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Biomedical subjects

L Brunner

Publications and source records attributed to L Brunner.

At least 37 records · Page 2Linked to original sources

[Surgical treatment for tetralogy of Fallot with unilateral absence of a pulmonary artery (author's transl)].

Among 843 patients with Tetralogy of Fallot, 10 showed unilateral absence of a pulmonary artery. In 7 cases the cause was congenital aplasia, whereas thrombosis of one of the pulmonary arteries following systemic-pulmonary anastomosis was the cause in the remaining 3 patients. According to the reports of other authors and to our own experiences, this rare malformation is treated best with palliative operations, the technique depending on the patient's age and on the individual anatomical condition. Only in very few cases with an acceptable pathologic anatomy there will be a reasonable chance for successful repair with reconstruction of the continuity from the right ventricle to the affected lung. However, if complete repair is performed, reconstruction of the absent pulmonary artery usually will be necessary for avoidance of pulmonary hypertension of the contralateral lung.

Adult↗

Relation between plasma concentrations and cardiovascular effects of oral oxprenolol in man.

Oxprenolol, 40, 80 and 160 mg, was administered orally to seven healthy volunteers. Over the following eight hours repeated measurements were made of the plasma concentrations and effects on heart rate, myocardial contractility (PEPc) and systolic and diastolic blood pressure in recumbency, in the upright position and during physical effort at a work load of 120 watts on a bicycle ergometer. The maximum plasma levels and the area beneath the plasma concentration curves increased roughly in proportion to the dosage increment. No evidence of first-pass inactivation in the liver was found. The half-life of the drug in plasma was approximately 80 minutes, irrespective of the dose administered. Oxprenolol slowed heart rate, prolonged PEPc and lowered systolic blood pressure, by comparison with values recorded after a placebo. The effects were generally least marked in the recumbent position and most marked during effort, when a clear-cut dose-response relation was found. The pharmacodynamic effects of oxprenolol were compared with its concentration in plasma. Marked beta-receptor blockade still persisted eight hours after dosing, although at this time, after doses of 40 and 80 mg, the drug could not be detected in plasma.

Administration, Oral↗

[Valvular replacement in florid endocarditis. Report on 5 cases].

This is an account of experience with valve replacement in patients with active endocarditis. In four patients the aortic valve was replaced, and in one, the mitral valve. Indication for surgery in all five cases was heart insufficiency. Two patients died, one of acute left heart failure five weeks postoperatively, and one of brain embolus in the presence of persisting acute endocarditis, four months postoperatively. Covered in the discussion are other indications for valve replacement in the presence of acute endocarditis, namely, serial emboli, fungus endocarditis, resistance to and toxic reactions of antibiotics, and mycotic sinus of valsava aneurysm. In conclusion, results obtained by other authors are reported.

Acute Disease↗

[Acute left heart failure following repair of atrial septal defects. Its treatment by reopening].

Among 716 patients operated on for an ASD, 15 of them, following closure of the defect, developed acute left heart failure requiring partial re-opening. The most prominent anatomical finding in these cases was hypoplasia of the left ventricle. Also remarkable in some patients was severe pulmonary hypertension, which may have led to right ventricular hypertrophy. Therefore, a marked difference of the stroke work of the left and right ventricle, respectively, appeared to be the essential underlying hemodynamic mechanism. The prognosis has been found to depend mainly on prompt surgical intervention; so in all poor-risk cases continued monitoring of left atrial pressure is indicated for early detection of impending left heart failure.--The high incidence of left heart failure as cause of death after repair of an ASD indicates the importance of this complication.

Adolescent↗

[The fate of the pulmonary hypertension after ASD-closure in adults (author's transl)].

10 female and 7 male patients, who were operated for secundum type Atrial Septal Defect with Pulmonary Hypertension, got postoperative check-ups including right heart catheterisations. The investigations were performed on the average 6.6 years postoperatively. There was a fall of the systolic pulmonary pressure and of the flow; pulmonary resistance fell in 8 cases and rose in 9. The low left ventricular cardiac index together with an elevated left atrial pressure may be the pathogenetic cause of postoperatively elevated pulmonary resistance.

Adolescent↗

[Refinement of mensurational methods in human pharmacology].

In healthy persons the changes in heart rate and myocardial contractility induced by oxprenolol and phentolamine are more marked in the erect position and during physical exertion then in recumbency. Similarly, a dose-effect relation with regarded to the negatively inotropic activity of oxprenolol is more readily detectable in the upright position.

Dose-Response Relationship, Drug↗