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Biomedical subjects

F Sebening

Publications and source records attributed to F Sebening.

At least 73 records · Page 4Linked to original sources
PubMed1984

[Isolated aortic isthmus stenosis: operation indications and results].

The goal of surgical correction of isolated coarctation of the aorta is normalization of the blood pressure. To assess the optimal age for the intervention with respect to operative morbidity and mortality, residual stenosis and recoarctation rate as well as the postoperative persistence of arterial hypertension without recoarctation, the pre- and postoperative findings of 237 patients (age at surgery: range one week to 17 years) were analyzed. The blood pressure, which was above the 95th percentile of age-matched normal values preoperatively in 93%, showed a clear decrease postoperatively in all age groups. On surgical correction, however, performed as of six years of age, there was a continuously increasing rate of persistent arterial hypertension without recoarctation which ranged from about 10% in those undergoing surgery between the ages of six and eight years to 31% in patients operated at ages between 13 and 17 years. In consideration of the operative results only with respect to the response of the resting blood pressure, insight is enabled only into one aspect of the prognosis, since the latter is equally dependent on the postoperative systemic arterial resistance. The systemic arterial resistance is already slightly elevated at three to five years of age, significantly increased as of six years of age, and at surgery after the age of six, shows a further increasing tendency. Accordingly, patients with postoperative normal or borderline-elevated blood pressure and apparently adequate surgical results, may be at risk of subsequent development of hypertension due to persistence of increased resistance, in particular, if surgery is performed after the age of five years.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

[Early correction of the interrupted aortic arch].

Between 1974 and March 1983, 14 infants with interruption of the aortic arch (IAA), ventricular septal defect (VSD), and patent ductus arteriosus (PDA) have been operated at our institution. In the beginning of our experience only palliative operations were performed, consisting in reconstruction of the aortic arch, closure of PDA and pulmonary artery banding (PBA). According to this procedure five patients were operated. Three of them died, the two survivors underwent successful closure of the VSD subsequently. Since 1979 the primary total correction, with repair of the extra- and intracardial anomalies in deep hypothermia and circulatory arrest, is the operation of choice. A total of nine patients underwent primary correction, in this latter group we observed two deaths only.

Aorta, Thoracic↗
PubMed1983

Phrenic nerve pacing for the treatment of central hypoventilation syndrome - state of the art and case report.

The application of phrenic nerve pacing is an effective method of respiratory support in adults with certain forms of acquired failure of automatic ventilation. The experience with one infant suffering from congenital central hypoventilation (Ondine's syndrome) is summarized in this report. Stimulation electrodes were implanted on the thoracic portion of each phrenic nerve. After a cumbersome period of intensive medical care and conditioning of the phrenic nerve-diaphragm-system, the patient could be weaned off the respirator. Severe upper airway obstruction, however, required tracheostomy. Bilateral simultaneous pacing has been effective now for more than 2 years providing the desired normal ventilation during sleep. The state of the art of phrenic nerve pacing is described.

Diaphragm↗
PubMed1982

Fibrin seal application. Clinical experience.

Clinical experience with fibrin gluing in cardiovascular surgery now extends over 4 years. The adhesive has been employed prophylactically for preclotting of prostheses or sealing of various suture lines including those of the bronchial system of infants. Together with collagen fleece it has turned out to be most effective for control of superficial bleeding due to adhesions or sources of bleeding difficult to reach. Two clinical examples are presented demonstrating the life-saving application of the collagen patch and fibrin gluing method.

Adult↗
PubMed1982

[Heart transplantation: successful treatment of postoperative complications. Case report with 19 months' follow-up].

In March, 1981, a 37-year old patient underwent cardiac transplantation, the first to be performed in Germany since 1969. Subsequent to the successful procedure, the patient has now been followed for more than 19 months. The indication for the intervention was established on the basis of endstage coronary artery disease. The operation was performed according to the technique of Lower and Shumway. Immunosuppression, in the early postoperative phase, was carried out with antithymocyte globulin, azathioprine and corticosteroids with administration oriented on the T-lymphocyte and total leukocyte counts as well as analysis of myocardial biopsies. In the late postoperative course, dosage of immunosuppressive agents was based almost exclusively on biopsy findings. Within the course of immunosuppressive therapy for cardiac transplantation, in particular, initial experience was gained with the use of antithymocyte globulin which was given in dosages of up to 12 mg/kg daily. The antithymocyte globulin proved effective for more than six weeks postoperatively. The alterations in immunosuppressive treatment necessitated by two gastrointestinal complications (perforated gastric ulcer, perforation of the small intestine) enabled a comparative analysis of the results of therapy with cyclosporin A given orally, intravascularly and intravenously. The Patient continues to be maintained on a regimen of cyclosporin A and corticosteroids and his general condition is good. For future cardiac transplantations, in the early postoperative course, alternating treatment with antithymocyte globulin, azathioprine and corticosteroids, on the one hand, with cyclosporin A and corticosteroids, on the other hand, would seem meaningful both to minimize adverse reactions as well as to provide effective immunosuppression. The experience rendered would promise to facilitate management of patients after cardiac transplantation.

Adolescent↗
PubMed1981

Cardiac contractile and metabolic effects mediated via the myocardial H2-receptor adenylate cyclase system. Characterization of two new specific H2-receptor agonists, impromidine and dimaprit, in the guinea pig and human myocardium.

The present study chartacterizes myocardial effects of two new histaminergic H2-receptor specific compounds, impromidine, and dimaprit, on cardiac contractile and metabolic parameters of the guinea pig heart and human papillary muscle in comparison to the well-known effects of catecholamines. Impromidine and dimaprit produced a dose-dependent stimulation of the right and left ventricular contractile force in the isolated perfused biventricular catheterized guinea pig heart with maximal stimulation rates equal to those of isoproterenol. Hemodynamic equieffective doses of isoproterenol (2.8X10(-9) mol/l), histamine (1.1X10(-5) mol/l), impromidine (4.6X10(-7) mol/l, and dimaprit (8.5X10(-6) mol/l) induced nearly identical increases in tissue concentrations of c-AMP. All compounds dose-dependently enhanced the activity of the myocardial adenylate cyclase with very similar KA-values in a particulate sarcolemmal membrane preparation of both guinea pig ventricles and human papillary muscles. No effect of either compound was seen on cardiac phosphodiesterase activity. Selective administration of the beta1-blocking agent metoprolol and the H2-receptor antagonist cimetidine clearly discriminates two independent receptors linked to the sarcolemmal adenylate cyclase system in the guinea pig and human myocardium. This is further supported by results obtained from beta-receptor-binding studies in which an interference of impromidine and dimaprit with the stereospecific binding of (-)[3H]-dihydroalprenolol to cardiac beta-receptors could be definitely excluded. The possible therapeutic role of both H2-agonists on the non-ischemic, surviving myocardium, which is transiently refractory to beta-adrenergic stimulation by catecholamines after myocardial infarction, will be discussed.

Adenylyl Cyclases↗
PubMed1981

Results of valvuloplasty for Ebstein's anomaly.

Sixteen patients, 8 males and 8 females were referred for surgery with the diagnosis of Ebstein's malformation of the tricuspid valve. The intervention was necessary because of deterioration of the clinical status. The age of the patients at the time of surgery ranged from 4 to 51 years. In 11 patients valvuloplasty was performed, in 5 patients the tricuspid valve was replaced with a bioprosthesis. One patient, with end-stage disease prior to surgery, died 2 days postoperatively rendering total mortality at 6.25%. Subsequent follow-up ranging from 8 months to 8 years was uneventful in the 15 survivors. Only 2 patients showed evidence of dysrhythmias, and demonstrated cardiothoracic ratios greater than 0.65. Cardiac catheterization in 3 patients, at one or 5 months postoperatively revealed normal pressure in the right heart. Provided the anterior tricuspid leaflet is of adequate size, surgical repair of Ebstein's anomaly through valvuloplasty appears to be feasible. The valvuloplasty consists of forming a monocusp valve with the anterior leaflet and plicating the atrialized portion of the right ventricle.

Adolescent↗
PubMed1980

Surgical treatment of transposition of the great arteries.

Between 1974 and 1979 171 patients with d-TGA were treated surgically, 109 had correcting operations. 77 patients with simple TGA had hemodynamic correction by atrial inversion techniques. 30 day survival rate was 96%. There were 3 late deaths. One patient had reoperation for superior vena cava obstruction. The methods of diagnosis, indication of surgery and the surgical procedure are described. Results of the Mustard technique (33 patients) technique in infants less than 2 years of age with simple TGA. Mortality was one patient in each group. The incidence of arrhythmia was greater with the senning technique. Better growth potential of the atria with the Senning technique warrants further use of this method.

Adolescent↗
PubMed1980

Operative treatment of TGA: comparison of Senning's and Mustard's operation in patients under 2 years.

Sixty-one patients with simple TGA operated on below 2 years of age using atrial inversion techniques were reported. The results of 27 Senning versus 34 Mustard procedures were compared. Postoperative observation time averaged 32 months after the Mustard operation and 12 months after the Senning operation. Early mortality rate was 3% (one patient) in the Mustard group and 7.4% (two patients) after the Senning operation. Sinus rhythm persisted in 20 out of 27 Senning patients and in 30 out of 34 Mustard patients. No baffle obstruction has been registered. Operation results and patient follow-up so far do not favor one technique. The Senning operation rarely requires patch material. Therefore, growth of the atria may be less disturbed.

Cardiac Catheterization↗