[Surgical treatment of angina pectoris. II. Results of a follow-up study of 175 consecutive patients admitted for operation].
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Biomedical subjects
Publications and source records attributed to T Haghfelt.
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The effect of coronary artery bypass surgery (CAB) on ventricular arrhythmias (VA) was studied in a prospective investigation involving 32 patients (mean age 54 years) who underwent CAB because of severe stable angina pectoris. Prior to CAB as well as 12 months later each patient was subjected to the following investigational programme: resting ECG, exercise ECG, 24-h ECG, selective coronary arteriography, ventriculography and cardiac catheterization. Exercise ECG showed VA in only three patients. The prevalence of VA during 24-h ECG was 56 and 66% on the two occasions (NS), while complicated VA (multiform, repetitive, R on T) was seen in 18 and 28%, respectively (NS). The persistence (number of 6-h periods showing VA) was 33 and 47% with regard to any VA (P less than 0.05), while complicated VA occurred in 13 and 15% of the 6-h periods (NS). Except for an increase in dp/dtmax/P at the postoperative measurement (P less than 0.05), no significant change in the performance of the left ventricle was seen after CAB though the graft patency was 77%. It is concluded that in patients with 'medically intractable' stable angina pectoris, CAB does not effect the occurrence of VA to any great extent--probably because left ventricular function is unchanged one year after as compared with that prior to CAB.
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In 404 consecutively admitted patients with their first myocardial infarction (MI), intraventricular block (IV) was a complication in 124 (31%). The following types of block were encountered: 21 (5%) had left bundle-branch block (LBBB), 73 (18%) left anterior hemiblock (LAH), 13 (3%) left posterior hemiblock (LPH); 7 (2%) right bundle-branch block (RBBB); 9 (2%) RBBB + LAH, and 1 (0.3%) RBBB + LPH. Patients with IV block at the time of admission did not develop total atrioventricular block more frequently in the acute phase of MI (0-30 days) or in the follow-up period (3-5 years) than patients without IV block. During the acute phase, only patients with RBBB with or without hemiblock showed significantly higher mortality than patients without IV blocks. The other types of IV block did not influence the short-term prognosis. Among patients who survived the acute phase, significantly lower long-term survival rates were found in patients with LBBB compared to patients without IV block, whereas the presence of LAH did not affect the long-term prognosis.
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Twenty-one males between 16 and 50 years of age were admitted during a five year period and treated for a corneal perforation and traumatic cataract. One did not attend the follow-up examination. Five patients were not offered contact lens owing either to their occupation or to bad visual acuity. Twelve patients were offered contact lens, but only four patients made permanent use of them and have good binocular function. Three patients were given an intraocular lens, two of these with good results. Many of the patients had considerable problems at work, and there appears to be a certain amount of relationship between the length of the sick leave and their later employment. Half of the patients had to change their occupation either totally or partly. Social security and social problems are discussed.
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