[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Jan 1995
Case Reports[Valve replacement in an infant with congenital mitral stenosis--report of a case which showed hemodynamics similar to that of hypoplastic left heart syndrome in neonatal period].
In the neonatal period, the patient showed severely hypoplastic left ventricle, severe mitral stenosis, patent foramen ovale and patent ductus arteriosus with right-to-left shunting, which resulted in the hemodynamics similar to that of hypoplastic left heart syndrome. However, progressive left ventricular growth was recognized after spontaneous closure of the foramen ovale, and the cardiac catheterization at the age of 6 months revealed almost normal left ventricular volume and systolic forward flow from the left ventricle to the descending aorta. The operation was performed at the age of 7 months under cardiopulmonary bypass with moderate hypothermia and cardiac arrest. ⋯ We consider that there were two important hemodynamic factors which led to successful biventricular repair in this case. First, early spontaneous closure of the foramen ovale accerelated the left ventricular growth and prevented right ventricular failure resulting from increased pulmonary blood flow. Second, considerable part of the systemic output was supplied through a large ductus arteriosus, and thus over-systemic pulmonary hypertension was avoided.
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Nihon Kyobu Geka Gakkai Zasshi · Dec 1994
Case Reports[Quadruple coronary artery bypass grafting with arterial grafts--application of internal thoracic artery and right gastroepiploic artery].
Arterial graft has been widely applied for coronary artery bypass because of its excellent long-term patency. However, when more than four coronary bypass graftings should be carried out using internal thoracic arteries (ITAs) and right gastroepiploic artery (GEA), some surgical techniques must be devised. ⋯ In another case, GEA was divided into two segments and used as two free grafts. From our experience, we believe it is possible to perform multiple coronary revascularization using only arterial grafts with one median skin incision.
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Nihon Kyobu Geka Gakkai Zasshi · Dec 1994
Review Case Reports[A case of successful surgical treatment for coarctation of the aorta associated with ruptured cerebral aneurysm].
We present a case of a sixteen year old boy with coarctation of the aorta who suffered ruptured cerebral aneurysm. Both cerebral and aortic lesions were successfully corrected. ⋯ Cerebroangiography demonstrated coarctation of the aorta. Clipping of cerebral aneurysm was done at first, then three months later, complete resection of the aortic coarctation and artificial graft replacement was done by using femoral veno-arterial cardiopulmonary bypass.
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Nihon Kyobu Geka Gakkai Zasshi · Nov 1994
Case Reports[Use of the inferior epigastric artery in redo coronary artery bypass grafting--a case report].
A 71-year-old man who had undergone coronary artery bypass grafting (CABG) 9 years ago, was admitted for chest compression on exertion. A severe stenotic lesion (75%) of the main trunk of the left coronary artery and occlusion of the bypass graft previously implanted to the right coronary artery were showed by coronary angiography. Redo-CABG using the left inferior epigastric artery (LIEA) and left internal thoracic artery (LITA) was successfully done, since the saphenous vein and right gastroepiploic artery were not suitable for bypass graft. Post operative cource was uneventful and good patency of LIEA and LITA graft were revealed by postoperative angiography 34 days after surgery.
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Nihon Kyobu Geka Gakkai Zasshi · Oct 1994
Case Reports[Intraoperative pulmonary angioscopy to undergo pulmonary embolectomy for acute massive pulmonary embolism].
An urgent pulmonary embolectomy on a patient under intraoperative angioscopy for the treatment of massive pulmonary embolism was performed and successfully saved the patient. The case was a 19-year-old man who had been bedridden over along period of time. He developed pulmonary embolism immediately after the initiation of walking rehabilitation. ⋯ Consequently, amount of clots were removed using forceps or an aspirating tube. The patient recovered from hypoxemia after surgery. The use of intraoperative angioscopy in the pulmonary artery proved to be very useful to examine the presence of emboli up to tertiary branches of pulmonary artery.