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Biomedical subjects

M Weyand

Publications and source records attributed to M Weyand.

84 records · Page 5Linked to original sources
PubMed1991

An alternative technique for orthotopic cardiac transplantation, with preservation of the normal anatomy of the right atrium.

The standard technique for orthotopic cardiac transplantation implies large atrial anastomoses which do not preserve the anatomical integrity of the donor atria. This may become a potential source of electrophysiological and mechanical atrial dysfunction, especially in the right atrium with the sinus node and the sensitive low-pressure atrioventricular valve. As an improvement we suggest an alternative technique which we have recently developed for orthotopic cardiac transplantation; it combines the simple, convenient left atrial connection of the standard technique with individual anastomoses of the superior and inferior venae cavae, preserving the right atrium of the donated heart intact. This technique and our first results in two cases are described. Postoperatively, no arrhythmias and no signs of tricuspid insufficiency were observed.

Adult↗
PubMed1990

Human cardiac allograft rejection. Correlation of grading with expression of different monocyte/macrophage markers.

Endomyocardial biopsies from human cardiac allografts were investigated with the use of immunohistochemical methods. A correlation between the different degrees of rejection reaction and subtypes of monocyte/macrophage infiltrates was established. Early and mild rejection is characterized by recently immigrated monocytes/macrophages positive for the monoclonal antibody Ki-M1. In contrast, the cellular infiltrates in severe and resolving rejection show strong expression of antigens recognized by Ki-M6 and Ki-M8, indicating increased phagocytotic function of monocytes/macrophages. The immunohistochemical assessment of monocytes/macrophages can thus be used, in addition to conventional histology, in the diagnosis of cardiac allograft rejection.

Antibodies, Monoclonal↗
PubMed1988

Heterotopic heart transplantation: current indications for the procedure, with results in 10 patients.

From January 1986 to September 1987, we performed 27 orthotopic and 10 heterotopic cardiac transplantations at our institution. Of the 10 heterotopic transplantation recipients, 9 were men; ages ranged from 36 to 65 years; and indications for transplantation were ischemic cardiomyopathy in 8 patients and dilatative cardiomyopathy in 2 patients. Five of the 10 heterotopic transplantation recipients received donor hearts under emergency conditions, when no hearts of suitable size for orthotopic transplantation were available. In 3 of the 10 heterotopic procedures, we performed pure left ventricular (rather than biventricular) bypass in patients with chronic conditions requiring only aneurysmectomy, or aneurysmectomy in combination with an aortocoronary graft. During postoperative hospitalization, the following complications occurred in the 10 heterotopic-transplantation recipients: 10 infectious episodes in 6 patients; 1 episode of severe graft rejection; and 1 episode of severe gastrointestinal bleeding. All these complications were overcome, and no patient in the heterotopic-transplantation group died. Fifteen months postoperatively, one male in the group lost his graft, but his own heart had by then recovered function, despite dilatative cardiomyopathy. More commonly, late investigation (6 months or longer after transplantation) has yielded ambiguous overall evaluations of pump performance of the recipients' native hearts, showing slight improvement in some instances and further deterioration in others. We conclude that heterotopic heart transplantation is a life-saving procedure in urgent cases when only small donor hearts are available, and that it offers a good chance of hemodynamic and functional improvement not only in emergency cases, but also in cases of chronic cardiomyopathy when there is salvageable myocardium.

Journal Article↗
PubMedDate not supplied

Plasmatic [corrected] factor XIII reduces severe pleural effusion in children after open-heart surgery.

Chylous effusions frequently occur after cardiac surgery due to severe damage to the lymphatic system, thus indicating that the insertion of a chest tube may be necessary. Factor XIII (FXIII) is discussed as being essential for wound healing. The aim of this retrospective study was to evaluate whether the application of a single dose of FXIII results in a reduced amount of pleural effusion, leading to an earlier release of patients from the hospital. The cases of 40 children with severe chylous effusions after open-heart surgery were examined. Twenty patients received FXIII and were compared to 20 age- and weight-matched patients who did not receive FXIII. Major parameters included the amount of effusion before and 1 and 3 days after the application of FXIII; the duration of chest tubes; the total amount of fluid loss via drainage; and the period of hospitalization. FXIII levels in plasma showed an inverse correlation with fluid loss. After application of a single dose of FXIII, a significant reduction of pleural effusion within the first 24 hours was detected. However, no difference was observed between the two groups when comparing the total amount of pleural effusions within the first 72 hours. Finally, the duration of hospitalization did not differ between the FXIII-treated and the control group. A single application of FXIII rapidly reduces the amount of chylous effusions in the early period after open-heart surgery. This effect is detectable only for 24 hours after the treatment and does not alter the further clinical outcome. Prospective clinical trials are warranted to determine if repeated application or a higher dose of FXIII may improve the clinical outcome of chylous leakages in children after open-heart surgery.

Case-Control Studies↗