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S K Krueger

Publications and source records attributed to S K Krueger.

36 records · Page 2Linked to original sources
PubMed1989

Accurate determination of the transaortic valve gradient using simultaneous left ventricular and femoral artery pressures.

Accurate determination of the transaortic valve gradient has required two catheters, one in the left ventricle and one in the ascending aorta. We now report a new technique for measurement of the transaortic valve gradient from the simultaneous left ventricular (LV) and femoral artery (FA) pressure tracings. This technique was compared with the "true" gradient obtained by measurement of the simultaneous LV and central aortic pressures, and is accurate (R = 0.999) and relatively simple. Other approaches used to determine the mean transaortic valve gradient were less accurate: simultaneous LV-FA (R = 0.991); aligned LV-FA (R = 0.974); averaged simultaneous and aligned LV-FA (R = 0.981); and nonsimultaneous LV-aorta pullback (R = 0.953). Thus, this new technique provides an accurate transaortic valve gradient without requiring the use of two central catheters.

Aorta↗
PubMed1989

Comparison of three techniques for percutaneous balloon aortic valvuloplasty of aortic stenosis in adults.

Three different techniques for percutaneous balloon aortic valvuloplasty h have been described: retrograde single balloon, retrograde double balloon, and antegrade techniques. This report describes our experience using the three techniques in twenty-five consecutive procedures. All techniques resulted in a significant decrease in transvalvular pressure gradient and an increase in calculated aortic valve area, without significant difference among the three. There was no increase in the degree of aortic regurgitation after valvuloplasty by any of the techniques. Vascular complications occurred only with the retrograde double balloon technique. Cardiac tamponade during balloon inflation occurred with both the retrograde single and double balloon techniques. Three deaths occurred; two during the antegrade technique and one after the retrograde double balloon technique. Thus, balloon aortic valvuloplasty can be effectively performed using any of the three techniques. However, the differing techniques have inherent advantages in specific situations, as well as potential complications.

Aged↗
PubMed1988

Echocardiographic evaluation of potential cardiac transplant donors.

Since the initiation of the UTAH Cardiac Transplant Program, echocardiography has been used to evaluate 74 potential donors including 65 of 71 hearts ultimately used for transplantation. Of these 65 donors, 46 had normal studies, nine had pericardial effusions, five had mild septal hypokinesia with otherwise normal function, four had equivocal mitral valve prolapse, and only one heart could not be visualized. All transplants were successful and all donor hearts exhibited satisfactory hemodynamic function immediately after transplantation, including the hearts that were mildly abnormal before transplantation. These hearts included 21 (29%) that could have been excluded by conventional screening criteria. Nine potential donor hearts with grossly abnormal echocardiograms were not used for transplantation, including eight hearts with severe hypokinesia and one heart with significant mitral and tricuspid regurgitation. Inspection or histologic analysis confirmed the presence of severe dysfunction or morphologic damage in those hearts subjected to these additional measures. We conclude that echocardiographic screening is a useful method of evaluating potential cardiac transplant donors. It can identify potential donors that would otherwise have been excluded and it can identify potential donors with severe cardiac dysfunction without the need for direct surgical inspection.

Adult↗
PubMed1983

Temporary pacemaking by general internists.

The medical records of 126 patients requiring 129 temporary pacemakers were viewed retrospectively. The pacemakers were inserted by general internists using venous access from subclavian and internal jugular veins under ECG guidances. Fluoroscopy was not used. There was 14% incidence of pacemaker electrode malfunction and a 4% risk of complication with no pacemaker-related mortality. These results compare favorably with reports from university cardiology services. Temporary pacemakers can be safely inserted by general internists without fluoroscopy.

Aged↗
PubMed1977

Protein-losing enteropathy complicating the Mustard procedure.

Protein-losing enteropathy is a reported complication of several cardiac diseases. Recently we encountered a patient with protein-losing enteropathy acquired as a late surgical complication of the Mustard procedure. An obstructed superior vena caval conduit was repaired surgically and the enteropathy was resolved.

Child, Preschool↗
PubMed1976

Echocardiographic features of combined hypertrophic and membranous subvalvular aortic stenosis: a case report.

Combined hypertrophic and membranous subvalvular aortic stenosis was detected by echocardiography. The diagnosis was established by the discovery of severe asymmetric septal hypertrophy, a membrane in the left ventricular outflow tract, narrowing of the left ventricular outflow tract, as well as high frequency fluttering and premature systolic closure of the aortic valve leaflets.

Aortic Stenosis, Subvalvular↗
PubMed1976

Aortic root dissection: echocardiographic demon-stration of torn intimal flap.

An unusual case of aortic root aneurysm with dissection is described. A large intimal tear allowed a flap of aortic tissue to sag into the lumen. The echocardiographic and angiographic findings simulated an aortic supravalvular membrane. Surgical replacement of the aortic valve and aortic root was successfully accomplished.

Angiocardiography↗
PubMed1976

Membranous subaortic stenosis complicated by aneurysm of the membranous septum and mitral valve prolapse.

The clinical, echocardiographic, and catheterization findings in a patient with discrete subaortic stenosis, aneurysm of the membranous interventricular septum, and mitral valve prolapse are presented. Echocardiography showed a subaortic membrane, abnormal aortic valve motion, accentuated systolic anterior motion of the membranous interventricular septum, and prolapsing mitral leaflets. Cardiac catheterization confirmed the diagnoses. The possible functional interrelationship of these lesions is discussed.

Adult↗
PubMed1975

Left atrial appendage aneurysm: correlation of noninvasive with clinical and surgical findings: report of a case.

Congenital left atrial appendage aneurysm is rarely diagnosed on the basis of an abnormal cardiac silhouette. Patients with a left atrial appendage aneurysm often present with symptoms of systemic emboli or supraventricular arrhythmias. A patient with left atrial appendage aneurysm was diagnosed by correlation of two noninvasive techniques echocardiography and radionuclide scintiscanning. Angiography was confirmatory and aneurysmectomy was successfully performed.

Echocardiography↗
PubMed1975

Echocardiographic Mimics of aortic root dissection.

Echocardiograms were recorded in two patients with suspected aortic root dissection. In the first patient with a massive pulmonary embolus, a simultaneous recording of the mitral ring and posterior aortic wall created a pattern similar to true posterior aortic wall dissection; in the second patient with severe generalized atherosclerosis, thickened aortic walls recorded echocardiographically were found at autopsy to be atherosclerotic plaques. These cases emphasize the potential for the false positive ultrasonic diagnosis of aortic root dissection.

Aortic Aneurysm↗
PubMedDate not supplied

The development of the blood-brain barrier in alcohol-exposed rats.

Circulating horseradish peroxidase (HRP) was used as a tracer to determine if the blood-brain barrier to protein was altered by dietary prenatal alcohol exposure. Animals were prepared for light microscopic visualization of HRP after HRP infusion on gestational days 16, 18, 20, 22 and postnatal day 4. There was no consistent evidence of HRP leakage through the BBB in the alcohol-exposed animals compared to control animals. Capillary endothelial cells and perivascular astrocytic endfeet were morphologically characterized by electron microscopy in rat optic nerve and cerebellum following dietary prenatal and postnatal ethanol exposure. Photomontages of optic nerve capillaries from G20 and P5 animals and cerebellar capillaries from P15 animals were examined for evidences of effects of alcohol on the development of the capillaries and adjacent astroglial endfeet. There was no consistent evidence of any alcohol-induced effect that could indicate a disruption of the vessel, the endothelial tight junctions, the perivascular glial limiting membranes, or the extent of vascular ensheathment by astrocytic endfeet.

Animals↗
PubMedDate not supplied

Predictors of improvement in left ventricular ejection fraction with carvedilol for congestive heart failure.

BACKGROUND: Beta-blocker therapy has been reported to improve survival and left ventricular ejection fraction (LVEF) in the setting of congestive heart failure (CHF). The magnitude and predictors of improved LVEF are unclear. METHODS: A total of 295 patients were enrolled in the study. Inclusion criteria were LVEF <35% at baseline and symptomatic (New York Heart Association class II to IV) CHF despite treatment with at minimum an angiotensin-converting enzyme inhibitor. Carvedilol was initiated at 3.125 mg twice daily and titrated to a target dose of 25 or 50 mg twice daily, depending on the patient's weight. Paired pretreatment baseline and 9 months with treatment follow-up quantitative LVEFs (assessed by resting radionuclide ventriculograms) were obtained in 161 (55 %) of the patients. RESULTS: LVEF improved from 25% +/- 6% at baseline to 36%+/-12% at follow-up (P<.001). Mean change in LVEF (deltaLVEF) was greater for nonischemic cardiomyopathy (NICM) (+14.5+/-2 LVEF points) than ischemic cardiomyopathy (deltaLVEF +/- 7.6+/-10 EF points, P = .001). The deltaLVEF was > or =21 LVEF points in 30% of the NICM group versus 10% of the ischemic cardiomyopathy group. Conversely, the deltaLVEF was unchanged to minimally improved (< or =5 LVEF points) in 21% of the NICM group versus 52% of the ischemic cardiomyopathy group. Multivariable analysis identified NICM and recent onset of congestive heart failure as correlates of improved LVEF. CONCLUSIONS: Carvedilol significantly improved LVEF, especially in patients with NICM and those with recent onset of CHF.

Adrenergic beta-Antagonists↗