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Biomedical subjects

A Beitzke

Publications and source records attributed to A Beitzke.

At least 73 records · Page 4Linked to original sources
PubMed1984

[Immunosuppressive therapy in congestive cardiomyopathy in childhood].

Two patients aged ten and fourteen years presented with clinical signs of acute viral myocarditis and cardiac failure. Within three months both showed clinical deterioration with development of severe mitral and tricuspid incompetence. From their third month of illness myocardial antibodies were constantly found by indirect immunofluorescence technique. Both were treated with prednisone 2 mg/kg/d and azothioprine 2-2,5 mg/kg/d from their ninth and third month of illness for fifteen and twelve months respectively. Both showed considerable improvement within weeks with resolution of their valve incompetence, diminution of heart size and normalization of their ECGs. Results from myocardial biopsies suggest that a number of patients with chronic congestive cardiomyopathy may have long lasting viral inflammation of the myocardium or myocardial fiber destruction by autoimmunmechanisms after viral infection. Our cases probably had acute myocarditis which led to chronic congestive cardiomyopathy. Immunosuppressive therapy seems to be justified in cases where chronic inflammation or destruction of the myocardium is suspected because of the results of cardiac biopsies, myocardial scintigraphy or demonstration of myocardial antibodies.

Adolescent↗
PubMed1983

Treatment of postsurgical chylothorax with fibrin glue.

The treatment of postsurgical chylothorax with fibrin glue is reported. Chylothorax developed in a 3 1/2-month-old infant 2 days after extrapleural ligation of a patent ductus arteriosus. At rethoracotomy the chyle leak could not be located. To stop chyle effusion, the region of the presumed leakage was sealed with fibrin glue and a pleural flap. It is suggested that early reoperation and closure of the chyle leak with fibrin adhesive should be considered in cases of postsurgical chylothorax in infants.

Chylothorax↗
PubMed1983

Use of prostaglandin E2 in management of transposition of great arteries before balloon atrial septostomy.

Fifteen infants with transposition of the great arteries and severe hypoxaemia were treated with prostaglandin E2 infusions before atrial septostomy was performed. Twelve patients had simple transposition and three had small ventricular septal defects. The infusion resulted in a highly significant increase of PaO2 from 22 +/- 3 mmHg to 37 +/- 5 mmHg within one to two hours. Only one patient did not respond to treatment. PaO2 remained constantly above 30 mmHg throughout prostaglandin infusion. After balloon atrial septostomy prostaglandin administration was stopped. Only two patients required reinfusion within 24 hours after septostomy because of a decrease of PaO2 below 25 mmHg. At angiocardiography before balloon septostomy the ductus was of aortic size in eight, and of about half the aortic diameter in six patients. In one infant the ductus was closed. One infant had to undergo early ductus ligation because of heart failure. In 10 of 11 infants who have undergone total correction the initially large ductus had closed spontaneously.

Dinoprostone↗
PubMed1983

[Shunt malfunction due to a Blalock-Taussig anastomosis of the pulmonary vein].

In two of 81 patients in whom a Blalock-Taussig shunt was created due to pulmonary atresia, the anastomosis was inadvertently placed on the pulmonary vein. The first case was a newborn with mirror-image dextrocardia, pulmonary valve atresia and a high ventricular septal defect. Subsequent to a Rashkind maneuver and treatment with prostaglandins, at the age of eleven days the shunt procedure was performed. Right sided pulmonary edema developed twelve hours after surgery and the infant died on the second postoperative day. Anastomosis of the shunt to the right pulmonary vein was revealed at autopsy. The second case was a six year-old boy admitted for corrective surgery with pulmonary valve atresia, main pulmonary artery atresia, large ventricular septal defect and patent ductus arteriosus. Because of additional systemic-pulmonary collaterals, the larger collaterals were ligated and the Blalock-Taussig shunt was carried out using a Goretex prosthesis. Nine months postoperatively, at follow-up cardiac catheterization, the ill-directed shunt was diagnosed and subsequently revised. The onset of ipsilateral pulmonary edema and increasing signs of congestive heart failure after surgical creation of a Blalock-Taussig shunt as well as the persistence of lowered oxygen partial pressure, cyanosis and poor general health, should alert the attending physician to rule out the rare complication of anastomosis to the pulmonary vein.

Arteriovenous Shunt, Surgical↗
PubMed1982

[Scimitar syndrome with horseshoe lung (author's transl)].

A combination of two rare malformations of the lung was observed in a four-year-old asymptomatic boy. He had typical scimitar syndrome (dextrocardia, hypoplastic right lung and right-sided anomalous pulmonary venous drainage into the v. cava inferior) together with horseshoe lung. Diagnosis was established by angiocardiography and computerized tomography. In the absence of recurrent pulmonary infections operative intervention is not necessary with normal pulmonary arterial pressure and resistance. To the best of our knowledge this case with both malformations seems to be the fourth which is reported in the literature.

Angiocardiography↗
PubMed1982

[Complications in 1000 cardiac catheter examinations in childhood].

Complications of cardiac catheterization of 1 000 subsequent investigations of pediatric patients were prospectively recorded. 18.2% of all patients presented in the newborn period with usual distribution of cardiac malformations of this age group. Total mortality was 1.8% within the first 24 hours. Newborn babies who were commonly hypoxic and in cardiac failure at the time of catheterization had a mortality of 9.3%. Causes of death were cardiac failure, hypoxia and severe arrhythmias. Comparing the first and second five hundred patients, mortality in the newborn seems to decrease with anaesthesia and ventilation of the patient. Increasing experience of the investigators and exclusion of non-operable malformations from catheterization by non invasive methods might also be responsible for this effect. The rate of arterial complications is 10% and high in our patients. Late venous thrombosis of the iliac veins and inferior vena cava in cyanotic malformations is one of the most serious problems. Apart from balloon atrial septostomy, the use of flow-guided balloon catheters in previous catheterizations could be responsible.

Adolescent↗
PubMed1981

[Mucocutaneous lymph node syndrome in Austria. Four cases with one fatal outcome. 2. Pathological findings].

First pathoanatomic case report of mucocutaneous lymph-node syndrome (MCLS) from Austria: A 3 1/2 year old boy was admitted to the Pediatric Department with a six day history of fever and bilateral conjunctivitis. He showed a maculous exanthema, red and fissuring lips, reddened tonsils and a coated tongue. Submandibular lymph nodes were swollen (1 cm diameter); ESR 128/138; peripheral leukocytosis 17 x 10(9)/l. On the tenth day of illness membranous desquamation from the fingertips and a strawberry tongue was observed. The ECG showed a myocardial infarction in the apical portion of the left ventricle. The boy died on the 25th day of illness. Pathological findings were found predominantly in the heart: Coronary arteries showed fibrous thickening of intimal layer, focal destruction of elastic membrane and aneurysms in both arteries. The aneurysm in the descending branch of the left coronary artery was 15 mm long and had a maximum diameter of 8 mm. It was completely occluded by a thrombus. Recurring anteroseptal myocardial infarction. Other investigated arteries were not affected. Tonsils as well as (paratracheal and parapancreatic) lymph-nodes showed a few ceroid pigment containing histiocytes.

Aneurysm↗
PubMed1981

[Prostaglandin E-2 in cyanotic heart defects in newborn (author's transl)].

14 newborn babies with pulmonary atresia (4) or transposition (TGA) (8) received Prostaglandin E2 infusions to correct their hypoxia and acidosis. 12 out of 10 patients were infused before diagnostic catheterization and creation of an interatrial communication by balloon atrioseptostomy. Infusions were stopped after septostomy in patients with transposition and prolonged up to palliative surgery in pulmonary atresia patients. All patients whose treatment was started in the first four days of life had a highly significant rise of their paO2. The only non-responder was a patient with TGA after septostomy who was a non-mixer and seven days old. Typical side effects of PGE2 were seen in two-thirds of all cases. One patient with TGA needed ductus ligation after PGE2 withdrawal because of congestive heart failure due to prolonged ductus patency. We conclude that prostaglandins of the E-type can safely be used in all cases of TGA with hypoxia and acidosis who are awaiting catheterization. Even when an adequate interatrial communication does not yet exist PGE2 seems to bring good oxygenation by opening the ductus. Used up to a maximum of 32 hours infusion-time heart failure was not seen.

Heart Defects, Congenital↗
PubMed1981

[Intrapericardial rhabdomyosarcoma in infancy (author's transl)].

At the age of three months an infant rapidly developed signs of cardiac failure as well as in- and exspiratory stridor, caused by an intrathoracic tumor. Thoracotomy and biopsy revealed an intrapericardial tumor, histologically myxosarcoma. In spite of chemotherapy and radiation the infant died at the age of seven months due to multiple intracerebral metastases now histologically rhabdomyosarcoma. This is one of the rare cases of primarily malignant intrapericardial tumors in infancy, and also shows the possible pleomorphism of childhood rhabdomyosarcoma. We know only one further case of pericardial rhabdomyosarcoma where similar histologic changes have been observed.

Biopsy↗
PubMed1980

[Surgical treatment of congenital heart disease in infants without use of extracorporeal circulation (author's transl)].

Between 1970 and 1978 135 infants with congenital malformations underwent operations due to congestive heart failure, progressive pulmonary hypertension, and severe cyanosis. Of them, 63% were acyanotic; 68% of all operations became necessary during the first 6 months of life. The late mortality rate was 5% and the hospital mortality rate 17%. A remarkably higher operative risk was found during the first 6 months of life. Ligation of patent ductus arteriosus as the most common lesion was done with a mortality rate of 2.5% which is comparable to the risk of late repair in childhood. Pulmonary artery banding could be performed in all acyanotic malformations with a mortality rate of 17% and of 12.5% in isolated VSD (including debanding and VSD closure in several cases). Coarctation of the aorta was corrected with a overall mortality rate of 26%. Because of a recurrence rate of 20%, the authors think that operations are only indicated in symptomatic cases of coarctation. In complex cyanotic malformations, a higher operative risk was observed in both pulmonary artery banding (38%) and shunt operations (44%). If surgical treatment is necessary, the earlier, the better.

Age Factors↗
PubMed1980

[Angiographic-clinical correlation in Fallot's-tetralogy during childhood (author's transl)].

Thirty-eight patients with Fallot's tetralogy were investigated in order to correlate their clinical and angiographic findings. In the light of embryological knowledge about the morphogenesis of Fallot's tetralogy there are good explanations for the various modes of clinical presentation. Patients with extreme cyanosis in the newborn period show diffuse hypoplasia of their right ventricular outflow tract and pulmonary arteries because of extreme malseptation of the conus with anteposition of the infundibular septum. Patients who present with cyanosis and blue spells in infancy show infundibular narrowing and dextro- and anteposition of the ascending aorta. Conal malseptation together with malrotation of the conus seem to be the responsible factors in this patient group. Malrotation of the conus without malseptation is probably the mechanism in patients who present initially without cyanosis and signs of left to right shunting. Anteposition and overriding of the aorta are the initial angiographic signs while right ventricular hypertrophy producing infundibular narrowing and subsequent cyanosis appear later.

Angiography↗
PubMed1980

Single origin of right and left pulmonary arteries from ascending aorta, with main pulmonary artery from right ventricle.

A previously undescribed anomaly is presented in which right and left pulmonary arteries arise via a single vessel from the ascending aorta while the main pulmonary artery arises normally from the right ventricle. This main pulmonary artery has no branches supplying the lungs and connects via a ductus arteriosus to the descending aorta. Additional anomalies were an atrial septal defect and tubular hypoplasia of the aortic isthmus.

Angiocardiography↗
PubMed1980

[Isolated endocarditis of the tricuspid valve in early infancy].

A newborn baby is admitted in the second week of life with osteomyelitis and septicemia due to Staph. aureus infection. In his tenth week of life--the osteomyelitis nearly overcome--the infant shows signs of heart failure with a murmur and cyanosis. Cardiac catheterization reveals tricuspid insufficiency and thrombosis of the right pulmonary artery. Postmortem examination shows isolated polypous endocarditis of the tricuspid valve together with thrombosis of the right and recent embolus of the left pulmonary artery. A similar case has to the best of our knowledge not been described.

Endocarditis↗
PubMed1980

[Tuberous sclerosis: first manifestation as cardiac arrhythmia in a newborn].

A newborn baby is found to have multifocal atrial tachycardia. Myoclonic seizures and depigmented nevi appear at the age of five months. The clinical diagnosis of tuberous sclerosis is confirmed by the result of cranial computerized tomography, which shows typical lesions. Though cardiac angiography fails to show an intracavitary tumor, multiple intramural rhabdomyomas of the myocardium are probably the cause of the persistent arrhythmia.

Arrhythmias, Cardiac↗
PubMed1980

[Ductus ligation in idiopathic respiratory distress syndrome of the premature infant].

In a 13-month period, ligation of the persistent ductus was carried out in 23 prematurely born babies with severe respiratory distress syndrome who were all respirator-dependent. Mean gestational age was 30.6 weeks (26-36 weeks), mean birth weight 1490 g (850-3090 g) with 3 patients under 1000 g. Signs of cardiac failure by large left to right shunt via ductus were seen at the end of the first week of life, radiologic signs as pulmonary edema were seen 1 to 2 days earlier. Mean age at operation was 13.5 days (4-27 days), mean duration of artificial ventilation 22 days (8-59 days). Indomethacin was used orally 12 of these patients without effect to close the ductus. One patient died of cerebral hemorrhage on his 17th day of life, 10 days postoperatively, one 3 1/2 months later at home with porencephaly and hydrocephalus. Four patients show radiologic signs of bronchopulmonary dysplasia. In the following 6 months up to December 1979, another 15 patients with IRDS underwent ductus ligation. Gestational age and birth weights were about the same as in the first group. Out of this second group which has not been followed up for a longer period. 3 babies died. Early mortality in both groups is 10.5% (4 out of 38 patients).

Birth Weight↗