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Biomedical subjects

G Fraedrich

Publications and source records attributed to G Fraedrich.

61 records · Page 4Linked to original sources
PubMed1981

Actively adhering endocardial leads for pacing in children.

Cardiac pacing in children still presents problems concerning the most favorable placement of the generator and, in particular, the growth-induced electrode complications. Whereas in infants epicardial implantation is unavoidable, one would prefer transvenous placement in older children to permit replacement or removal without extensive operative measures. The use of actively anchorable endocardial leads seems advantageous because of the possibility of placing long electrode loops in the cavity of the right atrium without increasing the risk of dislodgement. In this way overextension of the lead during growth may be avoided. Since June 1975 we have performed ventricular pacing in 10 children, aged 2 to 9 years, by using a transvenous screw-in electrode (surface 6 mm2). Acute threshold values ranged from 0.4 to 0.7 mA ap a pulse duration of 1.0 msec and sensitivity between 6.5 and 8.7 mV. Electrode function has been without complications up to now. In 6 patients we implanted programmable pacemaker systems which allowed postoperative threshold measurements. The chronic threshold value has not increased above 2.3 mA in any of these cases. In our opinion, actively anchorable endocardial leads present significant advantages for pacing in childhood.

Child↗
PubMed1981

[Technic of delayed skin flap transplantation].

In 38 patients a "delayed skin flap transplantation" was performed after excision of malignant melanomas. The skin graft can be stored in a refrigerator at 4 degrees C for 2 weeks without damage to the transplant. The transplantation was usually done 4 days postoperatively. Advantages of this method seem to be a decreased risk of local infection, early mobilisation of the patient, and generally good cosmetic results.

Dermatologic Surgical Procedures↗
PubMed1981

[Space occupying mediastinal processes].

About 1-2% of all tumors are found in the mediastinum. Any space-occupying swelling of the mediastinum has to be exstirpated. Even if a carcinoma cannot be completely removed, the tumor mass should be reduced as much as possible. The operation must not be delayed by any diagnostic uncertainties.

Diagnosis, Differential↗
PubMed1980

Continuous peritoneal dialysis (CPD)--an alternative to hemodialysis in acute renal failure after cardiovascular operations.

In our experience hemodialysis proved to be unsatisfactory in the treatment of acute renal failure after cardiovascular surgical intervention because of its negative influence on the often critical hemodynamic situation of the patients. In 21 cases we performed a continuous peritoneal dialysis (CPD) for 1 to 29 (mean 9.2) days by using a Tenckhoff catheter (16). Treatment was started when anuria occurred or when serum nonprotein nitrogen increased. Satisfactory volume equilibration was established by this treatment. A pathological increase of serum electrolytes could be prevented; serum potassium, in particular, did not exceed 5.6 mVal/l. No dysfunctions in acid-base balance occurred. The serum levels of nonprotein nitrogen decreased: Serum carbamid was diminished from 229 +/- 14 mg% to 160 +/- 10 mg% and serum creatinine from 7.7 +/- 0.6 mg% to 6.0 +/- 0.8 mg% (p < 0.05). Disturbances of hemodynamic and respiratory functions could be avoided by CPD. Peritoneal reactions were noted in 5 cases. In our opinion continuous peritoneal dialysis seems to be a suitable alternative to hemodialysis in the treatment of acute renal failure after open heart surgery.

Acute Kidney Injury↗
PubMed1979

Heart valve replacement with the St. Jude medical prosthesis -- first clinical results --.

Starting in February 1978 52 St. Jude Medical Prostheses have been implanted in 47 patients (age 13--73 years) in aortic, mitral and tricuspid positions. Perioperative death occurred in 3 cases. Post mortem examination of these patients showed unimpaired valvular function. There were no other complications in an accumulated total valve time of approximately 300 months. Prior to surgery and post-operatively, several hemolytic parameters were analyzed. There was only a mild elevation in Serum LDH (285 +/- 10 iV/L). Fifteen patients underwent recatheterization 3 months postoperatively. The mitral valves did not reveal an enddiastolic gradient at rest, while the aortic valves had a peak to peak gradient of 8 +/- 2.1 mmHg. A standardized stress consisting of an infusion of isoproterenol was used. The results were compared to results obtained in patients with Björk-Shiley prostheses under identical conditions and did not show a significant difference. The preliminary hemodynamic findings correlate with preceding in vitro results and preclinical data, and the first clinical experience is promising.

Adolescent↗
PubMedDate not supplied

Heart valve replacement with the new all-pyrolytic bi-leaflet St. Jude medical prosthesis.

Since February 1978, seventy-nine St. Jude medical prostheses have been implanted in seventy-two patients with an overall mortality of 8.5%. Clinical, hemodynamic and hematological findings are presented. Twenty-two patients have been catheterized postoperatively, and findings are presented. In vitro comparisons have made between the St. Jude and other prostheses.

Adolescent↗