Kati Järvelä

Tampere University Hospital Heart Center

Background: Low-molecular-weight heparin enoxaparin is widely used in pharmacological thromboprophylaxis after coronary artery bypass grafting (CABG). The aim of this study was to compare anti-factor X activity (anti-Xa) levels when the thromboprophylactic dose of enoxaparin was provided after CABG, with two different administration routes: contin...

Introduction There are several potential causes of QRS-axis deviation in the ECG, but there is limited data on the prognostic significance of QRS-axis deviation in ACS patients. Subjects and methods We evaluated the long-term prognostic significance of acute phase frontal plane QRS-axis deviation and its shift during hospital stay in ACS patients....

Introduction: Atrial fibrillation (AF) is a frequent finding in acute coronary syndrome (ACS), but there is conflicting scientific evidence regarding its long-term impact on patient outcome. The aim of this study was to survey and compare the ≥10-year mortality of ACS patients with sinus rhythm (SR) and AF. Methods: Patients were divided into 2...

Objectives. Mediastinal chest tubes are considered to be a significant factor causing postoperative pain after cardiac surgery. The aim of the study was to ascertain whether the duration of mediastinal drainage is associated with postoperative pain and opioid consumption. Design. A total of 468 consecutive patients undergoing cardiac surgery at the...

Background Long-term outcome of real-life acute coronary syndrome (ACS) patients with selected ECG patterns is not well known. Purpose To survey the 10-year outcome of pre-specified ECG patterns in ACS patients admitted to a university hospital. Methods A total of 1184 consecutive acute coronary syndrome patients in 2002–2003 were included and fo...

Background A positive T wave in lead aVR (aVRT+) is an independent prognostic predictor of cardiovascular mortality in the general population as well as in cardiovascular disease. Subjects and methods We evaluated the prognostic impact of aVRT+ in an ECG recorded as close to hospital discharge as possible in acute coronary syndrome patients (n = 5...

Objectives: To evaluate the effect of preoperative malperfusion on 30-day and late mortality, and postoperative complications, using data from the NORCAAD registry. Methods: We studied 1,159 patients who underwent ATAAD surgery between January 2005 and December 2014 at eight Nordic centers. Multivariable logistic and Cox regression analyses were...

Background: Significant fluid retention is common after cardiac surgery with the use of cardiopulmonary bypass (CPB). The aim of the study was to evaluate the effects of hypertonic saline-hydroxyethyl starch (HS-HES) solution on fluid accumulation in patients undergoing coronary artery bypass grafting surgery (CABG). Methods: Fifty adult male pa...

Objectives: To describe the relationship between the extent of primary aortic repair and the incidence of reoperations after surgery for type A aortic dissection. Methods: A retrospective cohort of 1159 patients treated for type A aortic dissection at eight Nordic low- to medium-sized cardiothoracic centers from 2005 to 2014. Data were gathered...

Objective: The authors studied the incidence of postoperative delirium among cardiac surgery patients using the Intensive Care Delirium Screening Checklist (ICDSC). Design: Prospective screening. Setting: Two university hospitals. Participants: A total of 1,036 consecutive patients. Interventions: None. Measurements and main results: Pat...

OBJECTIVES Aortic valve replacement (AVR) surgery is associated with potential risk to cerebral injury. On the other hand, improved cardiovascular functioning after the surgery may have positive impact on brain health. The aim of this preliminary study was to investigate the impact of AVR surgery on cognition, specifically on higher cognitive contr...

Background: The prevalence of persistent post-sternotomy pain (PPSP) varies largely and has been mainly studied using questionnaires. We decided to perform a systematic qualitative and quantitative sensory examination study on a power-calculated sample of patients who had undergone sternotomy for cardiac surgery. Pain was diagnosed as PPSP if the...

Background: Persistent post-sternotomy pain is a common problem, but the risk of developing it varies among patients. We sought to find out whether the risk of persistent post-sternotomy pain could be predicted by measuring the area of acute sensory dysfunction around the sternotomy wound. The secondary aim was to determine risk factors for persis...

In cardiac surgery, postoperative low cardiac output has been shown to correlate with increased rates of organ failure and mortality. Catecholamines have been the standard therapy for many years, although they carry substantial risk for adverse cardiac and systemic effects, and have been reported to be associated with increased mortality. On the ot...

The purpose of this study was to evaluate the accuracy of plasma cystatin C in acute impairment in renal function; plasma cystatin C was compared to plasma creatinine in two hundred patients undergoing elective CABG surgery. We performed a prospective clinical study of two hundred patients undergoing coronary bypass surgery. Plasma creatinine and c...

Cardiopulmonary bypass may have detrimental effects on intestinal function and decrease the concentrations of the active, long-acting metabolites of levosimendan, an inodilator used to improve cardiac function. The aim of this study was to evaluate the haemodynamic effects of preoperative levosimendan in patients undergoing high-risk cardiac surger...

The heart secretes natriuretic peptides (NPs) in response to myocardial stretch. Measuring NP concentrations is a helpful tool in guiding treatment. It has been suggested that sodium ion and hyperosmolality could affect NP excretion. If this is true, peri-operative NP measurements could be inconsistent when hypertonic solutions are used. With diffe...

The aim of the present study was to test the hypothesis that levosimendan has beneficial effects on cardiac performance and that the need for other vasoactive medications during and after cardiac surgery would be reduced by levosimendan in patients with severe aortic stenosis (AS) and left ventricular (LV) hypertrophy. A prospective, randomized, do...

Cardiac surgery is a stress that causes insulin resistance, which leads to an increase in insulin requirement. The aim of the present study was to evaluate the effect of a pre-operative oral carbohydrate drink vs. overnight fasting on perioperative insulin requirements in non-diabetic patients undergoing elective coronary artery bypass grafting (CA...

Patellar tendon rupture after total knee arthroplasty is a rare, but often catastrophic complication. Many different reconstruction techniques of patellar tendon rupture have been described with variable and often discouraging results. A case report with patellar tendon rupture after a total knee arthroplasty is presented. Also, an alternative surg...

This study evaluated the effects of 7.5% saline on plasma and other extracellular fluid volumes. After baseline measurements, eight healthy postmenopausal female volunteers received 4 ml.kg-1 of hypertonic saline over 30 min. After the fluid infusion, the volunteers were studied for 60 min. Plasma volume was measured using a dilution of 125-iodine-...

Twenty patients with lateral ankle instability were treated by a novel anatomical reconstruction technique (group A) and the results compared with 20 patients (group B) who, during the same period of time, underwent primary repair of ruptured lateral ligaments of the ankle. We reviewed 15 patients from group A and 17 patients from group B at a mean...

To compare the effects of 7.5% hypertonic saline (HS) and 0.9% normal saline (NS) on perioperative weight gain in cardiac surgical patients. Prospective, randomized study. University teaching hospital. Patients (n = 72) scheduled for elective coronary artery bypass graft surgery. Patients were randomly assigned to receive either 7.5% HS (36 patient...

In order to evaluate graft placement of the anterior cruciate ligament (ACL) reconstruction and its relationship to the clinical outcome of the patient, 100 patients were examined 7 years after an ACL reconstruction. Clinical assessment was performed using the standard knee ligament evaluation form of the International Knee Documentation Committee...

Prevention of hypotension during spinal anaesthesia is commonly achieved using fluid preloading. This may result in a substantial amount of excess free water retained in the body after spinal anaesthesia. We aimed to evaluate the effects of 7.5% hypertonic saline on extracellular water volume and haemodynamics when used for fluid preloading before...

To compare the effects of hypertonic (7.5%) saline (HS), normal (0.9%) saline (NS), and 6% hydroxyethyl starch (HES) on extracellular fluid volumes in the early postoperative period after cardiopulmonary bypass. A prospective, randomized, double-blind study. University teaching hospital. Forty-eight patients scheduled for elective coronary artery b...

Patients undergoing coronary artery bypass grafting often require volume loading after operation. In this situation hypertonic saline may be beneficial in restoring the haemodynamic balance and removing excess extravascular fluid. Forty coronary artery bypass grafting patients were randomly assigned to receive either hypertonic saline 7.5% (20 pati...

Hypertonic saline can be used for initial fluid administration before spinal anesthesia. It is effective in small-volume fluid resuscitation. This randomized double-blinded study compared the effects of 7.5% hypertonic saline (HS) and 0.9% normal saline (NS) in doses containing 2 mmol/kg of sodium in 40 ASA physical status I-II patients undergoing...

Mononukleoosi on Epstein–Barrin viruksen aiheuttama yleinen ja tavallisesti viaton in-fektio, jonka tyypillisinä oireina ovat katteinen eksudatiivinen nielutulehdus, imusolmuk-keiden turvotus ja korkea kuume. Taudinkuvaan liittyy joskus harvoin myös maksatu-lehdus. Mononukleoosin tarttuminen vaatii limakalvokontaktin. Tauti on yleensä lievä infekti...