Biomedical subjects

K Kyllönen

Publications and source records attributed to K Kyllönen.

5 recordsLinked to original sources

PubMed1982

Valve replacement for bacterial endocarditis.

During the 10-year period 1970-79, 88 patients underwent valve replacement for complications of bacterial endocarditis. The mean age of the patients was 42 (15-60) years. There were 64 men and 22 women. Thirty-three patients had a history of rheumatic fever. In 11 cases the murmur was heard already in childhood. In 44 cases (50%) no heart disease was diagnosed before the onset of symptoms of bacterial endocarditis. Strepto- and staphylococci were the most common organisms found in culture. In 12 cases a dental and in 12 a respiratory tract infection preceded the endocarditis. In 51 cases, however, the origin of the infection remained unestablished. Intractable heart failure and embolizations were most common indications for operation. Only 9 patients underwent operation in the acute phase. Aortic valve replacement (AVR) was performed in 58 cases, mitral valve replacement (MVR) in 19, both AVR and MVR in 6, AVR and aneurysm of sinus Valsalva repair in 3 cases, AVR and repair of VSD in one and AVR combined with myocardial revascularization and replacement of the ascending aorta for aneurysm in one case. The early mortality was 9 patients (10%) and late mortality 9 patients. During follow-up times of up to 10 years, 7 patients experienced embolic complications. They recovered uneventfully. One valve prosthesis was replaced because of thrombosis and another due to paraprosthetic leak. Two patients had a late recurrent bacterial endocarditis 5 and 8 years postoperatively. They were treated conservatively and recovered. It was concluded that after valve replacement for bacterial endocarditis, the risk of recurrent infection is relatively low and that results approaching those for elective valve replacement can be achieved.

Adolescent↗

PubMed1980

Effect of cold ischaemic arrest and subsequent coronary reperfusion on the intrinsic adrenergic innervation and neural noradrenaline of the atrial myocardium during aortic valve replacement.

The effect of cold ischaemic arrest (aortic cross-clamping for 50-70 min during general hypothermia of +30 degrees C, associated with local cardiac cooling with +4 degrees C saline solution) and subsequent coronary reperfusion (20-30 min) on the intrinsic adrenergic innervation of the right atrial myocardium, was studied in 10 patients in the course of prosthetic aortic valve replacement using the glyoxylic acid-induced fluorescence histochemical method. No clear changes were observed: (a) the morphological integrity of the intrinsic adrenergic nerve net remained intact, (b) no obvious depletion occurred in the neural noradrenaline level, (c) the procedure did not affect the "droplet fibres" (i.e. huge axonal accumulations of noradrenaline). Thus, the common need for catecholamine support during and after weaning off from cardiopulmonary bypass does not seem to be explained by damage to the adrenergic axons or depletion of the adrenergic neurotransmitter noradrenaline.

Aortic Valve↗

PubMed1976

Human serum and myocardium digoxin.

Linear correlation was demonstrated between serum digoxin and papillary muscle digoxin concentrations in patients undergoing mitral valve surgery. The mean ratio of myocardial tissue to serum digoxin concentrations was 6711. This result supports the use of serum digoxin as a guide for assessing the degree of digitalization under steady-state conditions.

Adult↗

PubMed1976

Mitral valve replacement with ball and tilting disc valve prosthesis. A clinical and haemodynamic study.

A survey is presented on the results of 100 consecutive patients who underwent mitral valve (78 patients) or mitral and aortic and/or tricuspid valve replacement (22 patients) with ball or disc valve prosthesis. The patients were followed-up from 6 to 54 months postoperatively. The mortality for mitral valve replacement was 13 (17%) early deaths (up to one month from operation) and 5 (6%) late deaths. The corresponding figures for multiple valve replacements were 9 (41%) and 3 (14%). A direct correlation was found between early mortality and preoperative functional class IV of the New York Heart Association (30% dead). Pulmonary hypertension combined with multiple valve disease resulted in an early mortality of 42%. No significant differences in early mortality figures after MVR were found between ball and disc valve prostheses. Predominant complications were respiratory infection and atelectasis (13%), acute myocardial infarction (11%) and haemorrhage (9%). Haemolysis was found in 9 patients and three other patients had haemolytic anaemia attributable to paravalvular leak which in two indicated the reapplication of the prosthesis. The main causes of death were heart failure, 8 early and 4 late deaths, and myocardial infarction, 5 and 4 respectively.

Adolescent↗

PubMed1975

Diaphragmatic pulmonary sequestration.

Two cases of diaphragmatic extralobar pulmonary sequestrations are described. One of them simulated a suprarenal tumour and the other was associated with a diaphragmatic hernia. Both of them were firmly attached to the left hemidiaphragm and were partly located within it. They had an arterial supply from the abdominal aorta. Both sequestrations were treated surgically by sequesterectomy. The patients had an uneventful recovery.

Adolescent↗