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Biomedical subjects

L Bergdahl

Publications and source records attributed to L Bergdahl.

At least 19 recordsLinked to original sources
PubMed1986

The immediate function of sequential aortocoronary vein grafts to closely adjacent myocardial areas.

Blood-flow measurements were performed in 72 patients after sequential vein grafting (Y-grafting) to LAD and diagonal branches. The mean blood flow in the joint graft was 69 ml/min, i.e. significantly more than the 36 ml/min in one branch when the other was occluded. When one branch was occluded for 10 min (11 patients), there was insignificant increase of the flow through the nonoccluded branch. The mean joint graft flow and branch flow increased insignificantly after administration of dipyridamole. Lower blood flow in one branch of the sequential graft than in the joint graft is due to insufficient collateral system. High rate of flow in the joint graft probably reduces the rate of early and late occlusion.

Blood Flow Velocity↗
PubMed1985

Pancreatitis after cardiac and cardiopulmonary transplantation.

In a review of 176 patients who died after either cardiac or cardiopulmonary transplantation, 15 cases of pancreatitis were identified. The diagnosis was clinically inapparent in 11 of the 15 cases of pancreatitis. A high index of suspicion should therefore be maintained when these patients are cared for. A variety of factors may have contributed to the occurrence of pancreatitis in these patients. These include infection, steroids, azathioprine, low-flow states, extracorporeal circulation, vasopressors, renal failure, and rejection.

Adolescent↗
PubMed1984

Early and late efficacy of three types of transvenous atrial leads.

Experience with three transvenous atrial leads, representing different principles, is presented. The types were screw-in (Vitatron Helifix-12), J-lead (Intermedics Lifeline 483-01) and straight-tined (Medtronic 6961). The study comprised insertion of 86 leads (30 Helifix, 40 Lifeline, 16 Medtronic) in 76 patients. Atrial fibrillation occurred during insertion in two patients, and in two others stable electrode positioning in the right atrial appendage was not achieved. Stable position and acceptable intracardiac P-waves were obtained in all the other patients (in 5 after change to another type of lead). Atrial triggered ventricular pacing was used in 34 cases and atrial pacing was used in 38. The P-wave amplitude at insertion was significantly less with Helifix than with Lifeline or Medtronic. The stimulation thresholds (range 0.25-2.5 V) did not differ significantly between the electrodes. Dislodgement of the electrode occurred during the first week in seven cases (5 Lifeline, 2 Helifix), but no late dislodgement occurred. The mean follow-up was 14 months (range 1-31). All three atrial leads offer acceptable function with regard to electro-physiological properties and electrode stability.

Adult↗
PubMed1981

The importance of a careful search for intra-abdominal testes in cryptorchidism. Report of a case with failure of urogenital union.

A five-year-old boy was operated upon for left-sided cryptorchidism. Failure of uro-genital union was found with the left testis and caput epididymidis intra-abdominally situated, and vas deferens and the rest of the epididymis in the lower part of the inguinal canal. The risk of development of malignancy in an intra-abdominal testis has been calculated to be one in 20. If it is impossible to find a testis in the inguinal canal or just inside the internal ring in a patient with cryptorchidism, the peritoneal cavity therefore must be opened and the abdomen carefully explored. The finding of a blind-ended vas deferens with epididymal tissue in the inguinal canal does not exclude an intra-abdominal testis.

Child, Preschool↗
PubMed1979

Surgical treatment of aneurysms of the ascending aorta: early experience with the sinus-shaped composite dacron graft.

This paper reviews the early and late results of 36 operations for aneurysms of the ascending aorta. Cystic medial necrosis was the predominant cause of aneurysm formation (56%), followed by arteriosclerosis (25%), previous aortotomy (11%) and syphilitic aortitis (8%). Dissection was encountered in 42%. The ascending aorta was replaced by a tubular Darcron graft in 26 patients, whereas 10 underwent aneurysmorrhaphy. Additional procedures were aortic valve replacement (27), resuspension of the aortic commissures (4) and coronary ostial implantation into sinus-shaped composite Dacron graft (4). Hospital mortality (0--18 days) was 8/36 patients (22%), but higher with cystic medial necrosis (30%), dissection (33%), duration of ECC greater than 180 minutes (38%), graft replacement (44%), emergency operation (45%) and heart volume greater than 900 ml/m2 BSA (50%). Late mortality (average 3 years) was 29%, but higher with cystic medial necrosis (33%), following aortic valve replacement (36%) and during anticoagulation (47%). Late cumulative survival (average 3 years) was 47% for the entire series, but only 33% in the presence of cystic medial necrosis. The poor overall prognosis for patients with cystic medial degeneration was closely related to a high incidence of fatal anastomotic complications and late deaths from cerebral haemorrhage during anticoagulation. Radical exclusion of the diseased aortic wall and omission of long-term anticoagulation are therefore desirable in order to lower the mortality rate. Surgery concerns the aneurysm per se, the aortic incompetence and the coronary ostia. The sinus-shaped composite graft with a Björk-Shiley prosthesis at its base appears to be a promising device for such a procedure, which should be performed electively, following early diagnosis in order to prevent dissection and emergency operations.

Adolescent↗
PubMed1979

Successful replacement of the aortic valve, mitral valve and ascending aorta with re-implantation of the coronary arteries.

A 63-year-old man was operated upon with replacement of the aortic valve, mitral valve and ascending aorta with re-implantation of the coronary arteries. A composite graft with a 27 mm Björk-Shiley tilting disc prosthesis was inserted with 3 continuous Prolene sutures in the aortic position. The coronary arteries were thereafter re-implanted in holes made in the graft. A 31 mm Björk-Shiley valve was sutured in the mitral position with about 20 isolated mattress sutures of Ti-Cron. Selective myocardial hypothermia was instituted with Ringer's solution of 4 degrees C. The total perfusion time was 185 min compared with 240 and 275 min in two previously reported, similar cases. We consider that the use of cardioplegia, a composite graft and continuous sutures makes it possible to reduce the operation time in these complex cases. Our patient is in good condition 9 months postoperatively.

Aortic Aneurysm↗
PubMed1979

Intrathoracic goitre: a review of 29 cases.

Twenty-nine patients suffering from intrathoracic goitre who were admitted to a thoracic surgical clinic were studied. Most patients had respiratory complaints but as many as 28% did not have any symptoms and their goitres were revealed on routine chest X-rays. Only seven patients were operated upon with a thoracic approach, usually a sternal split. All others were operated upon with a cervical collar incision. Three of the goitres were toxic and one malignant. Two of the patients died, one when inducing anaesthesia and the other of pulmonary embolism six days after the operation. General anaesthesia with endotracheal intubation is preferred when operating for intrathoracic goitre. The operation is started with a cervical collar incision and the patients prepared for a sternal split. Lateral thoracotomy may be necessary only when the mass is situated in the posterior mediastinum.

Aged↗
PubMed1978

Cystosarcoma phyllodes in young women.

A total of eight cases of cystosarcoma phyllodes in women under 25 years of age were reported to the Swedish Cancer Registry during a ten-year period (1960 to 1969). Only one of these tumors was malignant. It was successfully treated with simple mastectomy and postoperative radiation therapy. Of the remaining seven cases, six were treated with local excision of the lesion and one with simple mastectomy. In no case, did the tumor recur during a follow-up of an average of ten years. Local excision seems to be sufficient for the benign form of the tumor, whereas simple mastectomy is indicated for the malignant form. Radical mastectomy is indicated only of the tumor has invaded the pectoral fascia. The tumor rarely metastasizes to the axillary lymph nodes.

Adolescent↗
PubMed1978

Coarctation of the aorta. The world's longest follow-up.

A 32-year follow-up of the first coarctations of the aorta ever operated upon in the world has shown a systolic blood pressure below 155 mmHg in 12 of 18 patients and a diastolic blood pressure below 95 mm Hg in 15 of 18 patients. No gradient over the anastomosis was noted in 13 of 18 patients when measured by a cuff and in 5 of 12 patients when measured by catheterization. If the diameter of the anastomosis was 75% of that of that of the aortic arch, only a very small or no resting gradient was found. If there was no gradient at rest, there was usually only an insignificant or no gradient during exercise. A small gradient at rest was always higher during exercise, depending on the degree of work load, length of narrowed segment and aneurysm at the suture line. There was an incidence of 44% aortic valvular disease and of 20% degenerative changes in caput femoris. The anastomosis had grown with the patient.

Adolescent↗
PubMed1978

Acute appendicitis in patients over sixty.

In an investigation of 68 consecutive patients over the 60 operated on for acute appendicitis in 1969--1972 the symptoms and signs did not differ notably from those in younger patients. However, the disease was more advanced in the elderly patients with perforation of the appendix in 49%. Postoperative complications occurred in about one third of the series, but were never fatal. Use of broad-spectrum antibiotics (ampicillin) is recommended. The investigation showed that it is possible to reduce the mortality from acute appendicitis in elderly patients to a level comparable to that in younger ones.

Acute Disease↗