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G Sütsch

Publications and source records attributed to G Sütsch.

46 records · Page 3Linked to original sources
PubMed1991

Predictability of aortic dissection as a function of aortic diameter.

The role of aortic diameter on the occurrence of type A dissection was investigated in 73 patients with dilated ascending aorta at the time of pre-operative evaluation. Using transthoracic echocardiography for diagnosis and measurements, 54 patients were identified with type A dissection (group 1) and 19 without dissection (group 2). The true mean aortic diameters were identical (6.0 +/- 1.3 cm in group 1 and 6.4 +/- 1.4 cm in group 2; mean +/- SD; ns) as were the indexed aortic diameters (ratio of diameter/body surface area; 3.2 +/- 0.8 cm.m-2 and 3.4 +/- 0.7 cm.m-2, respectively; ns). However, the individual diameters showed a pronounced scatter in both groups (range from 3.6 +/- 11.0 cm). Of the 73 patients, 66 had surgery (47/54 with and 19/19 without dissection) and seven patients were treated medically. Emergency surgery was performed in 45/66 patients (all with acute type A dissection) and elective repair in 21/66 (19 without and two with chronic type A dissection). In-hospital mortality was 18% in the emergency group, 5% in the elective group and 57% in the medical group. It is concluded that patients with dilated ascending aorta have a substantial incidence of acute dissection. Their clinical course is unpredictable: acute dissection occurs in some, and in others the ascending aorta continues to enlarge without dissection. Because patients with dissection often arrive too late for elective repair and have to be operated on as emergencies with a higher operative risk, we recommend elective surgery before the diameter of the ascending aorta has reached 6 cm.

Aortic Dissection↗
PubMed1991

Left ventricular flow from apex to base during systole and isovolumic relaxation in a patient with hypertrophic cardiomyopathy and midventricular obstruction.

The occurrence of a left ventricular anterograde flow velocity (maximal: 3.9 m.s-1) is demonstrated in a 32-year-old patient with hypertrophic cardiomyopathy and midventricular obstruction, beginning at early systole and persisting throughout the isovolumic relaxation. Cardiac catheterization with simultaneous dual high fidelity pressure measurements in the apical and basal chambers confirmed the presence of the Doppler maximal instantaneous pressure gradient of 60 mmHg. Contrast left ventricular angiography excluded apical dyskinesia. In the two intracavity compartments, isovolumic relaxation time and the time constant of pressure decay (tau) were abnormal whereby tau was more delayed in the apical than in the basal portion. The presence of an apical high pressure zone during systole with impeded and delayed emptying through the midventricular obstacle and the late onset and prolongation of relaxation are thought to be the cause of the intraventricular flow from apex to base lasting from early systole throughout isovolumic relaxation.

Adult↗
PubMed1990

[Congenital heart defects and abnormalities newly detected with echocardiography in adolescents and adults].

In 12,576 consecutive Doppler-echocardiographic studies (DE) performed on 11,450 patients over 3 years (1987-1989), 183 newly diagnosed congenital heart abnormalities were detected in 161 patients. The age of the 161 patients (86 female, 75 male) ranged from 16 to 84 years (median 34.5). The highest incidences of pathologies were those of ASD II (29%) and VSD (11%). With decreasing frequency the following abnormalities were diagnosed: pulmonary valve disease (8%), interatrial septal aneurysms (7%), membranous subvalvular aortic stenosis (5%), anomalous pulmonary venous connections (4%), atrioventricular canal defects (4%), persistent left superior venae cavae (4%), patent ductus arteriosus (4%), aneurysms of the membranous septum (4%), and sinus venosus defects (3%). Less common findings were coarctation of the aorta (2.5%), persistent sinusoids (2.5%), arteriovenous fistulas (2.5%), congenital LV-aneurysms (2.5%), Ebstein's anomalies (1%), anomalies of the papillary muscles (1%) and RV-dysplasias (1%). Rare findings were a cor triatriatum, a tetralogy of Fallot, a partial defect of the pericardium, a pulmonic atresia with VSD, an isolated cleft of the tricuspid valve, and finally a connection of a hepatic vein to the right atrium. In conclusion, we found an incidence of 1.4% in newly diagnosed congenital heart disease in adolescents and adults undergoing DE. 32 of 159 patients (20%) were referred to surgery, while endocarditis prophylaxis was indicated in 45%.

Adolescent↗
PubMed1988

Uncertain role of endothelium-derived relaxing factor in mesenteric arterioles of cats and rabbits.

Experiments were undertaken in the mesentery of anesthetized cats and rabbits to investigate whether the endothelium of resistance vessels mediates relaxation of arteriolar smooth muscle through the endothelium-derived relaxing factor(s) (EDRF). The microcirculation was visualized by transillumination using intravital microscopy and a Millikan camera. Pictures were obtained at a rate of 400 frames/second. Arteriolar mean diameter and surface area were computer calculated. The animals were divided in two groups. In one group of experiments, EDRF was inactivated by direct injection of hydroquinone (HQ) into the superior mesenteric artery and the second group served as control. Norepinephrine or vasopressin constricted while acetylcholine or Ca-ionophore A23187 dilated arterioles. Hydroquinone failed to inhibit arteriolar dilation in situ. The effect of HQ on the endothelium in situ was ascertained by bioassay of superior mesenteric artery strips. Our results cast doubt on the role of EDRF in the dilation of mesenteric arterioles in felines and rabbits.

Acetylcholine↗
PubMed1987

Effect of a new phosphodiesterase type III inhibitor as a coronary vasodilator and positive inotropic agent.

Isolated rabbit coronary arteries, aortic strips, and a working rabbit heart preparation were used to assess the positive inotropic and vasodilator effects of a newly developed positive inotropic compound, CI 914. The substance had a relaxing effect on histamine preconstricted coronary arteries and aortic strips. At concentrations of 10(-4) mol.litre-1 the relaxing effect on the coronary arteries was significant only at a histamine concentration of 3 x 10(-4) mol.litre-1 (p less than 0.01) whereas at a concentration of 10(-3) mol.litre-1 the relaxing effect was significant at histamine concentrations of from 3 x 10(-5) mol.litre-1 to 3 x 10(-4) mol.litre-1. Aortic strips were more sensitive to the relaxing effect of CI 914, which was significant with 10(-4) mol.litre-1 at histamine concentrations of 3 x 10(-6) to 3 x 10(-4) (p less than 0.05 to p less than 0.01). In the isolated working heart preparation topically sprayed histamine significantly increased total and large coronary artery resistances (p less than 0.001 and p less than .01). This effect was significantly reduced (p less than 0.01 and p less than 0.02) when CI 914 10(-4) mol.litre-1 was present in the perfusion fluid. These findings show that the phosphodiesterase inhibitor CI 914, a positive inotropic agent, induces vasodilation in isolated coronary arteries and aortic strips of the rabbit and reduces the constriction of coronary arteries induced by histamine in the isolated working rabbit heart preparation.

Animals↗
PubMedDate not supplied

Endothelin in heart failure.

Congestive heart failure is a complex disease that results from pumping failure of the cardiac muscle and adaptational processes of the cardiovascular system to correct for the reduced blood supply to the organism. It is associated with increased vasoconstriction and impaired vasodilation in response to physical activity. The elevated vasoconstrictor tone is caused by the activation of compensatory mechanisms including the sympathetic nervous system and stimulation of the release of neurohormones like angiotensin II, catecholamines, and vasopressin. Furthermore, the vascular endothelium is importantly involved in the regulation of vascular tone as it releases a variety of vasoactive substances that act locally and systemically. In congestive heart failure, there is a marked imbalance between the diminished release or the increased inactivation of vasodilators on the one hand, ie, nitric oxide, and the elevated production, release, or reduced inactivation of vasoconstrictors such as endothelin-1 on the other hand. In addition to its very potent vasoconstrictor effects, endothelin-1 possesses antinatriuretic and mitogenic properties that are a common feature of substances that are involved in development of the deleterious consequences that render congestive heart failure a lethal disease. The spectrum of action of the endothelin system and the advent of specific antagonists for its receptors have made this system a very interesting target for clinical research and possibly for future therapeutic approaches.

Animals↗
PubMedDate not supplied

Coronary artery-right ventricular fistula in a heart transplant patient.

Routine coronary angiography 2 years after heart transplantation in a 48-year-old patient revealed a fistula from a septal branch of the left anterior descending artery to the right ventricle. This finding was not present at coronary angiography 1 year before. This coronary-ventricular fistula is most probably the result of repeated endomyocardial biopsies.

Angiography↗