| 21. |
- Chemtob, Raphaelle A, et al.
(författare)
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Stroke in acute type A aortic dissection: the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD).
- 2020
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Ingår i: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. - 1873-734X. ; 58:5, s. 1027-1034
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Tidskriftsartikel (refereegranskat)abstract
- Stroke is a serious complication in patients with acute type A aortic dissection (ATAAD). Previous studies investigating stroke in ATAAD patients have been limited by small cohorts and have shown diverging results. We sought to identify risk factors for stroke and to evaluate the effect of stroke on outcomes in surgical ATAAD patients.The Nordic Consortium for Acute Type A Aortic Dissection database included patients operated for ATAAD at 8 Scandinavian Hospitals between 2005 and 2014.Stroke occurred in 177 (15.7%) out of 1128 patients. Patients with stroke presented more frequently with cerebral malperfusion (20.6% vs 6.3%, P<0.001), syncope (30.6% vs 17.6%, P<0.001), cardiogenic shock (33.1% vs 20.7%, P<0.001) and pericardial tamponade (25.9% vs 14.7%, P<0.001) and more often underwent total aortic arch replacement (10.7% vs 4.7%, P=0.016), compared to patients without stroke. In the 86 patients presenting with cerebral malperfusion, 38.4% developed stroke. Thirty-day and 5-year mortality in patients with and without stroke were 27.1% vs 13.6% and 42.9% vs 25.6%, respectively. Stroke was an independent predictor of early- [odds ratio 2.02, 95% confidence interval (CI) 1.34-3.05; P<0.001] and midterm mortality (hazard ratio 1.68, 95% CI 1.27-2.23; P<0.001).Stroke in ATAAD patients is associated with increased early- and midterm mortality. Preoperative cerebral malperfusion and impaired haemodynamics, as well as total aortic arch replacement, were more frequent among patients who developed stroke. Importantly, a large proportion of patients presenting with cerebral malperfusion did not develop a permanent stroke, indicating that signs of cerebral malperfusion should not be considered a contraindication for surgery.
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| 22. |
- Clark, SC, et al.
(författare)
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EACTS guidelines for the use of patient safety checklists
- 2012
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Ingår i: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. - : Oxford University Press (OUP). - 1873-734X. ; 41:5, s. 993-1004
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Tidskriftsartikel (refereegranskat)
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| 23. |
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| 27. |
- Dellgren, G., et al.
(författare)
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Eleven years' experience with the Biocor stentless aortic bioprosthesis : clinical and hemodynamic follow-up with long-term relative survival rate
- 2002
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Ingår i: European Journal of Cardio-Thoracic Surgery. - 1010-7940 .- 1873-734X. ; 22:6, s. 912-921
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The long-term durability and hemodynamics of stentless valves are largely unknown. Our aim was to prospectively investigate long-term hemodynamic function and clinical outcome after aortic valve replacement with the Biocor stentless aortic bioprosthesis. Patients and methods. Between October 1990 and November 2000 we inserted the Biocor stentless aortic valve in 112 patients (male/female: 38:74) with a mean age of 78.5 years (median 79.3, range 60-88). The predominant diagnosis was aortic stenosis in 86% of the patients. Concomitant coronary artery bypass surgery was performed in 31% of the patients. Average prosthetic valve size was 23.3 +/- 1.6 mm. All patients were followed in a prospective study with a mean follow-up of 66 +/- 33 months. The follow-up was 100% complete with a closing interval from October I to December 31, 2001. The observed actuarial survival of patients was compared to expected survival for an age- and gender-matched comparison population as calculated from Swedish life tables by Statistics Sweden. Relative survival rates were calculated annually for the patient population. Results. Early mortality was 7% (8/112). Late mortality was 38% (43/112). Actuarial survival at 5 and 9 years was 74 +/- 5% and 38 +/- 7%, respectively. Observed survival among patients was not different from the expected survival for the comparison population and calculation of relative survival rates indicates a 'normalized' survival pattern for the patient population. At 5 and 9 years the actuarial freedom from valve-related death was 94 +/- 3% and 86 +/- 6%; from cardiac death, 82 +/- 4% and 57 +/- 8%; from valve reoperation, 96 +/- 2% and 87 6%; from structural valve degeneration, 96 +/- 2% and 87 +/- 6%; from thromboembolism, 89 +/- 4% and 71 +/- 9%; and from endocarditis, 96 +/- 2% and 90 +/- 5%. At 9 years the transvalvular mean pressure difference for all valves was 7.3 +/- 1.3 mmHg (range 6-10 mmHg) measured with Doppler echocardiography. Aortic regurgitation progressed slowly over time in a few patients and necessitated reoperation in two patients. Conclusion. The Biocor stentless bioprosthesis has an excellent hemodynamic function and confers a good long-term outcome. This patient population could be regarded as 'cured' from valve disease since the observed survival did not differ from the expected survival for an age- and gender-matched Swedish comparison population, a conclusion that is also supported by a constant relative survival after the first postoperative year. However, despite excellent long-term hemodynamics, patients with stentless bioprostheses need to be evaluated with echocardiography at regular intervals to discover the rare cases of progressive aortic regurgitation.
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| 28. |
- Dellgren, Göran, 1961, et al.
(författare)
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Extracorporeal membrane oxygenation as a bridge to lung transplantation: a long-term study
- 2015
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Ingår i: European Journal of Cardio-Thoracic Surgery. - : Oxford University Press (OUP). - 1010-7940 .- 1873-734X. ; 47:1
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Tidskriftsartikel (refereegranskat)abstract
- We investigated early outcomes in patients with end-stage pulmonary disease bridged with extracorporeal membrane oxygenation (ECMO) with the intention to perform lung transplantation (LTx).
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| 29. |
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| 30. |
- Dunning, J, et al.
(författare)
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Guideline for the surgical treatment of atrial fibrillation
- 2013
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Ingår i: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. - : Oxford University Press (OUP). - 1873-734X. ; 44:5, s. 777-791
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Tidskriftsartikel (refereegranskat)
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