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Biomedical subjects

H Oelert

Publications and source records attributed to H Oelert.

At least 217 records · Page 12Linked to original sources
PubMed1980

[The effects of Akrinor on the extrathoracic capacitance vessels during extracorporeal circulation and on cardiac haemodynamics of anaesthetized man (author's transl)].

The circulatory effects of Akrinor were investigated in anaesthetized patients during extracorporeal circulation and following open heart surgery. Arterial pressure, cardiac index and the maximal rate of rise of left ventricular pressure increased, whereas the resistance to flow in both circuits and the cardiac filling pressures remained unchanged. The compliance of the extrathoracic capacitance vessels during extracorporeal circulation was unaltered compared with the control group, but the volume content was less after Akrinor (200 ml). If this volume is shifted to the intrathoracic compartment in the intact circulation, the amounts seems too small to explain the increase in cardiac index. This increase and the subsequent rise of the arterial pressure seemed to be due to increased myocardial contractility.

Anesthesia↗
PubMed1979

Surgical treatment of double-outlet left ventricle in 2 patients with D-position and L-position of the aorta.

Two cases of double-outlet left ventricle (DOLV) are described, 1 with D-position and 1 with L-position of the aorta. Both patients had situs solitus, atrioventricular concordance with D-relationship of the two ventricles, a ventricular septal defect, and subpulmonary stenosis. The patient with D-position of the aorta was operated on using a technique similar to that for repair of Fallot's tetralogy but including emergency implantation of a bioprosthesis into the pulmonary artery position on the eighth postoperative day. Surgical correction in the patient with L-position of the aorta required the implantation of a composite valved conduit between the right ventricle and the pulmonary artery. The various surgical techniques for correction of DOLV are described, and the literature is reviewed. Postoperative right heart failure in both patients is explained by the impaired function of the right ventricle being exposed to gross pulmonary incompetence or by the persistence of elevated right ventricular pressure.

Adult↗
PubMed1979

Transmitral resection of subpulmonary stenosis in transposition of the great arteries.

Adequate surgical relief of left ventricular outflow obstruction (LVOO) in transposition of the great arteries (TGA) with atrio-ventricular concordance and intact ventricular septum, may to a significant degree depend on the severity of the lesion and the anatomic location of the ventricular septum and the mitral valve. A new approach to resection of subpulmonary obstruction in TGA through the left atrium and the retracted mitral valve is described. In contrast to dynamic stenosis, transmitral resection of a fixed subpulmonary narrowing will usually lead to a significant decrease of LVOO in TGA, with good clinical results.

Cardiomyopathy, Hypertrophic↗
PubMed1979

Cardiac valve replacement. Problems solved and unsolved.

In this review the present state of cardiac valve replacement is summarized on the basis of the literature and personal experience in approximately 1500 cases, using various prosthetic models. Durability, hemodynamic performance at rest and during exercise, and thromboembolic risk are considered in particular and our choice of the various valve models is discussed on these grounds. The long-term durability has been significantly improved and has possibly been solved in the more advanced mechanical valves, while this question is still open in the present biological prostheses. Hemodynamic performance is considered less than optimal in all conventional mechanical prostheses and in the xenografts. Pressure gradients are abnormal in all mechanical as well as in stented biological prostheses, the latter being less likely to solve the problem of a narrow aortic root. The significantly lower incidence of thromboembolism and total valve thrombosis and the absence of anticoagulation accidents in patients with bioprostheses has tipped the balance for the present in favor of the latter, particularly in mitral valve replacement and certainly in all those patients in whom anticoagulation in impossible, unlikely, or undesirable.

Aortic Valve↗
PubMed1979

Reconstruction of the right ventricular outflow tract including pulmonary valve replacement in 6 children under two years of age.

In 6 children under 2 years of age correction of congenital heart defects required reconstruction of the right ventricular outflow tract including replacement of the pulmonary valve. Outflow tract reconstruction consisted in implantation of a size 14 valved conduit in 2 patients with d-TGA and subpulmonary stenosis and 1-TGA and subpulmonary stenosis, and a size 16 valved conduit in 2 other patients with truncus arteriosus. In 2 children with DOLV, VSD and aneurysm of the pulmonary artery trunk, the pulmonary valve was replaced by porcine heterografts, sizes 19 and 21 respectively, after primary patch reconstruction of the right ventricular outflow tract. There was one operative death in a child with d-TGA, intact ventricular septum and severe subpulmonary stenosis. This child died in low cardiac output, probably because too much contractile muscle was lost at the site of anastomosis with the conduit. For reconstruction of the right ventricular outflow tract, pulmonary valve replacement has proven mandatory in cases with pulmonary hypertension in order to prevent postoperative right heart failure. Similarly, in cases with pulmonary stenosis and hypoplastic pulmonary arteries, postoperative pulmonary insufficiency can be deleterious to the right ventricle.

Aneurysm↗
PubMed1979

[Extrarenal effects of potassium-canrenoate. Haemodynamic investigations during neuroleptanalgesia in cardiosurgical patients (author's transl)].

Direct cardiac and vascular effects of the antikaliuretic diuretic potassium-canrenoate were measured in cardio-surgical patients during extracorporal circulation and immediatly after operations, each time in neuroleptanalgesia. During "steady state" extracorporeal circulation (aorta cross-clamped, constant flow rate of heart-lung-machine, constant hypothermia), in 13 patients no significant influence on peripheral circulation was found after i.v.-injection of 800 mg potassium-canrenoate. Neither arterial perfusion pressure (representing an arterial vascular reaction) nor changes in oxygenator-volume (indicating venous vasodilation or contraction) demonstrated significant differences in comparison to a control group. After cardiac surgery haemodynamic measurements were performed for a period of 60 minutes in 10 patients given 800 mg potassium-canrenoate. In comparison with a control group (n = 6), no significant differences in arterial pressure, heart rate, cardiac index and pulmonary arterial pressure were found. Left ventricular measurements, using a catheter tip manometer, revealed no direct positive inotropic effect of a single i.v.-injection of potassium-canrenoate. In acute myocardial failure during anaesthesia or in "low cardiac ouptut" following open heart surgery no improvement in myocardial contractility is obtained by i.v.-application of potassium-canrenoate; at the present there seems no alternative to other positive inotropic agents such as calcium, glucagon, dopamine, orciprenaline and epinephrine.

Adolescent↗
PubMed1979

[Aortopulmonary window: external occlusion in the newborn (author's transl)].

Correction of aortopulmonary window in the newborn infant carries a high operative risk. Even later in life operative mortality with or without cardiopulmonary bypass may amount to 30% and more. To reduce the operative risk a new technique for closure of the aortopulmonary window was employed in 2 infants aged 3 and 4 weeks, respectively. With this method the communication is externally occluded by 4 or 5 mattress-sutures, buttressed with Dacron strips on each side. Both infants underwent emergency operation because of intractable heart failure. The postoperative course was uneventful and both were discharged from the hospital in good condition.

Aorta↗
PubMed1979

[Preliminary experience with the catheter dilatation of coronary artery stenoses (author's transl)].

The method of percutaneous transluminal coronary angioplasty (PTCA) may in selected cases dramatically improve myocardial blood supply. Seven attempts were made between September and December 1978 at the Gollwitzer-Meier Institute of Cardiology; three dilatations were unsuccessful, two were moderately successful and two highly successful. The problems as to methodology and selection of patients submitted to this procedure are discussed.

Adult↗
PubMed1978

[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↗
PubMed1978

[Echocardiographic diagnosis of thrombus on a Hancock bioprosthesis in mitral position following endocarditis (author's transl)].

Acute stenosis of a Hancock bioprosthesis in mitral position was found eight months after surgery and three months following septic periproctitic abscess in a 59 year old woman. Echocardiography revealed almost complete valve obstruction by thrombus formation: unusual dense and inhomogenous structures between the anterior and posterior stent echos of the prosthesis were seen in systole as well as in diastole. Echocardiography appears to be a useful non-invasive method for detection of the rare thrombotic complications in Hancock bioprostheses.

Abscess↗
PubMed1978

["Hepatoportal pneumatosis with pneumatosis intestinalis in the neonate" (author's transl)].

A fullterm newborn infant two weeks of age, suffering from congestive heart failure due to a large patent ductus arteriosus, deteriorated suddenly presenting with a paralytic ileus. Radiographically diffuse intestinal pneumatosis and gas in the portal vein system could be shown. A mechanical reason was excluded by laparotomy shortly after which the infang died. Out of blood Klebsiella pneumonia could be grown. A survey of the literature on the syndrome of pneumatosis intestinalis and gas embolization into the portal vein system in the neonatal age group disclosed 41 cases. Based on this material etiology radiological features, differential diagnosis, prognosis and treatment is discussed in detail.

Air↗
PubMed1977

[Implantation of the intraaortic balloon catheter through the aorta ascendens (author's transl)].

In intraoperative cardiac low out-put syndrome balloon implantation through the ascending aorta can be accomplished for secure and rapid installation of IABP, if sternotomy has occurred and successful insertion through the common femoral artery has proven to be impossible. The disadvantage of rethoracotomy for explantation of the balloon catheter can be accepted without additional risk.

Aorta, Abdominal↗
PubMed1977

[Intracardiac correction of congenital heart anomalies in 104 infants (author's transl)].

From 1974 to 1976 104 infants (under 1 year of age) underwent intracardiac correction for congenital heart diseases. Mean age and body weight were 6.6 +/- 3.6 months resp. 5.66 +/- 1.4 kgs. The diagnoses and mortality rates were: transposition of the great arteries (TGA) with intact ventricular septum 27 (0), TGA plus associated anomalies 9 (0), ventricular septal defect (VSD) 20 (1), VSD plus associated anomalies 6 (1), total anomalous pulmonary venous drainage 9 (5), pulmonary stenosis and pulmonary atresia with intact ventricular septum 9 (2), aortic stenosis 7 (3), ASD I or II 7 (0), and miscellaneous 10 (3). Intracardiac correction was performed either on cardiopulmonary bypass and moderate hypothermia or in deep hypothermia with or without total circulatory arrest. The early mortality in the first group was 7% (6 out of 90), in the second group 64% (9 out of 14). With increasing experience, cardiopulmonary bypass has proven to be a save method for intracardiac correction of congenital heart anomalies in infancy even in the youngest age group under three months of age and under emergency conditions.

Age Factors↗
PubMed1977

[Rhabdomyomatosis of the heart and ventricular septal defect (author's transl)].

An unusual case of cardiac rhabdomyomatosis associated with a ventricular septal defect without signs of tuberous sclerosis is described. On 3 different angiocardiographies the region of the tumor seemed to be a right ventricular aneurysm. The tumor was identified as such only on operation and its nature defined histologically. Subtotal excision of the tumor and closure of the large ventriccular septal defect and debanding (pulmonary banding at the age of 8 month) was successfully undertaken at the age of 10 years.

Heart Neoplasms↗