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Biomedical subjects

G Semb

Publications and source records attributed to G Semb.

8 recordsLinked to original sources
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↗
PubMed1979

Surgical repair of isolated ventricular septal defects in the first year of life.

Since October 1975, 6 infants ranging in age from 5 to 9 months and weighing from 5.2 to 7.8 kg have been treated with primary closure of ventricular septal defect (VSD) at Ullevål Hospital. The indications for operation were large left-to-right shunts combined with persistence of heart failure in 4 patients, a large left-to-right shunt only in one and elevated pulmonary arterial resistance in one patient. Conventional cardiopulmonary bypass was used in all cases. There were no early or late deaths during the mean observation period of 17.3 months (range 3--25 months). One patient developed a recurrent VSD and was successfully re-operated on 8 months after the first operation; otherwise no signs of recurrence were found. The growth and weight gains have been satisfactory and the psychosomatic development of all the infants has been normal. All are in sinus rhythm with right bundle branch block in 4. Cardiac arrhythmias have not been in evidence.

Cardiopulmonary Bypass↗
PubMed1978

Immediate and late results of aortic valve replacement with the Björk-Shiley tilting disc valve.

Single aortic valve replacement was performed in 110 patients at Ullevål Hospital, Oslo, between 1971 and 1976. The follow-up period was 1 to 6 years (mean 31 months). The early postoperative mortality was 6.3% and the late mortality 8.2%. Postoperatively 44% of the surviving patients were in the N.Y.H.A. functional class I and 55% in class II, while 71% of the patients were in class III or IV pre-operatively. Objective evidence of improvement was shown by reduction in mean heart volume from 610 ml/m2 pre-operatively to 512 ml/m2 postoperatively (p less than 0.001). Electrocardiographic signs of left ventricular hypertrophy, measured as the combined voltage of Smax and Rmax in V1 to V6, were 56mV pre-operatively and 42 mV postoperatively (p less than 0.001). Myocardial failure was the main cause of death postoperatively. Sudden death occurred in 5 of the 9 patients in the late mortality group. Old age at the time of operation (65 to 71 years) was not associated with increased risk of death and complications, while alcoholism did increase the mortality rate.

Adult↗
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↗
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↗