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  • 1.
    Hedberg, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Funck, Bertil
    Swedish National Food Administration, Food Control Department, Meat Inspection Division, Luleå, Sweden.
    Engström, Karl Gunnar
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Cannulation of the noncalcified aorta generates particles of microembolic nature: an experimental study using pig aorta2008In: Journal of cardiac surgery, ISSN 0886-0440, E-ISSN 1540-8191, Vol. 23, no 1, p. 39-43Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIM OF THE STUDY: Aortic cannulation during cardiac surgery is a potential etiological factor for perioperative stroke. Cannulae may dislodge aortic-wall calcifications. In addition, the sharp edge of the cannula-tip may shear off vessel-wall tissue, which can be expelled into the lumen. This hypothesis concerning source of emboli was tested in a noncalcified aortic perfusion model.

    METHODS: Pig aortas were pressurized and cannulated. Washout samples were collected before and after cannulation (n = 40). Particles were deposited onto a 10-microm filter and evaluated by microscopy and digital image analysis.

    RESULTS: A higher incidence of particles generated by cannulation was noted as compared to before the maneuver (p < 0.001). This increase included small (<0.1 mm, p < 0.001) and intermediate-size particles (0.1-0.5 mm, p < 0.001). Particles above 0.5 mm were few and were not associated with cannulation.

    CONCLUSIONS: Cannulation was a source of embolic material in the noncalcified aortic model. However, these particles were less than 0.5 mm in diameter and may contribute to neurocognitive decline after cardiac surgery.

  • 2.
    Mariscalco, Giovanni
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Sessa, Fausto
    Vanoli, Davide
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Mantovani, Vittorio
    Sandro, Ferrarese
    Sala, Andrea
    Transthoracic echocardiography is adequate for the diagnosis of right coronary artery aneurysms2008In: Journal of cardiac surgery, ISSN 0886-0440, E-ISSN 1540-8191, Vol. 23, no 1, p. 72-74Article in journal (Refereed)
    Abstract [en]

    Coronary artery aneurysms (CAA) are rare but potentially fatal pathologies. This case was referred to our Unit after occasional echocardiographic finding of an intracardiac mass. A new detailed transthoracic echocardiogram was decisive for a diagnosis of a large CAA of the right coronary artery, compressing and dislocating the right atrium. Transesophageal echocardiography was not performed because of the data obtained. The diagnosis was confirmed by cardiac catheterization. The patient was managed with a surgical procedure.

  • 3.
    Tjang, Yanto Sandy
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Tenderich, Gero
    Hornik, Lech
    Körfer, Reiner
    Pediatric heart transplantation: current clinical review2008In: Journal of cardiac surgery, ISSN 0886-0440, E-ISSN 1540-8191, Vol. 23, no 1, p. 87-91Article in journal (Refereed)
    Abstract [en]

    Heart failure has been recognized as a major public health problem. Its incidence and prevalence is increasing and imposes substantial burden on the health care system. Despite much progress in development of many new drugs and innovations in palliative surgical strategy, nontransplant cardiac surgical procedures and the use of mechanical assist devices, pediatric heart transplantation remains the best treatment option for patients with end-stage heart failure. So far, more than 6000 pediatric heart transplantations have been performed worldwide. This article reviews some clinical aspects of pediatric heart transplantation, including the history, indications and contraindications, donor evaluation and recipient management, surgical techniques, risk factors of mortality, and survival of pediatric heart transplantation. The short- and long-term outcomes of pediatric heart transplantation are encouraging. However, the lack of donor hearts still hampers its clinical application.

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