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Biomedical subjects

H W Rautenburg

Publications and source records attributed to H W Rautenburg.

At least 19 recordsLinked to original sources
PubMed1987

[Measuring oxygen consumption in healthy infants and children and infants and children with heart diseases].

Oxygen consumption (VO2) must be known to calculate the hemodynamic parameters by Fick's principle. Often VO2 is not measured directly but calculated by nomograms. An open-system method was used for measuring oxygen consumption continuously in 140 healthy infants and children and 152 with congenital heart disease. The patients with heart disease were divided in three groups: I - with large left-to-right shunt (more than 40%), II - with a small left-to-right shunt, and III - without left-to-right shunt. In group I a significantly higher oxygen consumption was measured. There was also a difference in relation of indexed oxygen consumption to age between group I and all the other children. In a second part we compared two methods for determination of indexed oxygen consumption (VO2) in infants and children: measurement using an open system method estimation by using formulas. In healthy infants estimation showed higher values; but no difference was found in healthy children or those without significant left-to-right shunt. In children with congenital heart disease and large left-to-right shunt measured VO2 was significantly higher than the estimated values. No correlation was found in infants with large left-to-right shunt. But in these cases the exact calculation of the hemodynamic parameters would be of great importance. The results indicate that measurement rather than estimation of VO2 is necessary for calculation of hemodynamic parameters.

Child↗
PubMed1986

[Cervical aortic arch--symptoms and diagnosis in 2 children].

Two children with cervical aortic arch are presented. This anomaly is very rare. In one patient cervical aortic arch Type A (Haughton) was associated with a ventricular septal defect and patent ductus arteriosus. In the other child we report the only case of cervical aortic arch (Type B) in association with partial anomalous pulmonary venous return.

Aorta, Thoracic↗
PubMed1986

[Cardiologic findings in incidental heart sounds in childhood].

In a random sample of patients examined in the outpatient department of pediatric cardiology in Giessen, an innocent heart murmur was found in 1009 children. Results and methods of cardiological examination relevant to the practitioner were established by evaluating the individual diagnostic criteria. An anamnesis without any reference to heart disease is of special significance for the diagnosis of an innocent heart murmur. Another important factor is the experience of the examining doctor. Innocent murmurs are systolic and frequently of "musical quality", their intensity ranges from grade 1/6 to grade 3/6 (95.5%) and is greatest when the patient is supine (76%). Phonocardiography and the Amylnitrit-Test can give important hints. The electrocardiogram should be inconspicuous in terms of age. X-Ray and echocardiogram should be normal, but are not always necessary. Several examinations may be required to established a clear diagnosis. A diagnosis of an innocent heart murmur in children is possible in the practitioner's office, provided the doctor is familiar with the above mentioned criteria.

Child↗
PubMed1986

Incidence and pathogenesis of late aneurysms after patch graft aortoplasty for coarctation.

From 1957 to 1984 direct and indirect isthmoplasty as described by Vossschulte has been the method of choice for surgical therapy of coarctation of the aorta in our hospital. A total of 317 patients have been so treated, 54 of whom were less than 12 months old at operation. The hospital mortality in this group was 15% and the mortality in patients older than 1 year was 3%. The early results were encouraging, but during follow-up an increasing number of postoperative aneurysms have been detected. During reinvestigation an aneurysm was diagnosed in 18 cases. Therefore, we have studied the cause of these aneurysms. To this point reoperation has been performed in 15 patients having late aneurysms. Extensive resection of a fibrous membrane of the aortic isthmus at the first intervention seems to be an essential predisposing factor for development of aneurysms. Microscopic examination of the aneurysmal wall revealed degeneration of the media in more than half of the patients. From our experience we conclude that the posterior fibrous ridge should no longer be excised and the Vossschulte operative technique should be viewed more critically.

Adolescent↗
PubMed1985

[The treatment of arrhythmias in infants and children using propafenone].

Antiarrhythmic treatment was required in 35 patients aged one day to 11 8/12 years (average 5 7/12 years) for one or several of the following arrhythmias: paroxysmal supraventricular tachycardia (17), ventricular extrasystole (16), ventricular tachycardia (17), ventricular extrasystole (16), ventricular tachycardia (4), junctional tachycardia (4), and atrial flutter (3). 300 mg/m2/day oral propafenone was administered in 3 to 4 divided doses. The arrhythmia in 21 of the 35 patients had been unsuccessfully treated by digoxin (6), verapamil (5), ajmalin (4), propranolol (3), spartein (1), phenytoin (1), and lidocain (1) prior to the propafenone therapy. However, the arrhythmias could be abolished or reduced in 30 patients (85.7%) by Propafenone. In 5 patients with supraventricular tachycardia (2), junctional tachycardia (2), or ventricular extrasystole (1), propafenone therapy had no effect. In two other patients propafenone led to atrioventricular conduction disturbances and had to be discontinued. Propafenone is an effective well tolerated antiarrhythmic drug without major side effects in pediatric patients.

Anti-Arrhythmia Agents↗
PubMed1983

["Left anterior hemiblock" or "extreme left axis deviation" in the ECG of children].

A comprehensive study involving the use of ECG's from children at the Giessen University Children's Hospital was conducted with the specific intent of identifying all children with an extreme left-axis deviation. This study showed that, in a time period of five years, 212 out of 3618 children examined electrocardiographically had an extreme left-axis deviation according to very strict criteria, their ECG-types could be divided into three groups: 1. without heart defects, 2. with congenital heart anomalies, 3. after surgery for congenital heart problems. Measurement of the QRS-complex in eighty children without heart defect showed that fifty-nine of the children (73.8%) had a vector -QRS between -30 degrees to -90 degrees. Ih the 88 children with congenital heart defects, and in 20 with an extreme left-axis deviation previous to surgery, an angle of -60 degrees to -90 degrees was found, most often in children with complete A-V canals of Down's Syndrome (as well as in children with transposition of the great arteries, univentricular heart or other complicated malformations of the heart). And finally, an extreme left axis deviation was very often found after surgery to correct Tetralogy of Fallot, ventricular defect, or endocardial cushion defect. Since an extreme left-axis deviation often occurs in children without heart defects, we would like to suggest that the term "Left anterior Hemiblock" be reserved for cases where there is certainty that damage to the conduction system has occurred. In all other cases, we prefer the term "left-axis deviation" as a more appropriate because an anomaly in the conduction system is more likely than a "block" i.e. an interruption of the conduction of electrical impulses through the heart muscle.

Adolescent↗
PubMed1982

[Bicycle ergometric examinations and pulmonary function analyses after patch aortoplasty of coarctation of the aorta in children (author's transl)].

The blood pressure of patients who underwent surgical correction of coarctation of the aorta are usually controlled at rest in the upper and lower extremities. The assessment of the success of the operation is then based on these blood-pressure readings. It is, however, more important to control the blood pressure during standardized exercise so that assessment of the capacity for work in daily life could be made. This is best realized with the bicycle ergometric examination with simultaneous blood-pressure readings 40 patients who had undergone surgical correction of the coarctation of the aorta, using the Vossschulte indirect patch aortoplasty method, were examined. The examination results were compared with those of 35 healthy children. The bicycle-ergometric exercise was carried out in stepwise increasing loads of up to 2 Watt/kg body weight. The blood-pressure, were compared based on the age of the patient at the time of the operation, in relation to the time between the operation and the ergometric examination and the age of the patient at the time of the operation. The W170 (Physical working capacity at a heart rate of 170) and the maximum oxygen intake of the subjects were also used as parameters for comparison. It could be seen that the initial blood pressure at rest was, on the average, relatively higher than those of the control subjects. This tendency was also observed during the bicycle-ergometric examination. In some subjects, the blood pressure rose to dangerously high values particularly at 2 Watt/kg body weight. The blood pressures of the patients remained on the average higher than those of the control subjects during the resting phase after the exercise (control after 1' and 5') and normalized relatively slowly. 45% of the patients showed pathological blood-pressure values. The W170 of the patients, a parameter for precise assessment of the cardiorespiratory fitness, was measured. The findings in the patients showed only very slight difference compared to those of normal subjects in all the assessment parameters. This applies also to the maximum oxygen supply, particularly when one considers the standard deviation. It is advisable to consider limitation of activities, for example sport, in the special cases where there are dangerously high blood-pressure rises during exercise even though no subjective complaints are made by the patients and the blood pressures at rest are normal. It is, on the whole, interesting to note that the operated patients compare very favourably with the control subjects in the W170 and the maximum oxygen-intake values.

Adolescent↗
PubMed1980

[Frequency and time of diagnosis of congenital heart defects in an out-patient clinic (author's transl)].

The frequency of different forms of congenital heart disease was obtained from among a group of 1066 patients seen in a paediatric-cardiological out-patient clinic, the diagnosis being confirmed by cardiac catheterisation and (or) angiocardiography. Also recorded and analysed was the time the various defects, subsequently confirmed by other methods, were first diagnosed in an out-patient clinic. It became clear that cyanotic lesions and acyanotic ones with a large left to right shunt as well as additional pulmonary stenosis were diagnosed earlier than atrial septal defect, persistent ductus arteriosus, coarctation of the aorta, aortic stenosis or pulmonary stenosis--some of which were first noted by their murmur during examinations in the nursery school.

Age Factors↗