Congenital dislocation of the head of the radius. Report of case.
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Child↗
Biomedical subjects
H Rostad
Publications and source records attributed to H Rostad.
Bypass to the tibial and peroneal arteries using the great saphenous vein in situ.
In 22 patients with extensive atherosclerotic disease of the lower extremities 24 long bypasses have been performed. The main indications for surgery were rest pain and imminent or manifest gangrene. The semiclosed in situ vein technique was used in all except one case. Five grafts thrombosed within 2 weeks postoperatively, one of them was successfully reopened. At discharge 20 grafts were patent, and most of the patients had relief of their ischemic symptoms. After 5 years 26% of the long vein grafts were patent. In comparison, almost 70% of in situ femoro-popliteal vein grafts were patent. One patient is still living with an open long vein graft 14 years after surgery. The in situ vein technique is especially suited for long bypasses. The poorer results in the present series is probably due to an extremely advanced atherosclerotic disease and a high percent of small fibrotic veins with a diameter of 3 mm or less.
Adult↗
Coarctation of the aorta, early and late results of various surgical techniques.
In the 10-year period 1973-1983, 158 patients aged one day to 16.4 years were operated upon for coarctation of the aorta; 25% of them were less than one month of age. The main surgical procedure was aortoplasty with a prosthetic patch (114 patients), and resection and end-to-end anastomosis (36 patients). Associated cardiovascular anomalies were found in 42%. There were 11 early and 6 late deaths and the majority of these were due to severe coexistent cardiac lesions. The frequency of moderate and severe recoarctation was much higher in patients operated on with resection and end-to-end anastomosis than in those with aortoplasty and prosthetic patch, 25% and 6.7%, respectively. In 18 patients, surgery for recoarctation was necessary using aortoplasty and a prosthetic patch technique. There were no postoperative complications or deaths in these patients. So far, in 2 cases with a prosthetic patch, aneurysmal dilatation of the aorta adjacent to the patch has developed.
Adolescent↗
Screening of the carotid arteries with Doppler ultrasound in patients with coronary artery disease.
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Arteriosclerosis↗
Blood flow measurement in PTFE grafts.
In vascular surgery peroperative control of the result of reconstruction is essential. PTFE-grafts have been known to be "resistant" to flow registration with electromagnetic flowmetry because of the electrical isolation. Similarly, intraoperative Doppler registration has been impossible because of the attenuation of the ultrasound in the graft wall. The leading disturbances are obviously caused by air in the graft material and are not caused by the material itself. By squeezing the graft carefully between the thumb and forefinger, blood slowly penetrates the wall colouring it red. The squeezing is performed intermittently to avoid occlusion of the graft. Excellent flow registration is obtained after less than 2 min squeezing of the thin walled graft, while at least 5 min squeezing is necessary to obtain signals from thick walled grafts. To obtain satisfactory ultrasound signals more squeezing is necessary.
Animals↗
The great saphenous vein used in situ after vein valve extirpation. Long term results.
In 227 patients 252 extremities were operated on with femoropopliteal bypass using the in situ vein technique. The valves were extirpated through incisions in the vein. At discharge 14 grafts were thrombosed, mainly because of inadequate size of the vein graft. Ten years after surgery more than 50% of the patients had died, and only 25% of the implanted grafts were patent. The dominating cause of death was coronary infarction. Thirty one limbs were amputated. At the end of follow-up 51 grafts were patent 10 to 17 years after surgery, mean 10.84 ears. With regard to mortality and long term patency the most important factors were: Preoperative history of myocardial disease, smoking, size of the vein graft and peripheral "run-off".
Adult↗
Morphological changes in the saphenous vein after dilatation with silastic tubes. An experimental study.
In an attempt to make veins more suitable for bypass grafting, an experimental model in dogs was developed. The saphenous vein on the hind limbs was cannulated with a silastic tube, a ligature was placed proximally and distally, and the tube was left in situ for 1 to 9 weeks. Morphological studies including electron microscopy revealed "arterialization" of the veins with fibromuscular hyperplasia, increased deposition of collagen and preserved vasa vasorum. The endothelium was replaced by irregular cells, probably altered fibroblasts coated by an amorphous material. It is suggested that the "arterialized" veins may become more suitable for bypass grafting. But the luminal surface may be thombogenic and thus the usefulness of the graft may be diminished by thrombosis.
Animals↗
Correction of Fallot's tetralogy after palliative operations.
During the period 1960 to 1978, 98 patients underwent intracardiac repair of Fallot's tetralogy after palliative operations. Preoperative symptoms were cyanosis, dyspnea, increased fatigue with squatting and hypoxic spells. The hemoglobin concentration varied from 19 to 22 g/100 ml. At correction only 65 of 95 shunts were patent and needed surgical closure. Seventeen early deaths occurred (19%), the main causes being cardiac failure and arrhythmia. One patient died 3 years after correction from pneumonia. The subjective clinical result was excellent or good in all surviving patients. At repeat heart catheterization in 26 patients a high percentage of residual ventricular septal defects and pulmonary stenosis/insufficiency was found. However, the majority of defects were of minimal haemodynamic significance, and so far did not seem to do harm to the patients' subjective function.
Adolescent↗