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Biomedical subjects

W Rödiger

Publications and source records attributed to W Rödiger.

51 records · Page 3Linked to original sources
PubMed1976

[Surgical treatment of occlusive coronary artery disease. Methods and results (author's transl)].

A brief history of the development of coronary heart surgery is presented. Modern methods include the aorto-coronary bypass using saphenous vein graft or the thoracic internal artery, and the resection of ventricular aneurysm. The own experience with a group of 262 patients revealed a total mortality of 11,4%. Selected indication, improved surgical technique and postoperative care changed coronary surgery during the recent years into a routine method. The operative risk is characterized by the anatomical location of the occlusive artery disease as well as by the left ventricular function. But even in the group with high surgical risk the operative treatment is justified since life expectancy under conservative therapy is limited. In a group with 17 late death the main cause was due to cardiac insufficiency. In the group of survivors approximately 84% of the bypass were patent after an average period of 18 months.

Adolescent↗
PubMed1975

[Diagnosis, frequency and importance of the "low-output-syndrome" in the postoperative period after mitral valve replacement (author's transl)].

From 1970 until 1975 single mitral valve replacement was carried out in 162 patients using Björk-Shiley disc prostheses. The surgical mortality (within 30 days postoperatively) was 9.3% (n=15). Out of these 15 patients 9 died due to myogenic cardiac insufficiency. 21 patients with "Low-output-Syndrome" due to myogenic insufficiency however survived. The improvement of intraoperative myocardial protection since 1972 (using hypothermia and cardioplegic induced cardiac arrest) reduced the frequency of myogenic cardiac insufficiency to 1%. Unrelated to the above mentioned we saw in 18.5% of all patients after ECC-procedures a temporary "Low-output-Syndrome" after the 3rd postoperative day due to pericardial effusion.

Cardiac Output↗
PubMed1975

[Classification of mitral valve disease by clinical features and hemodynamic parameters (author's transl)].

Using the central venous oxygen saturation (SO2v) at rest and during exercise (50 Watt) a new classification of mitral valve disease is proposed, which corresponds with the recommendation of the NHA (1953). Contrary to the mostly subjective classification by clinical features, the new one results from objective hemodynamic parameters. The validity of the new proposed classification is shown using different clinical parameters.

Arrhythmias, Cardiac↗
PubMed1975

[Surgical treatment of coronary heart disease (author's transl)].

Until 1974 146 patients underwent coronary surgery in Hamburg. The total mortality rate for the first 100 postoperative days was 16,3 per cent. In the last years the mortality was reduced to 14 per cent. This group included all different selective and emergency surgical procedures for coronary disease. Due to the different degree of the coronary disease and/or of the impairment of the left ventricular function the mortality ranged between 0 per cent and 35 per cent. Some clinical parameters influencing the mortality rate are discussed.

Adult↗
PubMed1975

[Course of coronary disease. Evaluation of prognosis and progression of coronary insufficiency with atrial pacing and ergometry].

Significant reduction of angina threshold (145 Imp./min to 134 Imp./min) and increase of ST-segment depression (0.13 to 0.17 mV) indicating progression of coronary artery disease was seen in 34 subjects studied by atrial pacing at intervals betion (0.22 mV to 0.12 mV) during exercise, which correlated significantly with decrease of heart rate (121 to 110 beats/min), is interpreted as consequence of diminished sympathetic activity and myocardial O(2)-demand. The change of hemodynamic parameters during controlled exercise does not allow evaluation concerning the progress of coronary artery disease, whereas cardiac stress test with atrial pacing is reproducible. There was no difference in relation to reduction of angina threshold between the group after combined longterm medication with nitrate and ss-blocking agent and the control group. Plasma lipid abnormalities were predictive of subsequent reduction of angina threshold. Severe 2 and 3 vessel obstruction was seen more frequently in patients exhibiting reduction of angina threshold. Level of uric acid, obesity, hypertension, age, combination of risk factors, the initially studied myocardial lactate production and angina threshold during exercise and atrial pacing had no predictive value concerning reduction of angina threshold.

Adult↗
PubMedDate not supplied

Fluctuations of tumor markers in heart failure patients pre and post heart transplantation.

BACKGROUND: Elevated plasma levels of tumor markers may be caused by diseases other than malignancy, i.e. kidney, liver or circulatory disturbances. These conditions are not well defined, especially since there are only sparse reports on fluctuations of tumor markers related to cardiac function. PATIENTS AND METHODS: During our routine pre- and postoperative follow-up tumor marker determinations in heart failure patients were made in order to screen for possible occult neoplasm's which may either be a contraindication or a sequela of heart transplantation. The markers CA 12-5, CEA, CA 19-9, CA 72-4, TPA, TPS and CYFRA 21-1 were determined at three month intervals, besides clinical examination and hemodynamic measurements in a total of n = 118 patients pre- and n = 74 patients post heart transplantation. RESULTS: The results were grouped according the clinical status (NYHA-stage 1-4): CA12-5 (29.4 +/- 40.63 omega 151, 174 +/- 345 and 491 +/- 633 U/ml, p < 0.001 between all groups) and TPS (64 +/- 32, 118 +/- 153, 163 +/- 311 and 181 +/- 232 U/ml, p = 0.06 between all groups) were increasingly elevated in NYHA stages 1, 2, 3 or 4 respectively. A direct correlation to right atrial pressure (r = 0.41, p < 0.0001) and pulmonary capillary wedge pressure (r = 0.27, p < 0.001) was only found for CA 12-5. After heart transplantation a normalization of elevated pre-OP levels could be found. Comparable to heart failure patients poor graft function was also associated with elevated levels of CA 12-5 (113 +/- 99 vs 21.6 +/- 31 U/ml, p < 0.0001), CA 72-4 (8.4 +/- 3 vs 3.6 +/- 4, U/ml p = 0.03) and TPS (154 +/- 133 vs 66 +/- 28 U/ml, p < 0.001). The individual time course of the markers, especially of CA 12-5, correlated nicely to clinical events and hemodynamic measurements in some patients. Another finding was that CYFRA 21-1 levels were correlated to renal function. CEA, CA 19-9 and CYFRA 21-1 serum levels were not influenced by circulatory disturbances. CONCLUSION: We concluded that the tumor markers CA 12-5 and TPS (but not CEA, CA 19-9 and CYFRA 21-1) are associated with congestion and the clinical course of heart failure and HTx patients. These "nonspecific" changes have to be considered when tumor markers are determined in cancer patients with heart failure. Whether CA 12-5 blood levels may yield additional prognostic information in the management of cardiovascular patients has to be determined in further studies.

Antigens, Neoplasm↗