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H Scharfetter

Publications and source records attributed to H Scharfetter.

At least 37 records · Page 2Linked to original sources

Functional cardiac assessment before and after left ventricular anterior aneurysm repair, especially as related to work capacity.

Clinical, angiographic and hemodynamic parameters were assessed preoperatively and 12-20 weeks (mean +/- SD: 14 +/- 2) after left ventricular anterior aneurysmectomy in 31 consecutive patients. In 18 patients, associated coronary artery bypass surgery was necessary (1.4 grafts/patient). One patient with mitral valve insufficiency postoperatively required mitral valve replacement. No other complications and no deaths arose. The working capacity of the patients, as measured by bicycle exercise testing, compared a stage of exercise that the patient reached to the expected level of exercise for a normal person of the same sex, age and body surface. Expressed as percent of normals it increased from 39.3 +/- 28.9% (mean +/- SD) to 60.8 +/- 15.5% (p less than 0.001), angina-pectoris-free working capacity increased from 52.6 +/- 41.4 to 89.2 +/- 33.2 W (p less than 0.001). Left ventricular end-diastolic volume was determined by simultaneous biplane angiography and decreased from 277.1 +/- 84.7 to 191.0 +/- 49.1 ml (p less than 0.001). Ejection fraction increased from 35.4 +/- 12.4 to 41.0 +/- 9.6% (p less than 0.05). Left ventricular end-diastolic pressure after angiography decreased from 24.6 +/- 9.2 to 21.1 +/- 11.3 mm Hg (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Late complications following Björk-Shiley and Carpentier-Edwards heart valve replacements].

Valve related and valve induced, fatal or non fatal complications after Björk-Shiley valve replacement (n = 50) are compared with complications following Carpentier-Edwards valve replacement (n = 113). These patients had been operated upon between 1976 and 1982 and were followed up until 1985. Estimated actuarial cumulative survival following Carpentier-Edwards valve replacement (53 +/- 12% after a 100-month period) did not differ significantly from the estimate following Björk-Shiley valve replacement (80 +/- 6% after a 100-month-period), and subgroups of the cohort did not differ in survival after Carpentier-Edwards or Björk-Shiley valve replacement either. However, the estimate of actuarial cumulative event-free survival following Carpentier-Edwards valve replacement in patients under 40 years of age (46 +/- 14% after a 92-month period) was significantly worse (p less than 0.05) than with Björk-Shiley valves (100 +/- 0% after a 92-month period), (n = 30). The leading cause of clinical complications following Carpentier-Edwards valve replacement was a demonstrable degeneration of the bioprosthesis in 12 cases. The diagnosis of degeneration was established a mean of 73 months postoperatively (range 42-101 months).

Adult↗

[Surgical therapy of coronary disease: aortocoronary bypass. Risks and complications].

The aorto-coronary bypass surgery is a well established method for treating patients with coronary artery disease. In the last five years at the University Clinic in Innsbruck 417 operations have been performed. The operation letality decreased down to 0.66%, whereby the mean revascularisation rate increased to 2.8. The specific aim of this paper is to show the benefits and the risks of this operation to validate and to verify the benefits in regard to the risks, which could be kept very low.

Adult↗

[Intraoperative and postoperative course of enzyme activities in patients with angiographically closed and open aortocoronary bypass grafts].

30 patients who consecutively underwent cardiac surgery with extracorporeal circulation were investigated with regard to preoperative, intraoperative and postoperative activities of creatine kinase (CK) and CKMB isoenzyme (CK-MB), as well as myoglobin concentrations in the blood. 12 lead electrocardiograms were taken before and after the operation. At subsequent control angiography, of 18 patients with coronary heart disease 10 showed patent bypass grafts, whilst the remaining 8 patients had at least one occluded graft. 12 patients served as a control group, half of them undergoing mitral valve replacement and the other half aortic valve replacement. There was no significant difference in enzyme activity patterns between the groups. Specific determinations together with ECG monitoring can be of diagnostic help in perioperative control of these patients.

Aortic Aneurysm↗

[Improvement of specificity in evaluation of aortocoronary bypass grafts by serial (dynamic) computed tomography (author's transl)].

Serial (dynamic) Computed Tomography (CT) with a non-periodic reconstruction of 21 images per minute improves specificity in evaluation of aortocoronary bypass grafts. In 35 bypass grafts, selective coronary arteriography was performed the day after CT: Sensitivity of CT-technique was 92%, specificity 89%. Without additional serial Ct, sensitivity was 85%, specificity 67%. Quantitative CT-measurements of flow equivalents showed no significant differences within two groups with angiographically displayed different "run off".

Coronary Angiography↗

[Evaluation of coronary artery graft patency by computed tomography. Comparison with coronary arteriography (author's transl)].

In 14 patients with 19 coronary artery saphenous vein by-pass grafts (ACVB), computed transmission tomography has been performed the day before selective coronary angiography. Non-dynamic, contrast-enhanced sequential scans at 8-mm intervals were obtained starting at the cranial clips, ending at the left ventricle. CT scans were interpreted without knowledge of the catheterisation results. Sensitivity of this technique is 88%. Out of 17 ACVB patent by catheterisation, 15 ACVB are patent by CT. One occluded ACVB to the right coronary artery was thought to be patent by CT scan. This non-invasive technique shows promise as a method to follow up patients after ACVB-grafting.

Coronary Angiography↗

[Severe hemolytic anemia after mitral valvuloplasty].

A patient with mitral insufficiency is described who developed severe hemolytic anemia six months after mitral valvuloplasty. Various laboratory tests suggested that the cause of the hemolysis was mechanical. A second heart operation was therefore performed which revealed intact valve function. In view of the mechanical cause of hemolysis a bioprosthesis was implanted but the patient died shortly after this operation. Since similar cases are not found in the literature the authors invite discussion of the course in this case.

Acute Kidney Injury↗

[Serious hemolytic anemia after mitral valvuloplasty].

A patient with mitral insufficiency is described who developed severe hemolytic anemia six months after mitral valvuloplasty. Various laboratory tests suggested that the cause of the hemolysis was mechanical. A second heart operation was therefore performed which revealed intact valve function. With respect to the mechanical cause of hemolysis a bioprosthesis was implanted, but the patient died shortly after this operation. Since similar cases are not reported in the literature the authors invite for discussion of this case.

Anemia, Hemolytic↗

[Secondary isophageal reconstruction after resection of a cardia carcinoma (author's transl)].

Following abdomino-thoracical total gastrectomy and partial resection of the esophagus performed because of the presence of a stomac cancer located in the upper part of the organ an attempt was made to execute from a left sided thoracotomy an esophago-jejunostomy. During which it was found that the previously prepared loop of the jejunum was too short. The execution of a colon interposition in this particular operational state would have been too demanding on the patient; therefore the operation was concluded with a blind closure of the distal end of the esophagus and a jejunostomy (discussion of the resultant problems included in paper). The reconstruction of the digestive tract by retrosternal colon interposition a few weeks after the resection of the cancer proceeded without complication and with consequently excellent functional effect.

Cardia↗

[Primary malignant melanoblastoma of the esophagus (author's transl)].

Clinical and morphological aspects based on the observation of one case of oesophageal melanoblastoma are discussed. We want to point out that the characteristic morphology of the tumor enables us to exclude melanoma metastases and thus give an exact diagnosis. The importance of oesophagoscopy for the preoperative diagnosis is emphasized; radical resection is recommended for therapy.

Aged↗