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Biomedical subjects

D Redel

Publications and source records attributed to D Redel.

At least 19 recordsLinked to original sources
PubMed2001

Surgical management of complications caused by transcatheter ASD closure.

BACKGROUND: Transcatheter occlusion of uncomplicated atrial septum defects (ASD) is recognized as an effective and minimally invasive method. Sometimes, serious early and late complications require surgical intervention. We therefore investigated reasons and outcomes of the secondary surgical approach. METHODS: 5 patients (aged 5-73 yrs) were admitted to our institution for device explantation and surgical ASD closure. ASDOS devices (A devices) had to be explanted in 4 patients and a SIDERIS "buttoned" occluder (S device) had to be explanted in 1 patient. The period from transcatheter implantation to surgical explantation ranged from 1 hour to 3 years. RESULTS: 3 patients (60 %) had to be operated in an emergency setting. In our youngest patient (5 yrs), the A device separated and embolized into the aorta and pulmonary artery. A pregnant women who needed emergent cesarean section developed hemopericard and tamponade due to atrial perforation by a fractured leg of an A device. In another A device, a suspect endocarditis caused membrane perforation. Malpositioning of an S device was the reason for operation. All patients recovered well without neurological symptoms. CONCLUSIONS: Transcatheter closure of uncomplicated ASD is a feasible alternative but surgical stand-by is essential. Nevertheless more complicated ASD should be operated, especially since the cosmetically satisfactory techniques of minimal invasive heart surgery are available.

Adult↗
PubMed1996

Total UK multi-centre experience with a novel arterial occlusion device (Duct Occlud pfm).

OBJECTIVE: To report the total UK multicentre experience of a novel arterial occlusion device (Duct Occlud pfm). DESIGN: Descriptive study of selected non-randomised paediatric patients with a variety of aortopulmonary connections. SETTING: Five UK tertiary referral centres for congenital heart disease. PATIENTS AND METHODS: Between March 1994 and February 1995, 57 children aged 2 weeks to 14 years (median 50 months) underwent attempted closure of their aortopulmonary connection. Fifty one had persistent arterial ducts and 9 of them had had a Rashkind umbrella device implanted. Five patients had superfluous modified Blalock-Taussig shunts (mBTS). In one there was also a native major aortopulmonary collateral artery (MAPCA). Another patient had a native major aortopulmonary connection (APC). Transcatheter occlusion was attempted in all cases through a 4 F delivery catheter. RESULTS: Devices were successfully deployed in 49/57 (86%) patients. Seven of 51 cases with persistent arterial ducts were judged too large for the device and a Rashkind umbrella was used. 40 (91%) of the 44 in whom the detachable coil device was used had complete occlusion at 24 hours on colour flow Doppler echocardiography. Devices were successfully deployed in all 6 remaining patients (4 mBTS, 1 mBTS + MAPCA, and 1 APC). Embolisation of a device occurred on 4 occasions. Two devices were not retrieved but caused no apparent clinical problems. CONCLUSION: This novel detachable coil type occlusion system compares favourably with other methods of transcatheter occlusion of native, residual, or surgically created aortopulmonary shunts. The delivery system allows its use in small children.

Adolescent↗
PubMed1984

[Cortical hyperostoses after long-term prostaglandin E2 therapy].

Cortical hyperostoses are found to be side effects after therapy in early infancy with prostaglandin E1 and E2. Correlation seems to exist between dosage and duration of therapy. Radiologically the lesions cannot be differentiated from Caffey's disease. Pathogenetic relationship of the two diseases is discussed; 62 cases of newborn children with ductal related vitium cordis, who were treated for a short time or for longer with prostaglandin E2 are demonstrated.

Dinoprostone↗
PubMed1981

[Non-invasive determination of oxygen saturation with the oxygenmet pulse wave oximeter. Comparison with the invasive reflectometric method (author's transl)].

Oxygen saturation was determined non-invasively with the oxygenmet pulse wave oximeter 1471 and at the same time with the invasive reflectometric method. The determinations were carried out on 49 children (males = 24, females = 25) during 52 catherizations of the heart. Among these children aged between one week and 15 years were 11 children suffering from cyanotic heart disease. Depending on age and health condition 1-8 blood samples from different arterial regions were analysed reflectometrically. The comparison between the oxygen saturations determined non-invasively with the oxygenmet oximeter and the oxygen saturations obtained invasively with the aid of the reflectometric method, showed a very close correlation (r = 0.923), however the differences were statistically significant. The comparison of the calculated regression line with the ideal regression line revealed that the values of the two methods differed considerably, especially in the range of low oxygen saturations. The causes for these differences, especially the absorption effect of the skin and the subcutaneous tissue of cyanotic patients, were discussed.

Absorption↗
PubMed1980

[Diagnosis and treatment of pericardial effusions with the aid of 2-dimensional Doppler echo cardiography (author's transl)].

In a case of a large acute pericardial effusion the diagnosis and the following pericardiocentesis under visible control by means of 2-dimensional echocardiography (2 D-E) are described. The effusion coat around the heart can clearly be localised. Furthermore, a new echocardiographic system is used combining 2 D-E and range-gated pulsed Doppler technique that allows the registration of flow-velocity curves in the superior vena cava and the recognition of a beginning cardiac tamponade. If indicated, the following pericardiocentesis can be done under direct ultrasonic control avoiding any risk of heart perforation.

Adolescent↗
PubMed1980

[Congenital diverticulum of the right ventricle--Case report and review of the literature (author's transl)].

Diverticula of the right ventricle are extremely rare malformations of the heart. Nearly always they are congenital in origin and represent distinct anomalies from diverticula of the left ventricle both embryologically and clinically. Symptoms are caused by associated heart disease. Complications may arise from endocarditis, heart insufficiency or from rupture of the diverticulum which event almost always leads to death. Therapy consists in surgical removal of the diverticulum if the indication is given, at any rate in antibiotic prophylaxis for infective endocarditis. The prognosis of this malformation depends largely on the coexisting heart disease.

Anti-Bacterial Agents↗
PubMed1979

[Study of the glucose concentration in five vascular regions -- aorta, arteria pulmonalis, vena cava inferior, vena cava superior, vena hepatica -- in childhood (author's transl)].

Using the Beckman glucose analyzer, glucose concentration was determined in the serum of the fasting blood in five vascular regions -- aorta, arteria pulmonalis, vena cava inferior, vena cava superior, vena hepatica -- of 52 children (ages 2,5 months up to 14 years and 3 months, x = 6 years and 3 months, male = 28, female = 24) with a healthy metabolism. The comparison of the average values of the glucose concentrations determined in five vascular regions in childhood showed that the glucose concentration in the vena hepatica was statistically significant higher than in the other vascular regions. Moreover the comparison of the glucose concentrations revealed that the values in the vena cava inferior were statistically significant higher as compared to the values in the vena cava superior. The glucose concentrations in the arteria pulmonalis, the vena cava superior and the aorta were nearly equal. Compared with the older children, the younger children had in all the investigated vascular regions lower glucose concentrations.

Adolescent↗
PubMed1976

Regional distribution of vascular resistance in two models of experimental renovascular hypertension.

The regional distribution of the peripheral vascular resistance was studied in normotensive and hypertensive Wistar rats. Two models of experimental hypertension were investigated: (I) in 32 animals the right renal artery was constricted by a silver clip (two-kidney Goldblatt hypertension); (II) in 46 animals the left kidney was removed and the right renal artery was clipped as in the first group (one-kidney Goldblatt hypertension). The normotensive control group comprised 61 untreated animals of the same strain and age. The distribution of cardiac output to 14 tissues was determined by means of the particle distribution technique. The resistance was increased in all regions investigated, a decreased or unchanged resistance was not observed. For most of the investigated tissues the regional resistance was increased exactly in proportion to the total peripheral resistance (TPR). Exceptions to this were found in 2 regions where the change of local resistance deviated from that of TPR: the splanchnic area and the skeletal muscle. In both cases the 2 models differed from each other. In the two-kidney model the increase of resistance in the splanchnic circulation was more intense than in other organs. In contrast, in the one-kidney model the local change of resistance was less than that of TPR. The change of skeletal muscle resistance was not significantly different from the change of TPR in the two-kidney model, while in the one-kidney model the increase of local resistance was significantly higher than that of TPR. It is concluded that the etiology of the abnormal resistance is different in the 2 models investigated and that known extrinsinc pressor factors may play a role in the two-kidney, but not in the one-kidney Goldblatt hypertension.

Abdomen↗