CABG and SCS appear to be equivalent methods in terms of symptom relief in this group of patients. Effects on ischemia, morbidity, and mortality should be considered in the choice of treatment method. Taking all factors into account, it seems reasonable to conclude that SCS may be a therapeutic alternative for patients with an increased risk of surgical complications.

Life expectancy of Swedish haemophiliacs has been estimated for the period 1831-1980. The data were derived from 948 haemophiliacs of whom 580 survived throughout 1980. Applying standard demographic techniques, median life expectancy of patients with severe haemophilia was found to have increased fivefold, from a mere 11 years during the period 1831-1920 to 56.8 years during 1961-80. The corresponding estimates for patients with moderate haemophilia were 27.5 and 71.5 years, respectively. The limited data on patients with mild haemophilia did not indicate any significant improvements in mortality. From the beginning of this century to 1980 median life expectancy for Swedish males increased from 61.7 years to 75.6 years, an increase of 23%. Analysing the last 12 years of the study (1969-80), death rates for patients with severe haemophilia below the age of 45 were not much different from those of Swedish males in the population as a whole. The investigation implies that the mortality of haemophiliacs in Sweden is approaching that of the total male population.

The quality of life of patients with hypoventilation and home mechanical ventilation (HMV) has not been well described. Modern quality of life assessment techniques were therefore introduced in a cross-sectional study of patients treated with HMV. The aim was to study various aspects of the patient's quality of life and relate them to the underlying diseases, blood gases and the type of ventilatory connection. The study comprised 39 patients, most of them ventilated only during the night (n = 35). Nasal ventilation predominated (n = 29). Patients treated with HMV reported satisfactory levels of both psychosocial functioning and mental well-being that compared well with a general population group. Their quality of sleep was generally good. The quality of life measures were mainly influenced by the patients' underlying disease. Patients with scoliosis expressed in almost all instances the best quality of life. The quality of life of patients with ventilation by tracheostomy was reported to be at least as good as that of patients with nasal ventilation. The global quality of life estimation was mainly determined by the mental state of the patients and their sleep quality and only to a minor extent by physical handicaps. In conclusion, the patients treated with HMV reported good psychosocial functioning and mental well-being, in spite of severe physical limitations and dependence on regular nocturnal ventilation.

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Cardiac adaptation to aortic stenosis seems to be influenced by gender, males presenting larger left ventricular volumes and higher wall tension. The echocardiographic findings of a narrow left ventricular outflow tract, abnormally increased intraventricular velocity and increased relative wall thickness identified patients with increased risk of early postoperative mortality. However gender had no independent impact on early postoperative outcome.

Intraoperative lobar torsion occurred in 4 of about 2000 patients subjected to thoracotomy. Two of the patients died. Early diagnosis and proper management are of great importance to the outcome. Temporary deflation of the diseased lung by using double lumen endobronchial tube is a potential risk. Early progressive lobar opacity without signs of atelectasis on conventional chest radiograph is indicative of this serious complication. Computerized tomography and bronchoscopy are of diagnostic value. Exploratory thoracotomy must be performed without delay. The injured parenchyma should be sacrificed unless the diagnosis is obtained very early. When the injured lobe or lung is rotated back into normal position the airways may be flooded with serosanguinous fluid which promptly has to be removed. If an attempt is made to save the lobe or the lung, tracheostomy for frequent suction of the airways is indicated in order to prevent "spill-over" and dangerous postoperative hypoxia.

Patients undergoing aortic valve replacement had an improvement in functional status, as well as systolic and diastolic left ventricular function, and a reduction in left ventricular mass index, irrespective of prosthesis size and type. Mechanical valves are somewhat less obstructive than stented bioprosthetic valves of the same size. They are also associated with a concomitantly more pronounced reduction of left ventricular mass.