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Dahlin, Lars-Göran
Publications (10 of 33) Show all publications
Ahn, H. C., Baranowski, J., Dahlin, L.-G. & Nielsen, N. E. (2016). Transvenous Implantation of a Stent Valve in Patients With Degenerated Mitral Prostheses and Native Mitral Stenosis. Annals of Thoracic Surgery, 101(6), 2279-2284
Open this publication in new window or tab >>Transvenous Implantation of a Stent Valve in Patients With Degenerated Mitral Prostheses and Native Mitral Stenosis
2016 (English)In: Annals of Thoracic Surgery, ISSN 0003-4975, E-ISSN 1552-6259, Vol. 101, no 6, p. 2279-2284Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The purpose of this study was to report the use of a transvenous transseptal approach using a stent valve in patients with degenerated biological mitral valve prostheses, regurgitation after mitral repair, and native mitral stenosis.

METHODS: Ten patients (median age, 74 years; range, 20-89 years; 5 men and 5 women) with degenerated mitral bioprosthetic valves (n = 7), failed mitral repair (n = 1), or calcified native stenotic valves (n = 2) underwent transvenous implantation of a stent valve.

RESULTS: The procedure was initially successful in all patients. Predilation was performed for balloon sizing only in the 2 patients with native mitral stenosis. The stent valve was deployed during 1 period of rapid pacing. A guidewire, as a loop from the right femoral vein and through the left ventricular apex, facilitated a good angle and secure positioning of the stent valve. An ultrasonographically guided puncture of the apex was carried out in 6 patients, and in the other 4 we performed a minithoracotomy before apical puncture. All valves were implanted in a good position with improved function and without significant paravalvular leakage (PVL). There were no periprocedural deaths. The 30-day survival was 80% (8 of 10 patients), and 60% (6 of 10) of patients were still alive a median time of 290 days after the procedure.

CONCLUSIONS: Transvenous transseptal implantation of a stent valve was performed in 10 patients with mitral valve disease, with good early functional results. These high-risk patients must be carefully selected by a multidisciplinary team because the procedure carries a high mortality.

Place, publisher, year, edition, pages
Elsevier, 2016
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-128915 (URN)10.1016/j.athoracsur.2015.11.019 (DOI)000376502600041 ()26897322 (PubMedID)
Available from: 2016-06-07 Created: 2016-06-07 Last updated: 2018-03-19Bibliographically approved
Baranowski, J., Wallby, L., Ahn, H., Dahlin, L.-G., Nylander, E., Lindgren, B., . . . Nielsen, N.-E. (2014). TAVI without balloon predilation. A ramdomized single centre study.. In: : . Paper presented at ICI&CSI 2014, Frankfurt, Tyskland.
Open this publication in new window or tab >>TAVI without balloon predilation. A ramdomized single centre study.
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2014 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-114078 (URN)
Conference
ICI&CSI 2014, Frankfurt, Tyskland
Available from: 2015-02-07 Created: 2015-02-07 Last updated: 2015-03-30
Nielsen, N.-E., Wallby, L., Johansson, M., Ahn, H., Dahlin, L.-G. & Baranowski, J. (2014). Transcatheter valve implantation in 4 year old degenerated TAVI. In: : . Paper presented at Transcatheter valve implantation in 4 year old degenerated TAVI.
Open this publication in new window or tab >>Transcatheter valve implantation in 4 year old degenerated TAVI
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2014 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-114082 (URN)
Conference
Transcatheter valve implantation in 4 year old degenerated TAVI
Available from: 2015-02-07 Created: 2015-02-07 Last updated: 2015-03-31
Nielsen, N.-E., Wallby, L., Ahn, H. C., Dahlin, L.-G., Nylander, E., Lindgren, B., . . . Baranowski, J. (2014). Transcatheter valve-in-valve - an elegant solution to a surgical problem.. In: : . Paper presented at ICI&CSI 2014, Frankfurt, Tyskland.
Open this publication in new window or tab >>Transcatheter valve-in-valve - an elegant solution to a surgical problem.
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2014 (English)Conference paper, Published paper (Refereed)
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-114079 (URN)
Conference
ICI&CSI 2014, Frankfurt, Tyskland
Available from: 2015-02-07 Created: 2015-02-07 Last updated: 2015-03-31
Baranowski, J., Dahlin, L.-G., Nielsen, N.-E., Nylander, E., Wallby, L. & Ahn, H. (2013). Transcatheter aortic valve implantation without prior balloon dilatation - a non-randomized single centre experience. In: : . Paper presented at Thoraxmöte 16-18 oktober 2013, Linköping.
Open this publication in new window or tab >>Transcatheter aortic valve implantation without prior balloon dilatation - a non-randomized single centre experience
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2013 (Swedish)Conference paper, Oral presentation with published abstract (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-100830 (URN)
Conference
Thoraxmöte 16-18 oktober 2013, Linköping
Available from: 2013-11-13 Created: 2013-11-13 Last updated: 2013-11-25
Ahn, H., Baranowski, J., Dahlin, L.-G., Nielsen, N.-E., Nylander, E. & Wallby, L. (2012). TAVI without concomitant balloon dilatation. Paper presented at 4th Joint Scandinavian Conference in Cardiothoracic Surgery, 16-18 August 2012, Vilnius, Lithuania.
Open this publication in new window or tab >>TAVI without concomitant balloon dilatation
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2012 (English)Conference paper, Published paper (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-87607 (URN)
Conference
4th Joint Scandinavian Conference in Cardiothoracic Surgery, 16-18 August 2012, Vilnius, Lithuania
Available from: 2013-01-19 Created: 2013-01-19 Last updated: 2013-02-04
Friberg, Ö., Engström, K.-G., Hentschel, J., Freter, W., Åberg, B., Dahlin, L.-G., . . . Näslund, U. (2011). Carath – ett verksamhets­initierat  kvalitetsregister och processtöd. Ger toraxkirurgin bra möjlighet att följa vårdprocessen: [Carath - a quality registry and process support. Good possibility for throacic surgery to follow the care process]. Läkartidningen, 108(26-28), 1365-1369
Open this publication in new window or tab >>Carath – ett verksamhets­initierat  kvalitetsregister och processtöd. Ger toraxkirurgin bra möjlighet att följa vårdprocessen: [Carath - a quality registry and process support. Good possibility for throacic surgery to follow the care process]
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2011 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, no 26-28, p. 1365-1369Article in journal (Refereed) Published
Abstract [sv]

Vi redovisar här våra mång­åriga erfarenheter av uppbyggnaden och implementeringen av ett IT-processtöd (Carath) för specialiserad vård, i detta fall toraxkirurgi.

Kombinerade kvalitets- och processdata ur Carath har givit en unik möjlighet att följa för vårdprocessen relevanta nyckeltal.

Sjukvårdsprocesser är komplexa. Bristande detaljkunskap om dessa eller underskattning av tidsåtgång för planering leder till fel i databasen, vilka kan vara svåra att korrigera i efterhand.

Avsevärda resurser bör avsättas för att säkerställa en god validitet på data i ett kvalitetsregister.

Komplexiteten i att koppla ihop t ex kvalitetsregister och datajournal med varandra på ett tillförlitligt vis ska inte underskattas.

Abstract [en]

Carath is the name of a database and outcomes registry for cardiovascular surgery used and developed by four Swedish cardiothoracic centres in cooperation.  This report focuses on our experiences, positive and negative, of designing and implementing a “tailor made” database program for process control in mainly cardiac surgery. The system now provides valuable, and in some ways unique information on medical outcomes as well as administrative data. We have also become very aware of the difficulties involved in maintaining a good quality of data in multicentre medical registries. Several factors, not least the human factor, must be taken into account when building user friendly databases and quality registries. Variables must be well defined. Also, direct linking of data and outcomes directly from digitalised patient records has proved to be complicated - technically and due to the complexity of health care processes.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-76232 (URN)
Available from: 2012-03-30 Created: 2012-03-30 Last updated: 2017-12-07
Friberg, O., Dahlin, L.-G., Kallman, J., Kihlström, E., Soderquist, B. & Svedjeholm, R. (2009). COLLAGEN-GENTAMICIN IMPLANT FOR PREVENTION OF STERNAL WOUND INFECTION; LONG TERM EFFECTIVENESS. In: in INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS vol 33 (pp. S42-S42). , 33
Open this publication in new window or tab >>COLLAGEN-GENTAMICIN IMPLANT FOR PREVENTION OF STERNAL WOUND INFECTION; LONG TERM EFFECTIVENESS
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2009 (English)In: in INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS vol 33, 2009, Vol. 33, p. S42-S42Conference paper, Published paper (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-19402 (URN)
Available from: 2009-06-23 Created: 2009-06-22 Last updated: 2009-08-18
Friberg, Ö., Dahlin, L.-G., Källman, J., Kihlström, E., Söderquist, B. & Svedjeholm, R. (2009). Collagen-gentamicin implant for prevention of sternal wound infection, long term effectiveness.. Paper presented at International Journal of Antimicrobial Agents.
Open this publication in new window or tab >>Collagen-gentamicin implant for prevention of sternal wound infection, long term effectiveness.
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2009 (English)Conference paper, Published paper (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-52651 (URN)
Conference
International Journal of Antimicrobial Agents
Available from: 2010-01-07 Created: 2010-01-07 Last updated: 2010-01-13
Friberg, Ö., Dahlin, L.-G., Källman, J., Kihlström, E., Söderquist, B. & Svedjeholm, R. (2009). Collagen-gentamicin implant for prevention of sternal wound infection; long-term follow-up of effectiveness. Interactive Cardiovascular and Thoracic Surgery, 9(3), 454-458
Open this publication in new window or tab >>Collagen-gentamicin implant for prevention of sternal wound infection; long-term follow-up of effectiveness
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2009 (English)In: Interactive Cardiovascular and Thoracic Surgery, ISSN 1569-9293, E-ISSN 1569-9285, Vol. 9, no 3, p. 454-458Article in journal (Refereed) Published
Abstract [en]

In a previous randomized controlled trial (LOGIP trial) the addition of local collagen-gentamicin reduced the incidence of postoperative sternal wound infections (SWI) compared with intravenous prophylaxis only. Consequently, the technique with local gentamicin was introduced in clinical routine at the two participating centers. The aim of the present study was to re-evaluate the technique regarding the prophylactic effect against SWI and to detect potential shifts in causative microbiological agents over time. All patients in this prospective two-center study received prophylaxis with application of two collagen-gentamicin sponges between the sternal halves in addition to routine intravenous antibiotics. All patients were followed for 60 days postoperatively. From January 2007 to May 2008, 1359 patients were included. The 60-day incidences of any SWI was 3.7% and of deep SWI 1.5% (1.0% mediastinitis). Both superficial and deep SWI were significantly reduced compared with the previous control group (OR=0.34 for deep SWI, Pless than0.001). There was no increase in the absolute incidence of aminoglycoside resistant agents. The majority of SWI were caused by coagulase-negative staphylococci (CoNS). The incidence of deep SWI caused by Staphylococcus aureus was 0.07%. The results indicate a maintained effect of the prophylaxis over time without absolute increase in aminoglycoside resistance.

Place, publisher, year, edition, pages
Oxford University Press, 2009
Keywords
Antibiotics; Cardiac surgery; Complications; Mediastinitis; Regression analysis; Risk factors; Statistics; Wound infection
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-21243 (URN)10.1510/icvts.2009.207514 (DOI)19541691 (PubMedID)
Available from: 2009-09-30 Created: 2009-09-30 Last updated: 2017-12-13Bibliographically approved
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