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Biomedical subjects

J Ostermeyer

Publications and source records attributed to J Ostermeyer.

At least 55 records · Page 3Linked to original sources
PubMed1982

[Response of ventricular late potentials after surgical therapy of ventricular tachycardia].

19 patients with either previously documented sustained ventricular tachycardia (VT) (n = 16) or only inducible VT (n = 3, one of whom had recurrent syncope), due to previous myocardial infarction were studied pre- and postoperatively. Mean age was 53 +/- 6 years, 16 were male, 3 female. In all but one, VT could be induced preoperatively by programmed right ventricular stimulation. Late potentials (LP) were recorded at the end of or after the QRS-complex from the body surface using high-gain amplification and the signal averaging technique (RC-filter settings 100 to 300 Hz). Indication for surgery was either intractable VT or bypass grafting and/or aneurysmectomy. Preoperatively, mean duration of late potentials was 54 +/- 37.7 ms, mean amplitude was 12 +/- 14.0 mean V. Surgery was guided by epi- and endocardial mapping. In 14 cases endomyocardial encircling ventriculotomy was the main procedure, whereas in 5 patients only aneurysmectomy and bypass grafting were performed. Postoperatively, late potentials were no longer detectable in 12 cases, whereas in 6 of 7 cases there was a decrease in duration, but no essential change in amplitude. A postoperative electrophysiological study was performed in 18 cases. In those 12 patients with abolition of LPs, the maximal number of inducible ventricular echo beats using an extended stimulation program from three right ventricular sites, ranged between 1 and 5 in 9 cases, between 10 and 11 VE in 2 cases, whereas VT was induced in only 1 case. In 6 patients in whom LPs were still detectable, ventricular tachycardia could still be induced in 2 cases and a maximal response of ten echo beats was observed in another patient. Abolition of LP by surgery is closely related to the disappearance of the propensity to stimulus-induced VT. Thus the averaging technique may provide a non-invasive procedure to assess the successful outcome after operation for ventricular tachycardia. If, however, LPs are still present, this does not exclude successful surgical abolition of the propensity to ventricular tachycardia.

Cardiac Pacing, Artificial↗
PubMed1982

[Coronary arterial dissection following selective coronary artery perfusion].

Dissection of the three coronary vessels as a rare fatal complication after intraoperative cannulation is described. A 58-year-old man died from progressive cardiac failure 12 days after mitral and aortic valve replacement. The cause of death was a nearly 12-day-old anteroseptal myocardial infarction as a result of a dissection of all three coronary vessels including the septal arteries. Histologic examination revealed a tear of the left and right coronary artery at their ostia. Thrombi of different age in the dissection and satellite-like recent necroses surrounding the 12-day-old myocardial infarction indicate a gradual progression of the dissection.

Aortic Dissection↗
PubMed1982

The surgical treatment of ventricular tachycardias. Simple aneurysmectomy versus electrophysiologically guided procedures.

Between 1971 and 1982, 41 patients were operated upon for recurrent sustained ventricular tachycardia. All but three had severe coronary artery disease with a history of myocardial infarction. In 10 patients (Group I) simple aneurysmectomy with or without aorta-coronary bypass grafting was done. Thirty-one patients (Group II) had an electrophysiologically guided procedure, mainly partial or complete encircling endocardial ventriculotomy (EEV) at the earliest source of electrical activity during ventricular tachycardia. The results in the two groups indicate a clear superiority of electrophysiologically guided procedures over a simple aneurysmectomy regarding early and late disappearance of tachycardiac rhythm problems (p = 0.01); the differences between the two groups in hospital mortality (p = 0.43) and long-term survival are not significant. We compared our data with results in 160 cases of simple aneurysmectomy and 224 cases of electrophysiologically guided operations recently published in the literature. This comparison confirms the higher efficiency of mapping-guided procedures in eradicating ventricular tachycardias. The improvements in hospital and long-term survival, again, are not significant.

Adult↗
PubMed1980

Straddling atrioventricular valves in biventricular hearts. Observations made in 5 cases.

The report concerns 5 patients with straddling or overriding atrioventricular valves. The overriding phenomenon was found 4 times in tricuspid, once in mitral position. In addition to this malformation, 2 patients had congenitally corrected transposition of the great arteries (CTGA), one patient had transposition of the great arteries (TGA), and another a double outlet right ventricle (DORV). In 2 instances corrective surgery was done without compromising the anatomical and functional integrity of the straddling valve. Three patients with straddling degree B-C received palliative procedures, the ventricular septal defect (VSD) was left open in order to save the straddling atrioventricular valve and pulmonary artery banding was done for protection of the pulmonary vascularity. One corrected patient died in the early postoperative period.

Adolescent↗
PubMed1980

[Demonstration of retrograde block in a patient with preexcitation syndrome by intraoperative electrophysiological studies (author's transl)].

In a patient with a WPW syndrome, the electrophysiological investigation revealed a left-sided bypass conducting only in antegrade (A-V) direction. During right ventricular stimulation, there was a complete retrograde (V-A) block. Therefore no reentry tachycardia could be initiated. The patient was operated upon because of an aortic valve lesion. During operation the bypass was localized at the free wall of the mitral annulus by epicardial mapping. Even during direct stimulation at the ventricular insertion of the bypass, no retrograde conduction to the left atrium could be demonstrated. After ablation of the bypass by surgery, intra- and postoperative electrophysiological studies showed a normal antegrade activation pattern of the ventricles. The case reported demonstrates that the "heterodromia" of an accessory bypass can markedly influence the clinical setting in the WPW syndrome.

Action Potentials↗
PubMed1979

[The clinical relevance of intraoperative electrophysiologic mapping (author's transl)].

Electrophysiological intraoperative mapping is described as a technique for identification of the specialized AV conduction system during open heart surgery; furthermore it is suitable for delineating the morphological origin of ventricular tachycardias which requre surgical therapy. The mapping technique is described with respect to its methodical aspects and illustrated by means of congenital and acquired heart disease.

Bundle of His↗
PubMed1979

Surgery of life-threatening ventricular tachyarrhythmias associated with ventricular aneurysm.

In 11 patients with left ventricular aneurysm and ventricular tachyarrhythmia unresponsive to conventional antiarrhythmic therapy surgical treatment was performed by resection of the aneurysm. One patient underwent epicardial electrophysiological mapping intraoperatively, and the site of earliest activation during tachycardia was established. One patient did 11 hours postoperatively. Three patients are cured from their tachycardia 3 to 22 months after surgery. Six patients have still persistent premature ventricular beats which are now controlled satisfactorily with antiarrhythmic drugs. Our results demonstrate the therapeutic value of aneurysmectomy in the treatment of related ventricular tachyarrhythmias. The practical relevance of intraoperative electrophysiological mapping procedures for localizing the origin of ventricular tachyarrhythmias is a subject which merits further discussion.

Adult↗
PubMed1979

Intraoperative electrophysiologic mapping during cardiac surgery.

Intraoperative mapping is a method to document the surgical anatomy of cardiac tissues with electrophysiologic importance cartographically at time of surgery. The presented communication gives a survey of the present status of the technique of electrophysiologic mapping and its essential clinical applications. Special attention in this regard is directed to the intraoperative identification of the specialized AV conduction system in congenital cardiac malformations with unpredictable location of His bundle, to the detection of accessory AV bundles in patients with the Wolff-Parkinson-White syndrome and to the intraoperative morphological study of ventricular reentry tachycardias. Suitable technical equipment for "clinical" intraoperative electrophysiologic mapping is described in detail.

Cardiac Surgical Procedures↗
PubMed1979

Mitral atresis with normal-sized ventricles, ventricular septal defect, and dextro-transposition of the great arteries.

A case is described of mitral atresia, patent foramen ovale, subcristal ventricular septal defects (VSD), and dextro-transposition of the great arteries (d-TGA), coexisting with a normal-sized left ventricle and normal-sized great arteries in a 6 8/12-year old girl. The discussion is related to anatomic, embryologic, and surgical aspects of this particular condition, which, to our knowledge, has never been documented before.

Angiocardiography↗
PubMed1979

[Electrophysiological mapping during open-heart surgery (author's transl)].

Intraoperative electrophysiological mapping provides a method to identify the specialized atrioventricular conduction system and to localize the morphological origin of different tachycardiac rhythm disorders at time of surgery. The basic technical aspects and methodical implications are presented with respect to its clinical applications.

Atrioventricular Node↗