[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Jan 1997
[Effectiveness of continuous pulmonary perfusion during total cardiopulmonary bypass to prevent lung reperfusion injury].
The oxygen free radicals and the interaction between neutrophils and endothelium have been implicated in the pathogenesis of lung injury associated with cardiopulmonary bypass (CPB), and in the setting of total CPB, the ischemia-reperfusion injury has been suspected as the mechanism of lung injury. To prevent this reperfusion induced lung injury, we performed continuous pulmonary perfusion during total CPB. We studied 26 infants less than 1 year of age who underwent patch closure of ventricular septal defect. ⋯ PaO2/FiO2 ratio of group P at 3, 6, and 12 hours after CPB were higher than those of group N, although there were no significant difference When analysis was made on the infants with high pulmonary vascular resistance (preoperative Rp/Rs ratio > or = 0.1), PaO2/FiO2 ratio of group P (n = 6) at 3, 6 and 12 hours after CPB were higher than those of group N (n = 11), and the difference was statistically significant at 12 hours after CPB (291.1 +/- 15.5 versus 199.6 +/- 27.0, p = 0.027. These results implicate that young age, low body weight and especially high pulmonary vascular resistance were incremental risk factor of lung injury after CPB and, furthermore, ischemia reperfusion injury can be the initiating factor of lung injury. The results also suggest that continuous pulmonary perfusion during total CPB is an effective mean to prevent lung injury particularly for the infants with high pulmonary vascular resistance.
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Nihon Kyobu Geka Gakkai Zasshi · Jan 1997
Case Reports[A case of extracardiac noncoronary sinus Valsalva aneurysm associated with aortic regugitation].
A case of extracardiac noncoronary sinus Valsalva aneurysm was reported. A 11-year-old male with history of mild AR was admitted to the hospital due to severe AR. Echocardiography revealed that the severe AR and an aneurysm in the posterior part of the ascending aorta. ⋯ Then, valve repair composed by commissuroplasty and commissural suspension was carried out. And intraluminal patch closure technique in which the longitudinal diameter of patch was half of that of the aneurysm was effective on suspension of the valvular ring. Postoperative echocardiography showed decreasing of AR.
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Nihon Kyobu Geka Gakkai Zasshi · Jan 1997
Case Reports[Urgent replacement of aortic arch and descending aorta following replacement of ascending aorta for Stanford a aortic dissection--a case report].
A 37-year-old male who was on chronic dialysis regimen for IgA nephropathy developed acute Stanford A type aortic dissection. Replacement of the ascending aorta was performed with the aid of extracorporeal circulation, selective cerebral perfusion, and open distal anastomosis technique. The site of the intimal tear in the ascending aorta was resected and the gelatin-resorcin-formaldehyde (GRF) glue was applied to both stumps. ⋯ Continuous veno-venous hemofiltration was initiated immediately after both operations and the water balance was maintained well. The patient was discharged 1 month postoperatively. It was suggested that the inside of the dissected aortic wall should be also reinforced even when the GRF glue was used in patients who have a fragile intimal flap and a wide tear.
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Nihon Kyobu Geka Gakkai Zasshi · Jan 1997
Case Reports[A surgical case report--rare association of tetralogy of Fallot with cor triatriatum, unroofed coronary sinus and persistent left superior vena cava].
We experienced the rare association of Tetralogy of Fallot with cor triatriatum, unroofed coronary sinus and persistent left superior vena cava. Only one case of this association has ever been reported in the literature. ⋯ Cardiac catheterization 6 months after operation demonstrated the smooth drainage from LSVC into the right atrium without pressure gradient. His postoperative course has been uneventful.