PubMed Health⌕ Search

Biomedical subjects

K Haerten

Publications and source records attributed to K Haerten.

At least 55 records · Page 3Linked to original sources
PubMed1977

[Long term results after operation of patent ductus arteriosus or ventricular septal defect and pulmonary hypertension (author's transl)].

The behaviour of pulmonary hypertension and elevated pulmonary vascular resistance was followed up to 12 years postoperatively in 29 patients with patent ductus arteriosus (DAA) and 34 patients with ventricular septal defect (VSD). 8 of 11 patients with VSD and rest defect underwent a second operation. All patients had preoperatively pulmonary hypertension due to elevated pulmonary vascular resistance (RPA) and elevated pulmonary blood flow. Pulmonary arterial mean pressure (PPA) was usually reduced immediately after operation corresponding to the reduced pulmonary blood flow. In the later postoperative period PPA and RPA were either reduced to normal values, reduced but not normalized or increased progressively. In patients with moderate elevation of RPA before operation (200-800 dyn - sec cm-5) 34 % showed normalisation of RPA, 11 % increase of RPA in the follow-up period. In patients with severe elevation of RPA before operation (greater than 800 dyn - sec - cm-5) 11 % showed normalisation, 30 % an increase of RPA in the follow-up period. There was no correlation between age at operation and the late postoperative results. Exercise test were useful to confirm normalisation of the pulmonary vascular changes. The results in patients with VSD and rest defect demonstrate that apparently small left-t0-right shunts are able to stop the involution of organic changes in the pulmonary arteries. Prognosis of follow-up cannot be established from the hemodynamic results obtained early after operation. Therefore repeated hemodynamic investigations have to be performed in the later follow-up period.

Adolescent↗
PubMed1977

[Hemodynamic results after prothetic tricuspid valve replacement (author's transl)].

The hemodynamic results after prosthetic tricuspid valve replacement were investigated in 8 patients. One patient had myxoma in the right atrium with destruction of the tricupsid valve. 7 patients had multiple rheumatic valvular disease. In all these patients multiple valve replacement was performed. The pressure in the right and left atrium , the cardiac output, and stroke volume were determined in all cases at rest, in 5 patients also on exercise. Furthermore the subclavian venous blood flow was measured by Doppler ultrasound technique percutaneously. In all cases the pressure in the right atrium remained elevated after operation and increased on exercise with the increasing cardiac output. This pressure increase is due to an important obstruction of the prostheses to the blood flow. This could be demonstrated by determination of diastolic pressure gradients across the prostheses. In 5 cases the analysis of the pressure curves showed systolic elevation suspicious to tricuspid insufficiency. In all these cases a systolic regurgitation was seen in ultrasonic Doppler flow curves of the subclavian veins. This method seems to be of value in assessing tricuspid regurgitation after valve replacement. The hemodynamic results after prosthetic tricuspid valve replacement are unsatisfactory in most cases. Tricuspid valve replacement should be considered only in cases in whom valve-preserving procedures are not possible.

Adult↗
PubMed1977

[Hemodynamics after mitral valve replacement with Starr-Edwards, Björk-Shiley and Lillehei-Kaster protheses (author's transl)].

After mitral valve replacement hemodynamic abnormalities persist. These abnormalities were studied 1 year postoperatively. In 50 randomized patients; 15 with Starr-Edwards (SEM), 15 with Lillehei-Kaster (LKM) and 20 with Björk-Shiley (BSM) prostheses at rest and during exercise. Simultaneously were determined: pulmonary arterial pressure, left atrial pressure, left ventricular enddiastolic pressure, mean diastolic pressure gradient across the prostheses, cardiac index, stroke volume index, valve orifice area, and ejection fraction. The results show an important stenosis by the prostheses leading to high pressure increase in pulmonary artery and left atrium during excercise. This stenosis depends on valve size and type. Björk-Shiley tilting disc valves show the best hemodynamic results. This may be due to the most favourable ratio between internal and external diameter. Starr-Edwards prostheses with identical sizes show the most identical results if compared to each other. Therfore we suggest that Starr-Edwards prostheses open completely in every case. However, there is an important pressure gradient caused by the small internal diameter. Lillehei-Kaster pivoting disc valves reach surprisingly small functional valve areas. This may be caused by an incomplete opening of the disc.

Adult↗
PubMed1977

[Evaluation of social status and hemodynamic results four to six years after prosthetic valve replacement (author's transl)].

In 72 patients the professional and social status before and after prosthetic valve replacement was examined. In 60 of these patients the hemodynamic data (cardiac index, stroke volume index, pulmonary arterial pressure at rest and during exercise) were measured. The patients were classified according to their professional training, their last occupation, and their social status before operation. Postoperative changes in professional life and the daily work load were correlated to the hemodynamic results. The study shows that the social status plays a more important role in regaining the professional position postoperatively than the hemodynamic parameter.

Adolescent↗
PubMed1976

[Surgical management of acquired tricuspid insufficiency--valvular replacement or annuloplasty? (author's transl)].

61 patient underwent operative repair of acquired tricuspid insufficiency (T.I.) during correction of multiple valvular disease. 45% presented a relative T.I. through annular dilatation, while organic lesions of the tricuspid valve were found in 56% of the patients. A tricuspid valvular replacement was carried out in 17, and a tricuspid annuloplasty in 44 patients. We believe that during surgical management of multiple valvular lesions, all tricuspid insufficiencies of even when only of a slight to moderate degree - should be corrected aggressively. Tricuspid valvular replacement should be avoided if possible and a tricuspid annuloplasty should be performed.

Adolescent↗
PubMed1976

[Antiarrhythmic effect of disopyramide in ventricular extrasystole and auricular fibrillation].

Disopyramide (B 712) was tested in 39 patients with chronic arrhythmias of different kind: 23 cases with atrial fibrillation, 16 cases with ventricular ectopic beats, two cases with supraventricular tachycardias. The effect of disopyramide was compared to a pretreatment with one or several antiarrhythmic drugs (quinidine, beta-blocking agents, verapamil, ajmalin-bitartrat, aprindine, propafenone, diphenylhydantoin) which had been discontinued either due to ineffectiveness or the occurrence of intolerable side effects. Therapeutical effectiveness was controlled by on-line arrhythmia computers in the CCU or Holter monitoring. 15 patients were treated longer than 4 weeks up to 16 months (mean 35+/-22,6 weeks). The following results were achieved: 1 atrial fibrillation, abolition or significant reduction of the rate of recurrence in 10 out of 23 patients; slight reduction or no effect in 13 patients; 2. ventricular ectopic beats: abolition or significant reduction in 6 out of 16 patients, slight reduction or no effect in the remaining 10 patients. Patients who were treated successfully received the same dosis as those without therapeutical success. In cases with atrial fibrillation, the success was dependent on the duration of this arrhythmia prior to treatment. In comparison to the pretreatment with one or several of the above-mentioned anti-arrhythmic drugs, disopyramide was as effective as the drug given before. The analysis of the Ecg revealed a slight but insignificant prolongation of the time intervals. In 22 patients reversible dosage-dependent side effects were observed which are due to the vagolytic action of the drug: dry mouth, blurred vision, urinary hesitancy, nausea, headache. These side effects occurred at daily dosages between 400 to 800 mg increasing markedly in patients on 800 mg a day. The drug had to be discontinued in 4 cases because of side effects. During long-term treatment no severe side effects were observed. Thus, disopyramide may serve as an alternative to quinidine, especially if the latter has to be stopped because of side effects.

Adolescent↗
PubMed1975

[Banding for pulmonary artery and subsequent repair in large ventricular septal defect (author's transl)].

Banding of the pulmonary artery was performed in 233 children with large, non restrictive ventricular septal defects. The group of isolated large VSDs consisted of 95 patients, of whom 8 died (8,4 per cent). 32 patients were subjected to open-heart operation for closure of the VSD and debanding. In this "two-stage group" the mortality rate was 6,3 per cent. At the second operation the pulmonary artery always should be enlarged with a pericardial patch. Our recordings up to 6 1/2 years after correction show no gradients left in cases surgically treated in this manner. The time-interval between effective banding and debanding procedure may not be limited strictly; the subsequent operation however should be done within two or three years.

Age Factors↗
PubMed1975

[Letal rate and late complications following palliative surgery of transposition of the great arteria (author's transl)].

Between 1966 and 1973 145 palliative procedures were carried out on 110 infants with transposition of the great arteries. There were 23 early deaths (20.9 per cent). 85 per cent of the survivors were controlled till the end of 1974. Five late deaths and four cases of peripheral artery embolism were regarded. These complications, however, took place several years after palliation. The development of pulmonary hypertension doesn't seem to be as high as it is suspected sometimes. These results justify our conception, not to perform the Mustard-operation during the first two years of life.

Age Factors↗