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H Fischbach

Publications and source records attributed to H Fischbach.

61 records · Page 4Linked to original sources
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The correlation between blood pressure and morphometric findings in children with congenital heart disease and pulmonary hypertension.

The lungs of 68 children with malformations of the heart or the great vessels which could cause pulmonary hypertension were obtained at autopsy. We analysed the media of muscular pulmonary arteries morphometrically and calculated the area ratio (area media/total area of the vessel). As hemodynamic parameter we used the systolic blood pressure ratio (pulmonary/systemic). Additionally we employed the mean pressure of the pulmonary artery in 38 cases. We analysed the correlation between hemodynamic and morphometric parameters and obtained a product moment correlation of 0.7. There was a linear correlation between the area and pressure ratios. Younger children showed a higher relative thickness of the media than older children with comparable pressure ratios. After dividing the children into three age groups, we obtained an even higher correlation (r = 0.90 in the oldest group). We found these correlations not only in cases with left-to-right shunt but also in children with other heart defects. There was also a good correlation between the quantitatively measured data and the qualitative Heath and Edwards classification.

Adolescent↗
PubMedDate not supplied

[Hemodynamics and histology of the lung in 175 ventricular septal defects].

Lung biopsies obtained during operation from 175 patients with isolated or combined ventricular septal defect were examined histologically. The degree of the pulmonary hypertensive vasculopathy was classified according to the Heath and Edwards-grading. These morphological findings were compared to the hemodynamic data (pulmonary/systemic ratios of systolic pressure, resistance, and flow as well as mean pulmonary artery pressure). Pressure and resistance showed a good correlation to the histological changes. The combination of both variables, however, did not further improve the prediction of the severity of the vascular lesions. No relation was found between flow and pulmonary vasculopathy. Higher grades of the vasculopathy were associated with systolic pressure ratios exceeding at least 0.65, in most patients with even marked higher ratios. On the other hand an elevation of pulmonary blood pressure of pulmonary arterial resistance does not mean a more severe vasculopathy implicitly, since there were some patients with a considerable hemodynamic hypertension without at least severe histological changes. We conclude that patients with a systolic pulmonary pressure not exceeding about 75% of systemic pressure have a very low risk of a morphologically fixed hypertension. Therefore an urgent operation of such patients to prevent fixation of the pulmonary hypertension seems not to be necessary.

Adolescent↗
PubMedDate not supplied

[Hemodynamics and histology of lung blood vessels in 191 patients with atrioventricular canal].

The correlation between hemodynamic and histological changes of the small lung arteries was examined in 191 patients with atrio-ventricular canal. Lung biopsies were taken during palliative or corrective surgery. The histological findings were classified according to the Heath and Edwards-grading. The haemodynamic data were obtained within 3-4 months before operation (pulmonary/systemic ratios of systolic pressure, flow, and resistance as well as mean pulmonary artery pressure). The results indicated that the term atrioventricular canal must be divided into three different subgroups with regard of the development of HPVD: I. The incomplete atrio-ventricular canal (IAVC) showed a strong correlation between pulmonary hypertension and histological changes. II. The VSD-III (endocushion defect) developes HPVD in the first month of life similar to the complete av-canal. In about all children of this subgroup a serve pulmonary hypertension was found, therefore a correlation to the variety of histological findings could not be established. III. The CAVC was the largest subgroup of our patients. These patients had relatively the highest incidence of high-grade histological alterations. In 87% of the children with CACV we found histologically changes of the structure of the small arteries of the lungs mostly a hypertrophy of the media, but also alterations of the intima as proliferation of fibrosis. 88% of the children within the subgroup CAVC also hat a pulmonary hypertension with a systolic pressure ratio above 0.8.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Echocardiographic diagnosis and successful resection of a left ventricular rhabdomyoma in the neonatal period].

Among the rare heart tumours in childhood rhabdomyomas are mostly found in the neonatal period. They cause in 50% left- or right-sided obstruction. By means of 2D-echocardiography extent and relation to neighbouring structures can clearly be disclosed. Because of the severe natural history - mortality in the first year of life between 60 and 78% - successful operation was performed in a 2,5 kg weighing neonate.

Echocardiography↗