[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Mar 1995
Case Reports[A case of acute dissecting aortic aneurysm associated with congenital bicuspid aortic valve].
The congenital bicuspid aortic valve is recognized as a cause of aortic dissection. But in Japan, the case of aortic dissection associated with bicuspid aortic valve is rare. A 66-year-old man was referred to our hospital with a diagnosis of acute Stanford A type dissecting aneurysm associated with stenotic bicuspid aortic valve. ⋯ An operation consisting of aortic valve replacement and graft replacement of the aneurysm was performed on emergency basis because of remarkable dilation of the ascending aorta. He has been doing well after the operation and discharged from the hospital on the 46th postoperative day. It is though to be important to follow up with special concern about possible dilation of sinus of Valsalva due to intrinsic weakness of the aortic wall.
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Nihon Kyobu Geka Gakkai Zasshi · Mar 1995
Comparative Study Clinical Trial[Surgical treatment of type A aortic dissection based on the location of the entry].
From 1987 to February of 1994, 42 cases of acute aortic dissection and 31 cases of chronic dissection have been operated in out institution. Our surgical technique for the treatment of aortic dissection is a tubular graft replacement following a resection of the segment of aorta containing the intimal tear. The location of the entry was, therefore, important to determine the extension of graft replacement and to select the circulatory support method during operation. 52%, 33% and 14% of cases in acute aortic dissection had entries in ascending, arch and descending aorta, respectively. ⋯ In cases with the entry in ascending aorta, ascending aorta and partial aortic arch replacement was performed in 12 and 10, respectively, for acute dissection, whereas more extensive graft replacement procedure was selected for chronic dissection including complete arch replacement in three cases and two of them had concomitant Bentall type operation. Likewise, with the entry in aortic arch, partial arch replacement was performed more often in 9 than complete arch replacement in 5 for acute dissection, on the other hand, complete arch replacement procedure tended to be preferable in 6 cases for chronic dissection. For retrograde dissection with the entry in descending aorta, ascending aorta and complete arch replacement were performed in 4 and 6 cases, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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Nihon Kyobu Geka Gakkai Zasshi · Mar 1995
Review Case Reports[A successful management of acute ruptures of the right atrium and left ventricle due to blunt trauma].
It is difficult to save a patient with acute cardiac free wall rupture due to blunt trauma; only 9 patients abroad and 2 patients in Japan are reported to have survived rupture of the left ventricle. A 30-year-old female was injured in a motor-vehicle accident. Distension of the neck vein, chest X-P and echocardiograms suggested cardiac tamponade due to cardiac rupture. ⋯ Cardiac rupture should be suspected in all cases of blunt trauma, and the early diagnosis of cardiac tamponade is a key to patient survival. Echocardiography is especially convenient and useful for the diagnosis of this condition. Repair should be performed by median sternotomy and the potential necessity for cardiopulmonary bypass should not be ignored.