Biomedical subjects

Heidi Görler

Publications and source records attributed to Heidi Görler.

3 recordsLinked to original sources

PubMed2004

[Heart transplantation and assist devices].

BACKGROUND: Although drug therapy of patients with chronic heart failure has improved significantly over the years, mortality still remains high. At present, heart transplantation is the gold standard therapy for patients with end stage heart disease. Due to the limited number of organs, a growing number of patients require the implantation of mechanical assist devices. HEART TRANSPLANTATION: Because of the excellent long-term survival after cardiac transplantation, current studies focus on long-term complications. The aim of these studies is the establishment of an immunosuppressive strategy that effectively prevents cardiac allograft vasculopathy in combination with a low incidence of negative side effects. Furthermore, quality of life is a major focus of current interest. ASSIST DEVICES: Assist device implantation has changed from an experimental to a routine procedure in several centers. Still, many problems have to be solved. Especially because of recurrent infections the long-time use of assist devices is limited. For final judgment, results of current studies have to be awaited.

Clinical Trials as Topic↗

PubMed2004

Functional neointima characterization of vascular prostheses in human.

BACKGROUND: The purpose of this study was to evaluate neointimal functionality of synthetic vascular grafts repopulated by host cells after implantation. METHODS: We obtained reseeded inflow and outflow cannulas of 2 patients undergoing orthotopic heart transplantation after left ventricular assist device implantation 9 and 10 months before. After cell isolation we examined cellular function of reseeded cells and their capability to form a functional endothelial layer applying immunohistologic markers and quantitative Western blot for endothelial nitric oxide synthase activity. RESULTS: Neointima formation in inflow and outflow cannulas differs macroscopically and by histologic appearance. The neointima formation on the surface of the polyethylene terephthalate fiber (Dacron) grafts differs substantially from native aortic vessel wall with respect to cellular and extracellular matrix composition and cellular function. CONCLUSIONS: The neointima of Dacron prostheses is composed of cells with rudimentary physiologic endothelial function. We conclude that synthetic matrices are not suitable scaffolds for generating functional cardiovascular implants.

Blood Vessel Prosthesis↗

PubMed2002

[Surgery in advanced heart failure].

BACKGROUND: ACE inhibitors and beta blockers have reduced morbidity and mortality from chronic heart failure significantly during the last years. Apart from medical therapy several surgical strategies for the treatment of heart failure are available. PREREQUISITES OF SURGICAL TREATMENT: Surgical treatment should be directed towards the underlying etiology and mechanisms. To decide for a special surgical therapy indications and contraindications must be considered. SURGICAL PROCEDURES: The surgical therapy of heart failure can be performed with or without replacement of the heart. Especially concerning the organ-conserving techniques there has been significant progress during the last years: left ventricular aneurysmectomy, mitral valve surgery as well as high-risk coronary artery bypass surgery and electrostimulating procedures. Concerning heart replacement therapy, cardiac transplantation with a 10-year survival of 50% still remains superior to all available mechanical devices at the moment.

Cardiomyoplasty↗