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Biomedical subjects

B J Wintersperger

Publications and source records attributed to B J Wintersperger.

27 records · Page 2Linked to original sources
PubMed1999

[Evaluation of right heart load with spiral CT in patients with acute lung embolism].

PURPOSE: Purpose of this study was to evaluate whether spiral-CT allows judgment of right ventricular failure in patients with acute pulmonary embolism. MATERIALS AND METHODS: 61 patients underwent spiral-CT due to suspicion of acute pulmonary embolism. Patients with pulmonary embolism were divided into subpopulations according to the severity of pulmonary embolism in the CT scan. Cardiac measurements were performed on axial spiral-CT images and compared to those of patients without suspicion of pulmonary embolism or cardiac diseases. RESULTS: In 30 patients spiral-CT revealed acute pulmonary embolism. Significant differences in cardiac measurements in patients with severe and less severe pulmonary embolism were found on comparing the following dimensions: left ventricular width (p = 0.0003), left (p = 0.008) and right (p = 0.009) ventricular cross-sectional area, proportion of right to left ventricular width (p = 0.0003) and proportion of right to left ventricular cross-sectional area (p = 0.0001). The proportion of the cross-sectional areas (r = 0.65) and the proportion of the width (r = 0.60) of both ventricles correlated well with the severity of central pulmonary embolism. CONCLUSION: Besides reliable assessment of pulmonary embolism spiral-CT allows the evaluation of cardiac dimensions for judgment of right ventricular failure.

Adult↗
PubMed1999

Minimally invasive extirpation of a left-ventricular myxoma.

As myxomas usually are benign neoplasms a minimally invasive technique would be an interesting alternative for their extirpation because the surgical trauma is reduced. In one male patient with a diagnosed left-ventricular myxoma minimally invasive surgery was carried out using the Port-Access method. 2D echocardiography, EBT, and MRI were performed preoperatively to obtain exact information about topography, calcifications, and malignity. Minimally invasive extirpation was successful and the mitral valve could be preserved. Histopathological examination revealed a cardiac myxoma extirpated in toto. At one-year follow-up there was no recurrence of the tumor.

Adult↗
PubMed1999

Contrast-enhanced magnetic resonance angiography for control of minimally invasive coronary artery bypass conduits (MIDCAB/OPCAB).

OBJECTIVE: The purpose of this study was to delineate the course and determine the patency of venous and arterial conduits in the early postoperative period following minimally invasive bypass grafting. A less invasive magnetic resonance angiogram was evaluated as alternative to standard contrast angiography and cardiac catheterization. METHODS: Twelve patients (8 males and 4 females) with a mean age of 65.3 (+/- 7.4 ) years were evaluated four to seven days following minimally invasive direct coronary artery bypass surgery (MIDCAB) or off-pump multivessel revascularization with the Octopus stabilizer on the beating heart. Altogether 17 coronary bypass grafts were investigated: 12 left-sided mammary artery grafts to the LAD and five aortocoronary venous bypass grafts. The examination was performed with a 1.5 Tesla Magnetom Vision (Siemens AG, Erlangen) with phased array coil technology. Data acquisition was done with an ultrafast 3D gradient-echosequence in single breathhold and sagittal and coronal views. Contrast enhancement of the vessels was performed with automatic intravenous bolus injection of Gadolinium-DTPA after determination of the individual contrast transit time. Traditional contrast angiography was obtained in all patients during the same time period as a comparison to assess the sensitivity and specificity of the magnetic resonance imaging. RESULTS: All five venous grafts and 11 of the 12 IMA grafts were detected and shown to be patent with the MRA technique. Contrast angiography demonstrated complete patency for all 17 bypass grafts with adequate anastomoses and no evidence of stenosis. The calculated sensitivity for the visualization with MRA was therefore 92% for IMA grafts and 100% for venous grafts. CONCLUSION: The contrast-enhanced ultrafast MRA in single breathhold technique is a reliable, noninvasive method for visualization and determination of the patency of arterial and venous coronary grafts.

Aged↗
PubMed1998

Patency of coronary bypass grafts: assessment with breath-hold contrast-enhanced MR angiography--value of a non-electrocardiographically triggered technique.

PURPOSE: To determine the value of non-electrocardiographically triggered contrast material-enhanced magnetic resonance (MR) angiography in assessing the patency of venous and internal thoracic artery (ITA) grafts after coronary bypass surgery. MATERIALS AND METHODS: Twenty-seven patients with 76 coronary bypass grafts (48 venous, 28 ITA) were examined 26.5 months +/- 5.8 after surgery with MR angiography and conventional angiography. MR angiography was performed with a three-dimensional gradient-echo sequence after automated injection of contrast material; contrast agent administration was based on measurement of the individual transit time of the agent. Results of MR angiography were interpreted by two independent observers and compared with results of conventional angiography. RESULTS: The independent interpretations of the MR angiograms agreed with the results of conventional angiography in 96% and 91% of the grafts. After a final consensus reading, sensitivity was 95% for all grafts, 94% for venous grafts, and 96% for ITA grafts. Specificity was 85% for venous grafts and 67% for ITA grafts. Positive predictive value was 95% for all grafts, 94% for venous grafts, and 96% for ITA grafts. CONCLUSION: Non-electrocardiographically triggered contrast-enhanced MR angiography allows reliable assessment of the patency of venous and arterial coronary bypass grafts.

Adult↗
PubMed1998

[Control of the patency of coronary artery bypasses with contrast enhanced magnetic resonance angiography].

Contrast-enhanced 3D magnetic resonance angiography (MRA) has the potential for being a reliable method for CABG visualization and CABG patency determination in early postoperative period. 3D reconstruction was helpful in delineating CABG course and in several cases in detecting stenosis of coronary arteries. Compared to coronary angiography MRA is a non-invasive examination technique without iodine contrast medium and X-ray and is practicable in 30 min with minimal risk and low costs.

Aged↗
PubMed1997

[Contrast media enhanced magnetic resonance angiography for determining patency of a coronary bypass. A comparison with coronary angiography].

AIM: Assessment of graft patency with current non-invasive MRA techniques is particularly difficult for evaluating internal mammary artery grafts. Our aim is to determine the accuracy of a contrast enhanced MRA technique is assessing graft patency. METHODS: We examined 19 patients with a total of 53 grafts (32 venous/21 arterial), using an ultrafast contrast enhanced 3D gradient-echo technique and compared this with the results of selective angiography. RESULTS: Sensitivity of the contrast enhanced method was 95.2% for venous grafts, 94.4% for IMA grafts and 94.8% overall. Specificity was 85.7% overall, 90.9% for venous and 66.7% for IMA grafts. Positive predictive value was 94.4%. CONCLUSION: Compared with previous studies, visualisation of IMA grafts was improved by using contrast enhanced MRA. In this preliminary study, contrast enhanced MRA proved promising for the assessment of graft patency.

Adult↗
PubMedDate not supplied

[Multislice CT of the heart: clinical applications].

Since the introduction of last generation multislice MSCT systems and the development of simultaneous electrocardiographic-tracing image acquisition and retrospective reconstruction techniques into clinical routine, cardiac MSCT has been considered a very useful non-invasive technique for the study of cardiac pathology in the daily clinical practice. One of the main clinical applications of this diagnostic technique is the evaluation of the coronary arteries including detection and quantification of coronary calcium, multislice CT coronary angiography (anatomy, anatomical variants and anomalies of the origin and course), the angiographic evaluation of the patency of aortocoronary by-pass grafts and coronary stents, and plaque characterization. The new reconstruction and postprocessing programs allow to obtain, in addition, parameters of myocardial morphology and contraction and cardiac function. Other clinical applications include the characterization of cardiac masses and the evaluation of the pericardium.

Clinical Trials as Topic↗