[Perioperative antiplatelet therapy of patients with coronary stents]. / Perioperatives Management der Thrombozytenaggregationshemmung nach koronarer Stentimplantation.

The most feared complication after coronary stent implantation is the acutely occurring stent thrombosis, which usually leads to a myocardial infarction with its relatively high mortality. Dual antiplatelet therapy with acetylsalicylic acid and clopidogrel is currently the standard therapy after coronary stent implantation to prevent a life-threatening stent thrombosis. Surgery appears to increase the risk of stent thrombosis, myocardial infarction, and death, particularly when patients undergo surgery early after stent implantation. The incidence of complications is further increased when dual-antiplatelet therapy is discontinued preoperatively. This article reviews the current data of perioperative problems in patients after percutaneous coronary intervention.

[Medical treatment of chronic heart failure]. / Medikamentöse Therapie der chronischen Herzinsuffizienz.

Throughout the last decade the therapeutic approach to heart failure has undergone a considerable change. Current treatment is not just directed towards the relief of symptoms; additional objectives are prevention and progression of heart failure. Heart failure concerns not only the heart, but also the response of the body to the diminished function of the heart. Consequently the emphasis of treatment is no longer aimed solely at promoting the excretion of salt and water. Additional objectives are limitations of neuroendocrine and cytokine activation and the reversal of the extracardiac abnormalities. This paper concerns the medical treatment of heart failure according to the recommendations of the European Society of Cardiology.

[Ventricular arrhythmias: diagnosis and drug therapy]. / Ventrikuläre Rhythmusstörungen: Diagnostik und medikamentöse Therapie.

After a brief classification of antiarrhythmic drugs and their mode of action, ventricular dysrhythmias are defined and characterized with respect to underlying causes. A short chapter is dedicated to the treatment of acute ventricular tachycardia, a longer one to the prophylaxis of ventricular dysrhythmias, based on our knowledge in the "post CAST Study era' (CAST = Cardiac Arrhythmia Suppression Trial). A special interest is dedicated to patients commonly encountered in daily practise: patients with coronary artery disease, patients with chronic heart failure, and patients without underlying heart disease. Then a separate assessment is made of the proarrhythmic effects of antiarrhythmic drugs.

[Early results of transversalis-plasty. A prospective randomized comparison of non-resorbable and resorbable sutures]. / Frühergebnisse nach Transversalisplastik. Ein prospektiv randomisierter Vergleich von nichtresorbierbarem und resorbierbarem Nahtmaterial.

In a prospective randomized trial we analyzed the perioperative management, complications, and the recurrence rate of inguinal hernia repair using either resorbable (polydioxanone, PDS) or non-absorbable (polyamide, Ethilon) suture material. From January 1988 to June 1989, 484 consecutive transversalis fascia repairs were performed in 425 adult patients with inguinal or femoral hernia. Local anaesthesia was used in 273 cases. At least one year postoperatively, 390 patients with 445 repairs had a clinical follow-up. The recurrence rate after 360 primary herniae was 3.3% (Ethilon 2.3%, PDS 4.3%) while 5.9% rerecurrences were found following operation for recurrent hernia (Ethilon 2.5%, PDS 8.9%). The differences in the recurrence rates following the use of polyamide or polydioxanone were not statistically significant. Complications occurred in 5.2%. The postoperative hospital stay averaged 3.8 days and work was resumed after a mean of 3.9 weeks.