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Biomedical subjects

O M Hess

Publications and source records attributed to O M Hess.

At least 19 recordsLinked to original sources
PubMed1979

[Acute bacterial endocarditis caused by streptococci of Lancefield group C (author's transl)].

An Angell-Shiley heterograft valve was implanted in a 32-year-old woman with severe aortic regurgitation and stenosis. Post-operatively acute bacterial endocarditis occurred, due to group C streptococci. Because of severe acute aortic insufficiency with partial dehiscence of the heterograft valve and increasing left heart failure re-operation was necessary. After successful replacement of the valve an aortocoronary bypass was connected to the left circumflex artery because of displacement of the left coronary ostium. In addition, an aortoplasty was performed for spontaneous aortic rupture. Because of severe left heart failure with myocardial infarction in the course of the operation circulatory support with a paracorporeal artificial heart was necessary for 60 hours postoperatively. Despite transitory improvement the patient died from septic shock 30 days after the re-operation.

Adult↗
PubMed1979

[Immunohistologic findings in patients with myocardial hypertrophy].

Heart reactive antibodies have been found with direct and indirect immunofluorescence in patients with congestive cardiomyopathy. The authors therefore investigated by direct immunofluorescence 25 patients with aortic valve disease and 11 patients with congestive cardiomyopathy who underwent diagnostic heart catheterization and left ventricular endomyocardial biopsy. The left ventricular biopsies were fixed by bouin, formaline and freeze-drying. A first analysis was performed to determine auto- or formaline-induced fluorescence. A second analysis was performed to identify myocardial structures with positive fluorescence using 5 different anti-sera or patient's serum. The results showed positive fluorescence with anti-IgG-antibodies in patients with aortic valve disease (23%) and with congestive cardiomyopathy (73%). The immunoglobulin deposits were located mainly in the subendocardial connective tissue. These deposits showed also slight fluorescence with anti-IgM, anti-C1q and anti-C4 antibodies. However, a correlation between the hemodynamic and immunologic findings was not demonstrated. It is concluded that the myocardial immune complexes appear to be reactive and do not play an essential role in the pathogenesis of congestive cardiomyopathy.

Angiocardiography↗
PubMed1979

[Muscle fiber hypertrophy and myocardial function of the left ventricle in patients with chronic volume stress and cardiomyopathy].

Left ventricular angiography and endomyocardial biopsy were performed in 10 patients with aortic insufficiency and in 10 patients with congestive cardiomyopathy. Muscle fibre diameter and interstitial fibrosis were determined. In aortic insufficiency the diameter of muscle fibres is highest in the endstage, while in congestive cardiomyopathy it is highest in the earliest stage.

Aortic Valve Insufficiency↗
PubMed1979

[Plasma myoglobin level as a course criterium in patients with acute myocardial infarct].

Myoglobin and the enzymatic activity of creatine phosphokinase CK), MB-isoenzyme of CK (CK-MB), aspartate aminotransferase (GOT), alanine aminotransferase (GPT) and lactic acid dehydrogenase (LDH) were serially determined in 10 patients with acute myocardial infarction. Additionally the same parameters were assessed in 5 patients with angina pectoris for 24 hours after bicycle ergometry. 10 in-patients served as controls. Myoglobin was determined by radioimmunoassay and the other enzyme activities according to the current kinetic methods. Comparison of myoglobin with the enzymatic parameters showed that the myoglobin peak occurs 5.6 hours after the beginning of the sampling period, i.e. 7.3 hours earlier than CK and CK-MB and 11.6 hours earlier than GOT. In analogy to this finding the descending limb of the myoglobin curve was significantly earlier at a level of one third of the peak value, i.e. 8.2 hours earlier than CK-MB, 18.8 hours earlier than CK and 27.3 hours earlier than GOT. No signs of myocardial necrosis in terms of myoglobin or enzymatic activity could be detected after bicycle ergometry. It is concluded that myoglobin is a more sensitive parameter for assessment of the acute phase in patients with myocardial infarction than the usualy enzymatic parameters.

Acute Disease↗
PubMed1979

[Goldenhar syndrome].

The basic features of Goldenhar syndrome are preauricular appendices, epibulbar dermoids, vertebral and cardiac anomalies, and hypoplasia of the lungs. The syndrome appears to be caused by early damage during the first or second month of embryonic development. Prognosis is most often determined by the underlying heart disease. In the present study a 24-year-old female student is reported who exhibited a preauricular appendix on the right side, severe thoracic scoliosis, aplasia of the middle and lower lobes of the right lung, dextropositio cordis and an atrial septal defect with severe pulmonary hypertension. Cineangiocardiography revealed a mitral valve prolapse with slight mitral regurgitation and a dilated right ventricle with severe tricuspid regurgitation. Left and right ventricular function was slightly to moderately reduced. Selective coronary arteriography revealed a coronary fistula from an atrial branch of the left coronary artery to the right atrium. Symptomatic therapy with digitalis, anticoagulation and repeated venesection was initiated because of the severe hemodynamic findings. However, the patient developed syncope at increasingly frequent intervals and died 3 months after the initial examination.

Adult↗
PubMed1979

Hemodynamic changes after experimental reduction of the left atrium.

Two experimental models were studied to determine the hemodynamic consequences of atrial volume reduction as observed after operative correction of transposition of the great arteries. The volume of the left atrium (LA) was reduced either by inflation of an intracavitary balloon (group A) or by surgical intervention (group B) to 50--60% of the control values as determined by angiography. The angiographic data correlated well with the true volumes obtained by water displacement. This major reduction of LA volume caused small but constant hemodynamic changes. Although the LA stroke volume decreased by 50% and the LA/LV volume relation was reduced by 50% (from 0.42 to 0.21), there was only a slight increase of pulmonary artery pressure (7% in group A and 14% in group B) and a slight decrease in cardiac index (13% in group A and 10% in group B) and in left ventricular end-diastolic pressure (9% in group A and 11% in group B). The reduction of atrial volume results in only minor functional alteration of the intact heart.

Animals↗
PubMed1979

[Correlation the laevocardiogram and plain chest films in the presence of myocardial insufficiency (author's transl)].

A correlation was attempted in 106 patients with myocardial insufficiency between linear and volume parameters of the laevocardiogram and the corresponding parameters on plain chest films, as well as between pressure measurements and the degree of pulmonary congestion. Measurements on the plain radiograph provide only limited information on the function of the myocardium and the severity of myocardial lesion respectively. Nevertheless, they are of some value during the course of the disease.

Adolescent↗
PubMed1979

Pre- and postoperative left ventricular contractile function in patients with aortic valve disease.

In 43 patients left ventricular micromanometry and cineangiography were performed preoperatively and and 20 months after aortic valve replacement. A score of left ventricular functional impairment, derived from 5 to 8 haemodynamic variables, was calculated as: number of pathological indices x 100/total number of determined indices. Preoperatively the score of left ventricular functional impairment amounted to 35 per cent in group 1 (aortic stenosis: n = 19), to 61 per cent in group 2 (combined lesion:n = 15) (P less than 0.05), and to 87 per cent in group 3 (aortic regurgitation: n = 9) (P less than 0.001). In contrast, the functional classification according to the NYHA showed similar impairment in the 3 groups. Postoperatively the score of left ventricular functional impairment decreased significantly in all 3 groups to 10, 16, and 27 per cent, respectively, but the score of group 3 remained raised (P less than 0.05) as compared with that of group 1. The patients with residual left ventricular dysfunction had a higher preoperative left ventricular muscle mass than the patients with normal or near normal postoperative left ventricular function. It is concluded that (1) at similar functional impairment according to the NYHA classification left ventricular contractile function is more severely impaired in aortic regurgitation and in aortic regurgitation + aortic stenosis than in aortic stenosis alone, (2) left ventricular function improves significantly after valve replacement in all three forms of aortic valve disease, (3) residual functional impairment is greater in aortic regurgitation than in aortic stenosis or aortic stenosis + aortic regurgitation, and (4) persistent postoperative left ventricular functional impairment is found in the patients with severe preoperative hypertrophy.

Adult↗
PubMed1979

Left ventricular function in patients with hypertrophic nonobstructive cardiomyopathy.

From 1970 to 1977 the diagnosis of hypertrophic, nonobstructive cardiomyopathy was made by clinical, echocardiographic and hemodynamic findings in 13 patients (2 females and 11 males). Echocardiography showed asymmetric septal hypertrophy in 10 of the 12 evaluated patients (83%) and symmetric hypertrophy of the septum and the posterior wall in 2 patients (17%). Systolic anterior motion of the anterior mitral leaflet was found in 5 patients (42%) although there was no obstruction of the outflow tract. Significantly higher angiographic ejection parameters were present in the 13 patients with cardiomyopathy compared to 13 control patients and the angiographic lateral wall thickness was significantly larger in patients with cardiomyopathy than in controls. The clinical course was followed during 36 mth; a stable course was found in 8 (group A) and a deterioration in 5 patients (group B). Physical working capacity and left ventricular systolic ejection fraction were significantly higher in group A than in group B. Ejection fraction in group B was similar to that of the controls whereas physical working capacity was depressed. Thus, in nonobstructive cardiomyopathy a higher than normal ejection fraction is needed to maintain a normal physical working capacity. Th increased ejection performance seems, however, not to be related to an increase in muscle fiber shortening, but can be explained by geometric reasons.

Adult↗
PubMed1978

[The oto-vertebral syndrome].

The oto-vertebral syndrome is a rare combination of malformations of the ears, spinal anomalies, and congenital heart disease. The syndrome appears to be caused by early embryonic exogenous damage during the 6th or 7th week of embryonic development. The case is reported of a 28-year-old man with bilateral aplasia of the external ear, bilateral aplasia of the ear canal, hypoplasia of the mandibula, severe thoracic scoliosis, and ventricular septal defect with pulmonary hypertension. He was admitted with dyspnea on exertion, syncope, and severe cyanosis. Cardiac catheterization revealed severe pulmonary hypertension with moderate right-to-left and slightly left-to-right shunt (Eisenmenger syndrome). Right and left ventricular function, as evaluated by angiocardiography, was slightly reduced. Because of the severe hemodynamic alterations, symptomatic therapy with digitalis, repeated venesection, and anticoagulation was initiated.

Abnormalities, Multiple↗
PubMed1978

[Familial mesomelial dwarfism (Nievergelt syndrome)].

Familial mesomelic dwarfism was first described in 1944 by K. NIEVERGELT, who reported on a father and 3 sons by 3 different mothers who had shortening of the middle segment limbs. in the present study the family described by NIEVERGELT in 1944 is reevaluated and the mode of inheritance investigated over a period of 3 generations. Six patients with mesomelic dwarfism were found out of 43 family members. Two patients, a son of the first patient with mesomelic dwarfism and his son, were seen at our institution. Both presented a rare deformity-combination of the upper and lower extremities. In the upper extremities radio-ulnar synostosis, asymmetrically shaped elbow joints, subluxations of the radial head and a deficient supination capacity of the forearm were diagnosed. The deformities were nearly symmetrical, but a slight predilection for the left forearm was noted. In the lower extremities atypical club-feet with supination of the forefeet, shortening of tibia and fibula and marked synostosis of tarsal and metatarsal bones were seen. The legs were rhombic and supination and pronation of the forefeet were severely reduced. Synostosis of the tibia and fibula and deformities of the toes were found in both patients. The mode of inheritance was considered to be autosomal dominant with high penetrance. It is concluded that familial mesomelic dwarfism is an autosomal dominant disease of the upper and lower limbs with atypical club-feet, marked radio-ulnar, tibia-fibular and tarsal synostosis and deformities of the elbow joints.

Chromosome Aberrations↗