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Biomedical subjects

E Bos

Publications and source records attributed to E Bos.

At least 145 records · Page 8Linked to original sources
PubMed1987

Intraoperative two-dimensional echocardiography in complicated infective endocarditis of the aortic valve.

Six patients with complicated native and prosthetic aortic valve endocarditis were operated on. The data from cineangiocardiography and from precordial and intraoperative two-dimensional echocardiography were compared with the surgical findings. Surgical inspection revealed a mycotic aneurysm in six patients. In addition, a fistulous connection to the right atrium, an abscess in the interventricular septum, and mitral valve endocarditis were found in one of the patients. The pathologic conditions disclosed during the operation were correctly visualized with two-dimensional epicardial echocardiography, done before cardiopulmonary bypass. Cineangiography provided this information in one patient, and precordial two-dimensional echocardiographic analysis was correct in two patients. Thus, intraoperative two-dimensional echocardiography provides detailed information in complicated native and prosthetic aortic valve endocarditis that is of importance in the surgical management.

Adult↗
PubMed1986

Unguarded tricuspid orifice with two-chambered right ventricle.

Catheterization and anatomical data are presented of an infant with cyanosis due to a most unusual variant of unguarded tricuspid valve orifice in association with a two-chambered right ventricle. The inlet portion of the right ventricle ended blindly and was completely separated from the outlet portion by a muscular wall. The outlet chamber, which supported the pulmonary trunk, received its blood from the left ventricle through an outlet foramen. The condition is considered to be related to imperforate Ebstein's anomaly.

Cardiac Catheterization↗
PubMed1986

Growth and function of the right ventricular outflow tract after Fontan's procedure for tricuspid atresia: a two-dimensional echocardiographic study.

Two patients with classical tricuspid valve atresia were studied by two-dimensional echocardiography before and up to 6 years after Fontan's correction. Preoperative investigation revealed a diminutive right ventricular outflow chamber, which increased in size postoperatively and became functional. These data were compared to those obtained in normal individuals.

Adolescent↗
PubMed1986

Intraoperative epicardial two-dimensional echocardiography.

The usefulness of intraoperative epicardial two-dimensional (2D) echocardiography using a commercially available 5 MHz mechanical sector scanner was evaluated in 200 patients. The scanhead was inserted into a gas sterilized plastic bag and placed on the exposed heart. Unsuspected new diagnoses were made in 7 patients. In 68 patients additional morphologic information was obtained. This information influenced surgical management in 32 patients. Intraoperative echocardiographic analysis of the surgical correction revealed the expected results in 184 patients. In 16 patients the investigation provided important information in the decision of immediate reoperation. We conclude that epicardial two-dimensional echocardiography performed by the surgeon familiar with the interpretation of echocardiographic cross-sections yields important information for surgical management. The technique has become an important adjunct in our cardiac surgery department for immediate decision making and leads to optimal results.

Adolescent↗
PubMed1986

Coronary angioplasty for early postinfarction unstable angina.

Coronary angioplasty was performed in 53 patients in whom unstable angina had reoccurred after 48 hr and within 30 days after sustained myocardial infarction. Single-vessel disease was present in 64% of the patients and multivessel disease in 36%. The preceding myocardial infarction had been small to moderate in size in the majority of the patients. The left ventricular ejection fraction was more than 50% in 80% of the patients. Forty-five patients were refractory to pharmacologic treatment; eight were initially stabilized but once again became symptomatic with light exertion. Angioplasty was performed in 35 patients 2 to 14 days and in 18 patients 15 to 30 days after infarction (average 12 +/- 7 days after infarction). The initial success rate was 89% (47/53). The success rate of the patients treated at 2 to 14 days was lower (29/35, 83%) than that of patients treated at 14 to 30 days (18/18, 100%) but did not reach statistical significance (p less than .06). There were no deaths related to the procedure. In four of the six failures, emergency bypass surgery was performed and two patients sustained a myocardial infarction. Furthermore, a myocardial infarction complicated the angioplasty procedure in two other patients; thus the overall procedure-related myocardial infarction rate was 8% (4/53). At 6 months follow-up 26% (14/53) of all the patients who underwent angioplasty had recurrence of angina, which was successfully treated with repeat angioplasty, bypass surgery, or medical therapy. There were no late deaths. Late myocardial infarction occurred in two patients. Thus the total myocardial infarction rate after angioplasty at 6 months was 11% (6/53 patients).(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗
PubMed1985

Comparison of preoperative, operative and postoperative variables in asymptomatic or minimally symptomatic patients to severely symptomatic patients three years after coronary artery bypass grafting: analysis of 423 patients.

During a follow-up period of 3 years, among a consecutive series of 423 patients who gave informed consent for recatheterization both 1 and 3 years after coronary artery bypass grafting, the incidence of severely symptomatic patients with New York Heart Association class III or IV was 19% (79 of 423). The predictive value of approximately 80 clinical, angiographic and perioperative variables was too low to be of clinical value. Adverse clinical outcome was associated with a high closure rate of the grafts. Forty-six percent of the patients could not undergo reoperation because of unsuitable coronary anatomy. With intensive medical therapy half of these patients improved to functional class I or II, while of those patients who were reoperable 32% improved to class I or II with intensive pharmacologic treatment instead of reoperation. The nonresponders underwent reoperation, which resulted in improvement of symptoms to functional class I or II in most (83%).

Adult↗
PubMed1985

Quantitative assay for the transforming DNA activity in cell culture products for human use.

DNA isolates from a number of established cell lines have been tested for their transforming capacity in the NIH3T3 transformation assay. It has been found that this assay can be used to quantify the amount of transforming DNA at a submicrogram to milligram level. This assay system has been applied to validate the reduction of transforming DNA in various purification steps of cell culture products. The NIH3T3 assay system has been shown useful for in-process control and release of cell culture derived vaccines or therapeutics.

Animals↗
PubMed1985

Postoperative regression of left ventricular dimensions in aortic insufficiency: a long-term echocardiographic study.

The ability of preoperative M-mode echocardiography to predict the clinical course and the decrease in left ventricular size was assessed in 42 patients after uncomplicated valve replacement for isolated aortic insufficiency. During follow-up study, one patient died of chronic heart failure. The New York Heart Association functional class of the 41 survivors improved from 2.4 to 1.2. All patients had a preoperative M-mode echocardiogram. Serial echocardiographic measurements, available in 33 patients, showed a sustained decrease in left ventricular end-diastolic dimension after the first postoperative year from 73 +/- 8 to 57 +/- 9 mm at 6 to 12 months and to 53 +/- 9 mm at 3 years postoperatively (p less than 0.01). Left ventricular cross-sectional area decreased from 31 +/- 8 to 26 +/- 7 cm2 and then to 23 +/- 5 cm2 at the latest follow-up study (p less than 0.01). At 3 years postoperatively, M-mode echocardiograms were available in 37 patients: 24 had a normal left ventricular dimension (group 1), while 13 still had an enlarged left ventricle (group 2). The clinical course in these two groups was similar. The best preoperative predictor of persistent left ventricular enlargement was the end-diastolic dimension (p less than 0.05), whereas fractional shortening and the end-diastolic radius/thickness ratio were not predictive.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Aorto-coronary bypass surgery in 62 patients with severe left ventricular dysfunction--a follow-up study.

Long-term follow-up of 62 consecutive patients with severe left ventricular dysfunction (ejection fraction = less than 0.30) and disabling angina pectoris following aorto-coronary bypass surgery was investigated. Prior to surgery all patients had angina pectoris and a history of remote myocardial infarction, 35% were in congestive heart failure (CHF). Significant stenoses in 3 major coronary vessels were present in 51 patients (82%). An average of 3.5 grafts per patient were employed. Operative mortality (30 days) rate was 4.8% (3 patients) and 13 patients died during the following period. The average follow-up was 37 months (range: 6 to 116 months). At follow-up, the 5-year survival probability for these patients was 70% (SD = 9%). Thirty-one patients (67%) of the 46 survivors had complete relief of angina, but signs of CHF were still evident in 17 patients (36%). Compared to patients with ejection fractions above 0.30% (surgical mortality 1.4% and 5-year survival rate 94% (SD = 3%] the outcome of coronary artery bypass grafting in patients with poor left ventricular function showed a significantly higher surgical mortality (P = 0.03) and impaired long-term survival (P = 0.02). However, aorto-coronary bypass grafting can be performed in patients with severe left ventricular dysfunction with reasonable relief of angina and with an acceptable surgical mortality.

Adult↗
PubMed1985

Tandem coarctation of the thoracic aorta with hypoplasia of the abdominal aorta.

After resection of the coarctation in a 3-year-old child with end-to-end anastomosis, a second membrane was found 1.5 cm lower. After a successful reoperation with an aortoplasty using Gore-Tex weak femoral pulses persisted. At catheterization, an area of irregular narrowing of the abdominal aorta just distal to the superior mesenteric artery was found with hypoplasia of the iliac and femoral arteries. In addition, this child had a two-sided cheilo-gnatho-palatoschisis, vesicoureteral reflux and absence of gall bladder and hepato-duodenal ligament. It is worthwhile considering that a second or third aortic abnormality can be hidden by a coarctation of the aorta.

Aorta, Abdominal↗
PubMed1984

Survival in 1041 patients with consecutive aorto-coronary bypass operations.

The first 1041 patients who underwent an isolated aorto-coronary bypass operation in the same institution since it opened in 1971, were followed for up to 10 years to determine their prognosis. The mean follow-up time was 3.5 years. The probability of survival at five years was 94 +/- 2% (95% confidence limits). This was similar to the survival of the general Dutch population matched for age and sex. Multivariate survival analysis with the proportional hazards model did reveal a relationship of the rate of death with sex and age at operation; however this was not significant. There was a trend to a higher death rate with more vascular involvement (rate ratio of 3 vessel-versus 1 vessel disease of 1.9, N.S.) and a significant association with a low ejection fraction (EF) (ratio EF less than or equal to 0.30 v. EF greater than or equal to 0.55 of 2.7. P less than 0.05). Though surgery seems to eradicate the poor longterm outlook for patients with more serious vascular disease, the adverse influence of decreased left ventricular function on survival is not changed.

Angina Pectoris↗
PubMed1984

Coronary artery changes 3 years after reimplantation of an anomalous right coronary artery.

In this paper we report the sequelae of a patient with an anomalous right coronary artery (RCA) originating from the pulmonary artery (PA) in association with a normal heart, operated upon at the age of 13 years. Three years after the end-to-side reimplantation of the RCA, with a rim of the PA, into the aorta, the surgical result has been evaluated by cineangiography. Before operation both coronary arteries were tortuous and increased in size. Afterwards the left coronary artery showed a normalized calibre, although the RCA remained tortuous with no decrease of the internal diameter. The notable postoperative changes in shape and size of the LCA may be due to the disappearance of the steal phenomenon. The lack of involutive changes in the RCA could be explained by its thinner wall. Left ventricular wall motion, evaluated under resting conditions and during an atrial pacing stress test, was found to be normal.

Adolescent↗