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Biomedical subjects

M Fleisch

Publications and source records attributed to M Fleisch.

44 records · Page 3Linked to original sources
PubMed1995

[Management of patients with carotid stenosis and coronary heart disease].

Coronary and carotid atherosclerosis are often coexistent in the same patient. Therefore, patients presenting with carotid stenosis should be screened for coronary heart disease and vice versa. Patients with significant asymptomatic or symptomatic carotid stenosis have an elevated perioperative risk of cerebral ischemic attacks during operations with extracorporeal circulation and of myocardial infarction during carotid endarterectomy. The operations should be performed simultaneously, with carotid endarterectomy being done before sternotomy. This yields mortality and morbidity rates comparable with those for isolated operations on extracorporeal circulation. Medical therapy for such patients consists of platelet inhibitors with adequate cardiac medication.

Adult↗
PubMed1995

[Acquired heart diseases and pregnancy].

Understanding of the mechanisms of cardiovascular and hemodynamic adaptation during pregnancy helps to prevent or manage complications in cardiac patients during gestation. Manifestations of coronary heart disease are exceptional during pregnancy and delivery. The same is true of disorders of the pericardium. Peripartal cardiomyopathy is a myocardial disorder of undetermined cause occurring shortly before, during or after delivery, which may take a fatal course. Hypertrophic obstructive or non-obstructive cardiomyopathy is compatible with gestation and delivery without serious complications in most cases. Rheumatic mitral stenosis was the most common cardiac disorder until the 1950s. Nowadays it is rarely seen in this country. Surgical and other interventional therapies have greatly changed the outlook in pregnant women with valvular heart disease. A highly controversial issue is heart valve replacement in young women and management of anticoagulation during pregnancy. Like any other drug therapy, anticoagulation during gestation requires careful weighing of the benefit for the mother against toxic and teratogenic effects for the fetus. In women with heart disease the management of pregnancy should start, if possible, before conception. Thorough counseling and proper planning of pregnancy and of therapeutic measures is essential in order to avoid or manage complications.

Abnormalities, Drug-Induced↗
PubMed1991

Intra-hisian 2:1 atrioventricular block secondary to Lyme disease.

We describe a case of Lyme carditis with intra-hisian 2:1 atrioventricular (AV) block documented by electrophysiological study. To our knowledge, only two cases of AV block at the level of the His bundle has been described in the literature. Sinus rhythm was restored after 4 days of i.v. ceftriaxone.

Atrioventricular Node↗
PubMed1985

[Volume and regional contraction of the left ventricle studied with venous injection in subtraction angiography].

UNLABELLED: The end-diastolic and end-systolic volumes, the left ventricular ejection fraction, and segmental contraction of the left ventricle (5 areas) were determined at rest in 31 patients using two methods: conventional cineventriculography (as reference) and digital subtraction angiography by venous injection (the inferior vena cava). RESULTS: the volumes and ejection fraction obtained by digital subtraction angiography were reliable, though slightly less accurate than conventional ventriculography. Quantification of segmental contraction was satisfactory in the apical, anterolateral, and anteroinferior portions. It was less satisfactory in the posteroinferior portion with questionable reliability in the diaphragmatic portion. Qualitative dynamic assessment of contraction was satisfactory in most patients.

Angiography↗
PubMed1976

[Scintigraphic functional analysis with the gamma camera during renal perfusion (author's transl)].

The controlled progress of transplanted kidneys has already been useful. We have succeeded in finding a simple method to study the function of the renal parenchyma and the collecting system. This method was also applied to determine a flow volume relation during perfusion in comparison to impulse rates. In contrast the conventional parameters, which only describe a partial function of the organ, this simple method will deliver comprehensive information before transplantation.

Animals↗
PubMedDate not supplied

Proximal coronary artery stenosis: three-dimensional MRI with fat saturation and navigator echo.

The purpose of this study was to compare the diagnostic value of MR angiography (MRA) with conventional contrast angiography in coronary artery disease. Thirty-five patients underwent MRA and coronary angiography within 4 hours. Of these, three patients were investigated twice: once before and once after balloon angioplasty. The pulse sequence was a cardiac-triggered, single-slab, three-dimensional gradient-echo sequence, employing a spin-echo navigator echo measurement to track the variation of the diaphragm during the scan. The following segments of the coronary arteries were included in this prospective study: left main coronary artery, proximal and middle left anterior descending, proximal and middle left circumflex, proximal and middle right coronary artery, and intermediate branch, if present. In total, 176 segments were classified as normal or having a stenosis of less than 50% and as having a stenosis of more than 50%. Five patients were excluded because of lack of cooperation. Over all, 45 of 54 stenoses were detected and interpretable by MRA. Sensitivity, specificity, and positive and negative predictive values of MRA for detecting significant stenoses were 83%, 94%, 87%, and 93%, respectively. MRA identified significant stenoses within the major coronary arteries with a high degree of accuracy. Sensitivity and specificity are higher compared with exercise tests or scintigraphy or top of the precise localization.

Coronary Angiography↗
PubMedDate not supplied

Management and outcome of stents in 1998: long-term outcome.

In the first 20 years of its existence, percutaneous transluminal coronary angioplasty (PTCA) has emerged to become the most common major medical intervention. In the meantime, many different adjunctive devices, such as drills, lasers, cutters, and suckers, have been invented, but only stents (introduced in 1986) have become a major asset to PTCA. Their main benefit is reducing the incidence of acute occlusions caused by dissection and, thus, the need for emergency bypass grafting. The approximate 30% restenosis rate of PTCA between 3 and 6 months after the intervention is also reduced to approximately 20% by stents. In the long term, ie, after 6 months, the stented or nonstented lesion is stable and needs a revascularization procedure in only 4% of the lesions. After PTCA, progression of coronary artery disease plays a dominant role, necessitating subsequent interventions for new stenoses in as many as 10% of patients.

Angioplasty, Balloon, Coronary↗