Search PubMed⌕ Search

Biomedical subjects

H Rostad

Publications and source records attributed to H Rostad.

At least 37 records · Page 2Linked to original sources
PubMed1981

Surgical treatment of bacterial endocarditis. A review and follow-up of 36 patients.

Prosthetic valve implantation was performed in 36 patients with bacterial endocarditis. Thirty-two of them were in functional class III or IV (NYHA). The early mortality rate was 16.7%. In six patients perivalvular fistulas occurred and were of haemodynamic significance in three of them. At follow-up after 44 months on average, the clinical condition was excellent (functional class I or II) in 20 of the 26 survivors. The results encourage an active attitude towards surgical intervention in patients with valvular insufficiency due to bacterial endocarditis.

Adolescent↗
PubMed1981

Umbilical vein grafts and PTFE grafts for femoro-popliteal bypass. Preliminary results.

This retrospective, multiple-center study includes 172 PTFE (Gore-Tex) and 35 umbilical vein grafts (Bio-graft) used for femoro-popliteal bypass grafting. The one-year patency rate was approximately 63% in both groups. Until further experience is accumulated, autogenous saphenous vein should probably be the first choice for femoro-popliteal bypass grafting. Prosthetic grafts should preferably be used when the saphenous vein is absent or insufficient.

Aged↗
PubMed1980

Coarctation of the aorta. A follow-up study after surgical treatment in infancy and childhood.

Between 1951 and 1973, 138 patients aged 0 to 12 years were operated on for coarctation of the aorta. Ten of 18 infants died early. There were 3 late deaths, 2 occurred suddenly and 1 after reoperation. Three of the 125 late survivors had severe, 19 had slight symptoms, while 103 had no complaints, 3 of whom refused examination. The remaining 122 cases were examined between 2 and 24 years (mean 10.9 years) after the operation. Two patients had sequelae from an operative spinal cord injury and 2 had late hemipareses (traumatic in one). Recoarctation, defined as arm/leg pressure gradient exceeding mmHg, totally occurred in 18.7%, and in 4 of 7 cases operated on in infancy. Hypertension without recoarctation was observed in 17.2% and associated cardiovascular anomalies in 18% of the late survivors. It is suggested that the optimal age for surgical repair of coarctation of the aorta is between 4 and 6 years of age. A long-term follow-up is recommended in all patients.

Adolescent↗
PubMed1980

Arterial occlusive disease of the upper extremity.

Twenty-five upper extremities were operated upon in 24 patients because of arterial occlusive disease. Transthoracic endarterectomy was performed in 4 patients with short central occlusions of the subclavian artery. In the remaining patients, various bypass procedures were performed using reversed autogenous veins or prosthetic grafts. There were 2 early and 6 late deaths. One prosthetic graft had to be removed 2 months after the operation because of infection. At follow-up, 9 months to 17 years after surgery, 11 bypass grafts were patent. One vein graft and one prosthetic graft had occluded. The surgical technique, types of graft to be used, and the relation to long-term patency are briefly discussed.

Adolescent↗
PubMed1980

Infected arterial prosthetic graft with loss of limbs. A case report.

A case of serious infection after arterial graft implantation is reported. Sixteen months after the operation, a large abscess developed in the iliac fossa around the graft. On admission he was in a poor condition with septicaemia. Following arteriography, which showed occlusion of the lumbar aorta as well as the iliac arteries, both legs became completely ischaemic. Various surgical procedures were performed, including thrombectomy, axillofemoral bypass and femoropopliteal bypass. However, permanently sufficient circulation of the limbs could not be maintained and a femoral and crural amputation was necessary.

Adult↗
PubMed1979

Primary results with the new Hall-Kaster disc valve prosthesis in mitral position.

The Hall-Kaster central flow prosthetic heart valve was introduced in 1977 in an attempt to improve the hemodynamics of the disc valve prostheses. Towards this accomplishment, innovations in the tilting axis, the disc guidance mechanisms, and disc translational freedom cooperate to improve flow through both orifice segments of the open valve. The present study reports on the primary clinical and hemodynamic findings in the first 20 patients (mean age 57.6 years) with isolated mitral valvular disease, examined 3--4 months after insertion of the Hall-Kaster disc valve prosthesis. The hemodynamic findings displayed low gradients and high calculated valve areas (5). At rest, the mean diastolic pressure gradient across the smallest prosthesis used (O.D. 27) averaged 3.0 mmHg, vs. 2.6 mmHg across the largest valve sizes (O.D. 29--31). Calculated valve area was on an average 3.08 cm2 for the smaller valve, and 3.47 cm2 for the larger valves, which corresponded to an utilization of 81% and 77% of the orifice area measured in vitro. A comparison with earlier studies of mean diastolic mitral gradients with different mitral prostheses indicates that the Hall-Kaster disc valve represents an improvement towards a hemodynamically more efficient prosthesis for mitral valve replacement.

Aged↗
PubMed1979

Combined aortic and mitral valve replacement. A randomized study comparing the Björk-Shiley and Lillehei-Kaster disc valve.

The present series was comprised of 48 patients, 25 of whom received the Björk-Shiley (B-S) and 23 the Lillehei-Kaster (L-K) disc valves. The 2 groups were comparable with regard to age, and to preoperative clinical and hemodynamic status. The randomized selection was carried out at the beginning of the operation. The total mortality in the B-S and L-K groups was 16% and 21% respectively. All surviving patients were restudied 13-40 months (mean 27) after surgery. Late thromboembolic complications occurred in 2 patients with B-S and in 3 with L-K valves, all leaving minor neurological sequelae. There was a relatively large number of patients in the L-K group with unmeasurable values of haptoglobin, indicating more hemolysis in these patients. However, the difference was not statistically significant. The clinical and hemodynamic status was improved in both groups. In the aortic position a significant gradient was found across the L-K valve, while no significant obstruction in the flow was found in the B-S valve. The pulmonary arteriolar resistance was significantly higher in patients with B-S than in those with L-K valves. Otherwise, there was no significant differences between the 2 groups, neither with regard to clinical nor to hemodynamic status.

Aortic Valve↗
PubMed1979

Late sudden death after surgical correction of coarctation of the aorta. Importance of aneurysm of the ascending aorta.

Follow-up studies averaging 12 years postcorrective surgery of 343 patients with coarctation of the aorta disclosed 38 late deaths, 15 of which were sudden, unexpected and probably cardiovascular. All but two patients were normotensive postoperatively, and in 4 of these the cause of death was proven dissecting aneurysm of ascending aorta. In another patient this aneurysm was repaired surgically and in 3 other patients chest X-ray had shown a dilated ascending aorta before death. At follow-up the ascending aorta was dilated angiographically in 4 survivors, who had moderate systolic hypertension and aortic valve disease. The high incidence of aneurysm of ascending aorta in patients with coarctation is probably due to hypertension during the growth period, possibly in combination with congenital weakness of the aortic wall, and to concomitant aortic valve lesion.

Adolescent↗
PubMed1979

Mitral insufficiency following myocardial infarction.

Severe mitral insufficiency following myocardial infarction in 15 patients is reported. The mean interval from infarction to surgery was 2.8 years. All patients were operated on with mitral valve replacement and in 14 aortocoronary bypass and/or resection of left ventricular aneurysm was necessary as well. Rupture of one or more heads of the papillary muscle was found in 5 patients. In another 5 the papillary muscles were discoloured, fibrosed and shortened, and in the last 5 patients the mitral incompetence was caused by a marked dilatation of the atrioventricular ring. Five patients (33%) died, 3 early and 2 late after surgery. All the patients who died had a markedly imparied left ventricular function pre-operatively with end-diastolic pressures from 15 to 26 mmHg.

Coronary Artery Bypass↗
PubMed1979

Atrial septal defect of secundum type in patients under 40 years of age. A review of 481 operated cases. Symptoms, signs, treatment and early results.

In the period 1957--1976 481 patients under 40 years of age were operated on. Dyspnoea and increased fatigue were dominating symptoms in more than half of the series. In 202 cases the anomaly was discovered at routine examination in the absence of relevant symptoms. Almost half of the patients were operated under hypothermia, in the others extracorporeal perfusion was used. Four hospital deaths occurred, two of which were related to cardiopulmonary bypass.

Adolescent↗
PubMed1979

Total anomalous pulmonary venous drainage.

Twelve patients with total anomalous pulmonary venous drainage (TAPVD) underwent complete surgical correction. Six were of the supracardiac type, 2 were cardiac and 4 of the infracardiac type. Pulmonary hypertension due to pulmonary vein obstruction was present in 6 patients. There were 6 early deaths, which occurred on the table or soon after surgery. One patient died 8 months after the operation because of a marked obstruction of the pulmonary venous inflow. Early diagnosis and operative correction in these severely ill patients should not be delayed. Postoperative intensive care and long-term follow-up are of the greatest importance.

Cardiac Catheterization↗
PubMed1979

Clinical and haemodynamic observations after combined aortic and mitral valve replacement with the Björk-Shiley tilting disc valve prosthesis. Early and late results in 25 patients.

Combined mitral and aortic valve replacement with the Björk-Shiley tilting disc valve (pyrolite) was performed in 25 unselected patients characterized by markedly impaired functional capacity, hypokinetic central circulation and cardiomegaly before operation. Surgery was performed during extracorporeal circulation with deep hypothermia. The mitral valve was replaced first in all cases. There were no intra-operative deaths, but 2 patients died while still in hospital (8.0%). One patient died 2 months postoperatively due to progressive heart failure. The remaining patients--with the exception of one who had died of cancer of the ovary--were re-examined in average 28.7 (18-40) months postoperatively. Most patients had improved symptomatically and were in functional classes I-II (N.Y.H.A.). The haemodynamic findings indicated restoration to normal resting values of cardiac output, pulmonary artery pressure and pulmonary vascular resistance, but with an increase in left ventricular end-diastolic pressure (LVEDP). The mean diastolic gradient across the mitral prosthesis varied from 0 to 11 mmHg, while simultaneous pressure recordings from the left ventricle and the aorta, with one exception, disclosed no systolic pressure gradients (peak) across the aortic valve. Postoperative arterial thrombo-embolic complications occurred in 2 patients, resulting in only minor neurological sequelae.

Adult↗