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Biomedical subjects

W A Stertmann

Publications and source records attributed to W A Stertmann.

5 recordsLinked to original sources
PubMed1992

[Constrictive pericarditis--surgery with or without heart-lung machine?].

In patients suffering from constrictive pericarditis, the best hemodynamic results can be achieved by total mobilization of the heart and complete resection of the pericardium. Among 72 patients operated upon from 1969 to 1991, the use of extracorporeal circulation became necessary only twice. Therefore, we suggest the use of heart lung machine only in patients with bad myocardial function or in patients who need correction of additional diseases. Routine use of extracorporeal circulation is not mandatory.

Diagnosis, Differential↗
PubMed1990

[Neurologic complications of coronary bypass surgery--a prospective study].

Neurologic, cardiologic, and dopplersonographic findings of 303 patients undergoing coronary bypass surgery were evaluated in a prospective study. About 5% of the patients suffered from a prior stroke. Nearly 9% had a significant stenosis of an internal carotid artery detected by dopplersonography. Central nervous system complications occurred in 18.2% of the patients, predominantly temporary mental disturbances. Old patients and those with complicating heart failure were at higher risk for mental disorders. Approximately 3% of the patients suffered from a stroke with a permanent deficit. Half of them had a potential source of cardiogenic embolism. The risk of a complicating stroke was raised by the presence of a stenosis of a carotid artery, a heart failure, or an arrhythmia. The frequency of peripheral nervous system complications was 13.5% with temporary symptoms in about half of the cases. Brachial plexus paresis predominated with a particular risk in mammaria bypass grafting.

Adult↗
PubMed1990

A modified technique for the production of an arterio-venous shunt in sheep, allowing a comparison of biocompatibility of synthetic materials.

Polytetrafluorethylene (PTFE) prostheses were implanted in 12 sheep as a shunt between the carotid artery and the jugular vein using an end-to-side anastomosis technique. This technique allows repeated tests of the pharmacological and toxicological safety of artificial kidney units after both single and multiple administration. Furthermore, it enables the investigation of detoxification of compounds via dialysis, thus contributing to drug safety. Implantation of the prosthesis was uncomplicated. Connection to the extracorporeal circulation was achieved via catheters and maintained using a pump with an output of up to 300 ml/min. This enabled maintenance of extracorporeal circulation for several hours without clinical impairment to the animals. The AV-shunts remained functional for between 8 and 253 days (mean 112.3 days).

Animals↗
PubMed1990

[Transcranial Doppler sonography during pulsatile and non-pulsatile extracorporeal circulation].

Transcranial Doppler sonography (TCD) was used to determine the mean blood flow velocity of the middle cerebral artery (Vm-MCA) and pulsatility (systolic/diastolic flow velocity = S/D) in 25 patients undergoing aortocoronary bypass grafting before, during, and after extracorporeal circulation (ECC). Preoperatively, none of the patients had signs or symptoms of cerebrovascular disease. ECC was performed with 2.4 l/min per m2 under mild hypothermia (34 degrees C) using membrane oxygenators. After 20 min of nonpulsatile perfusion, ECC was switched to the pulsatile mode for 20 min. Nonpulsatile perfusion was applied for the remaining ECC period. Vm-MCA, S/D, mean arterial blood pressure (MABP), and nasopharyngeal temperature (T.np) were recorded continuously throughout the operation. Hematocrit and paCO2 were determined before, during, and after ECC. Following hemodilution after the introduction of ECC, Vm-MCA was significantly increased compared with the baseline values before ECC. With hematocrit and paCO2 varying insignificantly during ECC, the onset of pulsatile ECC decreased Vm-MCA and MABP simultaneously. After the re-establishment of nonpulsatile ECC, both Vm-MCA and MABP increased again. However, a linear relationship between the two variables could not be documented statistically. During pulsatile ECC, pulsatility (S/D) of the obtained TCD wave forms did not reach baseline values. In 4 cases, TCD showed cessation of diastolic blood flow velocity after induction of ECC or onset of pulsatile ECC. An increase in MABP or changes in ECC regimen promptly restored diastolic TCD signals in these cases. Our results support the concept of increased cerebral blood flow under mild hypothermic ECC. Compared with the nonpulsatile perfusion mode, we found Vm-MCA reduced during pulsatile ECC.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗