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Biomedical subjects

R Lufschanowski

Publications and source records attributed to R Lufschanowski.

34 records · Page 2Linked to original sources

Alterations in the coronary circulation of man following ascent to 3,100 m altitude.

Alterations in coronary blood flow associated with adaptation to high altitude were examined. Three normal men native to low altitude were studied, first at sea level, and again after 10 days' sojourn at 3,100 m altitude. During rest at high altitude, a 32% decrease in coronary blood flow was largely offset by a 28% increase in coronary arterial O2 extraction to maintain myocardial O2 delivery. The increase in O2 extraction resulted mainly from a decrease in coronary sinus blood O2 content and saturation. However, coronary sinus O2 tension remained constant, implying a decrease in the affinity of hemoglobin for O2. These observations are consistent with the hypothesis that coronary blood flow is regulated to maintain constant myocardial tissue O2 tension (as reflected here by coronary sinus blood O2 tension). The absence of a decrease in coronary sinus O2 tension or a decrease in myocardial lactate extraction imply that myocardial hypoxia did not develop. Therefore, myocardial hypoxia is not the basis for the decrease in cardiac stroke volume at high altitude reported previously and also observed in the present study.

Adaptation, Physiological↗

Occlusion of the left main coronary artery secondary to left ventricular angioma.

Our experience with a patient who had an angioma of the anterior wall of the left ventricle that produced complete occlusion of the left main coronary artery is presented. Diagnosis was made before surgery from findings on cineangiographic studies. Successful surgical treatment consisted of a double aortocoronary bypass to the left anterior descending and obtuse marginal coronary arteries. The angioma was left undisturbed.

Adult↗

[Anomalous origin of the left coronary artery from the pulmonary artery (author's transl)].

The case of a three year-old child with anomalous origin of the left coronary artery from the pulmonary artery is presented. He had a clinical picture and an electrocardiographic pattern of antero-lateral myocardial infarction that suggested a cardiac malformation. Once the diagnosis was established by cardiac catheterization and coronary arteriography, the defect was successfully correted by transplanting the anomalous coronary vessel to the aorta. The clinical, electrocardiographic and angiographic features of the anomaly are given.

Aorta↗

Surgical experience in patients with Marfan's syndrome, ascending aortic aneurysm and aortic regurgitation.

Surgical treatment of cardiovascular complications in patients with Marfan's syndrome is usually recommended with apprehension since the systemic nature of the disease predisposes to early and late complications. To define the incidence of these complications, 30 patients were evaluated after surgical treatment of aortic insufficiency and ascending aortic aneurysm at the Texas Heart Institute. To provide a minimal follow-up period of 5 years, only patients operated upon during of before 1968 were included in this series. There were 9 female and 21 male patients aged 4 to 80 years (mean 44 years). Aortic insufficiency was treated by valvuloplasty in 3 patients and by aortic valve replacement in 27. Graft replacement of the ascending aorta was required in 23 patients, and the aneurysm was excised and the aorta repaired by direct anastomosis in 7. Two patients were lost to follow-up study; 12 of the remaining 28 (42.8 percent) lived 5 years or more. The hospital mortality rate was 20 percent (6 of 30); the causes of death included dissection or rupture of the aorta in three patients, congestive heart failure in two and pulmonary embolism in one. The 24 survivors lived from 5 weeks to 9 years. Follow-up data were available on 22 of these patients. Ten of these (45.4 percent) died of late complications. Seven died suddenly, four of these had redissection, one patient had occlusion of the right coronary artery, and two had ventricular fibrillation of no apparent cause. The remaining three died of noncardiac causes. Although the risk of ascending aortic and aortic valve surgery in patients with Marfan's syndrome is high, 42.8 percent of the patients in our series survived 5 years or more. We believe that surgery should be recommended for patients with Marfan's disease who have dissection of the aorta or severe aortic regurgitation, or both.

Adolescent↗