Scandinavian cardiovascular journal : SCJ
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Scand. Cardiovasc. J. · Oct 2001
Randomized Controlled Trial Clinical TrialInsulin (GIK) improves central mixed and hepatic venous oxygenation in clinical cardiac surgery.
Insulin is a vasodilating agent and it was hypothesized that insulin (GIK) could improve systemic and regional oxygenation in cardiac surgery with cardiopulmonary bypass (CPB). Two questions were addressed: 1) Does insulin improve central mixed and hepatic venous oxygenation during CPB? and 2) Does this treatment reduce systemic levels of the proinflammatory mediators C3a and IL-6? ⋯ 1) GIK infusion improved central mixed and hepatic venous oxygenation in patients undergoing heart surgery. 2) During the conditions of this study, this had no effect on the proinflammatory mediators C3a and IL-6.
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Scand. Cardiovasc. J. · Sep 2001
Comparative StudyBetter preserved pulmonary endothelium-dependent vasodilation with off-pump coronary surgery.
To investigate if endothelium-dependent vasodilation in the pulmonary circulation was better maintained after off-pump coronary artery bypass grafting (CABG). An impaired pulmonary vascular response to acetylcholine has been observed after cardiopulmonary bypass (CPB) in children, adults and experimentally. ⋯ The better maintained endothelium-dependent vasodilation in the off-pump group indicated less endothelial dysfunction.
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We present a review of our experience in the management of thoracic vascular injuries during the past 10 years in one of Sweden's busiest emergency departments, with morbidity and mortality as the main outcome measures. ⋯ Early thoracotomy is important for salvage of patients with chest-wall vascular injury. Despite our limited experience, which is characteristic for Scandinavian and European countries, our results were satisfactory.
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Scand. Cardiovasc. J. · Jul 2001
Case ReportsMitral valve incompetence following blunt chest trauma after mitral valve repair. Recognition by three-dimensional echocardiography.
We present a unique case of mitral incompetence following blunt chest trauma in a 46-year-old woman who had undergone successful mitral valve repair 2 years before the accident. Three-dimensional echocardiography revealed the precise pathology, with partial avulsion of the annuloplasty ring and rupture of chordae tendineae.
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Scand. Cardiovasc. J. · Jul 2001
Myocardial uptake and release of substrates in type II diabetics undergoing coronary surgery.
Knowledge about myocardial metabolism in diabetic patients is limited, and even more so in association with myocardial ischaemia and cardiac surgery. This study investigates myocardial substrate utilization in type II diabetic patients after elective coronary artery bypass graft surgery (CABG). ⋯ Free fatty acids were the main source of energy for the heart whereas uptake of carbohydrates was restricted. The high extraction rates of beta-hydroxybutyric acid and glutamate suggest an adaptive role for these substrates during this unfavourable metabolic state for the post-ischaemic diabetic heart.