SATS 2009 Final Program - Scandinavian Association for Thoracic ...

Final Programme & Abstracts 

First Joint Scandinavian Conference 

in Cardiothoracic Surgery 

The 58 th Annual Meeting of the Scandinavian Association for Thoracic Surgery (SATS) 

The 29 th Annual Meeting of The Scandinavian Society of Extra Corporeal Technology (SCANSECT) 

The 2 nd Annual Meeting of The Scandinavian Associaton of Thoracic Nurses (SATNU) 

The annual meetings for The Swedish Association for Cardiothoracic Surgery and 

The Swedish Association for Cardiothoracic Anesthesiology and Intensive Care 

STOCKHOLM August 20-22 2009 

www.sats2009.org

Organisation 

Organizing Committee Scientific Committees 

Dan Lindblom (chairman, surgeon) 

SATS 

Jan Hultman (Conference president, anesthesiologist) 

Ulf Lockowandt (surgeon) 

Sten Samuelsson (anesthesiologist) 

Anders Albåge (surgeon) 

Jan van der Linden (anesthesiologist) 

Ulrik Sartipy (surgeon) 

SCANSECT 

Per Stensved (president of SCANSECT) 

Conny Rundby 

Pia Vanhanen 

SATNU 

Susann Edvinsson Larsson (president of SATNU, OR) 

Birgitta Martinsson (anest.) 

Jennie Sandberg (ICU) 

Sofia Lorentzi (ward) 

PHYSIOTHERAPISTS SESSION 

Ulrika Thunström 


Timo Savunen (Secretary general, surgeon) 

Anders Jeppsson (surgeon) 

Daniel Steinbrüchel (surgeon) 

Odd Geiran (surgeon) 

Jari Laurikka (surgeon) 

Tómas Guðbjartsson (surgeon) 

Jan van der Linden (anesthesiologist) 

Knut Kirkebøen (anesthesiologist) 

SCANSECT 

Anne Louise Bellaiche (chairperson) 

Micael Appelblad 

Vivian Høyland 

Líney Símonardóttir 

Peter Fast Nielsen 

SATNU 

Marita Ritmala-Castrén (chairperson) 

Gunilla Barr 

Liselotte Brahe 

Kari Hanne Gjeilo

Table of contents 

Awards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 06 

Programme Overview . . . . . . . . . . . . . . . . . . . . . . . 07 

Scientific Programme . . . . . . . . . . . . . . . . . . . . . . . 11 

Invited Speakers . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 

Registration and hotel accommodation ..........18 

Social Programme ..........................20 

General information .........................22 

Transportation .............................23 

Visiting Stockholm ..........................24 

Kistamässan Overview . . . . . . . . . . . . . . . . . . . . . . 26 

Exhibition .................................28 

Sponsors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 

Author's Index .............................31 

Abstracts .................................37 

Conference and Exhibition Secretariat 

MCI Stockholm Office 

P.O. Box 6911 

SE-102 39 Stockholm, Sweden 

Phone: + 46 8 5465 1500 

Fax: +46 8 5465 1599 

E-mail: confirmation-sweden@mci-group.com 

All correspondence to the Organizing Committee may be sent to the Conference secretariat for further distribution. 

STOCKHOLM, SWEDEN 3 

Stockholm Visitors Board - Olof Holdar

Dear Friends and Colleagues 

On behalf of SATS, it is a pleasure and privilege to welcome you to the annual SATS, SCANSECT 

and SATNU meeting in Stockholm, August 20-22. 

We are proud to present this event as the 

“First Joint Scandinavian Conference in Cardiothoracic Surgery” 

In modern cardiothoracic surgery the importance of the teamwork approach is evident. Accordingly, 

we have tried to make the programme interesting for all attendants regardless of field of expertise 

in cardiothoracic surgery and its clinical challenges. The national and international response to this 

approach has been good. This year we welcome an unusually large number of anesthesiologists 

to the meeting and the number of nurses has more than doubled since last year. In addition we 

welcome a group of physiotherapists with a special interest in cardiothoracic surgery. The large 

number of participants is probably also a result of this conference being a joint venture with 

the Swedish Associations for Cardiothoracic Surgery and Cardiothoracic Anaesthesiology and 

Intensive Care. Consequently we should have enough prerequisites for interesting discussions 

among delegates with different experiences and approaches to everyday clinical issues in the 

fascinating, complicated and developing field of cardiothoracic surgery. 

We have been very fortunate in attracting well-known international lecturers in all topics of the meeting. 

Just in mentioning the main topics I would like to express special thanks to Prof. Gerald Buckberg and 

Prof. Anelechi Anyanwu, who will take part in The Right Heart topic on Thursday. For the second main 

topic on Saturday Prof. Ottavio Alfieri and Francesco Maisano, will guide us through the evolving 

Transcatheter Techniques for Heart Valve Diseases. 

Apart from the scientific programme I hope you all will find the social programme attractive. 

Stockholm has a lot to offer and I think all of you will enjoy the city. With all the respect to our Italian 

colleagues, Stockholm is sometimes referred to as “The Venice of the North”. True or not, there is 

plenty of water in and around the city and it’s clean enough for a swim. 

The Organizing Committee at The Department of Cardiothoracic Surgery and Anaesthesiology, 

Karolinska University Hospital, has done a great job in making this event possible. In this I would 

like to thank all colleagues for their contributions. Many thanks to the MCI group here in Stockholm, 

a true professional Congress Organizer. Also special thanks to the generosity from sponsors of the 

conference. 

Once more, welcome to the "First Joint Scandinavian Conference in Cardiothoracic Surgery" in 

Stockholm, August 20-22, 2009 

Jan Hultman 

Conference President 

4 www.sats2009.org

Transcatheter 

Valve 

CardioVascular. Innovation through Collaboration. 

Ventor valve is not approved yet and still under clinical trial. 

UC201001044EE

Awards 


C.W.Lillehei Young Investigators Award 

Sponsored by St. Jude Medical, the prize of USD 5000 is given to the best young investigator abstract, according 

to a decision of the board of SATS scientific committee. 

The Karl Victor Hall Award 

Sponsored by Medtronic, the prize of USD 5000 is given to the best abstract. Candidates may be members or nonmembers 

of SATS, but the author should have Nordic nationality or residency in a Nordic country. The selection is 

made by the board of SATS scientific committee. 

SCANSECT 

Medtronic Best Perfusionist Paper Presentation Award 

This is the prize for the best perfusionist paper presentation. The award is of €1000 and is sponsored by Medtronic. 

Sorin Group Best First Time Perfusionist Presenter Award 

This prize is awarded the best presentation by a perfusionist who presents for the first time at an international 

meeting. The award is of €500 and is sponsored by the Sorin Group. 

SCANSECT Best Perfusion School Graduation Paper Presentation Award 

This prize is awarded a perfusionist for the best school graduation paper presentation. The award is of €500 and is 

sponsored by SCANSECT. 

Maquet Best Case Report Presentation Award 

This is the award for the best case-report presented by a perfusionist. The award is of €500 and is sponsored by 

Maquet Cardiopulmonary. 

Terumo Best Perfusion Poster Presentation Award 

This is awarded for the best poster presented by a perfusionist. The award is of €300 and is sponsored by Terumo. 

SATNU 

Mölnlycke Best Nursing Speaker/Poster Travel Award 

Given for the best speaker/poster presented by a nurse. The travel award is SEK 5000 and is sponsored by Mölnlycke. 

ADDITIONAL AWARDS 

In addition to these Scandinavian awards there are also some awards specific for the Swedish Associations of 

Cardiothoracic Surgery and Cardiothoracic Anesthesiology and Intensive Care. 

• Edwards Life-Sciences travelling grant on SEK 15000 for education in valve surgery 

• Octopus Limedic travelling grant on SEK 15000 for best presentation at the meeting 

• Orion Pharma´s award on SEK 15000 for the best anesthesiological presentation 

• “Cardiothoracic Anesthesiologist of the year” – an award on SEK 5000 from the Swedish Association for 

Cardiothoracic Anesthesiology and Intensive Care 


Programme overview 

Thursday, 20 August 2009 

SCANSECT SATNU Physiotherapists 


Opening ceremony and Welcome 

13:00-13:30 

Timo Savunen, Secretary General SATS 

Jan Hultman, Conference President 

Per Stensved, President SCANSECT 2009 

Susann Edvinsson Larsson, President SATNU2009 

Main topic 1: The Right heart 

Moderators: Ulf Lockowandt and Anders Jeppsson 

Speakers: 

Gerald Buckberg; The Right Ventricle; from Structure to Function 

Jan Hultman; Evaluation of Right Ventricular Function 

Lars Algotsson; Peri- and Post-operative Right Ventricular Failure 

Anelechi Anyanwu; Surgery for Functional Tricuspid Regurgitation 

13:30-15:30 

Pause; visit the exhibition! 

15:30-16:15 

Introduction of the 2009 Clarence Crafoord lecturer 

Lars Wiklund, Chairman of the Swedish Association for Thoracic Surgery 

2009 Clarence Crafoord lecture 

Professor Gerald Buckberg, UCLA 

A Unifying Geometric Approach to Dilated Cardiomyopathy from Many Causes 


16:15-16:30 

16:30-17:30 

Gala Dinner at Solliden, Skansen 

19:30 

Individual transportation

Programme overview 

Friday, 21 August 2009 



08:30-13:00 08:30-10:00 

08:30-10:15 08:30-10:00 08:30-09:00 

Oral abstract session 

Symposium; Weaning from long- Oral abstract session Introduction 

Moderators: Eva Berglin and Jan van der Linden 

term assist devices Moderators: Moderators: Unni Kleppe Ulrika Thunström 

Six abstracts nominated for the C.W Lillehei and K.V.Hall awards Laila Hellgren-Johansson and Haukeland and Marita 09:00-09:45 

Peter Svenarud Speakers: Lars Ritmala-Castren 

National guidelines for 

Lund, Asghar Khaghani , Conny 10:00-10:30 

chest physiotherapy 

Rundby, Maria Eriksson 

Invited lecture 

Charlotte Urell 

Waiting for heart surgery 9:45-10:30 

Bodil Ivarsson 

Current practice for 

Introduced by Gunilla Barr chest physiotherapy 

Elisabeth Westerdahl 

Pause 10:00-10:20 

Pause 10:15-10:45 

Pause 10:30-11:00 Pause 10:30-11:00 

10:20-11:30 10:45-13:00 11:00-13:00 11.00-11.30 

Oral abstract session (Cardiac) 


Oral abstract session Smärta, lungfunktion 

Moderators: Odd Geiran and Åsa Haraldsson 

Moderators: Per Stensved and Moderators: Anita Tracey och opiater 

Else Nygren 

and Lotte Brahe 

Maria Antonsson 

Introduced by Sofia 

Pause 11:30-11:50 

Broman 

11:50-13:00 11:50-13:00 


Oral abstract session (Basic 

(Cardiothoracic) Moderators: science) Moderators: Gabriella 

Tómas Guðbjartsson and Kristiina Lindvall and Ulrik Sartipy 

Hersio 

8 www.sats2009.org 

13:00-14:15 

Lunch, visit the exhibition! 

Symposium; Humanitarian Work in Cardiac Surgery 

Moderators: Dan Lindblom and Eva Ahlgren 

Speakers: 

Stefan Peterson; Impact of Cardiovascular Diseases in Developing Countries 

Sylvain Chauvaud; Experiences by Chaine de l´espoir 

Gino Strada; Experiences by Emergency 

Coffee; visit the exhibition! 

14:15-15.45 

Exchange of 

experiences 

Moderators; Ulrika 

Thunström and Sofia 

Broman 

Invited lecture 

Psychosocial aspects of 

heart failure 

Anna Strömberg 

Introduced by Anita Tracey 

Invited Lecture; 

Long Term Assist Devices 

previous, current and forecast 

Heinz-Hermann Weitkemper 

Introduced by Anne-Louise 

Bellaiche 

15:45-16:15 

16:15-17:15 Invited Lecture 

Critically Interpreting the 

mitral literature 

Anelechi Anyanwu 

Introduced by Sten Samuelsson 

Awards and pre-dinner party 

17:30-18:45 

Buses leave from Kista-mässan 

Buffet dinner at the Stockholm City Hall 

Steamboat tour in the Stockholm Archipelago 

18:45 

19:30 

21:15

Saturday, 22 August 2009 



08:30-10:00 Cardiogenic shock in myocardial Infarction 

Invited lecture Oral abstract 

Moderators; Anders Albåge and Jan Hultman 

Reducing VAP session 

Speakers: 

in the ICU Moderator; 

Lars Lund; Background and Current Guidelines for Intervention 

Eva Joelsson Alm Gun Faager 

Lars Wiklund; Revascularization and Other Surgical Options 

Introduced by Gunilla Barr 

Asghar Khaghani; Mechanical support 

General assembly 

10:00-10:30 General assembly 

General assembly 

09:30-10:30 

10:30-11:00 

Pause; vixit the exhibition! 

11:00-13:00 

Main topic 2; Transcatheter Valve Techniques 

Moderator: Anders Jönsson 

History and Future of Aortic Valve Implantation 

Speaker: Ottavio Alfieri 

Invited discussant: Kenneth Pehrsson 

History and Future of Mitral Valve Interventions 

Speaker: Francesco Maisano 

Invited discussant: Reidar Winter 

13:00-13:15 

Closing remarks 

Jan Hultman 

15:00-16:00 Visit at Karolinska. Contact 

Susann Edvinsson Larsson 

(susann.edvinssonlarsson@satnu.org) 

if you 

are interested 

STOCKHOLM, SWEDEN 9

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Scientific Programme 

THURSDAY, 20 AUGUST 2009 

13:00 - 13:30 Opening Ceremony Lecture room M2 

Welcome 

Timo Savunen, Secretary General SATS 

Jan Hultman, Conference President 

Per Stensved, President SCANCSECT 2009 

Susann Edvinsson Larsson, President SATNU 2009 

13:30 - 15:30 Main topic 1: The Right heart Lecture room M2 

Moderators: Ulf Lockowandt and Anders Jeppsson 

Speakers: 

Gerald Buckberg; The Right Ventricle; from Structure to Function 

Jan Hultman; Evaluation of Right Ventricular Function 

Lars Algotsson; Peri- and Post-operative Right Ventricular Failure 

Anelechi Anyanwu; Surgery for Functional Tricuspid Regurgitation 

15:30 - 16:15 Pause; visit the exhibition! 

16:15 - 16:30 Introduction of the 2009 Clarence Crafoord lecturer Lecture room M2 

Lars Wiklund, Chairman of the Swedish Association for Thoracic Surgery 

16:30 - 17:30 2009 Clarence Crafoord lecture Lecture room M2 

Professor Gerald Buckberg, UCLA 

A Unifying Geometric Approach to Dilated Cardiomyopathy from Many Causes 

19:30 Gala Dinner at Solliden, Skansen 

Individual transportation. 


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FRIDAY, 21 AUGUST 2009 

08:30 - 10:00 S01 SATS Award nominees’ Oral abstract session Lecture room M1 

Moderators: Eva Berglin and Jan van der Linden 

Six abstracts nominated for the C.W Lillehei and K.V.Hall awards 

08:30 - 08:45 S01:1 Impact of Papillary Muscle Relocation as Adjunct Procedure to Mitral Ring Annuloplasty in 

Functional Ischemic Mitral Regurgitation 

Henrik Jensen, Morten Jensen, Morten Smerup, Per Wierup, Steffen Ringgaard, 

J. Michael Hasenkam, Sten Lyager Nielsen, Denmark 

08:45 - 09:00 S01:2 Aprotinin reduces the antiplatelet effect of clopidogrel. 

Gabriella Lindvall, Ulrik Sartipy, Staffan Bjessmo, Peter Svenarud, Bo Lindvall, 

Jan van der Linden, Sweden 

09:00 - 09:15 S01:3 30-day outcomes in high risk-patients randomized to off-pump or on-pump 

coronary bypass Surgery 

Christian H Møller, Mario Perko, Jens Lund, Lars W. Andersen, Jan K. Madsen, 

Christian Gluud, Daniel A. Steinbrüchel, Denmark 

09:15 - 09:30 S01:4 Catheter based aortic valve implantation – results from the first 50 patients 

Hans Henrik Møller Nielsen, Leif Thuesen, Henning Rud Andersen, Vibeke E Hjortdal, 

Kaj-Erik Klaaborg, Carl-Johan Jakobsen, Ingeborg Böing, Denmark 

09:30 - 09:45 S01:5 The New TNM Staging System for Lung Cancer - A Review of 511 patients operated at 

Karolinska University Hospital. 

Per Bergman, Daniel Brodin, Luigi De Petris, Sweden 

09:45 - 10:00 S01:6 Non-selective cyclooxygenase (COX) inhibition decreases shunt during one-lung 

ventilation for thoracic surgery. 

Danguole Rimeika, Sten GE Lindahl, Claes U Wiklund, Sweden 

08:30 - 10:15 S02 SCANSECT Symposium; Weaning from longterm assist devices Lecture room E5 

Moderators: Laila Hellgren-Johansson and Peter Svenarud 

Speakers: 

Lars Lund; Cardiological aspects 

Maria Eriksson; Evaluation of myocardial recovery by echocardiography 

Conny Rundby; The role of the perfusionist 

Asghar Khaghani; The Harefield experience 

08:30 - 10:00 S03 SATNU Oral abstract session Lecture room M2 

Theme: Dealing with patients' physical postoperative problems 

Moderators: Unni Kleppe Haukeland and Marita Ritmala-Castren 

08:30 - 08:45 S03:1 Postoperative nausea and vomiting after cardiac surgery: nursing point of view 

Timo Murkka, Anu Niemi, Kati Järvelä, Pasi Maaranen, Heini Huhtala, Tero Sisto, Finland 

08:45 - 09:00 S03:2 Prediction of the consumption of opioid analgesics following minimally invasive correction 

of pectus excavatum 

Kasper Grosen, Hans K. Pilegaard, Mogens P. Jensen, Denmark 

09:00 - 09:15 S03:3 Gabapentin for postoperative pain management after cardiac surgery with median sternotomy 

Vibeke Laursen, Mariann Tang, Imran Parvaiz, Vibeke Hjortdal, Denmark 

09:15 - 09:30 S03:4 The effect of soothing music in response to stress and relaxation during bed rest after open- 

heart surgery. 

Ulrica Nilsson, Sweden 

09:30 - 09:45 S03:5 Nursemanaged insulin protocol improves treatment of hyperglycaemia in patients with 

diabetes undergoing open heart surgery 

Aase Lange, Denmark 

09:45 - 10:00 S03:6 Prevalance of postoperative problems among Danish heart-operated patients 14 days after 

discharge from hospital 

Dorthe Ibsen, Helle Greve, Denmark 

10:00 - 10:30 S03:B SATNU Invited Lecture Lecture room M2 

Waiting for heart surgery 

Bodil Ivarsson introduced by Gunilla Barr 



08:30 - 10:30 S04 Physiotherapists Lecture room M3 

08:30 - 09:00 Introduction 

Ulrika Thunström 

09:00 - 09:45 National guidelines for chest physiotherapy 

Charlotte Urell 

09:45 - 10:30 Current practice for chest physiotherapy 

Elisabeth Westerdahl 

Pause 

10:20 - 11:30 S05 SATS Cardiac Oral abstract session Lecture room M1 

Moderators: Odd Geiran and Åsa Haraldsson 

10:20 - 10:30 S05:1 Initial experience with a catheter based aortic valve implantation system. 

Henrik Ahn, Jacek Baranowski, Wolfgang Freter, Niels Erik Nielsen, Eva Nylander, 

Lars Wallby, Eva Tamas, Sweden 

10:30 - 10:40 S05:2 Echo-guided presentation of aortic valve minimises contrast medium exposure in Sapien 

aortic valve recipients. 

Jacek Baranowski, Henrik Ahn, Wolfgang Freter, Niels Erik Nielsen, Eva Nylander, 

Eva Tamas, Lars Wallby, Sweden 

10:40 - 10:50 S05:3 Survival and quality of life after aortic root replacement with cryopreserved homografts in 

acute endocarditis 

Sossio Perrotta, Obaid Aljassim, Odd Bech-Hanssen, Anders Jeppsson, 

Gunnar Svensson, Sweden 

10:50 - 11:00 S05:4 Mitral valve repair using Gore-tex neochordae, “respect rather than resect”. 

Susanne Juel Holme, John Christensen, Morten Kjøller, Thomas Fritz-Hansen, Denmark 

11:00 - 11:10 S05:5 Minimally invasive reoperative aortic valve surgery with patent coronary artery bypass grafts 

Giuseppe Raffa, Sudan, Carlo Pellegrini, Marcello Savasta, Matteo Pozzi, Mario Vigano, Italy 

11:10 - 11:20 S05:6 Hypothyroidism in cardiac surgery patients. A single unit follow-up. 

Aarne Jyrala, Gregory L Kay, United States 

11:20 - 11:30 S05:7 Continuous venovenous hemodialysis (CVVHD) with citrate calcium reduces 

postoperative bleeding complications after cardiac surgery 

Arndt-H. Kiessling, Michael Neher, Angela Kornberger, Andreas Lehmann, Bergner Raoul, 

Frank Isgro, Werner Saggau, Germany 


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10:45 - 13:00 S06 SCANSECT Oral abstract session Lecture room E5 

Moderators: Per Stensved and Else Nygreen 

10:45 - 11:00 S06:1 Fibrinogen and the acute inflammatory response after cardiac surgery 

Maria Kalabic, Anders Jeppsson, Helena Rexius, Sweden 

11:00 - 11:15 S06:2 Platelet aggregability before and after coronary artery bypass surgery 

Linda Önsten, Anders Jeppsson, Helena Rexius, Sweden 

11:15 - 11:30 S06:3 Will use of mini CPB lead to higher levels of haemoglobin, less use of blood products and 

improved fluid balance? 

Bente Övrebö, Hege Eikemo, Arve Mongstad, Finn Eliassen, Marit Farstad, 

Rune Haaverstad, Norway 

11:30 - 11:45 S06:4 In Vitro Comparison of the New In-line Monitor BMU 40 vs. the Conventional Laboratory 

Analyser ABL 700 

F. Oliver Grosse, Germany, David Holzhey, Volkmar Falk, Switzerland, 

Jan Schaarschmidt, Klaus Kraemer, Friedrich Wilhelm Mohr, Germany 

11:45 - 12:00 S06:5 Clinical Evaluation of the new BMU 40 In-Line Blood Analysis Monitor 

Jan Schaarschmidt, Michael Andrew Borger, Joerg Seeburger, Frank Oliver Grosse, 

Klaus Kraemer, Friedrich Wilhelm Mohr, Germany 

12:00 - 12:15 S06:6 ECMO - The Icelandic experience 

Thorsteinn Astradsson, Bjarni Torfason, Tomas Gudbjartsson, Liney Simonardottir, 

Felix Valsson, Iceland 

12:15 - 12:30 S06:7 Extracorporeal membrane oxygenation support for 59 days without changing the ecmo circuit 

Amrit Singh Thiara, Vivian Høyland, Hilde Norum, Tor Aasmundstad, Harald Karlsen, 

Arnt Fiane, Odd Geiran, Norway 

12:30 - 12:45 S06:8 Coagulation in oxygenator and arterial filter after recirculation 

Anne Louise Bellaiche, Peter Fast Nielsen, Pia Sprogøe, Oddvar Klungreseth, Denmark 

11:00 - 13:00 S07 SATNU Oral abstract session Lecture room M2 

Theme 11.00-11.45: Competence at work. Theme 11.45-13.00: Surviving heart disease 

Moderators: Anita Tracey and Lotte Brahe 

11:00 - 11:15 S07:1 How does nursing competence express itself in the operating room? 

Charlotte Walsoe, Denmark 

11:15 - 11:30 S07:2 The operating room nurses experiences of the medical equipment in their daily work 

Christine Roman-Emanuel, Doris Hägglund, Sweden 

11:30 - 11:45 S07:3 Surgical Team Member's Experiences, Routines and Views before Implementation of a 

Time-out protocol 

Shamini Murugesh, Arvid Haugen, Rune Haaverstad, Haldor Slettebø, Grethe Daavoy, 

Eirik Soefteland, Norway 

11:45 - 12:00 S07:4 Out of Hospital(OoH) management of patients on LVADs (Left ventricular assist devices). 

The Norwegian experience. 

Gro Sorensen, Einar Gude, Marianne Holter, Arnt Fiane, Norway 

12:00 - 12:15 S07:5 Gender and health-related quality of life after cardiac surgery 

Kari Hanne Gjeilo, Alexander Wahba, Pål Klepstad, Stian Lydersen, Roar Stenseth, Norway 

12:15 - 12:30 S07:6 Quality of life in patients and his relatives undergoing percutaneous pulmonary valve implant 

Brith Andresen, Gaute Døhlen, Lars Mathisen, Norway, Marit Andersen, Harald Lindberg, 

Erik Fosse, Norway 

12:30 - 12:45 S07:7 Addressing the Spouses Unique Needs after Cardiac Surgery when Recovery is 

Complicated by Heart Failure 

Susanna Ågren, Anna Strömberg, Rolf Svedjeholm, Sören Berg, 

Gunilla Hollman Frisman, Sweden 

12:45 - 13:00 S07:8 Patient education in a representative sample of patients having elective cardiac surgery in Iceland 

Heida Steinunn Olafsdottir, Brynja Ingadottir, Herdis Sveinsdottir, Iceland 



11:00 - 11:30 S08 Physiotherapists Lecture room M3 

Smärta, lungfunktion och opiater 

Maria Antonsson introduced by Sofia Broman 

11:50 - 13:00 S09 SATS Cardiothoracic Oral abstract session Lecture room M1 

Moderators: Tómas Guðbjartsson and Kristiina Hersio 

11:50 - 12:00 S09:1 Outcome after pulmonary metastasectomy: Analysis of surgical resections during a 5 year period. 

Kåre Hornbech, Jesper B. Ravn, Daniel A. Steinbrüchel, Denmark 

12:00 - 12:10 S09:2 Surgical resection of pulmonary metastases from colorectal carcinoma in Iceland 

Halla Vidarsdottir, Pall Moller, Jon Gunnlaugur Jonasson, Tomas Gudbjartsson, Iceland 

12:10 - 12:20 S09:3 The No touch vein graft harvesting technique for CABG preserves a functional vasa vasorum 

Mats Dreifaldt, Domingos Souza, Sweden, Andrzej Loesch, John Muddle, United Kingdom, 

Mats Karlsson, Lars Norgren, Sweden, Michael Dashwood, United Kingdom 

12:20 - 12:30 S09:4 Is there a place for total endoscopic ablation of atrial fibrillation? 

Anders Ahlsson, Espen Fengsrud, Peter Linde, Hans Tyden, Anders Englund, Sweden 

12:30 - 12:40 S09:5 Sternal Closure with Thermoreactive clips in 1000 High risk patients 

- A Single Centre Cohort Study. 

Sendhil Kumaran Balasubramanian, Joel Dunning, Vassilios Avlonitis, Michael Gill, 

Andrew Goodwin, Andrew Owens, Simon Kendall, United Kingdom 

12:40 - 12:50 S09:6 Cardiac Surgery in Patients with Haemophilia 

Mariann Tang, Per Wierup, Kim Terp, Jørgen Ingerslev, Benny Sørensen, Denmark 

12:50 - 13:00 S09:7 Surgical correction of pectus excavatum and carinatum - six years of experiences at 

Karolinska University Hospital. 

Per Bergman, Sweden 

11:50 - 13:00 S10 SATS Basic Science Oral abstract session Lecture room E4 

Moderators: Gabriella Lindvall and Ulrik Sartipy 

11:50 - 12:00 S10:1 Injection of Mesenchymal Stem Cells Modified with VEGF Gene in Ischemic myocardium 

Improves Cardiac Function in Rats 

Ping Hua, China, Yanqi Yang, Sweden, Ju Chen, Jiangzhou Peng, Bosheng Chen, 

Jie Han, Youyu Wang, China 

12:00 - 12:10 S10:2 Effect of Down-Regulated Cyclophilin D on Protection of Endothelial Cells Against 

Oxidative Injury 

Jiangzhou Peng, China, Yanqi Yang, Sweden, Ping Hua, Ju Chen, Jie Han, 

Bosheng Chen, Lei Xue, China 

12:10 - 12:20 S10:3 Validation of cystatin C with iohexol clearance in cardiac surgery. 

Björn Brondén, Atli Eyjolfsson, Sten Blomquist, Henrik Jönsson, Sweden 

12:20 - 12:30 S10:4 Platelet reactivity during Cardiopulmonary bypass (CPB) 

- Changes related to postoperative bleeding 

Gustaf Ehnsiö, Joakim Norderfeldt, Sören Berg, Joakim Alfredsson, Sweden 

12:30 - 12:40 S10:5 The Human heart releases cardiotrophin-1after coronary artery bypass grafting with 

cardiopulmonary bypass 

Yikui Tian, Xinhua Ruan, China, Jari Laurikka, Seppo Laine, Matti Tarkka, Finland, 

Minxin Wei, China 

12:40 - 12:50 S10:6 Acute kidney injury following coronary artery bypass surgery using the RIFLE criteria 

Solveig Helgadottir, Olafur Indridason, Gisli Sigurdsson, Hannes Sigurjonsson, 

Thorarinn Arnorsson, Tomas Gudbjartsson, Iceland 

13:00 - 14:15 Lunch; visit the exhibition! 

STOCKHOLM, SWEDEN 15


14:15 - 15:45 S11 Symposium; Humanitarian Work in Cardiac Surgery Lecture room M2 

Moderators: Dan Lindblom and Eva Ahlgren 

Speakers: 

Stefan Peterson; Impact of Cardiovascular Diseases in Developing Countries 

Sylvain Chauvaud; Experiences by Chaine de l´espoir 

Gino Strada; Experiences by Emergency 

15:45 - 16:15 Coffee; visit the exhibition! 

16:15 - 17:15 S12 SATS Invited Lecture Lecture room M1 

Critically interpreting the mitral literature 

Anelechi Anyanwu introduced by Sten Samuelsson 

16:15 - 17:15 S13 SCANSECT Invited Lecture Lecture room E5 

Long Term Assist Devices previous, current and forecast 

Heinz-Hermann Weitkemper introduced by Anne-Louise Bellaiche 

16:15 - 17:15 S14 SATNU Invited Lecture Lecture room M2 

Phychosocial aspects of heart failure 

Anna Strömberg introduced by Anita Tracey 

16:15 - 17:15 S15 Physiotherapists: Exchange of experiences Lecture room M3 

Moderators: Ulrika Thunström and Sofia Broman 

17:30 - 18:45 Awards and pre-dinner party 

18:45 Buses leave from Kistamässan 

19:30 Buffet dinner at the Stockholm City Hall 

21:15 Steamboat tour in the Stockholm Archipelago 


Stockholm Visitors Board - Christer Lundin

SATURDAY, 22 AUGUST 2009 

08:30 - 10:00 S16 SATS and SCANSECT; Cardiogenic shock in myocardial Infarction Lecture room M1 

Moderators: Anders Albåge and Jan Hultman 

Speakers: 

Lars Lund; Background and Current Guidelines for Intervention 

Lars Wiklund; Revascularization and Other Surgical Options 

Asghar Khaghani; Mechanical support 

08:30 - 09:30 S17 SATNU Invited Lecture Lecture room M2 

Reducing VAP in the ICU 

Eva Joelsson Alm introduced by Gunilla Barr 

08:30 - 10:00 S18 Physiotherapists Oral abstract session Lecture room M3 

Moderator: Gun Faager 

08:40 - 09:00 S18:1 Precautions after midline sternotomy. Are they necessary? 

Barbara Cristina Brocki, Charlotte Brun Thorup, Hanne Skindbjerg, Marianne Svalgaard, 

Jan Jesper Andreasen, Denmark 

09:00 - 09:20 S18:2 A randomized controlled trial on deep breathing exercises with positive expiratory 

pressure after cardiac surgery 

Charlotte Urell, Margareta Emtner, Marie Breidenskog, Elisabeth Westerdahl, Sweden 

09:20 - 09:40 S18:3 Physical activity on prescription (FaR®)-a long term follow-up of FaR® prescribed 

at a university hospital 

Susanna Wennman, Agneta Ståhle, Sweden 

09:30 - 10:30 SATNU General Assembly Lecture room M2 

10:00 - 10:30 SATS General Assembly Lecture room M1 

10:00 - 10:30 SCANSECT General Assembly Lecture room E5 

10:30 - 11:00 Pause; visit the exhibition! 

11:00 - 13:00 S19 Main topic 2; Transcatheter Valve Techniques Lecture room M2 

Moderator: Anders Jönsson 

History and Future of Aortic Valve Implantation 

Speaker: Ottavio Alfieri 

Invited discussant: Kenneth Pehrsson 

History and Future of Mitral Valve Interventions 

Speaker: Francesco Maisano 

Invited discussant: Reidar Winter 

13:00 - 13:15 Closing remarks Lecture room M2 

Jan Hultman 


Invited Speakers 

Ottavio Alfieri Ospedale San Raffaele, Milan, Italy 

Lars Algotsson Lund University Hospital, Lund, Sweden 

Maria Antonsson Uppsala University Hospital, Uppsala, Sweden 

Anelechi Anyanwu Mount Sinai Hospital, New York, USA 

Gerald Buckberg David Geffen School of Medicine, UCLA, Los Angeles, USA 

Sylvain Chauvaud La Chaîne de l’Espoir, Paris, France 

Maria Eriksson Karolinska University Hospital, Stockholm, Sweden 

Bodil Ivarsson Lund University Hospital, Lund, Sweden 

Eva Joelsson-Alm South Hospital, Stockholm, Sweden 

Asghar Khaghani Royal Brompton and Harefield Hospitals, London, UK 

Lars Lund Karolinska University Hospital, Stockholm, Sweden 

Francesco Maisano Istituto Scientifico San Raffaele, Milan, Italy 

Kenneth Pehrsson Karolinska University Hospital, Stockholm, Sweden 

Stefan Peterson Karolinska Institutet, Stockholm, Sweden 

Gino Strada Emergency, Milan, Italy 

Anna Strömberg Linköping University, Linköping, Sweden 

Charlotte Urell Uppsala University, Uppsala, Sweden 

Heinz-Hermann Weitkemper Bad Oeynhausen, Germany 

Elisabeth Westerdahl Örebro University Hospital, Örebro, Sweden 

Lars Wiklund Sahlgrenska University Hospital, Gothenburg, Sweden 

Reidar Winter Karolinska University Hospital, Stockholm, Sweden 

- Professor Gerald Buckberg, UCLA, Los Angeles, will give the annual Clarence Crafoord lecture, which usually 

is arranged during the Swedish annual meeting. Professor Buckberg was the 2007 Recipient of the American 

Association for Thoracic Surgery Scientific Achievement Award. He has published a large number of important 

articles in the fields of myocardial protection and left ventricular reconstruction. 

- Professor Anelechi Anyanwu, Director of Heart and Heart-Lung Transplantation at the Mount Sinai Medical 

Center, New York, will give a lecture on "How to read the mitral literature". His presentation might be considered as 

a follow-up to the very successful SATS postgraduate course in Copenhagen 2008, "From methodology to clinical 

evidence based decision making" 

Registration 

Registration & Information Desk 

Opening hours: 

Thursday, 20 August 10:00 - 17:30 

Friday, 21 August 07:30 - 17:30 

Saturday, 22 August 07:30 - 13:00 

Registration Fee (including VAT). 

On-site registration fee: 

• Delegates (members): SEK 5 100 

• Delegates (non-members): SEK 5 300 

• Nurses Physiotherapists and other health professionals fees: SEK 4 300 

• Nurses’ and Physiotherapists - only participation in nurses or 

physiotherapists sessions on Friday and Saturday: SEK 1 800 

• Accompanying persons: SEK 1 500 

On-site registration - please note some of the events might be fully booked. 

Cancellation & refund policy 

Credit cannot be given for unattended event, late arrivals or early departures. 

Hotel Accommodation 

The registration desk will handle inquires related to hotel accommodation. 


Cardiac lesions that work 

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UC200905135 EE

Social Programme 

All events are available for participants and accompanying persons and should have been prebooked on the 

registration form. For late bookings – please contact the registration desk for availability. 

A ticket is mandatory for entrance and will be handed out at the registration desk. 

Gala Dinner at Solliden, Skansen 

Thursday, 20 August at 19.30. 

The Gala Dinner will be held at Solliden Restaurant at Skansen, with a fabulous view of the Stockholm waterfront. 

The restaurant is located at Skansen, which is the world’s oldest open-air museum, founded in 1891. 

The Solliden Restaurant was built 1950-1952 and several well-known artists were commissioned to decorate the 

new restaurant, among them Hilding Linnqvist who painted the large fresco on the staircase called “The Story of 

Sweden”. This is a festive opportunity for all participants to meet and socialize. 

SEK 500 for registered delegates 

SEK 700 for non-registered delegates 

Dress code: Business suit/suit and tie. 

Individual transport. 

Reception at the Stockholm City Hall 

Friday, 21 August at 19.30. 

The City of Stockholm invites you to a buffet dinner at the Stockholm City Hall. The City Hall was designed by 

architect Ragnar Östberg in 1923 and is beautifully situated on the Riddarfjärden waterfront in central Stockholm. 

It is home to the central administration of the city. However, the City Hall is mostly famous for the Nobel Prize 

festivities, which are held in the Blue Hall every year on 10 December. 

By invitation from the City of Stockholm. Pre-registration is necessary. 

Transportation from the conference venue will be arranged. 

Steam boat tour in Stockholm Archipelago 

Friday, 21 August at 21.15. 

Experience the beautiful inner archipelago of Stockholm onboard a traditional steam boat. Enjoy a cup of coffee 

while viewing the typical archipelago sights and Stockholm’s magnificent location between Lake Mälaren and the 

sea. Extra drinks can be purchased in the bar onboard. 

SEK 100 for registered delegates 

SEK 200 for non-registered delegates 


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Stockholm Visitors Board - Richard Ryan

General Information 

in alphabetic order 

Audio-visual facilities 

All lecture halls are equipped with PC and PowerPoint. 

Business hours & Shopping 

Shops are open between 10.00 and 18.00 hrs on weekdays and from 10.00 to 15.00 hrs on Saturdays. Shops in the 

City centre have extended opening hours, some even on Sundays between 12.00 and 16.00 hrs. The main shopping 

streets in the centre of Stockholm are: Hamngatan, Biblioteksgatan, Drottninggatan and Västerlånggatan in the Old 

Town. The Kista Galleria (shopping mall) with its´ 125 shops is only a few minutes walk from the conference venue. 

Open 7 days a week between 10.00-21.00. 

Certificate of Attendance 

A Certificate of Attendance is inserted in the conference bag. 

Check – in/-out 

Hotel check-in time is 15.00 hrs or later. Check-out time is 12.00. 

Climate and Clothing 

The average temperature in August is around 18-20°C (approx. 65-68°F). 

Conference Language 

The official language of the conference is English. There will be no simultaneous interpreting. 

Conference Venue 

Kistamässan. Kista Expo Center. For information on the venue, please visit the venue website: 

www.kistamassan.com. Address: Kistamässan, Kistagången 1, 164 22 KISTA. Phone: +46 8-50665000 

Currency & Credit Cards 

The currency in Sweden is the Swedish Krona, SEK. A currency calculation can be found online at: 

www.x-rates.com/calculator.html 

Commonly accepted credit cards in hotels, restaurants and shops are American Express, Diners Club, Visa, Master 

Card and Euro card. Restaurants and shops generally display signs indicating what cards they accept. The registration 

desk accepts all these cards. 

Evaluation of the conference 

Shortly after the conference, an evaluation form will be e-mailed to you. We would appreciate if you could fill in the 

form as it is important for us to know what you think of this meeting and what we can improve to the next meeting. 

Exhibition 

The commercial exhibition will be held in conjunction with the conference, adjacent to the session halls. 

Insurance 

Neither the Conference Organisers nor the Conference Secretariat accept any liability for personal injuries sustained, 

or for loss or damage to property belonging to conference participants, either during or as a result of the conference. 

It is strongly recommended that you purchase an insurance policy of your choice as you register for the conference 

and book your travel. The insurance should be purchased in advance. 

Name Badges 

The delegate’s name badge will be provided at the registration desk. All delegates are required to wear the badge 

throughout the conference. Only badge holders will be admitted to the sessions. 

On-site registration 

On-site registrations will be accepted, however availability of hotel accommodation and participation in the social 

tours/events at that time may be severely limited. 


Smoking policy 

Kistamässan and the evening venues are all non smoking. Smoking is banned in public places in Stockholm, on 

public transport, in stores, restaurants and most pubs. Hotels offer special rooms for smokers. Please indicate your 

request on the registration form, when you make your hotel reservation. 

Speakers Ready room 

Presenters are kindly requested to hand in their presentation to the technicians in the Speaker´s Ready room, E3, 

at least 2 hours prior your session starts. If you bring your own laptop, please be sure to visit the technicians before 

your lecture in order to ensure the right equipment is in place. 

Speakers´Ready room, E 3 – opening hours 

Thursday, 20 August: 10:00 – 18:00 

Friday, 21 August: 07:30 – 17:00 

Saturday, 22 August: 07:30 – 13:00 

The lecture halls will be equipped with PC with PowerPoint. 

Time zone 

Sweden is 1 hour ahead of Greenwich Mean Time (GMT). 

Tourist information 

For tourist information about Stockholm and Sweden, please visit the website: www.stockholmtown.com, or contact 

the Tourist Centre on phone: +46 8 508 28 508 or info@svb.stockholm.se. 

Transportation 

Stockholm has a well-developed local transport system. For more information please visit SL (Stockholm’s public 

transport website), www.sl.se. 

Airports and Transport 

Arlanda Airport is located 42 km north of Stockholm. 

The Arlanda Express is the train service that links Stockholm City with the Airport. Book your Arlanda Express 

ticket in advance at the same time you register to the conference. MCI offers discounted tickets for travel with the 

Arlanda Express train from Arlanda to Stockholm. Your confirmation letter will serve as a ticket when presented to 

the train conductor. SEK 220 each way. 

Other ways to reach the city: 

Taxi: We recommend that you request a fixed price from the airport to the city, approx. SEK 450 - 550. Arlanda 

Airport-Kistamässan approx. SEK 385. 

Bus: There is direct bus connection from Arlanda Airport to the City Terminal in Stockholm. From Saturday, August 

22 there is also a direct connetion Kistamässan-Arlanda Airport. The journey from the airport to central station, 

takes about 40 minutes. The bus leaves Arlanda airport every 10 minutes. For information on the airport buses 

(prices, time tables etc.) please visit www.flygbussarna.se 

Bromma Airport 

Bromma is Stockholm's city airport and your fastest alternative to and from the Swedish capital. Bus: There is direct 

bus connection from Bromma Airport to the City Terminal in Stockholm. From Saturday, August 22 there is also a 

direct connection Kistamässan – Bromma airport, adapted to flight arrivals and departures. Driving time from central 

Stockholm is approx 20 minutes. From Bromma airport to Kistamässan approx 15 minutes. Local transport (SL): 

You can also catch a local bus to/from Stockholm-Bromma airport. Please visit www.sl.se for more information. 

Taxi: We recommend that you request a fixed price from the airport to the city, approx.SEK 220. Bromma Airport- 

Kistamässan approx. SEK 210. 

For information on the airport buses (prices, time tables etc.) please visit www.flygbussarna.se 

Travel to/from Stockholm central station to/from Kistamässan: 

By underground: Catch the Blue line from Rådhuset, direction 'Akalla' or the Green line direction 'Hässelby' and 

change trains at Fridhemsplan to Blue line 'Akalla'. The stations Kungsträdgården and T-Centralen are closed during 

the summer. Get off at the stop 'Kista' (15-20 min), a 10 minute walk to Kistamässan. 

By commuter train: Catch the commuter train from Stockholm central with the direction 'Märsta'. You get off at the 

stop 'Helenelunds station' (12 min travel) a 5 minute walk to Kistamässan. 


Visiting Stockholm 

Welcome to Stockholm, the Royal Capital of Sweden. Discover a city like no other - a city built on 

14 islands, where you are never far from the water. Well-preserved medieval buildings stand alongside 

modern architecture. Stockholm is also home of the Nobel Prize. And just outside the city, the archipelago 

of 24 000 islands is waiting to be explored. 

Stockholm is a city of contrasts - water and islands, history and innovation, small town and big city, short winter days 

and long, light summer nights - with a dazzling array of impressions. Thanks to the city’s compact size, you can see 

and do most things in a short space of time - which makes it a perfect destination for city breaks or longer stays, all 

the year round. 

Discover a city of contrasts. Go back 750 years in time and feel the medieval atmosphere of the Old Town 

“Gamla Stan” as you wander through the narrow streets. Stockholm has got history - but also the latest in 

fashion and IT. The trendy Stockholmers are often used as a test market by international companies, as they 

are quick to pick up on the latest trends. This is most obvious on the island of Södermalm, a hotbed of fashion, 

young culture and entertainment. 

Stockholm is one third water, one third green belt and one third city. The island of Djurgården, the world´s first 

National City Park, is only a short walk from the pulse of the inner city. Stockholmers and visitors alike come here 

to relax in the leafy shade and rest their eyes on green. 

Stockholm’s excellent transport links mean the city can offer reasonable access for all participants. 

Stockholm is very well positioned with most of Europe within three hours reach. It is a genuine meeting point in every 

respect and an increasingly important hub for flights to major destinations in the Baltic Sea Region, European Union 

and the expansive global community. 

Useful links 

Stockholm Visitor’s Guide 

This is the site where you can find nearly everything you need to know as a tourist in Stockholm: 

www.stockholmtown.com 

Guided boat tours 

During the period of April-December we highly recommend a 1 to 2 hour guided boat tour under the bridges of 

Stockholm: 

www.stockholmsightseeing.com 

Bus tours 

Guided bus tours around Stockholm, offered in eleven different languages, are available throughout the year: 

www.citysightseeing.com 

Boat tours in the archipelago and Lake Mälaren 

If you so only have one night or one day off in Stockholm, you cannot miss our archipelago. It consists of 24,000 

islands, of which only 3,000 are inhabited. Take a short trip of only a few hours, preferably during the evening with 

dinner onboard, to this unique place in the world. 

Choose Strömma Kanalbolaget if you prefer travelling by a steamboat or a boat from the turn of the century: 

www.strommakanalbolaget.com 

Choose Cinderellabåtarna if you want to see the whole archipelago, at 30 knots per hour, in only a few hours: 

www.cinderellabatarna.com 

Shopping in the city 

Here are some good links to great shopping in Stockholm city centre. NK is an exclusive department store: www.nk.se 

Sturegallerian is a stylish mall in the middle of the hottest district in town: www.sturegallerian.se 

Gallerian is one of the first malls in Sweden: www.gallerian.se 


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Kistamässan Overview 

KONFERENS 

Ground Floor 

KONFERENSENTRÉ 

Torshamnsgatan 18 c 

E10 

VIP-Lounge 

E9 

www.kistamassan.com 

E7 

E5 


E8 

E6 

WC WC 

Presscenter 

KONFERENSLOBBY 

E6 

GARDEROB 

RECEPTION 

E1 

E2 

E4 

HWC 

E3 

WC 

WC 

MÄSSHALL | ENTRÉHALL 

E3 

Speakers 

ready room 

E4

Kistamässan Overview 

KONFERENS 

First Floor 

M1 M2 

M1 M2 

Exhibition 

HALL & 1 

Poster area 

HALL 2 

www.kistamassan.com 

Mässplan Entresolplan 

M3 

M4 M3 


M5

Exhibition 

Exhibition opening hours 

Thursday 20 August: 12:00 - 17:30 

Friday 21 August: 08:00 - 18:45 

Saturday 22 August: 08:00 - 13:30 

List of Exhibitors 

Company Stand No. 

Aesculap AG B:20 

ATS Medical E:14 

Baxter Medical AB B:30 

Covidien Sverige AB C:20 

Carmel Pharma AB C:21 

Dicamed AB B:27 

Dräger Medical Sverige AB B:10 

Edwards Lifesciences E:21 

Hemax Medical A/S B:15 

Johnson & Johnson Nordic C:25 

Kanmed AB B:15 

KLS Martin Group B:12 

KRAUTH Surgical GmbH C:11 

Maquet Nordic AB D:31 

Master Surgery Systems AS B:21 

Medela Medical AB B:13 

Mediplast AB C:23 

Medi-Stim ASA E:31 

Medtronic AB E:11 

Orion Pharma AB C:13 

Philips Healthcare B:09 

Qualiteam s.r.l. B:24 

Scandinavian Cardiovascular Journal B:22 

Sorin Group Scandinavia AB C:10 

St. Jude Medical Sweden AB E:25 

SWEDISH ORPHAN INTERNATIONAL AB B:07 

Synthes AB B:11 

TERUMO D:30 

Vingmed Svenska AB C:30 


M2 

M1 

Exhibition Floor Plan 


Sponsors 

The organisers acknowledge the following organisations for their generous contribution: 

Gold Sponsor 

Silver Sponsors 

Bronze Sponsors 


Authors' Index 

A 

Aasmundstad, Tor S06:7 

Aazami, Mathias P01:41, P01:26 

Abdel Aal, Mohamed P01:19, P01:20 

Agger, Peter P01:03, P01:04 

Ahlsson, Anders S09:4 

Ahn, Henrik S05:1, P01:43, S05:2 

Aittomäki, Kristiina P01:32 

Alfredsson, Hordur P01:16 

Alfredsson, Joakim S10:4 

Alho, Hanni P01:32 

Aljassim, Obaid S05:3 

Andersen, Henning Rud S01:4 

Andersen, Karl P01:06 

Andersen, Knut S. P01:36 

Andersen, Lars W. S01:3 

Andersen, Marit S07:6 

Anderson, Rober H. P01:04 

Andreasen, Jan Jesper S18:1 

Andreassen, Arne K. P01:29, P01:30 

Andresen, Brith S07:6 

Arnorsson, Thorarinn 

P01:23, S10:6, P01:12 

Asgeirsson, Hilmir P01:15 

Astradsson, Thorsteinn S06:6 

Avlonitis, Vassilios S09:5 

B 

Balasubramanian, Sendhil Kumaran 

S09:5 

Baranowski, Jacek 

S05:1, P01:43, S05:2 

Bech-Hanssen, Odd S05:3 

Beck, Hans J. P01:14 

Bellaiche, Anne Louise S06:8 

Benetis , Rimantas P01:42 

Berg, Sören S07:7, S10:4 

Bergman, Per S09:7, P01:13, S01:5 

Bjessmo, Staffan S01:2 

Bjornholt, Jorgen P01:30 

Björnsson, Jóhannes P01:17 

Blomquist, Sten S10:3 

Bondo Jørgensen, Louise P01:05 

Borger, Michael Andrew S06:5 

Breidenskog, Marie S18:2 

Brocki, Barbara Cristina S18:1 

Brodin, Daniel P01:13, S01:5 

Brondén, Björn S10:3 

Brorsson, Bengt P01:25 

Böing, Ingeborg S01:4 

C 

Chen, Bosheng S10:1, S10:2 

Chen, Ju S10:2, S10:1 

Christensen, John S05:4 

D 

Daavoy, Grethe S07:3 

Dainius, Karciauskas P01:42 

Dashwood, Michael S09:3 

De Petris, Luigi S01:5 

Dreifaldt, Mats S09:3 

Drevdal, Julie P01:45 

Dunning, Joel S09:5 

Døhlen, Gaute S07:6 

E 

Eggen Hermansen, Stig P01:28 

Egle, Ereminiene P01:42 

Ehnsiö, Gustaf S10:4 

Eikemo, Hege S06:3 

Eliassen, Finn S06:3 

Ellensen, Vegard Skalstad P01:36 

Emtner, Margareta S18:2 

Englund, Anders S09:4 

Eriksson, Heidi P01:31 

Eyjolfsson, Atli S10:3 

F 

Falk, Volkmar S06:4 

Farstad, Marit S06:3 

Fengsrud, Espen S09:4 

Fiane, Arnt E. 

S06:7, S07:4, P01:29, P01:30 

Fluger, Ivo P01:07 

Fosse, Erik S07:6 

Frandsen, Jesper P01:04 

Franzén, Stefan P01:37 

Freter, Wolfgang 

S05:2, S05:1, P01:43 

Frey, Joana P01:08 

Fritz-Hansen, Thomas S05:4 


G 

Gardarsdottir, Marianna P01:06 

Geiran, Odd R. S06:7, P01:29, P01:30 

Gill, Michael S09:5 

Gjeilo, Kari Hanne S07:5 

Gluud, Christian S01:3 

Goodwin, Andrew S09:5 

Gottfredsson, Magnus P01:11 

Greve, Helle S03:6 

Grosen, Kasper S03:2 

Grosse, F. Oliver S06:5 

Grosse, Frank Oliver S06:4 

Grulichova, Jana P01:07 

Gudbjartsson, Tomas 

P01:06, P01:11, P01:12, P01:14, 

P01:15, P01:16, P01:17, P01:18, 

P01:23, S06:6, S09:2, S10:6 

Gude, Einar P01:29, P01:30, S07:4 

Gudjonsdottir, Marta P01:14, P01:15 

Gudmundsdottir, Ingibjorg P01:11 

Gudmundsson, Gunnar P01:17 

Gunnarsson, Gunnar Thor P01:06 

Gunnarsson, Sverrir I. P01:14, P01:15 

H 

Haaverstad, Rune 

P01:36, P01:45, S06:3, S07:3 

Hajek, Roman P01:07 

Han, Jie S10:1, S10:2 

Harjula, Ari P01:31 

Hasenkam, J Michael P01:03, S01:1 

Haugen, Arvid S07:3 

Haukeland, Unni Kleppe P01:45 

Helgadottir, Solveig S10:6 

Hiippala, Seppo 

Hjortdal, Vibeke E. 

P01:22 

P01:03, P01:04, S01:4, S03:3 

Hollman Frisman, Gunilla S07:7 

Holm, Jonas P01:40 

Holm, Peter P01:44 

Holme, Susanne Juel S05:4 

Holter, Marianne S07:4 

Holzhey, David S06:4 

Hornbech, Kåre S09:1 

Hreinsson, Hreinsson P01:12 

Hua, Ping S10:1, S10:2 

Huhtala, Heini S03:1 

Håkanson, Erik P01:40 

Hägglund, Doris S07:2 

Hämmäinen, Pekka P01:31 

Høyland, Vivian S06:7

I 

Ibsen, Dorthe S03:6 

Indridason, Olafur S10:6 

Ingadottir, Brynja S07:8 

Ingerslev, Jørgen S09:6 

Isaksson, Helgi P01:16 

Isgro, Frank S05:7 

Ivert, Torbjörn P01:25 

J 

Jakobsen, Carl-Johan S01:4 

Javangula, Kalyana 

P01:21, P01:33, P01:34, P01:35 

Jensen, Henrik S01:1 

Jensen, Mogens P. S03:2 

Jensen, Morten S01:1 

Jeppsson, Anders 

P01:01, P01:02, S05:3, S06:1, S06:2 

Joergensen, Inge Selchau P01:48 

Johannsson, Kristinn B. 

P01:14, P01:15 

Jonasson, Jon Gunnlaugur S09:2 

Jonsson, Steinn P01:16 

Jurga, Juliane P01:27 

Jyrala, Aarne S05:6 

Järvelä, Kati S03:1 

Jönsson, Anders P01:44 

Jönsson, Henrik S10:3 

K 

Kaartinen, Maija P01:39 

Kalabic, Maria S06:1 

Karciauskas, Dainius P01:42 

Kargar, Faranak P01:26, P01:41 

Karlsen, Harald S06:7 

Karlsson, Mats S09:3 

Kay, Gregory L S05:6 

Kendall, Simon S09:5 

Kiessling, Arndt-H. S05:7 

Kjøller, Morten S05:4 

Klaaborg, Kaj-Erik S01:4 

Klemenzson, Gudmundur P01:06 

Klepstad, Pål S07:5 

Klungreseth, Oddvar S06:8 

Kolackova, Martina P01:51 

Kornberger, Angela S05:7 

Kraemer, Klaus S06:4, S06:5 

Krejsek, Jan P01:51 

Kubicek, Jaroslav P01:51 

Kudlova, Manuela P01:51 

L 

Laine, Seppo S10:5 

Lange, Aase S03:5 

Langova, Katerina P01:07 

Laurikka, Jari S10:5 

Laursen, Vibeke S03:3 

Lehmann, Andreas S05:7 

Lemström, Karl P01:31 

Lindahl, Sten GE S01:6 

Lindberg, Harald S07:6 

Linde, Peter S09:4 

Lindvall, Bo S01:2 

Lindvall, Gabriella S01:2 

Loesch, Andrzej S09:3 

Lonský, Vladimir 

P01:07, P01:09, P01:51 

Lund, Jens S01:3 

Lunkenheimer, Paul P. P01:04 

Lydersen, Stian S07:5 

Lygren, Heidi P01:45 

M 

Maaranen, Pasi S03:1 

Maasilta, Paula P01:32, P01:39 

Madsen, Jan K. S01:3 

Magnusson, Björn P01:14, P01:15 

Malek, Hadi P01:26 

Mandak, Jiri P01:51 

Manilla, Maria N. P01:27 

Mariusdottir, Elin P01:18 

Mathisen, Lars S07:6 

Mohebi, Ahmad P01:41 

Mohr, Friedrich Wilhelm S06:4, S06:5 

Molitor, Martin P01:07, P01:09 

Moller, Pall S09:2 

Mongstad, Arve S06:3 

Muddle, John S09:3 

Murkka, Timo S03:1 

Murugesh, Shamini S07:3 

Mushtaq, Abid P01:34 

Musilová, Petra P01:32 

Myrmel, Truls P01:28 

Mäki, Kaisa P01:10 

Møller, Christian H S01:3 

Møller-Madsen, Maria Kirstine P01:03 


N 

Nair, Unnikrishnan 

P01:21, P01:33, P01:34, P01:35 

Neher, Michael S05:7 

Nielsen, Eva P01:04 

Nielsen, Hans Henrik Møller S01:4 

Nielsen, Niels Erik 

P01:43, S05:1, S05:2 

Nielsen, Peter Fast S06:8 

Nielsen, Sten Lyager S01:1 

Niemi, Anu S03:1 

Nilsson, Ulrica S03:4 

Njåstad, Anita P01:45 

Noohi, Freidoun P01:41 

Norderfeldt, Joakim S10:4 

Norgren, Lars S09:3 

Norum, Hilde S06:7 

Nylander, Eva 

P01:37, P01:43, S05:1, S05:2 

Nyman, Jesper P01:27 

O 

Oddsson, Saemundur J. P01:23 

Olafsdottir, Heida Steinunn S07:8 

Olafsdottir, Thora Sif P01:17 

Oterhals, Kjersti P01:45 

Owens, Andrew S09:5 

P 

Papaspyros, Sotoris 

P01:21, P01:33, P01:34 

Parvaiz, Imran S03:3 

Pellegrini, Carlo S05:5 

Peng, Jiangzhou S10:1, S10:2 

Perko, Mario S01:3 

Perrotta, Sossio S05:3 

Persson, Jenny P01:49 

Petursdottir, Vigdis P01:06 

Piilonen, Anneli P01:31 

Pilegaard, Hans K. S03:2 

Pooraliakbar, Hamid-Reza P01:26 

Povilas, Jakuska P01:42 

Pozzi, Matteo S05:5 

Påhlman, Carin P01:37 

Päiväniemi, Outi P01:32

R 

Raffa, Giuseppe S05:5 

Raoul, Bergner S05:7 

Rasmussen, Tina Seidelin P01:50 

Ravn, Jesper B. S09:1 

Rexius, Helena P01:01, S06:1, S06:2 

Rimeika, Danguole S01:6 

Ringgaard, Steffen P01:03, S01:1 

Roman-Emanuel, Christine 

P01:01, P01:02, S07:2 

Ruan, Xinhua S10:5 

Rylander Hagson, Pauline P01:47 

S 

Saggau, Werner S05:7 

Salminen, Ulla-Stina 

P01:10, P01:32, P01:39 

Samiei, Niloofar P01:41 

Sarkar, Nondita P01:27 

Sartipy, Ulrik S01:2 

Sarunas, Kinduris P01:42 

Savasta, Marcello S05:5 

Schaarschmidt, Jan S06:4, S06:5 

Seeburger, Joerg S06:5 

Segadal, Leidulf P01:36, P01:45 

Sigfusson, Nikulas P01:18 

Sigurdsson, Gisli S10:6 

Sigurjonsson, Hannes 

P01:06, P01:12, P01:23, S10:6 

Simek, Martin P01:07, P01:09 

Simonardottir, Liney S06:6 

Simpanen, Jarmo P01:38 

Sipponen, Jorma P01:10, P01:31 

Sisto, Tero S03:1 

Sjögren, Johan P01:11 

Skindbjerg, Hanne S18:1 

Slettebø, Haldor S07:3 

Smarason, Njall P01:12 

Smerup, Morten 

P01:03, P01:04, S01:1 

Soefteland, Eirik S07:3 

Soisalon-Soininen, Sari P01:39 

Sorensen, Gro P01:29, P01:30, S07:4 

Souza, Domingos S09:3 

Sprogøe, Pia S06:8 

Steinbrüchel, Daniel A. 

S01:3, S09:1, P01:05 

Steingrímsson, Steinn P01:11 

Stenseth, Roar S07:5 

Strömberg, Anna S07:7 

Ståhle, Agneta S18:3 

Sundh, Marie P01:47 

Suojaranta-Ylinen, Raili P01:22, P01:39 

Svalgaard, Marianne S18:1 

Svedjeholm, Rolf 

P01:24, P01:40, S07:7 

Svegby, Henrik P01:08 

Sveinsdottir, Herdis S07:8 

Svenarud, Peter 

P01:08, P01:27, S01:2 

Svensson, Gunnar S05:3 

Sørensen, Benny S09:6 

T 

Tamás, Éva 

P01:37, P01:43, S05:1, S05:2 

Tang, Mariann S03:3, S09:6 

Tarkka, Matti S10:5 

Terp, Kim S09:6 

Thiara, Amrit Singh S06:7 

Thimour-Bergström, Linda 

P01:01, P01:02 

Thorsteinsdottir, Steinunn Arna 

P01:46 

Thorsteinsson, Hunbogi P01:16 

Thorup, Charlotte Brun S18:1 

Thuesen, Leif S01:4 

Tian, Yikui S10:5 

Torfason, Bjarni S06:6 

Tornvall, Per P01:27 

Tracey, Anita P01:48, P01:50 

Tyden, Hans S09:4 

U 

Urell, Charlotte S18:2 

V/W 

Wahba, Alexander S07:5 

Vainikka, Tiina 

P01:10, P01:32, P01:39 

Vakkuri, Anne P01:10 

Wallby, Lars P01:43, S05:1, S05:2 

Walsoe, Charlotte S07:1 

Valsson, Felix S06:6 

van der Linden, Jan 

P01:08, P01:27, S01:2 

Wang, Youyu S10:1 

Vanky, Farkas P01:24, P01:40 

Wei, Minxin S10:5 

Wennervirta, Johanna P01:10 

Wennman, Susanna S18:3 

Vento, Antti P01:39 

Werkkala, Kalervo P01:38 

Westerdahl, Elisabeth S18:2 

Vidarsdottir, Halla S09:2 

Wierup, Per S01:1, S09:6 

Vigano', Mario S05:5 

Wiklund, Claes U S01:6 

Virolainen, Juha P01:31 

Wirup, Per P01:38 

Volt, Martin P01:51 


X 

Xue, Lei S10:2 

Y 

Yaghoubi, Nahid P01:26 

Yang, Yanqi S10:1, S10:2 

Z 

Záleaák, Bohumil P01:09 

Å 

Ågren, Susanna S07:7 

Ångerman-Haasmaa, Susanne P01:10 

Ö 

Önsten, Linda P01:01, S06:2 

Övrebö, Bente S06:3

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ABSTRACTS 


S01 

SATS AWARD NOMINEES ORAL ABSTRACT SESSION 

S01:1 

IMPACT OF PAPILLARY MUSCLE RELOCATION AS ADJUNCT PROCEDURE TO MITRAL RING 

ANNULOPLASTY IN FUNCTIONAL ISCHEMIC MITRAL REGURGITATION 

Jensen Henrik 1 , Jensen Morten 2 , Smerup Morten 3 , Wierup Per 3 , Ringgaard Steffen 4 , 

Hasenkam J. Michael 3 , Nielsen Sten Lyager 3 

1) Aarhus University Hosptital, Skejby, 2) Aarhus Univ. Dept. of Biomed. Eng., 

3) Aarhus University Hospital, Skejby, 4) Aarhus Univ. Hosp., MRI-Research Centre, Denmark 

Background 

The optimal surgical treatment in functional ischemic mitral regurgitation(FIMR) remains controversial. Recently, a 

posterior papillary muscle relocation(PMR) technique as adjunct procedure to ring annuloplasty has been proposed 

to prevent recurrent FIMR. In the present study we used 3D cardiac magnetic resonance imaging to assess the 

impact of relocating both papillary muscles as adjunct procedure to down-sized ring annuloplasty on mitral leaflet 

coaptation geometry in FIMR pigs. 

Methods 

Eleven FIMR pigs were randomized to down-sized ring annuloplasty(RA, n= 6) or RA combined with PMR(RA+PMR, 

n=5). In the RA+PMR group a 2-0 Gore-tex suture was attached to each trigone, exteriorized through the 

corresponding papillary muscle, mounted on an epicardial pad and tightened to relocate the myocardium adjacent to 

the anterior and posterior papillary muscles 5 and 15 mm, respectively. Using 3D magnetic resonance imaging the 

impact from these interventions on leaflet geometry was assessed. 

Results 

Following statistically significant(p

S01:3 

30-DAY OUTCOMES IN HIGH RISK-PATIENTS RANDOMIZED TO OFF-PUMP OR ON-PUMP CORONARY 

BYPASS SURGERY 

Møller Christian H 1 , Perko Mario 1 , Lund Jens 1 , Andersen Lars W. 1 , Madsen Jan K. 2 , 

Gluud Christian 1 , Steinbrüchel Daniel A 1 

1) Rigshospitalet, 2) Gentofte Hospital, Denmark 

Background 

Coronary artery bypass grafting (CABG) performed with (on-pump) and without (off-pump) cardiopulmonary bypass 

seems safe and results in about the same outcome in low-risk patients. Observational studies indicate that off-pump 

surgery may provide more benefit in high-risk patients. Our objective was to compare outcomes in high-risk patients 

randomized to CABG with or without cardiopulmonary bypass. 

Methods and Results 

We randomly assigned 341 patients with a EuroSCORE ≥ 5 and 3-vessel coronary disease to undergo on-pump 

versus off-pump CABG. Patients were followed up through the Danish National Patient Registry. The primary 

outcome was a composite of adverse cardiac and cerebrovascular events (i.e., all-cause mortality, acute myocardial 

infarction, cardiac arrest with successful resuscitation, low cardiac output syndrome/cardiogenic shock, stroke, and 

coronary reintervention). An independent event committee blinded for treatment allocation assessed the outcomes. 

Baseline characteristics were well balanced between groups, and the mean number of grafts per patient did not 

differ significantly between groups (3.22 in off-pump and 3.34 in on-pump, P = 0.11). No significant difference in the 

composite primary outcome (15% vs 17%, P = 0.48) or the individually components were found at 30-day follow-up. 

Fewer grafts were performed to the lateral part of the left ventricle territory during off-pump surgery (0.97 vs 1.14 

after on-pump surgery; P = 0.01). Conclusion - Both off- and on-pump CABG can be performed in high-risk patients 

with low short-term complications. Off-pump surgery seems to be associated with a reduced number of grafts to the 

lateral territory of the left ventricle. 

S01:4 

CATHETER BASED AORTIC VALVE IMPLANTATION – RESULTS FROM THE FIRST 50 PATIENTS 

Nielsen Hans Henrik Møller 1 , Thuesen Leif 1 , Andersen Henning Rud 1 , Hjortdal Vibeke E 1 , 

Klaaborg Kaj-Erik 1 , Jakobsen Carl-Johan 1 , Böing Ingeborg 1 

1) Aarhus University Hospital, Skejby, Denmark 

Background 

Aortic valve stenosis is a common cause of morbidity and mortality among the elderly population. Medical treatment 

is often inadequate and most patients ultimately need aortic valve surgery (AVS). Up to one third of patients 

requiring AVS is deemed inoperable due to co-morbidities and consequently high risk. At Aarhus University Hospital, 

Skejby, catheter based stentvalve implantation have been used to treat selected highrisk patients with aortic valve 

stenosis since 2006. 

Aim 

The aim of this study was to evaluate morbidity and mortality following catheter based aortic valve implantation. 

Materials and methods: A total of 50 patients were treated with an aortic 

stentvalve between february 2008 and february 2009. 15 were done via transfemoral (TFA-AVI) technique and 

35 via transapical technique (TAP-AVI). Median age of the patients was 83+ 6, 7 and 62% females. Mean logistic 

EUROscore was 19, 7% and 17, 5% in the TAP-AVI and TFA-AVI group respectively. 

Results 

Successful stent valve implantation were performed in 46/50 (92%) patients. The first two patients in this series 

died during procedure TFA-AVI. There were no peroperative deaths in the TAP-AVI group. 30 days mortality rate 

was 20% in TFA-AVI and 6% in TAP-AVI group. There was no incidence of peroperative MI or coronary occlusion 

requiring PCI/CABG. 

Conclusion 

Catheter based aortic stent valve implantation is a feasible technique, requiring close co-operation between 

surgeons, cardiologists and anesthesiologists. The procedure should be reserved for selected highrisk patients 

deemed inoperable to conventional surgery, until further studies, preferably randomized trials, have documented 

the technique. 


S01:5 

THE NEW TNM STAGING SYSTEM FOR LUNG CANCER - A REVIEW OF 511 PATIENTS OPERATED AT 

KAROLINSKA UNIVERSITY HOSPITAL. 

Bergman Per 1 , Brodin Daniel 2 , De Petris Luigi 3 

1) Dept of Cardiothor Surgery and Anesthesiology, Karolinska, 2) Dept of Lung Medicine, Karolinska, 

3) KS Biomic Center, Karolinska Institutet, Sweden 

Objective 

In spite of diagnostical progress and more systematically lymph node dissection during lung cancer surgery, lung 

cancer is still the leading cause of cancer death in both sexes. It is a significant public health problem and has 

continuously increased in incidence and particulary in women with 3.6%/year for the last decade. The TNM staging 

system plays hereby a predominant role in the choice of treatment and for the prediction of the prognosis. 

Methods 

A comparison between the old staging system (sixth edit.) and the new staging system (seventh. edit.) was made 

among 511 patients operated for lung cancer at Karolinska during 1982-2002. Of particular interest was the median 

survival time (Kaplan Meier method) and the difference between the old subgroup IA (tumor size 3 cm) and the new 

subgroups IA-a ( 2 cm) and IA-b (>2 - 3 cm). The T-stage (tumor size) is in these groups a decisive factor. 

Results 

Comparing the old subgroup IA (91 month + 9.6) with the new subgroups IA-a and IA-b, there was a unexpected, 

significant difference between the median survival time comparing the new subgroups IA-a (110 month + 8,01) 

respectively IA-b (64 month + 6,1) indicating that patients with tumor size > 2 cm have a more severe prognosis 

than tumor sized 2 cm. Conclusion: The new staging system seems to better elucidate the prognostic importance of 

tumor size than the previous edition. These findings are also in accordance with several other published studies. 

S01:6 

NON-SELECTIVE CYCLOOXYGENASE (COX) INHIBITION DECREASES SHUNT DURING ONE-LUNG 

VENTILATION FOR THORACIC SURGERY. 

Rimeika Danguole 1 , Lindahl Sten G 1 , Wiklund Claes U 1 

1) Karolinska University Hospital, Sweden 

Background 

Prostacyclin has been shown to exert modulating effects on hypoxic pulmonary vasoconstriction (HPV). The 

purpose of this study was to investigate if cyclooxygenase inhibition decreases shunt fraction and improves arterial 

oxygenation during one-lung ventilation (OLV). 

Methods 

Altogether 32 patients exposed to OLV for thoracic surgery were randomly assigned to receive 75 mg diclofenac 

or saline intravenously after induction of anesthesia. Measurements were done during two-lung ventilation (TLV) 

in supine and lateral position, after 5, 15 and 30 minutes of OLV before surgical ligation of pulmonary vessels 

and finally after TLV was re-established.There were no differences between groups in patient characteristics or 

preoperative conditions. Cardiac index, mixed venous oxygen tension, PaCO2 and mean pulmonary arterial pressure 

were similar in the groups. 

Results 

In the placebo group the shunt fraction increased from 12 % during TLV to 37 % at 15 minutes of OLV and 38 % 

at 30 minutes of OLV. In the diclofenac treated group shunt fraction increased from 12 % at TLV to 27 % after 15 

minutes of OLV and to 29 % at 30 minutes of OLV. Shunt fraction was significantly improved in the diclofenac group 

compared with the placebo group, at 15 minutes of OLV (P = 0.043). Conclusion: It was concluded that COXinhibition 

with diclofenac augments hypoxic pulmonary vasoconstriction and decreases shunt fraction during OLV 

for thoracic surgery. 


S03 

SATNU ORAL ABSTRACT SESSION 

THEME: DEALING WITH PATIENTS’ PHYSICAL POSTOPERATIVE PROBLEMS 

S03:1 

POSTOPERATIVE NAUSEA AND VOMITING AFTER CARDIAC SURGERY: NURSING POINT OF VIEW 

Murkka Timo 1 , Niemi Anu 1 , Järvelä Kati 1 , Maaranen Pasi 1 , Huhtala Heini 2 , Sisto Tero 1 , 

1) Heartcenter/ Pirkanmaa hospital district, 2) Tampere University, Finland 

Introduction 

Postoperative nausea and vomiting (PONV) is a very distressing adverse event. In this study, we tested the use of 

Apfel-score in predicting PONV among male cardiac surgery patients. This score consists of four predictors: female 

gender, history of motion sickness or PONV, nonsmoking, and the use of postoperative opioids. We also evaluated 

how harmful the patients and the nurses experienced PONV after coronary artery bypass grafting (CABG). 

Methods 

Fifty men undergoing CABG were interviewed preoperatively. PONV was treated according to a protocol. The 

patients were interviewed at the end of ICU stay and on the ward 2-5 days later. The ICU nurses answered a 

question: Is PONV a nursing problem in these patients? 

Results 

Total incidence of PONV was 34.7%. The measured incidences of PONV for Apfel-scores 1, 2 and 3 were 22, 41 and 

67% while the predicted incidences were 21, 39 and 61%. One third of the patients (32%) did not remember their 

ICU stay at all. Only one patient (2%) experienced insufficient treatment for PONV. Most of the ICU nurses (88.2%) 

did not consider PONV as a nursing problem in our ICU. 

Discussion 

Apfel-score predicted PONV very well in male cardiac surgery patients. PONV is common in this patient group, but 

the ICU nurses did not find it problematic, because they have sufficient tools to treat the patients. The patients were 

also satisfied. Therefore, we are now using even more aggressive treatment protocol. 

S03:2 

PREDICTION OF THE CONSUMPTION OF OPIOID ANALGESICS FOLLOWING MINIMALLY INVASIVE 

CORRECTION OF PECTUS EXCAVATUM 

Grosen Kasper 1 , Pilegaard Hans K. 2 , Jensen Mogens P. 3 

1) Aarhus University, 2) Aarhus University Hospital, Skejby, 3) Aarhus University Hospital, NBG, Denmark 

Background 

Minimally invasive correction of pectus excavatum (MIRPE) is primarily performed to obtain cosmetic and 

psychological benefits for the patient. MIRPE is often associated with postoperative pain management problems. 

This study estimates the effect of the severity of pectus excavatum on the postoperative consumption of opioid 

analgesics following the minimally invasive procedure in order to optimize pain management. 

Methods 

A retrospective study was conducted on 236 consecutive patients undergoing MIRPE from 2005-2008. The collected 

data included evaluation of preoperative pectus excavation depth, patient demographics, data for the peri- and 

postoperative period, including data on the pain management. The consumption of opioid analgesics was registered 

after discontinuation of epidural analgesia and the various types of opioid analgesics used during the study period 

were converted to morphine equivalents. 

Results 

The total morphine consumption following MIRPE ranged between 20 and 370 mg/day. Multiple linear regression 

analysis explained approx. 30% of the variation in log(morphine, mg/day) (R2=0.2957). There was a significant positive 

linear relationship between pectus severity and daily consumtion of morphine. Thus, postoperative consumption of 

morphine increased by 6% (95% CI: 0.3 to 11%) when preoperative pectus excavatum depth deteriorated with 1 cm. 

Conclusion 

This study confirms that pectus severity plays a significant role for the consumption of opioid analgesics 

following MIRPE. We conclude that knowledge of pectus severity might be useful in the prediction of the 

expected morphine consumption for future patients, especially in the critical transition period going from 

epidural analgesia to oral analgesia. 


S03:3 

GABAPENTIN FOR POSTOPERATIVE PAIN MANAGEMENT AFTER CARDIAC SURGERY WITH MEDIAN 

STERNOTOMY 

Laursen Vibeke 1 , Tang Mariann 2 , Parvaiz Imran 3 , Hjortdal Vibeke 2 

1) Aarhus University Hospital, Skejby, 2) Department of Cardiothoracic Surgery,SKS, 

3) Department of Cardiacthoracic Surgery,RH, Denmark 

Introduction 

Cardiac surgery with sternotomy is a major surgical trauma. The surgical injury and anaestesia is followed by pain, 

postoperative nausea and vomiting (PONV). Pain relief after surgery is prerequisite for moblisation and early return 

to pre-surgical level. The preferred drug for postoperative pain management is opioids which are known to have 

a series of side effects such as nausea, vomiting, constipation and delirium. More than one third of the patients 

experience PONV after cardiac surgery. PONV is associated with longer stay in post-anaesthesia care and may 

cause dehydration and prolonged recovery. Gabapentin was originally developed to treat spasticity but during the 

last decade more publications and reports have documented pain relief with use of Gabapentin. Hence no studies 

have evaluated Gabapentin as postoperative pain management after cardiac surgery. 

Aim/hypothesis 

To examine the effect of Gabapentin on postoperative pain after cardiac surgery with the hypothesis being that 

Gabapentin is an effective analgesic for postoperative pain and has a opioid sparing effect. 

Materials & Methods 

A clinical randomized, controlled and double blind study including 64 patients scheduled for cardiac surgery with 

median sternotomy. Patients were randomized to either placebo or gabapentin. The dosage of gabapentin was 1200 

mg on the day of surgery and 300 mg twice a day for the following five days. Four times a day the patients did pain 

assessment with Visual Analogue Score and PONV assessment. 

Results 

Data are being processed. 

S03:4 

THE EFFECT OF SOOTHING MUSIC IN RESPONSE TO STRESS AND RELAXATION DURING BED REST 

AFTER OPEN-HEART SURGERY 

Nilsson Ulrica 1 

1) Centre of Health Care Sciences, Sweden 

Music interventions have been evaluated as an appropriate intervention to reduce pain, stress and anxiety in 

a number of clinical settings. A new challenge is to study if music also can influence relaxation system that 

incorporates oxytocin. 

Aim 

To evaluate the effect of bed rest with music on stress and relaxation for patients who had undergone heart surgery 

on postoperative day one. 

Method 

Fifty-eight patients who had randomly allocated to either music listening during bed rest or bed rest only. The music 

was distributed through a music pillow connected to a MP3 player and the music, MusiCure, was soft, relaxing, and 

included different melodies of 60 to 80 bpm and was played for 30 minutes with a volume of 50-60 dB. Stress and 

relaxation response was assessed by s-cortisol, s-oxytocin, heart rate, respiratory rate, MAP, PaO2 , SaO2 and 

subjective pain, anxiety and relaxation levels. Results: In the music group levels of oxytocin increased significantly in 

contrast to the control group for which the trend over time was negative i.e. decreasing values. Subjective relaxation 

levels increased significantly more and there were also a significant higher levels of PaO2. After 30 minutes there 

was a significantly less s-cortisol levels in the music group. There was no difference in MAP, heart rate and SaO2 

between the groups. 

Conclusion 

Music intervention should bee used as an integral part of the multimodal regime administered to the patients that 

have undergone cardiovascular surgery. 


S03:5 

NURSEMANAGED INSULIN PROTOCOL IMPROVES TREATMENT OF HYPERGLYCAEMIA IN PATIENTS 

WITH DIABETES UNDERGOING OPEN HEART SURGERY 

Lange Aase 1 

1) Aarhus University Hospital Skejby, Denmark 

Background 

Strict glycemic control in critically ill patients is challeging for both nurses and physicians. Studies Have shown 

that aggressive glycemic control by a nursemanaged subcutaneous insulin protocol outside ICU improves mortality 

and morbidity as well as efficiency and safety. An audit made in 2006 at the Department of Cardiothoratic 

Surgery at Aarhus University Hospital Skejby, Denmark showed that only 62 % of patients with hyperglycemia 

were treated according to recommendations. The low compliance was presumably due to fear of hypoglycaemia 

and lack of knowledge. 

Objectives 

To determine the effect of focused education of nurses followed by implementation of a nursemanaged insulin protocol. 

Methods 

Intensive education of nurses followed by development and implementation of a nursemanaged insulin protocol. Two 

audits to determine if hyperglycaemia was treated according to the implemented insulin protocol. Blood glucose 

levels and insulin doses per day were documented in 15 patients before and in 15 patients after implementation of 

the protocol. 

Results 

Audit in 2006: number of measured hyperglycaemia values in 15 patients was 105 and 62 % were treated according 

to reccommendations. Audit in 2009: number of measured hyperglycaemia values in 15 patients after implementation 

of insulin protocol was 263 and 90,5 % were treated according to the nursemanaged insulin protocol. 

Conclusions 

Intensive education followed by development and implementation of a nursemanaged insulin protocol has increadsed 

compliance and led to a considerable improvement in the treatment of hyperglycaemia. Potentially this could lead to 

improved mortality and morbidity for this patientgroup. 

S03:6 

PREVALANCE OF POSTOPERATIVE PROBLEMS AMONG DANISH HEART-OPERATED PATIENTS 

14 DAYS AFTER DISCHARGE FROM HOSPITAL 

Ibsen Dorthe 1 , Greve Helle 1 

1) Rigshospitalet, Denmark 

Background 

Several patients call the heart-surgery ward because they don’t know where to address problems related to dyspnoea, 

medication, and infections. International research documents that many heart-operated patients experience 

emotional and physiological problems one year after their operation. The aim of this study is to gain knowledge 

about Danish heart-operated patients´ experience of these problems during the first 14 days after discharge from 

hospital, to uncover if the constructed questionnaire is useful to gain information about this, and as background for 

a clarifying telephone interview. 

Method 

Data was acquired by use of a semistructured questionnaire, followed up by telephone-interviews. 9 patients were 

asked to complete the questionnaire, and to participate in the interview 14 days after discharge. The results are 

preliminary as the study is not yet completed. 8 patients participated in the study, 6 males and 2 females, age 

between 50-72 years. 6/8 experienced depression in the first 7-14 days, 7/8 pain, 6/8 sleeping problems, 6/8 lack 

of energy. 

Conclusions 

Danish heart surgery patients seem to have the same emotional and physiological problems during the first 14 days 

after discharge, as shown in international research. The semistructured questionnaire and telephone interviews 

formed a basis for gaining knowledge of patients’ problems during the first 14 days at home. According to the 

preliminary results it seems important that nurses call their patients after discharge, and individualize the discharge 

dialogue to make sure that patients are more capable to act adequate upon the challenges, experienced after their 

discharge from hospital. 


S05 

SATS CARDIAC ORAL ABSTRACT SESSION 

S05:1 

INITIAL EXPERIENCE WITH A CATHETER BASED AORTIC VALVE IMPLANTATION SYSTEM. 

Ahn Henrik 1 , Baranowski Jacek 1 , Freter Wolfgang 1 , Nielsen Niels Erik 1 , Nylander Eva 1 , Wallby Lars 1 , Tamas Eva 1 

1) Linköping Heart Center, Sweden 

Fifteen patients (pts), 9 females and 6 males, mean age 78 (60-91) years were selected for transcatheter aortic 

valve implantation. The pts were evaluated according to our regular routines and denied for open chest surgery 

due to high risk profile with logistic Euroscore 22 (7-45) % and STS score 19 (10-30). Mean maximal velocity 

(Vmax) was 4.8 (3.8–6.5) m/s, the mean gradient was 60 (33-108) mmHg and the mean aortic valve area was 

0.5 (0.4–0.8) cm2. 

Methods 

All procedures were carried out in general anesthesia using the Sapien valve (Edwards Lifesciences). Ten transapical 

and 5 transfemoral implants were performed. 

Results 

All implantations (8 valves 26 mm and 7 valves 23 mm) were successful. Blood pressure failed to recover in 2 

pts following rapid pacing necessitating CPR with good recovery. However, 2 pts suffered from renal failure, one 

needing dialysis. 

One pt got a postoperative pericardial effusion. The 30-day mortality was 1/15 pts as well as the 90-day mortality. 

The residual aortic valve leaks (central and paravalvular) were small in all pts. Post-implant mean Vmax was 2.4 

(1.5–2.9) m/s and the mean gradient was 15 (4-37) mmHg. The mean ICU-stay was 2.6 (1-18) days. Pts were 

discharged after 10 (4-18) days. 

Conclusion 

This new technology worked well in our hands and the procedure was performed with reproducible and acceptable 

results. The patient selection is a challenge since serious comorbidity can impair results, disguising the potential of 

this promising technology. The long-term results will be the most important endpoints. 

S05:2 

ECHO-GUIDED PRESENTATION OF AORTIC VALVE MINIMISES CONTRAST MEDIUM EXPOSURE IN 

SAPIEN AORTIC VALVE RECIPIENTS. 

Baranowski Jacek 1 , Ahn Henrik 1 , Freter Wolfgang 1 , Nielsen Niels Erik 1 , Nylander Eva 1 , Tamas Eva 1 , Wallby Lars 1 


During Sapien aortic valve prothesis implantation a perpendicular position of the aortic valve to the radiation beam 

is a sine-qua-non for the optimal prosthesis delivery. This right valve-beam-angle is expected to lower risks for 

proximal and distal embolisation of the protheses, reststenosis, coronary artery occlusion, and AV-block occurrence. 

The current gold standard to achieve this optimal angle is to use repeated aortic aortograms. The Sapien valve 

candidates often have reduced renal function with contrast exposure being an important factor for their recovery. 

Material and methods 

Transcatheter Sapien aortic valve prostheses have been implanted in 15 patients. Various methods for perpendicular 

valve presentation during fluoroscopy were employed: statistical chance, CT, repeated ascendens aortograms and 

transthoracic echo-guided presentation in a new Linköping design. 

Results 

Statistical chance and CT have failed to be of help during the procedure. Repeated ascendens aortograms make 

the procedure feasible with the price of high contrast volumes and long fluoroscopy times. The transthoracic echoguided 

presentation resulted in a dramatic decrease in contrast ( from 223 ml/ procedure to 69 ml/procedure) and 

some in radiation exposure to the patients during the procedure. 

Conclusion 

Our echo-guided method for perpendicular aortic valve position lowers significantly the contrast media exposure in 

the fragile population of transcatheter aortic prosthesis recipients. 


S05:3 

SURVIVAL AND QUALITY OF LIFE AFTER AORTIC ROOT REPLACEMENT WITH CRYOPRESERVED 

HOMOGRAFTS IN ACUTE ENDOCARDITIS 

Perrotta Sossio 1 , Aljassim Obaid 1 , Bech-hanssen Odd 1 , Jeppsson Anders 1 , Svensson Gunnar 1 

1) Sahlgrenska University Hospital, Sweden 

Background 

Aortic root replacement with homograft is a theoretically attractive but technically demanding option in patients with 

infective endocarditis, especially in patients with subvalvular abscesses and/or prosthetic endocarditis. We report 

our midterm experience with cryopreserved homografts in acute infective aortic endocarditis. 

Methods 

All 62 patients operated with aortic homograft for severe acute aortic endocarditis between 1997 and June 2008 were 

retrospectively analysed. Fifty two (84%) had subvalvular abscesses. 24 patients (39%) had prosthetic endocarditis. 

Survival, perioperative complications, re-operations and quality of life (SF 36) were assessed. Mean follow-up was 

3.1 years (range 0 12). 

Results 

Nine patients (14%) died within 30 days. Pre and perioperative variables univariately associated with early 

mortality were CPB-time (p=0.003), prolonged inotropic support (p=0.03), reoperation for bleeding (p=0.01) and 

perioperative myocardial infarction (p

S05:5 

MINIMALLY INVASIVE REOPERATIVE AORTIC VALVE SURGERY WITH PATENT CORONARY ARTERY 

BYPASS GRAFTS 

Raffa Giuseppe 1 , Pellegrini Carlo 2 , Savasta Marcello 2 , Pozzi Matteo 2 , Vigano’ Mario 2 

1) The Salam Centre for Cardiac Surgery, Sudan 2) University of Pavia, Italy 

Objective 

Cardiac reoperations are associated with higher morbidity and mortality mainly due to the risk of damaging cardiac 

structures. Minimally invasive techniques may reduce the surgical risks. 

Methods 

Since 1997, more than 1000 mini-sternotomies have been performed at our department. Out of these, seventeen 

patients (15 males, 2 females, mean age: 68.7 years) had a patent graft on LAD. Mean ejection fraction was 

45% and NYHA class 2.7. Fifteen patients underwent native aortic valve replacement, whereas in two patients a 

malfunctioning valve prosthesis was replaced. 

Results 

Mean cardiopulmonary and aortic cross clamp time were 119.7±38.1 (range: 50-235) and 72±20 (range: 45-125) 

minutes, respectively. Mean cooling body temperature was 27.4 (°C). Antegrade cold crystalloid cardioplegia was 

delivered to all the patients. LIMA injury occurred in one patient and caused perioperative myocardial infarction, 

low cardiac output syndrome requiring intraaortic balloon pump and, eventually, hospital death (5.9%). Neither 

conversion to full sternotomy nor reoperation for bleeding occurred. Mean bleeding was 426±474 ml (range: 120- 

1950). Mean postoperative ICU and hospital stay were 1.6±1.1 and 7.5±2.6 days, respectively. Postoperative 

course was totally uneventful in ten patients (58.8%). Follow-up was complete for a total of 928 patient/months 

(range: 11-124): four late deaths occurred, two related to cardiac causes. Prosthesis related morbidity did not occur 

either early or late. Nine of the 12 survivors (75 %) are in NYHA class II. 

Conclusions 

Considering the low complication rate, a minimally invasive access in the presence of patent coronary artery grafts 

may represent a preferential surgical approach. 

S05:6 

HYPOTHYROIDISM IN CARDIAC SURGERY PATIENTS. A SINGLE UNIT FOLLOW-UP. 

Jyrala Aarne 1 , Kay Gregory L 1 

1) United States 

The aim of this study is to analyze patient presentation, early and late outcomes in patients with hypothyroidism (HT) 

compared to patients matched by age, gender and type of surgery. 

Of 1000 consecutive cardiac surgery patients operated between Jan 1999 and May 2000 80 pts had a diagnosis of 

HT (Group 1); 80 matched pts were identified from the database (Group 2). 

Additive EuroSCORE (ES) did not differ between the groups but logistic ES did (p=0.05). The proportion of very 

high-risk pts (log ES >25%) was higher in Group 1 (24.1% vs 17.7%), more pts had CHF (43.8%vs36.3%), had 

diabetes (43.8%vs35.0%), were in NYHA class III-IV (66.4%-55.0%) or had AF (16.5% vs 0 %). 

There were no operative deaths. Hospital mortality was similar. New AF occurred in 23.0 % of pts in Group 1 and in 

9.2% in Group 2. There were more pts in Group 1 with prolonged hospital stay (>10 days, 28.4% vs 18.3%) and 4 

times more pts in Group 1 needed extended care or rehabilitation after discharge. All-cause follow-up mortality (up 

to 107 months) was higher in Group 1 (43.0% vs 30.4%). 2 pts died in the postoperative period due to untreated HT. 

All comparisons have p-value 0.05 or lower. 

Conclusions 

HT pts are sicker at presentation than controls, their resource utilization is higher and survival lower. Occurrence of 

postoperative AF is considerably higher. Although there were no operative deaths and hospital mortality was similar, 

postoperative deaths occurred when HT was not adequately treated. 


S05:7 

CONTINUOUS VENOVENOUS HEMODIALYSIS (CVVHD) WITH CITRATE CALCIUM REDUCES 

POSTOPERATIVE BLEEDING COMPLICATIONS AFTER CARDIAC SURGERY 

Kiessling Arndt-h. 1 , Neher Michael 1 , Kornberger Angela 1 , Lehmann Andreas 1 , Raoul Bergner 1 , 

Isgro Frank 1 , Saggau Werner 1 

1) Klinikum Ludwigshafen, Germany 

Objective 

Continuous renal replacement therapy is the preferred method of treatment of acute renal failure after cardiac 

surgery. Efficient anticoagulation of the extracorporeal circulation is essential to prevent clotting of the system. 

Regional anticoagulation using citrate is assumed to reduce the risk of systemic bleeding. The present study 

investigates the safety of citrate dialysis (CI-CA) after cardiac surgery in comparison with conventional procedures 

using heparin (HEP). 

Methods 

In a prospective randomized, non-blinded monocentric trial (11/2008-02/2009), we compared continuous venovenous 

hemodialysis (CVVHD) using heparin (Diapact CRRT B.Braun AG, Germany) (n=26) against a citrate calcium 

method (Ci-Ca multifiltrate Fresenius Medical Care, Germany) (n =24). In the HEP group, the system was primed 

with 600 IE heparin and run with a minimum of 15000IE/24h of heparin on the basis of HEP test controls (0.4-0.7). 

Our primary end points were bleeding events, death, cardiac arrhythmia, creatinine levels and filter occlusion. 

Results 

There were no differences between the demographic data of the patient groups and no significant difference as 

far as the surgical procedures performed and postoperative catecholamine support are concerned. The incidence 

of bleeding was significant higher in the HEP group. No differences were found for the items: mortality, ICU stay, 

respirator time and arrhythmias. 

Conclusion 

CiCA proved effective and safe. A significant prolongation of filter patency was noted. A significant difference in 

mortality was not registered within the small study population. Changes of plasmatic calcium levels representing a 

potential risk of cardiac arrhythmia or cardiac output reduction did not occur. 


S06 

SCANSECT ORAL ABSTRACT SESSION 

S06:1 

FIBRINOGEN AND THE ACUTE INFLAMMATORY RESPONSE AFTER CARDIAC SURGERY 

Kalabic Maria 1 , Jeppsson Anders 1 , Rexius Helena 1 


Objective 

Fibrinogen concentrate can be used to prevent or treat bleeding after cardiac surgery but it may also raise plasma 

concentrations to supra-normal levels, potentially leading to hypercoagulability. Fibrinogen is an acute phase reactant 

and plasma concentration increases in response to the surgical trauma. The aim of the study was to establish the 

normal response of fibrinogen to cardiac surgery and its potential association to other acute phase reactants. 

Methods 

Fifteen on-pump CABG patients were included in a prospective observational study. Plasma concentrations of 

fibrinogen, C-reactive protein (CRP) and interleukin-6 (IL-6) were measured before surgery (baseline) and day 1 to 

day 4 after surgery. Plasma concentrations at the different time points were compared to baseline and correlation 

calculations between fibrinogen, CRP and IL-6 were performed. 

Results 

Fibrinogen plasma concentration increased during the study period from 3.9±0.6 to 7.8±1.9 g/L (p

S06:2 

PLATELET AGGREGABILITY BEFORE AND AFTER CORONARY ARTERY BYPASS SURGERY 

Önsten Linda 1 , Jeppsson Anders 1 , Rexius Helena 1 


Objective 

Platelet dysfunction may contribute to bleeding complications after Coronary artery bypass grafting (CABG). 

Impedance aggregometry is a new point-of-care method to assess platelet function. We determined platelet 

impedance aggregation before and after CABG surgery. 

Methods 

10 patients treated with aspirin and adenosine-diphosphate (ADP) receptor blocker clopidogrel and 9 patients treated 

with aspirin within 7 days before surgery were included in this prospective observational study. Platelet aggregation 

was compared between individual time points and between patients with or without clopidogrel treatment. Impedance 

aggregometry (Multiplate�), with ADP and thrombin receptor activated peptide 6 (TRAP) as activators. 

Results 

ADP-induced platelet aggregation at sternum closure was reduced compared to the day before surgery, to anesthesia 

induction and to the day after surgery (20±15 units vs. 41±24, 36±17 and 43±18, respectively (p

S06:4 

IN VITRO COMPARISON OF THE NEW IN-LINE MONITOR BMU 40 VS. THE CONVENTIONAL 

LABORATORY ANALYSER ABL 700 

Grosse F. Oliver 1 , Holzhey David 2 , Falk Volkmar 2 , Schaarschmidt Jan 1 , Kraemer Klaus 1 , Mohr Friedrich Wilhelm 1 

1) University of Leipzig - Heart Center, Germany 2) University Hospital, Zurich, Switzerland 

Background 

Reliable information about different blood parameters is essential maintaining haemodynamics, perfusion and gas 

exchange during CPB. For this purpose a precise and continuous monitoring is needed. The objective of this in vitro 

study was to compare a novel continuous in-line blood parameter monitoring system (CIBPMS) vs. a reference 

laboratory analyser. 

Methods 

The study was conducted as an in vitro prospective experimental study during a CPB simulation. The reliability of 

BMU 40 was tested in monitoring the pO2, SO2 and Hct under physiological and extreme conditions with regards 

to temperature, oxygenation and blood concentration. Four different tests were performed and conducted with five 

sensors each. Correlation analyses and Bland-Altman analyses were performed. 

Results 

A total of 350 measurement points were compared. All monitored values of blood parameters correlated highly with 

laboratory values (all r values > 0.90). Test 1: Biases of pO2(act) vary from -3.24 (±6.86) up to 6.0 (±17.89). The 

biases of pO2(37°C) ranged from -3.08 (±5.53) up to 68.8 (±67.82). Test 2: The biases (SD) for Hct ranged from 

-0.35 (±0.79) up to 2.35 (±0.91). The biases (SD) for SO2 vary from -0.45 (±0.86) up to 0.85 (±1.01). Test 3: The 

biases (SD) of Hct ranged from -0.67 (±1.49) up to -1.00 (±1.84). Test 4: The biases (SD) for SO2 vary from -0.36 

(±1.60) up to 0.48 (±0.90). 

Conclusions 

The BMU 40 is a reliable device in measuring the pO2, SO2 and Hct under normal physiological and extreme 

conditions with regards to temperature, oxygenation and blood concentration in simulation of CPB. The algorithm to 

calculate pO2(37°) under hypothermic conditions need to be adjusted.* 

*In the meantime a new software version of the BMU 40 has been developed. The algorithm to calculate pO2(37°) 

under hypothermic conditions has been improved and the miscalculation eliminated. 

S06:5 

CLINICAL EVALUATION OF THE NEW BMU 40 IN-LINE BLOOD ANALYSIS MONITOR 

Schaarschmidt Jan 1 , Borger Michael Andrew 1 , Seeburger Joerg 1 , Grosse Frank Oliver 1 , 

Kraemer Klaus 1 , Mohr Friedrich Wilhelm 1 

1) University of Leipzig, Heart Center, Germany 

Background 

Accurate information about different blood parameters is essential in maintaining haemodynamics, perfusion and 

gas exchange during cardiopulmonary bypass (CPB). For this purpose a precise and continuous measurement and 

monitoring, which is preferably visually available, is needed. The objective of this clinical study was to compare 

the newly developed continuous in-line blood parameter monitoring system (CIBPMS) BMU 40, based on optical 

luminescence and reflectance technology, with a reference laboratory analyser with regards to the precision of blood 

parameters measurement. 

Methods 

Thirty adult patients underwent elective cardiac surgery utilizing CPB and mild hypothermia (32°C). At five 

predetermined time points (S1 – S5) arterial and venous blood samples were analysed using the BMU 40 for five 

different parameters (paO2(37°C), paO2(act.), SvO2, Hb(ven) and Hct(ven)) and these results were compared to 

the gold standard laboratory analyser ABL 700. 

Results 

A total of 150 paired blood samples were included to compare means, to analyse correlation, to calculate measures 

of bias, precision, limits of agreement and 95% confidence intervals. Results revealed good agreement between the 

two devices for all parameters. Bias ± precision of S2 – S5 paO2(37°C) were 2.17 ± 9.61; paO2(act) 2.58 ± 9.54; 

SvO2 -1.44 ± 2.35; Hb(ven) 0.01 ± 0.42; Hct(ven) 0.04 ± 1.29. Statistically significant differences were detected 

for SvO2 (p

S06:6 

ECMO - THE ICELANDIC EXPERIENCE 

Astradsson Thorsteinn 1 , Torfason Bjarni 1 , Gudbjartsson Tomas 1 , Simonardottir Liney 1 , Valsson Felix 1 

1) Landspitali University Hospital, Iceland 

Background 

Extracorporeal membrane oxygenation (ECMO) can prove lifesaving in severe respiratory failure (ARDS) and 

cardiac failure (CF) refractory to conventional treatment. Because of the complicity and potential complications, 

ECMO treatment has been limited to larger medical centers. 

Aim 

This study evaluates ECMO treatment in Iceland a small and relatively isolated community. 

Results 

18 patients have been treated with ECMO in Iceland from 1991. Nine of those had ARDS while the other 9 had 

CF. Survival rate was 56% for both groups, the mean age of ARDS survivors was 20 compared to 50 years for 

non-survivors while the mean age of CF survivors was 33 vs 49 years for the non-survivors. Mean pre-ECMO 

ventilator time for ARDS survivors was 5,2 days (0,5-18) compared to 9,8 days (1-14) for ARDS non-survivors. One 

of four ARDS patients with a pre-ECMO ventilator time longer than 7 days survived and four of five patient with 

pre-ECMO ventilator time less than 7 days survived. CF survivors had lower APACHE II scores than non-surviving 

CF patients (14 vs 32). One patient died from hemorrhage related to anticoagulation, while three other patients 

survived significant hemorrhage. Recombinant factor VIIa was given to two patients both of which survived. All other 

non-survivors succumbed to their underlying diseases. 

Discussion 

Survival rates (56%) in Iceland are similar to those seen in recent publications. No age limit or pre-ECMO ventilator 

time limit has been implemented in Iceland. A stricter protocol regarding age and pre-ECMO ventilator time will be 

enforced in future ECMO candidates in Iceland. 

S06:7 

EXTRACORPOREAL MEMBRANE OXYGENATION SUPPORT FOR 59 DAYS WITHOUT CHANGING THE 

ECMO CIRCUIT 

Thiara Amrit Singh 1 , Høyland Vivian 1 , Norum Hilde 1 , Aasmundstad Tor 1 , Karlsen Harald 1 , Fiane Arnt 1 , Geiran Odd 1 

1) Rikshospitalet, Norway 

Background 

Veno-venous extracorporeal membrane oxygenation is an established support for the treatment of respiratory 

failure. We report the successful use of veno-venous ECMO in a 53 year old patient with Legionella pneumonia and 

acute respiratory distress syndrome (ARDS) with severe barotraumas. 

He was admitted to intensive care unit. His clinical course deteriorated, despite the continuous support with 

mechanical ventilation. 

Interventions 

He was placed on veno-venous ECMO for lung rest and while awaiting a response to continued medical treatment. 

He was supported by ECMO for 59 days without any changes in the ECMO circuit. There were no complications 

with the ECMO circuit during the support period. 

Conclusion 

ECMO can provide a chance of survival even in severe case of ARDS. This is likely the longest support ever reported 

using the same oxygenator. 


S06:8 

COAGULATION IN OXYGENATOR AND ARTERIAL FILTER AFTER RECIRCULATION 

Bellaiche Anne Louise 1 , Nielsen Peter Fast 1 , Sprogøe Pia 1 , Klungreseth Oddvar 1 

1) Aarhus University Hospital Skejby, Denmark 

We report a case of multiple coagulation in two successive oxygenators and one arterial filter when restarting 

bypass after 3 hours of recirculation. The case involves emergency surgery for dissection of the aorta with insertion 

of a homograft using 18 min. of deep hypothermic circulatory arrest and 4 hours of CPB. Bypass is terminated and 

protamin administered. Over the following three hours the bypass circuit is circulating while remaining bleeding 

is seeked managed surgically and with blood products, cryoprecipitate, haemocompletan and NovoSeven. Going 

back on bypass, clots are observed in the oxygenator which is replaced. After initiation of the second bypass period 

the arterial filter also shows clotting and is replaced. There is persistent high pressure in the whole circuit,- but 

no other clots could be determined at this point. After 1½ hours of bypass, shortly before weaning, new clots are 

observed in the second oxygenator. Bypass is terminated shortly after without problems. ACTs levels measured at 

half-hour intervals during the two bypass periods were all above the lower limit (400 sec. measured by Hemochron 

Jr) according to our protocol. Two days post-operatively the patient developed dilated pupils. CT scan shows brain 

infarction and the patient passed away the next day. Autopsy was not performed. Clots from the circuit could be a 

possible cause of the brain damage, however, other explanations are also possible. We present this case for peer 

discussion with the aim of avoiding similar incidents in the future. 


S07 

SATNU ORAL ABSTRACT SESSION 

S07:1 

HOW DOES NURSING COMPETENCE EXPRESS ITSELF IN THE OPERATING ROOM ? 

Walsoe Charlotte 1 

1) The Heart Centre, Rigshospitalet, Denmark 

An ongoing shortage of nurses in the operating room and generel recruitment difficulties challenges the Danish 

health system. As the shortage will continue in the years to come, politicians question the neccesity of exclusively 

nurses in the operating room and want to solve the situation by employing staff with a different education. The 

operating room nurses have no tradition documenting the essence and quality of nursing, and consequently now 

stand with a serious challenge in the discussion of the importance of nurses and nursing in the operating room. 

A study was conducted with the question “How does nursing competence and quality express itself in the operating 

room? ”. 

A search in CINAHL, PubMed and SweMed+ using the terms “nursing and operating room” resulted in 8 qualified 

articles, which have been used in this study. 

Patricia Benner was used in the theoretical analysis of the articles regarding the competence and essence of nursing 

in the operating room. 

Theories of the patients’ course of stay in hospital and quality control were used in the study. 

The nursing competence express itself in: 

- Caring - caring and technology are combined inseparable partners. 

- Congruity and continuity during the patients’ course of stay in hospital – the patients should recieve the same kind 

of nursing goals, vision and perspective throughout the course of their stay in hospital. 

- Safety and quality control – nurses must continously focus on development and an Evidence based practice. 

S07:2 

THE OPERATING ROOM NURSES EXPERIENCES OF THE MEDICAL EQUIPMENT IN THEIR DAILY WORK 

Roman-Emanuel Christine 1 , Hägglund Doris 2 

1) Sahlgrenska University Hospital, 2) Örebro University, Sweden 

Objective 

In the operating team, the operating room nurses are responsible for handling and maintenance of the medical 

equipment. The knowledge about the operating room nurse’s apprehension of work with medical equipment is 

limited. Increased knowledge in this area may increase nurse’s understanding of their role and ultimately, patient 

safety. The aim of this study was to describe how the operating room nurse’s experience the importance of the 

medical equipment in their daily work and their competence in medical equipment. 

Methods 

Forty-six operating room nurses working at a University Hospital were included in a prospective qualitative study. 

37/46 answered the questionnaire with tree open-ended questions. The answers of the questionnaire were analysed 

through a qualitative content analysis method according to Graneheim and Lundmann. 

Results 

The results demonstrated three main themes. The first theme described an increased understanding of how important 

it is to keep up your own competence within the field to ensure patient safety. The second theme described that the 

operating room nurse apprehend herself as a key-person in the operating-room teamwork with medical equipment. 

The third theme described positive and negative effects of the operating room nurse’s role as responsible for the 

medical equipment on the working-environment. 

Conclusion 

The main conclusion is that the competence level of operating room nurses and their experiences of medical 

equipment in their daily work influences safety for the patient, nursing and teamwork in the operating ward. 


S07:3 

SURGICAL TEAM MEMBER’S EXPERIENCES, ROUTINES AND VIEWS BEFORE IMPLEMENTATION OF 

A TIME-OUT PROTOCOL 

Murugesh Shamini 1 , Haugen Arvid 1 , Haaverstad Rune 1 , Slettebø Haldor 1 , Daavoy Grethe 1 , Soefteland Eirik 1 

1) Haukeland University Hospital, Norway 

Background 

Ensuring (1) correct patient (2) correct surgical procedure and (3) correct anatomic site/side for surgery is of prime 

importance for patient safety and may avoid medico-legal cases. Several studies confirm that a “Time-out” before 

the surgical incision can reduce the risk of making mistakes. The objective was to study the medical personnel’s 

experiences and views before implementation of a “Time-out” protocol in our Central Operation Unit (COU). 

Methods 

This survey was performed as a web-based questionnaire linked to our hospital’s e-mail system sent to all surgeons, 

anaesthesiologists, theatre nurses and anaesthesia nurses who were employed at the COU February 2009. Their 

experience with near-misses or mistakes, routines and views regarding the three check points and a “Time-out” 

protocol was registered. 

Results 

Feedback was received from 64% (427/275). Of these 38% had experience with unconfirmed patient identity, 

43% positioning on the wrong side, 80% unconfirmed anatomic site/side and 60% prepared for another procedure 

than planned. 50% of the responders regularly ensure patient identity, 61% regularly ensure operation site/ 

side and 52% usually ensure the type of procedure. 91% responded positively to a “Time-out” protocol being 

implemented in our operating theatres. 

Conclusions 

This study confirmed that a majority of the surgical team had experiences related to near-misses or mistakes of 

concern for patient safety. Our present system does not give a sufficient opportunity for the surgical team to ensure 

the three most important check points before the incision. The study supports the implementation of a “Time-out” 

protocol in our operating theatres. 

S07:4 

OUT OF HOSPITAL(OOH) MANAGEMENT OF PATIENTS ON LVADS (LEFT VENTRICULAR ASSIST 

DEVICES). THE NORWEGIAN EXPERIENCE. 

Sorensen Gro 1 , Gude Einar 1 , Holter Marianne 1 , Fiane Arnt 1 


The purpose was to describe our program for OoH management and what we have learned about challenges, joys 

and worries. 

Background 

15 Ventrassist LVAD for heart failure has during the last three years been implanted at the University hospital of 

Oslo. 11 patients had LVAD as bridge to transplant and 4 as chronic therapy. The patients were aged 10-65 (mean 

38.9) years old. Duration on pump was 4 weeks-22 months. Six patients have been successfully transplanted, one 

patient recovered after 13 months, six patients are ongoing and two died early after implant. 

The patients had very different family support, social network and length of illness before implant. 

The challenges the patients meet also differ considerably. A training program is planned for each patient depending 

on their individual situation but will always be focused about how to handle the LVADsystem, how to manage 

common daily situations, emergency procedures, exitsite care and monitoring system parametres. In addition to 

that, the local hospital will be trained and also have an important role in follow up. 

Conclusion 

A variety of physical, mental and social issues influenze the ability of the LVAD patient to cope with daily life. Being 

confident is the foundation pillar, and it is our responsibility as a team with VAD-coordinators, doctors and nurses 

to help them building their own framework. A prospective study will be performed to gain a better understanding of 

both patient and caregivers experience and what we as a VAD-team should focus on to optimize the support. 


S07:5 

GENDER AND HEALTH-RELATED QUALITY OF LIFE AFTER CARDIAC SURGERY 

Gjeilo Kari Hanne 1 , Wahba Alexander 1 , Klepstad Pål 1 , Lydersen Stian 2 , Stenseth Roar 1 

1) St. Olavs Hospital, 2) NTNU, Trondheim, Norway 

Background 

Women undergoing cardiac surgery are older, have more comorbidities and are more functionally impaired than men 

before surgery. It has been argued that gender differences regarding outcome tend to reflect differences that exist 

preoperatively rather than differences related to cardiac surgery itself. In addition a slower rate of physical recovery 

has been shown in female patients. However, the literature is not consistent regarding gender differences in healthrelated 

quality of life (HRQOL) outcomes after cardiac surgery. 

Design and methods 

A prospective study was designed to assess HRQOL in patients undergoing cardiac surgery with emphasis on 

gender differences. Between September 2004 and September 2005, 534 patients (413 males and 121 females) 

were consecutively included. HRQOL was measured by the Short-Form 36 (SF-36) before surgery with follow-up 

6 and 12 months after surgery. 

Results 

521 patients were alive after 12 months, 462 (89 %) and 465 (89.4%) responded after 6 and 12 months respectively. 

Female patients had less favorable scores than male patients on most subscales of the SF-36 both before and 

after surgery. Both male and female patients improved substantially after surgery, but female patients reported 

significantly less improvement on 2 of 8 subscales of the SF-36; role emotional and bodily pain. 

Conclusions 

The study demonstrates that there are gender differences concerning HRQOL both before and after cardiac surgery. 

However, a clear overall improvement in HRQOL over the first year after cardiac surgery, more specifically during 

the first 6 months for both genders was found. 

S07:6 

QUALITY OF LIFE IN PATIENTS AND HIS RELATIVES UNDERGOING PERCUTANEOUS PULMONARY 

VALVE IMPLANT 

Andresen Brith 1 , Døhlen Gaute 1 , Mathisen Lars 1 , Andersen Marit 1 , Lindberg Harald 1 , Fosse Erik 1 


Background 

The total number of patients with congenital heart disease is increasing. Many of these patients need repeatedly 

open heart surgery. Percutaneous pulmonary valve implant may reduce the total number of surgical events. 

Aim 

To examine the patients and their familys experience of postoperative convalescence and return to daily activity after 

treatment. This study is a pilot to a comparative clinical study where two different treatment techniques are used. 

Methods: Patients and relatives were included in a cohort study and underwent both a semi structured interwiew 

and a specially designed questionnaire (T.M.Achenbach, 2001). 

Preliminary results 

Eight patients median age 17 have been treated with PPVI at University Hospital of Oslo. The patients stayed 

median 3 days in hospital. Five of the patients and their family returned to daily activity from one to six days after 

the event. Three of the patients emphasized less pain as a positive issue. It was confirmed by five parents that the 

short hospital stay had a positive influence both on their family situation and their job relations. Less absence from 

work was emphasized as a positive socio-economic factor among parents. Seven of the patients had started one 

or two physical activities three months after the intervention. Improved school achievement and better ability in 

concentration was stated by 5 of the parents, six mentioned improved socialization with friends. 

Conclusion 

This novel technique seems to offer lesser impact regarding pain and everyday life to both patient and their closest 

relatives. It may have a sosioeconomic advantage. 


S07:7 

ADDRESSING THE SPOUSES UNIQUE NEEDS AFTER CARDIAC SURGERY WHEN RECOVERY IS 

COMPLICATED BY HEART FAILURE 

Ågren Susanna 1 , Strömberg Anna 2 , Svedjeholm Rolf 3 , Berg Sören 4 , Hollman Frisman Gunilla 1 

1) Anesthesia and Intensive Care, 2) European Society of Cardiology, 

3) Cardiothoracic Surgery, 4) Cardiothoracic Anesthesiology Intensive, Sweden 

Background 

Cardiac surgery places extensive stress on spouses who often are more worried than the patients themselves. 

Spouses can experience difficult and demanding situations when the partner becomes critically ill. 

Objectives 

To identify, describe, and conceptualize the individual needs of spouses of patients with complications of heart failure 

after cardiac surgery. 

Methods 

Grounded theory using a mix of systematic coding, data analysis, and theoretical sampling was performed. Spouses, 

10 women and 3 men between 39 and 85 years, were interviewed. 

Results 

During analysis, the core category of confirmation was identified as describing the individual needs of the 

spouses. The core category theoretically binds together three underlying subcategories: security, rest for mind 

and body, and inner strength. Confirmation facilitated acceptance and improvement of mental and physical 

health among spouses. 

Conclusions 

By identifying spouses’ needs for security, rest for mind and body, and inner strength, health care professionals can 

confirm these needs throughout the caring process, from the critical care period and throughout rehabilitation at 

home. Interventions to confirm spouses’ needs are important because they are vital to the patients’ recovery. 

S07:8 

PATIENT EDUCATION IN A REPRESENTATIVE SAMPLE OF PATIENTS HAVING ELECTIVE CARDIAC 

SURGERY IN ICELAND 

Olafsdottir Heida Steinunn 1 , Ingadottir Brynja 1 , Sveinsdottir Herdis 1 , 


Aim 

The aim of this study was to describe the perceived education and satisfaction with that education among patients 

undergoing elective cardiac surgery (CABG +/- AVR or AVR) at the Landspítali University Hospital in Iceland. 

Method 

This study used a descriptive, prospective correlational panel design. Data were collected with a questionnaire, at the 

hospital and at home six weeks later. Questions addressed patient education, symptoms, support and satisfaction 

with education, care and support as well as anxiety and depression that were measured with the Hospital Anxiety 

and Depression Scale. 111 patients who had surgery from January 15 until July 15, 2007, were invited to participate 

and 66 accepted. 

Findings 

The data analysis is not yet completed. The findings will describe the patients’ anxiety, symptoms, pain, perceived 

education and support and the correlation between those variables. 

Conclusion 

The preliminary findings indicate that the nursing care of cardiac surgery patients could be improved by identifying 

patients who are anxious per-operatively and provide them with individualised patient education at the hospital. 

Introducing post discharge follow-up is likely to increase patient satisfaction and recovery at home. 


S09 

SATS CARDIOTHORACIC ORAL ABSTRACT SESSION 

S09:1 

OUTCOME AFTER PULMONARY METASTASECTOMY: ANALYSIS OF SURGICAL RESECTIONS 

DURING A 5 YEAR PERIOD. 

Hornbech Kåre 1 , Ravn Jesper B. 1 , Steinbrüchel Daniel A. 1 


Objective 

Pulmonary metastasectomy for a wide range of different primary malignancies has become a progressively accepted 

treatment in patients with metastatic disease confined to the lungs. In the present single center study we analyze 

the results of management of pulmonary metastases in 5 years consecutive operations. We aim to define patients 

who are most likely to benefit from surgery by investigating long-term survival and prognostic factors associated 

with prolonged survival in a recent study population. 

Methods 

The data on all consecutive patients who underwent pulmonary metastasectomy between 2002 and 2006 were 

reviewed retrospectively. In total 178 patients underwent 256 surgical resections for suspected pulmonary metastases 

from different primary malignancies. 

Results 

Complete resection was achieved in 247 cases (96.4%). 25 patients (9.7%) had benign lesions and 25 patients 

(9.7%) had a primary lung cancer. 30-day morbidity and mortality were 6.6% and 1.9% respectively. Mean follow-up 

was 49.5 ± 17.8 months. The 5-year survival after metastasectomy according to primary tumour was: colorectal 

carcinoma 53.3%, sarcoma 20.9%, malignant melanoma 26.7%, renal cell carcinoma 38.1% and miscellaneous 

primary malignancies 50.0%. Of the prognostic factors analyzed by univariate analysis none were significant in all 

the different groups of cancers. 

Conclusions 

Pulmonary metastasectomy is a safe and effective treatment that leads to possible long-term survival in selected 

patients. Low morbidity and mortality rates in contrast with the lack of any other effective oncological treatment 

justify the aggressive approach of surgery. Solid prognostic factors need to be established. 

S09:2 

SURGICAL RESECTION OF PULMONARY METASTASES FROM COLORECTAL CARCINOMA IN ICELAND 

Vidarsdottir Halla 1 , Moller Pall 1 , Jonasson Jon Gunnlaugur 1 , Gudbjartsson Tomas 1 


Background 

Over half of patients operated for colorectal cancer are later diagnosed with recurrent disease, most often 

metastases in the liver or lungs. Pulmonary metastases can be removed surgically; however, the survival benefit has 

been debated. The aim of this study was to study surgical outcome of pulmonary metastasectomy in a well defined 

patient cohort. 

Materials and methods 

All patients that underwent complete pulmonary resection of metastatic colorectal carcinoma from 1984-2008. 

Average follow up was 41 months. 

Results 

Altogether 32 procedures on 27 patients were performed (age 63.5 yrs, range 35-80, 63% males). 19 with colon 

(70%) and 8 with rectal cancer (30%).The disease-free-interval was 29 months (range, 0-74) and 5 patients had 

undergone prior metastasectomy of the liver. Pre-thoracotomy CEA level was elevated in 9 of the patients. Eighteen 

patients had a solitary and 6 had two pulmonary nodules, other patients having multiple nodules. Lobectomy (n=18) 

and wedge resection (n=14) were the most common procedures. Three patients were operated for bilateral and 3 

for recurrent pulmonary metastases. All patients survived surgery and median length of hospital stay was 8 days 

(range, 5-58). Air leakage (19%) and pneumothorax (26%) were the most common complications. One and 5 year 

survival was 92.3 and 30.4%, respectively. 

Conclusion 

Surgical outcome in this series was good with low morbidity and mortality. The 5 year survival was 30.4 %, a much 

improved survival compared to patients with metastatic disease in general (

S09:3 

THE NO TOUCH VEIN GRAFT HARVESTING TECHNIQUE FOR CABG PRESERVES A FUNCTIONAL 

VASA VASORUM 

Dreifaldt Mats 1 , Souza Domingos 1 , Loesch Andrzej 2 , Muddle John 2 , Karlsson Mats 1 , 

Norgren Lars 1 , Dashwood Michael 2 

1) Örebro University Hospital, Sweden, 2) Royal Free Hospital, United Kingdom 

Objectives 

To evaluate the impact of vein graft harvesting technique on structure and function of vasa vasorum. 

Methods 

Segments of great Saphenous veins harvested either with conventional harvesting technique (CT) or no 

touch technique (NT) were obtained from patients undergoing CABG. Quantitative measurements, using 

immunohistochemistry and morphometry, were performed using a computerised imaging program. Ultrastructural 

analysis of vasa vasorum was performed using electron microscopy. Sections of in vitro perfused vein grafts with 

infusion of ink into the perfusion line were analysed using light-microscopy. Video footage of flow in an incised vasa 

vasorum in an implanted saphenous vein graft harvested with the NT was captured during a CABG operation. 

Results 

The total area of vasa vasorum in vein grafts harvested with NT was significantly larger both in the media (p 

= 0.007) and in the adventitia (p = 0.014) compared to vein grafts harvested with CT. Ultrastructural findings 

indicated that NT preserved an intact vasa vasorum while CT did not. Perfusion of vein grafts in vitro showed filling 

of ink in vasa vasorum in grafts harvested with NT. Video footage showed retrograde flow in vasa vasorum in vein 

grafts harvested with NT. 

Conclusion 

These findings show that the NT for saphenous vein graft harvesting for CABG preserves an intact and functional 

vasa vasorum. This could represent one of the mechanisms underlying the improved patency for vein grafts harvested 

with this technique. 

S09:4 

IS THERE A PLACE FOR TOTAL ENDOSCOPIC ABLATION OF ATRIAL FIBRILLATION? 

Ahlsson Anders 1 , Fengsrud Espen 1 , Linde Peter 1 , Tydén Hans 1 , Englund Anders 4 

1) Örebro University Hospital, Sweden 

Study objective 

To evaluate the feasibility, efficacy and safety of total endoscopic ablation (TEA) of atrial fibrillation (AF) using 

microwave or radiofrequency energy. 

Method 

TEA was performed using left single lung ventilation and CO2 insufflation in the right hemithorax. Through three 

right-sided working ports, an ablation catheter was positioned on the left atrial wall and a box lesion encircling all 

pulmonary veins was created (video demonstration). 

Results 

23 patients have undergone TEA since the start in May 2007. The indications were symptomatic AF in patients > 

50 years, and patients with a BMI > 35 were excluded. The median age was 67 yrs (52 – 83), and 5 patients were 

female. The frequency of paroxysmal/persistent/permanent AF were 9/5/9, respectively, and the median duration 

of AF 10 years. 

9 patients were ablated using a Flex X microwave catheter (Boston Scientific, USA) and 14 patients using a Cobra 

Adhere XL radiofrequency catheter (ESTECH, USA). There was no hospital mortality. One patient had a transient 

phrenical paralysis and one patient required a small thoracotomy to complete the ablation. The freedom of AF at 

follow-up was 7/10 patients (70%) after 12 months. Among radiofrequency ablated patients, the freedom of AF was 

9/9 patients after three months and 5/6 after 6 months. 

Conclusion 

TEA is a feasible method of AF ablation with preliminary acceptable results. The potential clinical role of TEA has to 

be further evaluated in prospective, randomised trials with careful monitoring of the AF burden during follow up. 


S09:5 

STERNAL CLOSURE WITH THERMOREACTIVE CLIPS IN 1000 HIGH RISK PATIENTS 

- A SINGLE CENTRE COHORT STUDY. 

Balasubramanian Sendhil Kumaran 1 , Dunning Joel 1 , Avlonitis Vassilios 1 , Gill Michael 1 , 

Goodwin Andrew 1 , Owens Andrew 1 , Kendall Simon 1 

1) The James Cook University Hospital, United Kingdom 

Background 

Nitillium thermoreactive clips are a novel method of sternalclosure. These clips are highly pliable at low temperature 

making them easy to place round the sternum but stiffen at body temperature. They also demonstrate elasticity 

on coughing, returning to their original position rather than cutting through. We sought to assess the incidence of 

sternal wound complications using these thermo-reactive clips(flexigrips) in 1,000 high-risk patients and identify the 

risk factors for deep sternal wound infection (DSWI). 

Methods 

From May-2004 to August-2008, 1,000 high-risk patients, had sternal closure using flexigrips. Perioperative and 

demographic variables were analyzed with univariate and multivariate logistic regression analysis to identify risk 

factors associated with DSWI. 

Results 

Median age was 64yrs and median BMI was 32. 85% were male, 30%diabetics and 75% had hypertension. 74% had 

CABG, 9% had valve replacements and 12% had combined procedures.There were no sternal complications in 981 

patients (98%). The total incidence of DSWI was 1.9% and sternal dehiscence was 1%. Superficial wound infection 

was 8.6%. Overall mortality was 1.6%. Multivariate analysis identified, BMI≥35 (Odds ratio 3.21:95%CI 1.16-8.85), 

type-II diabetes (Odds ratio 3.9:95%CI 1.27 – 12.3) and need for emergency resternotomy (Odds ratio 7.65:95%CI 

2.3-25.19) were significant risk factors for DSWI. 

Conclusions 

Thermo-reactive clips can be safely used for sternal closure in these high risk patients with an incidence of sternal 

dehiscence of 1%. Incidence of sternal dehiscence requiring surgery is low. BMI≥35, diabetes and mediastinal reexploration 

were additional predictors of DSWI. 

S09:6 

CARDIAC SURGERY IN PATIENTS WITH HAEMOPHILIA 

Tang Mariann 1 , Wierup Per 1 , Terp Kim 1 , Ingerslev Jørgen 2 , Sørensen Benny 2 

1) Department of Cardiothoracic Surgery, Aarhus University Hospital, Skejby, 

2) Center for Haemophilia and Thrombosis, Denmark 

Background 

Today the populations of haemophilia patients have a higher life expectancy than previously known, and age-related 

disorders are expected to become more prevalent. Cardiac surgery constitutes a major haemostatic challenge. 

Hence, only limited systematic information exists on efficacious and safe haemostatic substitution regimens during 

and after these major surgical episodes. Furthermore, postoperative thromboprophylaxis with antiplatelet drugs is 

questionable and seem problematic in patients with haemophilia. 

Aim 

Evaluation of our current experience and results with cardiac surgery in patients with haemophilia. Provide detailed 

information on the haemostatic treatment regimens adopted. Forward systematic details on the organization of 

haemostatic treatment regimens and postoperative thromboprophylaxis. 

Material & Methods 

Six patients with haemophilia A undergoing cardiac surgery. Information on concomitant disorders and EuroSCORE 

was registrated. Outcome measures were: (i)re-operation caused by bleeding, (ii) blood transfusion requirements, 

(iii) peri- and postoperative blood loss, (iv) peri- and postoperative complications and (v) postoperative development 

of inhibitors. Data was compared with historical data from patients without congenital haemophilia (n = 5977) as 

extracted from the Danish Heart Database. 

Results 

None of the six patients were reoperated due to bleeding and none developed inhibitors. Peri- and postoperative 

blood loss ranged from 565 to 1055 ml. No incidence of myocardial infarction or thromboembolic complications was 

seen. Data did not deviate from results with non-haemophiliacs undergoing major cardiac surgery. All patients were 

substituted with a recombinant factor VIII product. 

Conclusion 

Major cardiac surgery can safely be performed in patients with congenital haemophilia. Outcome measures were 

acceptable in comparison with data from non-haemophiliacs. 


S09:7 

SURGICAL CORRECTION OF PECTUS EXCAVATUM AND CARINATUM - SIX YEARS OF EXPERIENCES 

AT KAROLINSKA UNIVERSITY HOSPITAL. 

Bergman Per 1 


Objective 

The minimally invasive repair of pectus excavatum (p.e), the ”Nuss procedure” and the modified operation technique 

of pectus carinatum (p.c), the ”modified Ravitch procedure”, are becoming increasingly popular and has todaybecome 

well established and worldwide accepted. 

Methods 

Between 2004-2009, 76 patients in the county of Stockholm were operated at Karolinska (KS) and Clinica 

Vistahermosa (CV), Spain by the same surgeon. 46 cases with p.e were operated at KS and 10 cases were operated 

at CV. 8 cases with p.c were operated at KS and 12 cases at CV. 14 Pectus Bars (p.e) were also extracted at KS 

during this time. 

Results 

76 patients (68 men,8 women) with mean age of 17 years (range 12-34) were included. Mean time to discharge 

was 9 days (range 5-13) for Nussprocedure and 7 range (range 5-8) for modified Ravitch. Complications such as 

pain > 4 weeks occured in 6 patients (8%), intrapleural fluid in 1 patients (1%), small apical pneumothorax ocurred 

in 14 patients (25%) but had disappeared at the postop control 1 month later. Superficial infections localized in the 

incisions in 2 patients (3%). Deeper infection leading to removal of one stabilizator and one bar removal occured in 

2 patients (3%). Bars were removed after 3 years from 14 patients during this time. 

Conclusion 

These techniques have good outcome and few per/postoperative complications. The cosmetic results were very 

satisfying and the operations have very high Quality of Life appearence which also is going to be studied further. 


S10 

SATS BASIC SCIENCE ORAL ABSTRACT SESSION 

S10:1 

INJECTION OF MESENCHYMAL STEM CELLS MODIFIED WITH VEGF GENE IN ISCHEMIC 

MYOCARDIUM IMPROVES CARDIAC FUNCTION IN RATS 

Hua Ping 1 , Yang Yanqi 2 , Chen Ju 1 , Peng Jiangzhou 1 , Chen Bosheng 1 , Han Jie 1 , Wang Youyu 1 

1) The 2nd hospital Sun Yat-Sen University, China, 2) University Hospital, Linköping, Sweden 

Objective 

To observe effect of implantation of mesenchymal stem cells (MSCs) transfected by vascular endothelial growth 

factor (VEGF) on myocardium regeneration and angiogenesis in ischemic region, and consequent cardiac function in 

rats with acute myocardial infarction (AMI). 

Methods 

MSCs of Sprague Dawley rat were isolated, cultured, and labeled then with bromodeoxyuridine (BrdU). Some 

of them were transfected by adenovirus vector encoding VEGF (Ad.VEGF) gene. AMI was created by ligation of 

LAD artery in 40 rats. Four weeks after the ligation, left ventricle ejections fraction (LVEF) was measured with 

echocardiography. The rats were divided into four groups with 10 rats in each. Group I: implantation of MSCs 

transfected by Ad.VEGF; Group II: implantation of MSCs; Group III: injection of Ad.VEGF; and Group IV: untreated. 

Four weeks thereafter, myocardium regeneration and angiogenesis were evaluated with immunohistochemistry. 

LVEF measurement was repeated. 

Results 

MSCs labeled with BrdU were found in the ischemic region in group I and II with incorporation into capillaries, and 

stained by TnT antibody. The capillary density of 14.4±1.3/high power field (HPF) in group I and 13.6±1.1/HPF 

in group III were significantly higher than that of 5.9±1.7/HPF in group II and 0.00/HPF in group IV (P

S10:3 

VALIDATION OF CYSTATIN C WITH IOHEXOL CLEARANCE IN CARDIAC SURGERY. 

Brondén Björn 1 , Eyjolfsson Atli 1 , Blomquist Sten 1 , Jönsson Henrik 1 

1) Heart and Lung Division, USiL, Sweden 

Introduction 

Postoperative renal dysfunction after cardiac surgery is not uncommon. Plasma creatinine is the most commonly used 

biomarker of glomerular filtration rate (GFR). Serum cystatin C is a more sensitive biomarker of GFR than plasma 

creatinine, but has not been validated in cardiac surgery. Iohexol clearance is a reference method for determination 

of GFR. The aim of this study is to validate cystatin C with iohexol clearance in cardiac surgery. 

Method 

Twenty-one patients scheduled for elective coronary artery bypass grafting (CABG) where prospectively enrolled 

in the study. Before surgery and on the second postoperative day an iohexol clearance was performed. Cystatin 

C, creatinine, creatinine clearance and C-reactive protein (CRP) were determined before surgery and on the first, 

second, third and fifth postoperative day. 

Results 

A strong correlation between iohexol clearance and cystatin C was found both pre- and postoperatively (r = -0.80 and 

r = -0.89 respectively) and was stronger than the corresponding correlation for creatinine and creatinine clearance. 

A significant elevation of cystatin C concentrations was found on the second and third postoperative day, which was 

not seen in creatinine concentrations. No correlation was found between CRP, iohexol clearance and cystatin C. 

Conclusion 

This study validates cystatin C as a marker of glomerular filtration in cardiac surgery. The study did not indicate that 

the cystatin C levels were affected as a consequence of the inflammatory response. The study contributes to the 

assumption that cystatin C is superior to creatinine in detecting early decline in renal function in cardiac surgery. 

S10:4 

PLATELET REACTIVITY DURING CARDIOPULMONARY BYPASS (CPB) - CHANGES RELATED TO 

POSTOPERATIVE BLEEDING 

Ehnsiö Gustaf 1 , Norderfeldt Joakim 1 , Berg Sören 1 , Alfredsson Joakim 1 

1) Heart Centre,Linköping, Sweden 

Introduction 

The use of CPB during CABG surgery is associated with platelet dysfunction and consumption, contributing to 

perioperative bleeding. Our aim was to evaluate if platelet activity correlated to blood loss. 

Methods 

Platelet function in 30 patients undergoing CABG was analyzed using whole blood impedance aggregometry 

(Multiplate®) with ADP (adenosin diphosphate), TRAP (thrombin receptor activating peptide), AA (arachidonic 

acid) and COL (collagen) as activators. Platelet reactivity and platelet count was analyzed on multiple occasions 

perioperatively up to 18h postoperatively. 

Results 

Platelet reactivity to ADP and TRAP was significantly reduced at 30 minutes of CPB (p

S10:5 

THE HUMAN HEART RELEASES CARDIOTROPHIN-1AFTER CORONARY ARTERY BYPASS GRAFTING 

WITH CARDIOPULMONARY BYPASS 

Tian Yikui 1 , Ruan Xinhua 1 , Laurikka Jari 2 , Laine Seppo 2 , Tarkka Matti 2 , Wei Minxin 1 

1) China 2) Finland 

Objectives 

Cardiotrophin-1 is closely linked to many cardiovascular diseases, such as myocardial infarction and heart failure, 

and exhibits cardioprotective effect in ischemia-reperfusion injury. The present study was designed to investigate 

the course of CT-1 in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass 

(CPB), and to evaluate the relationship between plasma CT-1 levels and postoperative cardiac function. 

Methods 

Twenty-four patients undergoing elective CABG were studied. Radial artery blood samples were collected before 

CPB, 5 and 20 min after reperfusion, and 1, 6, 12 and 24 h after CPB. Coronary sinus blood samples were 

collected before CPB, 5 and 20 min after reperfusion. Plasma CT-1 levels were measured using the ELISA method. 

Hemodynamic data were collected. 

Results 

Peripheral CT-1 levels did not change significantly postoperatively. Trans-myocardial CT-1 levels increased significantly 

5 and 20 minutes after reperfusion as compared to baseline. A weak positive correlation (r=0.408, p=0.048) was 

found between trans-myocardial CT-1 levels at 20 min after reperfusion and CI at 12 hours after CPB. 

Conclusions 

The heart secretes CT-1 after ischemic injury. Endogenous CT-1 might be cardioprotective to ischemia-reperfusion 

injury in patients undergoing CABG, but the precise mechanism of this effect warrants further research. 

S10:6 

ACUTE KIDNEY INJURY FOLLOWING CORONARY ARTERY BYPASS SURGERY USING THE RIFLE CRITERIA 

Helgadottir Solveig 1 , Indridason Olafur 2 , Sigurdsson Gisli 2 , Sigurjonsson Hannes 2 , 

Arnorsson Thorarinn 2 , Gudbjartsson Tomas 2 

1) University of Iceland, 2) Landspitali University Hospital, Iceland 

Introduction 

Different rates of acute kidney injury (AKI) have been reported following open-heart surgery, ranging from 2 to 30%. 

This can be explained by variable study populations and a lack of consensus on AKI-criteria. Using international 

criteria we studied the incidence of AKI following CABG. 


A retrospective study of all patients that underwent CABG in Iceland, in 2002-2006. Concomitant CABG procedures, 

e.g. as part of valve procedures, were excluded. AKI was defined according to the RIFLE criteria, using pre- and 

post-op creatinine levels. 

Results 

Of 569 patients, 97 (17%) had reduced estimated glomerular filtration rate (eGFR200 μmol/L. The mean pre- and post-op creatinine level of the 

total study population was 92 and 104 μmol/L, respectively (p=0.0001). Ninety patients (15.8%) experienced AKI; 

58 fell into RISK, 16 in INJURY and 16 in FAILURE categories. Patients with AKI were 4.1 yrs older (p=0.0001) and 

had lower pre-op eGFR (72 vs. 80 mL/min/1.73m2, p=0.009). Female gender (28% vs. 16%, p=0.01), hypertension 

(74% vs. 59%, p=0.01) and acute surgery (11% vs. 2%, p

S18 

PHYSIOTHERAPISTS ORAL ABSTRACT SESSION 

S18:1 

PRECAUTIONS AFTER MIDLINE STERNOTOMY. ARE THEY NECESSARY? 

Brocki Barbara Cristina 1 , Thorup Charlotte Brun 1 , Skindbjerg Hanne 1 , Svalgaard Marianne 1 , Andreasen Jan Jesper 1 

1) Aarhus Univers. Hosp, Denmark 

Background 

Patients after midline sternotomy are instructed on activity precautions to avoid sternal wound complications. We 

question how restrictive those precautions must be, since they can lead to a decrease in quality of life in the 

postoperative period. 

Aims 

To identify mechanical stress factors causing sternal instability and infection in order to draw up evidence based 

guidelines for activity after sternotomy. 

Methods 

Literature review (CINAHL, Pub Med, Cochrane Library and PEDRO) and crosschecking references. 

Results 

Mechanical stress factors acting upon the sternum and the overlying skin are: constant coughing, BMI ≥ 35, skin 

stress due to macromastia, excessive bilateral arm movements leading to skin breakdown, and loaded activity with 

long lever arm. Our recommendations for precautions after midline sternotomy are: avoid stretching both arms 

backwards at the same time for 10 days; use leg rolling with counterweighting when getting in and out of bed; only 

move arms within pain free range; protect sternum when coughing by crossing the arms in a “self hugging” posture; 

use supportive sternal vest when coughing constantly or when BMI ≥ 35, use supportive bra when breast cup ≥D; 

loaded activity should be done with the elbows close to the body for 6 to 8 weeks. 

Conclusion 

Cough is considered the most important single mechanical stress factor causing instability. We found no evidence to 

support weight limitation regarding activity, as long as the upper arms are kept close to the body, and activity within 

pain free range. 

S18:2 

A RANDOMIZED CONTROLLED TRIAL ON DEEP BREATHING EXERCISES WITH POSITIVE 

EXPIRATORY PRESSURE AFTER CARDIAC SURGERY 

Urell Charlotte 1 , Emtner Margareta 1 , Breidenskog Marie 1 , Westerdahl Elisabeth 1 

1) Physiotherapy, Uppsala University Hospital, Sweden 

Objectives 

Deep breathing exercises with positive expiratory pressure (PEP) has been shown to be beneficial on oxygenation 

after cardiac surgery, but there is no consensus about the optimal duration and frequency of the treatment. The 

aim of this study was to investigate the oxygenation effect of deep breathing exercises with PEP, with two different 

breathing rates, the first two days after cardiac surgery. 

Methods 

In a prospective, randomized study 131 patients over 18 years, who underwent cardiac surgery were randomized 

in two groups: treatment group (TG) (n=63), 10 deep breaths x 3 in a PEP-device every hour awake the first two 

postoperative days and control group (CG) (n=68) 10 deep breaths x 1 every hour awake the first two postoperative 

days. The main outcome measures were arterial blood gases. Tests were performed the second postoperative day. 

Result 

Mean age was 68.5 years and 25% were women. TG had significantly higher arterial oxygen tension (PaO2 8.9 ± 

1.7 kPa vs 8.1 ± 1.4 kPa p= 0.004) and arterial oxygen saturation (SaO2 92.7 ± 3.7 % vs 91.1 ± 3.8%, p= 0.016) 

compared to the CG. Both groups had the same compliance to the breathing exercises. 

Conclusion 

A higher breathing rate resulted in an improved oxygenation and the groups had the same compliance to the exercises. 

Therefore a higher breathing rate should be recommended the two first postoperative days after cardiac surgery. 


S18:3 

PHYSICAL ACTIVITY ON PRESCRIPTION (FAR®)-A LONG TERM FOLLOW-UP OF FAR® PRESCRIBED 

AT A UNIVERSITY HOSPITAL 

Wennman Susanna 1 , Ståhle Agneta 2 , 

1) Karolinska University Hospital, 2) Karolinska Institutet, Dep. NVS, Sweden 

Background 

The use of FaR® to patients with high risk for lifestyle related diseases and as a treatment for different diseases has 

increased recently. The effects on FaR® have mostly been studied in primary health care settings. There is a lack 

of data regarding long-term effects. 

Objective 

To evaluate long-term effects of prescribing FaR®. 

Method 

The patients (n=34) who received FaR® after a physiotherapeutic intervention at Karolinska University Hospital, 

Solna, and participated at the follow-up twelve months later answered standardized questions regarding adherence, 

self-reported physical activity and health. 

Result 

The most frequent diagnosis for patients receiving FaR were cardiovascular, pulmonary or kidney diseases. A 

majority of the patients (65%) were physically active as prescribed or active in other activities. The remaining 

patients had a lower self-reported physical activity level and health. An increased physical activity level was 

measured among those who adhered to the prescription (p=0.05). There was no significant difference in selfreported 

health among those patients who adhered to the prescription and those who did not. 

Conclusion 

To prescribe FaR® is an effective method to positively influence self-reported physical activity level and the 

adherence to the prescription is very good. 

Key-words: counseling, life style, physical therapy, primary prevention, public health 


P01 

POSTER SESSION 

P01:01 

PLATELET IMPEDANCE AGGREGOMETRY AND POSTOPERATIVE BLOOD LOSS AFTER CORONARY 

ARTERY BYPASS SURGERY 

Roman-Emanuel Christine 1 , Thimour-bergström Linda 1 , Önsten Linda 1 , Rexius Helena 1 , Jeppsson Anders 1 


Objective 

Platelet dysfunction may contribute to increased bleeding after cardiac surgery but is difficult to assess. Impedance 

whole blood aggregometry is a new point-of-care method to evaluate platelet function. We investigated in an ongoing 

study if there is any correlation between impedance aggregometry, and bleeding and transfusions after 

coronary artery bypass grafting (CABG). 

Methods 

Fifty-five consecutive CABG patients (men age 67+-9 years, 13% women) were included in a prospective observational 

study. 52/55 patients were treated with aspirin and 26 were also treated with the ADP receptor blocker clopidogrel 

within seven days before surgery. Platelet impedance aggregometry (Multiplate®) with adenosine-diphosphate 

(ADP) and thrombin receptor activated peptide 6 (TRAP) as activators, was performed after induction of anesthesia 

and at sternum closure. Correlation between platelet aggregometry and postoperative bleeding was calculatedwith 

Spearman’s Rank sum test and platelet aggregometry variables were compared between transfused and nontransfused 

patients with student’s T-test. 

Results 

Mean postoperative blood loss was 561+-308 ml/12h and 20/55 patients (36%) were transfused with blood 

products. There was no significant correlation, neither between pre- and post-operative ADP-induced platelet 

aggregation and postoperative blood loss (r=-0.22, p=0.10 and r=–0.06, p=0.66,respectively) nor between pre- 

and post-operative TRAP-induced platelet aggregation and postoperative blood loss (r=0.06, p=0.68 and r=0.11, 

p=0.41). Furthermore, there were no significant differences in pre- and post-operative aggregometry variables 

between transfused and non-transfused patients. 

Conclusions 

Platelet function, as measured with impedance aggregometry with ADP and TRAP as activators do not correlate to 

postoperative bleeding and transfusion requirements after CABG. 


P01:02 

A COMPARISON OF ANTICOAGULANTS IN WHOLE BLOOD PLATELET IMPEDANCE AGGREGOMETRY 

IN CABG PATIENTS 

Thimour-Bergström Linda 1 , Roman-Emanuel Christine 1 , Jeppsson Anders 1 

1) Sahlgrenska University hospital, Sweden 

Objective 

Impedance aggregometry is a new method to evaluate platelet function. Blood samples are collected in test tubes 

with anticoagulants and analyzed in a point-of-care device. We investigated if blood samples from CABG patients 

collected in tubes with hirudin and citrate gives comparable results. 

Methods 

Twenty CABG patients (mean age 66 +10 years) were included in a prospective observational study. 19/20 patients 

were treated with aspirin and 10 were also treated with the ADP receptor blocker clopidogrel within seven days 

before surgery. Platelet impedance aggregation (Multiplate®), with adenosine-diphosphate (ADP) and thrombin 

receptor activated peptide 6 (TRAP) as activators, was measured after induction of anesthesia and at sternum 

closure. Aggregation was expressed as area under the curve. Absolute difference, relative difference and correlation 

coefficients (r) were calculated. 

Results 

In ADP-induced aggregation was the absolute difference between hirudin and citrate tubes -7±11 units (13±12 vs 

5±4 units) and the relative difference -27±78%. There was no significant correlation between hirudin and citrate 

tubes aggregation (r=0.25, p=0.11). In contrast, there was a strong correlation between hirudin and citrate tubes in 

TRAP induced aggregation (r=0.84, p

P01:04 

RIGHT VENTRICULAR 3-D ARCHITECTURE IS PRESERVED DURING EXPERIMENTALLY INDUCED 

RIGHT VENTRICULAR HYPERTROPHY 

Nielsen Eva 1 , Smerup Morten 1 , Agger Peter 1 , Frandsen Jesper 1 , Lunkenheimer Paul P. 2 , 

Anderson Rober H. 3 , Hjortdal Vibeke 1 , 

1) Aarhus University Hospital, Skejby, Denmark, 2) University Münster, Germany, 

3) University Collage, London, United Kingdom 

Introduction 

The three-dimensional architecture of the myocytes in the right ventricular (RV) myocardium is a major determinant 

of function, but as yet no investigator-independent methods have been used to characterize either the normal 

or hypertrophied state. Our aim was to assess and compare, using diffusion tensor MRI (DTMRI), the normal 

architecture with the arrangement induced by chronic hypertrophy. 


20 female piglets were randomized into either pulmonary trunk banding or sham operations. RV hypertrophy was 

assessed by in vivo cardiovascular MRI after 8 weeks. Hereafter hearts were excised and fixated, and DTMRI was 

performed to determine the helical angles of the myocytes aggregated within the walls, and the presence of any 

reproducible tracks formed by the aggregated myocytes. 

Results 

All banded animals developed significant RV hypertrophy, albeit no difference was observed in terms of helical 

angles or myocardial pathways between the banded animals and those undergone the sham operation. Helical 

angles varied from approximately 70º endocardially to -50º epicardially. Very few tracks were circular, with helical 

angles approximating zero. Reproducible patterns of chains of aggregated myocytes were observed in all hearts. 

Discussion 

The 3D-architecture of the RV is comparable to that found in the LV, although the RV lacks the extensive zone of 

circular myocytes found in the mid-portion of the LV walls. These circular tracks were also not observed in the RVs 

of banded animals. Without such beneficial architectural remodeling, the porcine RV seems unsuited structurally to 

sustain a permanent afterload increase. 

P01:05 

SURGERY FOR MYXOMA: A 10 YEAR EXPERIENCE 

Bondo Jørgensen Louise 1 , Steinbrüchel Daniel A. 1 


Introduction 

Myxoma is a benign neoplasm that represents the most common primary tumor of the heart accounting for about 

50 % of all benign cardiac tumors. Despite its benign pathology this tumor may cause significant complication and 

mortality by affecting blood flow and causing arrhythmias and emboli. 

Material/Methods 

The records of 35 patients which underwent surgery for cardiac myxoma at Rigshospitalet, Copenhagen, identified 

during the period 1998 to 2008 were reviewed. Patients aged ranged from 23 to 90 years (median age 60); women 

predominated by a ratio of 1.2:1. 

In 29 patients the tumor was located in the “left side” of the heart (left ventricle/atrium), in 7 patients the myxoma 

was found in the right atrium/ventricle. 

Results 

In 8 patients the myxoma was found accidentally, 9 presented with emboli (cerebral or pulmonary), 18 patients were 

investigated du to cardiac symptoms. No significant differences with respect to age, gender, BMI or tumor pathology 

could be demonstrated in patients presenting with emboli compared to patients with cardiac symptoms. In 6 patients 

CABG , valve surgery or MAZE was performed apart from myxoma resection. 30 day mortality was 2/35 (stroke/ 

acute MI), 3 patients died during a median 4 year follow op. 

Conclusion 

Although cardiac myxoma is a benign disease, this tumor form must be classified as potentially fatal due to a 

risk of embolisation. An embolic event was the initial clinical manifestation.in 25% of the patients. Therefore an 

echocardiography should be considered in adults and young adults with cerebral or pulmonary embolism. 


P01:06 

CARDIAC MYXOMA IN ICELAND - A NATION-WIDE CASE SERIES 

Sigurjonsson Hannes 1 , Andersen Karl 1 , Gardarsdottir Marianna 1 , Petursdottir Vigdis 1 , Klemenzson Gudmundur 1 , 

Gunnarsson Gunnar Thor 1 , Gudbjartsson Tomas 1 


Introduction 

Myxoma is the most common benign primary tumor of the heart, usually presenting with symptoms of systemic 

emboli or intracardiac obstruction. In recent years, incidental finding is also common. We studied all myxomas 

diagnosed in a well defined population during a 23 year period. 


A retrospective population-based study including all patients diagnosed with cardiac myxoma in Iceland from 1986 

until March 1, 2009 (> 4300 operations performed). Cases were identified through three different registries and 

databases. 

Results 

Nine cases were identified (3 males, 6 females) with mean age of 60.7 yrs (range 37-85). Age-adjusted incidence 

rate was 0.12 (95% CI: 0.05-0.22) per 100.000. Eight of the tumors were located in the left atrium and one in the 

right atrium. Average diameter was 4.4 cm (1.5-8.0). Dyspnea (n=5) and ischemic stroke (n=2) were the most 

common symptoms. Seven of the cases were diagnosed with transthoracal echocardiography and 2 with chest CT, 

one of them incidentally. All 9 patients underwent surgical resection, mean operation time being 238 min. All patients 

survived surgery and atrial fibrillation (n=5) was the most common complication. Median length of hospital stay was 

21 days and today (March 1, 2009), 7 of the 9 patients are alive with no signs of recurrent disease. 

Conclusions 

Cardiac myxomas have similar incidence, presenting symptoms and mode of detection in Iceland as in other series. 

To our knowledge this is the first study reporting the incidence of cardiac myxoma in an entire population. 

P01:07 

TOPICAL NEGATIVE PRESSURE OVER CONVENTIONAL THERAPY OF DEEP STERNAL WOUND 

INFECTION IN CARDIAC SURGERY. PROSPECTIVE ANALYSIS. 

Simek Martin 1 , Hajek Roman 1 , Fluger Ivo 1 , Molitor Martin 1 , Langova Katerina 1 , Grulichova Jana 1 , Lonsky Vladimir 1 

1) University Hospital Olomouc, Czech Republic 

Introduction 

We sought to compare clinical outcomes, in-hospital mortality and 1-year survival of two different treatment 

modalities of deep sternal wound infection, topical negative pressure and the conventional therapy. 

Methods 

Prospective analysis of 66 consecutive patients treated for deep sternal infection at our institution. A total of 28 

patients (February 2002 through September 2004) underwent conventional treatment, and 34 patients (November 

2004 through December 2007) had the application of topical negative pressure. Four patients (July 2004 through 

December 2004) who underwent a combination of both strategies were excluded from the study. Clinical and wound 

care outcomes were compared, focusing on therapeutic failure rate, in-hospital stay and the 1-year mortality of both 

treatment strategies. 

Results 

Topical negative pressure was associated with a significantly lower failure rate of the primary therapy (p

P01:08 

THE EFFECT OF CO2-INSUFFLATION ON THE TEMPERATURE OF THE STERNOTOMY WOUND 

Frey Joana 1 , Svegby Henrik 2 , Svenarud Peter 1 , van der Linden Jan 1 

1) Karolinska University Hospital, 2) Royal Technical University, Sweden 

Background 

The open surgical wound is exposed to heat loss through radiation, evaporation and convection. Also, general 

anaesthesia contributes to a decrease in body temperature. Mild core hypothermia has been shown to contribute 

to cardiovascular morbidity, transfusion demands, delayed wound healing, postoperative wound infections, and 

extended hospitalization. A number of measures to prevent core hypothermia have been assessed as to their 

effectiveness but warming the open surgical wound by insufflating CO2 has so far not been investigated. 

Methods 

In 10 patients undergoing heart surgery, the surface temperature of an open cardiothoracic wound was measured 

with an infrared camera. Thermographic images were taken 2 minutes after opening of the pericardium, 2 minutes 

after insufflating the wound with dry room-tempered CO2 at a flow rate of 5 L/min via a gas diffuser, and 2 minutes 

after again exposing the wound to ambient air. Later off-analysis measured the average surface temperature of the 

whole wound. 

Results 

Exposure to CO2 increased the median temperature of the whole wound by 0.5°C (p=0.01) and the two thirds most 

distal to the diffuser by 1,2°C (p2 had been turned off. In the area closest to the diffuser the temperature decreased 

with 1.8°C (p2. 

Conclusion 

Short term insufflation of dry room-tempered CO2 in an open surgical wound cavity increases the surface temperature 

of the whole wound significantly. However, the temperature of the area closest to the diffuser decreased, most 

propably due to convection. 

P01:09 

THE PECTORALIS MUSCLE AXIAL FLAP WITH V-Y SKIN PADDLE FOR COVERING OF STERNAL DEFECTS. 

Molitor Martin 1 , Simek Martin 1 , Záleaák Bohumil 2 , Lonský Vladimir 1 

1) University Hospital Olomouc, Czech Republic 

Introduction 

Infectious wound complication after cardiovascular surgery is serious problem with high rate of associated morbidity 

and mortality and usually lead to wound dehiscence with sternal osteomyelitis and both bone and soft tissue defects. 

When infection is managed the reconstruction of the thoracic wall remains the main problem. Tissues used to 

cover the defect must be well nourished and suture must be absolutely tension free. We introduce our method of 

reconstruction using pectoralis muscle axial flap with V-Y skin paddle. 

Method 

Right pectoralis muscle is freed in the extent that allows its comfortable shifting over whole sternal bone and V-Y 

skin paddle allows tension free skin suture in the midline. 

Results 

In the period of 2007-2009 we have performed four flaps. In two patients haematoma occured in the site of disconected 

humeral head of pectoralis muscle, in one patient in the proximal midline suture. In one patient peripheral necrosis 

of the distal part of the flap occured that needed resuturing and after that healed completely. All flaps survived and 

no dehiscence or other complication in the site of primary defect occured. 

Conclusion 

Our type of flap is reliable and easy to performe. It has excellent blood supply and allow tension free suture of all 

tissues. Nosignificant superficial necrosis can occur in the most peripheral part of the flap. Its main disadvantage is 

that it cannot be used in female patients due to breast. Insignificant medial shifting of the areola in male patient is 

well tolerated. 


P01:10 

CIRCULATORY ARREST AND BRAIN MONITORING 

Vainikka Tiina 1 , Wennervirta Johanna 1 , Ångerman-haasmaa Susanne 1 , Mäki Kaisa 1 , Vakkuri Anne 1 , 

Sipponen Jorma 1 , Salminen Ulla-Stina 1 

1) Helsinki University Hospital, Finland 

Brain monitoring in patients undergoing aortic arch surgery is unreliable. During cardiopulmonary bypass, deep 

hypothermia and circulatory arrest, brain damage may occur at any time point. 

Prospective patient enrollment started 11/2007. Patients (30) undergoing cardiopulmonary bypass, deep hypothermia 

and circulatory arrest are included. CAD patients operated on-pump (15) or off-pump (15) serve as controls. For 

brain monitoring, continuous EEG recording and NIRS oximeter are used. Neuropsychological tests are done 6 

months postoperatively. 

So far 18 patients, F/M = 5/13, 55.6 + 13.8 years, EuroScore 19.3% + 20.0%, were enrolled. Diagnosis was 

ascending aortic dissection in 12 and rupture of ascending aortic aneurysm in 1. Elective surgery was performed in 

additional 5. Circulatory arrest was 36.9 + 30.1 min. Both-sided (3) or right (5) selective cerebral perfusion was used 

in 8 for 38.4 + 26.6 min. 2 (6.7%) died intrahospitally, 6 (33.3%) had neurological complications; 3 severe cerebral 

infarctions. Neurological complications showed NIRS and/or EEG changes. So far 11 were controlled: 1 died, 2 were 

hospitalized for stroke, 8 were tested. All 6 not retired were working. 2 patients were intact, 5 showed mild cognitive 

changes, 1 was depressed. 10 on-pump controls, F/M = 1/9, 62.8 + 9.3 years, recovered uneventfully, 4 attended 

control: 2 were intact and 2 had mild cognitive changes. Of 3 off-pump controls, F/M=0/3, 61.3 + 15.8 years, 2 

attended and were intact. 

EEG and NIRS monitoring gives information of the timing and severity of intra-operative brain damage. In less 

severe neurological complications 6-month results are good. 

P01:11 

NEGATIVE-PRESSURE WOUND THERAPY (NPWT) FOR STERNAL WOUND INFECTION 

“THE FIRST CASES IN ICELAND” 

Steingrímsson Steinn 1 , Gottfredsson Magnus 2 , Gudmundsdottir Ingibjorg 3 , Sjögren Johan 4 , Gudbjartsson Tomas 2 

1) 2) 3) University of Iceland, Landspitali University Hospital, Faculty of Nursing, Uni. of Iceland, Iceland 

4) Lund University Hospital, Sweden 

NPWT has been shown to be effective for treating sternal wound infections (SWI). Rather than leaving the wound 

open after debridement or use closed irrigation, a sponge is placed in the wound and negative pressure applied. This 

reduces bacterial load, increases blood flow and stimulates formation of granulation tissue in the wound. The aim of 

this study was to evaluate the results of NPWT for SWI in Iceland. 

Consecutive case series, including all patients with SWI following cardiac surgery that required surgical revision, 

diagnosed between July 2005 and Dec 2008. During this period all patients with SWI were treated with NPWT. 

12 patients (age 69 yrs, 10 males, 9 following CABG) were identified (1,3% infection rate). Coagulase-negative 

staphylococci (n=6) and Staphylococcus aureus (n=4) were the most common pathogens. NPWT was initiated 

on the 19th day postoperatively (median, range 5-111) and the duration of treatment was 14 days (median, range 

5-36). In most cases (9/12) the sternal-wires were removed and the sponges replaced 2-8 times. Primary closure 

of the sternum was achieved following NPWT in 10 out of 12 cases. In one case of Pseudomonas aeruginosa 

infection, NPWT treatment failed and this patient was treated successfully with vinegar soaked gauzes. No major 

complications were directly related to NPWT, however one patient died of sepsis related to SWI. The other 11 

patients are alive today (Jan. 2009) and without signs of infection. 

This small series shows promising results for NPWT of SWI in Iceland and that major complications are rare. 


P01:12 

REOPERATION FOR BLEEDING FOLLOWING OPEN HEART SURGERY IN ICELAND 

Smarason Njall 1 , Sigurjonsson Hannes 1 , Hreinsson Hreinsson 1 , Arnorsson Þorarinn 1 , Gudbjartsson Tomas 1 


Introduction 

Postoperative bleeding is a potentially fatal complication following open heart surgery, with studies reporting a 

reoperation-rate for bleeding in the range of 2-6%. In Iceland surgical outcome after such reoperations has not been 

studied before. 


This retrospective study included all adults that underwent open heart surgery in Iceland between 2000-2005, and 

were reoperated for bleeding. 

Results 

There were 103 reoperations (mean age 68 yrs, 76% males), out of 1295 open heart procedures performed during 

the same period, giving a reoperation-rate of 8%. One third of the patients were taking aspirin and 8% clopidogrel 

less than 5 days before surgery. The bleeding in the primary operation averaged 1523 ml (range 300-4780) and 

3942 ml for the first 24 hours postoperatively. Every other patient was reoperated on within 2 h and 97% within 

24 hours. The patients received 16.5 units of packed cells, 15.6 units of plasma and 2.3 sets of thrombocytes. The 

most common postop complication was atrial fibrillation (58.3%), pleural effusion that needed drainage (24.3%), 

myocardial infarction (23.3%) and sternal wound infection (11.7%). Median length of stay was 14 days (range 6-85), 

including 2 days (range 1-38) in the ICU. Operative mortality was 15.5% and 1-year crude survival 79.6%. 

Conclusion 

Reoperation-rate of 8% is in the higher range compared to other studies. Bleeding is a serious complication, with 

high morbidity and significant mortality. Furthermore, cost is increased due to expensive transfusions and extended 

hospital stay. This emphasizes the necessity to find means to reduce post-operative bleeding. 

P01:13 

SURGICAL TREATMENT OF NEUROENDOCRINE BRONCHIAL TUMORS AT KAROLINSKA UNIVERSITY HOSPITAL 

Brodin Daniel 1 , Bergman Per 1 , 


Objective 

Due to the excellent prognosis of typical carcinoids (TC), parenchymal saving has been addressed for discussion 

as an alternative to anatomical resections. But many authors mean that there is not sufficient data to recommend 

parenchymal-saving (limited) operations in any carcinoids. The aim of the present study was to determine factors 

that could influence the long-time survival of patients treated surgically for neuroendocrine bronchial tumors and 

thereby help to establish criteria of limited operation. 

Methods 

The study was based on retrospective analysis of a total of 45 patients who were surgically treated for neuroendocrine 

bronchial tumours between 1987-2004. Cumulative survival was estimated by the Kaplan Meier method. Differences 

in survival were tested using log rank test. 

Results 

The 45 patients constituted 9 % of all operated and diagnosed lung tumours. Twenty-four were classified with TC, 

five with atypical carcinoids (AC), nine with small cell lung cancer (SCLC) and three with large cell lung cancer 

(LCNE). Four patients with carcinoids could not be further sub-classified. Overall 5-year survival rate was 73 %, for 

TC 96 %, AC 60 %, SCLC 22 % and LCNE 33%. Smokers and men had a shorter survival compared to non-smokers 

and women. Patients with AC had a higher mean age (67.9) than patients with TC (57.6). 

Conclusion 

There is a favourable outcome for the TC and these patients could be considered for parenchymal-saving 

operations. 


P01:14 

BILATERAL LUNG VOLUME REDUCTION SURGERY FOR SEVERE EMPHYSEMA 

Gunnarsson Sverrir I. 1 , Johannsson Kristinn B. 1 , Gudjonsdottir Marta 2 , Magnusson Björn 3 , 

Beck Hans J. 2 , Gudbjartsson Tomas 1 

1) Landspitali University Hospital, 2) Reykjalundur Rehabilitation Center, 3) Neskaupstadur Hospital, Iceland 

Introduction 

Lung volume reduction surgery (LVRS) can be used as a palliative treatment for severe emphysema in appropriately 

selected patients. The aim of this study was to evaluate the results of LVRS in Iceland. 


A prospective study of 16 consecutive LVRS patients (age 59 yrs, 10 males) with severe emphysema operated 

between 1986 and 2008. Approximately 20% of each lung was excised through a sternotomy, using a linear 

stapler. All patients were extubated at the end of the procedure. Function tests were done pre- and 2-4 months 

postoperatively. 

Results 

Average operation time was 86 min. (range 55-135) and hospital stay 26 days (range 9-85). There were no 

postoperative deaths and prolonged airleak was the most common complication (n=7). Four patients needed 

reoperation; including 3 with sternal dehiscence and one with sternal wound infection. Preoperatively, FEV1 was 0.97 

L (33% of predicted) and TLC 7,8 L (132% of predicted), RV 4.5 L (205% of predicted) and exercise capacity 69 W. 

Postoperatively FEV1 had increased significantly by 34% to 1,3 L (p=0.004), but other changes were not significant. 

Today (April 2009), 10 out of 16 patients are alive, with median crude survival of 96 months (range 9-151). 

Conclusion 

In this small series, FEV1 significantly improved after LVRS. All the patients survived surgery, however, complications 

were common and hospital stay extended. LVRS appears to benefit some patients with severe emphysema. However, 

due to small patient numbers our results have to be interpreted cautiously. 

P01:15 

SURGICAL RESECTIONS FOR GIANT PULMONARY BULLAE 

Gunnarsson Sverrir I. 1 , Johannsson Kristinn B. 1 , Asgeirsson Hilmir 1 , Gudjonsdottir Marta 2 , 

Magnusson Bjorn 2 , Gudbjartsson Tomas 1 

1) Landspitali University Hospital, 2) Reykjalundur Rehabilitation Center, Iceland 

Background 

Giant bullae are large dilated air spaces, often occupying more than 1/3 of the hemithorax in patients with emphysema. 

The aim of this study was to evaluate the surgical outcome of resections for giant bullae in Iceland. 


A retrospective review of 12 consecutive patients (age 58 yrs, 11 males) with severe emphysema who underwent 

bullectomy (8 bilateral and 4 unilateral) in Iceland during 1992-2008. Except for one lobectomy performed through a 

thoracotomy all patients were operated with wedge resection through sternotomy. In all cases pre- an postoperative 

lung function studies were performed. 

Results 

Average operation time was 91 min (range 75-150). Preoperatively FEV1 was 1.0 L (33% of predicted) and FVC 2.9 

L (68% of predicted). Two months postop an 80% increase in FEV1 was noted (1.8 L, 58% of predicted, p=0.015) 

but only 7% increase in FVC (2.9 L, 68% of predicted, p=0.6). All patient survived surgery and the most common 

complications were prolonged air leak (>7 days) (n=9) and pneumonia (n=2). One patient was reoperated on for 

sternal dehiscience. Median hospital stay was 36 days (range 10-74). Today (May 2009) 7 patients are alive, but the 

other 5 patients died 9 yrs median after the operation (100% 5-year survival). 

Conclusion 

Results of bullectomy in this small series is good. There was a significant increase in FEV1, major complications were 

rare and long-term survival acceptable. Prolonged air leak is a common postoperative complication that prolongs 

hospital stay of these patients. 


P01:16 

PNEUMONECTOMY FOR NON-SMALL CELL LUNG CANCER IN ICELAND: EARLY COMPLICATIONS 

AND LONG TERM SURVIVAL 

Thorsteinsson Hunbogi 1 , Jonsson Steinn 2 , Alfredsson Hordur 3 , Isaksson Helgi 4 , Gudbjartsson Tomas 3 

1) 2) 3) Fac. of medicine, University of Iceland, Dpt. of pulmonology, Dpt. of cardiothoracic surgery, 

4) Dpt. of pathology, Iceland 

Objective 

Pneumonectomy is required for large or central non small cell lung cancer (NSCLC). This study aims to investigate 

the indications, complications and surgical outcome of pneumonectomy for NSCLC in Iceland. 


A retrospective study of all pneumonectomies performed for NSCLC in Iceland 1988-2007. Clinical information was 

retreived from medical records and all cases staged using the TNM staging system. Survival and prognostic factors 

were evaluated using Cox multivariate analysis. 

Results 

77 patients (64% males) with mean age of 62.3 yrs. were operated on, 44% on the right side. Mediastinoscopy 

was performed in 31% of cases. Most patients were stage I or II (58%), but 17% and 21% were stage III A and IIIB, 

respectively. Mean operating time was 161 min., bleeding 1,1 L and hospital stay 11 days. Atrial fibrillation/flutter 

(21%), pneumonia (6%), empyema (5%) and respiratory failure (5%) were the most common complications. Three 

(3.9%) patients died within 30 and 8 (10.4%) within 90 days of surgery. Five year survival was 21%. Age (HR 1.035), 

airway obstruction (HR 2.9), large cell- or adenocarcinoma histology (HR 2.21) and TNM stage IV vs. I (HR 16.5) 

were independent predictors of poor survival. Operation in the later 10 year period predicted improved survival (HR 

0.55, p= 0,03). 

Conclusions 

Pneumonectomies for NSCLC in Iceland have a low rate of complications and operative mortality. Long term survival, 

however, is lower than expected, possibly related to insufficient preoperative staging, with only 1 out of 3 patients 

undergoing mediastinoscopy prior to pneumonectomy. 

P01:17 

MEDIASTINOSCOPY – INDICATIONS AND EARLY COMPLICATIONS. 

Olafsdottir Thora Sif 1 , Gudmundsson Gunnar 2 , Björnsson Jóhannes 3 , Gudbjartsson Tomas 1 , 

1) Department of surgery, 2) Department of pulmonary medicine, 3) Department of Pathology, Landspitali, Iceland 

Introduction 

Mediastinoscopy is an important tool for staging lung cancer and evaluating mediastinal pathology. The objective of 

this retrospective study was to investigate the indications and safety of mediastinoscopy in a well defined cohort of 

patients. 


All patients that underwent mediastinoscopy in Iceland between 1983-2007 were included. Clinical information was 

obtained from patient charts and pathology reports were reviewed. For comparison the study-period was divided 

into 5-year periods. 

Results 

282 operations were performed but in 34 cases data was missing, leaving 248 patients for analysis (mean age 59 

yrs, range 11-89, 150 males). A steady increase was seen in the number of operations, or 16 compared to 85 during 

the first and last periods, respectively (p500 ml (0,8%). There were two operative deaths, one due to a major intraoperative bleeding from a 

mediastinal tumor that infiltrated the aortic arch and one from a post-operative pseudomonas pneumonia. 

Conclusions 

The number of mediastinoscopies is increasing in Iceland, especially as a part of lung cancer staging. Mediastinoscopy 

is a safe procedure with low mortality and morbidity. 


P01:18 

THYMIC EPITHELIAL TUMORS: HISTOLOGY, STAGING AND THE RESULTS OF SURGICAL REMOVAL 

Mariusdottir Elin 1 , Gudbjartsson Tomas 2 , Sigfusson Nikulas 2 

1) University of the Iceland, 2) Landspitali University hospital, Iceland 

Objective 

Most thymic tumors are of epithelial origin with different clinical behavior and prognosis. Our aim was to study 

the histological subtype and tumor stage of thymic epithelial tumors in Iceland and evaluate the results of 

surgical treatment. 


16 consecutive patients (mean age 61 yrs, 10 males), diagnosed with thymic tumor in Iceland, from 1984 to 2009, 

were studied retrospectively. The histological subtype was determined according to the new WHO classification 

(A-C) and the Masoka-system used for staging the tumors. 

Results 

Seven patients had local symptoms (chest pain, cough), seven were diagnosed incidentally and 2 were diagnosed 

during a work-up for myasthenia gravis. Benign tumours were 12, and thymic carcinomas four (25%). The histological 

subtype was type A (n= 4), type AB (n=2), type B1 (n=1), type B2 (n=5) and type C (n=4), with no B3 tumors. 

Majority of the tumors were on stage I (n=4) or II (n=5) but the carcinomas were two on each stage, III and IV. 

Twelve of the 16 patients underwent a radical resection of the tumor through a median sternotomy. There were no 

major complications and all the patients survived surgery. Overall crude survival for the 16 patients at 5 years was 

56%, 75% for thymomas and 0% for thymic carcinoma. 

Conclusions 

Tumors in the thymus are rare, most of them benign thymomas with excellent prognosis. For thymic carcinomas, 

however, the prognosis is poor and these patients usually die within one year from diagnosis. 

P01:19 

MYOCARDIAL REVASCULARIZATION IN PATIENTS WITH SEVERE LEFT VENTRICULAR 

DYSFUNCTION, IS ON PUMP BEATING THE PREFERABLE TECHNIQUE? 

Abdel Aal Mohamed 1 

1) Riyadh, Saudi Arabia 

Objective 

This study compares early outcomes after on-pump beating-heart CABG and conventional CABG in patients with 

ejection fraction (EF) less than 30%. 

Methods 

From 2005 to 2008, 167 patients with ejection fraction less than 30% underwent CABG on-pump beating-heart 

CABG was done in 75 patients (group 1) and 95 patients were done using conventional technique (group2). Twelve 

patients in the conventional CABG group required insertion of intra-aortic balloon pump initiation intra-operatively 

or postoperatively, whereas only 2 patients required this in the on-pump beating-heart CABG group. 

Results 

In-hospital mortality was less in the on-pump beating-heart CABG group (2.25% versus 3.68). Twelve patients in the 

conventional CABG group required insertion of intra-aortic balloon pump initiation intra-operatively or postoperatively, 

whereas only 2 patients required this in the on-pump beating-heart CABG group.The ventilation time was longer 

in conventional group it was 10± 12.3 versus 7.6±11.7. No significant difference was found in morbidity including 

stroke, renal failure. The incidence of postoperative atrial fibrillation was significantly less in on pump beating group 

as compared to CPB group it was happened in 6 patients versus 21 respectively. The duration of intensive care unit 

stay was 2.9 ±1.65 in group 1 while it was 3.7± 1.78 group 2. The hospital stay was also shorter in the on-pump 

beating-heart CABG group, it was 6.8± 1.43 versus 8.6 ±2.13 and it was significantly difference. 

Conclusions 

On-pump beating-heart CABG can be performed safely on high-risk patients. 


P01:20 

SURGICAL REVASCULARIZATION AFTER ACUTE MYOCARDIAL INFARCTION, IS IT RUNNING 

AGAINST THE CLOCK? 

Abdel Aal Mohamed 1 

1) Riyadh, Saudi Arabia 

Objective 

The optimal timing for surgical revascularization after acute myocardial infarction (MI) remains controversial. Higher 

mortality for emergency coronary artery bypass grafting (CABG) after acute myocardial infarction (AMI), ranging 

from 5% to 30%, has been documented since the early 1970. 

Patients and methods 

We examined our experience retrospectively in 278 patients who underwent CABG between 2005 and 2007 at 

king Fahad cardiac center in king khaled university hospital, Riyadh, Saudi Arabia. We had three groups one who 

underwent CABG within 24hours (group 1) , group 2 between 1 to 3 days and last group 3 after 14 days. 

Results 

The operative mortality associated with increasing time intervals between MI and CABG were 11.68%, 7.05%, 

2.5 %, for group 1(within 24 hours), group 2 and 3 respectively. In comparison, the incidence of cerebrovascular 

(CVA) and atrial fibrillation (AF) were greater in group 1 and the length of ICU stay was longer for patients 

undergoing CABG early after MI (within 24 hours). Emergency coronary artery bypass grafting (CABG) after 

AMI within 24 hours (group 1) has a significantly higher risk. 

Conclusion 

Nonemergency surgical revascularization can be done safely at any time interval after acute myocardial infarction, 

certainly after 72 hours, without increase in operative mortality and acceptable 

P01:21 

SURVIVAL BENEFIT OF CORONARY ENDARTERECTOMY IN PATIENTS UNDERGOING COMBINED 

VALVE AND CORONARY BYPASS GRAFTING 

Javangula Kalyana 1 , Papaspyros Sotoris 1 , Nair Unnikrishnan 1 

1) Leeds General Infirmary, United Kingdom 

Objectives 

Coronary Endarterectomy (CE) in patients undergoing coronary artery graft (CABG) surgery has been shown to 

be useful in re-vascularization of patients with diffuse disease. We present our experience with CE in patients 

undergoing valve surgery combined with coronary bypass. 

Methods 

Between 1989 and 2008, 237 patients underwent CABG with valve surgery under a single surgeon. Of these, 41 

patients had in addition CE. The data was retrospectively obtained from the notes and database. The follow-up 

was obtained by telephonic interview. All variables were analyzed by univariate analysis for significant factors for 

in hospital mortality. Morbidity and long term survival was also studied. There were 29 males and 12 females with 

a mean age of 67.4 ±8.1 and body mass index of 26.3±3.3. Their mean euroscore was 7.6±3.2 and the log euro 

score was 12.2 ± 16.1. 

Results 

In hospital mortality was 9.8% (4 out of 41) with 6 late deaths. Long-term survival at 10 years was estimated to 

be 57.2% (95% CL 37.8%-86.6%). Average hospital stay was 12.7±10.43 days. ICU stay was < 48 hours in 32 

patients.The symptom relief was noted in majority with only 3 of the survivors having NYHA class II symptoms. One 

of the survivors was on nitrates and none required any further percutaneous or cardiac surgical intervention. 

Conclusions 

Coronary Endarterectomy does not increase mortality in combined procedures. By achieving more complete 

revascularization, it may be offering survival benefit in this group of patients. However this needs to be confirmed 

on studies with larger number of patients. 


P01:22 

URGENT CABG PREDISPOSES PATIENTS TO REOPERATIONS- MAINLY DUE TO EXCESSIVE BLEEDING 

Suojaranta-ylinen Raili 1 , Hiippala Seppo 1 


Treatment of acute coronary syndrome (ACS) demands aggressive anti-thrombotic therapy and occasionally 

also mechanical circulatory support. Both may increase the risk of reoperation after urgent CABG surgery. This 

retrospective study was focused on the causes of these reoperations. 

Methods 

The inclusion criteria were urgent or emergent CABG after admission for ACS and the use of cardiopulmonary 

bypass. Combined operations including valves or other procedures and off-pump surgeries were excluded. 544 

patients were found with an estimated 95.7 % coverage of the target population. All patient records were reviewed 

to verify the cause of reoperation. The results were compared to a group of elective CABG patients. The odds ratios 

with 95% confidence intervals were calculated for the relevant events. 

Results 

The groups were comparable regarding sex, age, perfusion time, number of distal anastomosis and ReDo operations. 

The urgent group had significantly higher Euroscore, all patients were exposed to anti-thrombotic therapy and 12.5% 

had perioperative intra-aortic balloon pump compared to just 1.1% in the elective group. In the urgent group the 

odds were 2,83 (1,40-5,70) for a reoperation due to excessive bleeding and 4,11 (1,53-11,04) for all other causes 

compared to the elective group. The proportion of reoperations for surgical bleeding was the same in both groups. 

Conclusions 

Urgent CABG increased the odds for reoperation three to four fold and in two cases out of three the indication was 

excessive bleeding. In both groups the cause of bleeding was surgical in more than two reoperations out of three. 

P01:23 

OBESITY AND THE RATE OF EARLY COMPLICATIONS AFTER CORONARY ARTERIAL REVASCULARISATION 

Oddsson Saemundur J. 1 , Sigurjonsson Hannes 1 , Arnorsson Thorarinn 1 , Gudbjartsson Tomas 1 


Introduction 

Traditionally obesity has been related to increased postoperative morbidity and mortality following open heart 

surgery. Recent studies, however, indicate that the association of obesity and complications is not straight-forward, 

with some studies even reporting a beneficial association (obesity paradox). The aim of this study was to study this 

relationship in a well defined cohort of CABG/OPCAB patients. 


A retrospective non-randomised study on all patients that underwent CABG/OPCAB in Iceland from June 2002 

to February 2005. There were 279 patients that were divided into two groups, an obese group (defined as BMI > 

30 kg/m2) (28%), and a non-obese group (BMI ≤30 kg/m2) (72%). Demographics, risk factors, complications and 

operative mortality (OM) of both groups were compared. 

Results 

Patient demographics were similar in both groups, including the rate of risk factors such as diabetes mellitus, 

hypertension and hyperlipidemia (Table 1). Type of surgery (CABG vs. OPCAB) was also comparable, however, 

EuroSCORE was significantly lower in the obese group and operation- and cross-clamp time longer. There were no 

significant differences in rates of either major or minor complications and the same was true for OM. Hospital stay, 

bleeding and transfusion requirements were also comparable between groups. 

Conclusion 

Obese patients seem to do as well as non-obese patients following coronary arterial revascularisation, at least 

regarding short-term complications and OM. Because obese patients had significantly lower EuroSCOREs, the 

effects of selection bias can´t be ruled out. 


P01:24 

HOW DOES INTRAOPERATIVE ASSESSMENT OF DISTAL LAD DISEASE TRANSLATE INTO 

CLINICAL OUTCOME? 

Svedjeholm Rolf 1 , Vanky Farkas 1 

1) Linköping University Hospital, Sweden 

Objective 

It is generally appreciated that the quality of coronary vessels are important for successful revascularization. 

Intraoperative assessment of coronary vessel quality by inspection, palpation and probing is routinely performed. It 

is questionable to what extent an assessment subject to investigator bias translates into clinical outcome. As our 

institutional database contained information about intraoperative assessment of quality of distal LAD we decided 

to investigate this issue. 

Method 

Data were registered prospectively in a computerized institutional database. 1751 patients had calcification of 

distal LAD classified by the surgeon as none, mild, moderate or severe. In 1034 patients it was classified as none 

or mild (Group NM) and in 234 patients it was classified as severe (Group S). These groups were compared with 

regard to outcome. 

Results 

Average age did not differ between Group S (65±1 years) and Group NM (66±1 years) but the proportion of 

patients with diabetes (28.2% v 15.3%; p

P01:26 

RETROTHYMIC ROUTING FOR SKELETONIZED INERNAL THORACIC ARTERIES: 

OPTIMAL LENGTHS, BEST COURSE, MAXIMAL PROTECTION 

Kargar Faranak 1 , Pooraliakbar Hamid-reza 1 , Yaghoubi Nahid 1 , Malek Hadi 1 , Aazami Mathias 1 

1) Shahed Rajaei Heart Hospital, Iran 

Introduction 

Routing in-situ internal thoracic arteries (ITAs) towards their coronary targets is a salient technical aspect. The latter 

should offer a smooth course providing maximal tension-free lengths, avoid technical flaws as graft kinking or errors 

in angulations of sequential anastomoses, decouple in-situ ITAs from respiratory mechanics, and offer protection by 

the time of re-sternotomy. In line with aforementioned prerequisites, we report on a new technique for routing of the 

both right and left ITAs. 


Since 2007 to present, 158 patients (mean age 59.53±9.3 years; female: 25.6%; mean preoperative EF: 43 ±8.36 %; 

mean logestic euroscore: 5.75 ± 6.5) underwent CABG using one or both skeletonized ITAs. The ITAs were routed 

using the current technique in a retrothymic position towards LAD system, RCA or circumflex artery branches. 

Results 

158 left and 55 right in-situ ITAs were used. The mean number of grafts per patient was 2.9±0.8 (venous: 1.03± 

1.1; arterial 1.87±0.96). 90 % of LITA was used to feed LAD system and 74% of RITA was anastomosed to RCA 

branches. A composite arterial graft was performed in 22% and 20% of patients needed concomitant coronary 

procedures. The overall hospital mortality was 1.8% and 3.6% of patients suffered perioperative MI mostly due to 

extensive concomitant endarterectomy. None of the patients suffered phrenic nerve dysfunction. 

Discussion 

Retrothymic routing for ITAs is a safe and reproducible method. Decoupling in-situ ITAs from respiratory mechanics, 

respecting the pleura, and avoiding splitting of the pericardium are some of its technical advantages. 

P01:27 

NUMBER OF CEREBRAL EMBOLI IS RELATED TO ACCESS SITE AT CORONARY ANGIOGRAPHY 

Nyman Jesper 1 , Jurga Juliane 1 , Sarkar Nondita 1 , Tornvall Per 1 , Manilla Maria N. 1 , 

Svenarud Peter 1 , van der Linden Jan 1 

1) Karolinska Institute, Sweden 

Background 

Stroke is a severe but unusual complication during coronary angiography (CA). Recent studies have shown that 

particulate cerebral emboli are common during CA, but their role in this context is not entirely understood. The choice 

of access site for CA might be of importance. The aim of this study was to evaluate if the number of particulate 

cerebral emboli when a radial is compared with a femoral access site during CA. 

Methods 

Patients undergoing CA were randomized to a right femoral or a right radial access site. A transcranial Doppler 

(Embodop, DWI, Germany) with bilateral probes was used to continuously register number of particulate emboli 

passing each middle cerebral artery (MCA) during CA. 

Results 

Fifty patients were included, of whom 8 patients were converted from radial to femoral access and are not presented. 

The total number of particulate emboli was higher with the radial than with the femoral access site (10.9 ± 6.3 

versus 6.9 ± 4.7, p

P01:28 

CORONARY ARTERY BYPASS GRAFTING IN ST-MYOCARDIAL INFARCTION. AN ASSESSMENT OF 

AVAILABLE GUIDELINE DATA 

Myrmel Truls 1 , Eggen Hermansen Stig 1 

1) UNN, Norway 

Objective 

Guidelines for treatment of ST-elevation myocardial infarction (STEMI) have been published from the American 

Heart Association in 2004, and from the European Society of Cardiology in 2008. These guidelines state a lack of 

data on timing and selection of patients for revascularization by CABG in evolving and established ST-elevation 

infarctions. 

Methods 

A systematic search of PubMed, EMBASE, Clinicaltrials.gov, and Cochrane Central Register on controlled studies 

assessing the application of CABG as one trial arm in STEMI. 

Results 

We found no controlled trials including CABG as the main treatment in one of the trial arms in STEMI-studies. In the 

Shock-trial, CABG was part of the early reperfusion-strategy, and the mortality in patients treated by CABG was 

equal to percutaneous coronary interventions (PCI). 

Conclusion 

Data from controlled trials using CABG in STEMI are almost non existent. There are, however, general data supporting 

early revascularization. Thus, the use of CABG in STEMI must rely on clinical judgement integrated in a primary 

PCI-strategy. There is a number of observational data indicating a too restrictive use of CABG in this setting, most 

probably affecting patients with multi-vessel disease. 

P01:29 

RECOVERY FROM CHRONIC MYOCARDITIS AFTER 14 MONTHS OF SUPPORT BY VENTRAASSIST LVAD 

Gude Einar 1 , Sorensen Gro 1 , Andreassen Arne K 1 , Geiran Odd R 1 , Fiane Arnt E 1 

1) Oslo University Hospital, Rikshospitalet, Norway 

16 years old female was admitted to ourhospital with heart failure after gastroenteritis in Greece. Myocardial 

biopsi showed myocarditis with massive leucocyte infiltration, intracellular oedema and cellular destruction. 

Echocardiography showed EF 10%, biventricular failure, cardiac output 1.7 l/min. 

In cardiogenic shock with VT, she was supported with ECMO, IABP and levosimendan. 

VentrAssist LVAD was implanted Sept-07, after 20 days on ECMO. 

After reconstruction of femoral artery due to embolus post ECMO, and an increase in liver enzymes responding to 

gradual increase in VAD speed she was out of hospital after 30 days, and discharged after 45 days. 

From January 2008 a gradual improventent in cardiac function was observed and LVAD explant was planned. 

Myocardial biopsi showed chronic myocarditis and inflammatory process until she was successfully treated with 

steroids 60 mg tapered down to 5 mg/day after 3 weeks. LVAD removal was delayed by a gastrointestinal infection 

with paralytic ileus and sepsis, treated with linezolid 10 days. After recovery invasive candida albicans was detected 

and treated for 3 weeks without recurrence. 

After 413 days with Ventrassist LVAD, ECHO showed EF 50%, LVEDD 45 mm, NT-Pro BNP 35 and normal right heart 

hemodynamics also when reducing pump speed to 1250 rpm. VO2 20 ml/kg/min, negative Troponin T. CRP

P01:30 

TWO PATIENTS WITH VENTRASSIST SUCCESSFULLY TREATED FOR CANDIDAS ALBICANS. 

Gude Einar 1 , Bjornholt Jorgen 1 , Andreassen Arne K 1 , Sorensen Gro 1 , Geiran Odd R 1 , Fiane Arnt E 1 

1) Oslo University Hospital, Rikshospitalet, Norway 

Infections are a major cause of morbidity and mortality in patients with LVAD. 

Secondary to antibiotic use, invasive fungal infections are a feared and well known complication. 

We present the history of two Ventrassist patients with invasive candida albicans that were successfully eradicated. 

Patient 1. 17 year old female with Ventrassist due to acute myocarditis. Because of myocardial recovery explant of 

Ventrassist was planned. After an episode of gastroenteritis complicated by paralytic ileus, Enterobacter cloacae was 

detected on a central venous line catheter. After 10 days of treatment with meropenem, Candida albigans was found 

in 3 consecutive blood cultures. She was successfully treated with caspofunginacetat for 3 weeks. No recurrence of 

fungal infection was found in serial blood culture or on explanted LVAD. LVAD successfully explanted. 

Patient 2. 52 year old female with Ventrassit due to heart failure. After initial improvement she experienced a 

cerebral hemorrage, surgically evacuated complicated by long term respirator use. After treatment with meropenem 

and linezolid for 12 days for Staphylococcus aureus and Enterococcus, Candida albicans was detected in blood 

culture. After treatment with caspofunginacetat for 3 weeks, fungal infection was no longer detectable in serial 

blood cultures. Follow up 3 months. Listed for heart transplantation. 

Conclusion 

Invasive Candida albicans has occured in two of our Ventassist patients secondary to antibiotic use. Both patients 

were successfully eradicated without evidense of recurrence. This is in contrast to our previous experience of fungal 

infections were foreign material must be replaced or removed before eradication of infection is possible. 

P01:31 

STRESS INDUCED CARDIOMYOPATHY, TAKOTSUBO SYNDROME, COMPLICATING EARLY 

RECOVERY AFTER LUNG TRANSPLANTATION 

Hämmäinen Pekka 1 , Virolainen Juha 1 , Eriksson Heidi 1 , Lemström Karl 1 , Piilonen Anneli 1 , Harjula Ari 1 , Sipponen Jorma 1 


Primary graft dysfunction, infection, and acute rejection are major concerns complicating early recovery after lung 

transplantation. We present a case report, in which stress induced cardiomyopathy mimicked severe delayed primary 

lung graft failure. 

A 56-year-old woman with emphysema was referred for lung transplantation. Among other examinations, her 

cardiac ECHO showed normal right and left ventricle function, with tricuspid gradient of 31 mmHg, and LV EF 

61%. Her coronary angiogram was normal. As suitable donor lungs became available, her CRP was 231 and she 

had recurrent pneumonia. The procedure itself was uneventful, and she was extubated 7 hours later. Native lungs 

contained macroscopically seen foci of aspergillosis. On 17th postoperative day, she unexpectedly presented twice 

grand mal type seizures on ward, after which she was intubated. Next morning chest-xray showed new congestive 

features, and pleural effusions were drained. Oxygenation further deteriorated and CT showed extensive alveolar 

infiltrates. Infection as well as acute rejection were initially considered possible. However, pro-BNP value, not 

determined earlier, was high 12300 ng/l. Cardiac echo showed normal right heart, but left ventricular anteroapical 

and posterior walls were largely akinetic, and planimetric estimate of ejection fraction was only 25-30% . The 

overall findings were compatible with Takotsubo syndrome. LV function was supported pharmacologically, and the 

outcome was excellent. 

Takotsubo syndrome has not earlier been described to complicate lung transplantation. Newly transplanted lungs 

are highly vulnerable to elevated left atrial filling pressure. Correct diagnosis and avoiding additional antirejection 

treatment most probably contributed to eradication of aspergillus. 


P01:32 

RECIPIENT CELLS IN BRONCHIAL ALLOGRAFTS 

Vainikka Tiina 1 , Päiväniemi Outi 2 , Musilová Petra 3 , Alho Hanni 1 , Maasilta Paula 1 , 

Aittomäki Kristiina 1 , Salminen Ulla-Stina 1 

1) Helsinki University Hospital, 2) Tampere University Hospital, Finland 3) Veterinary Research Institute, Czech Republic 

Lung transplantation is accepted therapy for end-stage pulmonary diseases. The main limitation on long-term 

survival is obliterative bronchiolits (OB). It is considered a manifestation of chronic allograft rejection. Histologically 

OB is manifested as epithelial cell injury, inflammation, fibrosis, and obliteration of the small airways. We studied 

recipient cells in bronchial allografts. 

29 random-bred pigs were used. Adequate, inadequate or no immunosuppression was given. 2 received control 

autografts and 9 male recipients received bronchial allografts from female donors. A series of allografts were 

transplanted subcutaneously on the ventral side of donors and were harvested serially during the follow-up. 

Histology (H&E) and y-chromosomes (FISH-method) using pig-spesific DNA-label were assessed. Additional 5 

female recipients received bronchial allografts from male donors. Samples of lung, liver, kidney and spleen were 

taken after 3 months to study y-chromosomes in female recipient organs (FISH). 

In male recipients with none or inadequate immunosuppression, rapid epithelial destruction occurred in bronchial 

allografts preceding obliteration. Adequate immunosuppression resulted in graft patency until 3 months (p

P01:34 

LONG-TERM RESULTS OF MITRAL VALVE REPAIR USING A MADE TO MEASURE GORE-TEX 

ANNULOPLASTY RING 

Javangula Kalyana 1 , Mushtaq Abid 1 , Papaspyros Sotoris 1 , Nair Unnikrishnan 1 


Objectives 

This study evaluates the long-term results of mitral valve repair using a made to measure Gore-tex Annuloplasty 

Ring configured to the actual circumference of the valve. 

Methods 

A retrospective review was conducted of 39 consecutive patients (mean age 61.6 +/- 10.3 years; range: 26-80 years, 

mean Euroscore 6.5) who underwent mitral valve annuloplasty between June 1996 to December 2007. The major 

causes of mitral regurgitation (MR) were annular dilatation and prolapse of the posterior leaflet. Quadrangular 

resection of the prolapsing posterior cusp was undertaken, when necessary. A 2 mm wide made-to-measure ring 

created from a 0.6mm thick Gore-tex, configured to the valve circumference was inserted with interrupted ethibond 

sutures supporting the posterior annulus. 

Results 

One patient with Gillian Barrie Syndrome (2.5%) died late; one (2.5%) had pacemaker insertion and one (2.5%) 

needed valve replacement 12 months later following infection. Postoperatively at 8 years the actuarial survival was 

92.5% and freedom from re-operation 97.1%. Clinical and echocardiography follow-up continued for a mean period 

of 6.1 +/- 1.62 years (range: 1.96 to 9.55), and was complete on 21 patients. The mean NYHA functional class at 

follow-up was significantly lower than the preoperative score (1.32:2.65, p=0.0008, paired t-test). Pre-operatively 

3 patients (14%) had mild MR, 5 (24%) moderate MR and 13 (62%) severe MR. Post-operatively, 13 patients (62%) 

had no detectable MR and 8 (38%) had mild MR. 

Conclusions 

Mitral valve repair using a made-to-measure Gore-tex ring configured to the actual circumference of the mitral valve 

is safe, cost-effective, durable and reproducible. 

P01:35 

THE LEFT ATRIAL ROOF APPROACH (LARI) - AN ASSET FOR MINIMALLY INVASIVE MITRAL SURGERY 

Javangula Kalyana 1 , Nair Unnikrishnan 1 


Background 

Adequate exposure and access is fundamental in mitral valve surgery. The conventional approach is interatrial 

groove using bicaval venous cannulation. The left atrial roof incision has the potential of facilitating an excellent 

exposure of mitral valve through a limited incision without major cardiac tissue trauma, which is particularly desirable 

for minimally invasive mitral surgery. 

We conducted this study to determine the safety, efficacy and technical ease of the LARI. 

Methods 

Retrospectively collected data of 95 consecutive patients who had mitral valve surgery by the same surgeon in the 

last 5 years were analysed. The patients were divided into two groups. Group 1 patients had LARI through minimally 

invasive sternotomy (MIS) or full sternotomy. Group 2 patients had the conventional paraseptal incision of the left 

atrium through a MIS or full sternotomy. The mitral valve was exposed with LARI in 81 patients (85%). Minimally 

invasive technique was used in 19% patients. 

Results 

More patients in the LARI group regained sinus rhythm on discharge. Concomitant procedures included AVR (25) 

TVR (2) AV repair (5) CABG (28) and LA and ventricular volume reduction (5). There was 1 death in group 2. 

Conclusions 

LARI is a safe technique.Compared to conventional interatrial approach, LARI has short cross clamp and bypass 

time. It has the added advantage of reduction in the incidence of AF, ICU stay, total hospital stay. It is feasible in 

redo surgery and is ideal for supervised surgical training. 


P01:36 

ACUTE DYSFUNCTION OF MECHANICAL AORTIC VALVE PROSTHESIS DUE TO PANNUS FORMATION 

Ellensen Vegard Skalstad 1 , Andersen Knut S. 1 , Segadal Leidulf 1 , Haaverstad Rune 1 

1) Haukeland University Hospital, Bergen, Norway. 

Background 

Acute dysfunction of mechanical prosthetic aortic valves is a life threatening complication. The common symptoms 

are chest pain and dyspnoea, which may be intermittent. Loss of valve click is often noticed by the patient or relatives. 

Patient history is of utmost importance for the diagnosis, which is confirmed by echocardiography, cinefluoroscopy or 

both. It is important to differentiate between thrombosis and pannus, as the former can be treated by thrombolysis, 

while the latter should be operated acutely. 

Patients and results 

We have reviewed 12 patients (13 episodes) suffering from acute dysfunction of a mechanical aortic valve caused 

by pannus formation. All patients were initially operated with a monoleaflet aortic valve prosthesis (Medtronic-Hall) 

between 1984 and 1999. Mean age at the primary operation was 48 years (range 22-66 years). 67% were female, 

33% male. Mean time from primary surgery to acute dysfunction was 11.5 years (range 4.3-24.7 years). One patient 

had redo-surgery twice. All the reoperated patients (67%) survived. Four patients (33%) died in-hospital before 

initiation of redo-surgery. The cause of death was confirmed by autopsy. 

Conclusion 

Acute dysfunction of mechanical aortic valves caused by pannus is a life threatening complication with high mortality. 

As soon as the diagnosis is confirmed, redo-surgery should be performed. In our material, the prognosis was good 

when the patients were reoperated in time, but bad for those who did not reach the operating theatre. 

P01:37 

EARLY HEMODYNAMIC PERFORMANCE OF PORCINE AND PERICARDIAL PROSTHESES IN 

AORTIC POSITION 

Påhlman Carin 1 , Nylander Eva 2 , Franzén Stefan 3 , Tamás Éva 3 

1) Faculty of Health Sciences, Linköping, 2) Dept. of Clin. Physiology Linköping, 

3) Dept. of Cardiothor. Surg., Linköping, Sweden 

Background 

The performance of the bioprosthesis after aortic valve replacement (AVR) is of major importance for the long-term 

outcome and quality of life. The aim of this retrospective study was to compare the early postoperative hemodynamic 

performances of pericardial versus porcine bioprostheses used in our institution. 

Methods 

The study group included 48 patients operated with isolated AVR in 2008. Hancock II (n=24) implants were compared 

to Perimount 2900 (n=24) matched for gender, age, body surface area and prosthesis size (labelled 21 to 27). 

Transthoracic echocardiography was performed 3-12 days postoperatively. 

Results 

The pericardial group had a significant lower max velocity and mean gradient (2.62 ± 0.44 m/s, 15.8 ± 4.2 mmHg 

versus 3.08 ± 0.44 m/s, 21.8 ± 6.5 mmHg, p

P01:38 

MITRAL ANNULOPLASTY WITH A NEW MEDTENTIA RING 

Werkkala Kalervo 1 , Simpanen Jarmo 1 , Wirup Per 2 

1) Helsinki University, Finland 2) Arhus, Denmark 

Medtentia Annuloplasty Ring (MAR) is a new implantable annulus support ring designed to provide support for the 

mitral annulus. The MAR ring consists of two helical rings and is rotated in place starting at the posterior medial 

comissur and rotated 360 degrees so that the lower ring of the MAR slides on the ventricular aspect of the mitral 

annulus, underneath all chordae.The MAR ring was tested in 12 adult patients undergoing mitral valve annuloplasty. 

In all cases a posterior leaflet prolaps was found and a reduction annuloplasty was performed. thereafter the MAR 

was implanted and the position was controlled with a dental mirror. Before permanent fixation of the conventional 

ring the MAR was removed. 

The mean time to implant the MAR was 1.5 min ( 0.5-5 min ). At this time no attempt to fix the MAR ring was done 

and it was removed. The duration of the removal time was 0.6 min (0.1-2 min). 

The MAR ring was easy and quick to implant and explant. During the procedure no damage to the mitral valve and 

chordae was noted. In all cases the ring cached all chordae. After implantation the MAR ring needs a quick fixation 

method to be easy and rapid method for mitral annuloplasty in conventional, minimal and robotic surgery. 

P01:39 

AORTIC VALVE REPLACEMENT IN THE ELDERLY 

Vainikka Tiina 1 , Soisalon-Soininen Sari 1 , Kaartinen Maija 1 , Suojaranta-Ylinen Raili 1 , 

Maasilta Paula 1 , Vento Antti 1 , Salminen Ulla-Stina 1 


Background 

Aortic stenosis rate increases with age. Thus, number of patients undergoing aor-tic valve replacement (AVR) is 

expected to grow, when the elderly population is increasing. 

Methods 

Patients (n=145) undergoing AVR with bioprostheses 1992 - 1997 were followed. At the time of operation, 30 were 

> 80 years, 94 were < 80 to > 70 years, and 21 < 70 years old. A follow-up control including echocardiographic 

examination took place at least 5 years postoperatively. Follow-up continued until July 31, 2006. 

Results 

In the oldest group, 30-day mortality was 3.3% and 6.4% in the middle group. In the middle group, 5 valve-related 

reoperations were performed. At time of follow-up, 84 (58 %) patients were alive and 60 (71%) attended. LVEF 

was improved being > 60% in all groups and the aortic valve gradient was lower than preoperatively in all and most 

decreased in the oldest group (p

P01:40 

SVO2 A MARKER WITH EXCELLENT SENSITIVITY AND SPECIFICITY FOR CARDIAC MORTALITY AFTER 

SURGERY FOR AORTIC STENOSIS 

Svedjeholm Rolf 1 , Holm Jonas 1 , Vanky Farkas 1 , Håkanson Erik 1 

1) Linköping University Hospital, Sweden 

Objective 

Adequate monitoring of hemodynamic state is essential after cardiac surgery and vital for medical decision making 

particularly concerning hemodynamic management. Unfortunately commonly used methods to assess hemodynamic 

state are poorly documented with regard to outcome. Mixed venous oxygen saturation (SvO2) was therefore 

investigated after cardiac surgery. 

Methods 

Detailed data regarding mortality was available on all patients undergoing aortic valve replacement for isolated 

aortic stenosis during 1995 - 2000 in the southeast region of Sweden (n=396). SvO2 was routinely measured on 

arrival to intensive care unit (ICU) and registered in a data base. A receiver operating characteristics (ROC) analysis 

of SvO2 in relation to mortality related to cardiac failure and all cause mortality within 30 days was performed. 

Results 

Area under the curve (AUC) was 0.97 (95% CI 0.96-1.00) for mortality related to cardiac failure (p=0.001) and 0.76 

(95% CI 0.53-0.99) for all cause mortality (p=0.011). The best cut off for mortality related to cardiac failure was 

SvO2 53.7% with a sensitivity of 1.00 and a specificity of 0.94. Negative predictive value was 100%. 

The best cut off for all cause mortality was SvO2 58.1% with a sensitivity of 0.75 and a specificity of 0.84. Negative 

predictive value was 99.4% 

Conclusions 

SvO2 on arrival to ICU after surgery for aortic stenosis demonstrated excellent sensitivity and specificity for 

postoperative mortality related to cardiac failure and fairly good AUC for all cause mortality with excellent negative 

predictive value. 

P01:41 

RESTORING SUBVALVAR CONTINUITY BY REIMPLENTING STRUT CHORDA IN THE SETTING OF 

RHUMATIC MITRAL VALVE REPLACEMENT1 

Kargar Faranak 1 , Samiei Niloofar 1 , Mohebi Ahmad 2 , Noohi Freidoun 1 , Aazami Mathias 1 

1) Shahed Rajaei Heart Hospital, Iran 

Introduction 

Preserving mitral subvalvar continuity is technically challenging in the setting of rheumatic heart valve disease. We 

report on a new technique to restore mitral subvalvar continuity by re-implanting the strut chorda that are primary 

mediators of LV-central fibrous body interplay. 


During 2009, 7 patients (mean age: 48.6 ± 12.6 y.o; female: 57%; mean LVEF: 44.29 %; mean PAP: 51 mmHg; 

mean logistic Euroscore: 9.5 ± 8 %) with rheumatic heart valve disease (mitral stenosis: 43%; mitral regurgitation: 

14%; mitral stenosis and regurgitation: 43%) underwent mitral valve replacement using the current technique that 

consists on preserving mitral subvalvar continuity by reimplanting mitral strut chorda to the mitral annulus and sitting 

a mechanical bi-leaflet valve prosthesis in an intra-annular position. 

Results 

All patients survived on operation; displaying an uneventful postoperative course. 5 patients (71.4%) required one 

or more concomitant procedures. The mean pump and ischemic times were 269 and 193 minutes respectively. At 

the time of discharge the means LVEF and trans-mitral prosthetic gradient were 42.14 % and 4.2 mmHg (ranged 

from 3 to 7) respectively. The re-implanted anterior and posterior strut chorda were identified in all patients on 

postoperative echocardiography without inferring with prosthetic valves leaflets. 

Conclusions 

Restoring the mitral subvalvar continuity by re-implanting the strut chorda is safe and reproducible in patients with 

rheumatic heart valve disease. The latter may be more physiologic rather than re-approximating marginal chorda to 

the annulus in terms of preservation of LV function that needs to be further investigated. 


P01:42 

DAVID PROCEDURE: EARLY AND MID-TERM RESULTS FIVE YEAR EXPIERIENCE 

Karciauskas Dainius 1 , Benetis Rimantas 1 , Egle Ereminiene 1 , Povilas Jakuska 1 , Sarunas Kinduris 1 

1) Kaunas Medical University, Lithuania 

Background 

Aortic valve sparing surgery offers a unique opportunity to preserve the aortic valve of patients with aortic root 

disease. 

Methods 

Between January 2004 and April 2009, David procedure was performed in 21 patients of 827 patients whom 

underwent aortic root and valve surgery in the Heart Center of Kaunas University of Medicine. Study protocol 

included clinical data (age), patients functional status (NYHA), left ventricule mass index, postoperative major 

adverse effects: reoperations for bleeding, stroke and lethal outcomes. Patients were observed up to 30 days after 

surgery for early results and annually for mid-term results. 

Results 

Mean age in group was 51.9 ± 3.3 y. Preoperative status (NYHA) of group was 2.8 ± 0.15. Early mortality rates, 

observed within the first 30 days, were only after emergency surgery due to Acute dissection (n=1) and there were 

no late mortality events. Reoperation rates due to bleeding events were noted only within first 12 hours: n=4. Annual 

doppler echocardiography revealed mild to moderate aortic insufeciency in three patients one year after surgery 

with left ventricule mass index reduction from 186.8 ± 13.3 g/m2 to 128.4 ± 12 g/m2. Neither thromboembolic 

complications nor stroke events were noted. 

Conclusions 

Aortic valve-sparing operations according to clinical outcomes are safe but there are some issues related with aortic 

valve competence which need full follow-up due to small cohort of patients and sufficient interval of time. 

P01:43 

TRANSCATHETER AORTIC VALVE IMPLANTATION IN HIGH-RISK SURGICAL CANDIDATES WITH LOW 

RISK SCORES 

Ahn Henrik 1 , Baranowski Jacek 1 , Freter Wolfgang 1 , Nielsen Niels Erik 1 , Nylander Eva 1 , Tamas Eva 1 , Wallby Lars 1 


There are patients (pts) with expected high risk at operation that does not get high-risk scores from the traditional 

measures as STS or logEuroscores. Among our first 15 pts who underwent a transcatheter aortic valve implantation 

there were 3 who principally were accepted after an extensive evaluation of the expected risk of an open chest 

operation. 


The first pt, a 75 year old man, had been operated 4 years before with a biological stented prosthesis (Perimount 

23 mm) and CABG. The operation was very complicated and the prosthesis became increasingly stenotic. The 

other 2 pts, a 60 years old woman and a 66 years old man, had been treated with full dose chest radiation due to 

previous malignancies. Both had developed heart failure with aortic stenosis as dominant lesion but mitral valve 

disease and secondary tricuspid insufficiency contributed to the clinical picture. The man had previously undergone 

a pericardectomy and PCI three times. 

The woman had a new malignancy diagnosed, curable but needing surgery without delay. 

Results 

The valve-in-valve procedure by the transapical approach was uneventful with good position and function of the new 

valve (Edwards Lifesciences, Sapien 23 mm). The woman got a Sapien 26 mm valve with good functional result. 

The third patient deteriorated quickly after the periods with rapid pacing needing resuscitation in combination with 

standard drug treatment. He recovered and showed no neurological symptoms in the early postop period. 

Conclusion 

Challenging intraoperative problems were avoided by this new catheter based technology. 


P01:44 

SUBCLAVIAN ARTERY APPROACH IN TRANSCATHETER AORTIC VALVE IMPLANTATION 

Holm Peter 1 , Jönsson Anders 1 


Objectives 

Transcatheter aortic valve implantation (TAVI) has evolved as a therapeutic option with reproducibly good results in 

patients (pts) considered to be at high risk for complications from conventional surgical valve replacement. Several 

thousands of pts have been treated with TAVI worldwide. The experience at our centre since February 2008 is 

limited to the CoreValve system. The purpose of this study was to report our experience with TAVI using the left 

subclavian artery as vascular access. 

Methods and Results 

A total of 55 pts with a mean age of 82±6 years and a logistic EUROSCORE of 24±11% underwent TAVI using the 

CoreValve prosthesis. In 50 pts the prosthesis was delivered using a transfemoral approach. In 5 pts (3 male) the 

left subclavian artery was used for access. The decision to use the subclavian artery approach was based on severe 

aortic angulations in two patients and inability to create femoral access because of small, calcified or tortuous 

femoral arteries in three pts. There was no 30-day mortality in any of the pts operated on using the subclavian artery 

as vascular access. 

Conclusions 

The left subclavian artery can be used as an alternative to create access in patients unsuitable for TAVI via the 

femoral arteries. This access has in our initial experience some advantages when compared to the femoral artery 

approach. The short and straight distance from the introducer positioned in the subclavian artery down to the aortic 

annulus offers enhanced stabilization during the expansion of the valve. 

P01:45 

CAN A PHYSICAL MOBILISATION PROGRAM FOLLOWING OPEN HEART SURGERY INFLUENCE ON 

POSTOPERATIVE ROUTINES? 

Haukeland Unni Kleppe 1 , Oterhals Kjersti 1 , Drevdal Julie 1 , Lygren Heidi 1 , Njåstad Anita 1 , 

Segadal Leidulf 1 , Haaverstad Rune 1 

1) Haukeland University Hospital, Norway 

Background and objectives 

Pulmonary complications are frequent following open heart surgery. Physical mobilisation is of prime importance 

to prevent postoperative respiratory complications. The main objective was to study whether a standard nursing 

protocol for mobilising patients could stimulate active and early mobilisation in general, and additionally reduce 

postoperative pulmonary complications. 

Methods 

According to the new protocol, minimum mobilisation of 57 patients (intervention group) included sitting in a chair 

30 min x 3 1. po. day and 60 min x 3 the 2. day. From day 3 patients should walk about and stay out of bed most 

of the day. Retrospectively complications were compared with a matched group of 59 patients (control group) with 

routine treatment. The mobilisation was registered in a data form. Clinical and demographic data were collected 

from patient files. 

Results 

The groups were similar with regards to age, gender and preop. risk factors (EuroScore). Mean age of all patients 

was 68 ± 12 years, range 27-89 years, and 72 % were men. The study revealed that systemizing respiratory 

complications is a difficult task and this will be further analyzed. No differences were found between the groups with 

respect to how many times patients were mobilised the first three po. days. However, patients in the intervention 

group stayed out of bed for longer periods both on day 1 (p = 0.018) and day 2 (p < 0.0001). 

Conclusions 

A postoperative nursing protocol may improve mobilisation of patients following heart surgery. Increased knowledge 

and focus on mobilisation may have influenced positively on mobilising routines on the ward. 


P01:46 

TELEPHONE SUPPORT FOR CARDIAC SURGERY PATIENTS AT HOME POST DISCHARGE FROM HOSPITAL 

Thorsteinsdottir Steinunn Arna 1 


Aims 

The aim of this quality project was to explore the educational needs, provide general support and evaluate the 

usefulness of telephone-support among cardiac surgery patients one to two weeks post discharge from Landspitali 

University Hospital (LUH). 

Method 

A descriptive exploratory method was used. All cardiac surgery patients (n=17) who were discharged from the 

heart-surgery unit at LUH over a one month period in spring 2009 received a phone call from a nurse at the unit. 

They received the call 6-15 days post-discharge. A purpose-made checklist was used to collect data on educational 

need. The list included questions on physiological and psychological issues. Information was also sought on use 

of health care services post-discharge, satisfaction with education received at the hospital and usefulness of the 

telephone call. 

Findings 

This intervention consisted of patient education, encouragement and support, screening for potential complications 

and facilitating access to various agents in the healthcare system. Patients expressed satisfaction with the phonecall 

and evaluated it as necessary even though they were content with the discharge education received. All of them 

had some questions or needed confirmation of their condition as being normal. Pain, problems with the operated 

leg, fatigue, oedema and psychological problems were the most common signs and symptoms these patients 

experienced. 

Conclusion 

Telephone-support seems to be a useful intervention for this patient group and improves their satisfaction and 

security at home. Many unforeseen questions and problems arise after discharge and addressing them timely may 

enhance recovery and prevent complications to become severe. 

P01:47 

THE MEMORIES AND EXPERIENCES OF PATIENTS AFTER HEART-SURGERY, AN INTERVIEW STUDY 

Sundh Marie 1 , Rylander Hagson Pauline 1 

1) Sweden 

Previous studies have shown that patients become strongly affected after heart-surgery and a stay in an intensivecare 

unit. The aim of this study was to describe the patient’s experiences and memories after open-heart-surgery. 

Four patients where included in the study and in-depth-interviews where made in the fourth to fifth day after surgery. 

A Qualitative content analysis of the interviews where made, which showed that the patients experienced several 

mixed feelings related to the surgery, such as pleasure and anxiety. They experienced how their abilities changed 

after the surgery with symptoms as confusion and amnesia. The experiences where affected by factors out of the 

patient’s control, such as the routines and environment of the ward. To be cared for in an intensive-care unit after 

heart surgery was described as a big incident in life and the patients felt the need of empathy, compassion and 

warmth. As employees of the ward we were capable of providing many of these needs, but we must not forget about 

the seriousness of the situation these patients are experiencing and we must never consider it to be a matter of 

routine. If we do so, it will show in our actions during the care of these patients and it will contribute to a negative 

experience of the patients. 


P01:48 

NURSING STUDY 30 DAYS AFTER DISCHARGE. 

Joergensen Inge Selchau 1 , Tracey Anita 2 

1) Aarhus University Hospital, Skejby, 2) Aalborg Hospital, Denmark 

Introduction 

In connection with The Danish On-pump Off-pump Randomization Study (DOORS) the project nurse contacts the 

patient by telephone 30 days after the heart operation. In connection with these interviews the project nurse has 

noticed that a lot of the patients experienced different types of problems which the nurses previously didn’t realise 

the extent of. The problems occur within the first month following the operation. 

Hypothesis 

Patients who have undergone a heart operation have problems of physical, psychological and social nature. 

Aim 

The aim of the investigation is to get a greater kvowledge about and gain an increased insight into the physical, 

psychological and social state of health of the patients. In the future this knowledge will be used in the guidance and 

information the heart patient receives during hospitalization in order that they are better prepared for discharge and 

their future life with a chronic illness. 

Method 

Telephone interviews with 350 patients based on a semi-structured interview guide. Focus is on the topics of pain 

- medicine administration - compliance, physical activity - exercise, breathing, nutrition - appetite - weight, sleep, 

health and discharge. Data will be analysed be means of quantitative content analysis. 

Results and conclusion 

Quantitative content analysis of the results of the investigation is expected to be carried out during the autumn of 

2009. Following which conclusion will be drawn and in perspective might have an influence on the care and treatment 

of the heart patients in the future. 

P01:49 

INTRAOPERATIVE CONTAMINATION OF SURGICAL INSTRUMENTS 

Persson Jenny 1 

1) Karolinska Universitetssjukhuset i Solna, Sweden 

Background 

Every year 2-5% of all surgical patients in the USA suffers from surgical wound infections, resulting in 500.000 

infections and 1.6 billion dollar in additional costs. These complications also results in higher mortality as a complication 

to surgery. Several factors are known to influence on the risk of surgical wound contaminations. Pathogens can 

contaminate surgical wounds by surgical instruments, which are exposed by all the factors for contaminations in the 

operating theatre. However, there are very few articles that have study the prevalence of microorganisms on surgical 

instruments. 

Objectives 

To study the prevalence of microorganisms on frequently used surgical instruments in aortic valve surgery with 

replacement to a biological implant. 

Do microorganisms occur on surgical instruments? 

What types of microorganisms occurs on surgical instruments? 

Does any step in the intraoperative procedure influence more than another step on the risk of contamination? 

Method 

The study is planned to be performed with a quantitative method on 20 operations. To handle all factors of 

contaminations, and to avoid influence of unwanted factors, the study has to be strictly standardized and controlled 

by a test protocol. To determine average and nominal time for the predefined steps in the intraoperative procedure, 

and to validate the optimal standardized sample collection technique for swabbing the instruments, two pilot 

studies will be performed. The two most frequently used instruments will be swabbed before or after a predefined 

intraoperative step and samples will be cultivated for identification and count. 


P01:50 

FINE FEATHERS MAKE FINE BIRDS. 

Tracey Anita 1 , Rasmussen Tina Seidelin 2 , 

1) Aalborg Hospital, Aarhus University Hosp, 2) Aalborg Hospital, Denmark 

Background 

The focus of the study is on the patient’s experience of wearing patient clothing. Patient clothing can be compared 

with night wear as it is designed for being worn in bed. The experience of wearing patient clothing is described as a 

feeling of being naked, anonymous or as if ones personality is camouflaged. Clothing is our cultural skin which finds 

expression in the way we’re dressed. By wearing patient clothing the patient shows that he belongs to the patient 

culture. Wearing patient clothing can result in decrease in spontaneous activity. 

- Why do patients wear patient clothing at all? 

- Does patient clothing get like a type of uniform that makes the patient anonymous? 

- How can it be that the patient doesn’t choose to wear their own clothes? 

- We experience that patient’s behaviour in connection with clothing is distinctly different during hospitalization than 

it is in private. Would one for example buy bread in the local bakers wearing only nightclothes? 

Aim 

The Aim is to investigate how patients in a Danish Hospital experience wearing patient clothing during hospitalization 

in a post-operative ward. 

Method 

Participant observation and semi-structured interview are the chosen qualitative methods that are used to create 

the empirical material. Each observer observes five patients in their own ward during daytime hours. Following this 

ten other patients are interviewed and the interviews are transcribed. 

Results 

The investigation is expected to be carried out during 2009 with subsequent reporting during the summer of 2010. 

P01:51 

IS MINI-CPB REALLY LESS HARMFULL THAN THE CONVENTIONAL CPB? THE RESULTS OF 

IMMUNOLOGICAL STUDY. 

Lonsky Vladimir 1 , Krejsek Jan 1 , Kudlova Manuela 1 , Kolackova Martina 1 , Mandak Jiri 1 , Kubicek Jaroslav 1 , Volt Martin 4 

1) Palacky University Hospital, Czech Republic 

Background 

The cardiac surgical intervention with the use of CPB is accompanied by the activation of complex immunity arm. 

This feature is associated with both pro-inflammatory and anti-inflammatory changes. The expression of various pro- 

and anti-inflammatory markers were compared between “conventional” and “mini” patients to evaluate potential 

benefits of mini-CPB. 

Methods 

54 patients who underwent primary isolated CABG were prospectively studied. 26 patients (MINI) were operated 

upon using a closed circuit IDEAL/SYNERGY, Sorin, Italy, second group of 28 patients (CPB) were operated with 

the use of conventional extracorporeal circulation with hardshell reservoir. Peripheral venous blood samples were 

collected before and after surgery and at the 1st, 3rd and 7th postoperative day. The expression of sTNF-alfa R 

80kDa, sTNF- alfa R 60kDa, IL-6, IL-10, PMN elastase, MCP-1 as plasmatic markers and CD64 (monocytes and 

granulocytes) CD163 (monocytes and granulocytes), CD95 (monocytes and granulocytes), TLR2 (monocytes and 

granulocytes), CD254 (monocytes and granulocytes) as cellular markers was studied with the use of flow cytometry 

or ELISA assay. 

Results 

Summarizing our results we can say that almost all studied pro- and anti-inflammatory markers were found to be 

significantly less activated in MINI group comparing to conventional CPB at the end of surgery (IL-6 p

Notes 


STOCKHOLM, SWEDEN

Notes 


STOCKHOLM, SWEDEN

Notes 


STOCKHOLM, SWEDEN

Notes 


SAS_S14_A5:AD 11/05/09 13:29 Side 1 

Dear Participant, 

The SAS Group welcomes you 

to Stockholm 

Stay in touch! 

www.flysas.com

SATS 2009 Final Program - Scandinavian Association for Thoracic ...

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