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- Lindström, Lena, et al.
(author)
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Lack of effect of synthetic pericardial substitute on right ventricular function after coronary artery bypass surgery : An echocardiographic and magnetic resonance imaging study
- 2000
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In: Scandinavian Cardiovascular Journal. - 1401-7431 .- 1651-2006. ; 34:3, s. 331-338
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Journal article (peer-reviewed)abstract
- Abnormal right heart function after cardiac surgery is a well-known finding. Inadequate preservation during the operation and restricted cardiac motion due to pericardial adhesions have been proposed as underlying mechanisms. This study focuses on the impact of a pericardial substitute implantation on right ventricular function, using echocardiography and magnetic resonance imaging. A test group of six patients (mean age 54 years) was examined before surgery, and 4-15 days and 5-9 months after coronary artery bypass surgery, where the pericardium was closed with a biodegradable pericardial patch. A group of 11 patients (mean age 63 years) in whom the pericardium was left open served as controls. Tricuspid annulus motion was markedly decreased, abnormal septal motion was present and decreased systolic to diastolic ratio in the vena cava superior flow was present in all patients in both groups one week after surgery. At the late follow-up, all patients still had decreased tricuspid annulus motion, while 17% of the patients in the test group and 22% of the patients in the control group (ns) demonstrated normal septal motion. We conclude that closing the pericardium with a biodegradable patch does not affect the postoperative changes in right heart function normally seen after open-heart surgery.
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- Tegnell, Anders, 1956-, et al.
(author)
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Coagulase-negative staphylococci and sternal infections after cardiac operation
- 2000
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In: Annals of Thoracic Surgery. - 0003-4975 .- 1552-6259. ; 69:4, s. 1104-1119
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Journal article (peer-reviewed)abstract
- Background. Coagulase negative staphylococci (CoNS) have been recognized as important pathogens in nosocomial infections, especially in connection with implanted foreign materials. In cardiac operation they are among the most common pathogens isolated from infected sternal wounds. The definition of the infection is very important. In this study we focus on deep postoperative chest infections.Methods. By studying 33 infected patients retrospectively and comparing them to 33 matched uninfected controls, we studied the characteristics and costs of the infections.Results. Typical for these infections is the late and insidious onset, and that the infections initially give only minor symptoms such as pain, redness, and serous secretion. We found the following risk factors for infection: number of preoperative days in a hospital, the total length of the operation, and if the patient had undergone an early reoperation due to causes other than infection. This kind of infection more than doubled the hospital costs for the patients affected.Conclusions. Coagulase negative staphylococci are the most important pathogens in deep postoperative infections in this material. They cause infections that are difficult to recognize since they give only discrete symptoms and start well after the patients leave the hospital. The risk factors for patients with CoNS infections are mostly associated with a long exposure to the hospital environment. The treatment is often difficult and costly because of multiresistant bacteria and frequent need for repeated surgical revisions.
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