451
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Eichinger WB, Goppel G, Bleiziffer S, Wagner I, Lange R, Bauernschmitt R. Allograft compared to synthetic materials regarding bacterial adherence in a standardized animal model of prosthetic valve endocarditis. Thorac Cardiovasc Surg 2006. [DOI: 10.1055/s-2006-925707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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452
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Saur D, Lange R, Baumgärtner A, Kucinski T, Weiller C. Aktivierbarkeit des Sprachsystems mit fMRT in der Akutphase des Schlaganfalls. AKTUELLE NEUROLOGIE 2006. [DOI: 10.1055/s-2006-952965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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453
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Schreiber C, Vogt M, Kostolny M, Günther T, Lange R. Surgical removal of a rhabdomyoma in a neonate as rescue therapy. Pediatr Cardiol 2006; 27:140-141. [PMID: 16235014 DOI: 10.1007/s00246-005-1067-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Primary cardiac and mediastinal tumors are rare at all ages. We report on a rescue therapy in a neonate due to a severely obstructed left ventricular outflow tract.
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454
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Kostolny M, Schreiber C, Henze R, Vogt M, Lange R. Temporary pulmonary vein stenosis during intraoperative transesophageal echocardiography in total cavopulmonary connection. Pediatr Cardiol 2006; 27:134-136. [PMID: 16235015 DOI: 10.1007/s00246-005-1063-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Two patients operated on by one of the authors (MK) developed hemodynamic instability after otherwise uneventful completion of total cavopulmonary anastomosis with an extracardiac tube. In both, a stenosis of the right pulmonary veins was demonstrated during routine intraoperative transesophageal echocardiography. The transesophageal probe was found to be the underlying problem. Apparently, the pulmonary veins became compressed between the probe and the extracardiac conduit.
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MESH Headings
- Aorta, Thoracic/abnormalities
- Aorta, Thoracic/diagnostic imaging
- Aorta, Thoracic/surgery
- Blood Vessel Prosthesis Implantation
- Central Venous Pressure/physiology
- Child, Preschool
- Diagnosis, Differential
- Echocardiography, Doppler
- Echocardiography, Transesophageal
- Female
- Heart Bypass, Right
- Heart Defects, Congenital/diagnostic imaging
- Heart Defects, Congenital/surgery
- Humans
- Infant
- Intraoperative Complications/diagnostic imaging
- Male
- Pulmonary Veno-Occlusive Disease/diagnostic imaging
- Reoperation
- Surgical Instruments
- Tricuspid Atresia/diagnostic imaging
- Tricuspid Atresia/surgery
- Vena Cava, Superior/abnormalities
- Vena Cava, Superior/diagnostic imaging
- Vena Cava, Superior/surgery
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455
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Eicken A, Sebening W, Genz T, Kaemmerer H, Lange R, Busch R, Hess J. Site of coronary sinus drainage does not significantly affect coronary flow reserve in patients long term after Fontan operation. Pediatr Cardiol 2006; 27:102-109. [PMID: 16261275 DOI: 10.1007/s00246-005-1036-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study was designed to investigate the impact of postoperative coronary sinus drainage pressure on coronary flow reserve (CFR) assessed by Doppler guidewire in patients long term after Fontan operation. Twenty-nine patients (median age, 17.4 years female, 11) at a median of 10.6 years after Fontan operation were examined with intracoronary Doppler guidewire during cardiac catheterization. Fourteen patients had coronary sinus (CS) drainage to the systemic venous atrium and 15 patients had CS drainage to the pulmonary venous atrium after Fontan operation. Median CS drainage pressure was significantly higher in systemic venous CS drainage compared to pulmonary venous CS drainage (11 vs 5 mmHg, p < 0.0001). Median CFR values for the right and left coronary artery did not differ significantly with respect to CS drainage. There was a positive correlation between coronary flow reserve and pulmonary arteriolar resistance (p < 0.05) in multivariate regression analysis. The site of coronary drainage into the systemic atrium or the pulmonary venous atrium did not significantly affect CFR. Our data do not support a surgical strategy of elective redirection of coronary sinus blood to a low-pressure compartment but support an early staged approach. The positive correlation between CFR and pulmonary resistance demands further evaluation.
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456
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Lange R, Hassa T, Weiller C, Dettmers C. Imaging cognitive fatigue in encephalomyelitis disseminata: a fMRI study. AKTUELLE NEUROLOGIE 2006. [DOI: 10.1055/s-2006-953209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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457
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Illies T, Rosenkranz T, Lange R, Vogel P. Susac Syndrom und Multiple Sklerose in einer Familie – Eine seltene und eine häufige Autoimmunerkrankung des ZNS? – Case report. AKTUELLE NEUROLOGIE 2006. [DOI: 10.1055/s-2006-953229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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458
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Botzenhardt F, Eichinger WB, Guenzinger R, Bleiziffer S, Wagner I, Bauernschmitt R, Lange R. Hemodynamic performance and incidence of patient-prosthesis mismatch of the complete supraannular perimount magna bioprosthesis in the aortic position. Thorac Cardiovasc Surg 2005; 53:226-30. [PMID: 16037868 DOI: 10.1055/s-2005-837678] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Complete supraannular placement and smaller stent design allow the implantation of a Perimount Magna bioprosthesis with a larger inner diameter than that of a standard Perimount. This study compares the hemodynamic performance and the incidence of patient-prosthesis mismatch (PPM) of both prostheses. METHODS 128 patients underwent aortic valve replacement, receiving either a Magna (n = 57) or a standard (n = 71) prosthesis. Inner aortic annulus diameter was measured intraoperatively by a hegar dilator to match echocardiographically obtained results to the annulus diameter instead of matching them to labelled valve size. RESULTS The Magna was significantly superior with respect to mean pressure gradient and effective orifice area in patients with an annulus diameter of 22-23 mm. In patients with an annulus diameter < 22 mm or > 23 mm, there was a non-significant trend towards superior hemodynamics in the Magna group. Severe PPM (effective orifice area index < or = 0.65 cm (2)/m (2)) was present in 11.1% (Magna) vs. 42.1% (Standard) of patients with an annulus diameter < 22 mm; in 0% (Magna) vs. 13.8% (Standard) with an annulus diameter of 22-23 mm; no PPM was seen in patients with annulus diameter > 23 mm in both groups. CONCLUSIONS The Perimount Magna had a significantly reduced incidence of patient-prosthesis mismatch and superior hemodynamics compared to the standard Perimount.
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459
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Bauer T, Schubert M, Lange R. Prozessintensivierung heterogen katalysierter Gas/Flüssig-Reaktionen mit Monolithreaktoren. CHEM-ING-TECH 2005. [DOI: 10.1002/cite.200500143] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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460
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Saur D, Lange R, Baumgaertner A, Schraknepper V, Rijntjes M, Weiller C. Dynamik der Reorganisation im sprachlichen System nach Schlaganfall: eine longitudinale fMRT-Studie. AKTUELLE NEUROLOGIE 2005. [DOI: 10.1055/s-2005-919272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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461
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Jonas M, Lange R, Biermann-Ruben K, Kessler K, Bäumer T, Schnitzler A, Siebner H, Münchau A. Stimulus- und Kontextfaktoren beim „direct matching“ von Fingerbewegungen. AKTUELLE NEUROLOGIE 2005. [DOI: 10.1055/s-2005-919581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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462
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Bäumer T, Bock F, Lange R, Rothwell J, Siebner H, Münchau A. Differentielle interhemisphärielle Interaktion über prämotorische und motorische Verbindungen - I1 und I3 vermittelte Phänomene? AKTUELLE NEUROLOGIE 2005. [DOI: 10.1055/s-2005-919360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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463
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Lange R, Maring JG. [New oncolytic agents and immunomodulators and their application]. NEDERLANDS TIJDSCHRIFT VOOR GENEESKUNDE 2005; 149:2256-7; author reply 2257-8. [PMID: 16235808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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464
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Bülow H, Klein C, Kuehn I, Hollweck R, Nekolla SG, Schreiber K, Haas F, Böhm J, Schnackenburg B, Lange R, Schwaiger M. Cardiac magnetic resonance imaging: long term reproducibility of the late enhancement signal in patients with chronic coronary artery disease. Heart 2005; 91:1158-63. [PMID: 16103547 PMCID: PMC1769072 DOI: 10.1136/hrt.2004.045609] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To determine long term reproducibility of the late enhancement (LE) signal in contrast enhanced magnetic resonance imaging (MRI) and potential changes of the signal after revascularisation. METHODS 33 patients (29 men, mean (SD) 61 (11) years) with coronary artery disease (CAD) and left ventricular dysfunction (ejection fraction 30 (7)%) underwent two contrast enhanced MRI procedures within 9 (3) months. Fifteen patients (group A: 14 men, 59 (12) years) had no interventions between the two studies. Eighteen patients underwent revascularisation after MRI 1 (group B: 15 men, 62 (9) years). Changes in the LE signal between the first and second MRIs were investigated in both groups as well as intraobserver and interobserver variabilities for delineation of the signal. RESULTS The LE signal was highly reproducible in groups A and B for segmental analysis (concordance 86% v 82%, respectively; kappa = 0.70 v 0.67) and summed scores (group A: r = 0.97, p < 0.001; group B: r = 0.93, p < 0.001). The LE signal was quantified as 27 (27) cm3 in group A versus 30 (16) cm3 in group B in the first MRI and 26 (25) cm3 versus 30 (15) cm3, respectively, for the second MRI (both not significant). Moreover, low intraobserver and interobserver variabilities were observed in segmental analysis (kappa = 0.86 and 0.74, respectively, for group A, and kappa = 0.87 and 0.82, respectively, for group B). CONCLUSION In patients with chronic CAD, the LE signal in contrast enhanced MRI is very stable over an extended time period. These results further characterise contrast enhanced MRI as a useful tool for myocardial viability assessment. Low intraobserver and interobserver variabilities promise robustness of the method for clinical application.
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465
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Ruge H, Wildhirt SM, Libera P, Vogt M, Holper K, Lange R. Left Atrial Thrombus on Atrial Septal Defect Closure Device as a Source of Cerebral Emboli 3 Years After Implantation. Circulation 2005; 112:e130-1. [PMID: 16145006 DOI: 10.1161/circulationaha.104.492017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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466
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Pflaumer A, Schwaiger M, Hess J, Lange R, Stern H. Quantification of periprosthetic valve leakage with multiple regurgitation jets by magnetic resonance imaging. Pediatr Cardiol 2005; 26:593-4. [PMID: 16082572 DOI: 10.1007/s00246-005-0821-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A patient with aortic prosthetic valve endocarditis required replacement of the prosthesis, After initial recovery, his left ventricular function gradually declined and echocardiography revealed minor paravalvular leakage and a cavern around the prosthesis. Magnetic resonance imaging was performed, flow-imaging and volume-based measurements showed high-grade paravalvular leakage of 45 and 58% regurgitant fraction, respectively. Intraoperatively, the dehiscence of more than half of the circumference of the aortic prosthesis was seen. This study shows that MRI can accurately assess even periprosthetic valve leakage with multiple regurgitation jets.
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467
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Bauernschmitt R, Schirmbeck EU, Knoll A, Mayer H, Nagy I, Wessel N, Wildhirt SM, Lange R. Towards robotic heart surgery: introduction of autonomous procedures into an experimental surgical telemanipulator system. Int J Med Robot 2005; 1:74-9. [PMID: 17518393 DOI: 10.1002/rcs.30] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The introduction of telemanipulator systems into cardiac surgery enabled the heart surgeon to perform minimally invasive procedures with high precision and stereoscopic view. For further improvement and especially for inclusion of autonomous action sequences, implementation of force-feedback is necessary. The aim of our study was to provide a robotic scenario giving the surgeon an impression very similar to open procedures (high immersion) and to enable autonomous surgical knot tying with delicate suture material. In this experimental set-up the feasibility of autonomous surgical knot tying is demonstrated for the first time using stereoscopic view and force feedback.
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468
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Güttel R, Kunz U, Turek T, Bauer T, Lange R. Theoretische Untersuchungen zum Einsatz von Monolithreaktoren in der Fischer-Tropsch-Synthese. CHEM-ING-TECH 2005. [DOI: 10.1002/cite.200590313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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469
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Marchal S, Torrent J, Masson P, Kornblatt JM, Tortora P, Fusi P, Lange R, Balny C. The powerful high pressure tool for protein conformational studies. Braz J Med Biol Res 2005; 38:1175-83. [PMID: 16082457 DOI: 10.1590/s0100-879x2005000800004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The pressure behavior of proteins may be summarized as a the pressure-induced disordering of their structures. This thermodynamic parameter has effects on proteins that are similar but not identical to those induced by temperature, the other thermodynamic parameter. Of particular importance are the intermolecular interactions that follow partial protein unfolding and that give rise to the formation of fibrils. Because some proteins do not form fibrils under pressure, these observations can be related to the shape of the stability diagram. Weak interactions which are differently affected by hydrostatic pressure or temperature play a determinant role in protein stability. Pressure acts on the 2 degrees, 3 degrees and 4 degrees structures of proteins which are maintained by electrostatic and hydrophobic interactions and by hydrogen bonds. We present some typical examples of how pressure affects the tertiary structure of proteins (the case of prion proteins), induces unfolding (ataxin), is a convenient tool to study enzyme dissociation (enolase), and provides arguments to understand the role of the partial volume of an enzyme (butyrylcholinesterase). This approach may have important implications for the understanding of the basic mechanism of protein diseases and for the development of preventive and therapeutic measures.
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470
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Schubert M, Boden S, Hampel U, Lange R. Untersuchung der Mehrphasenströmung in Trickle-bed-Reaktoren mittels Röntgenradiographie und Röntgentomographie. CHEM-ING-TECH 2005. [DOI: 10.1002/cite.200590120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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471
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Bauer T, Sauer S, Lange R. Hydrodynamische Charakterisierung von Minikanalreaktoren und Monolithreaktoren. CHEM-ING-TECH 2005. [DOI: 10.1002/cite.200590250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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472
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Bauer T, Guettel R, Roy S, Schubert M, Al-dahhan M, Lange R. Modelling and Simulation of the Monolithic Reactor for Gas–Liquid–Solid Reactions. Chem Eng Res Des 2005. [DOI: 10.1205/cherd.04335] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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473
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Günzinger R, Heimisch W, Augustin N, Mazzitelli D, Overbeck M, Bauernschmitt R, Lange R. Diastolic Unloading and Improved LV Pump Efficiency Early After Repair of the Insufficient Mitral Valve. Thorac Cardiovasc Surg 2005; 53:9-15. [PMID: 15692912 DOI: 10.1055/s-2004-830360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND This study aimed to evaluate the acute effect of mitral valve repair (MVR) on LV hemodynamics and geometry in patients with normal ventricular function. METHODS In 10 patients with severe mitral regurgitation undergoing MVR, pressure-volume relationships were recorded before annuloplasty prior to and after hemodilution and after MVR during stable circulatory condition, using the conductance catheter technique (CC). Analyses were done off-line; volume calibration was based on data obtained after completion of valve repair (mean +/- s.d.). RESULTS CC showed that only 61 +/- 15 % of left ventricular output was ejected into the systemic circulation, regurgitation volume being 39 +/- 15 %. MVR led to a reduction in LV stroke work index from 4.7 +/- 1.8 mm Hg x l x m (-2) at before valve repair to 2.2 +/- 1.0 mm Hg x l x m (-2) after surgery at unchanged cardiac index. LV diastolic filling parameters improved: LV relaxation time constant tau decreased from 52 +/- 15 to 37 +/- 11 ms and dP/dt (min) increased from - 873 +/- 231 to - 1286 +/- 283 mm Hg x s (-1). CONCLUSIONS Despite cardioplegic arrest, MVR leads to acute improvement of diastolic LV function early after the operation. This may explain why valve repair has an acute positive effect in patients with impaired LV function.
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474
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Schreiber C, Kostolny M, Hörer J, Cleuziou J, Holper K, Tassani-Prell P, Lange R. Is it necessary to fenestrate an extracardiac total cavopulmonary connection? Thorac Cardiovasc Surg 2005. [DOI: 10.1055/s-2005-862093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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475
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Schreiber C, Kostolny M, Hörer J, Cleuziou J, Holper K, Tassani-Prell P, Lange R. Minimal-invasive midaxillary muscle-sparing thoracotomy for atrial septal defect closure in prepubescent patients: Surgical experience in 36 consecutive patients. Thorac Cardiovasc Surg 2005. [DOI: 10.1055/s-2005-862088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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