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Biomedical subjects

H Warnke

Publications and source records attributed to H Warnke.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Percutaneous coronary angioplasty in chronic coronary disease with single and multiple obstructed vessels (analysis of 315 interventions 1978-1988)].

315 percutaneous transluminal coronary angioplasties performed during 1978-1988 in 261 patients with ischemic heart disease were analyzed for three different variants according to primary effectiveness, failure rate the most frequent complications and costs of materials as well as duration of intervention and fluoroscopy. Only variant 3 of the proceeding (soft-tip-applicators, flat profile balloon catheter, Kaltenbach long-wire technique, streptokinase rinsing of instruments, permanent infusion of instruments during the procedure) is an applicable routine method. It has a primary effectiveness of 86%. For multiple vessel PTCA this variant however resulted in significantly prolonged investigation and fluoroscopy intervals, so it is advisable only for selected groups of patients.

Adult↗
PubMed1990

[Nosocomial infections and sternum osteomyelitis].

A prospective study of the nosocomial infection rate in the Department of Cardiac Surgery of the Surgical Clinic (Charité) was done between January and December 1987. The investigation was performed computer aided. Data were recorded by an infection register. From 474 hospitalized operated patients 66 (14%) had some kind of nosocomial infection: at the first place wound infections with 5.1% (sternum osteomyelitis 2.1%), respiratory infections with 3.8% and infections of the urogenital system with 3.4%. The way of infection, selected predisposing and exposing factors, the microbacterial spectrum of wound infection, the antimicrobacterial chemotherapeutic strategy and surgical therapy are analyzed and demonstrated.

Bacteria↗
PubMed1988

Aortico-ventricular tunnel.

The authors report on three cases of aorticoventricular tunnel in two children and a baby. Clinical experience confirmed the necessity of earliest diagnosis and treatment, closure of both tunnel-ends, using a patch for the aortic stoma to prevent aortic valve incompetence.

Aorta↗
PubMed1988

[Initial clinical experiences with heart transplantation in East Germany].

An account is given in this paper of first experience from orthotopic heart transplantation. Six of eight patients with transplants have so far survived, with two of these having been in very good general condition for more than a year. All surgical indications were derived from myocardial dilatation. A triple combination of cyclosporine A, prednisone, and azathioprine was used for immunosuppression.

Follow-Up Studies↗
PubMed1988

[Biochemical studies of the assessment of transplant function following clinical heart transplantation--initial experiences].

Average and specific individual courses of the following parameters are reported in this paper, with reference being made to eight of eleven clinical heart transplantations so far performed at the authors' department: lactate, pyruvate, myoglobin, ASAT, ALAT, GGT, CK, CK-MB, LDH, LDH-1, and glycogen phosphorylase. Glycogen phosphorylase was found to deviate most strongly from normal, with the enzyme exhibiting two initial maxima. The enzyme activity in the serum vanished not later than twelve days from transplantation. The curve of myoglobin was largely parallel to that of phosphorylase. Phosphorylase seemed to be of particular suitability for assessment of ischaemic damage in the wake of transplantation. The individual courses seemed to suggest that none of the investigated parameters exhibited sufficiently sensitive correlations with pathomorphological signs of rejection.

Adult↗
PubMed1988

[Surgical problems of aortic isthmus stenosis].

Operations were performed on 84 infants for coarctation of the aorta between 1970 and 1987. An analysis was made of the results recorded from 45 of them (1983-1987). The youngest child had been two days of age. Additional cardiac (1983-1987). The youngest child had been two days of age. Additional cardiac defects were recordable from more than 60 per cent, while pulmonary pressures were above 75 in 50 per cent. Different surgical techniques were used and are recommended. The two-stage procedure was preferred in cases of associated intracardiac defects.

Aortic Coarctation↗
PubMed1988

[Use of walking and sauna therapy in the rehabilitation of hypertensive patients with ischemic heart disease following aortocoronary venous bypass operation with special reference to hemodynamics].

Rehabilitation results are reported concerning the behavior of blood pressure and heart rate, peripheral and central hemodynamics, after resting and during exercise and physical conditioning by running as training and sauna, respectively, in hypertensive patients with IHD after aortocoronary venous bypass (ACVB) surgery. Bicycle ergometric examinations an xenon wash-out (for the determination of the mean functional vessel cross section A) were performed in 43 male untrained patients before and after physical therapy. The left ventricular ejection fraction (EF) at rest was also determined in these patients. Significant increases in the ejection fraction at rest (on average by 7-8%) could be demonstrated in both therapy groups. The group average value for peripheral microcirculation improved only in the sauna group. Blood pressure after resting and on exercise was not influenced. Results are discussed on the basis of the literature and practical conclusions drawn.

Adult↗
PubMed1986

[2d operations in coronary artery surgery].

In coronary heart surgery, reoperations are performed on about seven per cent of all cases, primarily for progressive coronary artery sclerosis and sclerosis in autologous bypass veins. The problems relating to progressive coronary artery sclerosis and bypass sclerosis are expounded in this paper by the example of 14 patients, with reference being made to indications for recurrent surgical intervention for vascular reconstruction. Particular emphasis is laid on the surgical approach. With the given risk tolerable, coronary reoperation, today, is a genuine alternative in the treatment of recurrent angina pectoris, following bypass surgery. It is likely to enhance the patient's life expectancy and quality of life.

Adult↗
PubMed1985

[Surgical therapy of acute myocardial infarction].

All over the world the therapy of acute myocardial infarction has concentrated upon saving the ischaemically injured, but still viable cells of the myocardium. Also the acute coronary surgery, which among our groups of coronary-surgical patients has a proportion of 3.5% with 41 patients, answers this purpose. The preferred indication groups for acute coronary-surgical operations are the occlusion of the vessel after coronary dilation and the condition after intracoronary fibrinolysis. In these 22 patients the hospital lethality was only 4.5%. The reasonable active approach in acute myocardial infarction, particularly the combination fibrinolysis - acute coronary surgery, is a hopeful enlargement of the previous therapy for the highly imperilled patients with myocardial infarction.

Angina Pectoris↗
PubMed1985

[Left ventricular function following transluminal coronary dilatation or operative revascularization in chronic ischemic heart disease].

To assess changes in resting left ventricular function after reestablishment of myocardial perfusion, echocardiographic studies were performed before, at three resp. six days after as well as three months after successful PTCA in 19 patients and after coronary artery bypass grafting in 20 patients. Reference data were obtained from analog processing of values from 20 healthy control subjects. Baseline values (in addition to primary morphologic criteria) were indicative of a clearly functional selection pattern. As compared with those undergoing PTCA, patients who underwent bypass surgery had more unfavorable values for ejection fraction at rest. Immediately after the intervention, there was a consistent tendency to transiently reduced resting pump function. At three months, however, in both groups, cardiac performance had returned to control values and the global and regional parameters of contractility had either reached or exceeded the preoperative values. The mean values showed more improvement in the PTCA group, a finding most probably attributable to the more favorable baseline situation. Paradoxic septum motion was found frequently in those who had undergone bypass surgery. All patients with grafting to the right coronary artery were included in the latter group. Whether perioperative injury, the varying perfusion conditions or the pericardiotomy is responsible for this phenomenon, remains to be established.

Adult↗
PubMed1985

[Heart valve replacement with myocardial revascularization].

Coexisting coronary artery insufficiency includes risks to patients with valvular heart disease, thus complicating management. In 15 patients requiring aortic or mitral valve replacement preoperative coronary angiography demonstrated severe coronary stenoses which were treated by bypass grafts with valve surgery. These combined operations turned out to be safe and effective.

Adult↗
PubMed1982

[Improved protection of the myocardium with a combination of intra-aortic balloon counter-pulsation and aimed substrate administration in acute myocardial infarct--a comparative study].

In comparative studies in 36 mongrel dogs it was tried to find out how far intraaortic balloon pumping (IABP) applied solely and in combination with glucose-insulin-potassium (GIK) might influence the degree of acute myocardial ischemia. The ischemia lasted 3 hours. After 60 min myocardial ischemia IABP, the isolated GIK infusion, or the combination of IABP plus GIK were used. The directed GIK application into the aortic root was carried out by electronic triggering during the diastolic augmentation via a precoronary catheter. In the ischemic and in the non-ischemic myocardium of the left ventricle, ATP, creatine phosphate, and lactate were determined. Electronmicroscopical studies were carried out qualitatively as well as quantitatively. The isolated use of IABP suggested no protection of the energy-rich phosphates. The most significant morphological changes were found when exclusively the coronary ligature was applied and when only IABP was used, respectively. The best protective effect was achieved by our technique of the triggered GIK infusion via the precoronary catheter in combination with IABP. The ATP value (n mol/mg w.w.) in the ischemic area was 3.06 and in the non-ischemic one 4.96 in comparison to 1.96 and 3.99, respectively, in the control group. The creatine phosphate (n mol/mg w.w.) was 4.18 in the ischemic and 9.38 in the non-ischemic area in contrast to 2.36 and 6.99, respectively, in the control group. The technique of the triggered drug supply in combination with IABP offers the following advantages: --additive summation of IABP and substrate supply directed to the myocardium --high drug concentration in the myocardium --smaller drug load of the whole organism --clinical use of instable substances.

Animals↗
PubMed1980

[The mammary-coronary anastomosis. Indications--advantages--problems].

In 25 (5.3%) of surgically treated coronary patients the mammarocoronary anastomosis was performed. A follow-up angiographic checkings made after 1 to 3.5 years proved its patency in all instances. The minimal lumen of the internal thoracic artery at the anastomosis site should be 1.5 mm. The use of the internal thoracic artery, with the appropriate indication, is limited to the anterior ventricular branches of the left coronary artery. The peculiarities of the operation are described.

Adult↗
PubMed1980

[Diagnosis and surgical technic of intramural coronary arteries].

384 patients with ischaemic heart disease were treated surgically. Out of 165 patients operated upon consecutively, in 38 (23%) an intramural course of coronary arteries was found. Peroperative diagnosis of the intramural course of the anterior interventricular branch is feasible with a high probability; diagnostic criteria were also elaborated for the intramural course of the marginal branch. Several aspects of the operation technique and tactics are discussed.

Coronary Angiography↗
PubMed1979

[Cardiac tamponade following open-heart surgery (author's transl)].

Cardiac tamponade occurred in 9 (1,8%) of 488 patients following open-heart surgery. Delayed cardiac tamponade was observed in one case (0,2%). The mediastinal tamponade was caused by early occlusion of the chest tubes, pericardium closure and administration of anticoagulants. A reliable sign of mediastinal tamponade is the expanding cardiac silhouette demonstrated by roentgenogram. In outpatients receiving anticoagulants following open-heart procedures a life-threatening delayed cardiac tamponade may develop.

Adolescent↗
PubMed1978

[Electron microscopical findings of the myocardium in Fallot's disease and of the ventricular septal defects (author's transl)].

Ultrastructural quantitative and qualitative investigations of the myocardium of 7 children with Fallot's disease and 3 children with a ventricular septal defect (VSD) have shown bizarre nuclei and a slight increase in the myofibril share of the volume (Fallot's disease: 51.22%; VSD: 56.85%). This may be interpreted as a sign of a cellular hypertrophy. The mitochondria have a proportion of 35.07% and 33.75%, respectively. The glycogen content is relatively high. The lipofuscin bodies originate mainly from mitochondria having a percentage of 1.43 and 1.67, respectively. Particular signs of a lesion could not be observed. From the ultrastructural findings on the morphology of heart muscle cells it can be deduced that operations of vitia may be safely carried out.

Adolescent↗