Christian Schreiber - Academia.edu (original) (raw)

Papers by Christian Schreiber

Research paper thumbnail of Fontan completion rate and outcomes after bidirectional cavo-pulmonary shunt☆

European Journal of Cardio-Thoracic Surgery, 2010

Research paper thumbnail of Surgical Therapy of an Aberrant Origin of the Left Anterior Descending Coronary Artery from the Right Sinus of Valsalva: A Case Report

Heart Surgery Forum, 2006

Anomalous aortic origin of a coronary artery from the incorrect coronary sinus of Valsalva is a r... more Anomalous aortic origin of a coronary artery from the incorrect coronary sinus of Valsalva is a rare congenital cardiac defect that is associated with an increased risk of sudden death. In most of these defects, the anomalous coronary artery takes an intramural course between the great arteries and leaves the aortic wall from the appropriate coronary sinus of Valsalva. Many times this anomalous artery shares a common orifice with the other coronary artery. We report on a previously healthy 15-year-old boy who presented with signs of an anterolateral myocardial infarction after physical activity (soccer game). Transthoracic echocardiography revealed an aberrant origin of the left anterior descending coronary artery from the right sinus of Valsalva. Repair was accomplished by unroofing the intramural segment. Because the intramural segment was below the commissure, detachment of the intercoronary commissure was not necessary. To conclude, transthoracic echocardiography can accurately depict this rare anomaly, and in symptomatic patients surgical therapy is indicated.

Research paper thumbnail of A new treatment option for pulmonary valvar insufficiency: first experiences with implantation of a self-expanding stented valve without use of cardiopulmonary bypass

European Journal of Cardio-thoracic Surgery, 2007

Objective: Pulmonary regurgitation is the predominant problem in the long-term follow-up of tetra... more Objective: Pulmonary regurgitation is the predominant problem in the long-term follow-up of tetralogy of Fallot (TOF) patients after primary repair. Apart from standard homograft implantation, a percutaneous valve delivery approach has been described recently. A right ventricular outflow tract (RVOT) diameter of greater than 22mm, however, precludes percutaneous valve delivery. We describe a novel technique with a transventricular implantation of

Research paper thumbnail of Reciprocal Regulation of Rac1 and PAK1 by HIF-1α: A Positive-Feedback Loop Promoting Pulmonary Vascular Remodeling

Antioxidants & Redox Signaling, 2010

Pulmonary vascular remodeling associated with pulmonary hypertension is characterized by media th... more Pulmonary vascular remodeling associated with pulmonary hypertension is characterized by media thickening, disordered proliferation, and in situ thrombosis. The p21-activated kinase-1 (PAK-1) can control growth, migration, and prothrombotic activity, and the hypoxia-inducible transcription factor HIF-1a was associated with pulmonary vascular remodeling. Here we studied whether PAK-1 and HIF-1a are linked in pulmonary vascular remodeling. PAK-1 was expressed in the media of remodeled pulmonary vessels from patients with pulmonary vasculopathy and was upregulated, together with its upstream regulator Rac1 and HIF-1a in lung tissue from lambs with pulmonary vascular remodeling. PAK-1 and Rac1 were activated by thrombin involving calcium, thus resulting in enhanced generation of reactive oxygen species (ROS) in human pulmonary artery smooth muscle cells (PASMCs). Activation of PAK-1 stimulated HIF activity and HIF-1a expression involving ROS and NF-kB, enhanced the expression of the HIF-1 target gene plasminogen activator inhibitor-1, and stimulated PASMC proliferation. Importantly, HIF-1 itself bound to the Rac1 promoter and enhanced Rac1 and PAK-1 transcription. Thus, PAK-1 and its activator Rac1 are novel HIF-1 targets that may constitute a positive-feedback loop for induction of HIF-1a by thrombin and ROS, thus explaining elevated levels of PAK-1, Rac1, and HIF-1a in remodeled pulmonary vessels. Antioxid. Redox Signal. 13, 399-412.

Research paper thumbnail of Bidirectional cavopulmonary connection without additional pulmonary blood flow in patients below the age of 6 months

European Journal of Cardio-thoracic Surgery, 2008

Objective: The bidirectional cavopulmonary connection (BCPC) has shown excellent results as an in... more Objective: The bidirectional cavopulmonary connection (BCPC) has shown excellent results as an intermediate step towards permanent palliation in functional single ventricle morphology. The optimal timing of the BCPC, though, remains unclear. This investigation focuses on results in a subgroup of patients under 6 months of age. Methods: Between 2001 and 2006, 124 patients received a BCPC followed by an extracardiac

Research paper thumbnail of Early Graft Failure of Small-Sized Porcine-Valved Conduits in Reconstruction of the Right Ventricular Outflow Tract

Annals of Thoracic Surgery, 2006

Background. The quest for an alternative to homografts for reconstruction of the right ventricula... more Background. The quest for an alternative to homografts for reconstruction of the right ventricular outflow tract is ongoing. The Shelhigh No-React (NR-4000PA series) treated porcine pulmonic valve conduit (SPVC) was developed as a potential alternative.

Research paper thumbnail of The fate of systemic blood pressure in patients after effectively stented coarctation

Aims The current study was designed to assess midterm results of stent implantation into the aort... more Aims The current study was designed to assess midterm results of stent implantation into the aorta for native and recurrent coarctation (CoA) in children and young adults. Methods and results Forty-three patients (native CoA, 8; female, 12) were treated with stent implan- tation at a median age of 16.8 years (range 7.9-44.8 years). Only stents dilatable to an adult size

Research paper thumbnail of A Regulated Trial of Bicuspid Aortic Valve Repair Supported by Geometric Ring Annuloplasty

The Annals of Thoracic Surgery, 2015

Annular stabilization is important during bicuspid aortic valve (BAV) repair to obtain the best l... more Annular stabilization is important during bicuspid aortic valve (BAV) repair to obtain the best long-term results. This report describes the early outcomes of a novel bicuspid annuloplasty ring for this purpose. Under regulatory supervision (NCT02071849), a geometric bicuspid annuloplasty ring was used during valve repair in 16 patients. Three patients had Sievers type 0 valves, 11 had Sievers type 1, and 2 had Sievers type 2. Thirteen patients had left-/right-coronary cusp fusion, 1 had right-/noncoronary cusp fusion, and 2 had both. Moderate to severe aortic insufficiency (AI) was present in 13 of 16 patients, and 3 had mild AI with aortic aneurysms. Ascending aortic aneurysms, root aneurysms, or both were replaced in 7 of 16 patients. The Dacron-covered titanium ring had circular base geometry and two outwardly flaring subcommissural posts positioned opposite on the circumference. The ring was implanted into the annulus beneath the valve, and then leaflet repair was performed. Immediate postrepair echocardiograms showed grade 0 residual AI in all patients, with good cusp mobility and effective height, and satisfactory gradients. There were no in-hospital or late mortalities. Two patients experienced leaflet tears from long annular suture tails, requiring late valve replacement. After implementation of a lateral suture fixation technique, no more failures occurred. At a mean follow-up time of 9 months, the remaining 14 patients were in New York Heart Association class I, with predominant grade 0 AI. As a technique for BAV repair, internal ring annuloplasty produces major annular remodeling and stabilization. Annular reduction and reshaping to a 50/50% symmetric circular geometry facilitates leaflet repair and enhances cusp coaptation. Geometric ring annuloplasty could have useful applications in BAV repair.

Research paper thumbnail of Muscular ventricular septal defect in a newborn with truncus arteriosous communis: perventricular transcatheter closure under echocardiographic guidance only: a case report-response to the comment of dr anderson

World journal for pediatric & congenital heart surgery, 2015

ABSTRACT

Research paper thumbnail of Creating an arc-shaped aorta: use of the subclavian artery for interrupted aortic arch repair

The Annals of thoracic surgery, 2015

With interrupted aortic arch (IAA), a direct anastomosis may produce an angular-shaped aortic arc... more With interrupted aortic arch (IAA), a direct anastomosis may produce an angular-shaped aortic arch instead of the normal arc-shaped aorta, when the discontinuity is considerably long. That may lead to aortic stenosis and to compression of the pulmonary artery or the main bronchus. If a tube graft is used, reoperation for graft exchange is inevitable. We demonstrate the results of using the subclavian artery for creating an arc-shaped aorta in IAA repair. Between February 2006 and October 2012, 23 patients underwent IAA repair using the subclavian artery. The subclavian artery was closed distally, divided, and longitudinally incised from the transected end to the aorta. This flap was used to bridge the gap of the IAA, by forming the posterior wall of a new aortic segment. The arch was completed using glutaraldehyde-fixed autologous pericardium (52%) or homograft (48%). Median follow-up time was 4.8 years (range, 1.3 to 6.9). There were no early deaths and 1 late death. On postoperati...

Research paper thumbnail of Muscular ventricular septal defect in a newborn with truncus arteriosus communis: perventricular transcatheter closure under echocardiographic guidance only, a case report

World journal for pediatric & congenital heart surgery, 2014

We report a case of a 3.5-kg newborn presenting with a muscular ventricular septal defect (VSD) i... more We report a case of a 3.5-kg newborn presenting with a muscular ventricular septal defect (VSD) in the setting of truncus arteriosus communis (common arterial trunk). Reparative surgery using a hybrid approach included perventricular closure of the muscular VSD on the beating heart.

Research paper thumbnail of A Comparative Histopathological Study of Heparin Coated and Uncoated Polytetrafluoroethylene Shunts in Children With Congenital Heart Defect

World journal for pediatric & congenital heart surgery, Jan 23, 2014

Recently, heparin coated polytetrafluoroethylene (PTFE) shunts are available and are believed to ... more Recently, heparin coated polytetrafluoroethylene (PTFE) shunts are available and are believed to improve inherent shunt problems such as thrombosis and excessive and incomplete neointima formation or occlusion. We aimed at comparing the potential histopathological differences in the neointima (in) between uncoated (UCS) PTFE shunts and heparin coated (HCS) PTFE shunts. Thirteen shunts (six UCS and seven HCS) were analyzed. The specimens were fixed in formalin, embedded in paraffin or in methylmethacrylate, and characterized by standard and immunohistochemical staining. The thickness of pseudointima proliferation was graded as follows: 0 = no cell layers, 1 = few layers <100 µm, 2 = partial layers >100 µm, 3 = complete layers <300 µm, 4 = complete layers >300 µm, and 5 = occlusion. Mean shunt size was 3.4 ± 0.2 mm in UCS and 3.1 ± 0.2 mm in HCS (P = .053). Mean time of implantation was 163 ± 75 days in UCS and 97 ± 52 days in HCS (P = .091). There were no significant diff...

Research paper thumbnail of eComment: Surgical treatment of coarctation in adult patients yields better long-term results with regard to hypertension but carries a substantial risk

Interactive cardiovascular and thoracic surgery, 2009

Research paper thumbnail of Delayed Perforation of a Transcatheter Patent Foramen Ovale Occluder 10 Years After Implantation

The Annals of Thoracic Surgery, 2015

Research paper thumbnail of A Rare Anomaly of a Single Coronary Artery Arising From the Right Pulmonary Artery in a Neonate

World Journal for Pediatric and Congenital Heart Surgery, 2014

An anomalous origin of the entire coronary circulation from the right pulmonary artery is a very ... more An anomalous origin of the entire coronary circulation from the right pulmonary artery is a very rare congenital malformation. We report on a male newborn presenting with hypoplastic aortic arch and coarctation of the aorta in whom a previously undetected single coronary artery originating from the right pulmonary artery was detected at the time of corrective surgery. The patient underwent a resection of the coarctation with a patch enlargement of the aortic arch and a successful reimplantation of the coronary artery into the aorta.

Research paper thumbnail of Aortic Aneurysm 31 Years after Coarctation Repair with Direct Anastomosis

Background: Despite primary success, 9% of patients develop aortic (pseudo)aneurysms after surgic... more Background: Despite primary success, 9% of patients develop aortic (pseudo)aneurysms after surgical repair of aortic coarctation at or near the site of repair late after operation. Case Study: A chest X-ray in a 32-year-old asymptomatic man, 31 years after coarctation repair, depicted a ballooning of the distal aortic arch. A multislice CT confirmed an aneurysm. The aneurysm was resected using selective head perfusion.

Research paper thumbnail of Successful Primary Correction of Tetralogy of Fallot with Pulmonary Atresia and Aortopulmonary Window in a 2,220-g Neonate with a Valved Bovine Jugular Vein Conduit

Prenatal diagnosis of tetralogy of Fallot with pulmonary atresia (TOF/PA) was confirmed in a newb... more Prenatal diagnosis of tetralogy of Fallot with pulmonary atresia (TOF/PA) was confirmed in a newborn with a birth weight of 2,095 g. Additionally, an aortopulmonary window (APW) type I was diagnosed on echocardiography. The operation was performed at the age of 4 weeks due to congestive heart failure. The APW was closed with a pericardial patch, the ventricular septal defect (VSD) with a Dacron patch, and the right ventricular outflow tract (RVOT) was reconstructed with a 12-mm bovine jugular vein valved conduit (Contegra, Medtronic Inc., Minneapolis, MN, USA). At 15-month follow-up, the patient is in excellent clinical condition without medication. On echocardiography, the conduit showed a mean gradient of 11 mmHg with first-degree insufficiency.

Research paper thumbnail of Seltene Form der Myokarditis mit akutem Herzversagen und erfolgreicher \Rescue-Therapie\ mit biventrikulärem Unterstützungssystem

Anamnese und Befunde: Eine 37-jährige Patientin wurde im kardiogenen Schock bei Multiorganversage... more Anamnese und Befunde: Eine 37-jährige Patientin wurde im kardiogenen Schock bei Multiorganversagen eingewiesen. Echokardiographisch war die linksventrikuläre Funktion zunächst auf 35% reduziert. Klinisch bestand der V.a. eine Myokarditis. Anamnestisch bestand ein grippaler Infekt seit 1 Woche. Innerhalb von 24 h kam es zu einer weiteren dramatischen Reduktion der linksventrikulären Funktion auf 7%. Links-bzw. Rechtsherzkatheteruntersuchungen unter Entnahme von rechtsventrikulären Myokardbiopsien wurden durchgeführt. Die histo-und molekularpathologischen Untersuchungen ergaben die Diagnose einer Enterovirusmyokarditis.

Research paper thumbnail of Mitral-valve replacement in children under 6 years of age

European Journal of Cardio-thoracic Surgery, 2000

Objective: In patients with congenital mitral-valve disease, reconstructive surgery is the primar... more Objective: In patients with congenital mitral-valve disease, reconstructive surgery is the primary goal. However, in cases with severely dysplastic valves or failed repair, mitral-valve replacement (MVR) is the only option. We analyzed, retrospectively, data of 35 patients younger than 6 years of age, who underwent MVR at our institution.Methods: Between 1974 and 1997, 35 children underwent MVR. The ages ranged

Research paper thumbnail of Valve-Sparing Aortic Root Replacement in the Presence of Coronary Anomalies

The Annals of Thoracic Surgery, 2014

Aortic root replacement in the presence of coronary anomalies can be challenging. Because the ano... more Aortic root replacement in the presence of coronary anomalies can be challenging. Because the anomalous coronary often arises close to a commissure, reconstruction with traditional buttons can be technically difficult without compromising either the leaflets or the coronary artery. A method of valve sparing root surgery termed &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;aortic valve and root restoration,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; using aortic ring annuloplasty and formal valve repair, and then incorporating the anomalous coronary into the commissural suture line, may offer a simple solution to this problem.

Research paper thumbnail of Fontan completion rate and outcomes after bidirectional cavo-pulmonary shunt☆

European Journal of Cardio-Thoracic Surgery, 2010

Research paper thumbnail of Surgical Therapy of an Aberrant Origin of the Left Anterior Descending Coronary Artery from the Right Sinus of Valsalva: A Case Report

Heart Surgery Forum, 2006

Anomalous aortic origin of a coronary artery from the incorrect coronary sinus of Valsalva is a r... more Anomalous aortic origin of a coronary artery from the incorrect coronary sinus of Valsalva is a rare congenital cardiac defect that is associated with an increased risk of sudden death. In most of these defects, the anomalous coronary artery takes an intramural course between the great arteries and leaves the aortic wall from the appropriate coronary sinus of Valsalva. Many times this anomalous artery shares a common orifice with the other coronary artery. We report on a previously healthy 15-year-old boy who presented with signs of an anterolateral myocardial infarction after physical activity (soccer game). Transthoracic echocardiography revealed an aberrant origin of the left anterior descending coronary artery from the right sinus of Valsalva. Repair was accomplished by unroofing the intramural segment. Because the intramural segment was below the commissure, detachment of the intercoronary commissure was not necessary. To conclude, transthoracic echocardiography can accurately depict this rare anomaly, and in symptomatic patients surgical therapy is indicated.

Research paper thumbnail of A new treatment option for pulmonary valvar insufficiency: first experiences with implantation of a self-expanding stented valve without use of cardiopulmonary bypass

European Journal of Cardio-thoracic Surgery, 2007

Objective: Pulmonary regurgitation is the predominant problem in the long-term follow-up of tetra... more Objective: Pulmonary regurgitation is the predominant problem in the long-term follow-up of tetralogy of Fallot (TOF) patients after primary repair. Apart from standard homograft implantation, a percutaneous valve delivery approach has been described recently. A right ventricular outflow tract (RVOT) diameter of greater than 22mm, however, precludes percutaneous valve delivery. We describe a novel technique with a transventricular implantation of

Research paper thumbnail of Reciprocal Regulation of Rac1 and PAK1 by HIF-1α: A Positive-Feedback Loop Promoting Pulmonary Vascular Remodeling

Antioxidants & Redox Signaling, 2010

Pulmonary vascular remodeling associated with pulmonary hypertension is characterized by media th... more Pulmonary vascular remodeling associated with pulmonary hypertension is characterized by media thickening, disordered proliferation, and in situ thrombosis. The p21-activated kinase-1 (PAK-1) can control growth, migration, and prothrombotic activity, and the hypoxia-inducible transcription factor HIF-1a was associated with pulmonary vascular remodeling. Here we studied whether PAK-1 and HIF-1a are linked in pulmonary vascular remodeling. PAK-1 was expressed in the media of remodeled pulmonary vessels from patients with pulmonary vasculopathy and was upregulated, together with its upstream regulator Rac1 and HIF-1a in lung tissue from lambs with pulmonary vascular remodeling. PAK-1 and Rac1 were activated by thrombin involving calcium, thus resulting in enhanced generation of reactive oxygen species (ROS) in human pulmonary artery smooth muscle cells (PASMCs). Activation of PAK-1 stimulated HIF activity and HIF-1a expression involving ROS and NF-kB, enhanced the expression of the HIF-1 target gene plasminogen activator inhibitor-1, and stimulated PASMC proliferation. Importantly, HIF-1 itself bound to the Rac1 promoter and enhanced Rac1 and PAK-1 transcription. Thus, PAK-1 and its activator Rac1 are novel HIF-1 targets that may constitute a positive-feedback loop for induction of HIF-1a by thrombin and ROS, thus explaining elevated levels of PAK-1, Rac1, and HIF-1a in remodeled pulmonary vessels. Antioxid. Redox Signal. 13, 399-412.

Research paper thumbnail of Bidirectional cavopulmonary connection without additional pulmonary blood flow in patients below the age of 6 months

European Journal of Cardio-thoracic Surgery, 2008

Objective: The bidirectional cavopulmonary connection (BCPC) has shown excellent results as an in... more Objective: The bidirectional cavopulmonary connection (BCPC) has shown excellent results as an intermediate step towards permanent palliation in functional single ventricle morphology. The optimal timing of the BCPC, though, remains unclear. This investigation focuses on results in a subgroup of patients under 6 months of age. Methods: Between 2001 and 2006, 124 patients received a BCPC followed by an extracardiac

Research paper thumbnail of Early Graft Failure of Small-Sized Porcine-Valved Conduits in Reconstruction of the Right Ventricular Outflow Tract

Annals of Thoracic Surgery, 2006

Background. The quest for an alternative to homografts for reconstruction of the right ventricula... more Background. The quest for an alternative to homografts for reconstruction of the right ventricular outflow tract is ongoing. The Shelhigh No-React (NR-4000PA series) treated porcine pulmonic valve conduit (SPVC) was developed as a potential alternative.

Research paper thumbnail of The fate of systemic blood pressure in patients after effectively stented coarctation

Aims The current study was designed to assess midterm results of stent implantation into the aort... more Aims The current study was designed to assess midterm results of stent implantation into the aorta for native and recurrent coarctation (CoA) in children and young adults. Methods and results Forty-three patients (native CoA, 8; female, 12) were treated with stent implan- tation at a median age of 16.8 years (range 7.9-44.8 years). Only stents dilatable to an adult size

Research paper thumbnail of A Regulated Trial of Bicuspid Aortic Valve Repair Supported by Geometric Ring Annuloplasty

The Annals of Thoracic Surgery, 2015

Annular stabilization is important during bicuspid aortic valve (BAV) repair to obtain the best l... more Annular stabilization is important during bicuspid aortic valve (BAV) repair to obtain the best long-term results. This report describes the early outcomes of a novel bicuspid annuloplasty ring for this purpose. Under regulatory supervision (NCT02071849), a geometric bicuspid annuloplasty ring was used during valve repair in 16 patients. Three patients had Sievers type 0 valves, 11 had Sievers type 1, and 2 had Sievers type 2. Thirteen patients had left-/right-coronary cusp fusion, 1 had right-/noncoronary cusp fusion, and 2 had both. Moderate to severe aortic insufficiency (AI) was present in 13 of 16 patients, and 3 had mild AI with aortic aneurysms. Ascending aortic aneurysms, root aneurysms, or both were replaced in 7 of 16 patients. The Dacron-covered titanium ring had circular base geometry and two outwardly flaring subcommissural posts positioned opposite on the circumference. The ring was implanted into the annulus beneath the valve, and then leaflet repair was performed. Immediate postrepair echocardiograms showed grade 0 residual AI in all patients, with good cusp mobility and effective height, and satisfactory gradients. There were no in-hospital or late mortalities. Two patients experienced leaflet tears from long annular suture tails, requiring late valve replacement. After implementation of a lateral suture fixation technique, no more failures occurred. At a mean follow-up time of 9 months, the remaining 14 patients were in New York Heart Association class I, with predominant grade 0 AI. As a technique for BAV repair, internal ring annuloplasty produces major annular remodeling and stabilization. Annular reduction and reshaping to a 50/50% symmetric circular geometry facilitates leaflet repair and enhances cusp coaptation. Geometric ring annuloplasty could have useful applications in BAV repair.

Research paper thumbnail of Muscular ventricular septal defect in a newborn with truncus arteriosous communis: perventricular transcatheter closure under echocardiographic guidance only: a case report-response to the comment of dr anderson

World journal for pediatric & congenital heart surgery, 2015

ABSTRACT

Research paper thumbnail of Creating an arc-shaped aorta: use of the subclavian artery for interrupted aortic arch repair

The Annals of thoracic surgery, 2015

With interrupted aortic arch (IAA), a direct anastomosis may produce an angular-shaped aortic arc... more With interrupted aortic arch (IAA), a direct anastomosis may produce an angular-shaped aortic arch instead of the normal arc-shaped aorta, when the discontinuity is considerably long. That may lead to aortic stenosis and to compression of the pulmonary artery or the main bronchus. If a tube graft is used, reoperation for graft exchange is inevitable. We demonstrate the results of using the subclavian artery for creating an arc-shaped aorta in IAA repair. Between February 2006 and October 2012, 23 patients underwent IAA repair using the subclavian artery. The subclavian artery was closed distally, divided, and longitudinally incised from the transected end to the aorta. This flap was used to bridge the gap of the IAA, by forming the posterior wall of a new aortic segment. The arch was completed using glutaraldehyde-fixed autologous pericardium (52%) or homograft (48%). Median follow-up time was 4.8 years (range, 1.3 to 6.9). There were no early deaths and 1 late death. On postoperati...

Research paper thumbnail of Muscular ventricular septal defect in a newborn with truncus arteriosus communis: perventricular transcatheter closure under echocardiographic guidance only, a case report

World journal for pediatric & congenital heart surgery, 2014

We report a case of a 3.5-kg newborn presenting with a muscular ventricular septal defect (VSD) i... more We report a case of a 3.5-kg newborn presenting with a muscular ventricular septal defect (VSD) in the setting of truncus arteriosus communis (common arterial trunk). Reparative surgery using a hybrid approach included perventricular closure of the muscular VSD on the beating heart.

Research paper thumbnail of A Comparative Histopathological Study of Heparin Coated and Uncoated Polytetrafluoroethylene Shunts in Children With Congenital Heart Defect

World journal for pediatric & congenital heart surgery, Jan 23, 2014

Recently, heparin coated polytetrafluoroethylene (PTFE) shunts are available and are believed to ... more Recently, heparin coated polytetrafluoroethylene (PTFE) shunts are available and are believed to improve inherent shunt problems such as thrombosis and excessive and incomplete neointima formation or occlusion. We aimed at comparing the potential histopathological differences in the neointima (in) between uncoated (UCS) PTFE shunts and heparin coated (HCS) PTFE shunts. Thirteen shunts (six UCS and seven HCS) were analyzed. The specimens were fixed in formalin, embedded in paraffin or in methylmethacrylate, and characterized by standard and immunohistochemical staining. The thickness of pseudointima proliferation was graded as follows: 0 = no cell layers, 1 = few layers <100 µm, 2 = partial layers >100 µm, 3 = complete layers <300 µm, 4 = complete layers >300 µm, and 5 = occlusion. Mean shunt size was 3.4 ± 0.2 mm in UCS and 3.1 ± 0.2 mm in HCS (P = .053). Mean time of implantation was 163 ± 75 days in UCS and 97 ± 52 days in HCS (P = .091). There were no significant diff...

Research paper thumbnail of eComment: Surgical treatment of coarctation in adult patients yields better long-term results with regard to hypertension but carries a substantial risk

Interactive cardiovascular and thoracic surgery, 2009

Research paper thumbnail of Delayed Perforation of a Transcatheter Patent Foramen Ovale Occluder 10 Years After Implantation

The Annals of Thoracic Surgery, 2015

Research paper thumbnail of A Rare Anomaly of a Single Coronary Artery Arising From the Right Pulmonary Artery in a Neonate

World Journal for Pediatric and Congenital Heart Surgery, 2014

An anomalous origin of the entire coronary circulation from the right pulmonary artery is a very ... more An anomalous origin of the entire coronary circulation from the right pulmonary artery is a very rare congenital malformation. We report on a male newborn presenting with hypoplastic aortic arch and coarctation of the aorta in whom a previously undetected single coronary artery originating from the right pulmonary artery was detected at the time of corrective surgery. The patient underwent a resection of the coarctation with a patch enlargement of the aortic arch and a successful reimplantation of the coronary artery into the aorta.

Research paper thumbnail of Aortic Aneurysm 31 Years after Coarctation Repair with Direct Anastomosis

Background: Despite primary success, 9% of patients develop aortic (pseudo)aneurysms after surgic... more Background: Despite primary success, 9% of patients develop aortic (pseudo)aneurysms after surgical repair of aortic coarctation at or near the site of repair late after operation. Case Study: A chest X-ray in a 32-year-old asymptomatic man, 31 years after coarctation repair, depicted a ballooning of the distal aortic arch. A multislice CT confirmed an aneurysm. The aneurysm was resected using selective head perfusion.

Research paper thumbnail of Successful Primary Correction of Tetralogy of Fallot with Pulmonary Atresia and Aortopulmonary Window in a 2,220-g Neonate with a Valved Bovine Jugular Vein Conduit

Prenatal diagnosis of tetralogy of Fallot with pulmonary atresia (TOF/PA) was confirmed in a newb... more Prenatal diagnosis of tetralogy of Fallot with pulmonary atresia (TOF/PA) was confirmed in a newborn with a birth weight of 2,095 g. Additionally, an aortopulmonary window (APW) type I was diagnosed on echocardiography. The operation was performed at the age of 4 weeks due to congestive heart failure. The APW was closed with a pericardial patch, the ventricular septal defect (VSD) with a Dacron patch, and the right ventricular outflow tract (RVOT) was reconstructed with a 12-mm bovine jugular vein valved conduit (Contegra, Medtronic Inc., Minneapolis, MN, USA). At 15-month follow-up, the patient is in excellent clinical condition without medication. On echocardiography, the conduit showed a mean gradient of 11 mmHg with first-degree insufficiency.

Research paper thumbnail of Seltene Form der Myokarditis mit akutem Herzversagen und erfolgreicher \Rescue-Therapie\ mit biventrikulärem Unterstützungssystem

Anamnese und Befunde: Eine 37-jährige Patientin wurde im kardiogenen Schock bei Multiorganversage... more Anamnese und Befunde: Eine 37-jährige Patientin wurde im kardiogenen Schock bei Multiorganversagen eingewiesen. Echokardiographisch war die linksventrikuläre Funktion zunächst auf 35% reduziert. Klinisch bestand der V.a. eine Myokarditis. Anamnestisch bestand ein grippaler Infekt seit 1 Woche. Innerhalb von 24 h kam es zu einer weiteren dramatischen Reduktion der linksventrikulären Funktion auf 7%. Links-bzw. Rechtsherzkatheteruntersuchungen unter Entnahme von rechtsventrikulären Myokardbiopsien wurden durchgeführt. Die histo-und molekularpathologischen Untersuchungen ergaben die Diagnose einer Enterovirusmyokarditis.

Research paper thumbnail of Mitral-valve replacement in children under 6 years of age

European Journal of Cardio-thoracic Surgery, 2000

Objective: In patients with congenital mitral-valve disease, reconstructive surgery is the primar... more Objective: In patients with congenital mitral-valve disease, reconstructive surgery is the primary goal. However, in cases with severely dysplastic valves or failed repair, mitral-valve replacement (MVR) is the only option. We analyzed, retrospectively, data of 35 patients younger than 6 years of age, who underwent MVR at our institution.Methods: Between 1974 and 1997, 35 children underwent MVR. The ages ranged

Research paper thumbnail of Valve-Sparing Aortic Root Replacement in the Presence of Coronary Anomalies

The Annals of Thoracic Surgery, 2014

Aortic root replacement in the presence of coronary anomalies can be challenging. Because the ano... more Aortic root replacement in the presence of coronary anomalies can be challenging. Because the anomalous coronary often arises close to a commissure, reconstruction with traditional buttons can be technically difficult without compromising either the leaflets or the coronary artery. A method of valve sparing root surgery termed &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;aortic valve and root restoration,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; using aortic ring annuloplasty and formal valve repair, and then incorporating the anomalous coronary into the commissural suture line, may offer a simple solution to this problem.