Characterization of a calcified intra-cardiac pseudocyst of the mitral valve by magnetic resonance imaging including T1 and T2 mapping.

Background: Even though intra-cardiac cystic lesions are extremely unusual in adults, they should be considered in the differential diagnosis of patients presenting with valvular masses. Cardiac magnetic resonance imaging has emerged as modality of choice for non-invasive characterization of cardiac masses.

Case Presentation: We report a case of an intra-cardiac mass of the mitral valve in a 51-year old male, detected by echocardiography after transient ischemic attack and retinal artery occlusion.

[Strategies for quality assessment of emergency helicopter rescue systems. The Graz model].

Purpose: Preclinical emergency medical treatment necessitates a comprehensive interdisciplinary knowledge by the emergency physician as well as a high level of manual dexterity. The quality of treatment therefore depends on the level of education and continuous training in emergency medical techniques. Based on an evaluation of the frequency of life-saving interventions by a physician-staffed rescue helicopter system, strategies for in-hospital training of relevant skills are suggested.

Angiotensin-converting enzyme polymorphisms and their potential impact on left ventricular myocardial geometry after aortic valve surgery.

Background And Aim Of The Study: Genetic variants of the angiotensin-converting enzyme (ACE) cascade may influence left ventricular myocardial mass (LVMM) regression after aortic valve surgery. Postoperative long-term changes in LV indices were investigated in patients with asymptomatic aortic regurgitation (AR) and symptomatic aortic stenosis (AS) and related to alleles of ACE polymorphisms.

Methods: A total of 96 patients was included in the study, 21 with class IIa AR (22%) and 75 with class I AS (78%) recommendations for surgery.

Partial liquid ventilation combined with two different gas ventilatory strategies in acute lung injury in piglets: Effects on gas exchange, respiratory mechanics, and hemodynamics.

Background/purpose: Partial liquid ventilation (PLV) has been shown to improve oxygenation and lung mechanics in different models of acute lung injury. This study was designed to investigate the effects of 2 gas ventilatory strategies during PLV on gas exchange, respiratory mechanics, and hemodynamics in acute lung injury in piglets.

Methods: After induction of acute lung injury, the animals were assigned randomly to 2 groups with different positive end-expiratory pressure (PEEP) levels and tidal volumes (Vt) (group A, Vt > 12.

Partial liquid ventilation versus conventional mechanical ventilation with high PEEP and moderate tidal volume in acute respiratory failure in piglets.

This prospective randomized pilot study aimed to test the hypotheses that partial liquid ventilation combined with a high positive end-expiratory pressure (PEEP) and a moderate tidal volume results in improved gas exchange and lung mechanics without negative hemodynamic influences compared with conventional mechanical ventilation in acute lung injury in piglets. Acute lung injury was induced in 12 piglets weighing 9.0 +/- 2.

Late dissection of the ascending aorta after previous cardiac surgery: risk, presentation and outcome.

Objective: Aortic dissection is a potentially life-threatening condition and may follow surgical interventions as a complication with distinct presentation and high mortality. Information on the incidence and etiology of aortic dissections following cardiac surgery is sparse and inconsistent. The true incidence of this entity may so far have been underestimated.

[Autocapture(TM) and Capture Management(TM) Current concepts in pacing threshold and output management].

Pacing threshold is not a stable value during the pacemaker's life. It is affected by many physiological, pharmacological and pathophysiological factors. A pacing system able to confirm capture and automatically adjust its output to the actual pacing threshold is highly desirable for a prolonged battery life and maximal patient safety.

[Lead stability in long-term follow-up of bipolar leads].

From 1990 to 1999, 2,853 ventricular and 1,084 atrial bipolar leads of various manufacturers (Medtronic, Biotronik, Vitatron, Ela, Pacesetter and Stöckert) were implanted during first implantations of pacemakers at the University of Graz, Dept. of Cardiac Surgery. Surgical complications with the need of reintervention were analyzed during a follow up period of up to 10 years.

The effect of positive end-expiratory pressure during partial liquid ventilation in acute lung injury in piglets.

Objectives: To investigate the effects of positive end-expiratory pressure (PEEP) application during partial liquid ventilation (PLV) on gas exchange, lung mechanics, and hemodynamics in acute lung injury.

Design: Prospective, randomized, experimental study.

Setting: University research laboratory.

Partial liquid ventilation combined with kinetic therapy in acute respiratory failure in piglets.

Objective: To investigate the effect of the combination of kinetic therapy (KT) with partial liquid ventilation (PLV) on gas exchange, lung mechanics and hemodynamics in acute lung injury (ALI).

Design: Prospective, randomized, controlled pilot study.

Setting: University research laboratory.

The influence of different strategies on clinical outcome in patients undergoing total cavopulmonary connection.

Background: We report on results of a prospective clinical trial designed to demonstrate the influence of various strategies in "Total Cavopulmonary Connection" (TCPC) for palliative therapy of patients with "single ventricle" physiology.

Methods: From 1989 to 1997, a total of 47 patients (mean age 4.8 +/- 3.

Minimally invasive versus conventional aortic valve operations: a prospective study in 120 patients.

Background: Risk evaluation comparing the minimally invasive and standard aortic valve operations has not been studied.

Methods: Four surgeons were randomly assigned to perform the minimally invasive (L-shaped sternotomy) (group 1) or the conventional (group 2) operation in 120 patients exclusively.

Results: In both groups (n = 60) a CarboMedics prothesis was implanted in 90% of patients.

Effects of inhaled nitric oxide during permissive hypercapnia in acute respiratory failure in piglets.

Objective: To look for the effects of inhaled nitric oxide on oxygenation and pulmonary hemodynamics during acute hypercapnia in acute respiratory failure.

Design: Prospective, randomized, experimental study.

Setting: University research laboratory.

Inhaled nitric oxide in infants and children after open heart surgery.

Objective: To assess the effects of inhaled nitric oxide (NO) on oxygenation and pulmonary circulation in infants and children with critical pulmonary perfusion and/or hypoxemia after open heart surgery.

Study: A prospective case series report.

Setting: A multidisciplinary pediatric intensive care unit in a University hospital

Patients: From June 1993 to March 1996 37 pediatric patients after open heart surgery were treated with inhaled NO.

Activation of the clotting system: heparin-coated versus non coated systems for extracorporeal circulation.

Unlabelled: The purpose of this experimental study was to compare heparin-coated versus non-coated systems for extracorporeal membrane oxygenation (ECMO), to investigate the dynamic course of clotting activation in both groups.

Methods: Eight pigs weighing 19.7 (+/- 1.

[Accessory mitral valve tissue as a rare cause of subaortic stenosis and valvular aortic insufficiency].

An unusual case of subaortic stenosis and aortic regurgitation caused by accessory mitral valve tissue in a 10 year old boy is reported. Two-dimensional and Doppler echocardiography revealed the characteristic feature of a mobile, parachute-like mass in the left ventricular outflow tract pro-lapsing into the aortic valve during systole and, thus, producing a systolic pressure gradient of 70 mm Hg between the left ventricle and aorta and causing mild aortic regurgitation. The accessory valve tissue was completely excised via an aortotomy without injury to the normal mitral and aortic valves.

Assessment of lung function in neonates during extracorporeal membrane oxygenation.

We report our experience with pulmonary function testing in 11 out of 22 full-term neonates with severe respiratory failure, treated at the ECMO center Graz (Austria) during the period from 1990 to 1995. Altogether 17 out of 22 patients survived ECMO and all of them were successfully weaned from ECMO. Pulmonary function was assessed by monitoring expiratory tidal volume on the ventilator and estimating respiratory system compliance from the ratio tidal volume/(PIP-PEEP).

Inhaled nitric oxide in patients with critical pulmonary perfusion after Fontan-type procedures and bidirectional Glenn anastomosis.

Objective: The aim of this study was to evaluate the effects of inhaled nitric oxide in patients with critical pulmonary perfusion after Fontan-type procedures and bidirectional Glenn anastomosis.

Methods: Inhaled nitric oxide (mean 4.1 +/- 0.

Partial liquid ventilation combined with inhaled nitric oxide in acute respiratory failure with pulmonary hypertension in piglets.

This study was a prospective, randomized, controlled design to evaluate gas exchange, lung mechanics, and pulmonary hemodynamics during partial liquid ventilation (PLV) combined with inhaled nitric oxide (NO) in acute respiratory failure (ARF) with pulmonary hypertension (PH). ARF with PH was induced in 12 piglets weighing 9.7-13.

Venous thrombosis in and after extracorporeal membrane oxygenation: detection and follow-up by color Doppler sonography.

The purpose of our study was to evaluate thrombosis of venous vessels during and after extracorporeal membrane oxygenation (ECMO) using color Doppler sonography. We prospectively performed serial color Doppler sonography investigations in 30 ECMO patients [age: newborn to 3 years, male:female = 20:10, venoarterial (VA) ECMO = 18, venovenous (VV) ECMO = 12]. During ECMO obstruction and/or thrombosis of the superior vena cava (SVC) was observed in 2 neonates on VA ECMO.

Concomitant procedures in the small versus standard aortic root.

Background And Aims Of The Study: Aortic valve replacement (AVR) in the small aortic root (SAR) has always been a severe challenge with an uncertain surgical outcome. The purpose of this study was to assess the surgical and clinical performance of 19 mm and 21 mm CarboMedics valves (CPHV) based on a review of valve-related morbidity and mortality over a period of six years.

Methods: A total of 361 patients undergoing aortic valve replacement (AVR) with the CPHV between January 1989 and August 1995 was subdivided and studied.

Activation of the clotting system during extracorporeal membrane oxygenation in term newborn infants.

Objectives: To determine the degree of clotting activation that occurs with the usual anticoagulation regimen with systemic heparinization.

Methods: To allow a standardized comparison of the patients, this study focused on the first 48 hours of extracorporeal membrane oxygenation (ECMO) in term newborn infants. The ECMO perfusion circuit consisted of a roller pump, silicone membrane lungs, and silicone rubber tubing.