Search PubMed⌕ Search

Biomedical subjects

H Oelert

Publications and source records attributed to H Oelert.

258 records · Page 15Linked to original sources
PubMedDate not supplied

Routine extracorporeal circulation with a centrifugal or roller pump.

In a randomized, prospective clinical trial, 50 patients undergoing elective coronary artery bypass grafting (CABG) were divided into two groups of 25 each. Group I had a centrifugal pump (CP, Biomedicus) and Group II a roller pump (RP, Stöckert) as the arterial line. Neither group differed significantly, and variables during surgery were kept to a minimum. The parameters studied included the cellular blood elements and their components, such as PMN-elastase (PMN-E), plasma hemoglobin (pHb), beta-thromboglobulin (beta-TG), and D-dimer (D-D) and thrombin-antithrombin III complex (TAT) as indicators for activated coagulation. Blood and urine samples were taken at induction of anesthesia, every 15 minutes throughout extracorporeal circulation (ECC), at arrival in the ICU, and 1, 3, 6, 12, and 24 hours thereafter. No difference between the groups was found in bypass time, ECC flow or volume, or fluid balance. Significant differences in favor of Group I were found in pHb (p less than 0.05), beta-TG (p less than 0.01), D-D (p less than 0.05), and platelet counts (p less than 0.05). These differences were clearly ECC time dependent, became significant after 90 minutes of bypass, but disappeared within hours after surgery. No difference in patient outcome, ICU time, or need for volume substitution was seen. It is concluded that the RP can be safely used for routine ECC, but should be supplied with a CP in complex and prolonged cardiosurgical procedures to avoid severe postperfusion syndrome.

Coronary Artery Bypass↗
PubMedDate not supplied

Treatment of major venous obstruction with an expandable endoluminal spiral prosthesis.

Six patients with extensive iliofemoral and/or caval thrombosis were treated by thrombectomy and subsequent implantation of an expandable endoluminal spiral prosthesis in case of congenital caval stenoses (1) or extravascular compression or traction (5). Five of these patients had undergone previous surgery and thrombosis had developed despite low dose heparin given postoperatively. Three patients had had an unsuccessful thrombectomy prior to spiral implantation. No complications related to the endoluminal prosthesis occurred. There was one retroperitoneal hematoma from guide wire perforation of the inferior vena cava (IVC) necessitating laparotomy and reversal of the previously constructed femoral av-fistula with subsequent iliofemoral rethrombosis. All other endoluminally reconstructed veins remained open at early and late (up to 12 months) review confirmed by phlebography. We conclude that with increasing clinical experience endoluminal relining of obstructed major veins will probably become a valuable method of venous reconstruction with minimal surgical trauma.

Adolescent↗
PubMedDate not supplied

The Carpentier-Edwards supra-annular bioprosthesis for aortic valve replacement. Clinical experience in 234 patients.

Between January 1980 through December 1983, aortic valve replacement (AVR) was performed in 234 patients with a Carpentier-Edwards supra-annular bioprosthesis. There were 177 isolated AVRs and 18 AVRs combined with coronary artery bypass grafting (CABG): one bypass was done in 9 patients, 2 in 7 and 3 in 2 patients. Additional valve surgery was: mitral valve reconstruction in 14, mitral valve replacement in 12 and additional tricuspid reconstruction in 2. AVR combined with various other procedures was performed in 11 other patients. Early mortality for isolated AVR was 5%. Follow-up information was obtained until June, 1984. During this observation period (19.8 +/- 7 months), late mortality was 4%. Follow-up information was obtained on 212 of the 234 patients (91%). Preoperatively, 77% of the patients were in NYHA class III, 16% were in class IV. Postoperatively, 82.5% had improved to functional class I and II (I: 42.5%, II: 40%), only 17% were in class III. A diastolic murmur indicating aortic regurgitation was noted in 25 patients (11%). The murmur occurred early in 3, and late within 2 years in 21 instances: 7 patients required reoperation. Intraoperative findings were: leaflet perforation (3), leaflet rupture (1), suture dehiscence (2), and endocarditis (1). Histology and electron microscopy of the 4 malfunctioning valves showed changes in collagen structure and minimal calcification. The possible causes of valve failure are discussed.

Adult↗
PubMedDate not supplied

Partial repair followed by total correction in congenital heart anomalies.

A two stage corrective operative approach is required for a variety of complex heart anomalies. Different anomalies require different approaches in the various age groups. The technique, results, and complications of elective primary partial repair followed by full correction are described.

Aorta, Thoracic↗