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W Seybold-Epting

Publications and source records attributed to W Seybold-Epting.

At least 19 recordsLinked to original sources
PubMed1998

Intermediate follow up of the TEKNA bileaflet valve.

BACKGROUND AND AIM OF THE STUDY: The study aim was to collect intermediate clinical data on the TEKNA bileaflet valve. METHODS: This nine-center clinical study involved 884 patients implanted between June 1990 and October 1993. The population consisted of 522 (59.0%) males and 362 (41.0%) females. Mean age at implant was 59.1 +/- 11.8 years (range: 14.7 to 88.4 years). Indication for valve replacement was dependent on the position: stenosis was the predominant reason in the aortic position; regurgitation was more pronounced for the mitral position. A total of 261 (29.5%) patients underwent concomitant procedures. Mean follow up is 2.7 +/- 1.2 years; total follow up is 2386.1 patient-years (pt-yr). RESULTS: Total operative (< or = 30 days postoperative) mortality rate was 3.7%; seven patients (0.8%) died due to valve-related causes. Total postoperative (> 30 days postoperative) mortality rate was 2.5%/pt-yr and included a valve-related mortality rate of 1.1%/pt-yr. The following valve-related complication rates (%/pt-yr) were reported for the long-term postoperative period: thromboembolism 0.6; valve thrombosis 0.3; bleeding events 1.5; non-structural deterioration 0.6; and endocarditis 0.4. No structural valve deterioration was reported. Actuarial freedom at four years was: overall survival rate 86.9 +/- 1.4%; valve-related survival rate 94.7 +/- 1.0%; freedom from thromboembolism 96.8 +/- 0.9%; valve thrombosis 99.3 +/- 0.3%; endocarditis 98.5 +/- 0.5%; bleeding events 94.3 +/- 1.0%; and non-structural deterioration 98.2 +/- 0.6%. CONCLUSIONS: The data indicate that observed mortality is due mainly to non-valve-related disorders. Risk of thromboembolic and bleeding events was low (0.9%/pt-yr and 1.5%/pt-yr, respectively). We conclude that this valve is safe and efficacious for use.

Actuarial Analysis↗
PubMed1996

[Bilateral coronary fistula: a case report and review].

A case is presented of an atypical arteriovenous coronary artery fistula which occurred in a young man who was admitted to hospital with constant stress-dependent dyspnea and a feeling of thoracic constriction. A continuous systolic-diastolic murmur above the 5th intercostal space to the left of the sternum was present. By means of transoesophageal echocardiography and heart catheterization a rather atypical bilateral coronary fistula was found. A bilateral coronary fistula had been formed from RCA and RCX which drained via a common intramural cavity into the right ventricle. The fistula was operatively closed. Bilateral coronary artery fistula are rare, being found with a frequency of 0.002-0.013% in heart catheterization. In 36 reported instances of bilateral fistulae it has been noted that drainage into the pulmonary artery is more common than is the case with single coronary artery fistulae. The therapeutic considerations correspond with those for single fistulae.

Adult↗
PubMed1984

Aortic arch replacement with profound hypothermia and temporary circulatory arrest.

Two cases of aortic arch aneurysm are reported. In each case, resection and replacement with a woven Dacron graft were performed with the patient in profound hypothermia and temporary circulatory arrest. Barbiturates and lidocaine provided additional cerebral protection. One patient died 27 days postoperatively of hepatic failure due to preexisting alcoholic liver cirrhosis. Clinical and autopsy studies showed intact neurological function and cerebral structures. The second patient had an uneventful postoperative course. The neurological examination, the skull computer tomogram and electroencephalogram disclosed no evidence of cerebral ischemic damage. Our findings suggest that by using barbiturates and lidocaine with profound hypothermia and temporary circulatory arrest, adequate cerebral protection for aortic arch replacement is provided.

Journal Article↗
PubMed1983

Local hemostasis with fibrin glue after intracardiac repair of tetralogy of Fallot and transposition of the great arteries.

In the last year fibrin glue Tissucol was used for local hemostasis in 21 patients subjected to correction of tetralogy of Fallot (ToF) and in 10 patients subjected to Senning-procedure in transposition of the great arteries (TGA). The postoperative blood loss was compared with the blood loss of 20 ToF-patients and 10 TGA-patients who had undergone correction one year ago without fibrin glue. Between the 2 groups were no differences in age, sex, bodyweight (BW), coagulation state or operative management. Two hours postoperatively the blood loss with fibrin glue was 2.2 ml/hr/kg BW in ToF-patients and 2.4 ml/hr/kg BW in TGA-patients, whereas without fibrin glue it was 4.2 ml/hr/kg BW in ToF (p less than 0.01) and 4.5 ml/hr/kg BW in TGA (p less than 0.01). The same significant difference (p less than 0.01) was found 6 hours postoperatively with 1.4 versus 2.2 ml/hr/kg BW in ToF and 1.9 versus 2.5 ml/hr/kg BW in TGA. Over the following 18 hours the secretion from the chest tubes was identical in both groups. Six patients with ToF and one patient with TGA required reoperation for bleeding. The blood loss per kg BW per hour at reoperation was 6.9 ml with and 8.2 ml without fibrin glue (N.S.). The blood loss of patients who did not require reoperation at the same time was 4.6 times lower with fibrin glue and only 3.7 times lower without fibrin glue. Fibrin glue reduces blood loss after intracardiac repair of ToF and TGA by local hemostasis at patches and suture lines. The application of fibrin glue can facilitate differentiation of surgical bleedings and the indication for reoperations.

Child↗
PubMed1982

[Thrombotic obstruction with tilting disc valves (author's transl)].

Valve thromboses were observed in nine patients, seven females and two males, aged 46 years on average, between 1/2 and 5 1/2 years after replacement of a mitral valve (n = 6) or an aortic valve (n = 3) by a tilting disc valve (Björk-Shiley, n = 6; Lillehei-Kaster n = 3). In eight cases reoperation was necessary, mainly as an emergency. One patient died preoperatively, five died intra- or postoperatively. Besides the adequate valve type, prophylaxis of valve thrombosis by conscientious anticoagulation is the most important measure. Should leading symptoms - disappearance of valve click and increasing cardiac insufficiency during irregular anticoagulation - occur, immediate referral to cardiac surgery is required.

Adult↗
PubMed1981

[Transposition of the great arteries: results of treatment in the years 1967--1980 (author's transl)].

To demonstrate how the prognosis for a newborn with transposition of the great arteries (TGA) has improved, the clinical data of 121 children diagnosed between January 1967 and December 1979 were reviewed. 104 patients had an initial balloon atrial septostomy; 34 infants needed palliative operations (resection of ductus or coarctation, banding of the pulmonary artery and aortic-pulmonary anastomosis). Corrective surgery was according to Mustard (43), Senning (7), Rastelli (5) or an anatomic correction (2). 80% of the infants survived the first month of life. 25% died between the first month and corrective surgery. The mortality of the intraatrial switch operations decreased from 28% before 1976 to 12% in the following years. After Mustard's operation cardiac rhythm disturbances occurred in 39.4%, hemodynamic complications in 24,2% of the cases. Neurological complications developed more frequently in children with simple TGA (27.3%) than in children with combined TGA (18.2%). Owing to improvement of conservative and operative treatment the 2-years survival rate increased from 48.5% between 1967--1970 to 62.5% between 1977--1979.

Arrhythmias, Cardiac↗
PubMed1981

[The influence of LAP and cardiac output on the pulmonary gas exchange. Intraoperative studies in cardio-surgical patients (author's transl)].

In 21 patients haemodynamic parameters and pulmonary gas exchange were investigated after open heart surgery with cardio-pulmonary bypass (aortic valve replacement, AVR (n = 8); mitral valve replacement, MVR (n = 6); aorto coronary bypass; ACB (n = 7). For describing gas exchange function of the lung the O2-CO2 diagram was used. Stepwise increase of left atrial pressure (LAP) was followed by increasing cardiac output (CO) only in the AVR and ACB groups, whereas in the MVR group CO did not increase. Rising venous admixture (Qs/Qt) under these circumstances was related to CO only in the AVR and ACB groups. In the MVR group Qs/Qt did not change. Qs/Qt is related to low VA/Q areas in the lung. Increased CO leads to rising Qs/Qt from these low VA/Q-areas.

Carbon Dioxide↗
PubMed1981

[Optimal left ventricular filling pressure after cardiopulmonary bypass (author's transl)].

To determine the optimal left ventricular filling pressure (LAP) after cardiopulmonary bypass (CPB) left ventricular function curves were constructed in ten patients with coronary heart disease, seven with aortic stenosis and normal left ventricular filling pressures (NLVFP), eight with aortic stenosis and pathologic elevated left ventricular filling pressure (ELVFP), and nine with mitral valve disease, cardiac index = CI, stroke index = SVI, left ventricular stroke work index = LVSWI were plotted against left atrial pressure = LAP and correlated with myocardial lactate extraction. After CPB, CI and LVSWI increased 52 to 53% and 50 to 80%, respectively, in the patients with NLVFP. In the patients with preoperatively ELVFP SVI did not increase significantly with increasing LAP, resulting in no augmentation of CI and LVSWI. Total systemic resistance increased in these patients, and myocardial lactate metabolism shifted to production in the patients with severe aortic stenosis. Thus, the results show that SVI, CI and LVSWI cannot be augmented by increasing LAP above 15 mm Hg if preoperative left ventricular function is already impaired. Elevation of LAP above 20 mm Hg can induce myocardial ischemia and cause low cardiac output with increased peripheral vascular resistance.

Aortic Valve Stenosis↗
PubMed1981

[Coronary bypass].

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Angina Pectoris↗