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Biomedical subjects

K Bühlmeyer

Publications and source records attributed to K Bühlmeyer.

At least 73 records · Page 4Linked to original sources
PubMed1980

Operative treatment of TGA: comparison of Senning's and Mustard's operation in patients under 2 years.

Sixty-one patients with simple TGA operated on below 2 years of age using atrial inversion techniques were reported. The results of 27 Senning versus 34 Mustard procedures were compared. Postoperative observation time averaged 32 months after the Mustard operation and 12 months after the Senning operation. Early mortality rate was 3% (one patient) in the Mustard group and 7.4% (two patients) after the Senning operation. Sinus rhythm persisted in 20 out of 27 Senning patients and in 30 out of 34 Mustard patients. No baffle obstruction has been registered. Operation results and patient follow-up so far do not favor one technique. The Senning operation rarely requires patch material. Therefore, growth of the atria may be less disturbed.

Cardiac Catheterization↗
PubMed1980

Effect of prostaglandin E1 on pulmonary circulation in pulmonary atresia. A quantitative morphometric study.

The structural effect of prostaglandin E1 on the pulmonary circulation in pulmonary atresia has been studied by applying quantitative morphometric techniques to the injected and inflated lungs of eight babies who had received prostaglandin E1 for between 30 hours and 12 days. The most striking effect was on the pulmonary arterial smooth muscle. Relative arterial medial thickness was reduced and muscle did not extend as far along the arterial pathway as compared with the normal and with untreated cases of pulmonary atresia, dying at a similar age. The reduction in muscularity tended to increase the longer the duration of infusion. In all cases the thin arterial media was less compact than normal, and localised aneurysmal dilatations occurred, varying in extent and severity between cases. The preacinar arteries were dilated in comparison with the untreated cases, but, by contrast, the intra-acinar arteries remained abnormally small. The number of intra-acinar arteries per unit area of lung was greater in prostaglandin E1 treated than in untreated cases. Infusion of prostaglandin E1 is now the ideal emergency treatment for pulmonary atresia, but the findings in the present study suggest that it should be given for as short a time as possible before the pulmonary blood flow is increased by surgical treatment.

Humans↗
PubMed1978

[Tracheal compression by the innominate artery. Angiographic investigations (author's transl)].

Angiocardiograms in 11 infants without anatomical abnormalities of the heart and the great arteries were compared with angiocardiograms in 17 patients with tracheal compression caused by the innominate artery. The direction of the left ventricular outlet, the course of the aortic arch, the innominate artery and the right common carotid artery were studied with regard to the position of the trachea and the vertebral bodies. Course and origin of the innominate artery depends on the direction of the left ventricular outflow. The influence of haemodynamic factors in the formation of the aortic arch system is discussed. The innominate artery, which is arched in early infancy, straightens due to the descending heart and the growth of the infant. Its topographic relation to the trachea changes with age. In view of these developmental changes it is unlikely, that an aberrant origin of the innominate artery accounts for the tracheal compression.

Brachiocephalic Trunk↗
PubMed1978

[Prostaglandin E1 therapy in infants with cyanotic congenital heart malformations: hemodynamic and angiographic findings (author's transl)].

During emergency cardiac catheterization, the mechanism of action of prostaglandin E1 (PG-E1) was studied in 7 newborn infants with cyanotic congenital heart malformations and decreased pulmonary blood flow. The main effects upon hemodynamics were an increase of pulmonary blood flow and a decrease of systemic blood flow. At the same time systemic blood pressure decreased slightly and a rise in systemic vascular resistance was calculated. An aortogram before and 15--20 minutes after the infusion of Pg-E1 was started, demonstrated a marked increase of the pulmonary blood flow and a dilation of the ductus arteriosus. Together with these hemodynamic effects the arterial and central venous oxygen saturation rose. In one infant with severe Tetralogy of Fallot, the ductus had already closed and could not be reopened by PgE1. In this infant PG-E1-Infusion had no effect upon arterial oxygen saturation. From these observations it can be concluded that dilation of the ductus is responsible for the rise in arterial oxygen saturation. 3the different indications for therapy with PG-E1 in the neonate are discussed.

Cardiac Catheterization↗
PubMed1978

Special problems in pulmonary atresia with ventricular septal defect: extreme hypoplasia of intrapericardial pulmonary arteries and autofocal collateral vessels.

4 patients with pulmonary atresia and ventricular septal defect are presented, who were selected from a group of 50 patients in whom intrapericardial pulmonary arteries were present. In 2 patients the pulmonary arteries were not only extremely hypoplastic but also displayed only minimal anastomoses with the arterial hilar vessels. They were considered not to be accessible for corrective surgery. In another patient about 50% of the pulmonary perfusion were supplied by collateral vessels not connected to the intrapericardial pulmonary arteries. The question is discussed, to what extent the systemic vessels are necessary for pulmonary perfusion and whether they may be all ligated at the time of corrective surgery. In the last patient anastomoses between 2 systemic vessels and the pulmonary arteries could be demonstrated, the right one of which was very hypoplastic. In this case a right-sided shunt operation combined with ligation of the collateral vessels seemed to be advisable to promote adaption of the pulmonary artery and to simplify the subsequent corrective procedure.

Adolescent↗
PubMed1978

[Entry into pulmonary artery in complete transposition of the great arteries (author's transl)].

In 91 children with complete transposition of the great arteries investigated by heart catheterization since 1974 the pulmonary artery was probed at the first investigation in 46% and at the second preoperative investigation in 85%. Considering only the last 2 years the pulmonary artery was entered in 93% during the second catheterization. When an additional catheterization was necessary the pulmonary artery was always entered. This was mostly achieved by a flow-directed balloon-catheter preformed before introduction into the vein by alternating application of hot and cold water or in the left atrium by use of a guide wire.

Cardiac Catheterization↗