Thoraxchirurgie, vaskuläre Chirurgie
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Thoraxchir Vask Chir · Oct 1977
[Classification of psychopathological disorders after open-heart surgery (author's transl)].
A better discrimination of phenomenology and severeness of psychopathological disorders after open-heart surgery has been obtained: a) There is no equal distribution of degrees of severeness, a high correlation of severeness with duration of the disorders, a low correlation with age and no dependance of sex. b) Disorientation, clouding of consciousness and disorders of awareness arise earlier, delusions, hallucinations and paranoid ideas tentatively later after surgery. c) Three psychopathological syndromes have been identified. They appear in different frequency, intensity and can be combined.
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Thoraxchir Vask Chir · Aug 1977
[Pulmonary contusion after blunt chest trauma--an experimental model (author's transl)].
A model in the rat for pulmonary contusion after blunt chest trauma is described. It is possible to avoid trauma of the mediastinal organs, liver and spleen; therefore it is possible to produce pulmonary contusion with a good reproducebility. The parameter for the extent of contusion was the lungweight which rose statistically with a specific force of trauma. Simultaneous injection of high doses of prednisolone with the blunt chest trauma inhibits the increase of the lung weight.
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A total of 47 infants (2,7 to 9,6 kg in weight, 3 days to 21 months of age, 89% under one year) underwent early total correction of severe congenital heart defects in profound hypothermia of about 22degreesC and circulatory arrest (11 to 64 minutes). 8 patients were operated upon without extracorporeal circulation (ECC) (mortality 63%). 37 infants were additionally cooled and rewarmed with ECC (mortality 22%). The most common diagnosis were: Total atrioventricular canal (11), aortic stenosis with and without combined lesions (8), tetralogy of Fallot (7), ventricular septum defect (7) and transposition of the great arteries (4).
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Thoraxchir Vask Chir · Oct 1976
[Early and late complications due to direct and indirect aortic-isthmus-Plastic (author's transl)].
During the last 20 years 156 patients underwent a direct and indirect aortic-isthmus-plastic. Early complications occurred in 7.6%. 5 patients developed an aneurysm in the area of isthmus-plastic. ⋯ The indirect aortic-isthmus-plastic first described by Vosschulte represents an elegant surgical method of functionally reestablishing the aortic lumen by retaining the posterior wall for further growth potential. This technique can be performed with a low mortality rate and no recurrent coarctation of the aorta.
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Thoraxchir Vask Chir · Aug 1975
[Acute left heart failure following repair of atrial septal defects. Its treatment by reopening].
Among 716 patients operated on for an ASD, 15 of them, following closure of the defect, developed acute left heart failure requiring partial re-opening. The most prominent anatomical finding in these cases was hypoplasia of the left ventricle. ⋯ Therefore, a marked difference of the stroke work of the left and right ventricle, respectively, appeared to be the essential underlying hemodynamic mechanism. The prognosis has been found to depend mainly on prompt surgical intervention; so in all poor-risk cases continued monitoring of left atrial pressure is indicated for early detection of impending left heart failure.--The high incidence of left heart failure as cause of death after repair of an ASD indicates the importance of this complication.