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Biomedical subjects

I Hammerer

Publications and source records attributed to I Hammerer.

At least 37 records · Page 2Linked to original sources
PubMed1980

[Mucocutaneous lymph node syndrome or infantile perlarteritis nodosa with extensive vascular involvement].

The authors report on a male infant displaying all the clinical features of the mucocutaneous lymph node syndrome (MLNS) as described by Kawasaki in 1967. In the same patient, diffuse dilatation of the whole arterial tree--as known in infantile periarteriitis nodosa but so far not shown in MLNS--could be demonstrated angiographically during the acute phase of the disease. As the vascular findings at postmortem examination in MLNS and periarteriitis nodosa were the same too, the authors believe that separation of these diseases is not justified.

Aneurysm↗
PubMed1979

[The double-chambered right ventricle (author's transl)].

Report on two girls with an obstruction within the right ventricle beneath the infundibulum. A muscular band - probabaly the abnormally situated moderator band - emerges at right angles from the ventricular septum, crosses the lumen and ends at the anterior wall of the right ventricle, thus separating a high-pressure inflow chamber from a low-pressure out-flow chamber. The latter compartment is distinctly larger than the infundibular chamber in Fallot's tetralogy. In bt connecting the left ventricle with the hig-pressure compartment. In one patient an increase of severity of the obstruction could be documented; this child showed a subvalvular membranous aortic stenosis. The diagnosis has to be established by meticulous pressure recording between pulmonary and tricuspid valve and by dye injection into the right ventricle. Ventricular septum defect (in 80%), subvalvular aortic stenosis (in about 10%), pulmonary valvular and peripheric stenosis and open Ductus Botalli are the most important accompanying lesions. The malformation - not diagnosed prior to surgery - causes serious trouble during operation. The investigator thus has to be aware of this condition in every pulmonary valvular ahd subvalvular stenosis especially when accompanied by a ventricular septum defect.

Cardiac Catheterization↗
PubMed1979

[The risks involved in the heart catheter examination. A retrospective evaluation of the complications after 700 examinations. I. Method, patients, diagnoses (author's transl)].

A retrospective study is undertaken in order to assess the kind and frequency of complications which occurred in 700 heart catheterizations performed in 539 infants and children. This paper deals with the distribution of age groups and diagnoses. The percentages of the different age groups resemble closely those of the "Cooperative Study" of Braunwald and ass. (1968) with the exception that newborns and infants are represented in greater number. This id due to a more active approach to investigation of cardiac malformations in infancy. With regard to the diagnoses those malformations are highly represented which are susceptible to low-risk surgery (Ductus Botalli, atrial septal defect, coarctation, pulmonic and aortic stenosis) and those where surgery is inevitable (tetralogy, transposition of great arteries). Aortic stenosis, too, shows a higher than real incidence because the exact degree of severity can be ascertained only by use of invasive methods. On the other hand there are relatively few ventricular septal defects, because many of them diminish spontaneously in size and do not need catheterization. The rare anomalies are represented in small numbers.

Adolescent↗
PubMed1979

[The risks involved in the heart catheter examination. A retrospective evaluation of the complications after 700 examinations. II. Complications (author's transl)].

The author reviewed the complications of 700 heart catheterizations in infants and children performed between 1970 and 1978 with a frequency of 55 to 113 investigations per year. Arrhythmias occurred on 70 occasions (10%), death within 24 hours: 14 (2%), extravasation of contrast media: 11 (1,6%), perforation by catheter: 6 (0,9%), cyanotic spells 5 (0,7%), myocardial ischemia: 4 (0,6%), respiratory arrest: 4 (0,6%), convulsions: 2 (0,3%), wound infection: 2 (0,3%), icterus 2 (0.3%), lung atelactasis: 1 (0,15%), bacterial endocarditis: 1 (0,15%), pyrexia: 1 (0,15%), exanthema: 1 (0,15%), pulmonary edema: 1 (0,15%), meningitis purulenta and hepatitis as possible complications: 1 (0,15%) each. The mortality figue of 2% lies well within the range of rates reported by Ho and ass. (1972): 1,5%, Stanger and ass. (1974): 3,0%, Rowe (1978): 0,95%, and Graham (1978): 2,9%. Mortality mainly occurs in sick neonates and infants with complex cardiac malformations. It could be lowered by a more aggressive approach to diagnostic work-up of suspected cardiac disease, as well as by using more sophisticated catheterization techniques and material and by introducing intensive care principles on the infant ward. Catheter related mortality (e. g. by perforation, severe arrhythmia) could be reduced to zero during the last three years. Myocardial staining by contrast media and electrocardiographic alterations suggesting myocardial ischemia occurred comparatively often but were never followed by serious or long lasting sequelae. Their occurrence was not related to the diagnosis or to the age of the patient. Respiratory arrest and convulsions could only be observed in sick infants. The seizures were not directly related to angiocardiography. All other complications were incidental events. Arrhythmias and vascular complications are discussed in separate papers.

Atrial Fibrillation↗
PubMed1979

[The risks involved in the heart catheter examination. A retrospective evaluation of the complications after 700 examination. III. Irregularities of heart (author's transl)].

Disturbances of heart rhythm, observed during 700 heart catheterizations in infants and children, are discussed. Paroxysmal supraventricular tachycardia has been observed in 25 investigations (3,6%), sinus bradycardia in 18 (2,6%), junctional rhythm in 10 (1,4%), second degree AV-block in 9 (1,3%), ventricular fibrillation in 8 (1,1%), sinus tachycardia in 7 (1%), complete block in 7 (1%), asystole and atrial flutter in 2 (0,3%) each, and ventricular tachycardia in 1 (0,15%). Supraventricular tachycardia occurred equally in all ages without preference of a special malformation. The two patients with WPW-syndrome, however, showed this disorder in each of three catheterizations. Propranolol and verapamil succeeded in terminating the attacks. Junctional rhythm and sinus tachycardia presented equal behavior and benignity. Sinus bradycardia, second and third degree AV-block, and especially ventricular fibrillation occurred mostly in neonates and infants, many of them cyanotic and suffering from complex malformations and therefore needing multiple catheter manipulations. Bradycardia was in two, asystole in one of the very sick neonates associated with subsequent death within 24 hours. Once asystole resulted in immediate death after pulmonary angiography in a child with severe pulmonary hypertension. Ventricular fibrillation could be terminated promptly by DC countershock in all patients, but three of the children died subsequently. Complete block occurred only in children with systemic right ventricular pressure, 4 of the 7 patients having pulmonary hypertension, too. In two instances the block subsided spontaneously, the rest could successfully be treated with orciprenaline (Alupent R). Life threatening arrhythmias became less frequent as a consequence of earlier investigation, if severe heart disease was suspected, and by closer control of cyanosis, acidosis and temperature before, during, and after catheterization.

Arrhythmias, Cardiac↗
PubMed1979

[The risks involved in the heart catheter examination. A retrospective evaluation of the complications after 700 examinations. IV. Vascular complications (author's transl)].

The review of 700 heart catheterizations in infants and children revealed arterial occlusion in 30 instances after 175 catheterizations (17,1%), but 29 of them after 88 arteriotomies (32,9%) and only 1 after 87 percutaneous arterial catheterizations (1,1%). In two cases thrombectomy of the femoral artery was necessary, brachial artery occlusion was never felt to indicate surgical intervention. Since percutaneous sheath catheterization is used in combination with systemic heparinization no obvious occlusion occurred after about 80 investigations. This may be due to a minimum of intimal damage by the sheath and prohibition of thrombus growth at the site of puncture. Occlusive thrombosis of the femoral vein has been assessed clinically and sometimes angiographically in 7 cases out of 468 (0,4%). In two older children the vein was explored and thrombectomy performed. All other were cyanotic infants; in two of them femoral vein occlusion became manifest as late as two days after investigation by venous cutdown. Thrombosis of inferior vena cava has never been observed neither early nor late. Venous bleeding occurred in 6 infants after vessel disruption and 1 arterial hematoma in a boy because of incomplete compression of puncture site. In 4 instances the catheter could not be inserted because the vessels were too small or too spastic. One time a spring guide entered a small artery in the groin or small pelvic region. Forceful withdrawal stripped the arter. -- This study reveals that the most frequent complication, i. e. arterial occlusion, after adoption of modern techniques does not occur more frequently than in institutions with a larger number of catheterizations per year.

Arterial Occlusive Diseases↗
PubMed1979

[Familial occurrence of Elfin's face (Williams-Beurens Syndrome =wbs) and supravalvular aortic stenosis (= svas) (author's transl)].

Three siblings out of two families -- the mothers being sisters -- have signs of WBS: a girl shows the complete picture of elfin's face syndrome; a boy who needed surgical treatment for severe supravalvular aortic stenosis, presents only with minimal signs of the peculiar facies like his mother. His brother has slight supravalvular aortic stenosis. The three children described show trivial peripheral pulmonary stenosis. It is known that SVAS and WBS may show a dominant mode of inheritance with variable expressivity. The purpose of this study was to find signs which would prove a dominant inheritance in this kinship. Dental malpositions and coarse upperlip with shallow philtrum where the only symptomes found in the patients and their mothers. If we accept this traits as markers for the syndrome than we could assume a dominant way of inheritance.

Abnormalities, Multiple↗
PubMed1977

[Wide-spread haemangioma racemosum of the mediastinum associated with paresis of the diaphragm; a finding to be considered in the differential diagnosis of the arteriovenous aneurysm of the thorax (author's transl)].

The paper reports on a 5 year old boy showing a sprawling haemangioma racemosum of the right side of the mediastinum. The vascular tumor is fed by a tortuous A. thoracica interna dextra and numerous arterial vessels arising from the right subclavian artery and from the aorta including the right coronary artery and branches from the abdominal aorta. The child presents also paresis of the right diaphragm probably secondary to the pressure of the pulsatile tumore along the course of the phrenic nerve. After ligation of three major feeding arteries the continuous murmur disappeared and fatigability and anorexia became less. Apart from this report a review of the literature on vascular malformations of the arterio-venous fistula type within the thorax sums up the most important features of these vascular anomalies: haemodynamics, localisation, clinical signs, therapy, natural history, therapy and etiology.

Arteriovenous Malformations↗
PubMed1975

[Disturbances of cardiac rhythm in neonates and infants (author's transl)].

The authors report on the kinds and frequency of cardiac rhythm disturbances observed in neonates and young infants at the University Children's Hospital of Innsbruck within the past 3 years. Four children who were already in utero suspected to have arrhythmia are dealt with in greater detail. The etiology and pathogenesis of rhythm disturbances are briefly outlined and the therapeutic measures summarized.

Arrhythmias, Cardiac↗
PubMedDate not supplied

Pacemaker therapy in a pediatric patient with hypertrophic obstructive cardiomyopathy and rapid intrinsic atrioventricular conduction.

A 13-year-old boy with hypertrophic obstructive cardiomyopathy was treated with dual-chamber pacing after severe progression of left ventricular outflow tract obstruction and of clinical symptoms despite drug therapy. Rapid intrinsic atrioventricular conduction was overcome and complete preexcitation of the septum achieved by omitting atrial sensing and programming constant atrial pacing with a short atrioventricular delay of 70 msec. After 8 weeks of therapy, a reduction of the left ventricular outflow tract gradient from 125 to 16 mmHg and remodeling of the left ventricle were demonstrated.

Adolescent↗