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Biomedical subjects

L Bergdahl

Publications and source records attributed to L Bergdahl.

At least 19 recordsLinked to original sources
PubMed1986

The immediate function of sequential aortocoronary vein grafts to closely adjacent myocardial areas.

Blood-flow measurements were performed in 72 patients after sequential vein grafting (Y-grafting) to LAD and diagonal branches. The mean blood flow in the joint graft was 69 ml/min, i.e. significantly more than the 36 ml/min in one branch when the other was occluded. When one branch was occluded for 10 min (11 patients), there was insignificant increase of the flow through the nonoccluded branch. The mean joint graft flow and branch flow increased insignificantly after administration of dipyridamole. Lower blood flow in one branch of the sequential graft than in the joint graft is due to insufficient collateral system. High rate of flow in the joint graft probably reduces the rate of early and late occlusion.

Blood Flow Velocity↗
PubMed1985

Pancreatitis after cardiac and cardiopulmonary transplantation.

In a review of 176 patients who died after either cardiac or cardiopulmonary transplantation, 15 cases of pancreatitis were identified. The diagnosis was clinically inapparent in 11 of the 15 cases of pancreatitis. A high index of suspicion should therefore be maintained when these patients are cared for. A variety of factors may have contributed to the occurrence of pancreatitis in these patients. These include infection, steroids, azathioprine, low-flow states, extracorporeal circulation, vasopressors, renal failure, and rejection.

Adolescent↗
PubMed1984

Early and late efficacy of three types of transvenous atrial leads.

Experience with three transvenous atrial leads, representing different principles, is presented. The types were screw-in (Vitatron Helifix-12), J-lead (Intermedics Lifeline 483-01) and straight-tined (Medtronic 6961). The study comprised insertion of 86 leads (30 Helifix, 40 Lifeline, 16 Medtronic) in 76 patients. Atrial fibrillation occurred during insertion in two patients, and in two others stable electrode positioning in the right atrial appendage was not achieved. Stable position and acceptable intracardiac P-waves were obtained in all the other patients (in 5 after change to another type of lead). Atrial triggered ventricular pacing was used in 34 cases and atrial pacing was used in 38. The P-wave amplitude at insertion was significantly less with Helifix than with Lifeline or Medtronic. The stimulation thresholds (range 0.25-2.5 V) did not differ significantly between the electrodes. Dislodgement of the electrode occurred during the first week in seven cases (5 Lifeline, 2 Helifix), but no late dislodgement occurred. The mean follow-up was 14 months (range 1-31). All three atrial leads offer acceptable function with regard to electro-physiological properties and electrode stability.

Adult↗
PubMed1984

Traumatic disruption of the thoracic aorta.

Fourteen cases of injury to the thoracic aorta treated in 1959-1981 are reviewed. Acute rupture was present in nine patients and chronic post-traumatic aneurysm in five. Most of the patients had other, associated injuries, and physical signs of the aortic injury were often scanty. Widening of the mediastinum was the most common roentgenographic finding. All the aortic ruptures were localized to the isthmus. One patient declined surgery. Another died on the operating table just before surgery was started. A third patient died peroperatively from severe bleeding when the aneurysm was dissected free. All of the other 11 patients survived operation without major complications. At follow-up (mean 10 years), ten patients were alive and well and one had died of unrelated cause. The most recent operations were performed with the aid of a TDMAC (Gott) shunt, which makes aortic repair safe and simple. Because aortic trauma often is accompanied by other, severe injuries which make transportation of the patient risky, and so as not to delay operation, the aortic lesions should be repaired at general surgical units. If necessary, a thoracic surgeon should be brought to the hospital.

Accidents, Traffic↗
PubMed1983

Extracranial carotid and vertebral artery aneurysms.

Extracranial carotid aneurysms are uncommon, and in the past their management has not always been satisfactory. These aneurysms may be caused by arteriosclerosis, infection or trauma, or they may be congenital. Neurologic symptoms are common. Surgery is recommended for symptomatic aneurysms in patients of all ages. Non-growing aneurysms in old patients can be conservatively managed. Six cases of carotid and one case of vertebral artery aneurysm are reported. The mode of clinical presentation, etiologic factors, angiographic findings and methods of management are discussed.

Adolescent↗
PubMed1983

Intrathoracic tracheal rupture following blunt chest trauma.

Intrathoracic tracheal rupture following closed chest trauma is a potentially lethal injury which can be successfully repaired if the diagnosis is made early. Dyspnoea, mediastinal emphysema and pneumothorax which do not respond to intercostal tube drainage should alert the clinician to the possibility of intrathoracic tracheal rupture. A case is described. A 17-year-old boy sustained two longitudinal lacerations of the membranous portion of the intrathoracic trachea in association with blunt chest trauma. The diagnosis was delayed because of coexisting head injury. The tracheal lacerations were successfully repaired via a right thoracotomy. The principles of management in such injuries are reviewed.

Adolescent↗
PubMed1981

The importance of a careful search for intra-abdominal testes in cryptorchidism. Report of a case with failure of urogenital union.

A five-year-old boy was operated upon for left-sided cryptorchidism. Failure of uro-genital union was found with the left testis and caput epididymidis intra-abdominally situated, and vas deferens and the rest of the epididymis in the lower part of the inguinal canal. The risk of development of malignancy in an intra-abdominal testis has been calculated to be one in 20. If it is impossible to find a testis in the inguinal canal or just inside the internal ring in a patient with cryptorchidism, the peritoneal cavity therefore must be opened and the abdomen carefully explored. The finding of a blind-ended vas deferens with epididymal tissue in the inguinal canal does not exclude an intra-abdominal testis.

Child, Preschool↗
PubMed1981

Repair of double-outlet right ventricle. Experience of 13 cases.

Surgery for double-outlet right ventricle (DORV) was performed in 13 patients between November 1974 and January 1979. Subaortic ventricular septal defect (VSD) was present in 11 patients, complicated forms of DORV in 2 patients and 5 patients had important concomitant cardiac defects. Six infants (mean age 0.6 years) without pulmonary stenosis (PS) required operation because of pulmonary hypertension, whereas the 7 patients with PS underwent surgery at a considerably later stage (mean age 6 years). Interventricular tunnel-repair established continuity between the systemic ventricle and great artery in 12 patients. One case with subpulmonic VSD was managed by transposition of both venous return and arterial outflow, while the use of valved external conduits was generally avoided. Atrial incision was sufficient to permit complete intraventricular repair in 8 patients, including one pulmonary valvulotomy. Important co-existing PS was otherwise treated as in cases of tetralogy of Fallot and required transannular patch grafting in 2 instances. Hospital mortality was 3/13 patients (23%) and mainly confined to serious associated cardiac malformations which were not amenable to correction. All 10 survivors are functionally improved 1.5-5 years after surgery. Clinical and invasive re-evaluation (3 patients) could not identify the development of systemic ventricular outflow tract obstruction. One patient, who underwent enlargement of a restrictive VSD, presented angiographic evidence of a moderate aortic incompetence. No other important complications were associated with the tunnel-repair and none of the 10 survivors had complete heart block.

Adolescent↗
PubMed1981

Aortic valve replacement in patients over 70 years.

Twenty-seven patients 70 years of age or more were operated upon with aortic valvular replacement with an early mortality rate of 7%. No more patients died during a mean follow-up period of 28 months. The Björk-Shiley standard tilting disc valve was implanted in 15 cases and the new convexo-concave model in 12 cases. Sixty-seven per cent of the patients had narrow aortic roots (21 and 23 mm prosthesis diameters) compared with 40% of younger patients. Thrombo-embolic complications occurred in 2 patients who had not received anticoagulant treatment. No such complications were recorded in the remaining 23 surviving patients treated with anticoagulants. All the surviving patients (except one who was re-operated because of a thrombotic encapsulation of the disc) were markedly improved postoperatively. High age alone is no longer an absolute contra-indication for aortic valve replacement. The convexo-concave Björk-Shiley tilting disc prosthesis is suitable in these patients because of its low resistance of flow at small diameters. The importance of anticoagulant treatment even in elderly patients is emphasized.

Age Factors↗
PubMed1980

Gallbladder carcinoma first diagnosed at microscopic examination of gallbladders removed for presumed benign disease.

The patients who survive gallbladder carcinomas more than five years are usually those in whom the carcinoma was first diagnosed at microscopic examination of gallbladders removed for presumed benign disease. A group of 32 such patients (from a series of 120 cases) was studied. The prognosis was very bad (longest survival 2.5 years) in 21 of the patients where the cancer involved all the layers of the gallbladder wall. The prognosis was far better in the 11 patients in which the cancer was confined to the mucosa or submucosa. Sixty-four per cent of the patients were alive after 5 years and 44% after 10 years. Five of the 11 patients died because of recurrence. Simple cholecystectomy had been performed in all the patients except one who underwent a right hepatic lobectomy. Radical cholecystectomy including a wedge resection of liver tissue and dissection of the regional lymph nodes is recommended in all patients with inapparent gallbladder carcinomas.

Adenocarcinoma↗
PubMed1980

The effect of a nylon mesh blood filter in the arterial line during extracorporeal circulation.

Forty patients with different cardiac diseases underwent perfusion with the Shiley bubble oxygenator without a filter in the arterial line (Group A). This group was compared with a similar group of patients (Group B), in whom an Intersept nylon mesh filter was used in the arterial line. There were no differences according to age, weight or duration of perfusion between the two groups. The average postoperative bleeding via the chest tubes was 361 ml/m2 B.S.A./24 hours in group A compared with 414 in group B (p less than 0.05). One patient in the filter group died on the table because of myocardial failure, while the remaining 79 patients could leave hospital alive. One patient in each group showed impaired consciousness, but no other neurological complications were recorded in the patients. There were no significant differences in haematocrit, B-haemoglobin or leucocyte counts after 15 min, 1 hour, at the end of perfusion or 1 hour, respectively 24 hours postoperatively. The platelet count after 1 hour of perfusion was 55.8 x 10(9)/l in the filter group compared with 80.4 x 10(9)/l in group A (p less than 0.05), there were, however, no significant differences in B-platelet counts at the end of perfusion or later. Our study showed that a nylon mesh filter in the arterial line can reduce the platelet count. As no measureable advantages were found in the filter group we cannot recommend an arterial line filter.

Blood Cell Count↗