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T Frøysaker

Publications and source records attributed to T Frøysaker.

78 records · Page 5Linked to original sources
PubMed1979

Fresh autologous blood in open-heart surgery. Influence on blood requirements, bleeding and platelet counts.

The role of fresh autologous blood on haemostasis was studied in 30 patients undergoing aortic valve replacement. All the patients were extremely haemodiluted during the perfusion by using a non-haemic priming solution and withdrawal of 15% of the blood volume at the start of operation. In half of the patients, the autologous blood was retransfused immediately after the termination of perfusion. In the other half, donor blood was given in this period, while the retransfusion of autologous blood was delayed until three hours postoperatively. An increase of circulating platelets was found after the withdrawal of blood and replacement with double the amount of Ringer's acetate. Significantly less donor blood and plasma was transfused in the patients receiving early transfusion of autologous blood. An average reduction of 36% donor blood and 45% plasma was obtained. The blood losses were also less in these patients, but the differences were not significant.

Adult↗
PubMed1978

Aorto-coronary saphenous vein bypass graft. Peroperative flow studies related to late graft patency.

In aorto-coronary saphenous bypass grafts, peroperative flows measured by electromagnetic flowmetry were studied at rest and after injection of papaverine to reduce vasomotor tone. The results were correlated to graft patency approximately 14 months after operation and showed that patent grafts had greater flow values, both at rest and after papaverine, than grafts which were occluded at the re-examination. There was, however, considerable overlapping between the two groups, and no clear distinction between flow values in successful and unsuccessful grafts either at rest or after papaverine was found. No correlations were demonstrated between peroperative graft flow on one hand and the presence or absence of ventricular dyskinesia or electrocardiographic evidence of previous transmural myocardial infarction on the other.

Adult↗
PubMed1978

Influence of aorto-coronary saphenous vein bypass surgery on left ventricular function. Comparison before and one year after surgery in 80 patients.

To assess the haemodynamic effects of aorto-coronary saphenous vein bypass grafting, pre- and post-angiographic left ventricular end-diastolic pressure (LVEDP) and ejection fraction (EF) were measured before and in average 14 months after surgery in 80 patients. Symptomatic improvement occurred in 91% (73 of 80). In 43 patients with patent graft(s), pre-angiographic LVEDP and EF were unchanged (p always greater than 0.05), while postangiographic LVEDP was significantly reduced. Unchanged pre- and postangiographic LVEDP and EF were observed in 28 patients with double or triple grafts, with at least one graft patent and the other(s) occluded. Unchanged pre- and postangiographic LVEDP and reduced EF were observed in 9 patients with occluded single, double or triple grafts. We conclude that successful aorto-coronary saphenous vein bypass surgery in general does not improve resting left ventricular performance, but that the beneficial effect on left ventricular function can be demonstrated after a stress test such as ventriculography. A single graft to the left anterior descending artery seems to be of particular importance in this connection. On the other hand, deterioration was evident after unsuccessful surgery, particularly in patients with occlusions of 2 or 3 grafts. Digitalis therapy after operation or electrocardiographic indices of postoperative myocardial infarction apparently did not influence left ventricular performance.

Adult↗
PubMed1978

Cardiac surgery in extreme haemodilution without donor blood, blood products or artificial macromolecules.

A triple aorto-coronary vein bypass was performed in a 56-year-old Jehovah's Witness. Neither donor blood, albumin nor artificial macromolecules were used. Ten litres of non-haemic fluid were given during surgery and an additional 4 litres during the first 18 postoperative hours. During perfusion the haematocrit fell to 19 vol% and total protein in serum to 29 g/l. Eighteen hours after surgery, the patient was extubated without any signs of oedema and with a positive water balance of only 2.2 l. Diuretics were not given. Acid-base and electrolyte values were within normal limits both during and after operation. This and similar cases reported in the literature show that during extracorporeal circulation it is possible to reduce the concentrations of red cells and plasma proteins to below 40% of pre-operative values without serious complications.

Angina Pectoris↗
PubMedDate not supplied

Left ventricular aneurysm and severe cardiac dysfunction: heart transplantation or aneurysm surgery?

We analyzed data from 26 patients with left ventricular aneurysm and severe congestive heart failure to evaluate our selection criteria for aneurysm surgery and heart transplantation. The operative results for patients who underwent aneurysm resection (group A, n = 14) were compared with those of patients who were accepted for heart transplantation (group B, n = 12). All patients were monitored and reinvestigated after surgery. Functional status and left ventricular angiographic and hemodynamic findings were significantly worse in group B than in group A, but with great overlap between the groups. The presence of mitral insufficiency or right ventricular dysfunction (or both), however, was important in our selection for transplantation. Two patients died after aneurysm surgery, whereas one died before heart transplantation. Functional status (p less than 0.004) and left ventricular ejection fraction (p less than 0.05) improved after aneurysm resection, whereas hemodynamic values remained unchanged. Symptoms were relieved (p less than 0.001), and, except for cardiac index, hemodynamic values were normalized in group B. We conclude that the combination of a left ventricular ejection fraction of less than 25%, mitral insufficiency, and right ventricular dysfunction favors heart transplantation in patients with left ventricular aneurysm and end-stage heart disease. The lack of donor organs and acceptable results of aneurysmectomy, however, justify conventional surgery even in high-risk patients.

Adult↗