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ABSTRACT: Accidents do occur during the performance of different domestic chores in the garden. The resulting injuries can lead to serious morbidity and, in some cases, they can be fatal. We present a case of trauma, in a 69-year old man, caused by a fall from a tree on a vertical metal rod in his garden. The rod entered the abdominolumbal region on the right side making an exit above the left clavicle. On arrival, he was in a stable circulatory condition. A chest X-ray (Fig. ), thoracic and abdominal sonography followed by chest and abdominal CT scan (Figs. - , ) were performed and they showed no severe injury of the heart, lung, bronchi, liver and right kidney. He underwent an emergent surgical intervention by a team of cardiothoracic, vascular and abdominal surgeons. Longitudinal sternotomy and laparotomy allowed us to remove the metal rod carefully with no severe signs of injuries of abdominal and thoracic organs. There were no surgical postoperative complications.
The Thoracic and Cardiovascular Surgeon 07/2006; 54(4):286-8. · 0.88 Impact Factor
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ABSTRACT: Three months after orthotopic cardiac transplantation, a 46-year-old man developed paroxysmal supraventricular tachycardia. Electrophysiological investigation of the arrhythmia led to the diagnosis of an atrioventricular reentrant tachycardia involving a left lateral concealed accessory pathway. When antiarrhythmic drugs failed to suppress the arrhythmia, radiofrequency catheter ablation of the accessory pathway was performed without complication.
Pacing and Clinical Electrophysiology 06/2006; 17(11):1778 - 1781. · 1.35 Impact Factor
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ABSTRACT: We present the case of a 23-year-old African professional footballer who was admitted on April 1, 1999 to the Cardiology Department of the University Hospital in Magdeburg, on an emergency basis, from a regional lung clinic. According to the history, he was involved in a collision with an opposing player during a football match in his country (in Africa). He lost consciousness for a short time, but continued playing to the end of the match. About two months later he was invited by a German football club for a check-up, with the view to ultimately playing for the club. The team did not find him physically fit enough to play professional football, so he decided to go to Paris by bus on March 31, 1999. During the journey he suddenly became cardio-pulmonary decompensated and had to undergo cardio-pulmonary resuscitation (CPR). He was intubated and placed on a respirator and immediately transferred to a nearby lung clinic. From the lung clinic he was transferred to the Intensive Care Unit of the Cardiology Department of the Magdeburg University Hospital, on April 1, 1999 as an emergency case. He was intensively treated with catecholamines, intravenous ACE inhibitors and diuretics. His clinical condition did not improve appreciably. His chest X-ray showed extreme dilatation of the right and left heart as well as extreme pulmonary congestion.
The Thoracic and Cardiovascular Surgeon 09/2005; 53(4):223-5. · 0.88 Impact Factor
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ABSTRACT: Optimized uni- or biventricular pacing therapy improves left ventricular function in 80% of patients (responders) with wide QRS in surface ECG. Immediate improvement could be shown by an increase of LV dP/dt up to 28% and aortic pulse pressure up to 16%. Chronic improvement was documented by prolongation of the 6-minute-walk-test by 60 meters, an improvement of O2 uptake by 23% at exercise, and improvement of quality of life score and NYHA classification. This controlled study has shown for the first time a significant clinical improvement of congestive heart failure by pacing therapy in a selected group of patients. Conventional right ventricular stimulation is insufficient in this group of patients characterized by LBBB. These results support the hypothesis that optimized ventricular stimulation is an effective chronic therapy of congestive heart failure by improvement of left ventricular hemodynamics. Epicardial placement of the left ventricular electrodes in 50 patients was possible without operative and with low (2%) early mortality.
Zeitschrift für Kardiologie 02/2001; 90 Suppl 1:10-5. · 0.97 Impact Factor
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ABSTRACT: Summary Optimized uni- or biventricular pacing therapy improves left ventricular function in 80% of patients (responders) with wide QRS in surface ECG. Immediate improvement could be shown by an increase of LV dP/dt up to 28% and aortic pulse pressure up to 16%. Chronic improvement was documented by prolongation of the 6-minute-walk-test by 60 meters, an improvement of O2 uptake by 23% at exercise, and improvement of quality of life score and NYHA classification. This controlled study has shown for the first time a significant clinical improvement of congestive heart failure by pacing therapy in a selected group of patients. Conventional right ventricular stimulation is insufficient in this group of patients characterized by LBBB. These results support the hypothesis that optimized ventricular stimulation is an effective chronic therapy of congestive heart failure by improvement of left ventricular hemodynamics. Epicardial placement of the left ventricular electrodes in 50 patients was possible without operative and with low /2%) early mortality. Zusammenfassung Die optimierte uni- und biventrikulre Schrittmachertherapie verbessert die linksventrikulre Funktion bei 80% der Patienten (Responder) mit breitem QRS-Komplex sowohl akut durch eine Steigerung des linksventrikulren Drucks (LV dP/dt) um bis zu 28% und des Pulsdrucks um bis zu 16% als auch chronisch, gemessen an einer anhaltend verbesserten O2-Aufnahme in der Spiroergometrie um 23%, verbunden mit einer Verlngerung der Gehstrecke um 60 m im 6-Minuten-Gehtest, einer Verbesserung des Lebensqualitsscores und des NYHA-Stadiums. Die kontrollierte Studie zeigt damit erstmals eine signifikante klinische Verbesserung der Herzinsuffizienz durch Schrittmachertherapie bei einer ausgewhlten Patientengruppe. Eine konventionelle rechtsventrikulre Stimulation ist fr diese, durch einen Linksschenkelblock charakterisierte und dominierte Patientengruppe unzureichend. Die Ergebnisse untersttzen die Hypothese, dass die optimierte ventrikulre Stimulation eine effektive chronische Behandlungsmethode der Herzinsuffizienz durch Verbesserung der linksventrikulren Hmodynamik ist. Die epikardiale Platzierung der linksventrikulren Elektrode kann ohne operative und mit geringer Frhmortalitt (2%) vorgenommen werden.
Zeitschrift für Kardiologie 01/2001; 90(13):I10-I15. · 0.97 Impact Factor
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Herzschrittmachertherapie & Elektrophysiologie 05/1998; 9:99-100.
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Herzschrittmachertherapie & Elektrophysiologie 03/1998; 9 Suppl 1:99-100.
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ABSTRACT: Three months after orthotopic cardiac transplantation, a 46-year-old man developed paroxysmal supraventricular tachycardia. Electrophysiological investigation of the arrhythmia led to the diagnosis of an atrioventricular reentrant tachycardia involving a left lateral concealed accessory pathway. When antiarrhythmic drugs failed to suppress the arrhythmia, radiofrequency catheter ablation of the accessory pathway was performed without complication.
Pacing and Clinical Electrophysiology 12/1994; 17(11 Pt 1):1778-81. · 1.35 Impact Factor
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ABSTRACT: Due to the invasive nature of myocardial biopsies, a complication rate of up to 2.5%, and the limitations, e.g., at focal distribution of rejection, there is a continuous need for reliable, non-invasive parameters in recognizing moderate (grade 2) and severe (grade 3) acute cardiac allograft rejections in patients treated with cyclosporine A. 64 biopsies of 20 patients with previous heart transplantations in the past 3 weeks to 36 months (mean 11 months) were compared prospectively to Doppler and echocardiographic results. Parameters of systolic function such as percent fractional shortening (FS) and systolic wall thickness of the posterior wall (SWT) remained without significant changes at grade 2 and grade 3 rejections. The same is valid for relaxation parameters such as maximum velocity of posterior wall reduction (PTR), the time interval of endsystole to maximum velocity of posterior wall reduction (tES-PTR), and the isovolumic relaxation time (IVRT). Left-ventricular filling parameters such as maximum early diastolic flow velocity (VEmax) increased significantly from 73.3 +/- 15.2 cm/s in the rejection-free interval (grade 0) to 103.9 +/- 15.0 cm/s at grade 2 rejection and 101.1 +/- 9.2 cm/s at grade 3 rejection (both p < 0.001). A sensitivity of 50% and a negative predictive value of 77% are, however, too low to diagnose or exclude a moderate or severe acute rejection in the individual case.(ABSTRACT TRUNCATED AT 250 WORDS)
Zeitschrift für Kardiologie 04/1994; 83(3):225-33. · 0.97 Impact Factor
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ABSTRACT: Twenty-seven consecutive patients with refractory ventricular arrhythmias were investigated for implantation of an nonthoracotomy cardioverter-defibrillator lead system. Supply with a nonthoracotomy lead system could be achieved in 25 of 27 patients (92.5%), while implantation proved impossible in two patients due to elevated defibrillation thresholds. After implantation of an endocardial defibrillation electrode no differences were found compared to the implantation of an endocardial defibrillation electrode with a subcutaneous chest wall defibrillation patch with regard to the defibrillation thresholds obtained for monophasic defibrillation waveform. Supply with an endocardial defibrillation lead system was successful in 18 of 25 patients (72%). Ten consecutive patients with implantation of an endocardial defibrillation lead system alone were compared for defibrillation efficacy following monophasic and biphasic defibrillation waveforms. Defibrillation with biphasic waveforms led to a decrease in the necessary defibrillation energy from 19 J (4.6 J) to 10 J (4.0 J). There was occurrence of refractory ventricular fibrillation that could not be controlled by endocardial and transthoracic defibrillation in two patients during the intraoperative testing of defibrillation thresholds. In both cases these arrhythmias could be terminated by the described method of endocardial/extrathoracic defibrillation (200 J). Further perioperative complications were not observed. Over a mean follow-up of 6.8 (1-17) months all patients demonstrated regular functioning of the cardioverter-defibrillator. Dislocation of defibrillation electrodes did not occur. Implantation of a cardioverter-defibrillator can be performed without thoracotomy in the majority of cases. The use of defibrillator systems with biphasic waveform widens the scope for implantation of nonthoracotomy defibrillating lead systems.
Zeitschrift für Kardiologie 03/1993; 82(2):99-107. · 0.97 Impact Factor
