| 1. |
- Aberg, B, et al.
(författare)
-
Delayed left ventricular free wall rupture complicating coronary artery bypass surgery. A case report.
- 1985
-
Ingår i: Scandinavian journal of thoracic and cardiovascular surgery. - : Informa UK Limited. - 0036-5580. ; 19:3, s. 273-7
-
Tidskriftsartikel (refereegranskat)abstract
- Rupture of the left ventricular free wall is a not uncommon life-threatening complication of acute myocardial infarction and after prosthetic mitral valve replacement. To our knowledge, no case of left ventricular rupture after coronary artery bypass surgery has been reported. A case is now described in which coronary artery bypass grafting was complicated by delayed rupture, which was successfully repaired. Different etiologic factors are discussed, but the cause considered most likely was trauma from elevation of and traction on the heart in exposure of its posterior aspect.
|
|
| 2. |
- Berggren, H, et al.
(författare)
-
Myocardial Protective Effect of Maintained Beta-Blockade in Aorto-Coronary Bypass Surgery
- 1983
-
Ingår i: Scandinavian Cardiovascular Journal. - : Informa Healthcare. - 1401-7431 .- 1651-2006. ; 17:1, s. 29-32
-
Tidskriftsartikel (refereegranskat)abstract
- Twenty-nine patients were randomly allocated to two groups before undergoing aorto-coronary bypass surgery. In one group the beta-blocking medication was withdrawn three days preoperatively, and in the other group it was maintained. The patients in the latter group were additionally given 100 mg metoprolol per os two hours before surgery. The degree of myocardial injury, as judged from cumulated activity of S-CK B, was less when the beta-blockade was maintained.
|
|
| 3. |
- Borowiec, Jan, et al.
(författare)
-
Decreased blood loss after cardiopulmonary bypass using heparin-coated circuit and 50% reduction of heparin dose
- 1992
-
Ingår i: Scandinavian journal of thoracic and cardiovascular surgery. - 0036-5580. ; 26:3, s. 177-185
-
Tidskriftsartikel (refereegranskat)abstract
- In a randomized, double-blind study of patients undergoing elective coronary artery grafting, the effect of heparin-coated circuit combined with 50% reduction of systemic heparin bolus was investigated. Ten patients comprised group HC (heparin-coated) and ten group C (controls). The mean total doses of heparin were 172 IU/kg in group HC and 416 IU/kg in group C and the respective protamine doses were 0.96 and 3.96 mg/kg (both p < 0.001). Activated clotting times during cardiopulmonary bypass were significantly shorter in group HC, and both intra- and postoperative bleeding was significantly less than in group C (7.7 vs. 11.7 ml/kg, p = 0.036, and 6.9 vs. 9.7 ml/kg, p = 0.004). Hemoglobin loss via the drains was 22.5 g in group HC and 43.7 g in group C (p < 0.005). Hemolysis at the end of bypass was significantly greater in group C. Apart from one perioperative myocardial infarction in group HC the postoperative course was uneventful. Use of a heparin-coated circuit is concluded to permit complication-free reduction of heparin and protamine doses and to decrease both intra- and postoperative bleeding, which may favorably influence the outcome of coronary artery grafting.
|
|
| 4. |
- Borowiec, Jan W., et al.
(författare)
-
Circulating cytokines and granulocyte-derived enzymes during complex heart surgery : A clinical study with special reference to heparin-coating of cardiopulmonary bypass circuits
- 1995
-
Ingår i: Scandinavian journal of thoracic and cardiovascular surgery. - 0036-5580. ; 29:4, s. 167-174
-
Tidskriftsartikel (refereegranskat)abstract
- Blood contact with artificial surfaces during cardiopulmonary bypass (CPB) triggers a systemic inflammatory response in which complement, granulocytes and cytokines play a major role. Heparin-coated CPB circuits were recently shown to reduce complement and granulocyte activation in such circumstances. The present study comprised 20 complex heart operations, 10 with heparin-coated circuits (group HC) and 10 controls (group C), with evaluation of changes in terminal complement complex, the granulocyte enzymes myeloperoxidase and lactoferrin, and the cytokines interleukin-6 (IL-6) and interleukin-8 (IL-8). Standard heparin dose and uncoated cardiotomy reservoir were used in all cases. In both groups the levels of enzymes and terminal complement complex rose significantly, beginning at conclusion of CPB, above base values, without significant intergroup differences. IL-6 and IL-8 also increased significantly, but tended to be lower in the HC group, starting at CPB end and continuing until 20 hours postoperatively: for IL-6 the difference was significant at CPB end (83 +/- 18 vs 197 +/- 39 micrograms/l, p = 0.21). Significantly increased inflammatory response was thus found during complex heart operations even with use of heparin-coated CPB sets. The heparin-coating of circuits seems to diminish cytokine production.
|
|
| 5. |
- Dubiel, T W, et al.
(författare)
-
Mitral valve prosthetic implantation with preservation of native mitral valve apparatus
- 1994
-
Ingår i: Scandinavian journal of thoracic and cardiovascular surgery. - 0036-5580. ; 28:3-4, s. 115-121
-
Tidskriftsartikel (refereegranskat)abstract
- To avoid postoperative morbidity and mortality often associated with left ventricular dysfunction after mitral valve replacement (MVR) for chronic mitral insufficiency, reconstruction or preservation of the native mitral valve apparatus may be attempted during mitral prosthetic implantation (MPI). The effects of mitral surgery on heart function, studied with echocardiography and radionuclide angiography, were compared in seven patients with MPI (study group) and five with MVR (control group) who underwent complete preoperative, early postoperative and 3-6 months follow-up examinations. Preoperatively there was significant intergroup difference only in right ventricular ejection fraction measured at radionuclide angiography, which was lower in the MPI group (p < 0.05). At follow-up the MPI group had improved as regards this fraction (p < 0.005) and stroke volume index (p < 0.05). The number of patients with improved NYHA class at follow-up was significantly greater in the MPI group. Our preliminary experience with preservation of the native mitral valve apparatus thus suggests that the method offers haemodynamic advantages for postoperative right ventricular function.
|
|
| 6. |
- Ernofsson, Mats, et al.
(författare)
-
Thrombin generation during cardiopulmonary bypass using heparin-coated circuits or standard circuits
- 1995
-
Ingår i: Scandinavian journal of thoracic and cardiovascular surgery. - 0036-5580. ; 29:4, s. 157-165
-
Recension (övrigt vetenskapligt/konstnärligt)abstract
- For quantitative comparison of thrombin generation during cardiopulmonary bypass (CPB) with heparin-coated vs conventional CPB circuits, thrombin-antithrombin III complex (TAT) and prothrombin fragment 1 + 2 (F1 + 2) were analyzed in 20 patients undergoing combined heart valve surgery and coronary artery bypass grafting (CABG), in ten cases with heparin-coated circuits (COMB-HC) and in ten with standard circuits (COMB-C). Extensive thrombin generation was found in both groups, with maximal TAT and F1 + 2 levels at the end of CPB. Of 15 operations with only CABG, seven were performed with heparin-coated circuits and heparin dose 40% of normal (CABG-HC), and eight with standard circuits and normal heparin doses (CABG-C). TAT was maximal at the end of CPB and F1 + 2 peaked 3 hours after protamine injection. At the end of CPB both levels were significantly higher in the CABG-HC than in the CABG-C group, though thrombin generation was less than in the COMB groups. The abundant thrombin generation during CPB thus was much more pronounced during complex operations. Use of heparin-coated circuits did not reduce thrombin generation, which was increased by 60% reduction of the systemic heparin dose. The clinical implications are still unknown, as no complications were observed.
|
|
| 7. |
- Johansson, Torsten, et al.
(författare)
-
Intra- and Postoperative Cerebral Complications of Open-Heart Surgery
- 1995
-
Ingår i: Scandinavian Cardiovascular Journal. - : Informa Healthcare. - 1401-7431 .- 1651-2006. ; 29:1, s. 17-22
-
Tidskriftsartikel (refereegranskat)abstract
- A consecutive series of 1400 patients who had undergone open-heart surgery was retrospectively reviewed concerning postoperative cerebral dysfunction. The 30-day mortality was 1.6%. Forty-one patients (2.9%) showed signs of cerebral dysfunction, which proved fatal in seven cases. Neurologic symptoms were observed immediately after surgery in 14 patients, suggesting intraoperative damage. In 20 others there was an interval between surgery and the onset of cerebral symptoms, which in 12 cases were preceded by supraventricular tachycardia. Computed tomographic scans were performed on 27 patients and showed recent brain infarction in 22. No bleeding was found. At followup 34 of the 41 patients were alive, 21 of them with neurologic sequelae and 13 reporting complete recovery. Nineteen of the 34 survivors experienced no diminution of quality of life. Since half of the cerebral complications occurred postoperatively, more aggressive prevention and management of supraventricular tachyarrhythmia and anticoagulation therapy should be considered.
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
|
|
