[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
-
Nihon Kyobu Geka Gakkai Zasshi · Aug 1994
Review Case Reports[2 cases of the tension pneumopericardium following blunt chest trauma resulting in the cardiac tamponade].
A 63-year-old man (case 1) was brought to our emergency unit following a high speed collision. He developed fatal cardiopulmonary arrest shortly after arrival despite resuscitation efforts. Tension pneumopericardium was revealed by chest X-ray and CT examination. ⋯ In a patient with traumatic pneumopericardium who requires mechanical ventilatory support, continuous pericardial drainage should be considered. In addition, tension pneumopericardium may occur in patients with breathing spontaneously as in our cases. In these cases, careful observation and immediate subxiphoid pericardial drainage are required.
-
Nihon Kyobu Geka Gakkai Zasshi · Aug 1994
Case Reports[Mitral valve replacement secondary to resection of mycotic cerebral aneurysm in acute phase of bacterial endocarditis--a case report].
We report a case of mitral valve replacement after ruptured mycotic aneurysm resection in acute phase of bacterial endocarditis. We have experienced a 68-year-old man with vegetation at the anterior leaflet of mitral valve and multiple systemic embolization. ⋯ Mitral valve was replaced three days after successfully. If there was no heart failure preoperatively, valve replacement operation is recommended in acute phase of infected endocarditis or few days after cerebral aneurysmectomy.
-
Nihon Kyobu Geka Gakkai Zasshi · Aug 1994
Case Reports[Thrombolytic therapy of thrombosed Björk-Shiley aortic valve prosthesis--report of four cases].
Prosthetic valve thrombosis is associated with high mortality. Thrombolytic therapy is a promising alternative to valve replacement in the management of prosthetic valve thrombosis. To determine the efficacy and safety of thrombolytic therapy for thrombosed Björk-Shiley aortic valve prosthesis, 4 patients who received urokinase intravenously for this disorder were analyzed. ⋯ A protocol for the safe treatment of thrombosed valve is urokinase in initially administered in the doses as 960,000 units for 24 hours, then followed by a maintenance infusion at the half dose every 24 or 48 hours later. Thrombolytic therapy should be continued for 1 week at least to prevent rethrombosis even normalization of valve function was documented clinically. Simultaneous heparin infusion of 10,000 units for 24 hours is then started to replaced by warfarin treatment adjusted to obtain optimal prothrombin times.(ABSTRACT TRUNCATED AT 250 WORDS)