Zeitschrift für Kardiologie
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Historical Article
History of cardiac surgery in Germany--in consideration of her relation to the German Cardiac Society.
As late as the end of World War II (1945), cardiac surgery did not play a clinical role worldwide. Successful cardiac operations were singular events often caused by unexpected circumstances. In contrast, the first successful suture of a cardiac stab wound by Ludwig Rehn (1896 in Frankfurt am Main) followed after experimental investigation of this topic in the laboratory. ⋯ This development was hampered even more in the eastern parts of the country. Above-average efforts there, equalized the degree of clinical care in a few years. The co-operation between the German Cardiac Society (founded 1927) and the German Society for Thoracic and Cardiovascular Surgery (founded 1971) was of great benefit for this satisfying development.
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Due to the isolation of German medicine in World War II accompanied by the destruction of many hospitals, German pediatricians did not show any serious interest in the treatment of children with congenital heart diseases, nor did they take notice of the progress achieved by Helen Taussig, Alfred Blalock and other cardiologists and surgeons in the western world. This problem was even worse in East Germany. Only a few German internists and forward-looking surgeons were able and ready to take care of this group of principally operable children in places like Bonn/Düsseldorf, Marburg/Munich, Berlin, and Hamburg. ⋯ Thus, within the last three to four decades German pediatric cardiology gradually caught up with international standards and in some fields of cardiovascular research even assumed a leading role. The care of the growing numbers of surviving patients with congenital heart disease has become a new challenge that has to be met by experienced cardiologists. To maintain the level of competence, future activities should however, not only concentrate on the optimal care of patients with congenital heart disease but also be responsible for cardiovascular research.
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A 65 year old man with a history of mechanical aortic valve replacement acquired Enterococcus faecalis mediated infective endocarditis about 3 years later. Transesophageal echocardiography revealed formation of an aneurysm confined to the anterior mitral valve leaflet. ⋯ With sudden perforation of the mitral valve aneurysm, subsequent hemodynamic deterioration and pulmonary oedema, the patient underwent emergency mitral and aortic valve replacement. The postoperative course was uneventful.
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Case Reports
[Atrial tachycardia, atrial flutter, atrial fibrillation: curative therapy by focal ablation in a pulmonary vein].
We describe the case of a 50-year-old woman with the clinical diagnosis of cardiomyopathy associated with supraventricular tachycardia refractory to pharmacological treatment. The totally irregular tachyarrhythmia was the result of different episodes of atrial tachycardia, atrial flutter and atrial fibrillation that could be identified in the surface ECG. ⋯ Ablation of this focus represented a curative antiarrhythmic therapy also restoring a normalized ventricular function. Thus, an ablation of the AV node with consecutive pacemaker implantation could be prevented.