| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
- Dellgren, G., et al.
(författare)
-
Eleven years' experience with the Biocor stentless aortic bioprosthesis : clinical and hemodynamic follow-up with long-term relative survival rate
- 2002
-
Ingår i: European Journal of Cardio-Thoracic Surgery. - 1010-7940 .- 1873-734X. ; 22:6, s. 912-921
-
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.
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
|
|
| 11. |
|
|
| 12. |
|
|
| 13. |
- Jeppsson, Anders, 1960, et al.
(författare)
-
Surgical repair of post infarction ventricular septal defects: a national experience
- 2005
-
Ingår i: Eur J Cardiothorac Surg. - : Oxford University Press (OUP). - 1010-7940. ; 27:2, s. 216-21
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Ventricular septal rupture is a rare but feared complication after acute myocardial infarction. Most reports about outcome after surgical treatment are single center experiences. We investigated the results after surgical repair in all patients in Sweden during a 7-year period. METHODS: All patients undergoing surgical repair 1992-1998 were identified with the aid of the Swedish Heart Surgery Registry. The patients (n=189, 63% men, mean age 69+/-8 years) were operated at 10 different centers. Pre-and peri-operative variables were collected from the Registry and individual patient charts. Mortality was calculated and a Cox proportional hazards regression model was used to identify independent predictors for early and late mortality. Mean follow-up was 2.4 years. RESULTS: Seventy-seven of the 189 patients died within 30 days (41%). Urgent repair (Risk Ratio 4.2 (2.0-8.9), P<0.001) and posterior rupture (RR 2.1 (1.3-3.4), P=0.002) were independent predictors of 30-day mortality. Total cumulative survival (Kaplan-Meyer) was 38% at 5 years. For patients that survived the first 30 days (n=112), 5 year cumulative survival was 67%. Independent predictors for mortality after 30 days were number of concomitant coronary anastomoses (RR 1.5 (1.2-2.0), P=0.001), residual postoperative shunt (RR 2.7 (1.4-5.4), P=0.004) and postoperative dialysis (RR 3.4 (1.5-7.5), P=0.003). CONCLUSIONS: Early mortality after surgical repair of post infarction septal rupture is still considerable. Early repair and posterior rupture are predictors of early mortality. Long-term survival in patients surviving the immediate postoperative period is limited by pre-existing coronary artery disease, postoperative renal failure and the presence of a residual postoperative shunt.
|
|
| 14. |
|
|
| 15. |
|
|
| 16. |
|
|
| 17. |
- Settergren, G, et al.
(författare)
-
How much cardiac output is enough?
- 2002
-
Ingår i: Journal of cardiothoracic and vascular anesthesia. - : Elsevier BV. - 1053-0770. ; 16:5, s. 663-663
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
|
|
| 18. |
|
|
| 19. |
|
|
