Transluminal closure of patent ductus arteriosus: long-term results of 208 cases treated without thoracotomy.

Patent ductus arteriosus was the first inborn cardiac defect ever eliminated by percutaneous transvascular therapy. The method, results, and complications of Ivalon plugging of the ductus in 208 patients between 5 and 62 years old and treated between 1967 and 1985 are described. Permanent closure was accomplished in 197 patients (94.

[Measurement of left ventricle asynergy by various measuring procedures. II. Findings in patients with post-infarction states].

In 30 patients with postinfarction condition (11 infarctions of the posterior wall, 11 infarction of the anterior wall, 8 aneurysms of the anterior wall) the regional contraction of the left ventricle was analysed by 3 different metrical methods (semiaxis, surface and angular method) on the basis of the kineventriculogramme in the 1st oblique diameter. With all 3 methods a significant reduction of the mean contraction amplitude could be proved in the affected ventricular region. Using the semiaxis method, in all 30 patients an asynergy could be identified.

[Evaluation of asynergies in the left ventricle using various metric methods. I. Findings in patients with normal heart function].

The delimitation of regional disturbances of contraction of the left ventricle (asynergies) demands knowledge of the behaviour of the contraction of the normal left ventricle. For the exact recognition of asynergies and for scientific inquiries in these cases the use of objective metrical methods is necessary. Therefore, in 14 patients without organic heart disease the behaviour of the regional contraction of the left ventricle was determined on the basis of the cineventriculography according to three different metrical methods (semiaxis, surface and angular method).

[Preoperative renal artery embolization of malignant tumors in external patients].

In 53 external patients with extensive malignant renal tumours before nephrectomy the renal artery was closed centrally by radioopaque ivalonchips. 46 arteries were completely obturated, in 7 cases the embolization was incomplete. This method of embolization is indicated preoperatively because there are some advantages concerning technique of operation.

[Prophylaxis of pulmonary embolism by inferior vena cava filter (author's transl)].

30 patients underwent implantation of the Mobin-Uppin filter for recurrent life threatening pulmonary embolism. 20 patients could be followed by phlebography. In 11 cases obstruction of the inferior vena cava was observed.

[Function of the left ventricle in pacing-induced angina pectoris].

In 48 patients with angiographically ascertained coronary arteriosclerosis and 15 patients with unconspicuous cardiac findings a complete pressure-flow-volume-analysis of the left ventricle in rest and under artificial atrial tachycardia (atrial pacing) was carried out. In 26 patients with coronary arteriosclerosis a typical angina pectoris could be induced, however, in this group a specific constellation of the findings of the initial values was not present. Under influence of angina pectoris an increase of the disturbances of the regional contraction, connected with a significant decrease of the ejection fraction and of the isovolumetric contractibility parameter Vpm.

[Diagnosis and surgical technic of intramural coronary arteries].

384 patients with ischaemic heart disease were treated surgically. Out of 165 patients operated upon consecutively, in 38 (23%) an intramural course of coronary arteries was found. Peroperative diagnosis of the intramural course of the anterior interventricular branch is feasible with a high probability; diagnostic criteria were also elaborated for the intramural course of the marginal branch.

[Radiological methods in arteriosclerosis obliterans].

Of the X-ray methods for the demonstration of disturbances of the blood supply only the angiography is of practical importance. The proof of vascular calcium on so-called X-ray pictures of the soft parts informs about wall processes, but says absolutely nothing about a disturbed flow. The diagnosis of an obliterating vascular disease is still successful on the extremities with the help of the simple clinical means of pulse palpation, auscultation, measuring of the blood pressure with comparison of the sides, particularly when load methods are included.

[Preoperative embolization of the renal artery in kidney neoplasms].

In 15 patients with extensive malignant renal tumours before operation the artery of the kidney concerned was closed by foam substance particles (ivalon) after percutaneous selective catheterisation. The occurring ischaemic pain was controllable by medicaments and eased off after hours. In most cases the nephrectomy followed on the same day, but it can be performed also on the following day.

[Surgical treatment in deep venous thrombosis of the legs and pelvis (author's transl)].

The only effective causal therapy in thromboses of the deep pelvic and femoral veins is fibrinolysis or operative thrombectomy. Concerning the contraindications, fibrinolysis is successful only up to the 5th day. After that time patients with deep vein thrombosis were submitted to thrombectomy and at the same time, to prevent renewed thrombosis secondary to a slowing down of the flow, a peripheral arteriovenous fistula was temporarily positioned.