[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Sep 1993
Case Reports[A successful surgical treatment of traumatic dissecting aneurysm].
Dissecting thoracic aortic aneurysm caused by blunt trauma was reported. A 64-year-old woman involved in automobile accident was transported to our hospital. Chest X-ray showed multiple rib fractures and enlargement of mediastinal shadow. ⋯ She suffered from acute renal and respiratory failure soon after admission, but underwent operation 6 months after the trauma because of enlargement of false channel. Graft replacement was performed and postoperative course was uneventful. Histopathologic findings showed dissection of adventitia of the aorta.
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Nihon Kyobu Geka Gakkai Zasshi · Aug 1993
[Assessment of left ventricular contraction with LV Emax during cardiopulmonary bypass in patients with open heart surgery].
There are few reports on the assessment of left ventricular contraction during cardiopulmonary bypass (CPB) in open heart surgery. LV Emax is thought to be a load-independent index of left ventricular function. We used a left ventricular conductance catheter to measure LV Emax from "non-working beating heart" during CPB in 16 patients who underwent open heart surgery. ⋯ But in 2 other patients DOB didn't increase LV Emax during CPB. In order to be weaned from CPB, the two patients needed epinephrine and intraaortic balloon pumping. We concluded that change of LV Emax made by intravenous administration of dobutamine is one of useful indexes to assess left ventricular contractility during cardiopulmonary bypass.
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Nihon Kyobu Geka Gakkai Zasshi · Aug 1993
Case Reports[Application of cryopreserved allograft to aortic root replacement for valve detachment case due to aortitis].
A 54-year-old male who had received an aortic valve replacement with SJM 23 about 3 years before suffered from an acute cardiac failure because of the valve detachment. From his clinical course, it was diagnosed that the aortic valve insufficiency was complicated by an aortitis. We operated on him by an aortic root replacement using a cryopreserved allograft which we prepared. ⋯ Indication of the allograft valve to an aortitis case is still controversial. We think the allograft is recommendable to valve detachment case due to aortitis, because the softness of the graft decreases a compliance mismatch between the graft and the patient's annulus, which may prevent redetachment. Although we felt concern about redetachment of the conduit due to the weakness of the patient's aortic annulus, no complication regarding the allograft happened at all as yet.
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Nihon Kyobu Geka Gakkai Zasshi · Aug 1993
[Study on prevention of paraplegia during occlusion blockade of the thoracic aorta--examination of the evoked potential in the motor nerve induced by stimulation of the motor area of cerebral cortex].
In an attempt to trace the motor neurons in the descending tract of the motor system of the spinal cord and anterior horn, we have succeeded in inducing a potential in the peripheral motor nerve (evoked motor nerve action potential: EMNAP) by stimulating the motor area of the cerebral cortex in dogs, we have examined the characteristics of this potential. Besides the EMNAP, we have induced the conventional somatosensory evoked potential (SSEP) and evoked spinal cord potential (ESCP) during spinal ischemia. These are compared with each other, with theoretical predictions and with pathological findings. ⋯ Disorder of the anterior horn cells were also observed histopathologically. Direct monitoring of the alpha-motoneuron in the anterior horn, which is most susceptible to disorders, seems appropriate as a method for preventing paraplegia. EMNAP may be useful for monitoring motor function of the spinal cord not only during chest surgery but also for other types of diagnosis and treatment.
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Nihon Kyobu Geka Gakkai Zasshi · Apr 1993
Review Case Reports[Left atrial free-floating ball thrombus in a patient without mitral valve disease].
A free-floating ball thrombus in the left atrium is a rare clinical problem with potentially catastrophic consequences. Thus, early diagnosis and prompt surgical intervention are mandatory. This report dealt with a free-floating ball thrombus in the left atrium in a case without mitral valve disease. ⋯ The intact mitral valve was also confirmed at operation. The patient recovered uneventfully. Usefulness of echocardiography, particularly transesophageal echocardiography, for precise diagnosis and intraoperative management of a free-floating ball thrombus in the left atrium is discussed.