Search PubMed⌕ Search

Biomedical subjects

M Turina

Publications and source records attributed to M Turina.

At least 469 records · Page 26Linked to original sources
PubMed1982

[Ventricular septal defect after operation in hypertrophic obstructive cardiomyopathy (author's transl)].

After surgical resection in idiopathic hypertrophic subaortic stenosis, a ventricular septal defect was observed in one patient at a later date. The defects was closed in a second operation. - The hemodynamically relevant changes in the vascular bed of the lung with preoperative congestion and postoperative shunt found their expression in discrete changes only of the chest x-ray.

Cardiomyopathy, Hypertrophic↗
PubMed1981

[Technic and long term results of pacemaker treatment with atrial electrodes].

A new implantation technique in the upper lateral part of the right atrium has reduced the complication rate of atrial electrodes to less than 4% at 11 months' follow-up. P-wave amplitude and acute and chronic threshold are in the order of conventional ventricular electrodes. In 10 of 56 patients with atrial-triggered ventricular pacemakers the cardiac output at rest and during exercise was found to be respectively 8% and 17% higher than with fixed-rate ventricular pacing. This hemodynamic benefit is longlasting, in contrast to findings with non-atrial synchronized pacing.

Adult↗
PubMed1981

[Surgical treatment of heart rhythm disorders].

Six patients underwent cardiac surgery for refractory tachyarrhythmias. Four had Wolff-Parkinson-White syndrome and 2 ventricular tachycardias after myocardial infarction. The results of preoperative electrophysiologic studies corresponded in 5 cases to intraoperative findings of epicardial and pace-mapping. These patients were free of symptoms for the 4-16 months' follow-up. In one patient with divergent results, tachycardia and preexcitation returned two months postoperatively. In the light of the foregoing the authors suggest surgical treatment for 1. preexcitation with life-threatening arrhythmias, 2. refractory ventricular tachycardias with coronary artery disease and 3. preexcitation in patients undergoing open heart surgery for other reasons.

Adult↗
PubMed1981

[Surgical risk in patients over 70].

501 instances of surgery during 1979 in 390 patients aged 70 years or older are reported. The total preoperative mortality rate was 5.4% of operations or 6.9% of patients. Surgery in this patient group was more frequent (1979 11%, 1956/57 8.3%) while the mortality rate had decreased significantly. Urgent operations were frequent (23%), with five times the mortality rate (15%) than for elective operations (2.6%). It is therefore desirable to avoid urgent interventions and operate under elective conditions, though this is not always possible in practice.

Aged↗
PubMed1981

[Differentiated pacemaker therapy].

17 patients were treated by atrial (AAI) or atrial-triggered ventricular pacing (VAT). The atrial electrode was placed using a new endocardial screw-in technique. No complications occurred during a follow-up period of 3 months. Cardiac output at rest was measured in 12 patients before pacemaker implantation and was 3.571/min with VVI pacing at a heart rate (HR) of 70/min and 3.97 l/min (HR 75/min) with AAI or VAT pacing (p less than 0.001). Measurement of cardiac output was repeated in 7 patients with AV-block III degrees 10 weeks after pacemaker implant and the result was 4.40 l/min (HR 77/min) on VAT stimulation. During dynamic exercise in 5 patients, cardiac output under VAT pacing was 20% higher than with VVI pacing. This difference remained unchanged after 10 weeks. It is concluded that atrial electrodes can be placed reliably by the new technique. In contrast to VVI pacing, the hemodynamic benefits of atrial-triggered ventricular pacemakers appear to be long lasting.

Adult↗
PubMed1981

An experimental study on transannular patching of the right ventricular outflow tract with and without a pulmonary valve monocusp mechanism.

The efficacy of a pericardial patch in the right ventricular outflow tract (RVOT) with a monocusp valve mechanism was investigated experimentally. Hemodynamic performance of the right ventricle and angiographic competence of the valve were compared in animals after patching of the RVOT and removal of the pulmonary valve (group I), patching of the RVOT, removal of the pulmonary valve and implantation of a monocusp valve (group II), patching of the RVOT, partial removal of the pulmonary valve and implantation of a monocusp valve (group III) and a control group (IV). Postoperative effective right ventricular cardiac index, stroke volume and stroke work improved significantly from group I to III, but did not reach the control values of group IV. Angiographically the monocusp valve allowed some early diastolic regurgitation due to late closure (group II) if it was not supported by remnants of the animal's own pulmonary valve (group III).

Animals↗
PubMed1980

[Stimulation rate of lithium powered pacemakers in the event of battery depletion].

Between 1976 and 1977, 347 lithium powered pacemakers with capacity below 1.8 Ah have been implanted at Zürich University Hospital. 25 (7%) had to be explanted after an average of 37.3 months because of premature battery depletion, the reason for which was low resistance electrodes (Elema EMT 588 A and C) in CPI-502 UD and Telectronics 150B. Both types showed a drop in stimulation rate as an EOL-characteristic, as predicted by manufacturer. Rate controls at 6 month intervals have proven a reliable means of detecting premature failure. With ARCO Li-3D, prediction of battery depletion was possible only in one case out of 5 because of sudden and unpredictable EOL. In pacemaker dependent patients this type should be explanted by the end of the guarantee period at the latest.

Coronary Disease↗
PubMed1980

[Correlation of preoperative hemodynamics on late postoperative outcome in chronic aortic insufficiency].

92 patients with severe chronic aortic regurgitation underwent surgery between 1973 and 1977. Patients with coronary artery disease and significant postoperative prosthesis dysfunction were excluded from the study. The overall mortality during the follow-up (1.5-7 years, average 3.5 years) was 8.7%. It was not higher in patients undergoing reoperation or additional operation for aneurysm of the aorta ascendens. The preoperative left ventricular ejection fraction, end-diastolic volume index and end-diastolic pressure, and the cardiac index and cardio-thoracic ratio in chest roentgenogram, did not reliably predict a fatal late outcome. The late postoperative outcome in patients with severely impaired left ventricular ejection fraction (less than 40%), high enddiastolic pressure (greater than 25 mm Hg), low cardiac index (less than 2.2 l/min/m2) and high cardio-thoracic ratio (greater than 0.60) was not worse than in the entire group of patients. Higher postoperative mortality was seen only in patients with a severely elevated left ventricular end-diastolic volume index (greater than 220 ml/m2).

Adult↗
PubMed1980

Reoperations after valvular heart surgery: indications and late results.

The incidence of reoperations after valvular heart surgery was higher after valve-preserving procedures and after valve replacement with biological prostheses than after implantation of mechanical prostheses. The indication for reoperation was elective in the vast majority of cases; usually it was due to progressive late deterioration of repaired valves or of tissue valves. Symptoms are not a sensitive indicator in timing the reintervention. Progression of clinical signs, radiological and ECG alterations and echocardiographic criteria must be followed closely once late deterioration has been diagnosed. Criteria for reoperation are basically the same as for primary valve surgery. Hemolytic anemia and recurrent emboli were rare indications for reoperation in the presented material. Paravalvular leak was the most frequent indication for reoperation following the implantation of mechanical heart valve prostheses. A number of valve-related complications requiring emergency reoperations are presented; immediate recognition of these conditons and immediat intervention are mandatory. Bacterial endocarditis remains a severe complication after valvular heart surgery and threatens patients with mechanical prostheses in particular. The late results of reoperations depend mainly upon the state of disease reached by the time of reintervention, i.e., upon the right timing of the reoperation.

Adult↗
PubMed1980

Congenitally corrected transposition of the great arteries: a clinical and surgical study.

From 1967 to 1979, 40 patients with the diagnosis of congenitally corrected transposition of the great arteries (C-TGA) have been followed. Associated cardiac defects were present in all but one patient, most frequently ventricular septal defect (80%), and pulmonary stenosis (70%). Left sided atrio-ventricular valve dysfunction developed in 25%, third degree atrio-ventricular block (at least intermittently) in 33% of the patients. Twenty-eight patients were operated: palliative procedures were done in 6, corrective operations in 22 patients. Ten of the 40 patients have died during a mean observation period of 4 years: 4 early postoperatively, 3 late postoperatively and 3 non-operated patients. Sudden unexplained cardiac arrest has been the most frequent cause of death (2 late postoperative and 2 non-operated patients). The incidence of residual ventricular septal defects and residual pulmonary stenosis after corrective surgery has been relatively high owing to the complex anatomy in these patients. Also reconstruction of the atrio-ventricular valves has been difficult because of severe deformities, particularly of the left side. It is concluded that in C-TGA the pacemaker should be implanted early, at the first sign of AV-conduction disturbance. Since the relief of the pulmonary stenosis is difficult, the operation should be deferred until an adequate-sized conduit can be implanted.

Adolescent↗