Open distal anastomosis in conjunction with partial cardiopulmonary bypass and mild hypothermia for repair of descending thoracic aortic aneurysms.

The duration of spinal cord ischemia is probably the most important single factor in the pathogenesis of paraplegia after repair of descending thoracic aortic aneurysms. We describe a modification of open distal anastomosis technique originally presented by Dr. Cooley, in which we use partial cardiopulmonary bypass with femoral cannulation and mild hypothermia.

Life-threatening Mycoplasma hominis mediastinitis.

Mycoplasma hominis infections are easily missed because conventional methods for bacterial detection may fail. Here, 8 cases of septic mediastinitis due to M. hominis are reported and reviewed in the context of previously reported cases of mediastinitis, sternum wound infection, pleuritis, or pericarditis caused by M.

Heart transplantation in Finland 1985-1995.

Background And Aims: Since improved immunosuppression in the 1980's, heart transplantation is a well established procedure to treat patients with end-stage heart failure. The first heart transplantation in Finland was performed in 1985. Since then the activity has gradually increased to a level of about 25 annual transplants.

Prosthetic bifurcation grafting in occlusive and aneurysmal aortoiliac disease--a follow-up study.

A comparative clinical study was made of patients undergone prosthetic bifurcation grafting for non-ruptured abdominal aortic aneurysm n = 135 or aortoiliac occlusive disease n = 180 between January 1982 and December 1986. Patients in aneurysmal group were older, predominantly men, had hypertension more often and had better distal run-off at the time of operation. Smoking was over-presented among aortoiliac occlusive disease patients.

Posterolateral diaphragmatic hernia in adults--acute symptoms, diagnosis and treatment. Case report.

Acute herniation through a posterolateral diaphragmatic defect is rare in adults. Two cases in which such herniation occurred by sudden inversion, a 29-year-old man and a 17-year-old girl, are presented. The symptoms, diagnosis and treatment are discussed.

Hematuria is an indication of rupture of an abdominal aortic aneurysm into the vena cava.

During a period of 13 years 11 patients were operated on because of a spontaneous aortocaval fistula caused by a ruptured abdominal aortic aneurysm. The classic diagnostic signs of an aortocaval fistula (pulsatile abdominal mass with bruit and high output heart failure) were present in approximately half of the patients, whereas hematuria was a constant finding in all patients. Six patients had macrohematuria, and five had microhematuria.

Diagnosis and treatment of subclavian artery aneurysms.

The diagnostic features and operative results in 13 patients with subclavian artery aneurysms were analysed. Symptoms related to subclavian artery aneurysms were present in seven patients, whereas six patients were asymptomatic and the aneurysm was discovered incidentally on chest X-ray. Angiography was the most valuable diagnostic examination and was also necessary in planning the operation.

Long-term follow-up of St. Jude Medical valve.

St. Jude Medical bileaflet valve replacement was performed on 182 patients--aortic in 90, mitral in 70, both sites in 20 and tricuspid in two. The 30-day mortality was 4.

Indications for and risks in reoperation for coronary artery disease.

Seventy-one coronary artery bypass grafting (CABG) reoperations were performed during a 17-year period, comprising 2.7% of all CABG operations. The main indication (in 87%) was vein graft failure alone or combined with other causes.

Primary cardiac tumours--operative treatment of 20 patients.

This report describes a series of 20 patients operated on for a primary cardiac tumour. The majority of the tumours (16) were benign myxomas; 12 of them were located in the left atrium, two in the right atrium and two were biatrial. Two lipomas were found; one was epicardial and the other was located in the left atrium.

Surgical technique and operative mortality in coronary artery bypass. A postmortem analysis with castangiography.

Post-mortem analysis with castangiography was performed on 54 patients who died within 30 days of coronary artery bypass surgery. Myocardial failure was the cause of 85% of the deaths. There were 215 coronary anastomoses (4.

Primary tumours of the sternum.

In 1966-1986, two men and four women (mean age 47.5 years) underwent surgery for primary sternal tumour. Three of the tumours were benign (two condromata, one osteochondroma) and three were malignant (two chrondrosarcomata, one reticulum cell sarcoma).

Results of reoperations for coronary artery disease.

Seventy-one patients undergoing reoperation for coronary artery disease were examined on average 2.5 years postoperatively. Operative mortality was 9.

Management of vascular complications in thoracic outlet syndrome.

Arterial complications of thoracic outlet syndrome (TOS) were surgically treated in 11 patients (12 limbs) and venous complications in five (6 limbs). Arteriography showed total occlusion or significant stenosis of the subclavian artery in eight patients (bilateral in 1), with complicating peripheral thrombosis in three. Two patients had unilateral subclavian artery aneurysm: One was the patient with bilateral subclavian occlusion, and the other also had brachial artery embolism.

Primary tumours of the ribs.

Thirty-four primary rib tumours (24 benign, 10 malignant) were surgically treated in 1966-1985. The mean age was higher and the tumour diameter was greater in the patients with malignant, than in those with benign neoplasm. The benign tumours were excised without operative death.

Hypothermia and circulatory arrest in reconstruction of aortic arch. A report of nine cases.

From 1982 until October 1985 we operated 9 cases of aortic aneurysm involving the transverse aortic arch (5 male and 4 female, from 26 to 69 years). Two patients had an acute dissecting aortic aneurysm, the others had an aneurysm of the aortic arch involving also the ascending aorta in 5 cases and the descending aorta in 1. Three patients underwent aortic valve replacement and implantation of coronary orifices.

Cardiorespiratory function after correction of tetralogy of Fallot. Modifying effect of previous shunt operation.

Of 28 patients with total surgical correction of tetralogy of Fallot in adult life, 22 had previously undergone Blalock-Taussig shunt operation. Possible modifying effects of the shunt on pulmonary ventilation and perfusion and on exercise tolerance were investigated with spirometry, radiospirometry and bicycle ergometry. The observed ventilatory volumes and capacities and diffusing capacity were significantly lower than the predicted values.

Correlation of NYHA classification, bicycle ergometry and right heart haemodynamics after total correction of tetralogy of Fallot in adults.

Thirty-two patients who had undergone correction of Fallot's tetralogy in adult life were examined on average 6.3 years postoperatively, at mean age 25.8 years.

Surgical treatment of occlusion of the infrarenal abdominal aorta. Experience with 55 patients.

A series of 55 patients with occlusion of the infrarenal abdominal aorta operated on in the 15-year period 1966-1980 is presented. The type of operation was an extra-anatomic reconstruction in four cases and some type of anatomic repair in 51 cases. The operative mortality was 5.