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Biomedical subjects

C Salzmann

Publications and source records attributed to C Salzmann.

At least 19 recordsLinked to original sources
PubMed1996

[Coronary fistula in adults. Review with reference to personal experience].

A consecutive series of 5384 coronary arteriograms was retrospectively investigated for the presence of coronary artery fistulas. 15 fistulas were found in 14 patients, corresponding to a prevalence of 0.26%. All the fistulas were small and hemodynamically insignificant. There were no fistula-associated complications. Most of the fistulas were discovered as incidental findings during an otherwise indicated coronary angiography (8 patients). In the 6 patients without other cardiac pathology, the investigation was performed because of a systolo-diastolic murmur in 2 cases, myocardial ischemia caused by a "coronary-steal phenomenon" in 2 cases, and chest pain in 2 cases. With the exception of a fistula between two coronary arteries and a postoperative fistula, all of them originated from the proximal part of the coronary arteries (9 from the right, 6 from the left). Most of the fistulas drained into the main pulmonary artery (73%).

Adult↗
PubMed1995

Coronary stenting without anticoagulation.

Stents are useful bail-out devices in coronary angioplasty. They are also used electively for situations associated with poor angioplasty results (e.g., restenotic lesions, venous grafts) and may reduce restenosis rates. However, the significant incidence of stent thrombosis necessitated aggressive anticoagulation with associated hemorrhagic complications. This remains a major limitation of stenting. We present our experience of stenting with half (disarticulated) Palmaz-Schatz coronary stents in eight consecutive patients, managed with aspirin alone. No patient experienced acute or subacute stent thrombosis.

Adult↗
PubMed1994

[Myocardial infarct in patients with normal coronary arteries].

Between November 1992 and April 1993, 864 coronary angiographies were performed at our institution. In 14 patients (1.6%), no significant coronary disease (> 50% stenosis) was found despite documented myocardial infarction. Of these, 2 patients (0.2%), aged 46 and 33 years, had perfectly smooth coronary arteries at angiography. The most commonly postulated mechanism of myocardial infarction in such patients is coronary spasm with superimposed thrombosis. The same risk factors as those operative in atherosclerotic coronary artery disease are thought to play a role in this setting. The prognosis is good. In one of the patients with < 50% stenosis of coronary vessels, a history of cocaine abuse could be elicited as the possible causal factor of acute myocardial infarction. Cocaine-induced coronary spasm can lead to arrhythmias, myocardial infarction or accelerated coronary atherosclerosis even in patients with normal coronary arteries. Myocarditis must be considered in the differential diagnosis of acute myocardial infarction in young patients with chest pain, typical electrocardiographic and enzymatic changes but without risk factors.

Adult↗
PubMed1994

Use of half (disarticulated) Palmaz-Schatz stents for thrombus-containing coronary lesions.

Coronary stenoses associated with thrombus can lead to poor angioplasty results and increased procedural complications. Stenting in the presence of thrombus is associated with an increased risk of stent thrombosis. We report eight patients in whom half a Palmaz-Schatz stent was implanted for inadequate angioplasty results owing to thrombus. Stenting resulted in improved angioplasty results; no stent thrombosis occurred.

Angioplasty, Balloon, Coronary↗
PubMed1992

[Heart sounds--a mathematical transformation of blood pressure? On the origin of heart sounds].

Two main theories exist concerning the origin of the heart sounds. The first proposes that rapid pressure fluctuations cause the cardiac valve leaflets to vibrate and produce the sound. The second theory suggests that sudden pressure perturbations cause the entire cardiohemic mass to vibrate as a whole. In 35 patients (26 men and 9 women, aged 18 to 73) with various heart diseases microtransducer catheters (Millar) were used to simultaneously record aortic pressures and aortic internal phonocardiograms in order to determine if they had a common mode of origin and propagation. The propagation velocities of the first heart sound and the foot of the aortic pressure pulse were found to be similar, 5.24 +/- 0.61 m/s and 5.97 +/- 1.87 m/s respectively (+/- SE). It was possible to derive facsimiles of the aortic internal phonocardiogram by double differentiation of the corresponding aortic pressure pulse and conversely to derive the pressure pulse by double integration of the phonocardiogram. These data support the concept that the low-frequency pressure variations produced by the entire cardiohemic mass, which predominate in the aortic pressure pulse waveforms, are generated and propagated in the same manner as the high-frequency pressure variations, which are the first and second heart sounds.

Adolescent↗
PubMed1990

[Peripheral arterial complications of various catheter angiography methods].

Between 1980 and 1988 12,251 arterial punctures for cardiac catheterization (CC), percutaneous transluminal angioplasty (PTA), or pure diagnostic intraarterial angiography (IAA) have been performed in our clinics. 54 (0.44%), 39 (0.63%, CC), 12 (0.67%, PTA), 3 (0.07%, IAA) patients suffered from a complication at the site of the arterial puncture necessitating surgical correction. Adults developed false aneurysms or large hematomas whereas children tended to show thrombotic arterial occlusions. Generally the surgical procedures of these complications proved to be quite simple (over two thirds) but some, especially in children, turned out to be more difficult. 3 arterial spasms in children and 1 prolonged wound healing in the groin, all without long-term sequelae and 1 severe graft infection necessitating ligation of the common femoral artery with severe ischemic signs for several months were the only complications of our corrective surgical procedures. We therefore plead for these iatrogenic complications of arterial puncture for an early correction performed by a surgeon with at least some experience in vascular surgery.

Adolescent↗
PubMed1989

[Education of heart surgery patients--did it reach the goal?].

To find out how well informed they were about their disease and operation, 104 patients who had undergone aortocoronary bypass surgery (group A) or heart valve replacement (group B) were asked to complete a questionnaire on discharge from the operating hospital and, after patient briefing during in-hospital rehabilitation, again 3 months after the operation. The level of anxiety and presence of depression were also assessed. We found the following percentages of wrongly or inadequately answered questions (the figures in brackets are from the second questionnaire 3 months after the operation): all questions 40 (27), anticoagulation 26 (15), prophylaxis of endocarditis 54 (29), risk factors 21 (21), nutrition 56 (38), exercise 47 (32), anatomy/physiology 35 (21), postoperative course 40 (24). The learning effect was significant (p less than 0.005) for all but the risk factor questions. There were no significant differences between men and women or between group A and group B. With a proportion of 14% (13%) anxiety was a common problem which had subsided by the end of rehabilitation. With percentiles of 3% (5%), depression was rare.

Anxiety↗
PubMed1986

Comparison of computed tomographic lung density with haemodynamic data of the pulmonary circulation.

Computed tomographic (CT) lung density measurements were prospectively correlated with pulmonary haemodynamic data in 33 patients with chronic heart disease. Cardiac catheterisation and five specific computed tomographic scans (three at nearly total lung capacity, one at functional residual capacity, and one at residual volume) were performed. There was a significant correlation between anterior lung density and mean pulmonary artery pressure (r = 0.86), pulmonary vascular resistance (r = 0.80), and pulmonary artery wedge pressure (r = 0.65). Lung density, as measured by CT, thus provides a valuable estimate of pulmonary arterial pressure and pulmonary vascular resistance, but is affected by other pathological conditions, such as emphysema and congestional or post-inflammatory fibrosis.

Adult↗
PubMed1984

[A new model for the quantitative analysis of left ventricular regional function].

A computer-assisted model for quantitative analysis of left ventricular segmental wall motion is presented. In contrast to standard rectangular and radial chord methods, no coordinate and reference system is used. Normal wall motion of 5 ventricular segments in the RAO projection was evaluated in 20 patients with normal ventriculograms. Segmental wall motion abnormalities after myocardial infarction were then analyzed by the computer-assisted method in 60 patients and the results compared with the visual assessment of an experienced cardiologist as standard reference. 96% of all segments with normal motion, 95% of all hypokinetic segments and 100% of all dyskinetic segments were correctly identified by computer analysis. Akinesia, however, was detected only in 25% of all cases and misinterpreted chiefly as hypokinesia. Further refinement of the software should improve detection of akinesia and classification of hypokinesia.

Adult↗
PubMed1984

[Treatment of stable angina pectoris: when to operate?].

The decision whether to treat the patient with stable angina medically or surgically is influenced by factors which determine the natural course of coronary artery disease: severity of coronary narrowing, presence or absence of collaterals, area of myocardium at risk, left ventricular function, presence of ventricular arrhythmias, risk factors. In the present study diagnostic criteria are discussed which may enable the physician to identify the coronary patient who is especially at risk for myocardial infarction or sudden death. Our knowledge of the natural course of ischemic heart disease and the medical and surgical possibilities has identified two groups of patients who profit from coronary bypass surgery: (1) patients with angina pectoris refractory to medical therapy, and (2) patients with left main disease or triple vessel disease, particularly if left ventricular function is also mildly to moderately affected. Patients with one- or two-vessel disease should undergo surgery only if proximal coronary narrowing jeopardizes a large myocardial area. The possibilities and limitations of percutaneous transluminal coronary angioplasty as an alternative to coronary bypass surgery are briefly discussed.

Angina Pectoris↗
PubMed1980

Apoproteins and lipids as discriminators of severity of coronary heart disease.

Serum apoprotein and lipid concentrations were measured in 63 patients undergoing coronary angiography. Thirty-eight patients had 50% or higher grade stenoses, 25 had chest pain, but no significant stenoses. Among the patients with higher grade stenoses 71% had hyperlipoproteinemias as opposed to 12% in patients without stenoses. As compared to suitable normal controls, patients with angiographically documented coronary heart disease showed significant changes in all lipid and apoprotein concentrations under study. However, differences between the two patients groups were also noted. Among these, apo A-I, A-II and B, total cholesterol and LDL cholesterol were statistically significant. These results indicate that apoprotein A and B levels, total cholesterol and LDL cholesterol are good discriminators of the severity of coronary heart disease, while HDL cholesterol is a more suitable parameter for epidemiological studies.

Adult↗