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Biomedical subjects

T Kurtz

Publications and source records attributed to T Kurtz.

29 records · Page 2Linked to original sources

[Aortic and mitral monovalvular replacements. Comparison of the ball prosthesis of Starr-Edwards (1260-6120) and the tilting disc prosthesis of Bjork-Shiley. Series of 390 patients].

The evaluation of short and long term replacement by the Björk-Shiley tilting disc prosthesis (BS) and by the Starr-Edwards ball and cage prosthesis (SE) was carried out on a series of 390 consecutive patients. In mitral replacement, operative mortality rate (SE 5.9 P. 100 - BS 4.8 P. 100), 5 year actuarial survival (SE 79.8 P. 100 +/- 3.8 P. 100 - BS 86.3 P. 100 +/- 9 p. 100) incidence of thromboembolic complications and valvular thrombosis (SE 1.6 P. 100 - BS 1.3 P. 100) as well as the degree of post-operative improvement were virtually identical in both types of prosthesis. Likewise, in aortic valve replacement, operative mortality rate (SE 4 p. 100 - BS 3.2 p. 100), 5 year survival (SE 82 +/- 7.8 P. 100 - BS 86 +/- 3.3 p. 100) incidence of thromboembolic complications (SE 2.2 p. 100 - BS 1.8 p. 100) and the degree of post-operative improvement were not statistically different. However, the incidence of sudden death was statistically smaller with a BS prosthesis than with a SE prosthesis (respectively 1.6 p. 100 and 6.9 p. 100).

Actuarial Analysis↗

[Massive pulmonary embolism Apropos of 26 embolectomies with definitive survival, 10 of them by Trendelenburg's operation].

The authors report 26 pulmonary embolectomies carried out successfully, 10 of them having been Trendelenberg procedures and 16 having been carried out under extracorporeal circulation. The latter method gives better results, and appears to be the procedure of choice. The haemodynamics before operation were always abnormal, and there were 4 cardiac arrests, 11 cases of severe shock, and 6 cases with less severe hypotension. In the other cases, cyanosis, respiratory distress and signs of acute cor pulmonale were the clinical features of the massive embolus. It was possible to carry out arteriography in 14 cases, and this showed extensive pulmonary vascular obstruction in between 70 and 90%. In 4 cases this procedure was followed by an exacerbation, and extremely urgent treatment became neccessary. This examination is important for diagnosis and for assessment of the prognosis. It seems clear to the authors that surgery has a certain place, alongside medical fibrinolysis of a severe prognosis. It seems clear to the authors that surgery has a certain place, alongside medical fibrinolysis of a severe pulmonary embolus. The essential indications for surgery are moribund patients, those in whom fibrinolysis is contraindicated or unsuccessful, and those with massive obstruction of the pulmonary arterial tree.

Adult↗

[Post-traumatic interventricular communication. Closure under extracorporeal circulation].

Report of one case of acquired traumatic interventricular septal defect due to a stab injury of the right ventricle by a knife. The highly-placed penetrating injury involved the muscular septum and very probably resulted in a right bundle-branch block of the His system. Surgical operation performed in view of a starting clinical intolerance with moderately increased right cardiac pressures, was done under ECC with easy suture of the septal wound. The post-operative course was normal and a quick clinical cure was noted, which persisted for 8 months after surgery. The interest of this case, in addition to the very severe condition of the patient who had sustained 11 stab-knife wounds, lies in the high localization of the septal wound, which explains the involvement of the intracardiac conduction pathways.

Adult↗

[Roentgen morphologic study of arthrosis of the sternoclavicular joint].

X-rays of 102 sternoclavicular joints from post-mortem examination were interpreted systematically. In 89 cases we found an osteoarthrosis. We investigated the correlation between stage of osteoarthrosis and size and form of articular surface, age, sex and right or left preference. We also made a review about anatomy, embryology and pathology of the sternoclavicular joint. The differential diagnosis of sternoclavicular pain is discussed.

Adult↗