Search PubMed⌕ Search

Biomedical subjects

P G Bjørnstad

Publications and source records attributed to P G Bjørnstad.

At least 19 recordsLinked to original sources
PubMed2000

[Catheter closure of open ductus arteriosus--the first 100 patients].

BACKGROUND: Patent ductus arteriosus is increasingly treated with catheter based techniques. We present our results as by the end of 1998 of the first 100 patients given such treatment. MATERIAL AND METHODS: The 100 patients between 0.6 and 31.4 years were initially treated with one of these devices: The Rashkind umbrella (60 patients), Cook PDA coils (31 patients) or Amplatzer ductal occluders (ten patients). Seven umbrella patients were treated twice, one with an additional umbrella, six with coils; two coil patients twice, one with another coil and one--after embolisation--with a peg. RESULTS: The overall complete closure rate for all groups was 90% after nine patients had been treated a second time. The primary complete closure rate in pegs was 100%, after reintervention 85% in umbrella and 97% in coil patients. Neither umbrellas nor pegs have embolised. One coil embolised in the course of implantation of 40 coils (2.5%). No other complication has occurred. INTERPRETATION: The closure of the arterial duct with catheter techniques compares favorably with surgery and is now established as the method of choice. Following the investigational introduction of pegs there is no longer an upper limit in the size of ducts suitable for such treatment.

Adolescent↗
PubMed1997

[Catheter treatment of congenital heart defects. Arterial septal defects and open ductus arteriosus].

The results of new methods for catheter treatment of congenital heart defects are presented. Between 1989 and 1996 closure of a patent ductus arteriosus was performed in 66 instances on 63 patients, eight of which were with coils. Three patients were treated twice, one with an additional umbrella, two with coils. The overall complete closure rate for umbrellas was 75%, after two ducts, which were initially totally occluded, recanalized. In six more patients the procedure was either aborted or indication was not present. All six ducts treated with coils as the first procedure were completely closed. One of two patients who had residual leak after previous umbrella treatment achieved complete closure after subsequent coil implantation. Closure of atrial septal defects in the oval fossa was performed using the Amplatzer septal occluder in seven children. Complete closure was achieved in all of them. There have been no complications, in particular there have been no cases of embolization in any of the groups. The results seem to indicate that coil occlusion of a persistently patent duct may be at least as good as the umbrella in terms of complete closure. So far both methods have been safe, but experience with coils is limited. The closure of atrial septal defects shows encouraging results. We will continue to offer this treatment as an alternative to open heart surgery in carefully selected patients.

Adolescent↗
PubMed1996

Cardiac findings in generalized lipodystrophy.

The cardiac findings in eight patients, two of whom were female, with total lipodystrophy (Berardinelli-Seip's disease) are reported. One of them had the acquired form of the disease. Four patients died at a mean age of 32 years. As far as we know, at least three of them most likely died for cardiac reasons, one shortly after recovering from an attempted suicide. All eight patients had hypertrophic hearts, mostly with deranged diastolic, but also systolic, function. One had pulmonary hypertension. We conclude that generalized lipodystrophy is a serious disease with cardiac affection leading to cardiac dysfunction and early death. There is no specific cardiac treatment, and the treatment should be according to the general guidelines for patients with hypertrophic, dysfunctioning hearts.

Adult↗
PubMed1994

[The "umbrella closure" of the ductus arteriosus].

The technical details of the method are outlined, and the Norwegian experience reported: From September 1988 to January 1994 we attempted to close open ducts with the Rashkind technique in 26 patients. Two ducts were too small to accept the device, and in one case the implanted device could not be released. This patient was referred to surgery. In the remaining 23 patients the device was left in place. The mean X-ray fluoroscopy time was 15 minutes. No complications occurred. In eight patients (35%) a residual shunt could be detected by ultrasonic Doppler technique, but in seven of them haemodynamical significance was lacking. The umbrella method is a good alternative to traditional treatment.

Adolescent↗
PubMed1994

[Williams-Beuren syndrome in Norway].

The author describes the Williams-Beuren syndrome and the cases of 57 patients in an attempt to increase awareness of the syndrome, which probably is underdiagnosed. Its characteristic features are a combination of a special facial appearance and a mental condition: The face typically shows a broad, flattened upper lip, small chin, and hypoplasia of teeth, often strabism, flattened nasal bridge and fullness around the eyes. Mentally the patients appear to be happy, talkative, pleasant children, who are indiscriminatingly friendly and have serious difficulties in concentrating. Only 53% of the patients have an affected heart, of whom 93% have supravalvular aortic stenosis, peripheral pulmonic stenoses or combinations of the two. Nine patients have had heart operations. The facial features in children of different age groups and races are depicted.

Abnormalities, Multiple↗
PubMed1993

[Hypoplastic left heart syndrome. Present experiences and future possibilities].

The authors report experiences from Norwood's staged palliation for hypoplastic left heart syndrome performed in Philadelphia on Norwegian children. Although there is no universal agreement that these children should be operated at all, the Norwegian health authorities have decided that all expenses for transport, examination and treatment shall be covered by the National Health Insurance Scheme. Since 1987 a total of 21 children have been transported to USA for operation. Eight of these children have completed all the planned stages of the operative treatment. Two are waiting for stage 3. 11 children have died. The authors discuss how to proceed with regard to treatment of this complicated patient group in future.

Atrial Function, Left↗
PubMed1993

Mental health and psychosocial functioning in adolescents with congenital heart disease. A comparison between adolescents born with severe heart defect and atrial septal defect.

Twenty-six adolescents, aged 13-18 years, with severe congenital heart disease were matched for sex, age and living area with 26 adolescents with repaired atrial septal defect and regarded as physically fit. These two groups were compared according to somatic condition, psychopathology, psychosocial functioning and chronic family difficulties. A higher rate of psychiatric problems in the complex group, an association between psychosocial functioning and physical capacity, as well as an association between psychosocial functioning and chronic family difficulties were observed. These findings suggest that physical capacity is of crucial importance for mental health and functioning of adolescents with congenital heart disease. The association with chronic family difficulties also suggests that a comprehensive biopsychosocial approach is necessary in the treatment and rehabilitation of these patients.

Adolescent↗
PubMed1990

[Percutaneous closure of ductus arteriosus using the umbrella technic].

In four patients between three and five years of age we performed closure of open ductus arteriosus with the Rashkind umbrella technique after percutaneous approach from the right groin. The smallest internal ductus diameter measured between 2 and 4 mm, and pulmonary blood flow was from 1.4 to 2.0 times systemic flow. In all four patients, pulmonary artery pressure was normal. In three patients the ductus arteriosus was completely closed, in the fourth a small residual shunt persisted. There were no complications. We describe the method in detail.

Catheterization↗
PubMed1989

Senning operation for transposition of the great arteries in the first month of life.

Twelve patients with uncomplicated transposition of the great arteries were operated upon in the first month of life following an initial Rashkind procedure. They were all in a clinically unacceptable condition and were mostly acidotic or bad mixers without acidosis. Two patients died postoperatively from a cerebral haemorrhage not discovered prior to operation. One patient died 5 months postoperatively from bronchiolitis. At postoperative follow-up, all patients were asymptomatic. Cardiac catheterization showed that 1 patient had a significant upper caval vein stenosis, 2 patients had small atrial shunts, and 1 patient had an unimportant pulmonary stenosis. Innocent atrial rhythm disturbances were encountered in 1 case only, whereas 9 patients had normal sinus rhythm at the last examination. The Senning operation remains a good alternative for transposition repair in the neonate.

Acidosis↗
PubMed1988

Balloon dilatation of pulmonary artery banding in dogs: an experimental study.

The technique at our institution for banding of the pulmonary artery (PA) makes debanding by balloon dilatation theoretically possible. Previously we tested this hypothesis in an in vitro study (see previous article in this issue). This study describes balloon dilatation in dogs. Eight Labrador Retriever dogs had a PA band placed early in life, and when their body weight had doubled, they were restudied and debanded by balloon dilatation or surgical removal. One dog died of a virus infection before debanding and was excluded from the study. Five of the dogs (groups 1 and 2) underwent balloon dilatation with satisfactory relief of the gradient across the PA band. Two dogs (group 3) underwent surgical debanding without a plastic procedure on the PA, and this also produced satisfactory relief of the gradient. All dogs in group 2 and 1 dog in group 3 were studied 3 months later, and 1 dog in group 2 was also studied 6 months after the debanding procedure. The systolic pressure gradient fell from a mean of 54 to 18 mm Hg after the debanding procedure. There was no difference in the gradient after debanding in the balloon group compared to the surgical group.

Animals↗
PubMed1988

In vitro balloon dilatation of the banded pulmonary artery.

The pulmonary artery of unfixated human heart-lung specimens was banded by placing a Dacron tape around the artery and securing the tape with a 5.0 Prolene suture at selected circumferences. The banding was successfully dilated with a balloon catheter in 24 instances. The mean pressure necessary to burst the suture securing the tape was 2.4 atmospheres.

Catheterization↗
PubMed1988

Aortic wall lesion in balloon dilatation of coarctation of the aorta.

A successful balloon dilatation of a native coarctation of the aorta was done in a five-day-old child. Two days later she was operated upon because of critical aortic stenosis, but died. The post-mortem examination showed a lesion of the intima and media at the coarctation site, and it seemed that the adventitia alone was what prevented rupture of the vessel.

Aortic Coarctation↗
PubMed1988

Surgical repair of aortico-left ventricular tunnel (ALVT).

ALVT is a very rare congenital malformation. Until 1983 a collective review reported only 37 cases published. A 5-month-old girl with a body weight of 5.5 kg was referred for cardiomegaly and cardiac murmur. 2D-echo revealed the diagnosis which was later confirmed by angiography. The child was then operated upon with extracorporeal circulation using deep hypothermia (20 degrees C). The aortic orifice of the tunnel was closed with 3 pledget reinforced sutures. Cross-clamp time was 17 min. Electromagnetic flowmetry suggested an insufficiency of 78% preoperatively, and postoperatively this was reduced to 6%. Angiography was performed two weeks postoperatively, revealing mild valvular aortic insufficiency. She was discharged from the hospital 15 days postoperatively. ALVT should be corrected surgically as soon as the diagnosis is made.

Aorta↗