Scandinavian journal of thoracic and cardiovascular surgery
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Scand J Thorac Cardiovasc Surg · Jan 1979
Postpericardiotomy syndrome diagnosed by echocardiography.
In order to evaluate the present incidence of post-pericardiotomy syndrome (PPS) and the reliability of conventional diagnostic methods in its detection, 194 consecutive patients were studied by echocardiography one month after cardiac surgery and thereafter every third month up to one year, and also during hospitalization if symptoms or signs of PPS appeared. PPS was diagnosed on the basis of pericardial effusion demonstrated by echocardiography and was found in 15 patients (8%) 7-142 days (mean 44 days) after operation. ⋯ Hence in 40% of the patients echocardiography was the only way to make correct diagnosis. In the investigation of a patient with chest pain and/or fever after cardiac surgery, echocardiography seems very useful since the conventional electrocardiogram and the chest X-ray are often unreliable because of the changes caused by the cardiac surgery per se.
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Scand J Thorac Cardiovasc Surg · Jan 1979
Fresh autologous blood in open-heart surgery. Influence on blood requirements, bleeding and platelet counts.
The role of fresh autologous blood on haemostasis was studied in 30 patients undergoing aortic valve replacement. All the patients were extremely haemodiluted during the perfusion by using a non-haemic priming solution and withdrawal of 15% of the blood volume at the start of operation. In half of the patients, the autologous blood was retransfused immediately after the termination of perfusion. ⋯ Significantly less donor blood and plasma was transfused in the patients receiving early transfusion of autologous blood. An average reduction of 36% donor blood and 45% plasma was obtained. The blood losses were also less in these patients, but the differences were not significant.
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Scand J Thorac Cardiovasc Surg · Jan 1978
Clinical evaluation of the Björk-Shiley tilting disc valve in the tricuspid position. Early and late results in 10 isolated and 51 combined cases.
Tricuspid valve replacement with the Björk-Shiley tilting disc valve was performed in 61 consecutive patients with either organic disease causing valve malfunction or functional regurgitation of severe degree. The early mortality rate was 21% (13/61) for the entire series. It was 10% (1/10) for tricuspid valve replacement alone, 27% (9/33) for mitral and tricuspid valve replacement, and 18% (3/17) for triple valve replacement. ⋯ One patient, however, had a recurrent prosthetic thrombosis which was successfully treated with streptokinase. Only one patient in the series, who underwent triple valve replacement, suffered from systemic embolism, an incidence of 0.7 per 100 patient years. There were no episodes of pulmonary embolism or infective endocarditis.
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Scand J Thorac Cardiovasc Surg · Jan 1977
Randomized Controlled Trial Clinical TrialModerate and extreme haemodilution in open-heart surgery. Blood requirements, bleeding and platelet counts.
Requirements of donor blood, bleeding and platelet counts were investigated during moderate and extreme haemodilution in patients undergoing aortic valve replecement. A preliminary study of 60 patients, divided in two groups of 30 patients each, was first made. A moderate haemodilution was used in one group and an extreme haemodilution with the aid of autologous transfusion was utilized in the other. ⋯ The circulating platelet counts fell less during and after the operation in this group than in the moderately diluted patients. After adjustment for the dilution, the platelet counts fell to about 60% in the moderate dilution group during the perfusion, but rose to about 130% in the extremely diluted patients. These findings are discussed.
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Scand J Thorac Cardiovasc Surg · Jan 1975
Case ReportsErgot-induced vasospasm of the lower extremities treated with epidural anaesthesia.
No reliable treatment to reverse severe ergot-induced vasopasm is available. A case of ergotamine-induced vasospasm of the lower extremities is presented. A combined treatment of vasodilators, infusion of low molecular dextran and high epidural anaesthesia apparently prevented extremity gangrene from occurring.