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Biomedical subjects

D Dacar

Publications and source records attributed to D Dacar.

50 records · Page 3Linked to original sources
PubMed1985

[Open heart surgery in Jehovah's Witnesses].

Patients who are Jehovah's Witnesses present a special problem when undergoing open heart surgery since they refuse blood transfusion. We performed 15 open heart operations for both acquired and congenital heart disease using a modified version of isovolaemic haemodilution and bloodless prime technique of extracorporeal circulation. Two patients died. One death might have been at least indirectly related to the regimen which excludes blood substitution. We believe that our experience demonstrates the feasibility of open heart procedures in Jehovah's Witnesses, although the mortality risk is increased in these patients.

Adolescent↗
PubMed1984

[Myocardial changes in acute pulmonary artery embolism--an experimental study].

Massive pulmonary embolism usually causes acute right ventricular hypertension. Structural and hemodynamic effects of right ventricular overloading were studied in piglets (weight 17-22,5 kg). Pulmonary arterial obstruction (PAO) was achieved by temporary banding of the main pulmonary artery, the external diameter of the vessel being reduced to one-third (Group I) or by half (Group II) of the original size. In Group I PAO caused a twofold increase of systolic right ventricular pressure (RVP), whereas the systolic left ventricular pressure decreased to 30% of its original value; PAO was terminated after 25 seconds. After PAO, no changes of right or left ventricular function were observed in Group I. Electron microscopy revealed mitochondrial alterations and fragmentations of the sarcomeres. In Group II, PAO was maintained for 60 minutes. Due to PAO, the systolic RVP increased to twice the original value and the systolic aortic pressure decreased by 10%. During the PAO period, a continuous increase of enddiastolic RVP was observed in Group II. After termination of PAO, contractility parameters for the right ventricle were reduced, and right ventricular diameters (RVD) and enddiastolic RVP were increased in comparison to the pre-PAO values. As hemodynamic alterations increased corresponding to the duration of PAO, it is concluded that in case of acute pulmonary embolism early relief of right ventricular overloading may be important.

Acute Disease↗
PubMed1983

[Aortic valve replacement in cardioplegic heart arrest].

The St. Thomas cardioplegic solution was introduced in our clinic in January, 1980. Before, aortic valve replacements were carried out using cold ischaemic cardiac arrest as myocardial preservation technique. In 62 aortic valve replacements performed since January 1980, there was no hospital mortality. Moreover, there were fewer intraoperative and postoperative complications. Intraoperative serum potassium was not essentially elevated after cardioplegic perfusion of the heart, although most of the cardioplegic effluate passed into the extracorporeal circulation. Postoperative serum-creatinphosphokinase levels were significantly higher after cold ischaemic arrest than after cardioplegia.

Aortic Valve↗
PubMed1982

[Infrared contact coagulation for hemostasis in liver and spleen].

With infrared contact coagulation (ICC) hemostasis of hepatic and splenic tissue is achieved by coagulation and mechanic compression of the bleeding surface. Thus, an eventual loss of energy due to a thick layer of blood can be avoided. After coagulation, the anti-adhesive effect of the cap of the ICC device prevents fresh bleeding. After experimental incisions on liver and spleen of various animal species hemostasis could be achieved quickly by application of ICC. Postoperative observation and histologic investigations were carried out until the 80th postoperative day. Hemostasis was observed in all cases, there were no signs of recidivant bleeding at relaparotomy. A slow absorption f necrotic tissue was observed. This could be a disadvantage regarding long term wound healing.

Animals↗
PubMed1982

[Role of the pericardium in acute volume overload].

The function of the pericardium in acute volume overloading may be defined as protection against ventriculo-atrial regurgitation at high filling pressures, limiting transmural pressures and, therefore, protecting against ventricular distension as well as supporting the filling of the ventricles by suction in the systolic contraction. Thus, it may be important to close the open pericardium carefully after open heart surgery. Pericardial drainage should prevent cardiac tamponade.

Animals↗
PubMed1982

[Hemostasis in the liver induced with tissue glue - comparison of 2 glue-component combinations].

After experimental hepatic resection in rabbits and piglets, haemostasis was achieved by using two types of tissue glue - fibrin glue and gelatin-resorcin-formaldehyde glue (GRF-glue). With both glues, an elastic adhesive film could be produced. Fibrin glue was completely absorbed by granulation tissue at the 11th postoperative day. After using GRF-glue a toxic necrosis and a subsequent demarcation of necrotic tissue could be observed, with the adhesive substance being not absorbed after 11 days. When used together with a collagen fleece, fibrin glue was not spilled away by tissue haemorrhage. Therefore it seems to be especially suited for haemostasis on the liver. With both glues, no leakage was observed after raising the portal vein pressure to 300 mm Hg during in vitro experiments.

Animals↗
PubMed1981

[Centrifugal blood pump (animal experiments) (author's transl)].

A new centrifugal blood pump (Medtronic 1861), suitable as an extracorporeal left ventricular assisting device was tested in vitro with respect to its efficiency and haemolysis. Cannulation was carried out by applying the Zwart technique. Additionally, comparative investigations into haemolysis were performed by using the centrifugal pump and an occlusive roller pump at equal output levels. Moreover, the haemodynamic efficiency of the centrifugal pump in combination with the Zwart cannulation technique was tested in landrace pigs. When the described centrifugal pump and tube system were used, a sufficient pump output and a low rate of early haemolysis could be observed. By applying the centrifugal pump together with the Zwart cannulation technique and conical tubes specially shaped, a complete relief of the left ventricle could be attained experimentally.

Assisted Circulation↗
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↗
PubMedDate not supplied

[Successful treatment of therapy refractory shock lung in a newborn infant with congenital varicella using extracorporeal membrane oxygenation].

A newborn with congenital varicella complicated by varicella pneumonia was transferred to our hospital on day 16 of life for the consideration of extracorporeal membrane oxygenation (ECMO). The newborn received varicella zoster immunoglobulin 13 hours after birth since the mother developed a varicella exanthema two days before delivery. On day 10 of life the newborn became clinically symptomatic with red macules and pustules. The chest roentgenogram revealed reticular pulmonary infiltrates in the right upper lobe. Antibacterial chemotherapy was initiated. In the following days the cutaneous lesions progressed, and respiratory symptoms like tachypnoea and oxygen dependence occurred. Chest roentgenograms revealed diffuse reticular and patchy pulmonary infiltrates. On day 14 of life antiviral chemotherapy with acyclovir was started. ECMO was initiated in the veno-arterial mode on day 17 due to severe respiratory failure despite maximal conventional assisted ventilation and carried out for 14 days. With the age of 10 weeks he was discharged from the hospital with mild chronic lung disease without oxygen requirements and without neurological handicap. ECMO might be considered as life saving support in newborns with severe congenital varicella, considered to have a high mortality risk.

Acyclovir↗