PubMed Health⌕ Search

Biomedical subjects

R Mair

Publications and source records attributed to R Mair.

26 records · Page 2Linked to original sources
PubMed1993

Cardiac angiosarcoma--a diagnostic dilemma.

A 25-year-old man suffering from sudden onset of haemoptysis after 1 week of orthopnoea, fatigue and general weakness was admitted to a cardiology department in Vienna. No diagnosis was made. Four weeks later cardiopulmonary resuscitation and pericardiocentesis were necessary because of cardiac tamponade. Although all modern imaging procedures were performed, a diagnosis of rapidly progressive primary cardiac angiosarcoma could not be established. Definitive diagnosis was established only after exploratory median sternotomy. The patient exhibited no response to chemotherapy. He died 5 days after surgery as a result of respiratory failure.

Adult↗
PubMed1993

[Surgical management of coronary heart disease and simultaneous carotid artery stenosis].

Simultaneous carotid endarterectomy and open-heart procedures (bypass, aortic and mitral valve replacement, arterial myxoma) were performed on 89 patients. The indication for carotid endarterectomy were either preoperative neurological symptoms (n = 36) or radiologically verified, hämodynamically relevant stenosis of more than 50-60% (n = 53). The postoperative course was uneventful in 80 patients (90%). Neurological complications occurred in 5 patients; 4 had required surgery for pre-operative neurological symptomatology and 1 of these patients died from postoperative stroke. Cardiac complications occurred in 4 patients, one of whom died because of bypass thrombosis with subsequent myocardial infarction. Many authors have different opinions regarding indication, technical procedures and optimum time of operation. We consider the simultaneous operative procedure of carotid endarterectomy and open heart procedures justified in view of the neurological complication rate of approximately 5% in our group of patients.

Aged↗
PubMed1992

Early results of cryopreserved pulmonary allografts as aortic valve substitute.

Excellent clinical results with pulmonary autografts and experimental evidence that the pulmonary valve can withstand the higher stress in the systemic circulation led us to use the cryopreserved pulmonary allograft for aortic valve replacement. From September 1988 to March 1991, 45 consecutive patients (59.9 +/- 12.0 years, 25 men and 20 women) received a cryopreserved pulmonary allograft in the aortic position from our hospital based valve bank. All allografts were inserted freehand in the subcoronary position. There were 3 in-hospital deaths (7%) and 1 patient had severe valvular incompetence immediately postoperatively requiring reoperation after 4 weeks. Forty-one patients were followed at 3-6 month interval for 14.7 +/- 7.8 months (3-28 months) and valve performance was assessed routinely by means of color flow Doppler echocardiography: 34 patients (83%) had no or trivial aortic valve regurgitation. Valvular incompetence class II was present in 2 patients (5%) whereas 3 (7%) demonstrated class II-III. Severe aortic regurgitation (class III-IV) could be detected in 2 patients (5%). Both had to undergo reoperation 4 months and 15 months, respectively, postoperatively. Macroscopic and histological evaluation of the explanted valves demonstrated absence of significant degeneration. We assume that a mismatch in size between allograft and aortic annulus could have lead to dilatation of the allograft valve ring and consequently to valvular incompetence. Pulmonary cryopreserved allografts achieve acceptable short-term results which can be improved if initial technical problems can be avoided.

Adult↗
PubMed1992

Aortic valve replacement with the pulmonary autograft--experience of 23 cases.

Since 1988 an intensive homograft-program has existed at the Linz General Hospital. We have installed an own hospital-based homograft bank, where the allografts, after a 24-hour sterilization-period in an antibiotic solution and a controlled freezing procedure, are stored in liquid nitrogen at -196 degrees C. In 1991 for the first time aortic valve replacement was performed by pulmonary autograft in 23, mainly younger, patients. Essentially our technique conforms with that of D. N. Ross, in the course of which 18 autografts were implanted in subcoronary position and 5 aortic-root replacements were performed. 3 patients died perioperatively, 2 times a severe post-operative bleeding with following hypoxemic brain damage being the cause; 3 more patients had to be rethoracotomized because of postoperative bleedings. All these were attributed to a technical difficulty, which was overcome. In one patient a left-ventricular assist device had to be installed due to a left-ventricular failure, a successful heart transplantation followed on the 8th postoperative day. A follow-up was conducted in all patients every 3 months. In 2 patients a substantial valve incompetence of grade II-III and grade III was detected, all other patients showed no regurgitation of clinical relevance. Despite our initial difficulties it is our opinion that the many advantages-no anticoagulation necessary, no valve sound, less incidence of bacterial endocarditis, and longer durability-do justify this operative procedure.

Adolescent↗
PubMed1992

[Development of arterial revascularization of the myocardium at the Linz general hospital. Personal experiences with 1000 patients].

Arterial revascularization of the myocardium, particularly the use of the internal mammary artery (IMA) as a bypass graft in coronary artery surgery has become an established procedure over the past decade. From March 1986 to June 1991, of 2070 patients who underwent coronary heart surgery at our department, revascularization of the myocardium was performed with an IMA graft in 1000 cases, whereby the percentage increased from 10.4% in 1986 to 75.0% in 1991 (p less than 0.01). The range of indications gradually widened throughout the period, age no longer being a contradiction today. One reason for this development is the substantial improvement in IMA preparation technique. No increase was found in rethoracotomy rate or in the rate of perioperative infarctions. The mean age of patients receiving an IMA graft increased from 55.2 years (1986) to 64.7 years (1991) and therefore reflects the change in ranges of indication. 54 IMA jump grafts were anastomosed, in 30 cases bilateral IMAs were used and the IMA was implanted as a free graft twice. In the future these successful results with the implementation of IMA grafts will lead to a further displacement of the saphenous vein as main bypass material.

Austria↗
PubMed1980

Odor discrimination and memory in Korsakoff's psychosis.

Korsakoff's syndrome is an organic brain disease, characterized by severe amnesia, that has been associated with olfactory perceptual deficits. Two experiments utilized normal observers to describe the effect of similarity on odor recognition memory and to develop methodology to measure odor discrimination and memory in patients with Korsakoff's disease. The results demonstrate an impaired capacity to discriminate between odors among patients with this disease that is not attributable to impaired sensitivity or to rapid decay of memory stores. These results are compared with results from animals with lesions affecting the medial layer of the mediodorsal thalamic nucleus and its neocortical projections. This structure is consistently damaged in Korsakoff's disease and receives a major input from primary olfactory cortex.

Alcohol Amnestic Disorder↗
PubMedDate not supplied

[Symptomatic congenital complete atrioventricular block--a medical challenge].

Congenital complete atrioventricular block is a rare entity. The association between this disease, maternal connective tissue disease and maternal antibodies [anti-Ro (SS-A) resp. anti-La (SS B)] is well known. Diagnosis can be made by means of fetal Doppler-echocardiography by the 16th week of gestation. In our case diagnosis was established in the 21st week of gestation. Ventricular rate was 55/min, atrial rate 70/min. There were no signs of fetal hydrops. There were no signs of maternal connective tissue disease, but anti-Ro and anti-La antibodies could be detected. The mother was treated with steroids from the time of diagnosis until the end of pregnancy. Altogether 9 Doppler-echocardiographic studies were performed. A recurrence of normal rhythm did not occur. A slow but continuous decrease of atrial and ventricular rate was observed. Interestingly, there was no development of fetal hydrops until the very end of pregnancy when the fetal heart rate reached a low of 28 beats per minute. We speculate, that the therapy with steroids might have played an important role in the prevention of early hydrops. At the onset of fetal hydrops delivery should be considered. In symptomatic complete atrioventricular block we prefer the implantation of a permanent pacemaker system immediately after birth. Efficient care for the fetus resp. the newborn can only be achieved through well planned cooperation.

Adult↗