M Kamler

Publications (28)40.69 Total impact

• Article: Pulmonale Hypertonie vor Lungentransplantation und mittleres Überleben bei COPD, Alpha-1-Antitrypsin-Mangel und Lungenfibrose

  M Kamler, R Erbel, Helmut Teschler, Urte Sommerwerck
  ldots. 01/2012;
• Article: Complex acute dissection of the aortic arch – a novel hybrid concept for one stage

  J. Benedik, K. Tsagakis, M. Kamler, P. Tossios, Th. Mathias, H. Eggebrecht, H. Jakob
  Acta chirurgica Belgica 01/2010; · 0.43 Impact Factor
• Article: . Complex acute dissection of the aortic arch – a novel hybrid concept for one stage

  J. Benedik, K. Tsagakis, M. Kamler, P. Tossios, Th. Mathias, H. Eggebrecht, H. Jakob
  Acta Chir Belg, 2010;(110):178-84. 01/2010;
• Article: ICU controlled delay for acute type a aortic dissection repair after intervention for total visceral malperfusion: a way out of a dilemma?

  K Tsagakis, N Pizanis, M Kamler, T Konorza, T Zoepf, R Erbel, H Jakob
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  ABSTRACT: Despite immediate surgical repair of the entry site in acute thoracic aortic dissection with visceral malperfusion, the results are poor. Primary restitution of visceral flow by intervention might be one way to cope with this problem, but probably causes ischemia/reperfusion associated problems after prolonged complete visceral ischemia. In this report, we demonstrate a successful attempt of controlled delay of thoracic aortic surgical repair after visceral flow restitution with stable hemodynamics.
  The Thoracic and Cardiovascular Surgeon 09/2008; 56(5):298-300. · 0.88 Impact Factor
• Article: Coronary artery bypass surgery after lung injury due to a displaced atrial pacemaker lead.

  D Wendt, M Kamler, H Jakob
  The Thoracic and Cardiovascular Surgeon 05/2008; 56(3):181-2. · 0.88 Impact Factor
• Article: [Legal bearings of telemedicine in Germany].

  B Schütze, M Kamler
  DMW - Deutsche Medizinische Wochenschrift 04/2007; 132(9):453-7. · 0.53 Impact Factor
• Article: Heart transplantation and consecutive mitral valve replacement.

  I Aleksic, J A Piotrowski, M Kamler, P Massoudy, H G Jakob
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  ABSTRACT: A 48-year-old man was diagnosed with progressive mitral insufficiency due to fibrosis of papillary muscles and chordae tendineae, necessitating mitral valve replacement (MVR) 8 months after cardiac transplantation. Donor echocardiography and inspection of the heart at procurement were inconspicuous. The patient is alive, free from valve-related complications and functionally improved six years after MVR. The limited yet successful experiences with left-sided valve repair or replacement in the transplanted heart are reviewed.
  The Thoracic and Cardiovascular Surgeon 07/2005; 53(3):178-80. · 0.88 Impact Factor
• Article: Immunohistochemical differentiation of eosinophilic heart diseases using antibodies against eosinophil activation markers.

  F Grabellus, G Mall, P A Schnabel, H Wieneke, U Pfeifer, C Kersting, K J Schmitz, J Wohlschläger, H H Sigusch, E Bierhoff, M Kamler, H-H Scheld, H A Baba
  [show abstract] [hide abstract]
  ABSTRACT: Eosinophilic heart syndromes are rare in Western countries and include endocarditis parietalis fibroplastica (EPF) and hypersensitivity myocarditis (HM). There are striking differences in natural history and morphological findings. Since diagnosis can be difficult when analysing small myocardial biopsies lacking the characteristic histological features, we studied a set of immunohistochemical markers in order to characterize the activation status of the infiltrating eosinophils to distinguish between these two entities. This study is based on the investigation of seven explanted hearts and one left ventricular specimen collected during implantation of a left ventricular assist device from a total of seven patients with HM. Also investigated were three right and three left ventricular specimens from five patients with EPF. We used antibodies (Ab) against EG1, and EG2, CD44, and CD69 which have been described as markers to distinguish between resting and activated eosinophils. The EG1 to EG2 ratio of eosinophils and the immunoreactivity against CD44 showed no differences between the two entities. However, eosinophils in the EPF were completely negative for CD69, whereas eosinophils reacted positively within the HM group. The immunohistochemical investigation of eosinophilic heart diseases using antibodies against CD69 can be a useful tool to distinguish between hypersensitivity myocarditis and endocarditis parietalis fibroplastica.
  Histopathology 02/2005; 46(1):89-97. · 3.08 Impact Factor
• Article: Deleterious effects of oxygen during extracorporeal circulation for the microcirculation in vivo.

  M Kamler, D Wendt, N Pizanis, V Milekhin, U Schade, H Jakob
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  ABSTRACT: Clinical complications arising from extracorporeal circulation (ECC) have been linked to disturbances in the microcirculation. Hyperoxia, a mainstay of supportive treatment, is clinically used for a variety of pathological states. In previous in vivo animal experiments we found increased leukocyte/endothelial (L/E) cell interaction following ECC due to oxygen derived free radicals. This study was carried out to investigate the link between arterial pO2 during ECC and the potential damage to the microcirculation, supposedly caused by oxygen derived radicals. Intravital fluorescence microscopy was used on the dorsal skinfold chamber preparation in syrian golden hamsters. ECC was introduced via a micro-rollerpump (0.7 ml/min) and a 60 cm silicon tube (1 mm inner diameter) shunted between the carotid artery and the jugular vein after application of 300 IE Heparin/kg/bw. Experiments were performed in chronically instrumented, awake animals (age: 10-14 weeks, weight: 65-75 g). Control inspired room air, experimental group 1 inspired 100% oxygen, group 2 received 100% oxygen and 2000 IE of Heparin i.v. (n=7/group), that releases endothelial bound superoxide dismutase, a natural scavenger of oxygen derived free radicals in the hamster. Results: Normobaric inhalation of 100% oxygen increased arterial pO2 from 64+/-8.1 mmHg to 512+/-124 mmHg (P<0.05 vs. baseline). ECC under 100% oxygen reduced functional capillary density (FCD) to 70% of baseline values 8 h after ECC (P<0.05). Adherent leukocytes in postcapillary venules and arterioles increased significantly (P<0.05). 2000 IE Heparin prevented the reduction in FCD and decreased the number of adherent leukocytes. Reduction in FCD, increased leukocyte adherence to the microvascular endothelium of postcapillary venules and arterioles under hyperoxia compared to ECC under room air conditions, demonstrates harmful effects of oxygen during ECC in vivo. A high dose of Heparin enhances functional capillary density, thus attenuating the microvascular dysfunction/damage in the period after ECC.
  European Journal of Cardio-Thoracic Surgery 09/2004; 26(3):564-70. · 2.55 Impact Factor
• Article: Severe left ventricular failure after double lung transplantation: pathophysiology and management.

  M Kamler, U Herold, J Piotrowski, T Bartel, H Teschler, H Jakob
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  ABSTRACT: Patients undergoing bilateral lung transplantation for end-stage pulmonary hypertension may experience various complications. We describe a patient who underwent transplantation for chronic pigeon breeder's disease, who had secondary pulmonary hypertension and deteriorated right heart function, and who developed severe left heart failure during the weaning phase after successful double lung transplantation. The patient was stabilized with catecholamines and an intra-aortic balloon pump. Left heart function increased within 7 days and normalized at Day 18. Otherwise, the post-operative course was uneventful.
  The Journal of Heart and Lung Transplantation 02/2004; 23(1):139-42. · 4.33 Impact Factor
• Article: [A "late" scimitar syndrome. Diagnostic contribution of cardiac computed tomography].

  G Kerkhoff, G Albes, M Montag, M Kamler, H Jakob, T Budde
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  ABSTRACT: A 51-year-old female hospitalized with a non-specific colitis, presented a crescent-like shadow in the right lower lung accompanied by a reduced right lung volume on a routine chest x-ray. There was no family history of congenital heart disease. The initially performed, noninvasive, contrast enhanced cardiac CT (electron-beam tomography [EBT]) proved the suspected diagnosis of a partial, anomalous pulmonary, transdiaphragmatic vein drainage (APVD) in combination with a hypoplastic right lower lobe and dextrocardia. These findings are in accordance with scimitar syndrome. Regarding to the clinical situation with symptoms like slowly progressive dyspnea on exertion and low exercise tolerance for the last 2 years and an invasively documented left-to-right shunt ratio >50% (Qp:Qs = 2.6 : 1) surgical repair was recommended. The anomalous vein was connected to the left atrium creating a "neo-septum". On a postoperative checkup after 9 months the patient is without any medication, symptoms during moderate activity are relieved, exercise tolerance was substantially better and noninvasive imaging visualized the corrected drainage of the anomalous vein to the left atrium.
  Zeitschrift für Kardiologie 08/2003; 92(7):595-600. · 0.97 Impact Factor
• Article: Ein "spätes" Scimitar-Syndrom

  G. Kerkhoff, G. Albes, M. Montag, M. Kamler, H. Jakob, T. Budde
  [show abstract] [hide abstract]
  ABSTRACT: Summary. A 51-year-old female hospitalized with a non-specific colitis, presented a crescent-like shadow in the right lower lung accompanied by a reduced right lung volume on a routine chest x-ray. There was no family history of congenital heart disease. The initially performed, noninvasive, contrast enhanced cardiac CT (electron-beam tomography [EBT]) proved the suspected diagnosis of a partial, anomalous pulmonary, transdiaphragmatic vein drainage (APVD) in combination with a hypoplastic right lower lobe and dextrocardia. These findings are in accordance with scimitar syndrome. Regarding to the clinical situation with symptoms like slowly progressive dyspnea on exertion and low exercise tolerance for the last 2 years and an invasively documented left-to-right shunt ratio >50% (Qp:Qs = 2.6 : 1) surgical repair was recommended. The anomalous vein was connected to the left atrium creating a "neo-septum". On a postoperative checkup after 9 months the patient is without any medication, symptoms during moderate activity are relieved, exercise tolerance was substantially better and noninvasive imaging visualized the corrected drainage of the anomalous vein to the left atrium.
  Zeitschrift für Kardiologie 01/2003; 92(7):595-600. · 0.97 Impact Factor
• Article: [Donor organ harvesting].

  H Lang, M Kamler, U Herold, M Malagó, H Jakob, C E Broelsch
  Der Chirurg 06/2002; 73(5):517-35; quiz 536-7. · 0.70 Impact Factor
• Article: Near-fatal hemoptysis and emergency surgical repair after aortic patch-plasty.

  M Kamler, S Tuengerthal, H Rauch, S Hagl, H Jakob
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  ABSTRACT: A 38-year-old man presented with massive hemoptysis followed by hemorrhage shock. The patient's history revealed a Dacron patch repair for aortic coarctation and recoarctation carried out twice, once 23 and once 10 years ago. Diagnosis of a ruptured descending aortic aneurysm with an aortobronchial fistula into the left lower lobe was established using CT scan. Emergency surgery consisted of left pneumonectomy and descending aortic graft replacement during deep hypothermic circulatory arrest. The patient was discharged 12 days later.
  The Thoracic and Cardiovascular Surgeon 11/2001; 49(5):310-1. · 0.88 Impact Factor
• Article: [Surgical treatment of infective endocarditis: the Essen experiences].

  U Herold, J Piotrowski, H van de Wal, M Kamler, C Yildirim, C Naber, R Erbel, H Jakob
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  ABSTRACT: BACKGROUND: Instead of immediate diagnosis and effective antibiotic treatment morbidity and mortality in infective endocarditis remains high. If the infection cannot be controlled or the disease progresses irreversible destruction of cardiac structures results. SURGICAL THERAPY: In this case surgical therapy should be considered immediately. The outcome of surgical repair is not depending on the implanted prosthesis, but solely on timing of the operation.
  Herz 10/2001; 26(6):409-17. · 0.92 Impact Factor
• Article: Hirudin protects from leukocyte/endothelial cell interaction induced by extracorporeal circulation.

  M Kamler, T Chatterjee, A Stemberger, M M Gebhard, S Hagl, H Jakob
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  ABSTRACT: The clinical complications of Extracorporeal Circulation (ECC) have been linked to disturbances in the microcirculation. In order to prevent these deleterious effects, a biodegradeable agent to coat the extracorporeal circuit was tested. Intravital fluorescence microscopy was used on the hamster skinfold chamber model in permanently instrumented, awake animals. ECC was introduced via a micro-roller-pump and a silicon tube shunted between the carotid artery and the jugular vein. The ECC-tube system was coated with PEG-Hirudin-Iloprost, two additional groups received either Iloprost i.v. (0.8 mg/kg/h) or Hirudin i.v. (1 mg/kg b.w.). ECC for 20 minutes resulted in an increase in rolling and adherent leukocytes in postcapillary venules (Roller 9 to 36 [%]; Sticker 24 to 330 [n/mm2]). Use of the coated tube system reduced L/E cell interaction (Roller 9 to 24* [%], Sticker 28 to 194* [n/mm2]; *p<0.05), whereas Hirudin i.v. nearly abolished it. The protective effects of the coating and of Hirudin i.v are probably a result of an attenuated activation of the coagulation-fibrinolytic system.
  The Thoracic and Cardiovascular Surgeon 07/2001; 49(3):157-61. · 0.88 Impact Factor
• Article: Sepsis and catecholamine support are the major risk factors for critical illness polyneuropathy after open heart surgery'.

  R I Thiele, H Jakob, E Hund, S Tantzky, S Keller, M Kamler, U Herold, S Hagl
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  ABSTRACT: Critical illness polyneuropathy (CIP) remains a problem after open heart surgery. Recently, we reported about a retrospectively performed study pointing out that sepsis, the application of higher amounts of catecholamines and intervention such as chronic venovenous hemodiafiltration may be involved in the onset of CIP. A prospectively performed study is presented in order to evaluate the significance of risk factors initially after open heart surgery. From June 1997 until September 1998, patients undergoing open heart surgery and being ventilated beyond 3 days were prospectively enrolled in the study and underwent a standard protocol of electromyographic investigation in order to determine CIP. Several items were recorded: amount of catecholamines, serum levels of urea, creatinine, albumin, and glucose. The duration of sepsis and chronic venovenous hemodiafiltration were reevaluated. Additionally the age, the left ventricular end-diastolic pressure prior to the operation, the time of ICU stay and the time of ventilatory support were compared. Within the observation period, 37 adult patients could be enrolled in the study, whereas 12 patients did develop CIP and 7 patients did not. Patients developing CIP required significantly different amounts of epinephrine (0.17 +/- 0.02 vs. 0.09 +/- 0.01 mg/kg/day, p < 0.05, t-test) higher amounts of norepinephrine (0.06 +/- 0.02 vs. 0.02 +/- 0.01 mg/kg/day, p<0.05, t-test), and lesser dosages of dobutamine (2.2 +/- 0.5 vs. 4.9 +/- 0.7, p<0.05, t-test). After cardiac surgery, the plasma levels of urea was initially significantly elevated in patients developing CIP (127.4 +/- 10.5 vs 97.3 +/- 18.5, p<0.05, t-test) Patients suffering from CIP stayed significantly longer in the ICU (40.3 +/- 11.7 vs. 19.6 +/- 11.3 days, p < 0.05 t-test) with an extended time of ventilator support. (769.6 +/- 05.0 vs 295.0 +/- 134.0 hours, p<0.05, t-test). Patients of the CIP group were suffering significant longer from sepsis than patients without CIP. Sepsis and catecholamine support and an increased level of urea were associated with the development of CIP. The prevention of sepsis and a modulation of the catecholamine support in order to improve microcirculatory flow may reduce the onset of CIP in patients undergoing open heart surgery.
  The Thoracic and Cardiovascular Surgeon 06/2000; 48(3):145-50. · 0.88 Impact Factor
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  Article: In vivo leucocyte-endothelial cell interaction induced by extracorporeal circulation: reduction by a coated tube system

  M Kamler, T Chatterjee, H Jakob, A Stemberger, MM Gebhard, S Hagl
  Critical Care 04/1999; 3:1-1. · 4.93 Impact Factor
• Article: Doubly angled pleural drain circumventing the transcostal route relieves pain after cardiac surgery.

  H Jakob, M Kamler, S Hagl
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  ABSTRACT: Standard pleural drainage after cardiac surgery is accomplished through the intercostal space and the divided parietal pleural, often causing severe additional chest pain. To circumvent this route of insertion a doubly angled polyvinyl chloride drain was developed which can be placed via the median approach through the rectus abdominis muscle just beside the anterior mediastinal drains without irritation of the heart and parietal pleura into the phrenico-costal sinus.
  The Thoracic and Cardiovascular Surgeon 11/1997; 45(5):263-4. · 0.88 Impact Factor
• Article: [Alpha 2-adrenergic agonists. Use in chronic pain--a meta-analysis].

  J Motsch, M Kamler
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  ABSTRACT: alpha(2)-adrenergic agonists, mimicking the action of the inhibitory transmitter norepinephrine, cause antinociception due to postsynaptic inhibition of spinothalamic projection neurons, presynaptic inhibition at the central nervous system termination of primary sensory nerves, presynaptic inhibition of brainstem noradrenergic neurons and a generalized decrease in central nervous system sympathetic efferent activity. There is a mutual potentiation of antinociceptive effects of clonidine and morphine. Clonidine is used in chronic pain states for treatment of neuropathic, neuralgic and deafferentiating pain. Based on a meta-analysis of the studies published in the years 1996-1996, the therapeutic efficacy of systematically administered clonidine was evaluated in chronic pain states. Out of 403 screened published studies, only 9 fulfilled the selection criteria. Besides three case reports with successful clonidine treatment, four placebo-controlled studies could be analyzed treating the following chronic pain states: chest pain despite normal coronary angiograms; painful diabetic neuropathy; postherpetic neuralgia; hyperalgia in patients with sympathetically maintained pain and chronic low back pain. Although three studies demonstrated statistically significant improvement in pain scores, the improvement in pain relief in these cases was slight. Long-term treatment was successful in a few responders over a period of 17 months. Hyperalgesia caused by sympathetically maintained pain was relieved by topical (transdermal) application of clonidine. Based on this evaluation a grade C recommendation is derived, which relates to responders. Successful treatment is expected only in pain states with increased sympathetic nervous system activity. Therefore, in chronic pain, treatment with systemic clonidine is of no significant value.
  Der Schmerz 11/1997; 11(5):339-344. · 0.88 Impact Factor