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V Gliech

Publications and source records attributed to V Gliech.

At least 19 recordsLinked to original sources
PubMed2006

Bland-White-Garland syndrome and atrial septal defect - rare association and diagnostic challenge.

We report on a 40-year-old woman referred for evaluation of a cardiac murmur and dyspnea on exertion. The electrocardiogram (ECG) showed incomplete right bundle branch block, and echocardiography revealed a large atrial septal defect (ASD, ostium secundum type) with dilated right-sided heart chambers. At cardiac catheterization, a large left-to-right shunt (78% of the pulmonary blood flow) was found, and surprisingly, the additional diagnosis of anomalous origin of the left coronary artery from pulmonary artery (ALCAPA) was established. After ASD closure and left coronary artery ligation with implantation of a vein graft to the left anterior descending artery, she had an uneventful 18-years follow-up. We discuss the interaction of the two associated conditions, and based on the herein reported unusual combination, we highlight typical features of non-invasive examinations including auscultation, ECG, and echocardiography in adult patients with ALCAPA.

Adult↗
PubMed2005

[Left atrial myxoma: second recurrence 20 years after the first operation].

We report about a 52-year old woman, who underwent a resection of a left atrial myxoma 20 years ago. Twelve years later she suffered from exertional dyspnea. Echocardiography revealed a recurrent myxoma. This was resected. Eight years later the woman suffered from disturbances of heart rhythm and from angina pectoris. The coronary arteries were normal, but a recurrent left atrial myxoma was found and operated. We conclude a long-term follow-up is inevitable in patients after the resection of a myxoma.

Adult↗
PubMed2004

Transcatheter closure of patent foramen ovale (PFO) in patients with paradoxical embolism. Periprocedural safety and mid-term follow-up results of three different device occluder systems.

AIMS: Interventional PFO closure has previously been reported to reduce the risk for recurrent thromboembolic events. The aim of the present study was to evaluate three different occluder systems in respect to (a) the safety and practicability and (b) the mid-term risk of recurrent thromboembolic events. METHODS AND RESULTS: Since 08/98 until 12/02, 307 consecutive patients (138 women, 169 men, mean age 43 years) with a symptomatic PFO underwent PFO closure using the PFO-Star ( n=177), Amplatzer PFO occluder ( n=69) and CardioSeal/Starflex ( n=61 ). Implantation was successful in all patients. Periinterventional complications occurred in 9 patients (5x ST-segment elevations, 1x arteriovenous fistula, 2x TIA, 1x device dislodgement). All of them were reversible and not associated with a specific type of device. During the median follow-up of 24 months (25/75th percentiles: 14/37 months), the annual risk of recurrence was 0.6% for TIA, 0% for stroke and 0.2% for peripheral embolism (PFO-Star: 0.8%, Amplatzer PFO occluder: 0.7% and CardioSeal/Starflex: 1.0%). CONCLUSION: Interventional PFO closure appears to be safe and a promising technique in symptomatic PFO patients with a low incidence of periinterventional complications and recurrent thromboembolic events using three different devices (PFO-Star, Amplatzer PFO occluder or the CardioSeal/Starflex).

Adult↗
PubMed2003

[Left ventricular pseudoaneurysm after mitral valve replacement].

We report about a woman with a rare complication after mitral valve replacement 24 years ago. The patient had a massive hemorrhage some hours after operation. We performed invasive diagnostics because of an increasing pressure gradient across the prosthesis and revealed a left ventricular pseudoaneurysm. Before the planned reoperation the patient died suddenly. As the cause of death, we assumed a rupture of the pseudoaneurysm.

Adult↗
PubMed2001

Suture closure of the brachial artery access site post-coronary catheterization.

A total of 18 diagnostic and interventional coronary angiographic patients were treated with a suture mediated closure device for achievement of hemostasis at the brachial artery puncture site. One case resulted in crossing over to standard manual compression due to incomplete tissue capture post-closure. One post-procedural bleeding was reported as well as one case of radial artery vasospasm. No late or major complications were reported.

Aged↗
PubMed1999

[Follow-up of dissection of the right coronary artery and wall of the ascending aorta after directional coronary atherectomy. A case report].

We report on a patient in whom a restenosis after two PTCA procedures was treated with directional coronary atherectomy. In the second DCA maneuvre a spiral dissection, type D, developed from ostium to restenosis with a balloon shaped part in the wall of the aorta ascendens. This part disappeared nearly completely by next day. The dissection in the right coronary artery persisted three months later until a bypass operation and was not visible after two years.

Aortic Dissection↗
PubMed1998

Fibrinogen breakdown, long-lasting systemic fibrinolysis, and procoagulant activation during alteplase double-bolus regimen in acute myocardial infarction.

Recent clinical studies comparing accelerated versus bolus administration of alteplase tissue plasminogen activator (t-PA) suggest similar thrombolytic efficacy, but reveal higher bleeding complications among older patients during the double-bolus regimen. The objective of the present study was to characterize the hemostatic profile of t-PA administered as double-bolus doses of 50 mg, at intervals of 30 minutes. Among 50 patients with acute myocardial infarction treated by double-bolus t-PA thrombolysis, coagulation and fibrinolysis parameters, as well as t-PA levels, were monitored. Monitored t-PA levels peaked at 5 and 35 minutes and were detectable within the therapeutic range even after 90 minutes. Marked systemic fibrinolytic activation was indicated by 75% depletion of both plasminogen and fibrinogen, as well as by 19-fold and 300-fold increases of fibrin degradation and fibrinogen degradation products. Plasminogen-activator inhibitor activity was completely suppressed. Pronounced procoagulant activation was reflected by a 3.4-fold increase of both factor XIIa and prothrombin fragment 1+2, and by a threefold increase of thrombin-antithrombin complex. Independent of t-PA weight dosage, fibrinolytic activation was more pronounced among older patients (> or = 63 years). We conclude that t-PA after bolus administration has a long half-life. Double-bolus regimen leads to a long-lasting systemic fibrinolytic state, which is even more remarkable among older patients--a fact that may explain the higher bleeding complications reported for this age group.

Aged↗
PubMed1997

[Rupture of PTCA balloons--an in vitro study].

A large number of PTCA balloon catheters from different manufacturers were examined following their use. Several of these balloons had been previously used for PTCA for the mere purpose of guide wire support. Each balloon was evaluated starting at 8 atm. The pressure was increased in steps of 1 atm until rupture. This stepwise increase of pressure was documented at each level in a short cine film. During dilatations, balloons were in room air until rupture. None of the balloons ruptured before the rated burst pressure. A few of the balloons tolerated pressures of approximately 27 atm. With increasing pressure the shape of the balloons became distorted. Most assumed a banana shape. Most of the balloons ruptured after developing a small hole. Increasing pressure produced increasing diameter, and, generally, we found a linear increase. Most balloons increased by > 15% in diameter over the nominated diameter before rupture. The burst pressure in all balloons was not influenced by the prior mode of dilation, duration of dilation, maximum pressure applied, or length of the balloon. Balloons with smaller diameter ruptured later than compared to those with larger diameters. Our findings demonstrated that all of the balloons tolerated the manufacturers' recommended inflation pressure supporting the safety in their use.

Angioplasty, Balloon, Coronary↗
PubMed1996

Multiplane transoesophageal echocardiography is the only definitive ultrasound approach in adult supravalvular aortic stenosis.

This report describes a rare case of isolated supravalvular aortic stenosis (SVAS) in a 28 year-old female patient. A congenital heart defect, diagnosed at birth, was until 1994 suspected to be a valvular aortic stenosis (VAS). Cardiac catheterization led to the diagnosis of supravalvular aortic stenosis, which could easily be confirmed by multiplane but not by monoplane transoesophageal echocardiography (TEE). Precordial examinations had not revealed the vitium, probably because the SVAS is a rare malformation of the ascending aorta, but with multiplane TEE the aortic narrowing could be imaged clearly and pressure gradients comparable to those found with invasive measurements were established. The advantage of this non-invasive method for diagnosis and preoperative preparation are discussed in detail.

Adult↗
PubMed1990

[Percutaneous transvascular pulmonary valvuloplasty. Early and late results].

Since the introduction into practice in may 1986 at the Institute of Cardiovascular Diagnostics we performed 45 valvuloplasties until March 1990 in 34 children (6.2 +/- 4.9 years old) and 11 adults (29.5 +/- 9.6 years) with valvular pulmonary stenosis. The invasively obtained pressure gradient at the valve diminished from 83.4 +/- 30.7 mm Hg to 35.7 +/- 19.0 mm Hg. Intraoperative complications in three patients (short term asystole, severe bradycardia, increase of right ventricular pressure to 300 mm Hg after valvuloplasty) were controlled, but demanded the end of the intervention. No significant insufficiency of pulmonary valves after valvuloplasty was seen. 18 patients were clinically investigated 14.6 +/- 9.4 months after intervention. The late results for these patients proved the method as a long term curing treatment. According to our present results pulmonary valvuloplasty is the alternative method for valve surgery especially in critical pulmonary valve stenosis in newborns.

Adult↗
PubMed1990

[Persistent and patent ductus arteriosus. Different forms and sizes].

In 563 consecutive heart catheter investigations in sucklings, infants and children 109 open ducti were diagnosed. 75 children (13.3%) had a ductus arteriosus persistens (DAP) and 34 a ductus arteriosus (DAA). We were able to measure 89 ducti. Groups were formed according to the age of the children, of DAP or DAA and the intended treatment. The sizes of the ducti constitute a set of data for improving the methods for closure or newly developed transvasal methods of conservation of the ductus as an aortopulmonary shunt.

Aortography↗
PubMed1990

[Castaneda-de Leval's modified Fontan operation in complex cyanotic defects with subsequent percutaneous transluminal embolization of systemic pulmonary collaterals].

The case of a five year old boy with a double-inlet-left-ventricle and the aorta in 1-malposition, large VSD, ASD and pulmonary stenosis is reported, that showed after modified Fontan surgery severe effusions and a severe protein loss syndrome. Aortopulmonary collaterals were detected as the cause of this and successfully treated in several sessions by percutaneous transluminal embolization.

Child, Preschool↗
PubMed1989

[Embolization therapy using detachable balloons].

Report on the application of a new (valve equipped) detachable balloon for percutaneous transvasal embolization therapy in 372 patients with (noncerebral) curative preoperative and palliative indications.

Embolization, Therapeutic↗