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Biomedical subjects

G Walterbusch

Publications and source records attributed to G Walterbusch.

30 records · Page 2Linked to original sources

Evaluation of fibrin seal in animal experiments.

This paper presents experimental investigations to evaluate fibrin seal for bleeding control under systemic heparinization as well as some of the benefits and limits of fibrin-presealing vascular prostheses. Local hemostasis using fibrin seal plus collagen fleece was achieved in 3 standardized sources of bleeding produced in mongrel dogs under full heparinization. Water porosity was measured in 3 standard prosthetic materials of different porosity. It could be shown that all graft types investigated were sufficiently sealed up to a pressure of 600 mmHg. The influence of fibrinolysis on the stability of the fibrin network in vascular grafts was tested by in vitro experiments using urokinase incubation. While water permeability increased in fibrin-sealed fabric without aprotinin added, no fibrinolysis-induced leakage was observed in those exposed to aprotinin. Surface thrombogenicity of the fibrin-sealed grafts was higher than in blood-preclotted prostheses, if not rinsed with isotonic saline. After rinsing, thrombogenicity decreased below values obtained in grafts preclotted conventionally. Survival studies in animals show no difference between blood-preclotted and fibrin-presealed prostheses both 3 and 7 days after implantation.

Animals↗

Clinical experience with fibrin glue for local bleeding control and sealing of vascular prostheses.

This report concerns our clinical experience with fibrin glue for local bleeding control and for sealing of vascular prostheses. Hemostasis could be achieved in 90% of 124 applications of the glue under different indications. Local application of fibrin adhesive is recommended in all types of bleeding difficult either to approach or control by conventional surgical technique. Complete sealing of low pore vascular grafts could be obtained in all operations under extracorporeal circulation and full heparinization. Highly porous grafts sealed with fibrin glue also were explored under conditions thus far requiring tightly woven grafts.

Aorta↗

Fibrin adhesive: an important hemostatic adjunct in cardiovascular operations.

Fibrin adhesive was applied 413 times in a group of 340 patients undergoing extracorporeal circulation whenever conventional suturing appeared impossible, difficult, or dangerous, with a success rate of 95%. Fibrin-presealed woven or knitted fabric was inserted in 60 heparitized patients, 45 of whom underwent cardiac procedures. There was perfect sealing of the fabric in all but one instance. Fibrin gluing has become a routine method, reducing man-hours and blood loss and occasionally salvaging patients' lives. Fibrin-presealed knitted prostheses are expected to replace woven fabric because of its known poor healing qualities.

Blood Vessel Prosthesis↗

Congenital obliteration of the suprahepatic inferior vena cava: case report.

A rare case of congenital obliteration of the suprahepatic portion of the inferior vena cava (IVC) associated with early liver cirrhosis is presented. The clinical signs of the condition and the standard methods of diagnosis are outlined. A survey of the available surgical management is given and a new alternative operation described. It consists of an indirect transatrial-transdiaphragmatic reconstruction of the IVC. For the first time, it has been used successfully for reconstruction of the interrupted vessel. Ten months following the operation, the patient shows no signs of portal hypertension or caval obstruction.

Child, Preschool↗

The use of fibrin glue for sealing vascular prostheses of high porosity.

Vascular prostheses of different porosity (Cooley Very Soft; Miliknit Lo-Por; Microvel; Sparks Mandril) were pretreated with fibrin glue and the permeability was assessed both in vitro and in 12 dog experiments by descending aorta replacement under full systemic heparinization. It was found that all types of prostheses were completely sealed after the pretreatment. In 28 patients undergoing descending or abdominal aorta replacement under systemic heparinization high porosity knitted Dacron grafts were pretreated with the fibrin glue only. There was no blood loss across the prosthetic wall. It is concluded that graft-pretreatment with fibrin glue allows for combining full heparinization and the use of high porosity vascular grafts.

Animals↗

[Reconstruction of the aorta in mycotic aortic aneurysm--report of two cases of salmonella infection (author's transl)].

Two patients with infected aortic aneurysm underwent surgical treatment. When using autologous tissue in place of the infected aorta a recurrent aneurysm was observed four months later. Extraanatomical bypass of the infected area with prosthetic material and consecutive removal of all infected tissue seems to be the only successful management. This is confirmed by another patient who was treated successfully in this way. Prolonged antibiotic therapy after resection of infected aneurysms seems to be mandatory.

Aneurysm, Infected↗

[Studies on the local motility and blood circulation of the heart muscle during and after long-term coronary strangulation].

In ten young pigs a severe prolonged and critical stenosis of a major coronary artery was produced under control of an electromagnetic flowmeter. With stepwise constriction flow could be reduced to 55% of control with only minor hemodynamic changes. Local myocardial segment shortening was depressed to approximately 30% of control values. Hypokinesis was partially reversible within the first 135 min after reperfusion and had disappeared 24 h later. Computerized perfusion scintigraphy with radioactive microspheres gives a reliable approximation of the degree of myocardial blood flow reduction.

Animals↗

The effect of coronary flow restriction on the viability of porcine myocardium.

The effect of a prolonged (3 hours) defined coronary flow restriction on early (30 minutes) and late (24 hours) reperfusability and survival of the myocardium was studied in a closed-chest pig model. Coronary blood flow (CBF) was restricted to 51 +/- 4% (moderate flow restriction) and 36 +/- 6% (severe flow restriction) of preexisting resting flow values. Regional determination of the restricted CBF after severe flow restriction showed the anticipated extension of the ischemic area from endocardial to epicardial layers and to the lateral border zone. Upon early reperfusion a hyperemic effect was observed, which reflected the preceding degree of underperfusion. The maximal hyperemic effect was found in samples with CBF restriction to 38% of the control flow values. Twenty-four hours after blood flow restitution the hyperemic effect had disappeared. At this time control flow values had not returned, where previous CBF restriction had exceeded 50%. The amount of infarcted tissue in the area supplied by the left circumflex artery was 5.7% after moderate, and 31.6% after severe flow restriction. Morphologically the infarcted myocardium consisted of disseminated necrosis after moderate, and of confluent necrosis after severe flow restriction. At flow restriction exceeding 50%, the chances of reestablishing perfusion and thus salvaging the myocardium appear minimal.

Animals↗