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Biomedical subjects

O Albrechtsen

Publications and source records attributed to O Albrechtsen.

At least 19 recordsLinked to original sources
PubMed1992

[Clinical picture of acute pulmonary embolism. Relations to the degree of vascular obstruction].

In 132 consecutive patients treated for pulmonary embolism, duration of symptoms, number of embolic episodes before the diagnosis, circulatory affection (stable circulation (n = 61), reversible shock (n = 60), circulatory collapse (n = 11), electrocardiographic findings and systolic pulmonary pressure (n = 60) were analysed in relation to 1) underlying diseases (orthopedic surgical patients (n = 43), gynecological-abdominal surgical patients (n = 22), preembolic healthy patients (n = 42), miscellaneous medical patients (n = 25)), and 2) the obstruction of the pulmonary vascular bed quantified by a scintigraphic or angiographic score. While embolic score did not differ between the groups of underlying diseases, preembolic healthy patients with deep vein trombosis (n = 30) had longer mean duration of symptoms (14 days), more embolic episodes, (1.7 episode) and higher pulmonary pressure (72 mmHg) than the material on an average with values of 7 days, 0.9 episodes and 57 mmHg, respectively (p less than 0.001). Among patients with reversible shock or circulatory collapse, half had at least one previous embolic episode, one fifth from two to four. Embolic score correlated well with the circulatory affection (p less than 0.001). A high pulmonary pressure correlated with long duration of symptoms and a high number of embolic episodes (p less than 0.002). Sinus tachycardia and electrocardiographic signs of acute right ventricular strain (complete and incomplete right bundle branch block, SIQIIITIII-pattern and inverted T-waves in V2-4) correlated positively to the circulatory affection and inversely to duration of symptoms and number of embolic episodes (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1992

[Aggressive treatment of acute pulmonary embolism. 132 consecutive patients treated with heparin, streptokinase or embolectomy, 1975-1987].

During 1975-1987, 132 patients were treated for acute pulmonary embolism with heparin (n = 41), streptokinase (n = 52), or embolectomy (n = 39). In 1984, the indications for embolectomy were broadened to include all patients with central emboli, also those who were circulatory stable. The heparin-, streptokinase-, and embolectomy groups differed from each other as regards the degree of circulatory impairment (stable circulation/reversible shock/circulatory collapse: 68/32/0% versus 52/48/0% versus 16/56/28%, p less than 0.0001) and embolic score (20 for complete obstruction; 5.6 +/- 3.4 versus 8.7 +/- 2.8 versus 13.2 +/- 2.4, p less than 0.0001), but were comparable in terms of prognosis (30-day mortality/10-year survival +/- standard error: 7%/61 +/- 9% versus 13%/59 +/- 9% versus 18%/61 +/- 10%). Stable circulation, reversible shock, and circulatory collapse prior to embolectomy resulted in 30-day mortalities of 0%, 9%, and 45% respectively (p less than 0.01). During 1984-1987, no early or late deaths after embolectomy were observed in patients without circulatory collapse (n = 10). In comparable patients (embolic score greater than or equal to 9, symptom duration less than or equal to 7 days, no circulatory collapse), streptokinase treatment (n = 13) and embolectomy (n = 25) resulted in 10-year survival +/- standard error of 46 +/- 16% and 82 +/- 10% respectively (p less than 0.0001) and in an embolic score-reduction (score before minus score after treatment) of 5.7 +/- 2.3 and 10.5 +/- 2.9, respectively (p less than 0.0001). Embolectomy during extracorporeal circulation should be considered the treatment-of-choice in patients with acute central emboli.

Acute Disease↗
PubMed1992

Nonpharmacologic treatment of supraventricular and ventricular tachyarrhythmias. A review of 249 consecutive patients.

Incapacitating or life-threatening tachyarrhythmias were treated nonpharmacologically in 249 patients from 1982 to 1991. Among 92 patients surgically treated for supraventricular tachycardia the cure rate was 93% and the complication rate 12%. Radiofrequency catheter ablation gave an equal cure rate in 51 patients, but with no major complications or mortality. Direct-current catheter ablation of the His bundle was successful in 96% of 27 patients with drug-refractory atrial fibrillation or other supraventricular tachyarrhythmias. Among 64 patients undergoing surgery for ventricular tachycardia/ventricular fibrillation, the perioperative mortality was 9%, estimated 5-year survival 69% and estimated 5-year freedom from the preoperative arrhythmias 72%. Of 18 patients treated with implantable cardioverter defibrillator, three (18%) died of heart failure during follow-up. Nonpharmacologic treatment of tachyarrhythmias is concluded to be effective and often definitively curative. The safety-risk ratio is improving as new treatment modalities are developed.

Adolescent↗
PubMed1989

Curative surgical treatment of atrioventricular junctional re-entrant tachycardia by perinodal dissection.

The medical treatment of an atrioventricular junctional (AV-nodal) re-entrant tachycardia (AVJRT) is often ineffective due to failure of response or significant side effects. Recently, reports of curative surgical procedures using either dissection or cryocoagulation in the AV node area with preservation of normal AV conduction, have been published with excellent short term results in small series. The present paper describes our experience of surgical treatment using the dissection method in five patients. In all patients, AVJRT with short retrograde conduction intervals was diagnosed during the pre- and intraoperative electrophysiological studies. The earliest site of atrial activation during tachycardia was seen close to the triangle of Koch, antero-medially to the AV node. Elective open heart surgery was performed and after cold cardioplegic arrest, the right atrial endocardium was incised and the perinodal atrium carefully disconnected from the AV node. After surgery, a tachycardia could not be induced in any of the patients. In a follow-up period of 14-29 months, all patients have been free of symptoms without antiarrhythmic drugs. Early electrophysiological evaluation of patients with supraventricular tachycardia is advocated and in patients with medically refractory AVJRT, surgery is recommended.

Adolescent↗
PubMed1989

Surgery of ventricular tachycardia and ventricular fibrillation in patients with coronary artery disease and LV-aneurysms.

In 26 patients with left ventricular aneurysm and ventricular tachycardia and/or ventricular fibrillation following myocardial infarction, coronary angiography, left ventriculography and electrophysiologic examination were performed preoperatively. Surgery in all cases consisted of aneurysmectomy and mapping-guided endocardial resection of the area found to be the arrhythmogenic center. Four patients died peroperatively or during the postoperative hospital stay. The 22 survivors were followed up for 3-48 (mean 22) months postoperatively. There were no late deaths. Repeated electrophysiologic studies were performed in 18 of the survivors. Freedom from ventricular tachycardia and fibrillation was achieved in 21 patients, 17 after surgery alone and four after combined surgical and medical treatment. The remaining patient still has ventricular tachycardia despite combined treatment.

Adult↗
PubMed1988

Three-dimensional visualization of velocity profiles in the ascending aorta in humans. A comparative study among normal aortic valves, St. Jude Medical and Starr-Edwards Silastic Ball valves.

Blood velocities were recorded intraoperatively in the ascending aorta approximately 6 cm downstream of the aortic annulus in eight patients with normal aortic valves (prior to coronary bypass surgery) and in seven patients after implantation of a St. Jude Medical valve (4) or Starr-Edwards Silastic Ball valve (3) in the aortic position by means of constant temperature hot-film anemometry. The velocities were measured during 5-15 heart cycles at 41 predetermined measurement points almost evenly distributed in the cross sectional area. Velocity profiles were visualized three-dimensionally at 100 time intervals during one mean heart cycle. The standard deviation of velocities was correspondingly three-dimensionally visualized. For the patients with normal aortic valves the velocity profiles were generally flat but skew, with the highest velocity closer to the left vessel wall at the start of systole. During systole the skewness turned counter-clockwise with the highest velocities closer to the posterior, right and finally anterior vessel wall at the end of systole. In patients with an artificial heart valve in the aortic position the design of the valve was reflected on the contour of the profiles. The findings correspond well with model studies.

Adult↗
PubMed1988

Analysis of velocity in the ascending aorta in humans. A comparative study among normal aortic valves, St. Jude Medical and Starr-Edwards Silastic Ball valves.

To analyze velocity spectral energy distribution in humans, blood velocities were recorded by means of hot-film anemometry at 41 predetermined measurement points in the cross-sectional area of the ascending aorta approximately 6 cm downstream of the aortic valves. Measurements were made in 8 patients with normal aortic valves, in 4 after insertion of a St. Jude Medical (SJM) aortic valve and in 3 after insertion of a Starr-Edwards Silastic Ball (SSB) aortic valve. Data analysis based on Fast Fourier Transform demonstrated that turbulence energy was lower in patients with normal aortic valves than in patients after insertion of an artificial valve in the aortic position and probably more pronounced after SSB valves than after SJM valves. The spatial distribution of the turbulence energy above 100 Hz was more irregular than corresponding laminar velocities previously presented. The VER100 (Velocity Energy Ratio at 100 Hz, i.e. the velocity energy above 100 Hz divided by the total velocity energy) proved useful for evaluating differences in flow disturbances downstream of different aortic valves. The mean VER100 in the three categories of patients were respectively 0.3, 1.4, and 2.1%.

Adult↗
PubMed1984

Clinical experience with porcine xenografts in the mitral position.

In a 7-year period, 120 porcine xenografts, 16 of Hancock and 104 of Carpentier-Edwards type, were implanted in the mitral position in patients with isolated mitral valve disease. The operative mortality was 4.2%. The actuarial survival after 5 years was 93%. Death during the observation period was valve-related in two cases. Three valves had to be exchanged, one because of calcification and two because of prosthetic endocarditis. The risk of contracting prosthetic endocarditis was 0.38% per patient year. All the patients received peroral anticoagulant medication indefinitely. Two minor embolic episodes occurred, both in the first 6 post-operative months. The probability of freedom from thromboembolism was thus 98.2% after 7 years. In functional evaluation of 92 patients observed for at least 6 months, more than 90% were in NYHA class I or II. Porcine xenograft is a good valve substitute in the mitral position with a low incidence of complications, especially of thromboembolism, in patients on maintenance anticoagulant therapy. Long-term observations of this type of valve substitute are not yet available, however.

Adolescent↗
PubMed1982

Visualising velocity profiles in great arteries--a preliminary report.

Using a constant temperature anemometer and an L-shaped 1 mm conical hot-film anemometer probe, blood velocities were registered in a patient after implantation of a Starr-Edwards ball valve in the aortic position. Velocities were registered at 41 predetermined points in the ascending aorta, equally distributed over the cross-sectional area. Data were recorded on tape and later analysed to make three-dimensional plots of the velocity profile at 200 time intervals during one "mean" heart cycle, and a film of the velocity profile in this cycle was made. The film gave the impression of great velocity fluctuations at different places in the cross-sectional area.

Aorta, Thoracic↗
PubMed1982

Surgical treatment of bacterial endocarditis.

Valve replacement was performed during a 7-year period in 27 patients with acute or subacute infective endocarditis. Twenty-three patients had single valve affection--16 aortic and 7 mitral--and 4 patients had affection of both the aortic and mitral valves. Eight of the patients with aortic valve lesion had congenital aortic valve stenosis and 2 of the mitral patients had mitral prolapse. Two patients were operated upon only on the echocardiographic finding of valvular vegetations. The rest of the patients were operated because of cardiac insufficiency, intractable infection or peripheral embolization. Five patients died and 22 patients (82%) were discharged. One of these patients died in the follow-up period. The remaining 21 patients all belong to class I or II (NYHA) postoperatively. There were no cases of reinfection. Emphasis is placed on the use of echocardiography in detecting valvular vegetations, and the need to take the proper surgical action as a result of this finding, even in asymptomatic patients.

Adolescent↗