[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Dec 1997
Case Reports[Open heart surgery in a Jehovah's Witness boy--a case report of successful management of aortic regurgatation and aneurysm of sinus Valsalva due to infective endocarditis].
Jehovah's Witness who require operation represent a challenge to the physician because of the patients' refusal to accept blood transfusion. We report an 8-year-old male of Jehovah's Witness who underwent a surgical treatment of infective endocarditis. He was transferred to our hospital because of high fever and heart murmur. ⋯ We also used Cell-Saver to reduce blood loss. The patient made an uncomplicated recovery. Erythropoietin therapy contributed substantially to the successful outcome of this case.
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Nihon Kyobu Geka Gakkai Zasshi · Dec 1997
Case Reports[Temporary use of left ventricle-to-pulmonary artery extracardiac conduit for the surgical repair of complete transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction].
A 1.8-year-old boy was first admitted to our hospital at 12 days of age with the diagnosis of transposition of the great arteries (TGA), ventricular septal defect (VSD), and left ventricular outflow tract obstruction (LVOTO). Echocardiography and catheter examination at 10 months of age disclosed severe organic stenosis of left ventricular outflow tract (LVOT) with its diameter of 5.6 mm (50% of N) and the left to right ventricular (LV/RV) pressure ratio of 0.6. At 1.8 years of age, he underwent complete correction which comprised intraatrial switch (Senning procedure), direct closure of VSD, and removal of thickened endocardium at LVOT. ⋯ The third catheter examination at the age of 3.9 years confirmed LV/RV pressure ratio of 0.43. The patient is leading a normal life. without medication 3 years after the operation. This experience draws us to conclude that placement of left ventricle-to-pulmonary artery conduit concomitantly with the intraatrial switch is a useful adjunctive procedure for the complete correction of TGA, small VSD, and LVOTO, and that, in a subset of the patients, this procedure may allow amelioration of LVOTO and secondary removal of the conduit.