PubMed Health⌕ Search

Biomedical subjects

T Frøysaker

Publications and source records attributed to T Frøysaker.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Treatment of unstable angina pectoris].

We present the results of an acute revascularisation program for unstable angina. Of the 63 consecutive patients included in the program 61 had significant coronary artery disease. Coronary bypass grafting was performed in 39 and percutaneous transluminal angioplasty in 9. There were two perioperative myocardial infarctions and one death in hospital. 13 patients were found unsuitable for revascularisation. At follow-up (14-26 months) 60 patients were still alive (95%). In the revascularised group 30 patients (65%) were free of angina pectoris. Accordingly, in patients who do not respond to medical therapy, acute revascularisation may be performed with low operative mortality, low incidence of perioperative myocardial infarctions, and good long term results.

Angina Pectoris↗
PubMed1989

Experiences with closed chest, temporary atrio-arterial, ventricular bypass with a centrifugal pump after open heart surgery.

Twelve patients with refractory myocardial failure following open heart surgery were treated with a temporary left (10), right (1) or biventricular (1) assist circuits driven by extracorporeal pumps. Ten of 11 patients were weaned from the pump oxygenator. During left ventricular assist, maximal pump flow was 2.2 +/- 0.6 l/min per m2 at a cardiac index of 2.5 +/- 0.9 l/min per m2. Diuresis was above 1 ml/kg body weight per h in 7 of 9 patients perfused for 13-36 h. Seven patients were weaned from the assist pump after 13-33 h of ventricular bypass with 4 hospital survivors. Two patients died after circulatory assistance of multiple organ failure, 1 from cerebral damage. In the other patients, the main problems were cardiac. Three patients are currently long term survivors 12-17 months after surgery.

Cardiopulmonary Bypass↗
PubMed1989

Encircling endocardial ventriculotomy for malignant ventricular arrhythmias. Effect on cardiac performance.

Cardiac performance and hemodynamics were studied with radionuclide ventriculography in 19 survivors of aneurysmectomy and encircling endocardial ventriculotomy for recurrent, sustained ventricular arrhythmia (group I). To characterize the effect of the ventriculotomy on cardiac function, comparisons were made with a similar group of patients who underwent aneurysm surgery for angina pectoris and/or congestive heart failure (group II). Functional classification revealed no difference between the groups and they achieved the same level of exercise after surgery. No intergroup difference was found postoperatively with respect to right or left ventricular ejection fraction, regional ejection fractions, peak ejection rate, cardiac index or stroke volume. Peak filling rate was also similar, as were cardiac volumes. Exercise did not change any parameter of this intergroup similarity. The authors conclude that most patients with moderately impaired left ventricular function who undergo left ventricular aneurysmectomy with encircling endocardial ventriculotomy do not differ in postoperative hemodynamics and systolic or diastolic function from those treated with simple aneurysmectomy.

Adult↗
PubMed1988

Improvement in cardiac performance and exercise tolerance after left ventricular aneurysm surgery--a prospective study.

Forty two patients were studied prospectively by rest and exercise radionuclide ventriculography before and after (10 +/- 4 months) left ventricular aneurysm resection. Functional classification (NYHA) improved from 3.0 +/- 0.6 to 2.3 +/- 0.5 (p less than 0.0001) with an increase in double product (p less than 0.01) and total exercise workload (p less than 0.04) over preoperative values. End-diastolic volume was significantly reduced (p less than 0.0001) and resting global left ventricular ejection fraction (LVEF) improved significantly (p less than 0.03) after surgery, as did regional ejection fractions of the lateral/inferior wall (p less than 0.01). Cardiac index (CI) at rest, however, remained unchanged. Under exercise, improvement of global (p less than 0.0003) and regional ejection fractions (p less than 0.02) was more pronounced and a significant increase was also observed for CI (p less than 0.003). Improvement in left ventricular performance occurred both in patients with single and multiple vessel disease, but was more distinct in the latter group who additionally received coronary artery bypass grafts. These patients were furthermore postoperatively able to increase global LVEF at exercise (p less than 0.05). We conclude that aneurysm resection with or without coronary bypass relieves cardiac symptoms and improves exercise tolerance and left ventricular function at rest and on exercise in most patients.

Adult↗
PubMed1988

Plasma atrial natriuretic peptide in cardiac transplant recipients. A prospective study.

Cardiac transplantation in 10 patients with congestive heart failure resulted in reduction of high plasma concentrations of atrial natriuretic peptide (ANP), preoperatively five-fold above normal, to a level two-fold above normal, which was maintained throughout a 12-week follow-up period. Cardiac function was normalized in all patients. Transient increases in plasma ANP, in four cardiac recipients 3-10-fold their basal levels, could neither be related to rejection episodes nor to cardiac dysfunction, but rather to signs of fluid and sodium retention. High plasma ANP levels in cardiac transplant recipients suggest that the capacity to secrete ANP is preserved in the transplanted heart.

Adolescent↗
PubMed1988

Unstable angina pectoris. Experience with an acute revascularization program.

One year's experience of an acute revascularization program for unstable angina pectoris is presented. In the total material of 63 patients, significant coronary artery stenosis was found in 61 and normal coronary arteries in two. Coronary artery bypass grafting was performed in 39 patients (62%) and percutaneous transluminal angioplasty in nine (14%). There were two perioperative myocardial infarctions and one hospital death. Thirteen patients were not eligible for revascularization. At follow-up (14-26 months) 60 patients were still alive (95%). In the revascularization group, one patient had died, but of the remaining 46 patients, 30 (65%) were free of angina pectoris, and in addition six had only minor symptoms.

Adult↗
PubMed1988

Human heart transplantation. Rejection risk factors.

The present analysis of risk factors in human cardiac transplantation is based on a review of 682 endomyocardial biopsies from 52 grafts in 51 recipients. Acute rejection was diagnosed in 149 biopsies (21.8%). The cumulative 1-year graft survival was 91.5 4%. Four out of seven patients died of irreversible rejection. An univariate analysis using the linearized rate of total rejection showed significantly higher frequency of acute rejection when donor and recipient differed for two HLA-DR antigens compared to zero or one HLA antigen disparity (p less than 0.01), as well as in patients treated with low dose steroids, Cyclosporine (CyA) and Azathioprine (p less than 0.01), compared to treatment with CyA high dose steroids. Other risk factors were graft ischemia extending 60 minutes (p less than 0.05) and patient age exceeding 40 years (p less than 0.05). A multivariate analysis using the competing risk hazard model for irreversible (= lethal) rejection was performed. The presence of two HLA-DR mismatches between donor and recipient was found to be an independent risk factor (relative risk = 8.9), and immunosuppression with CyA and high dose steroids without Azathioprine another (relative risk = 15.3). Potential risk factors such as donor and recipient sex, donor age, prior surgery and time on extracorporeal circulation were not of significant prognostic value neither in regard to rejection nor irreversible rejection.

Azathioprine↗
PubMed1988

Heart transplantation in Norway. Morphological monitoring of cardiac allograft rejection. A 3-year follow-up.

A brief description is given of the most important morphological changes in endomyocardial biopsy specimens taken from cyclosporin A (CyA)-treated cardiac allograft recipients. The National Hospital of Norway was, in 1983, the first Scandinavian hospital to perform a heart transplantation, an event facilitated by the new immunosuppressive drug CyA. Up to now (February 1987), 38 allogeneic orthotopic transplants have been carried out on a total of 37 patients, of whom 32 are alive and clinically well. There was no operative mortality, but 5 patients died of other causes: Two early rejections, one arrhythmia due to moderate rejection, one Toxoplasma myocarditis and one early graft failure due to donor heart coronary artery disease. The observation time ranges from six weeks to 39 months. The first 9 patients received CyA and prednisolone; all subsequent recipients were treated with Azathioprine additionally. Thirty six grafts were controlled by 557 sequential biopsy procedures which yielded 2783 endomyocardial specimens for histopathological examination. A histological diagnosis of rejection was made 99 times in 32 grafts (mean 2,6). Twenty four biopsies were obtained on clinical indication in 15 patients, and rejection was diagnosed in 11 biopsies. Evaluation of endomyocardial biopsies is important in monitoring cardiac recipients and provides a morphological index of acute rejection. Serial biopsies with adequate endomyocardial sampling from different areas of the right ventricle make it possible to diagnose acute cellular rejection at an early stage and are essential to control immunosuppressive treatment. Endomyocardial biopsy is a safe and reliable procedure and plays an important role in the management of cardiac allograft rejection.

Adolescent↗
PubMed1987

Failure of combined acetylsalicylic acid and dipyridamole to prevent occlusion of aortocoronary venous bypass graft.

Patients scheduled to receive at least three aortocoronary venous bypass grafts were randomized to active medication or to placebo. The former were given dipyridamole (DP) preoperatively and acetylsalicylic acid (ASA) was added after the operation. For the next 3 months they received DP 75 mg and ASA 325 mg thrice daily. The placebo regimen was identical and the study was conducted with double-blind technique. One patient in each group died. DP-ASA was discontinued in six patients because of gastrointestinal side effects (bleeding peptic ulcer in 2 cases). Angiography after 3 months revealed the patency rate of individual grafts to be 68% in the DP-ASA group and 77% in the placebo group. DP-ASA therefore did not prevent occlusion of aortocoronary venous bypass grafts.

Aspirin↗