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R Griepp

Publications and source records attributed to R Griepp.

9 recordsLinked to original sources
PubMed1987

Angioplasty for coarctation of the aorta: long-term results.

Balloon coarctation angioplasty (BCA) was performed in seven consecutive patients (five boys and two girls) 18 months to 18 years old (mean 9.5) with isolated discrete unoperated coarctation of the aorta. A No. 8F or 9F catheter was chosen with balloon lengths of 30 or 40 mm and maximum inflation diameters 1 mm less than the smallest measured aortic diameter determined 1 cm proximal to the coarctation site. A 10 sec inflation-deflation cycle of 6 to 8 atmospheres (90 to 120 psi) was performed. The peak systolic pressure gradient (PSG) before BCA ranged from 35 to 70 mm Hg (mean 58), and immediately after BCA it decreased to 0 to 20 mm Hg (mean 7). One to two year follow-up (mean 14 months) of the seven patients revealed a PSG range of 10 to 30 mm Hg (mean 19). Repeat angiography was performed immediately proximal to the coarctation site. Three patients (43%) had evidence of aneurysm formation at or immediately distal to the balloon dilatation site. One patient had coarctation restenosis. While initial results with BCA for unoperated coarctation were encouraging, current data raise serious concerns about its long-term safety and efficacy.

Adolescent↗
PubMed1985

Retrograde intubation in patients undergoing open heart surgery.

Cardiovascular changes during difficult intubation were studied in 25 patients undergoing open heart surgery. The study was divided into two phases. Phase A from the first laryngoscopy to the fourth unsuccessful one; Phase B from a stabilization period until after retrograde intubation was performed. During phase A, heart rate (HR) increased significantly from 75 +/- 6.5 beats/min before laryngoscopy to 95 +/- 8.5 (p less than 0.05) after the last laryngoscopy. Mean arterial pressure (MAP) also increased from 82.5 +/- 4.75 mmHg to 105 +/- 5.15 (p less than 0.005) after the last laryngoscopy. Cardiac index (CI) decreased from 2.9 +/- 0.3 L . min-1 . m-2 before to 2.55 +/-0.2 after the last laryngoscopy. Pulmonary capillary wedge pressure (PCWP) increased from 10.5 +/- 1 mmHg before to 19.25 +/- 1.5 (p less than 0.01) after the last laryngoscopy. No statistically significant changes in HR, MAP, CI, and PCWP occurred before and after intubation during Phase B. Three patients had elevated ST segments during Phase A which responded to IV nitroglycerin and propranolol. None was detected during Phase B. There were more lacerated lips and teeth damaged during Phase A. One patient developed a small peritracheal haematoma after the retrograde intubation, for which no treatment was required. This technique is safe and produces minimal cardiovascular changes for difficult intubation in patients undergoing open heart surgery.

Aortic Valve↗
PubMed1979

Glucose-induced insulin release during acute and chronic hypoxia.

Glucose-induced insulin release was studied in young dogs during acute and chronic hypoxia, alone and in combination. Six experimental animals were rendered chronically hypoxic (PaO2, 43.4 +/- 0.5 torr) by creation of a right-to-left shunt at age 6-8 wk. Six control animals underwent sham procedures (PaO2, 85 +/- 2.2 torr) at the same age. During air breathing, glucose-induced plasma insulin increases were similar in chronically hypoxic and control animals. When severe hypoxia was acutely produced by ventilation with low-oxygen mixtures in experimental (PaO2, 23.7 +/- 1.7 torr) and control animals (PaO2, 26.3 +/- 1.0 torr), plasma insulin responses were markedly inhibited in both. On the other hand, acutely lowering oxygen tensions of control animals (PaO2, 37.5 +/- 1.4 torr) to levels close to those of air-breathing chronically hypoxic animals did not affect the insulin responses. These observations suggest that glucose-induced insulin release is inhibited by acute severe hypoxia despite previous chronic oxygen deficiency. In contrast, moderate hypoxia, acute or chronic, does not appear to affect the insulin response to a glucose load.

Animals↗
PubMedDate not supplied

Residual dissection of the thoracic aorta after repair: MRI-angiographic correlation.

Thirteen patients' status post repair of thoracic aortic dissection were studied with both magnetic resonance and angiography. MRI was an accurate modality in identifying residual dissection when aortography was used as the gold standard. MRI can be used as a noninvasive modality for the follow-up of these patients.

Aortic Dissection↗