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Biomedical subjects

L Heikkinen

Publications and source records attributed to L Heikkinen.

22 records · Page 2Linked to original sources

Suprapubic cystostomy catheterization in open-heart surgery.

Monitoring of the urinary output is mandatory during open-heart surgery and in the immediate postoperative period. During 1980-81 we noticed an alarming rise in the number of post-catheterization urethral strictures affecting men who had undergone open-heart surgery. To avoid this serious complication, we switched from conventional urethral catheterization to suprapubic cystostomy for these patients. The first 93 cases with suprapubic drainage have now been analysed as regards the advantages and complications of this technique. The advantages were clear: The patients were satisfied with the method and no urethral strictures developed. The only side effect was haematuria, which in 9 cases led to occlusion of the catheter and required extraneous maneouvres. Suprapubic cystostomy thus seems to be a good alternative to conventional urethral catheterization in open-heart surgery. The possible causes of the urethral complications in this particular group of patients also are discussed.

Cardiac Surgical Procedures↗

Primary malignant melanoma of the oesophagus. A case report.

A primary malignant melanoma of the oesophagus was surgically treated in a 71-year-old man. Maximally radical excision of the tumour was performed, with broad 'safety' margins and radical ablation of the para-oesophageal tissue at tumour level, without touching the tumour. When oesophagoscopy shows a tumour strongly suggestive of melanoma, confirmation should be made with fine-needle aspiration biopsy in preference to histologic biopsy, to avoid explosive spread of the tumour.

Aged↗

Polydioxanone in coronary vascular surgery.

We have used polydioxanone (PDS) in 50 patients who underwent coronary artery bypass grafting. The anastomoses consisted of suturing an autologous vein graft to the coronary artery (122 operations), a vein graft to the aorta (63 operations) and the internal mammary artery to the coronary artery (33 operations). The recipient coronary artery was subjected to endarterectomy in 28 instances. The anastomoses proved to be reliable in the early postsurgical period; no bleeding was attributed to the PDS suture. Clinical follow-up for a maximum of two-and-half years, completed using control coronary angiograms in selected cases, demonstrated good results. The practical properties of PDS were evaluated to be at least as good as those of polypropylene. Experiments have clearly shown that small artery anastomoses heal more favourably after the use of absorbable sutures than after the use of nonabsorbable sutures. Because of this finding and on the basis of our clinical experience, we believe the application of PDS in coronary surgery should be recommended as an alternative treatment.

Adult↗