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Biomedical subjects

E Kreuzer

Publications and source records attributed to E Kreuzer.

At least 73 records · Page 4Linked to original sources
PubMed1991

Pericardial mass mimicking constrictive pericarditis.

Persistent pericardial hematoma due to blunt chest trauma is extremely rare. We report a case of constricted myocardium resulting from a large, partially organized hematoma in the right cardiophrenic angle. The hematoma was assumed to be caused by an occupational accident 17 years before diagnosis. Constriction could only be controlled by complete removal of the fibrous posterior capsule of the hematoma, which covered the epicardium of the right heart.

Aged↗
PubMed1991

Mediastinitis and mycotic aneurysm of the aorta after orthotopic heart transplantation.

After cardiac transplantation, bacterial mediastinitis is a rare but dangerous early complication. Of the 113 patients who underwent heart or heart-lung transplantation at our hospital from August 1981 to April 1989, 8 developed purulent mediastinitis. Treatment involved surgical débridment, local irrigation, drainage, and high-dose systemic antibiotics. No patient died of an acute mediastinal infection. In 2 cases, however, chronic mediastinitis led to the formation of a huge mycotic aneurysm of the ascending aorta. Eleven days after surgical intervention for rupture, 1 patient died of aneurysmal rerupture; the 2nd patient remains well 16 months after prosthetic replacement of the ascending aorta and reconstruction of the necrotic proximal portion of the left coronary artery with a saphenous vein patch.

Journal Article↗
PubMed1991

[Intraoperative contrast echocardiography using sonicated iopromide (Ultravist 370) for imaging the post-bypass myocardial region].

In order to minimize the rate of inadequate myocardial revascularizations, an intraoperative evaluation of regional myocardial perfusion could have practical impact. Current bypass flow measurements have inherent limitations and can determine only epicardial blood flow. To analyze regional graft-dependent myocardial blood flow an echocardiographic short-axis view of the left ventricle was performed intraoperatively in 11 patients undergoing elective coronary artery bypass surgery. After injection of 2 ml of sonicated lopromid (Ultravist 370) into 14 vein grafts, contrast enhancement in the corresponding myocardial regions was clearly visible, no side-effects occurred. Contrast decay halftimes (T/2) were determined by computer-assisted videodensitometry and compared to electromagnetic flow (EMF) rates, which were measured immediately before. T/2 ranged from 2.1 to 6.9 (mean 4.1 +/- 1.5) s and did not correlate to the EMF-rates of 55 to 100 (mean 80 +/- 16) ml/min. Thus intraoperative myocardial echocardiography is a safe and feasible method which allows on-line visualization and off-line quantitation of regional myocardial perfusion intraoperatively.

Adult↗
PubMed1990

Intraoperative myocardial contrast echocardiography for assessment of regional bypass perfusion.

The intraoperative determination of the success of surgical myocardial revascularization remains problematic because of major limitations in all currently used methods. To assess the regional blood flow of the bypass graft-dependent myocardial segments, 2 ml of sonicated iopromid (a nonionic x-ray contrast medium) was injected into the bypass graft in the beating heart. Simultaneously electromagnetic flow measurements were performed. Eleven graft injections in 8 men (mean age +/- standard deviation 60 +/- 4 years) were performed without any adverse effects. Excellent 2-dimensional cross-sectional views of the left ventricle were obtained in all cases. Ten of 11 injections resulted in adequate myocardial opacification. Computer-assisted evaluation by videodensitometry resulted in time-intensity curves with contrast decay half-times (T1/2) from 2.2 to 6.9 seconds (mean 4.3 +/- 1.4). The corresponding electromagnetic flow ranged from 55 to 100 ml/min (mean 80.0 +/- 16.2). there was no correlation between contrast 2-dimensional echocardiography-derived T1/2 and electromagnetic flow (r = 0.32; p = 0.38). Thus, myocardial contrast echocardiography is a feasible and safe method for intraoperative evaluation of the success of bypass graft surgery. It offers online visualization of perfusion of revascularized myocardium and may allow immediate intraoperative revision of unsuccessful bypass graft placement.

Aged↗
PubMed1990

Deviated trachea in hypoplasia and aplasia of the right lung: airway obstruction and its release by aortopexy.

Three cases of male infants with hypoplasia and aplasia of the right lung and dextrocardia are reported. The infants developed increasing obstructive respiratory distress in the first 4 months of life. In all three cases, there was an opaque right hemithorax with overinflation of the left lung, a posterior deviation of the trachea with pulsatile stenosis, and a posteriorly located aortic arch. Hypoplasia (two cases) or aplasia (one case) of the right pulmonary artery and an absence or a remnant of the right main bronchus were also observed. Associated malformations were esophageal atresia with an abnormal high pouch of the proximal esophagus in case 1, and hypertelorismus syndrome in case 2. Because of severe respiratory distress in all three patients, an aortopexy was performed at the ages of 5 months (one infant) and 10 months (two infants). The obstructive respiratory signs disappeared postoperatively in the following weeks. It has been observed that tracheal stenosis in aplasia or hypoplasia of the right lung may be caused by the dislocated aortic arch. An aortopexy can release the airway compression in such cases. Because of associated malformations, a careful evaluation of the airway and vessels is recommended.

Airway Obstruction↗
PubMed1988

Subsensitivity of the failing human heart to isoprenaline and milrinone is related to beta-adrenoceptor downregulation.

The number of cardiac beta-adrenoceptors and the positive inotropic effect of isoprenaline and milrinone were measured in cardiac membranes and isolated, electrically driven muscle strips from nonfailing donor hearts and from patients with mitral valve disease (NYHA II-III), ischemic heart disease, and dilated cardiomyopathy (NYHA IV). In nonfailing hearts, the number of beta-adrenoceptors were 41.5 fmol/mg protein (mean, n = 3). In ischemic heart disease and NYHA II-III, there was a loss of cardiac beta-adrenoceptors (22.1 fmol/mg protein, mean, n = 3; 23.2 +/- 2.7 fmol/mg protein, n = 30), respectively. In NYHA IV, there was a pronounced reduction of the number of cardiac beta-adrenoceptors to 12.1 +/- 1.5 fmol/mg protein (n = 15). The Kd value did not differ in either group. Correspondingly, the positive inotropic effect of isoprenaline was more pronounced in nonfailing myocardium, reduced in NYHA II-III and ischemic heart disease and almost blunted in NYHA IV. Similar results were observed with the phosphodiesterase inhibitor milrinone. A good correlation of the beta-adrenoceptor density to the maximal positive inotropic effect of isoprenaline and milrinone was observed. Neither the number of cardiac beta-adrenoceptors nor the positive inotropic effect of isoprenaline correlated with the age of the patients. We conclude that the number of cardiac beta-adrenoceptors and the positive inotropic effect of beta-adrenoceptor agonists are reduced in the failing human heart depending on the severity of heart failure. Furthermore, the positive inotropic effect of milrinone is also reduced and related to the reduction of beta-adrenoceptors. The lack of correlation with the age of the patients provides evidence for a predominant role of heart disease rather than aging in the reduction of beta-adrenoceptors and subsensitivity to cyclic AMP-increasing positive inotropic agents in the failing human heart.

Aging↗
PubMed1988

[Diagnosis of a perforating aortic aneurysm as a late complication following enlarging aortoplasty using central venous digital subtraction angiography].

11 years after patch aortoplasty due to coarctation of the aorta a 33 year-old patient experienced two spontaneous haemoptyses. A centralvenous digital subtraction angiography demonstrated a large aneurysm of the proximal descending aorta penetrating the left upper lobe of the lung. The successful emergency surgical treatment consisted of implantation of a dacron-prosthesis.

Adult↗
PubMed1987

[Kidney cancer with invasion of the vena cava: classification, surgical strategy and results of treatment].

A new classification of vena caval tumor thrombi is recommended from our experience with 37 cases. For advanced tumor thrombi a surgical technique with routinely performed thoracotomy, inserting a Sarns-catheter and preparing the cardiopulmonary bypass is mandatory. If metastases are absent the prognosis of the renal carcinoma is nearly as good as in cases without tumor extension into the vena cava. The total 2-year-survival rate in our series is 47%, for the cases without metastases it is 65%. The total 5-year-survival rate is 25% and for patients without metastases 57%.

Adult↗
PubMed1986

Pregnancy after in vitro fertilization, cryopreservation, and embryo transfer.

We reported on the first pregnancy achieved in the Erlangen IVF program after cryopreservation and embryo transfer. After hMG stimulation in the first treatment cycle, nine oocytes were retrieved by laparoscopy from a 31-year-old woman and three embryos transferred. Five other oocytes were fertilized and developed to four- to eight-cell embryos, which were subsequently cryopreserved. Transfer of these embryos two cycles later resulted in a singleton pregnancy and the birth of a healthy girl.

Adult↗
PubMed1985

Experiences with the first 100 consecutive pregnancies achieved after in vitro fertilization and embryo transfer at the University Women's Hospital in Erlangen.

As of March 31, 1985, 100 clinical pregnancies have been achieved since the program for extracorporeal fertilization was started in Erlangen. 531 (71%) of 768 follicular punctures resulted in an embryo transfer. The overall pregnancy rate is 13% with regard to the total number of laparoscopies and 19% with regard to the number of embryo transfer. The most effective stimulation proved to be the pure hMG regimen. Employing this protocol, we have achieved a clinical pregnancy rate after IVF and ET of 32% during the last 6 months. Oocyte recovery related to the number of patients is 97%, with laparoscopy being superior to ultrasonically guided puncture. The success rate is appreciably affected by both the number of transferred embryos and the atraumatic transfer technique. We question the rationale of supporting the luteal phase.

Abortion, Spontaneous↗