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Biomedical subjects

B Bjarke

Publications and source records attributed to B Bjarke.

At least 19 recordsLinked to original sources
PubMed1989

Follow-up study on children with infective endocarditis.

A follow-up study on 36 children having had infective endocarditis during the time period 1971-80 was performed. All answered a questionnaire and 33 underwent a complete non-invasive cardiac examination including exercise test. The study comprised 406 patient years. During this time there were four late deaths and three recurrent attacks of endocarditis. Seventeen (47%) took prophylactic antibiotics. Two patients had been operated on because of the initial infection and another five had developed intracardiac sequelae. An ability index given to each patient before the infection and at the follow-up showed that as a group these patients were doing well.

Adolescent↗
PubMed1988

Probable homozygotic form of the Marfan syndrome in a newborn child.

A case of Marfan's syndrome diagnosed in a newborn boy is described. Both parents were affected by the disease but none of them was aware of it. The boy had cardiac, skeletal and ocular manifestations from birth. He suffered early from severe congestive heart failure due to mitral insufficiency and died at four months of age of pneumonia. The family history is described in this report.

Adult↗
PubMed1986

Infective endocarditis in Swedish children. I. Incidence, etiology, underlying factors and port of entry of infection.

A retrospective study of Swedish children with infective endocarditis (IE) during the period 1971-80 was made. Sixty-six instances were identified in 64 children (0.39 cases per 100,000 children per year). Fifty (78%) had a previously known heart disease. Most commonly this was a ventricular septal defect and tetralogy of Fallot. Seventy-one percent had positive blood cultures. Streptococcus viridans and Staphylococcus aureus were most commonly isolated. Twenty-two percent of the children had undergone previous cardiac surgery. One case closely followed cardiac surgery and in only nine children could a definite port of entry of infection be demonstrated.

Adolescent↗
PubMed1986

Infective endocarditis in Swedish children. II. Location, major complications, laboratory findings, delay of treatment, treatment and outcome.

66 cases of infective endocarditis (IE) during 1971-1980 were studied. The infection was in most cases located to the mitral or aortic valve. Major complications were found in 43 children. In 17 children there was a long history of infection for which medical consultation had previously been sought prior to correct diagnosis. Antibiotics were administered to 60 children, in 58 intravenously while 2 received oral therapy only. Acute surgical intervention was necessary in six children and three of these children died. In all, 15 (23%) children died as a consequence of the infection.

Adolescent↗
PubMed1983

Surgical repair of aortico-left ventricular tunnel in a 7-day-old child.

A 7-day-old girl was successfully operated on for aortico--left ventricular tunnel. She seems to have been the youngest patient with successful repair of the malformation. The case was the second of its type operated on at the Karolinska Hospital. Severe congestive heart failure is usually an early occurrence in aortico--left ventricular tunnel. The high mortality rate without operation illustrates the importance of early diagnosis and surgery. A patch closure technique is recommended as permitting optimum function of the aortic valve.

Aorta↗
PubMed1981

Repair of double-outlet right ventricle. Experience of 13 cases.

Surgery for double-outlet right ventricle (DORV) was performed in 13 patients between November 1974 and January 1979. Subaortic ventricular septal defect (VSD) was present in 11 patients, complicated forms of DORV in 2 patients and 5 patients had important concomitant cardiac defects. Six infants (mean age 0.6 years) without pulmonary stenosis (PS) required operation because of pulmonary hypertension, whereas the 7 patients with PS underwent surgery at a considerably later stage (mean age 6 years). Interventricular tunnel-repair established continuity between the systemic ventricle and great artery in 12 patients. One case with subpulmonic VSD was managed by transposition of both venous return and arterial outflow, while the use of valved external conduits was generally avoided. Atrial incision was sufficient to permit complete intraventricular repair in 8 patients, including one pulmonary valvulotomy. Important co-existing PS was otherwise treated as in cases of tetralogy of Fallot and required transannular patch grafting in 2 instances. Hospital mortality was 3/13 patients (23%) and mainly confined to serious associated cardiac malformations which were not amenable to correction. All 10 survivors are functionally improved 1.5-5 years after surgery. Clinical and invasive re-evaluation (3 patients) could not identify the development of systemic ventricular outflow tract obstruction. One patient, who underwent enlargement of a restrictive VSD, presented angiographic evidence of a moderate aortic incompetence. No other important complications were associated with the tunnel-repair and none of the 10 survivors had complete heart block.

Adolescent↗
PubMed1981

Detachment of the septal tricuspid leaflet during transatrial closure of isolated ventricular septal defect.

In 27 (18%) of the 151 patients who underwent transatrial closure of isolated ventricular septal defect (VSD) between 1966 and 1979, the tricuspid valve was partially detached in order to achieve better exposure. All 27 patients had defects of the membranous or paramembranous type situated behind the tricuspid septal cases, tight chordae tendineae crossed over the defect and inserted in the edge of the VSD. A 15 to 20 mm incision in the septal leaflet was usually needed to expose the defect sufficiently. There were two operative deaths among the 27 patients, both unrelated to the tricuspid incision. The remaining patients had uncomplicated postoperative courses. There were no long-term complications or instances of significant tricuspid valve incompetence, major residual shunt, or heart block at follow-up. Three patients, operated upon at the ages of 3, 3, and 6 years, respectively, had residual pulmonary hypertension. In one patient, who died 4 years postoperatively in a traffic accident, the tricuspid valve was intact and the previous incision could hardly be seen. It is concluded that detachment of the septal tricuspid leaflet is a safe procedure during transatrial closure of a VSD.

Adolescent↗
PubMed1978

Function and dimensions of the circulatory system in anorexia nervosa.

The functional and dimensional components of the oxygen transporting system was studied in 17 female and 11 male patients suffering from anorexia nervosa. Both groups were 14.9 years old, on average, and had lost about 25% of their weight. Measurements at rest included blood and heart volume, heart rate, blood pressure, oxygen uptake (VO2), RQ, blood lactate (LA) and in 6 of the patients cardiac output. During bicycle ergometry the determinations of heart rate, blood pressure, LA, VO2 and cardiac output were repeated and maximal aerobic power was determined. A low metabolic rate with bradycardia and hypotension was apparent at rest. Blood and heart volume was decreased proportionally to the weight loss. On a given work load VO2 was lowered to the same extent as the resting metabolic rate. At maximal effort VO2 was reduced out of proportion to the circulatory dimensions and maximal heart rate was low. During exercise cardiac output was normally related to VO2 and stroke volume was maintained, indicating a normokinetic circulation and an unimpaired myocardial function. The main cause of the low maximal aerobic power seems to be the reduced muscle mass.

Adolescent↗
PubMed1975

Oxygen uptake and cardiac output during submaximal and maximal exercise in adult subjects with totally corrected tetralogy of fallot.

Ten female and eight male adults with tetralogy of Fallot, the majority totally corrected at adult age, have been studied at rest and during submaximal and maximal exercise on a bicycle ergometer. Oxygen uptake was determined by the Douglas bag technique and cardiac output by the dye-dilution method. Maximal oxygen uptake was reduced about 30-40% from normal. Thus a complete normalization of the aerobic working capacity was not achieved in spite of an intracardiac repair that was considered surgically satisfactory. Cardiac output response to exercise was subnormal, mainly due to small stroke volumes and partly because of low heart rates. A fall in stroke volume of more than 10 ml was found in 8 of the patients during exercise. No correlation was found between stroke volume during maximal excercise, on the one hand, and the presence of a particular residual defect, anatomy of the right ventricular outflow tract prior to operation and the use of a right ventricular outflow patch on the other. However, too few patients were studied to allow any definite conclusions as to the possible influence of these variables. It remains to be shown whether the haemodynamic abnormalities will be less and the aerobic work capacity better if total correction is undertaken at an early age.

Adult↗
PubMed1975

Oxygen uptake arterial blood gases and blood lactate concentration during submaximal and maximal exercise in adult subjects with shunt-operated tetralogy of fallot.

Ten female and six male adult subjects with shunt-operated tetralogy of Fallot have been studied at rest and during submaximal and maximal exercise on an average 20 years after the palliative operation. There was a considerable reduction in the aerobic work capacity, maximal oxygen uptake (VO2) being 1.00 1/min STPD. Though ventilation (VE) was out of proportion to VO2 as indicated by an abnormally high ventilation equivalent (52.1), values for VEmax were low (50.81/min BTPS) and of approximately the same order as in a comparable group of totally corrected TOF patients. In spite of increased VE in relation VO2 the PaCO2 increased from 30 mmHg at rest to 49 mmHg during maximal exercise, while PaCO2 decreased from 60 mmHg at rest to 44 mmHg during submaximal exercise I. During heavier exercise no further fall was noted. Base excess decreased from -2.9 to -9.8 mEq/l. Thus a combined respiratory and metabolic acidosis was at hand during exercise, the metabolic component, however, being normal. Maximal blood lactate concentrations were low (5.8 mmol/l) and contrasted with the high intramuscular lactate concentrations earlier reported in some of the patients. The low values found for VO2 max indicate that a palliative operative procedure in TOF is no alternative to an intracardiac repair in the long-term course. The two main factors limiting exercise tolerance were acidosis and accumulation of lactate within the muscle cell.

Adult↗