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Biomedical subjects

J Hasse

Publications and source records attributed to J Hasse.

At least 109 records · Page 6Linked to original sources
PubMed1982

Accuracy of serial myocardial perfusion scintigraphy with thallium-201 for prediction of graft patency early and late after coronary artery bypass surgery. A controlled prospective study.

To assess the accuracy of serial myocardial perfusion scintigraphy with thallium-201 (201Tl) to predict graft patency early and late coronary artery bypass surgery, rest and exercise 201Tl and coronary arteriography were performed preoperatively and 2 weeks and 1 year after operation. The scintigraphic results were compared with graft patency, symptoms, left ventricular function and physical work capacity in a consecutive series of 55 patients with a total of 154 grafts. Serial 201Tl had an 80% sensitivity, 88% specificity and 86% overall accuracy in detecting or excluding graft occlusion, which was predicted by reversible ischemia as well as persistent "new scar" segments. Occluded grafts were correctly localized by 201Tl scintigraphy in 61%. Postoperative apical 201Tl defects were frequent (two-thirds of cases), and were the result of intraoperative transapical venting of the left ventricle. After coronary bypass graft surgery, ejection fraction at rest was unchanged. Left ventricular end-diastolic pressure and physical work capacity improved significantly. In the presence of new perfusion defects detected postoperatively, physical work capacity was reduced significantly. New 201Tl defects in addition to typical or atypical angina provided a high probability of graft occlusion, while in the absence of new 201Tl defects all grafts were patent in more than 90% of patients, all of whom had no or only atypical chest pain. We conclude that serial 201Tl imaging after coronary artery bypass surgery is an accurate noninvasive method that can be used routinely to assess graft function, to localize spatially occluded grafts and to identify patients with a high likelihood of graft occlusion who may need invasive studies.

Angina Pectoris↗
PubMed1981

Echocardiographic features of the correctly functioning St. Jude Medical valve prosthesis.

The St. Jude Medical valve (SJM) is a new low-profile bileaflet prosthesis with central flow. We investigated 10 patients with aortic valve replacement and 11 with mitral valve replacement by means of combined echocardiography and phonocardiography. In patients with aortic valve replacement, echocardiography revealed during systole the anterior and posterior part of the ring together with both leaflets. During diastole, patients with mitral valve replacement showed part of the anterior leaflet and the entire posterior leaflet together with the posterior ring. Distinctive opening sounds were missing. In aortic prostheses, maximal opening followed S1 0.06 +/- 0.02 second. An amplitude of the posterior leaflet of 9.8 +/- 1.3 mm and a leaflet separation of 4.8 +/- 0.9 mm were measured. In mitral prostheses the maximal opening followed A2 0.10 +/- 0.02 second, the Q-closure interval was 0.07 +/- 0.03 second and leaflet separation was 4.4 +/- 0.8 mm. In both aortic and mitral positions, high values for opening and closing velocities were measured, and closing velocities exceeded opening rates. These findings establish the normal pattern and values in echocardiography and phonocardiography for patients with aortic valve replacement as well as mitral valve replacement with SJM prostheses.

Adult↗
PubMed1981

Morphologic studies in saphenous vein grafts for aorto-coronary bypass surgery. Part I: Morphology of the Graft using ordinary surgical preparation techniques.

Vein bypass grafts in 8 patients were examined by light microscopy (LM) only or, in addition, by transmission electron microscopy (TEM) and scanning electron microscopy (SEM) before stretching, after stretching and immediately before implantation. Before stretching, the endothelium showed only discrete changes and detachment of the endothelium was rare. After stretching severe endothelial damage was evident, including loss of large areas of endothelium and extensive endothelial tears. Before implantation there had been an extension of the tears and the endothelial detachment in individual preparations. The most important factor causing damage is stretching of the vein. The incubation medium may also play a significant role. Damage incurred before operation or during removal, and hypoxia are of lesser importance. By avoiding endothelial damage it should be possible to limit the occurrence of early postoperative thrombosis and possibly severe late changes as well.

Coronary Artery Bypass↗
PubMed1981

Morphologic studies in saphenous vein grafts for aorto-coronary bypass surgery. Part II: Influence of a pressure-limited graft dilation.

The evidence of considerable damage caused by stretching to the vein transplants for aorto-coronary bypasses led us to a modified technique of vein dilation that allows control and limitation of the pressure to which the veingraft is exposed. The efficiency of this procedure in terms of reduced damage to the vascular wall was investigated by microscopic and electronmicroscopic methods. It could be shown that the integrity of the intimal layer of vein grafts can be maintained to a high degree. Clinically this implies that the long-term patency rate of aorto-coronary veingrafts may be improved. This will be subject to further coronarographic studies during the follow-up of a present series of patients.

Aged↗
PubMed1980

Successful palliation by means of a bovine artery graft in a 4-day-old infant with type B interruption of aortic arch and right descending aorta.

In a 4-day-old baby a unique form of interrupted aortic arch was diagnosed, where the interruption was located between the right carotid and the right subclavian arteries in a right descending aorta. The additional large ductus was ligated, the VSD was palliated with pulmonary arterial banding. For the repair of the interrupted aortic arch with its long distance between the ascending and descending portions and the complicating proximity of the superior vena cava, a long pliable material had to be used. The anastomosis was successfully performed with a bovine arterial heterograft.

Animals↗
PubMed1980

[Residual pneumothorax following lobectomy].

Residual pneumothorax may result in spite of correct pleural drainage after lobectomy, segmental or wedge resection. This is due to persistent alveolar or bronchiolar air fistula particularly often in combination with a discrepancy between the size of the pleural cavity and the remaining lung tissue as in bilobectomy. The management of this problem is dealt with on the base of experiences with 56 cases in a consecutive series of 250 patients. It is shown that in a stabilized situation - mostly after 10 to 14 days - pleural drainages safely can be removed and spontaneous resorption of a residual pneumothorax can be expected without further treatment even after intervals of several months on an outpatient base. Bronchopleural fistula formation must be ruled out and absence of atelectasis or compressing effusion confirmed.

Drainage↗
PubMed1980

[The diagnostic use of computed tomography in the management of mediastinal abscess (author's transl)].

Computed tomography (CT) is of outstanding importance in the current diagnosis of mediastinal pathology. We have recently treated a patient who underwent laryngectomy and then experienced a septic temperature pattern during the postoperative period which was suspect of mediastinal abscess. A mediastinal CT was obtained, and uncovered a lesion in the anterior mediastinum. Although the test was unable to differentiate between an abscess and a degenerating metastasis, the test was instrumental in first revealing the presence of the lesion, localizing it exactly, and enabling an effective surgical approach to be used for exploring the mediastinum. This entailed an anterior mediastinotomy with partial resection of a rib.

Abscess↗
PubMed1979

[Presurgical determination of lung function in patients with bronchogenic carcinoma].

90 out of 202 lung cancer patients hospitalized for preoperative investigations were scheduled for radical surgery. 15 patients were not operated on because of insufficient lung function data. The operation was performed in 75 patients. The complication rate was 11% and mortality 8%. 7 out of 8 patients who subsequently developed severe complications had fulfilled the criteria for lung resection only after intensive antibronchitic treatment. Nearly all the survivors showed the predicted preoperative minimal lung function values after the operation. The limit of 1000 ml for postoperative FEV1 is justified, since patients with these or larger functional reserves nearly all had a favourable early and late postoperative course, and also because lung function values continuously deteriorate in chronic obstructive lung disease.

Aged↗
PubMed1979

Right-to-left atrial shunt in cardiac dislocation following extensive pneumonectomy.

Previous reports dealing with cardiac herniation following intrapericardial pneumonectomy illustrate the critical and often lethal hemodynamic sequelae of this complication. In the case presented here, the first and nearly exclusive sign of cardiac herniation after left-sided pneumonectomy with extensive resection of the pericardium was systemic arterial hypoxemia. Subsequent investigations suggested inter-atrial right-to-left shunt in the presence of a patent foramen ovale, caused by slight right-ventricular outflow obstruction with consecutively reversed pressure relationships at atrial level. This explanation was supported by the operative findings, and reversibility was achieved by pericardial reconstruction with parietal pleura. When the patient died 8 months later due to general progression of a mucoepidermoid carcinoma, autopsy confirmed a large patent foramen ovale.

Adenocarcinoma, Mucinous↗
PubMed1979

[Management of traumatic rupture of the aorta].

Traumatic rupture of the thoracic aorta is a common injury in automobile accidents. It is the result of a crushing chest injury, most frequently associated with sudden deceleration. Approximately 10 to 20% of the individuals with traumatic rupture of the aorta survive temporarily. Diagnosis may be difficult, but if the lesion is promptly diagnosed, appropriate surgical treatment may be life-saving. 9 patients with traumatic aortic rupture have been operated on at our unit since 1969. 2 died postoperatively from acute respiratory distress syndrome. 7 survived the immediate postoperative period without major complications. 2 of them died later after four weeks because of complications not related to the operation. Based on the literature and on our own experience some directions in the management of the traumatic rupture of the thoracic aorta are presented.

Accidents, Traffic↗
PubMed1978

[Treatment of iatrogenic transvenous foreign body embolism].

Embolization of central venous devices, such as infusion catheters, ventriculo-atrial drains for hydrocephalus or intracardial pacemaker leads, may cause fatal secondary complications. Removal of the embolized foreign bodies is therefore mandatory in the majority of cases. 26 in a series of 27 patients underwent removal procedures which have been successful in 24. The specific approach is described in the different subgroups of embolized foreign bodies. Removal has been achieved transvenously through the internal jugular vein in most instances of embolization of infusion or pressure catheters, using forceps or ureteric stone catheters. Thoracotomy was necessary in 8 patients, twice with with cardio-pulmonary bypass. There were no complications due to interventions for catheter extraction. This experience justifies an active approach to treatment once the diagnosis is established.

Adolescent↗
PubMed1976

[Therapy of refractory ventricular tachycardia in congenital diverticulum of the left ventricle. Clinical aspects and surgical therapy of a rare malformation].

True congenital diverticulum of the left ventricle is an extremely rare lesion, usually associated with defects of the pericardium and the diaphragm. It is defined as a finger-like extension of the ventricular chamber with its wall consisting of all three layers of a normal heart-wall and with the ability to contract properly. Additional cardiac malformations may lead or contribute to early death; if not, the patients die from rupture of the diverticulum. To our knowledge the isolated form without pericardial defect has been reported only once before. The findings are described in an adult who presented with ventricular tachycardia at the age of 43 years. Complete normalization was achieved by resection of the diverticulum with the aid of cardiopulmonary bypass. The literature is reviewed for comparable cases. Etiological considerations are presented and the clinical features are discussed.

Adult↗
PubMed1976

Surgical correction in complete levotransposition of the great arteries with an unusual subaortic ventricular septal defect.

Six children with an uncommon variant of complete (that is, physiologically uncorrected) transposition of the great arteries are described. In this malformation, levoposition of the aorta is coincident with situs solitus and concordant atrioventricular relations. All patients underwent successful surgical correction. Four had a ventricular septal defect; in three, the defect was subaortic and because of its unusual anatomic features, a right ventriculotomy was required for repair. Interatrial transposition of venous return was carried out in all cases by insertion of a baffle, as in complete dextrotransposition of the great arteries. The surgical verification of the arterial positions in these cases illustrated the fallibility of the so-called loop rule. The significance of the cases in relation to terminology, classification and morphogenesis of this variant is discussed.

Angiocardiography↗
PubMed1976

[Cor triatriatum: total correction in an infant using normothermic inflow occlusion (author's transl)].

Successful correction of cor triatiatum in a 3-month-old infant is presented. The diagnosis was established preoperatively by separate angiocardiographic visualization of the two left atrial compartments. To our knowledge all successful total corrections were done under cardiopulmonary bypass. In this case, the abnormal diaphragm in the left atrium was resected under normothermic inflow occlusion. We believe that the technically very simple resection of the diaphragm does not necessitate the use of extracorporeal circulation in an infant, provided the diagnosis can be made beyond any doubt before the operation.

Heart Atria↗