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Biomedical subjects

H Seboldt

Publications and source records attributed to H Seboldt.

At least 55 records · Page 3Linked to original sources

[Myocardial protection utilizing hypothermia and cardioplegin during surgical correction of congenital heart disease (author's transl)].

Our methods of myocardial protection are demonstrated in 846 patients subjected to open heart surgery for correction of congenital heart disease. They include body hypothermia and injection cardioplegia using magnesium-asparate-procaine. The spectrum of myocardial protection reaches from normothermia without cardioplegic arrest during short periods of extracorporeal circulation to profound body hypothermia with multiple injections of the cardioplegic solution in complex cardiac malformations. The results in 586 patients with left to right shunt, 140 patients with cyanotic cardiac malformations and 120 patients with congenital valve lesions are presented. Attention is directed to possible negative sequelae of overdosage of magnesium-asparate.

Aspartic Acid↗

[Monitoring myocardial performance after open heart surgery by calculation of diastolic and systolic pressure time index (author's transl)].

In order to determine the incidence of subendocardial ischemia after open heart surgery, subendocardial blood flow was monitored in 171 patients subjected to mitral and/or aortic valve replacement or coronary revascularization by on-line calculation of Diastolic (DPTI) and Systolic Pressure Time Index (TTI). Body hypothermia with an esophageal temperature of 25 degrees C and magnesium-aspartate-procaine cardioplegia were applied for myocardial protection. Ten patients developed low cardiac output state with two early deaths. In the two patients with fatal low cardiac output DPTI/TTI remained below 0.8. In the remaining 8 patients DPTI/TTI rose to 1.4 after a mean recovery time of 36 hours. In 161 patients (94%) no low cardiac output state evolved and DPTI/TTI rose to 1.3 within 60 min. after termination of cardiopulmonary bypass. Our results indicate that body hypothermia of 25 degrees C combined with magnesium-aspartate-procaine cardioplegia can reduce the incidence of subendocardial ischemia, but does not prevent this complication completely after anoxic times beyond 60-70 minutes.

Blood Pressure↗

[Determination of glycoside concentrations in human tissue by means of radioimmunoassay (author's transl)].

After extraction of myocardial and skeletal muscle biopsy and autopsy specimens tissue glycoside concentrations can be determined by radioimmunoassay. Total tissue extraction of digoxin and beta-methyl-digoxin varies between 87 and 95%, the variation coefficient for repeated determinations is 10.2%. Glycoside concentrations of left ventricular papillary muscle obtained after mitral valve replacement were 69.0 +/- 25.05 ng/g with a tissue to serum relation of 46.6 +/- 8.96:1 and a correlation coefficient of r = 0.8442. In autopsy left ventricular papillary muscle glycoside concentrations were 105.2 +/- 27.35 ng/g with an almost identical tissue to serum relation of 46.2 +/- 9.57:1 and a corresponding serum concentration of 2.3 +/- 0.63 ng/ml. In adults glycoside concentrations of autopsy specimens of the right ventricle were significantly lower by 28 to 30% than those of the left ventricle. Glycoside concentrations of skeletal muscle specimens (m. pectorialis major) were 14.7 +/- 10.35 ng/g with a tissue to serum relation of 9.7 +/- 3.00:1 (r = 0.8377), which corresponds to approximately 1/5 to 1/4 of the concentrations of the left ventricular myocardium.

Aged↗

[Determination of serum-digitalisglycoside concentrations by radioimmunoassay before, during and after operations with extracorporal circulation (author's transl)].

In 13 adult patients serum-glycoside concentrations, renal glycoside elimination and endogenic creatinine clearance were determined before, during and in the first 4 days following the operation. A postoperative digitalis cumulation has not been seen. But there was a diminished digitalis tolerance in the immediate postoperative phase. Two patients got ventricular bigeminus. The low potassium values at the same time may possibly affect the sensitivity of digitalis.

Adolescent↗

[Reversibility or irreversibility of pulmonary function changes after cardiac surgery on insufficient or stenotic cardiac valves (author's transl)].

In 69 patients with mitral- or aortic valves disease lung function tests were made preoperatively and 2 to 4 years after cardiac surgery. We wanted to demonstrate the extent and the improvement of restriction, obstruction and disturbed diffusing capacity of the separate diseases with different severities. We found correlations between the clinical grade of the disease and the changes in lung function. In particular grade III of the mitral stenosis showed severe restriction, obstruction and disturbed diffusing capacity. Patients with mitral insufficiency III had changes of mild degree, aortic diseases were without disturbed lung function. All detected changes of lung function were irreversible and could not be influenced by postoperative hemodynamic improvements.

Aortic Valve↗