PubMed Health⌕ Search

Biomedical subjects

E J Jahnke

Publications and source records attributed to E J Jahnke.

At least 19 recordsLinked to original sources
PubMed1989

Percutaneous (nonsurgical) supported angioplasty in unprotected left main disease and severe left ventricular dysfunction.

A 69-year-old patient with the equivalent of severe, unprotected left main coronary artery disease associated with marked left ventricular dysfunction with ventricular aneurysm who had Class IV angina, underwent supported angioplasty utilizing a total percutaneous approach. The patient tolerated occlusion of his main left coronary artery for a total of 7 minutes without difficulty, during dilatation of left anterior descending and two circumflex lesions. He was discharged the following day, symptom free.

Aged↗
PubMed1981

Left ventricular pseudoaneurysm secondary to infection after coronary bypass surgery.

We present a case of left ventricular pseudoaneurysm following coronary bypass surgery. The cause was infection, dating from the bypass procedure 1 1/2 years before. Repair of pseudoaneurysm in a patient with a bypass is complicated by the presence of grafts which should be protected from injury. Details of successful management in this case are presented.

Coronary Artery Bypass↗
PubMed1980

Spontaneous closure of residual ventricular septal defect following surgical repair of ventricular septal defect complicating acute myocardial infarction.

Spontaneous closure of ventricular septal defects in patients with congenital heart disease is well documented. Also, successful closure of ventricular septal defects complicating myocardial infarction performed in the acute phase have been reported, although the mortality rate is high. Intra-aortic balloon pumping has been helpful in this regard, as it was in our patient. Our case is of interest in that it demonstrates the possibility of spontaneous closure of a residual ventricular septal defect resulting from rupture of the interventricular septum, secondary to acute myocardial infarction, partially closed at surgery. Clearly, the residual defect was small in that the patient was substantially benefitted by surgery and the postoperative catheterization revealed a small 5% step-up in oxygen saturation at the right ventricular level.

Heart Septal Defects, Ventricular↗
PubMed1980

Myocardial revascularization in patients with chronic renal failure.

Symptomatic coronary artery disease in patients with chronic renal failure can complicate their management in a dialysis program. Hypotension associated with hemodialysis and the anemia of chronic renal disease can produce anginal episodes refractory to medical management. Untreated coronary artery disease may be a contraindication to renal transplantation in an otherwise acceptable candidate. We have encountered three cases of coronary artery disease severe enough to necessitate coronary bypass in patients from our long-term hemodialysis program. All three patients had uncomplicated postoperative courses, none had perioperative infarction, and in all three patients postoperative angiography demonstrated patency of all grafts. One patient subsequently underwent successful renal transplantation; the other two patients have continued in hemodialyses since bypass. We believe our experience and the reported experience of others confirm the feasibility of coronary bypass grafting in patients with chronic renal failure.

Adult↗
PubMed1976

Bypass of the right and circumflex coronary arteries with the internal mammary artery.

Our experience with the internal mammary artery (IMA) for coronary bypass grafting in the past 3 years includes 323 grafts in 253 patients. After an initial group of IMA to left anterior descending (LAD) coronary artery grafts, we began using the IMA to bypass circumflex and small right coronary arteries (RCA). This report describes our experience with IMA bypass of coronary vessels other than the LAD. A total of 96 patients have had an IMA graft to the circumflex or RCA. Most of these patients had two or more bypasses. The mortality rate for this group has been 7 per cent, 7 of 96 patients. Postoperative angiography in 82 of 89 survivors has shown a patency rate of 98 per cent in 83 of 85 grafts studied. We conclude that the IMA is the vessel of choice for coronary artery bypass and that it can be used to bypass any of the main coronary arteries.

Adult↗
PubMed1975

The rechargeable cardiac pacemaker. A clinical evaluation in 25 patients.

After five years of laboratory development and in vivo testing, a rechargeable cardiac pacemaker with R-wave inhibited demand circuitry was introduced into clinical use in February 1973. We have used the rechargeable pacemaker in 25 patients in the past 1 1/2 years. The series includes 14 women and 11 men, with an age range of 38 to 80 years. Eleven of the patients had the rechargeable system implanted as a replacement for a failing or a failed conventional pacemaker. These 11 patients accounted for 26 previous pacemakers. The rechargeable pacemaker is smaller than conventional pacemakers, and it promises to obviate the need for periodic pulse generator replacement. Our initial experience with the rechargeable pacemaker has been favorable, and patient acceptance has been good.

Adult↗
PubMed1975

Objective elaluation of bypass surgery in patients with acute coronary artery disease.

80 patients with acute coronary artery disease, including 70 patients with PIA, 8 patients with acute myocardial infarction, and 2 patients with cardiogenic shock, underwent bypass surgery. The surgical mortality rate was 1.4% in patients with PIA and during an average follow-up period of 15 months none of the patients died of cardiac disease. Ventricular function, as indicated by systolic ejection fraction and segmental wall motion, was noted to improve in many patients. Postoperative studies showed the internal mammary artery to be superior to the saphenous vein graft for left coronary bypass procedures. This was demonstrated by 100% patency of internal mammary artery grafts to the left anterior descending coronary artery. We believe that when a patient presents with one of the syndromes of acute coronary artery disease such as unstable angina, severe chest pain suggestive of infarction without infarction, status anginosis, recurrent ventricular tachycardia or acute myocardial infarction complicated by evidence of potential extension, cardiogenic shock, heart block or rupture, these patients deserve at least coronary and left ventricular cineangiographic studies with hemodynamic evaluation. Our experience to date suggests that myocardial revascularization and catheterization carry a lesser risk than that of medical treatment.

Acute Disease↗