Biomedical subjects
F Loogen
Publications and source records attributed to F Loogen.
[Echocardiographic observations in malfunctioning heart valves due to thrombosis (author's transl)].
The study includes two patients with obstruction of prosthetic heart valves by thrombosis. In the first patient, a thrombus attached to the ventricular side of the cage of a Smeloff-Cutter mitral prosthesis caused incomplete excursion of the ball in most cardiac cycles, which was detected by echocardiography. In the second patient a thrombosis of the atrial and ventricular side of a Lillehei-Kaster mitral prosthesis delayed opening of the disc. The initial part of the opening movement was "rounded", the excursion of the disk diminished. The cases presented indicate that in patients whose condition deteriorates after prosthetic valve replacement, echocardiography can help identify the cause. In particular, the technique makes it possible to differentiate between valvular dysfunction and muscular insufficiency of the left ventricle. Comparison with recordings obtained in the early postoperative period facilitate the detection of a malfunctioning prosthesis.
[The prognostic value of the H-V interval in patients with intraventricular conduction defects (author's transl)].
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[Sensitivity and accuracy of thallium-201 myocardial scintigraphy in the detection of coronary artery and myocardial disease (author's transl)].
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[The applicability of systolic time intervals in patients before and after aortic valve replacement (author's transl)].
In order to evaluate the systolic time intervals (STI) for characterizing the left ventricular pump function and the clinical course in patients with aortic valve disease, 35 patients with aortic stenosis (AS) and 25 patients with aortic insufficiency (AI class III or IV (NYHA) were studied before and 1 year after valve replacement either with Björk-Shiley, Lillehie-Kaster or Starr-Edwards aortic prostheses. Left ventricular ejection time index (LVETI), preejection period index (PEPI) and PEP/LVET were determined and compared with cardiac index (CI), stroke volume index (SVI) and ejection fraction (EF). Prosthetic valve replacement leads to a high significant decrease of LVETI from preop. 468 +/- 31 ms to postop. 394 +/- 26 ms (mean normal values 415 ms) and an increase of PEPI from 100 +/- 26 ms to 136 +/- 25 ms (normal 132 ms) as of PEP/LVET from 0.21 +/- 0.09 to 0.41 +/- 0.12 (normal 0.31). Pre- as well as postop. there is no difference in STI between AS and AI. Also the groups with the three prosthetic valve types do not differ significantly. LVETI and PEPI correlate only postop. with CI and SVI, but PEP/LVET correlates well with EF (r = -0.73) before and after operation. The comparison of STI with the hemodynamic data suggest that preop. values of STI near normal and postop. LVETI below, PEPI and PEP/LVET above the mean values of the whole group with aortic valve replacement indicate left ventricular pump dysfunction. The STI are helpful in the pre-/postop. follow-op of patients with severe aortic valve disease to characterize the clinical and hemodynamic course.
[Echocardiographic determination of the severity of mitral stenosis by the mitral valve closure index (author's transl)].
In 34 patients with mitral stenosis or combined mitral valve disease class II, III or IV (NYHA), the mitral valve closure index (MVCI, Shiu et al. 1977), based on the rate of diastolic apposition of the anterior and posterior mitral leaflet echos, and the diastolic closure rate (EF-slope) were determined and compared with hemodynamic data such as mean left atrial pressure (PLA), mean diastolic pressure gradient across the stenotic valve (DP) and mitral valve orifice area (Q), calculated by the Gorlin formula. MVCI and EF-slope correlated more favorably with DP (MVCIr = -0.71, EF-sloper = -0.53) than with Q and PLA. The results were not different in patients with sinus rhythm or atrial fibrillation. Using MVCI or EF-slope thie discrimination between severe and moderate or between moderate and light mitral stenosis was uncertain. Nevertheless, MVCI below 30 was associated with light, above 50 with severe mitral stenosis. In spite of the relationship between MVCI or EF-slope and the severity of mitral stenosis, in the individual case an exact quantification of mitral stenosis is not possible due to the great variability of echocardiographic data. For the assessment of the severity of mitral stenosis the mitral valve closure index is not superior to the EF-slope.
[Potentialities and limitations of echocardiography (author's transl)].
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[Control of antiarrhythmic drug efficacy in patients with chronic recurrent ventricular tachycardia by electrical stimulation (author's transl)].
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[Clinical, hemodynamic and angiographic results after coronary bypass surgery (author's transl)].
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[Initiation and termination of ventricular tachycardia by electrical stimulation (author's transl)].
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[After care following heart-valve replacement surgery].
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[Therapeutic possibilities and prognosis in idiopathic cardiomyopathies].
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[Rehabilitation and after care in heart diseases].
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[Long-term results following valve-conserving surgery].
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[Long-term results following heart-valve-replacement surgery].
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[Results of endarterectomy in coronary artery surgery (author's transl)].
In a series of 432 aortocoronary bypass procedures endarterectomies were performed in 58 patients (13.4%) on 60 coronary arteries. Except of two vein patch grafts all endarterectomized arteries were bypassed with a saphenous vein graft. The majority of the patients had an endarterectomy of the right coronary artery. Clinical control investigations were performed in 43 out of 47 survivors including 30 with coronary angiograms 5.2 months (mean) after surgery. 26 out of 31 endarterectomized arteries (83.9%) were open angiographically whereas the patency rate to non-endarterectomized arteries of the same patients was 86.4%. The hospital mortality was high; 11 out of 58 patients (19%) deceased. All patients who died postoperatively had a three vessel disease with diffuse coronary sclerosis. Only three had no myodardial infarction prior to surgery, seven had one to four infarctions before surgery. The relatively high mortality intends for the future a more strict revision of the indications for coronary surgical procedures. But not in all cases the preoperative coronary angiograms and ventriculograms allow a clear estimation of the local arterial conditions.
Prognosis and possible presymptomatic manifestations of congestive cardiomyopathy (COCM).
In order to find evidence of prognosis and of presymptomatic manifestation of congestive cardiomyopathy (COCM) in fifty-eight patients, the extent of morphological changes of endomyocardial catheter biopsy (EMCB), clinical and haemodynamic data were correlated to the clinical course. In addition, clinical, haemodynamic, angiographic, morphological and His-bundle electrographic studies were performed in patients with left bundle branch block (LBBB), normal left ventricular end-diastolic volume, and normal coronary arteries (n = 43). Related to a 10-year mortality rate of 70% from the onset of symptoms, COCM is one of the most severe heart diseases. Endomyocardial catheter biopsy (EMCB) allowed clear prognostic separation in patients with COCM and seems to be of diagnostic value in patients with only slightly enlarged hearts and in patients with a short history of symptoms. The studies also revealed much evidence that at least some patients with LBBB, normal left ventricular end-diastolic volume (LVEDV) and normal coronary arteries exhibit an early stage of COCM. In these patients especially EMCB with severe changes of heart muscle cells and/or impaired left ventricular function may indicate subsequent COCM. So that there is now a new indication for performing EMCB.
[Studies on the cardiac effect of glucagon in patients with chronic failure of left ventricle (author's transl)].
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