Biomedical subjects

K Kilzer

Publications and source records attributed to K Kilzer.

5 recordsLinked to original sources

PubMed1992

[Abnormal origin of the ramus circumflexus sinister from the left atrium in a 30-year-old patient with aortic isthmus stenosis and atrial septal defect].

In this case report a 30-year-old woman suffering from progressive angina pectoris and dyspnea, having been operated on previously for atrial septum defect at the age of 19 and later aged 24 for coarctation of the aorta, is described. Upon observation, patient showed cardiac symptoms already under mild stress and remained resistant to nitroglycerin. Rest-ECG and serum cardiac enzymes were repeatedly without findings, while stress-ECG at a level of 100 W showed a ST-segment depression of 0.15 mV, at the same time complaining of angina pectoris symptoms. Coronary angiography revealed a left circumflex coronary artery arising from the left atrium being fully supplied by the left anterior descendent artery and the right coronary artery via pronounced collaterals, both originating from the ascending aorta. Despite such severe symptoms patient refused surgery suturing the abnormally arising artery. One year following coronary angiography patient is suffering from stabile angina pectoris without occurrence of myocardial infarction or another cardiovascular event.

Adult↗

PubMed1991

[Coronary artery anomalies in adulthood].

In a series of 3000 consecutive coronary angiographies carried out in adults (period October 1988 through February 1991) the incidence of coronary artery anomalies was investigated. Among these there were 7.2% of patients with left-, 3.8% with right-sided and 89% with bilateral coronary artery supply. 10 cases revealed a double left anterior descendent artery (LAD), whereas in 2 patients the left circumflex artery (CX) was missing. In approximately 1% of patients origin anomalies of coronary arteries were observed, above all of the right coronary artery (RCA). A pronounced kinking of the coronaries was seen in 22 cases (11 LAD, 11 RCA) and a bridging in 2.5% of patients (74 LAD, 1 CX, 1 RCA). Of the latter, there were 21 hemodynamic active stenoses (more than 75% diameter stenosis) of which in 12 cases this narrowing was the sole cause for the heart complaints. During the same period there were 8 patients with coronary anomalies leading to shunt development out of which a 30-year-old female revealed clinically a coronary steal phenomenon. Aneurysms of the coronary arteries were observed in 54 cases (2%) whether congenital or acquired could not be ascertained. In total, there were 194 coronary anomalies in the total series (6.5%) being clinical significant in 22 cases (0.7%).

Adult↗

PubMed1990

A new steroid-eluting epicardial lead: experience with atrial and ventricular implantation in the immature swine.

The first study with investigational steroid epicardial leads was carried out in mature canine with prototype leads. Because the demand for epicardial leads is highest in small infants and the prototype steroid-eluting lead has been redesigned, this study was carried out in immature swine to evaluate the newly designed lead. Six immature swine (2 at 5 weeks of age and 4 at 6 weeks) underwent epicardial implantation of four porous platinized tip leads: one steroid and one nonsteroid on the right atrium; one steroid and one nonsteroid on the right ventricle. At implantation, the lead terminals were connected to a percutaneous access device subcutaneously placed in the right lateral neck. This allowed chronic measurements by using an insulated needle connected with a cable to the pacing systems analyzer. Measurements were obtained at implantation and weekly for 3 weeks. Compared to the nonsteroid atrial leads, the steroid atrial leads had lower mean thresholds (P less than 0.01) at 1, 2, and 3 weeks after implantation. The mean threshold values from ventricular steroid leads were also lower and exhibited little increase from implant with the highest mean threshold of only 1.02 V, however, a statistically significant difference between steroid and nonsteroid was not reached. This newly designed steroid epicardial lead provided favorable results for continual human clinical study.

Animals↗

PubMed1978

Contrast agents lower ventricular fibrillation threshold.

Ventricular fibrillation thresholds were measured in anesthetized, closed-chest dogs during the injection of Renografin 76 or Conray 400 into the left coronary artery. Both agents significantly lowered fibrillation threshold--Renografin to 58 +/- 7%; Conray to 20 +/- 5% of control, respectively. The experimental method estimates fibrillatory potential of contrast media more precisely than previous methods. The initial results parallel relative toxicities observed in clinical usage.

Animals↗

PubMedDate not supplied

A proposed mechanism for transient increases in arterial pressure and flow during angiographic injections.

In a series of animal experiments, we have confirmed the observation that arterial pressure and flow increase distal to the injection site during power injections through non-obstructing catheters. Our data suggest that the phenomenon is secondary to the transient production of turbulence. Thus, for a given injection rate, catheters with smaller end holes create more fluid velocity, which increases the Reynolds number and causes augmentation of downstream pressure and flow. The addition of side holes decreases the fluid velocity of the injectate and minimizes the hemodynamic effects. The discussion deals with factors contributing to the generation of local turbulence, the magnitude of pressure and flow changes caused by the injections, and the clinical implications of these artifacts.

Angiography↗