Search PubMed⌕ Search

Biomedical subjects

F Leisch

Publications and source records attributed to F Leisch.

At least 55 records · Page 3Linked to original sources
PubMed1987

[Intravenous thrombolysis in acute myocardial infarct. Clinical and angiography results in 124 patients and the significance of early revascularization].

124 patients with evolving acute myocardial infarction received high-dose intravenous streptokinase (1.5 Mio U within 60 min i.v.). Hospital mortality was 4% and 11% of the patients suffered from a streptokinase-related complication (most frequent bleeding problems). All complications could be treated medically. The angiographic control in 111 patients (90%) after a mean of 11 +/- 8 days after thrombolysis demonstrated a patent antegrade perfused infarct-artery in 85 patients (77%). From the first 55 patients only 16% had a revascularization procedure. An early revascularization in 39 patients (57%) of the last 69 patients reduced the reinfarction rate from 15 to 7%. The hospital mortality was not influenced (3.6 vs 4.3%). High-dose i.v. streptokinase-application is associated with low treatable complication rates and clinically relevant reperfusion rates. An early revascularization (coronary angioplasty, bypass-surgery) reduces the reinfarction rate to about 50% and improves left ventricular function.

Aged↗
PubMed1987

Enhanced accessory pathway conduction following intravenous amiodarone in atrial fibrillation. A case report.

We observed a dangerous increase of ventricular rate following the intravenous administration of amiodarone in a patient with atrial fibrillation and rapid ventricular response associated with the Wolff-Parkinson-White syndrome. The mechanism of enhanced accessory pathway conduction remains speculative. A possible explanation for the shortened antegrade effective refractory period of the accessory pathway is afforded by the hypotensive action of amiodarone or its dissolvent which might trigger beta-adrenergic reflexes. Intravenous amiodarone should be used with caution in patients with atrial fibrillation and rapid ventricular response via an accessory pathway.

Amiodarone↗
PubMed1987

[Hemodynamic effects of intravenously administered celiprolol in patient with coronary heart disease and depressed left ventricular function].

Hemodynamic changes after intravenous application of 10 mg celiprolol-HCl (3-[3-acetyl-4-(3-tert-butylamino-2-hydroxy-propoxy)-phenyl]-1,1-diethyl urea hydrochloride. Selectol; in the following briefly called celiprolol) were investigated over an interval of 30 min in 15 patients with angiographically determined coronary heart disease and depressed left ventricular function (ejection fraction less than 60%, left ventricular end-diastolic pressure (LVEDP) greater than 12 mmHg). One patient suffered from severe left ventricular failure with lung edema and could not be evaluated. The heart rate was not influenced, the arterial pressure was significantly reduced (p less than 0.01), similarly LVEDP (p less than 0.001), and pulmonary pressure (p less than 0.01). Cardiac output and total peripheral resistance were not changed significantly. The hemodynamic working profile of celiprolol in patients with depressed left ventricular function is that of a beta 1-receptor blocker with a strong intrinsic sympathomimetic activity (ISA = Intrinsic Sympathetic Activity) and vasodilating properties--even on preload. The intravenous application of celiprolol in patients with severely depressed left ventricular function can cause pump failure.

Adrenergic beta-Antagonists↗
PubMed1986

Influence of a variant angina on the results of percutaneous transluminal coronary angioplasty.

Nineteen (86%) of 22 patients with variant angina and important coronary stenoses (greater than 60%) had successful percutaneous transluminal coronary angioplasty. The acute complications in two patients were not caused by coronary spasms but by dissection with disturbance of perfusion. One of these two patients required a coronary bypass graft; the other was treated conservatively. Myocardial infarction developed in both patients. Despite long term administration of nifedipine (30-80 mg daily), restenoses occurred within six months (on average after 10 weeks) in nine patients with symptoms and one without. In four patients the restenoses exceeded the degree of stenosis before angioplasty. Five patients were revascularised by surgical means. Vessels in three out of four patients were later successfully dilated. After a mean period of observation of 24 months (6-51 months) 18 of the 19 patients are symptom free and do not require medication. The results confirm that angioplasty is an effective method of treating patients with variant angina and important coronary stenoses. The problem of the high frequency of restenosis, however, remains unresolved.

Angina Pectoris, Variant↗
PubMed1986

[Percutaneous pulmonary valvuloplasty in adults].

Percutaneous balloon pulmonary valvuloplasty was performed in 6 adult patients (aged 21-59 years, mean age: 43 years) with congenital pulmonary valve stenosis and systolic pressure gradients of 50 to 120 mm Hg (mean: 78 mm Hg). In 5 patients the procedure was successful: mean systolic right ventricular pressure was reduced from 99 +/- 26 to 55 +/- 7 mm Hg and the trans-stenotic pressure gradient from 77 +/- 28 to 31 +/- 12 mm Hg. Valvuloplasty with a 20 mm balloon was not effective in a patient with a wide pulmonary anulus (diameter 25 mm). In 1 patient only, the balloon occlusion led to severe systemic hypotension with syncope. Short-term follow-up (3 months) demonstrated symptomatic improvement and persistent reduction of the pressure gradient in all successfully treated patients. In conclusion, percutaneous balloon pulmonary valvuloplasty appears to be an effective method with low risk of complications for the treatment of pulmonary valve stenosis in adults.

Adult↗
PubMed1985

[Main coronary artery stenosis: significance of the clinical stage for angiographic and surgical risk].

86 patients with significant main coronary artery stenosis (greater than 50%) were divided into 61 with stable and 25 with unstable angina pectoris. The coronary morphology (isolated main coronary artery stenosis, degree of stenosis, additional vessel disease) and the left ventricular function (ejection fraction, left ventricular end-diastolic pressure) were the same in both groups. Deaths due to coronary angiography amounted to 2.3% and involved two patients with unstable angina. 82% (n = 50) of the patients with stable angina and 83% (n = 19) with unstable angina were considered operable. 69% of the stable and 74% of the unstable group were actually revascularised. Operative deaths amounted to 3.4% and again involved two patients with unstable angina. During an average post-operative follow-up period of 38 months 5% of the operated and 28% of the non-operated patients died (P less than 0.05). The investigation demonstrated that for patients with main coronary artery stenosis operability in stable angina is no different from that in unstable angina. Angiographic and operative deaths in patients with unstable symptomatology, however, were markedly higher than in those with stable angina.

Angina Pectoris↗
PubMed1984

[Intracoronary lysis of acute myocardial infarct].

A report is presented on 21 patients admitted with acute myocardial infarction in whose pain duration had not exceeded three hours. The coronary angiogram revealed occlusion of the supply-vessel to the infarcted area in 18 patients and only subtotal stenosis in the 3 remaining cases. Intracoronary administration of streptokinase (2000 to 4000 U/min) achieved thrombolysis in 15 out of 18 patients (83%) with thrombotic occlusion. All patients with exception of 2 patients revealed after thrombolysis a greater than or equal to 80% remaining stenosis. 2 patients without successful recanalisation died due to pump failure on the first or fourth day, respectively, following myocardial infarction. Reinfarction occurred in 2 patients out of successful treated cases, 4 patients required aortocoronary bypass-surgery for impending reinfarction or unstable angina pectoris. Angiographic control in the fourth week following myocardial infarction demonstrated reocclusion of the corresponding vessel in 3 cases, 2 of whose had a reinfarction. There was no change in the mean ejection fraction in the patients with persistent recanalisation between the acute and the chronic stage of infarction.

Adult↗
PubMed1984

[Ventricle septum rupture in acute myocardial infarct: clinical, electrocardiographic, angiographic and surgical aspects].

The findings in 17 patients with ventricular septal rupture are analyzed retrospectively. Clinically this complication of acute myocardial infarction was characterized by a new holosystolic murmur and simultaneous deterioration in patient condition. Infarct related conduction disturbances were documented in 7 of the 17 patients before the rupture occurred. Early repair of the ventricular septal defect was carried out in 9 patients, 3 of whom died in the perioperative period. Survivors showed a significantly higher ejection fraction (45.5 +/- 4.5%) and significantly fewer asynergic radiants (25.8 +/- 4.5) than nonsurvivors (29.3 +/- 2.5% ejection fraction) and (37.7 +/- 2.5 asynergic radiants). Owing to the high mortality during the first few days, patients with ventricular septal rupture should be assigned urgently to a cardiological center where it is possible to carry out cardiac catheterization, angiography and ventricular septal repair without delay.

Aged↗
PubMed1984

Role of percutaneous transluminal coronary angioplasty in patients with variant angina and coexistent coronary stenosis refractory to maximal medical therapy.

Percutaneous transluminal coronary angioplasty (PTCA) was performed with initial success in 7 patients with variant angina and significant (greater than 60%) coronary stenosis. The mean degree of stenosis was reduced from 77 +/- 12% to 29 +/- 15% and the mean systolic pressure gradient from 78 +/- 18 to 25 +/- 9 mmHg. Apart from a reversible spasm in one patient, PTCA was free of acute complications. Despite long-term treatment with nifedipine, nitrates, and warfarin (patients 1 to 5) or aspirin (patients 6 and 7) restenoses occurred in 4 of 7 patients. An aortocoronary bypass was necessary in 2 patients, 3 respectively 6 weeks after PTCA because of tighter restenoses than before PTCA. Another patient underwent successful repeat angioplasty after 6 weeks and remained improved. During a mean follow-up observation of 21 months (6 to 30 months), 4 patients were asymptomatic, even without medication. In one of these patients, the follow-up angiography (6 months after PTCA) demonstrated a restenosis. These results suggest that PTCA demonstrated a restenosis. These results suggest that PTCA can be performed without a higher risk of acute complications in patients with variant angina. Although the recurrence rate is high in these patients, sustained clinical improvement was achieved in a substantial percentage of patients in our study.

Adult↗
PubMed1984

[Catheter dilatation of coronary artery stenosis. 2 years' experience].

We report our experiences with the first 40 patients treated by percutaneous transluminal coronary angioplasty (PTCA) over the past two years. The technique was successful in 25 patients (63%) with 28 coronary stenoses, reducing the degree of stenosis from a mean of 81 to 25% (p less than 0.001) and the coronary pressure gradient from 70 to 26 mm Hg (p less than 0.001). Because of reduction of coronary blood flow with evolving myocardial infarction an emergency aortocoronary bypass surgery was necessary in two patients (5%). An additional patient suffered a myocardial infarction (2.5%). Within a follow-up observation of 6 months, restenoses occurred in 7 patients (33%); 5 of them were treated with bypass surgery and one was redilated successfully. Our first experiences with PTCA are similar to the results of other institutions.

Angioplasty, Balloon↗
PubMed1983

[Aortic valve prolapse].

The aortic valve prolapse which can be diagnosed by echocardiography is usually found in patients with the floppy valve syndrome. The clinical symptoms are identical with those of the mitral valve prolapse. The frequency of aortic valve prolapse in 67 cases of mitral valve prolapse was 8.9%, the frequency of aortic insufficiency 5.9%. A main etiological factor of aortic valve prolapse is a myxomatous degeneration of valvular tissue which can affect one or more cardiac valves.

Aortic Valve↗
PubMed1983

[Intracoronary streptokinase therapy in recent myocardial infarct. Results in patients with pain lasting less than 3 hours].

A report is presented on 14 patients admitted with acute myocardial infarction, in whom pain duration had not exceeded 3 hours. The coronary angiogram revealed occlusion of the supply vessel to the infarcted area in 11 patients and only stenosis in the 3 remaining cases. Intracoronary administration of streptokinase (2000 or 4000 U/min) achieved thrombolysis in 10 out of the 11 patients with thrombotic occlusion. None of the patients with successful recanalization died during hospitalization (3 to 4 weeks); re-infarction occurred in 2 cases. Angiographic control in the 4th week following infarction demonstrated reocclusion of the responsible vessel in 3 cases. Stenosis was unchanged in 5 patients, whilst reduction of the degree of stenosis was recorded in 2 patients. 2 patients required aortocoronary bypass surgery for recurrence of angina during mobilization. There was no change in the mean ejection fraction in the patients with persistent recanalization between the acute and the chronic stage of infarction.

Adult↗
PubMed1983

[Rupture in myocardial infarct: predisposing factors?].

The clinical, electrocardiographic and pathomorphologic findings of 37 patients with cardiac rupture and of 40 consecutive patients who died from other causes during acute myocardial infarction were analyzed in regard to predisposing factors for myocardial rupture. Useful diagnostic parameters, to assess the risk of myocardial rupture could not be identified. Pacemaker therapy for bradycardia did not increase the risk of myocardial rupture.

Aged↗
PubMed1983

[Arrhythmia in unstable angina pectoris].

79 ECGs, recorded during angina pectoris, from 52 patients were studied to determine the relations of arrhythmias and ST-segment changes and to evaluate the relationship between the prevalence of arrhythmias, the severity of coronary artery disease and left ventricular function. Arrhythmias were found in 22% of the ECGs (VPCs in 9, VT in 4, SVPCs in 3, sinus bradycardia in 1). Angina pectoris attacks accompanied by ST-segment elevation, ST-segment depression or unchanged ST-segment showed disturbances of rhythm in 47%, 24% and 0%. If coronary spasm without significant coronary stenoses was the cause for myocardial ischemia, arrhythmias appeared with 75% more often than in myocardial ischemia caused by organic stenoses (19%). Patients with disturbances of rhythm during spontaneous angina pectoris do not have anymore deterioration in left ventricular function than patients without arrhythmias.

Adult↗