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Biomedical subjects

I H Rygg

Publications and source records attributed to I H Rygg.

7 recordsLinked to original sources
PubMed1991

Aortic valve replacement with the Lillehei-Kaster prosthesis in 262 patients: an assessment after 9 to 17 years.

A 9 to 17-year follow-up after aortic valve replacement with the Lillehei-Kaster prosthesis was carried out in 262 patients with a mean age of 53 years. All patients were traced. The operative mortality was 7.3%. The observed survival of the total series after 5, 10 and 15 years amounted to 75%, 61%, and 49% respectively. The majority of survivors showed improvement of functional capacity and decrease of heart volume. Freedom from valve-related death, thromboembolism and valve-related morbidity and mortality after 15 years amounted to 94%, 85% and 75% respectively. Only two instances of valve thrombosis were seen, and fracture of the prosthesis was never encountered. These results compare favourably with those obtained with the Starr-Edwards and the Björk-Shiley prostheses. Analysis of the relative survival rates, i.e. the observed survival rates as ratios of those of the general population, indicates that the 10-year survival of patients with aortic stenosis is close to normal, whereas the survival rates of patients with aortic incompetence and with combined aortic stenosis and incompetence are significantly lower. It is suggested that earlier operation should be considered in patients with aortic incompetence and with combined stenosis and incompetence in order to lower the late mortality rate.

Aortic Valve Insufficiency↗
PubMed1986

Cerebral blood flow during early cardiopulmonary bypass in man. Effect of procaine in cardioplegic solutions.

Cerebral blood flow (CBF), plasma procaine concentrations, and somatosensory evoked potentials (SSEP) were recorded in 2 groups of patients in whom either a high-procaine cardioplegic solution (Bretschneider's n = 29), or a low-procaine cardioplegic solution (St. Thomas', n = 13) was used. In the Bretschneider's group, marked changes in CBF occurred (p less than 0.001). Mean CBF was 27 (range 18 to 51) ml/(100 g X min) between sternotomy and the onset of extracorporeal circulation (ECC). A mean of 6 minutes after the onset of ECC, and before the administration of Bretschneider's cardioplegic solution, CBF increased to 39 ml/(100 g X min). After administration of the cardioplegic solution, CBF decreased significantly within the first 15 minutes, and then gradually increased to a mean of 68 (range 43 to 108) ml/(100 g X min). Cerebral blood flow was 45 ml/(100 g X min) just after ECC was stopped. Marked plasma procaine concentrations, up to 100 mg/l, were reached just after the infusion of Bretschneider's solution. The flow was significantly reduced (p less than 0.015) in patients with plasma procaine greater than or equal to 10 mg/l, when compared to patients with plasma procaine values less than 10 mg/l. In the St. Thomas' cardioplegic solution group the same reduction in CBF did not occur (p less than 0.02). Despite the depressant effect of procaine on CBF in the Bretschneider group, a consistent brain hyperperfusion was observed in all patients during hypothermic ECC if their blood pressure was sufficient to produce hyperemia. In rats (n = 6), during normothermia without extracorporeal circulation, the effect of procaine was much more pronounced. The CBF fell from a mean resting level of 108 ml/(100 g X min) to 68 and 54 ml/(100 g X min) after 15 and 35 minutes, respectively, of continuous infusion of Bretschneider's solution. The flow returned to the resting level about 40 minutes after termination of the infusion.

Adult↗
PubMed1979

Debanding and repair of ventricular septal defect: a new technique for older patients.

Between October 1972 and April 1977 15 patients underwent definitive repair of a ventricular septal defect (VSD) and reconstruction of the pulmonary artery at the banding site. This report presents pre- and post-operative haemodynamic data in 12 patients, seven to 22 years after banding (mean 13.4). Banding of the pulmonary artery was performed before the age of 6 months (mean 4). The indications were increased pulmonary blood flow and intractable heart failure. As we had previously become dissatisfied with patch angioplasty of the main pulmonary artery, we introduced a new technique in this group of excising the site of the band and anastomosing the pulmonary artery end-to-end. The gradient between the right ventricle and pulmonary artery was abolished completely in nine cases and reduced to below 30 mmHg in the remaining three patients. This technique is used only in older patients in whom the banding has persisted for a long time. In children under 2 years of age we usually remove the band and dilate the pulmonary artery.

Adolescent↗
PubMed1976

Acute aortic regurgitation and abscess of sinus of Valsalva due to fulminating ulcerative endocarditis. Report of three fatal cases in children.

Acute aortic regurgitation due to ulcerative endocarditis developed in 3 children aged 10, 6, and 7 years, respectively. All had congenital aortic valve lesions. Intractable congestive heart failure ensued about 2 weeks, 1 week, and a few days, respectively, after onset of infection. Two patients were operated on in the acute stage, and in both, perivalvular spread of the infection was found with abscess formation of the right sinus of Valsalva perforating through the interventricular septum to the right ventricle; valve replacement and repair were performed, but both patients died. The correct diagnosis was missed in the third patient, who was thought to have myocarditis and who died one week after onset of infection: at autopsy a perforation of a bicuspid aortic valve and an aneurysm of the sinus of Valsalva were found.

Abscess↗