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Biomedical subjects

W Hepp

Publications and source records attributed to W Hepp.

71 records · Page 4Linked to original sources
PubMed1980

[Aneurysm of the infrarenal abdominal aorta].

The experience with 125 consecutive patients who underwent operations for infrarenal aortic aneurysm is presented. Two intervals of four years each were reviewed and compared: period A (1970-1974) and period B (1975-1978). With a simpler and shorter technique (dissection method), and more frequent operations (+72%), the operative mortality in cases of nonruptured aneurysms decreased from 14.3% (A) to 2,1% (B); in cases of ruptured aneurysms, from 61,1% (A) to 48,4% (B). In cases of elective operation there was no significant correlation of mortality to age, concomitant coronary disease (52,5%), and occlusive disease of peripheral vessels. The improved results are due to simplification and standardization of operative procedures and to use of efficient intensive care possibilities.

Age Factors↗
PubMed1979

Experimental studies on the use of microwaves for the localized heat treatment of the prostate.

High frequency tumor therapy requests heating of a well defined area, whereas the surroundings should be unaffected. This sort of therapy should be more tolerable than a whole body heating. For this purpose a new developed microwave applicator (433.9 MHz) for local heat application was tested in animals. Using this rectally insertable applicator the prostate of dogs were irradiated. The temperature of the rectum, the urethra and the prostate were measured and recorded using specially developed thermistor probes. The effect of hyperthermia on the prostate and the surrounding tissue was analyzed macroscopically and micromorphologically. It was shown that local heating of the prostate of dogs is possible. The induced damages of the prostate and surrounding tissue is not severe enough to be untolerable.

Animals↗
PubMed1979

[Reconstructive measures to prevent lower extremity amputation for atherosclerotic occlusive disease in old age and the results obtained between 1973 to 1977 (author's transl)].

Within a 5-year-period 102 patients over the age of 70 were admitted with atherosclerotic occlusive disease. All patients had rest pain or necrosis. In 12,8% only a primary amputation could be performed. The procedures and results of reconstructive surgery on 89 patients were demonstrated: mortality rate of 11,2%, a secondary amputation rate of 13,5% and improvement of 75,3%. The problems after amputation in the senium are discussed.

Age Factors↗
PubMed1979

[External mechanical cardiac stimulation. Methods and possible application (author's transl)].

External mechanical cardiac stimulation represents a noninvasive method for myocardial stimulation which has significant advantages of external electric stimulation. This paper describes a new method using pressure- and shockwaves for transthoracic cardiac stimulation. On the basis of animal experiments the potential value of external mechanical stimulation for emergency medicine and various other therapeutic and diagnostic procedures are discussed.

Animals↗
PubMed1978

[Reconstructive surgery of the peripheral arteries in elderly people].

The results of reconstructive surgery of atherosclerotic occlusive disease in the senium are reported on 71 patients. Mortality rate of 14.68% and improvement of 63.38% showed clearly better results than described in literature with an amputation mortality rate between 26% and 60%. In the authors' opinion also in the senium the reconstructive surgery of the peripheral arterial system should be preferred if general and local operability are given.

Age Factors↗
PubMed1975

[Experiences with the Sparks-prosthesis in the periphery (author's transl)].

According to our own experiences it is not advisable to implant the Sparks-Mandril in an extremity which gangrene. The ideal case for implantation is the patient with short walking distance and an unsuitable vena saphena magna. The prothesis is useful for the femoro-crural bypass procedure. The thrombogenicity of the Mandril can be neglected by heparinization of the patient or after careful perfusion of the prothesis.

Bacterial Infections↗
PubMedDate not supplied

Present role of extraanatomic bypass graft procedures for aortoiliac occlusive disease.

In a retrospective follow-up the long-term results and present role of axillofemoral and transverse femorofemoral bypass grafts are evaluated. During the period from 1970 until 1989 173 extraanatomic bypass operations were carried out on 150 high risk patients. There were 131 axillofemoral and 42 femorofemoral bypass grafts. In elective operations the mortality ranged from 5.3% for the axillofemoral bypass and 2.4% for the femorofemoral bypass. A five year postoperative follow-up showed a cumulative patency rate of 86.82% for the femorofemoral bypass, 73.74% for the axillo-bifemoral bypass and 43.18% for the unilateral modification. After ten years the results of femorofemoral bypass remained unchanged. In contrast nearly every second axillofemoral bypass showed one to five graft occlusions. Considering the low operative mortality, the short operating time, the late results and the high late mortality independent of the surgical procedure on the one hand femorofemoral bypass has presented more and more as surgical method of choice in cases of unilateral iliac artery occlusion and unilateral branch occlusion of aortoiliac bifurcation grafts as well. On the other hand in cases of bilateral occlusive disease in high risk patients axillofemoral bypass has been displaced more and more by anatomical surgical procedures as endarterectomy or unilateral bypass using retroperitoneal approach. Since 1986 axillofemoral bypass has no longer been performed in elective cases. Nowadays an indication does exist only for deep wound infection in retroperitoneal or inguinal space.

Adult↗
PubMedDate not supplied

Occlusion of aortofemoral bifurcation grafts: how to improve the results?

Forty-three patients with graft occlusion after aortofemoral bifurcation bypass surgery were analysed (1971-1986, 52 bypass branches, 75 graft occlusions). The late occlusion dominated with 73.1%. A poor run off was the main reason in 40.4%. A reduced inflow was responsible in 36.6%, especially caused by graft kinking. Bypass thrombectomy was performed in 56.7%, in 35.8% in combination with a distal reconstruction. Graft exchange was indicated in 39.6% but in 25.6% extraanatomical reconstruction was performed due to a high risk situation. Perioperative mortality rate measured 13.9%, not depending on the surgical procedures. Four times a major amputation was unavoidable. Therefore, in nine patients (= 20.9%) extremity or life could not be preserved. The rate of bifurcation graft occlusions can be reduced by technical improvement of the proximal anastomosis as to the mentioned guidelines.

Amputation, Surgical↗
PubMedDate not supplied

Late results following extra-anatomic bypass procedures for chronic aortoiliac occlusive disease.

During the period from 1970 to 1983 150 extra-anatomic bypass operations were carried out on 129 high risk patients revascularizing 157 extremities. There were 124 axillofemoral and 26 femorofemoral bypass grafts. In elective operations the mortality ranged from 4.9% for the axillofemoral bypass and 3.7% for the femorofemoral bypass. A five year postoperative follow-up showed a cumulative patency rate (according to life table method) of 80.21% for the femorofemoral bypass, 79.90% for the axillobifemoral bypass (Type IV) and 45.77% for the unilateral axillofemoral bypass (Type I and II). Considering the low operative mortality, the short operating time, the late results and the high late mortality independent of the surgical procedure, the femorofemoral bypass and in many ways also the axillobifemoral bypass represent suitable and effective methods of operation for high risk patients, whereas unilateral and bilateral axillofemoral grafts showed a high rate of graft thrombosis and poor long term results (Type I and III).

Adult↗
PubMedDate not supplied

Aneurysms of the infrarenal abdominal aorta: principles and results of surgical treatment.

With the surgical treatment of closed abdominal aortic aneurysms, the patient can have long-term survival and the danger of rupture can be avoided. Surgical repair on asymptomatic closed aneurysms can be performed with a very low risk (a mortality rate of below 1%). The main prerequisite for such protective surgery is an early diagnosis, best done by a routine check-up of all elderly people suffering from arterial hypertension, peripheral occlusive disease or other signs of arteriosclerosis. Computerized tomography (CT) and the ultrasound technique have gained a predominant position in such protective screening programs. Through the standardization and simplification of the operative techniques, surgical repair has been made simpler, safer and shorter, and the operative risk for patients with intact aneurysms has been remarkably reduced. A ten-year retrospective evaluation of 162 operated patients demonstrates a reduction in operative mortality from 14.3% to 2.8% in the group of patients with nonruptured aneurysms in the last period (1975-1979). On the other hand, progress has been made much more limited in surgery for ruptured aneurysms (operative mortality only reduced from 61.1% to 52.3%). The repair of closed or ruptured aortic aneurysms should be mainly restricted to special units with a highly trained surgical team. This type of surgery should no longer be the subject of occasional intervention by general surgeons.

Aorta, Abdominal↗