| 1. |
- Kölbel, Tilo, et al.
(författare)
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Endovascular treatment of venous occlusive disease
- 2009
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Ingår i: Gefässchirurgie. - : Springer Science and Business Media LLC. - 1434-3932 .- 0948-7034. ; 14:4, s. 292-292
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Forskningsöversikt (refereegranskat)abstract
- In the past, open surgical techniques such as thrombectomy and bypasses were the treatments of choice for acute and chronic venous occlusive disease of the iliocaval vein segments, but the results were often disappointing. With the introduction of endovascular techniques in the 1990s, open techniques were widely replaced by endovascular interventions. Proper preoperative imaging with computed tomography and magnetic resonance phlebography has become an important part of procedure planning, but phlebography by direct puncture with contrast injection in the immediate proximity of the iliofemoral segment is still the most informative diagnostic method. Catheter-directed thrombolysis with recanalization and stenting of underlying chronic obstructions is becoming the treatment of choice for patients with acute iliofemoral thrombosis, as conservative treatment is not satisfactory for preventing postthrombotic syndrome. Recanalization of chronic iliac vein occlusions with balloon angioplasty and stenting can reestablish normal venous flow in the iliac veins and inferior vena cava and relieve symptoms in the majority of treated patients. New treatment modalities offer stimulating options for patients not treated adequately either by medical or open surgical therapy.
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| 2. |
- Kölbel, Tilo, et al.
(författare)
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The Chimney Technique
- 2009
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Ingår i: Gefässchirurgie. - : Springer Science and Business Media LLC. - 1434-3932 .- 0948-7034. ; 14:3, s. 206-212
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Tidskriftsartikel (refereegranskat)abstract
- A thoracic chimney graft is a stent or stent graft that is deployed in a supraaortic branch vessel, protruding somewhat proximally into the free aortic lumen like a chimney parallel to the main aortic stent graft. The chimney graft is used to preserve flow to vital aortic side branches covered by the main aortic stent graft. Standard off-the-shelf stent grafts can be used to instantly treat lesions with inadequate fixation zones. The chimney graft offers an alternative to fenestrated stent grafts in urgent cases, in aneurysms with challenging neck anatomy, and in thoracic endovascular aortic repair for reconstituting an unintentionally covered aortic side branch. We describe our experience with this technique and review the current literature. More data and further technical improvements are necessary before the chimney graft can be widely advocated.
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| 3. |
- Häggström, Jens, et al.
(författare)
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Hämodynamische und neuroendokrine Kurzzeiteffekte von Pimobendan und Benazepril bei Hunden mit myxomatöser Mitralklappenerkrankung und kongestiver Herzinsuffizienz
- 2014
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Ingår i: Kleintier-praxis. - 0023-2076. ; 59, s. 365-378
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Tidskriftsartikel (refereegranskat)abstract
- Hintergrund:Pimobendan und Benazepril werden häufigzusammen mit Diuretika zur Behandlung von Hunden mit kongestiver Herzinsuffizienz (CHF; congestive heart failure)infolge myxomatöser Mitralklappenerkrankung (MMVD; myxomatous mitral valve disease) eingesetzt.Ziel:Vergleich der Kurzzeiteffekte von Pimobendan und Benazeprilauf die kardiale Pumpfunktion, die Herzgröße und das neuroendokrine Profil bei Hunden mit CHF infolge MMVD.Tiere:Sechzehn Hunde privater Besitzer.Material und Methoden:Siebentägige, einfach verblindeteProspektivstudie. Die Hunde wurden durch eine Furosemid- Monotherapie stabilisiert und randomisiert einer Behandlungmit Pimobendan (0,4–0,6 mg/kg/Tag) oder Benazepril(0,25–1,0 mg/kg/Tag) zugeteilt. Sie wurden einer First- Pass-Radionuklid-Angiokardiografie unterzogen und dieHerzdimensionen mittels Radiografie und Echokardiografie gemessen. Darüber hinaus wurden die zirkulierenden Konzentrationenneuroendokriner Hormone bestimmt.Ergebnisse:Die Ausgangsvariablen unterschieden sich nichtzwischen den Behandlungsgruppen. In der Pimobendan- Gruppe wurden im Vergleich zur Benazepril-Gruppe höhereAbnahmen der Herzfrequenz (p = 0,001), der herzfrequenznormalisiertenpulmonalen Transitzeit (p = 0,02), der Größe des linken Atriums (p = 0,03) sowie der systolischen und diastolischenlinksventrikulären Durchmesser (p < 0,001 bzw. p = 0,03) und Volumina (p < 0,001 bzw. p = 0,02) gefunden, während dieEjektionsfraktion in der Pimobendan-Gruppe stärker anstieg (p = 0,02). Von den neuroendokrinen Hormonen unterschiedsich nur das N-terminale proatriale natriuretische Peptid(NT-proANP) (n = 0,04) im Vergleich zwischen den Gruppen. Innerhalb der Gruppen stieg in der Pimobendan-Gruppe dasPlasmaaldosteron an (p = 0,01) und die Konzentrationen von NT-proANP (p = 0,01) sowie NT-proBNP (p = 0,02) verringertensich, während sowohl NT-proANP (p = 0,02) als auch Plasmavasopressin(p = 0,01) in der Benazepril-Gruppe sanken.Schlussfolgerungen und klinische Bedeutung:Pimobendan verbessert bei Hunden mit CHF infolge MMVD die kurzzeitiggemessene Herzfunktion in höherem Maße als Benazepril. Eine Pimobendan-Behandlung ermöglicht es dem Herzen,bei geringeren endsystolischen und enddiastolischen Dimensionen zu arbeiten und gleichzeitig ein adäquatesVorwärtsschlagvolumen aufrechtzuerhalten. Einige derWirkungen der Behandlung auf das neuroendokrine Profilkönnten therapeutische Relevanz haben.
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| 4. |
- Werdan, K., et al.
(författare)
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Curriculum Kardiologie 2., aktualisierte Auflage
- 2020
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Ingår i: KARDIOLOGE. - : SPRINGER HEIDELBERG. - 1864-9718 .- 1864-9726. ; 14:6, s. 505-536
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Tidskriftsartikel (refereegranskat)abstract
- The updated second edition of the "Curriculum cardiology", first edition 2013, aims to show which competences a cardiologist should nowadays master. It is very pleasing that in this second edition representatives of the Young German Cardiac Society (Young DGK) have contributed as authors. The increasing specialization within cardiology should, however, only represent one side of the coin: there must also still be a common foundation of cardiology, embedded in the discipline "internal medicine". This foundation includes the basis of theoretical knowledge, practical skills (competence levels I-III) and an occupational and professional attitude of the (prospective) cardiologist. New additions to the advanced training since the first edition of the curriculum in 2013 are, for example a chapter on digital cardiology, the further training in psychocardiology, which was newly introduced into the model further training regulations and finally also the explicit formulation of shared decision making in the interests of cardiac patients. The curriculum should give the prospective cardiologist the possibility to structure the further training as efficiently as possible and ultimately to retain and expand that which has been learned in the sense of a "professional lifelong" qualification. The curriculum also aims to reach the trainers and the Medical Councils and demonstrate which contents and skills should be mediated in the further training to become a cardiologist from the perspective of the German Cardiac Society (DGK).
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| 5. |
- Nentwich, Karin, et al.
(författare)
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Ein Patient mit Aortenstenose und schwerer Ausflussbahn-Obstruktion : eine diagnostische Herausforderung [A patient with aortic valve stenosis and severe obstruction of the left ventricular outflow tract: a diagnostic challenge]
- 2010
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Ingår i: Deutsche Medizinische Wochenschrift. - : Georg Thieme Verlag. - 0012-0472 .- 1439-4413. ; 135:20, s. 1016-1019
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Tidskriftsartikel (refereegranskat)abstract
- History and admission findings: A 83-year-old male patient was admitted with dyspnoe and paroxysmal atrial fibrillation. A severe aortic stenosis was diagnosed 9 months before. Investigations: Echocardiography now revealed severe obstruction of the left ventricular outflow tract, as part of an obstructive cardiomyopathy, mild aortic valve stenosis and mark4d left atrial dilatation. Therapy and course: After spontaneous conversion into sinus rhythm the patient remained asymptomatic and continuing conservative treatment was recommended. Conclusion: It may be difficult to diagnose the correct components of systolic obstruction when there is both obstructive cardiomyopathy and aortic valve stenosis and thus decide on the optimal management of such a case.
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| 6. |
- Hagendorff, Andreas, et al.
(författare)
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Manual zur Indikation und Durchführung spezieller echokardiographischer Anwendungen
- 2021
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Ingår i: Der Kardiologe. - : Springer Nature. - 1864-9718 .- 1864-9726. ; 15:6, s. 595-641
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Tidskriftsartikel (refereegranskat)abstract
- The second manual on indications for and performance of echocardiography focusses on specific echocardiographic modalities and special problems in several patient cohorts. Practical aspects are discussed with priority. Established echocardiographic modalities are transesophageal, stress and contrast echocardiography. Modern technologies, such as 3D echocardiography and deformation imaging play an important role in nearly all scenarios of clinical echocardiography. This complete echocardiographic spectrum is incorporated into emergency and intensive care medicine, monitoring interventions of structural heart diseases, cardiac surgery, patients with cardiac assist devices, adult patients with congenital heart diseases and the care of highly infectious patients in pandemics. The diagnostic procedures of conventional and modern echocardiography are highlighted in this manual. The use of 3D echocardiography to characterize cardiac morphology and the application of deformation imaging to objectify cardiac function are already established in clinical practice. Stress echocardiography to detect myocardial ischemia and viability or to diagnose valvular heart diseases, assessment of coronary flow reserve to analyze myocardial perfusion and contrast echocardiography for left ventricular opacification and tumor characterization are increasingly being used to improve diagnostics. As mentioned for conventional echocardiography in the last manual of echocardiography in 2009, the modern features in echocardiography require standardized documentation and acquisition of certain images with optimized ultrasound settings, because conclusive and reproducible data analysis can only be performed if the image quality is sufficient.
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| 7. |
- Häggström, Jens, et al.
(författare)
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Die Wirkung von Pimobendan bei Hunden mit praklinischer myxomatoser Mitralklappen- erkrankung und Kardiomegalie: Die EPIC-Studie - Eine randomisierte klinische Studie
- 2017
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Ingår i: Kleintier-praxis. - 0023-2076. ; 62, s. 64-87
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Tidskriftsartikel (refereegranskat)abstract
- Background Pimobendan is effective in treatment of dogs with congestive heart failure (CHF) secondary to myxomatous mitral valve disease (MMVD). Its effect on dogs before the onset of CHF is unknown.Hypothesis/Objectives Administration of pimobendan (0.4-0.6 mg/kg/d in divided doses) to dogs with increased heart size secondary to preclinical MMVD, not receiving other cardiovascular medications, will delay the onset of signs of CHF, cardiac-related death, or euthanasia.Animals 360 client-owned dogs with MMVD with left atrial-to-aortic ratio >= 1.6, normalized left ventricular internal diameter in diastole >= 1.7, and vertebral heart sum >10.5.Methods Prospective, randomized, placebo-controlled, blinded, multicenter clinical trial. Primary outcome variable was time to a composite of the onset of CHF, cardiac-related death, or euthanasia.Results Median time to primary endpoint was 1228.days (95% CI: 856 -NA) in the pimobendan group and 766 days (95% CI: 667-875) in the placebo group (P =.0038). Hazard ratio for the pimobendan group was 0.64 (95% CI: 0.47-0.87) compared with the placebo group. The benefit persisted after adjustment for other variables. Adverse events were not different between treatment groups. Dogs in the pimobendan group lived longer (median survival time was 1059 days (95% CI: 952-NA) in the pimobendan group and 902 days (95% CI: 747-1061) in the placebo group) (P =.012).Conclusions and Clinical Importance Administration of pimobendan to dogs with MMVD and echocardiographic and radiographic evidence of cardiomegaly results in prolongation of preclinical period and is safe and well tolerated. Prolongation of preclinical period by approximately 15 months represents substantial clinical benefit.
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