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Biomedical subjects

M Peuster

Publications and source records attributed to M Peuster.

29 records · Page 2Linked to original sources
PubMed2000

Endovascular stenting as an emergency treatment for neonatal coarctation.

We describe a neonate with critical coarctation of the aorta. Since treatment with Prostaglandin E1 had failed to reopen the arterial duct, and surgery was deemed to be associated with an unacceptably high risk in this unstable neonate, it was decided to perform balloon dilation of the coarctation as a palliative procedure to stabilize the patient. Balloon angioplasty failed to reduce the pressure gradient across the coarctation, so a stent was implanted retrogradely as an emergency procedure. Subsequently, the stented segment was resected surgically and end-to-end anastomosis created without complications at seven months of age.

Aortic Coarctation↗
PubMed2000

A novel method for transcatheter closure of atrial septal defect within an aneurysm of the fossa ovalis: double sheath technique.

An aneurysm of the fossa ovalis is frequently associated with an atrial septal defect. Intervention with transcatheter closure of such defects may be difficult since it bears the risk of inadvertent deployment of the device with both umbrellas in the right or left atrium. A novel technique for the closure of such multiperforated aneurysms of the fossa ovalis, which allows central positioning and controlled deployment of the device, is reported.

Aortic Dissection↗
PubMed1999

Percutaneous transluminal angioplasty for the treatment of complete arterial occlusion after retrograde cardiac catheterization in infancy.

Nine patients with arterial thrombosis were treated with transcatheter recanalization and subsequent balloon dilation of the occluded vessel. Repeat angiography or duplex sonography 3 to 14 months after intervention showed completely patent arteries without restenosis in 7 patients; there was residual narrowing of the vessel in the remaining 2 patients.

Angiography↗
PubMed1998

Transcatheter recanalization and subsequent stent implantation for the treatment of early postoperative thrombosis of modified Blalock-Taussig shunts in two children.

Two babies with duct-dependent cyanotic congenital heart disease were palliated with modified Blalock-Taussig shunts. One patient was diagnosed to have tetralogy of Fallot, and the other patient, tricuspid atresia type Ia. Early postoperative arterial oxygen saturations dropped significantly due to shunt thrombosis. Both patients were successfully treated with angioplasty and stent implantation.

Angioplasty, Balloon, Coronary↗
PubMed1998

[Percutaneous transcardiac intraluminal balloon angioplasty for reopening an arterial thrombosis after percutaneous arterial heart catheterization in a 19-month-old patient with tetralogy of Fallot].

Cardiac catheterization is a common cause of arterial thrombosis in children. Besides heparin therapy, fibrinolysis plays a major role in the therapeutic approaches to arterial thrombosis while surgery is rarely performed in pediatric patients. We report on a 19 month old patient with tetralogy of fallot, who developed thrombosis of the right femoral artery after a retrograde interventional cardiac catheterization. We performed an antegrade balloon angioplasty of his thrombosed femoral artery using a transvenous, transcardial approach via a ventricular septal defect. There were no complications. Doppler sonography showed no residual stenosis after 4 months.

Angioplasty, Balloon↗
PubMed1998

[Mechanical recanalization of venous thrombosis and pulmonary embolism with the Clotbuster thrombectomy system in a 12-year-old boy].

The treatment of patients with deep vein thrombosis and pulmonary embolism with contraindications for a thrombolytic therapy is a therapeutic challenge. We report on a 12 year old patient who was treated for large cell lymphoma according to NHL-BFM 95: Block AA protocol. During his therapy, he developed a thrombosis of his right femoral vein and pulmonary embolism affecting the left segments 4, 5, 8, and 9. Because of cerebral metastasis a fibrinolytic therapy was contraindicated. Therefore, we performed a mechanical thrombectomy using the Amplatz thrombectomy device. The postinterventional scintigraphy showed a markedly improved pulmonary perfusion; dopplersonography 4 months postinterventionally showed a patent right femoral vein.

Angiography↗
PubMed1998

[Interventional therapy for hemangioendothelioma of the liver in a newborn infant using a central venous approach].

We report on a newborn (birth weight 3600 g) with high-output cardiac failure due to a large hepatic hemangioendothelioma requiring mechanical ventilation. One day post-partum therapy with steroids, furosemide, and digitalis was initiated. Despite this, the clinical condition deteriorated. Therefore, selective coil-embolization of the arterial vessels supplying the hemangioendothelioma was performed using a venous approach with passage to the arterial side via the ductus arteriosus. After the embolization the patient improved quickly and he was extubated 4 days postinterventionally. Follow-up sonography 4 months postinterventionally showed dramatic regression of the hepatic tumor. We conclude that the coil-occlusion of hepatic hemangioendothelioma should be performed early in symptomatic newborns as arterial puncture and its associated complications can be avoided by using a venous approach with passage to the arterial side via the ductus arteriosus. In addition, in this age group, access to the portal system can be gained through the umbilical vein to occlude portal venous supplies to the hepatic hemangioendothelioma.

Catheterization, Central Venous↗
PubMed1998

Radiofrequency current application on immature porcine atrial myocardium: no evidence of areas of slow conduction after 12-month follow-up.

INTRODUCTION: Radiofrequency current (RFC) application is a widely used procedure for treatment of supraventricular arrhythmias. The purpose of this study was to investigate late electrophysiologic sequelae of RFC lesions at immature atrial myocardium in pigs, as they have not yet been systematically investigated in vitro. METHODS AND RESULTS: RFC application (temperature guided) was performed in seven piglets (mean age 6 weeks) by a steerable 6-French electrode catheter positioned at the lateral aspect of the tricuspid valve annulus. After 12 months, hearts were removed, and lesions with surrounding tissue were isolated. The viable tissue at the border of the specimen was paced with a cycle length of 500 and 600 msec. One hundred fifty impalements were performed on each specimen using capillary microelectrodes to record action potential characteristics from the lesion's surface and the surrounding tissue. In all seven specimens, no transmembrane action potentials from the fibrotic surface of each of the lesions could be recorded. The surrounding viable tissue was sharply demarcated electrically. No areas of slow conduction were detected. Action potential characteristics as mean maximum diastolic transmembrane potential, mean action potential duration at 90% repolarization, and upstroke velocity of phase 0 of the action potential were all normal. CONCLUSION: No evidence of areas of slow conduction 12 months after RFC application at immature atrial myocardium suggests that this technique is safe regarding occurrence of late atrial tachyarrhythmias after the procedure.

Action Potentials↗
PubMedDate not supplied

[Case report: neonatal hypertension].

BACKGROUND: Neonatal arterial hypertension is rare with an incidence between 0.2 - 3 %. Clinical presentation varies widely and is in some cases dramatic. PATIENT: A 4-day old full-term neonate was admitted to the intensive care unit with severe congestive heart failure and metabolic acidosis. Mechanical ventilation was initiated and dobutamine administered because of poor systolic function. Continuous monitoring of blood pressure revealed severe arterial hypertension (30 to 40 mm Hg above the 95th percentile). Ultrasonography showed an echogenic left kidney with normal perfusion. Laboratory examinations revealed a raised peripheral renin activity, thrombocytopenia, slightly raised d-dimers, a microhematuria and mild proteinuria. After resolution of hypertension under therapy with an ACE-inhibitor, a MAG3 renal scan showed complete absence of renal function on the left side. Renal artery stenosis was excluded by venous transcardial angiography. Under therapy with Captopril, the patient was discharged and followed up for 8 months. He is developing normally with normal serum creatinine (0.4 mg/dl), but low renal function (17 %) of the left side as assessed by DMSA-scan and compensatory right kidney hypertrophy are observed. DISCUSSION: Diagnosis and treatment of neonatal hypertension are discussed with respect to the proposed case. After exclusion of other causes we conclude that a perinatal microangiopathic event may have lead to the renal lesions with malignant renovascular hypertension.

Age Factors↗