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Biomedical subjects

E Sivertssen

Publications and source records attributed to E Sivertssen.

At least 19 recordsLinked to original sources
PubMed1991

[Cardiopulmonary resuscitation attempts at Ullevål hospital during January 1989-July 1990].

During the period January 1989 to July 1990, 68 in-hospital cardiopulmonary resuscitations were attempted in 65 patients at Ullevål Hospital. The total number of deaths during the same period was 2,166. 21 patients survived initially (32%). Nine patients died later, and 12 patients (18%) were discharged from hospital without major cerebral disability. Six patients were alive at follow-up 13-25 months after cardiopulmonary resuscitation. No differences in survival were found between males and females, or between patients under and over 70 years of age.

Adult↗
PubMed1991

Degree of coronary artery disease predicted by exercise testing.

The ability of exercise testing to predict the extent of coronary artery disease was examined in 268 male patients undergoing both coronary angiography and bicycle testing with electrocardiography before coronary artery bypass surgery. When maximal ST-depressions limited by symptoms increased from 0 to 4 mm or more, the percentage of patients with 'serious' coronary disease, defined as either triple vessel disease or left main stem stenosis, increased from 50% to 80% (P = 0.0001). The patients in the lowest third of physical work capacity showed only a slightly increased risk of serious disease. This tendency was abolished in patients who were using beta-blockers, whereas the relationship between ST-depression and disease was not affected by this medication. The probability of finding left main stem stenosis in a patient increased from 5 to 30% with increasing ST-depression: beta-blockers did not affect this relationship, but there was no additional predictive effect of implicating the level of physical work capacity. It is concluded that traditional electrocardiography during exercise is of value when selecting patients for angiography, but that the physical work level obtained during the test does not predict the degree of coronary pathology.

Adrenergic beta-Antagonists↗
PubMed1990

Risk factors for morbidity and mortality in mitral valve replacement.

Risk factors of operative mortality and long term survival were identified in 219 patients who underwent mitral valve replacement (MVR) using Bjørk-Shiley mechanical prostheses. Early mortality was 7.3%. The accumulated follow-up time was 1134 patient-years, and the 5-year survival for the total cohort was 78 +/- 3%. Independent prognostic factors of early mortality were poor NYHA class, which carried a relative risk (RR) of 3.2, and ischaemic aetiology, with a RR of 2.2. Ischaemic aetiology was the sole predictor of heart pump failure requiring intra-aortic balloon pump support (RR = 2.7). Independent risk factors of total mortality (early and late) were male sex (RR = 2.3), NYHA class III-IV (RR = 2.4), presence of mitral regurgitation (RR = 3.2) and relative heart volume (RR = 1.6 for a 800 ml/m2 size compared to a heart of 550 ml/m2). Our results underline the importance of patient-related factors in MVR, and indicate that care is needed in comparing the quality of MVR from different institutions with respect to mortality and morbidity. The results of MVR are palliative rather than curative except in female patients with NYHA class II function and mitral stenosis, in whom cure was attained.

Adolescent↗
PubMed1989

Surgical treatment of left ventricular aneurysm. Analysis of risk factors, morbidity and mortality in 205 cases.

Left ventricular aneurysm was surgically treated in 205 patients during the decade 1975-1984. The patients had had one to five myocardial infarctions, the latest days to years (mean 32 months) preoperatively and 92% were in NYHA functional class III or IV. The main indications for surgery were angina (47%), congestive heart failure (38%) and arrhythmia (15%). The 176 anterior, 23 posterior and six combined aneurysms were treated with resection (130 cases) or plication (75). The early mortality was 5%. Univariate analysis identified arrhythmia, concomitant valve replacement and need for intra-aortic balloon pumping (IABP) as significant risk factors, and multivariate analysis revealed the indication for surgery and need for IABP as the only independent predictors of total mortality. The survival rates 5 and 10 years postoperatively were respectively, 74% and 60%. At follow-up after 1/2-10 years, almost 90% of the surviving patients had improved functional status. Left ventricular aneurysm thus can be surgically treated with low mortality rate and good functional result.

Adult↗
PubMed1979

Escape rhythm in complete A-V block. The recovery phase after overdrive suppression from artificial ventricular suppression from artificial ventricular pacing.

In 60 patients with third degree A-V block, recovery of escape rhythm from overdrive suppression after ventricular pacing has been studied. Implanted unipolar VVI pacemakers were inhibited by chest wall stimuli. A total of 165 rhythmograms were studied. In 37, the rate was irregular, in the other 128 the escape rate increased gradually, following an exponential curve until stabilization after 3 minutes. In 29 of these rhythmograms, a possible exit block of the first escape impulse was observed. In 99 rhythmograms without exit block, escape rhythm recovery time was an average 1.45 times basal escape RR intervals. Overdrive suppression was most marked in patients with a slow escape rhythm.

Cardiac Pacing, Artificial↗
PubMed1979

Left ventricular function after aortocoronary bypass surgery.

Aortocoronary bypass operations without additional myocardial surgery or valve replacement were performed at Ullevål Hospital in 190 patients during the period May 1971 to Dec. 1975. Postoperatively re-examination was made by left-heart catheterization in 124 patients at a mean interval of 18.2 months and right-heart catheterization in 108 patients at a mean interval of 16.0 months after surgery. The mean postoperative values for PCVP at rest, PCVP during exercise, LVEDP before contrast and LVEDP after contrast were significantly lower than the mean pre-operative values. The difference between pre- and postoperative values were largest in patients with elevated PCVP or LVEDP values before surgery, whereas in patients with low pre-operative values the mean values after surgery were unchanged or increased. The results indicate that marked improvement of left ventricular function may occur after aortocoronary bypass operations, even in patients with signs of ventricular failure at rest. A stress test is, however, of importance in evaluating the haemodynamic consequences of coronary surgery. No difference was found in patients with single versus patients with double or triple shunts. Post-operative shunt occlusion was found in 44 of 258 grafts at re-examination. No difference was found between patients with all shunts patent and patients with one or more shunts occluded as regard to mean postoperative PCVP and LVEDP values.

Adult↗
PubMed1978

Cardiac arrhythmias in patients with serious pulmonary diseases.

During a 5-year period, 1969-1973, 451 patients with acute severe pulmonary diseases were admitted to the three medical intensive care units (MICU) at Ullevaal Hospital. In 39% of the patients a major cardiac arrhythmia was recorded in the units during a mean observation time of 24 h. The subsequent mortality in the hospital was 31% in patients with arrhythmias in the MICU, and 8% in patients without arrhythmias. The association between arrhythmias and mortality was significant (P less than 0.004) in patients with a diagnosis of pneumonia. There was also an association (P less than 0.04) between arrhythmias and the severity of lung disease. Continuous electrocardiographic monitoring of patients with severe pneumonia or acute exacerbations of obstructive lung disease is recommended.

Acute Disease↗
PubMed1977

Aorto-coronary vein bypass and valvular surgery.

During the period 1972--1975, 26 patients underwent valvular surgery combined with aorto-coronary saphenous vein bypass at Ullevål Hospital, Oslo. Aortic valve replacement was performed in 13 patients, mitral valve replacement in 8 and double valve replacement in 3 patients. The Björk-Shiley tilting disc valve was used in all cases. A Carpentier ring was inserted in one case and an open mitral commissurotomy was performed in another. Twenty-nine saphenous vein grafts were inserted. Three early deaths (all patients in functional class IV (NYHA)) were due to myocardial failure. There were 2 late deaths (both patients in functional class III before operation) of which one was due to myocardial infarction and the other to ventricular fibrillation. The overall mortality was 19%. At follow-up with a mean observation time of 11 months, 19 of the 21 survivors were improved at least one functional class. Only 2 patients had mild angina pectoris. No valvular dysfunction was found. Twenty-one of 22 re-examined grafts were patent (95% graft patency). Valvular surgery combined with aorto-coronary vein bypass in this material shows low mortality and good clinical and haemodynamic results in patients in functional class II and III. Patients should be operated upon before they reach functional class IV, as the mortality in that group is very high.

Adult↗
PubMed1976

Pacemaker wires and electrodes. A follow-up study.

In 362 patients on permanent pacing, a follow up with regard to pacemaker electrode function time and connection to pulse-generators has been carried out. In 12 patients Elema epicardial electrode were used with an average function time of 3.8 years. 232 Elema EMT 588 endocardial electrodes were used in 216 patients. Average observation time for the electrodes was 3.3 years. Sixty-eight electrodes have been followed for more than 5 years. Early electrode complications comprise 10 per cent of displacements before implantation of the pulse-generator and another 6 per cent of electrode displacements within the first 3 months after implantation. Eleven per cent of the electrodes had to be corrected due to high threshold value before implantation and another 6 per cent during the first 3 months after implanattion of pulse-generator. On hundred and fifty-five unipolar electrodes of the types Cordis, Medtronic, Elema EMT 282, and Stanium were implanted in 149 patients. Average observation time for the electrodes were 1.2 years. During the first 3 months after pacemaker implant 7 per cent of the electrodes were dislocated, 5 per cent failed due to high threshold value. Three perforations of the right ventricle occurred, without serious complications. Late complications i.e. after 3 months, for EMT 588 electrode included 4 per cent electrode dislocations, 4.5 per cent failure due to high threshold, 3 cases of wire break and 4 defects in the insulation. Many of the late electrode complications were probably caused by replacement operations for pulse-generators. The most frequent late complications for the conventional unipolar electrode was wire break which occurred in 5 cases.

Arrhythmias, Cardiac↗
PubMed1975

Selective coronary arteriography.

A series of 414 selective coronary arteriographies in 322 patients has been done at Ullevål Hospital from May 1971 to Jan. 1974. Judkins technique was used in all cases. The indications for arteriography, the diagnoses as regards the coronary arteries, the therapeutic consequences,and the complications of selective coronary arteriography are described.

Adolescent↗
PubMed1975

Aortocoronary vein bypass in patients with angina pectoris.

In the 3-year period from May 1971 to April 1974, 90 patients had aortocoronary bypass for angina pectoris at Ulleval Hospital. One patient died shortly after the operation (operative mortality 1.1%). There were no further deaths in the observation period. Clinical improvement was seen in 93% of the patients, early shunt patency in 92%. The study suggests that patients with isolated affection of the right coronary artery should not have bypass, because these patients 1) had less severe symptoms, 2) had better preserved left ventricular function, and 3) seemed to have a smaller chance of benefiting from the operation than the other patients. Multiple shunts gave good clinical results and carried no higher surgical risk than did single shunts. Good clinical results were seen also in patients with occluded shunts provided they had at least one patent shunt too. Graft occlusion occurred early and was associated with low graft flow as measured intraoperatively. Graft occlusion was not usually followed by demonstrable myocardial necrosis. In view of the small operative risk and the high score of symptom relief it is concluded that all patients with angina pectoris that does not readily respond to medical treatment, should be considered for aortocoronary bypass.

Adult↗
PubMed1975

Registration of sinus node recovery time in patients with sinus rhythm and in patients with dysrhythmias.

Sinus node recovery time (SRT) after rapid atrial pacing has been recorded in 66 patients, 28 with coronary heart disease, 11 with advanced AV block, 10 with sick sinus syndrome and 17 with paroxysmal tachyarrhythmias. In patients with a normal functioning sinus node SRT was related to the basal heart rate. On an average SRT was 130% of the basal P-P interval with an upper limit of 160%. In patients with a presumed normal atrial function the mean SRT was found to be 1 080 msec, with an upper limit of 1 500 msec. This corresponds with previously published observations. In all 5 patients examined, beta-receptor blockade (propranolol 5 mg i.v.) prolonged SRT. The prolonged SRT was related to sinus bradycardia. Verapamil (Isoptin 5 mg i.v.) had no effect on SRT in the 7 patients examined. The observation of an SRT of more than 1 500 msec indicates a poor sinus node function. Recording of a normal SRT, however, cannot exclude a sinus node dysfunction, as normal SRT is occasionally found even in patients with a clinically proved dysfunction.

Arrhythmia, Sinus↗