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Biomedical subjects

M Paneth

Publications and source records attributed to M Paneth.

At least 37 records · Page 2Linked to original sources
PubMed1981

Valve replacement without preoperative cardiac catheterization.

During the year 1978, the decision to perform cardiac catheterization in patients with valvular heart disease was delayed until clinical and noninvasive assessment have been completed. As a result, 184 patient underwent operation without invasive studies, and 59 had elective catheterization. Another 62 patients were referred during the same period for valve replacement after routine catheterization had been performed elsewhere. Age, sex distribution, symptoms, and cause of valve disease were similar in all three groups, although we managed emergencies and second operations more frequently without catheterization. In all patients, the preoperative diagnosis was confirmed, and no unexpected pathologic process was encountered. Operative mortality was the same in all three groups, and after two years of follow-up there was no difference in survival or symptoms. No uncorrected valve lesions became apparent in uncatheterized patients. We conclude that routine catheterization is unnecessary before valve replacement but can be reserved for specific indications in some patients.

Adolescent↗
PubMed1980

Survival after resection of small cell carcinoma of the bronchus.

Forty patients who underwent curative resection for oat cell carcinoma of the bronchus between 1959 and 1974 are reviewed. During the same period there were 24 patients who underwent thoracotomy but who were found to have inoperable lesions. Of the 40 patients who underwent curative resection, 11 patients remain alive and well with no evidence of recurrence. Ten of these patients have survived five years or more, an overall five-year survival rate of 25%. We consider that surgery should be considered as a possible first line of treatment in patients with small cell carcinoma of the bronchus.

Adult↗
PubMed1980

Results of mitral valvuloplasty with a suture plication technique.

Between January, 1975, and October, 1978, a total of 243 patients underwent repair of the mitral valve with a suture plication technique. Mitral valve replacement (MVR) was performed in 36 cases in which significant residual regurgitation was apparent on testing the valve after repair. The hospital mortality rate was 5.7%. Five patients required MVR within 1 month of operation. A total of 190 patients were discharged from hospital with what was considered to be a satisfactorily functioning mitral valve. Excluding patients from overseas, detailed follow-up information is available in 80 cases. Of these 80 patients, 13 have subsequently undergone MVR. Factors favorably affecting survival and durability of repair are degenerative valve disease and age below 55 years. Clinical and echocardiographic assessment indicate that this method of repair initially produces good symptomatic improvement and a normal or nearly normal pattern of left ventricular filling. The good early results are only maintained in patients with degenerative valve disease. We therefore no longer use or recommend this technique for elderly patients with rheumatic valve disease.

Adult↗
PubMed1978

Anticoagulants and the Björk-Shiley prosthesis. Experience of 390 patients.

From September 1972 to January 1975, 390 patients underwent valve replacement using the Björk-Shiley tilting disc prosthesis. For the group as a whole hospital mortality was 13.3 per cent and was lowest in those undergoing isolated mitral or aortic valve replacement (5.3 and 9.4%, respectively). Available for follow-up were 209 patients of whom 123 were maintained on dipyridamole and 96 on warfarin. Thromboembolic complications were significantly (P less than 0.01) commoner in the dipyridamole (28 of 123, 22%) than warfarin (6 of 86, 7%) treated group. In the dipyridamole treated group the incidence of thromboembolic complications was similar whichever valve was replaced and thromboembolic complications were responsible for 14 of the 28 late deaths. In the warfarin treated group thromboembolic complications only occurred in patients with a mitral prosthesis. Anticoagulation is indicated for all patients with this prosthesis wherever inserted.

Anticoagulants↗
PubMed1976

Coarctation of the aorta in infancy and childhood.

The management and results of treatment in 181 children with coarctation of the aorta are presented. In this series, 79% of the patients presented in the first year of life and 55% presented as neonates. One hundred and fifty patients were operated on, with a total surgical mortality of 21%. Only one surgical death occurred in those operated on after 3 months of age. The higher mortality in young infants is closely related to associated cardiac anomalies and to the frequency of aortic and isthmal hypoplasia. Our findings suggest that neonates presenting with heart failure and coarctation should be operated on early, as the surgical mortality under 6 weeks is 45%, whereas there is an 86% mortality in neonates who were not operated on. Analysis of follow-up indicates that when operation can be performed electively the optimal period for sugical treatment is between 6 months and 1 year of age. If operation is performed after this age, there may be persistent systemic hypertension despite relief of aortic obstruction.

Adolescent↗
PubMed1975

[Differentiated surgical therapy in congenital lobar emphysema (author's transl)].

Congenital lobar emphysema (CLE) is a clinical and radiological entity with a multiplicity of etiological factors. Six patients are presented with CLE of the left upper lobe. In three of them CLE was associated with cardiovascular malformation i.e. persisting ductus arteriosus and in one case additionally with double aortic arch. These infants were treated by division of the compressing vascular structure without lobectomy. Only one required secondary resection. Left sided CLE presumably caused by vascular compression should be considered a special group in which surgical correction without lung resection is justified.

Aorta↗
PubMed1975

[Critical outflow valve obstruction under the age of one year (author's transl)].

This report represents the Brompton Hospital experience of infants and neonates with critical pulmonary valve stenosis and aortic valve stenosis. There were 25 patients with critical pulmonary valve stenosis and 8 with critical aortic valve stenosis. Critical pulmonary stenosis: Among the 25 patients up to one year of age, 11 were girls and the commonest presenting symptom was cyanosis seen in 15, the commonest physical sign being a systolic ejection murmur with a single 2nd sound. A more detailed analysis of the symptoms, signs and findings at special investigation will be presented. The evolution of a satisfactory technique of operation will be indicated in these critically ill patients, and the late follow-up will be presented. Critical aortic stenosis: There were 8 patients in this group all of whom were male. Dyspnoea was the commonest presenting symptom with a systolic ejection murmur and hepatomegaly as the commonest signs. All patients in this group underwent open aortic valvotomy and/or valvuloplasty with 3 deaths. A late follow-up of the survivors will be presented. In summary, a series of 33 patients up to the age of one year with critical obstruction of either the pulmonary or aortic valves will be presented. (his is one of the larger series to be reported in this age group.

Aortic Valve Stenosis↗
PubMed1975

Carcinoid heart disease: successful tricuspid valve replacement.

A woman aged 46 was found to have severe tricuspid valve disease 14 years after the diagnosis of a malignant carcinoid tumour of the ileum and 33 years after the onset of symptoms attributable to the disease. Increasing ascites requiring repeated paracentesis had not responded to chemotherapy including infusion of 5-fluorouracil and vincristine into the coeliac artery. The tricuspid valve was replaced by a Björk-Shiley prosthesis. After operation there was no recurrence of ascites or oedema. She remains well one year and 11 months later. It is suggested that valve replacement surgery should be considered more often in patients with carcinoid heart disease. Hepatomegaly and ascites sould not be attributed too readily to advancing malignant disease without careful consideration of the role of right-sided valvar lesions in the production of these signs.

Adult↗