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C Döhlemann

Publications and source records attributed to C Döhlemann.

29 records · Page 2Linked to original sources
PubMed1978

[Tracheal compression by the innominate artery. Angiographic investigations (author's transl)].

Angiocardiograms in 11 infants without anatomical abnormalities of the heart and the great arteries were compared with angiocardiograms in 17 patients with tracheal compression caused by the innominate artery. The direction of the left ventricular outlet, the course of the aortic arch, the innominate artery and the right common carotid artery were studied with regard to the position of the trachea and the vertebral bodies. Course and origin of the innominate artery depends on the direction of the left ventricular outflow. The influence of haemodynamic factors in the formation of the aortic arch system is discussed. The innominate artery, which is arched in early infancy, straightens due to the descending heart and the growth of the infant. Its topographic relation to the trachea changes with age. In view of these developmental changes it is unlikely, that an aberrant origin of the innominate artery accounts for the tracheal compression.

Brachiocephalic Trunk↗
PubMed1977

[Transposition of the great arteries: natural history and indications for surgery after balloon-atrioseptostomy (author's transl)].

The natural history of 162 children with transposition of the great arteries is referred, whose first heart catheterization fell between 1967 and June 1975. In 149 of them balloon atrial septostomy (BAS) was performed, with a mean increase in arterial oxygen saturation of 21 %. In 11 cases BAS was repeated after inadequate first BAS, but again without success. In 19 patients an atrial septectomy (Blalock-Hanlon) was performed later on, with 20% mortality. 3 children died during or immediately after BAS. The early mortality after BAS was 13% and the late mortality 17%. These values include the mortality of palliative operations which were necessary to bridge over the time until "corrective" operations could be performed. The operative mortality of Mustard operations was 10% for the simple TGA and 16% for all TGA cases operated on. On the basis of the mortality values of the BAS, of atrioseptectomy (Blalock-Hanlon) and of the Mustard procedure the proceeding after BAS and the indication for operations is thoroughly discussed.

Heart Atria↗
PubMed1976

Oxygen transport in congenital heart disease: influence of fetal hemoglobin, red cell pH, and 2,3-diphosphoglycerate.

In 48 individuals (age 1 day to 13 years) with congenital heart disease, blood oxygen transport function was studied in order to evaluate adaptive changes in shunt hypoxemia and to investigate the in vivo regulation of erythrocyte 2, 3-diphosphoglycerate concentration (RBC 2, 3-DPG) in the presence of fetal hemoglobin (HbF). Arterial pO2 and oxygen content, oxygen capacity, acid base status, oxygen affinity, HbF fraction, plasma pH, red cell pH, and RBC 2, 3-DPG were determined. During the first 50 days of life values of standard P50 (stdP50) (37, pH 7.4), actual in vivo P50 (actP50), RBC 2, 3-DPG, O2 capacity, arterial plasma pH, and red cell pH were scattered around the normal range, although tending to low values for stdP50 and arterial plasma pH and to high values for O2 capacity. After the third month, stdP50 actP50, RBC 2, 3-DPG, O2 capacity, and red cell pH were found to be elevated. Plasma pH and actP50 were scattered around the normal range (Figs. 1 and 2). Intraerythrocytic pH in hypoxemic infants was increased compared with normal children when related to plasma pH (Fig. 3). A close to normal intraerythrocytic pH was therefore found in the hypoxemic infants with low plasma pH, and an increased intraerythrocytic pH in the hypoxemic children with normal plasma pH (Fig. 1). A significant negative correlation exists between erythrocyte H+ ion and 2, 3-DPG concentration (Fig. 5); regression constants derived from data at high (mean 47%) and low (mean 9%) fractions of HbF are not significantly different (Regression Equations 8 and 11 in Table 1). Thus, the known difference in 2, 3-DPG binding to fetal or adult deoxyhemoglobin does not measurably influence the erythrocyte 2, 3-DPG concentration, indicating that in vivo the 2, 3-DPG synthesis in hypoxia is virtually regulated by the erythrocyte pH, which in turn is determined by plasma pH and the oxygenation state of hemoglobin.

Adaptation, Biological↗
PubMedDate not supplied

Innominate artery enlargement in congenital arteriovenous fistula with subsequent tracheal compression and stridor.

To demonstrate that airway obstruction may be the first manifestation of a congenital fistula, a female newborn is reported who presented with increasing stridor during her first 23 months of life. Magnetic resonance imaging and Doppler echocardiography revealed an enlarged innominate artery with turbulent flow. Angiography demonstrated an arteriovenous fistula between the right subclavian artery and right subclavian vein and an abnormal origin of the right internal thoracic artery. Bronchoscopy showed a pulsating compression of the middle section of the trachea. Closure and division of the fistula and aortotruncopexy were performed. The stridor disappeared, and there was marked relief of the tracheal obstruction, confirmed by bronchoscopy. It is concluded that, a search for enlarged vessels is necessary in cases of airway obstruction.

Airway Obstruction↗
PubMedDate not supplied

Intravascular ultrasonography of an adolescent boy with a coronary artery aneurysm due to Kawasaki disease.

A 14-year-old boy developed coronary aneurysms during the course of Kawasaki disease. The vessel wall morphology of the coronary arteries was assessed by intravascular ultrasound imaging (IVUS). There was intimal thickening proximal to, within, and distal to a large coronary aneurysm in the left anterior descending coronary artery only 18 months after the acute onset of Kawasaki disease. Intimal thickening without calcification is a new IVUS finding within a persistent coronary aneurysm. It may indicate that the healing process, via cell proliferation is continuing, with the risk of causing a stenosis.

Adolescent↗
PubMedDate not supplied

Acute inferior cardiac inflow obstruction resulting from inadvertent surgical closure of a prominent Eustachian valve mistaken for an atrial septal defect.

A 5-month-old boy with a VACTERL syndrome underwent cardiac surgery for correction of a common arterial trunk and closure of an atrial septal defect. A prominent Eustachian valve was mistaken for the atrial septum and surgically closed. Thirty months later, after gradual shrinking of the foramen ovale with associated reduction of the right-to-left shunt, the boy presented with acute symptoms of a lower inflow obstruction, characterized by hepatomegaly and engorged abdominal vein pattern (Medusa's head). The boy was reoperated successfully after the condition had been recognized.

Abnormalities, Multiple↗
PubMedDate not supplied

MRI in pre- and postoperative assessment of tracheal stenosis due to pulmonary artery sling.

OBJECTIVE: To evaluate the potential of MRI in the assessment of tracheal stenosis due to tracheal or vascular malformations, 45 children with severe respiratory distress were examined prospectively during a period of 1 year. Five of these children had tracheal stenosis due to a sling left pulmonary artery (SLPA). MATERIALS AND METHODS: Magnetic resonance examinations of the anesthetized children were performed with a 1.5 T Siemens MR imager using electrocardiographically gated T1-weighted SE sequences in transverse and sagittal slice orientations. Slice thickness was 3 mm and each sequence was repeated after shifting the slice position by 1 mm. Monitoring during the examinations included ECG, oscillatory blood pressure, respiratory rate, and oxygen concentration. Magnetic resonance findings were compared with esophagography, selective pulmonary angiography, bronchoscopy, Doppler sonography, and surgery. All examinations were repeated after surgical therapy to assess the improvement in tracheal stenoses and the patency of the ligated and reimplanted left pulmonary arteries. RESULTS: Magnetic resonance imaging clearly revealed the course of the SLPA and its topographic relationship to the trachea as well as the coexistence of cardiovascular and tracheobronchial or esophageal malformations. The degree and length of tracheal stenoses, which were measured in the pre- and postoperative axial slices and graphically displayed, as well as the angles of the right and left main stem bronchi, could be accurately determined. CONCLUSION: Magnetic resonance imaging in combination with bronchoscopy yielded the necessary and sufficient information for diagnosis and aided the surgeon in planning operative strategy and in postoperative follow-up.

Angiography↗