased by 7.3 points (from 56.8 to 49.5%; p less than 0.05). Exercise REF of incompletely revascularized regions was highly significant inferior to that of completely revascularized regions (49.5 to 58.4%; p less than 0.01). GEF is a weighted balanced of the three regional ejection fractions. The most important parameter is REF of LAD territory.

Adult↗
PubMed1982

Stenosis of the supraaortic branches combined with coronary artery disease: one-stage surgical treatment.

Combined one-stage surgery of the supraaortic branches and the coronary arteries was performed on 17 consecutive patients, 13 men and 4 women, having a mean age of 56.7 +/- 8 years. Angina pectoris was the primary symptom in all patients. Signs of cerebro-vascular insufficiency were present in 4 cases, 2 with syncopies, one with amaurosis fugax, and one with drop-out symptoms. All patients were invasively examined. Coronary angiogram verified triple vessel disease in 13 cases, double vessel disease in 3 and single vessel disease in one. Angiography of the carotid artery proved unilateral disease in 11 patients, in 5 both sides were either stenosed or occluded. One patient had a left-sided proximal 80% lesion of the subclavian artery. In all cases, the supraaortic branches were done first, followed by revascularization of the coronary artery system. All patients survived the early postoperative course; one died suddenly 33 months after operation. After 16.8 +/- 14 months, 11 out of 15 patients felt much better. Signs of cerebro-vascular insufficiency were not present. Our conclusion: one-stage surgery of the supraaortic branches and the coronary arteries would seem justified. A list of indications is presented.

Adult↗
PubMed1982

Valve replacement for chronic mitral insufficiency; long-term follow up using technetium pertechnetate scintigraphy.

Technetium Pertechnetate Scintigraphy was performed in 12 patients (9 men and 3 women, average age 48 +/- 13 years) on an average 19.8 +/- 11 months after valve replacement for chronic mitral insufficiency. Preoperative conventional ventriculography had revealed increased enddiastolic and endsystolic volumes (230.9 +/- 66 resp. 73.5 +/- 26 ml). 59.4 +/- 9% of the stroke volume (157.5 +/- 47 ml) regurgitated into the left atrium. Ejection-fraction (67.7 +/- 6%) was normal in all cases. Postoperative first pass technique was employed using a fast multicrystal camera (Baird Atomic, system 77). Volumes were assessed measuring normalized total count rate (count integral of the left ventricle divided by the maximum count density). 19.8 +/- 11 months after valve replacement enddiastolic and endsystolic volumes revealed normal at rest (121.8 +/- 38 resp. 52.8 +/- 35 ml) and after maximum exercise (122.0 +/- 29 resp. 37.6 +/- 22 ml). Ejection fraction responded physiologically to exercise by rising from 57.7 +/- 12 to 69.7 +/- 10%.

Adult↗
PubMed1981

[Antibiotic prophylaxis with cephalosporins in heart surgery].

60 minutes after i.v. injection tissue levels of 7 different cephalosporins were obtained using biological assay. The following concentrations were measured: cephalothn 1.4 micrograms/g; cepharin 4.7 micrograms/g; cephacetrile 11.2 micrograms/g; cephradine 15.4 micrograms/g; cefazedone 26.9 micrograms/g; cefamandole 40.3 micrograms/g, and finally cefoxitin 43 micrograms/g. The high tissue levels of cefamandole and cefoxitin are especially remarkable as i.v. doses of both antibiotics had been 50 mg/kg body weight ( doses of all other cephalosporins 100 mg/kg body weight). Except cephalothin, all cephalosporins tested were suitable for antibiotic prophylaxis in cardiac surgery.

Cardiac Surgical Procedures↗
PubMed1981

[Heart transplantation 1981. A status determination].

This is a report based on the experience of Stanford University in Palo Alto/California (Chief: N. Shumway). The operation is above all indicated in patients suffering from endstage cardiomyopathy respectively coronary heart disease. Stage IV valve patients (according to N. Y. H. A.) represent no candidates at the present time. Main contraindications are age over 50 years, pulmonary hypertension (above 8--10 resistance units), florid infections and diabetes mellitus. Perfect postoperative care is the key for success at Stanford; only that way long-term results compare favourably to those of kidney transplants: for the patient group after 1973 long-term survival rate is 55 percent.

Adult↗
PubMed1981

Treatment of acute left heart failure using dobutamine and intraaortic counterpulsation. Animal experiments and first clinical experiences.

Ten anesthetized mongrel dogs had a left anterolateral thoracotomy; the left anterior descending coronary artery was then ligated. After 60 min five animals each were treated either with dobutamine (4 microgram/min/kg; for 10 min), or with dobutamine and intraaortic counterpulsation. Combined treatment of cardiogenic shock proved superior. Those five dogs had significantly lower heart rates and dp/dt/p-values. Due to IABP the non-ischemic parts of the left ventricle were better perfused; there was no difference in treatment with regard to ischemic parts. The combined treatment was successfully inaugurated in two patients with cardiogenic shock.

Adult↗
PubMed1981

Surgical treatment for congenital occlusion of the inferior vena cava in its diaphragmatic portion.

This is a case report on a congenital occlusion of the inferior vena cava in its diaphragmatic part. Additionally, the proximal 10 cm within the retrohepatic portion of the vessel were highly stenotic. With exception of the vena hepatica brevis all larger hepatic veins were occluded. Correction was achieved using a 14 mm Gore-Tex (Polytetrafluoroethylene) graft, which connected the abdominal part of the inferior vena cava to the right atrium.

Adult↗