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Biomedical subjects

B Rigler

Publications and source records attributed to B Rigler.

88 records · Page 5Linked to original sources
PubMed1980

[Ductus ligation in idiopathic respiratory distress syndrome of the premature infant].

In a 13-month period, ligation of the persistent ductus was carried out in 23 prematurely born babies with severe respiratory distress syndrome who were all respirator-dependent. Mean gestational age was 30.6 weeks (26-36 weeks), mean birth weight 1490 g (850-3090 g) with 3 patients under 1000 g. Signs of cardiac failure by large left to right shunt via ductus were seen at the end of the first week of life, radiologic signs as pulmonary edema were seen 1 to 2 days earlier. Mean age at operation was 13.5 days (4-27 days), mean duration of artificial ventilation 22 days (8-59 days). Indomethacin was used orally 12 of these patients without effect to close the ductus. One patient died of cerebral hemorrhage on his 17th day of life, 10 days postoperatively, one 3 1/2 months later at home with porencephaly and hydrocephalus. Four patients show radiologic signs of bronchopulmonary dysplasia. In the following 6 months up to December 1979, another 15 patients with IRDS underwent ductus ligation. Gestational age and birth weights were about the same as in the first group. Out of this second group which has not been followed up for a longer period. 3 babies died. Early mortality in both groups is 10.5% (4 out of 38 patients).

Birth Weight↗
PubMed1979

[Age at correction and postoperative hypertension in isolated coarctation of the aorta (author's transl)].

A follow-up study of 46 cases of isolated coarctation of the aorta (age at surgical treatment 1 to 48 years) is presented. The late postoperative blood pressure was the higher the later surgical treatment was carried out. When surgical treatment was carried out at an age of more than 14 years, an increase of the residual hypertension rate was observed. A relatively low rate of residual hypertension can be expected after correction at about 6 to 10 years. Surgical treatment in infancy does not seem to have beneficial effects since according to other reports correction at this age does not reduce the residual hypertension rate essentially. Apart from the elevated residual hypertension rate surgical treatment at an advanced age generally has a lowering effect on blood pressure values.

Adolescent↗
PubMed1978

[Pulmonary artery arrosion due to parietal endocarditis--a late complication of a haemodynamically ineffective VSD (author's transl)].

A case of late complication after operative correction of a valvular pulmonary stenosis is reported. Chronic pulmonary embolism secondary to bacterial endocarditis situated opposite to an uncorrected small ventricular septal defect in the right ventricle caused arrosion of the pulmonary artery and subsequent severe fatal bronchial hemorrhage. The relation between VSD and bacterial endocarditis and the surgical consequences are discussed.

Adult↗
PubMed1978

[Surgery of congenital acyanotic cardiac malformations (author's transl)].

Congenital heart lesions are found in 0.8% of all newborns; four-fifths of them are correctable. Two thirds of all surgical procedures are done in acyanotic malformations, mainly in septal defects, patent ductus arteriosus, coarctations of the aorta and valvular stenosis. Within the last twenty years corrective repair has been established with good results in these lesions. Therapeutic problems still remain in cases of late diagnosis and in some rare and complex anomalies like malformations of the aortic arch, of the coronary arteries, in some types of aortopulmonary window and atrioventricular canal. Surgery becomes urgent in babies suffering from severe heart disease because of progressive pulmonary hypertension, inadequate growth or severe heart failure (despite intensive medical treatment). For certain lesions corrective repair (patent ductus arteriosus, coarctation) is definitely indicated, for others (ventricular septal defect, atrioventricular canal) urgent palliation or early total repair is debatable. In most patients with uncomplicated lesions treated in time during childhood a low operative mortality below 1% was observed. A higher mortality rate was found (10 to 50%) in patients with pulmonary artery disease or associated pulmonary lesions. A significantly higher mortality could also be observed in the advanced age group (4.7%) and in infants below one year of age (11,5%), underlining the important point of the age at operations. Recurrence of lesions occured in 1% of our patients after closure of ventricular septal defects, reconstructions of mitral valve disease and early corrected coarctations. Nevertheless, most of these patients can expect a normal growth, life span and ability to work.

Cyanosis↗
PubMed1976

[Homologous liver and liver-kidney transplantation--experimental study].

Animal experiments were carried out for giving an opinion about several problems in hepatic transplantation, such as blood clotting disturbance, liver-kidney transplantation, and vitality of the graft. 54 allogenic orthotopic and heterotopic liver transplantations and liver-kidney transplantations were performed on pigs, the major part without portosystemic decompressing bypass, following the technique of Calne. 17 animals survived for a longer period. Preservation up to 20 hours could successfully be outlasted by help of hypothermic immersion or intermittant gravitational perfusion up to the limit of eight hours. Aside from biochemical observation, severe blood clotting disturbances only occurred after a longer ischemic period. After en-bloc transplantation the function of the graft was checked by means of angiography and intravenous pyelography. Due to higher tolerance against ischemia, the kidney of the en-bloc graft always started functioning when the function of the liver was intact. The changes of bioelectric resistance of the liver before and after transplantation, measured by help of the impedance method of Lechner and Rodler, correlated with the time of surviving and with several biochemic parameters.

Animals↗
PubMedDate not supplied

Dissection of the descending aorta after balloon angioplasty of native coarctation.

A 12-year-old girl underwent successful balloon angioplasty for a waist-like native coarctation. The balloon size/coarctation diameter ratio was 3.3. Postdilatation angiography showed a small aneurysm at the coarctation site. On frequent review the patient remained symptom-free and normotensive. Recatheterization was performed 14 months after balloon aortoplasty, when angiography revealed a massive aortic dissection extending from the origin of the left subclavian artery to both iliac arteries. She underwent partial replacement of the thoracic aorta. Balloon angioplasty of a narrow waist-like native coarctation may lead to extensive wall dissection and should be considered critically.

Aortic Dissection↗
PubMedDate not supplied

Treatment of acute aortic type B dissection with stent-grafts.

PURPOSE: To evaluate the feasibility of endoluminal stent-grafts in the treatment of acute type B aortic dissections. METHODS: In five patients with acute aortic type B dissections, sealing of the primary intimal tear with an endoluminal stent-graft was attempted. Indication for treatment was aneurysm formation in two patients and persistent pain in three patients. One of the latter also had an unstable dissection flap compromising the ostium of the superior mesenteric artery. The distance from the intimal tear to the left subclavian artery was <0.5 cm in four patients, who had typical type B dissections. In one patient with an atypical dissection the distance from the primary tear to the left subclavian artery was 4 cm. This patient had no re-entry tear. Talent tube grafts (World Medical Manufacturing Cooperation, Sunrise, FL, USA) were used in all patients. RESULTS: Stent-graft insertion with sealing of the primary tear was successful in all patients. The proximal covered portion of the stent-graft was placed across the left subclavian artery in four patients (1x transposition of the left subclavian artery). Left arm perfusion was preserved via a subclavian steal phenomenon in the patients in whom the stent-graft covered the orifice of the left subclavian artery. The only procedural complication we observed was an asymptomatic segmental renal infarction in one patient. In the thoracic aorta thrombosis of the false aortic lumen occurred in all patients. In one patient the false lumen of the abdominal aorta thrombosed after 4 weeks; in the other three patients the status of the abdominal aorta remained unchanged compared with the situation prior to stent-graft insertion. As a late complication formation of a secondary aneurysm of the thoracic aorta was observed at the distal end of the stent-graft 3 months after the primary intervention. This aneurysm was treated by coaxial insertion of an additional stent-graft without complications. CONCLUSION: Endoluminal treatment of acute type B aortic dissections seems to be an attractive alternative treatment to surgical repair. Thrombosis of the false lumen of the thoracic aorta can be induced if the primary tear is sealed with a stent-graft. This could protect the dissected thoracic aorta from delayed rupture.

Acute Disease↗
PubMedDate not supplied

[Purulent pericarditis during abscess-forming pneumonia].

The case is described of a 6 months old infant who developed purulent pericarditis during the course of pneumonia. Pericarditis probably developed in this condition by contiguous spread from the pleura. Diagnosis of impending cardiac tamponade was masked by the occurrence of massive unilateral empyema. The management of this condition is discussed by open surgical drainage. Real-time two-dimensional echocardiography is useful for diagnosis and surveillance in this disease.

Anti-Bacterial Agents↗