[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Dec 1991
Case Reports[A case report of chronic traumatic dissecting aneurysm of the thoracic aorta].
A 63-year-old male, who sustained a blunt chest trauma in a traffic accident, was referred to our hospital for his traumatic aneurysm. An operative repair was undertaken 3 months after the trauma. ⋯ Graft replacement was performed under the left heart bypass by using the BioMedicus centrifugal pump. He is doing well 3 years after the operation.
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Nihon Kyobu Geka Gakkai Zasshi · Dec 1991
[Usefulness of recombinant human erythropoietin in cardiac surgery with autologous blood transfusion].
The efficacy and method of administration of recombinant human erythropoietin (EPO) in adult cardiac surgical patients when given preoperatively was evaluated. We used EPO intravenously (iv) with 40 mg ferric oxide for a total of consecutive 47 patients. The patients were divided into group A (n = 14; EPO 200 IU/kg iv 3 times a week from 3 weeks prior to surgery to 2 weeks after surgery, donation of 800 ml) and group B (n = 33; EPO 200 IU/kg iv everyday from 8 days prior to surgery to 2 weeks after surgery, donation of 400 ml). ⋯ A hemoglobin change between pre-donation and surgery was +0.14 +/- 1.3 (g/dl) in group A, +0.04 +/- 1.0 (g/dl) in group B, -1.7 +/- 1.3 (g/dl) in group AO and -1.0 +/- 0.6 (g/dl) in group BO. In a comparison of post-surgical hemoglobin levels between group A and group B, we demonstrated that the level in group B, +2.1 +/- 1.8 (g/dl) was significantly higher than that in group A, +11.1 +/- 1.6 (g/dl) 2 weeks after surgery. There was no evidence to show an aggravation of anemia in the pre-surgical period in EPO-treated groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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Nihon Kyobu Geka Gakkai Zasshi · Nov 1991
Case Reports[Successful complete repair of interrupted aortic arch and associated with DiGeorge syndrome in neonate].
We report a rare case of interrupted aortic arch and a right aortic arch associated with DiGeorge syndrome, in neonate. Through a median sternotomy bypass was established placing an arterial perfusion cannula both in the ascending aorta, and in the main pulmonary artery. The right and left pulmonary arteries were temporarily occluded, while this pulmonary cannula perfused the lower part of the body. ⋯ The patient had hypocalcemia and thymic abnormalities which was consistent with the DiGeorge syndrome. He was treated with calcium gluconate and alfacalcidol, but no serious infection due to immunodeficiency was seen after operation. Post operative catheterization revealed no pressure gradient at the site anastomosis of the aortic arch and satisfactory results.
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Nihon Kyobu Geka Gakkai Zasshi · Oct 1991
Review Case Reports[Bilateral diaphragmatic plication for an adult patient].
Bilateral phrenic nerve paralysis is a very rare complication in open-heart surgery. An 65-year-old woman sustained respiratory distress after coronary artery bypass grafting because of bilateral phrenic nerve paralysis. ⋯ She successfully weaned from ventilator support without difficulty a few days after plication. We believe that surgical plication of the diaphragm is a safe and effective technique for a distressed adult patient with paralyzed diaphragm.
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Nihon Kyobu Geka Gakkai Zasshi · Oct 1991
Case Reports[Clinical features of hypernatremic hyperosmolar delirium following open heart surgery].
Five cases of hypernatremic hyperosmolar delirium after open heart surgery were reviewed. Minimum serum osmolarity at the time of developing delirium in these cases was 336 mOsm/l. Blood glucose level did not reached to the levels of the typical criteria of hyperosmolar hyperglycemic nonketotic diabetic coma in all cases. ⋯ In order to treat the patients with hypernatremic hyperosmolar delirium, the correction of serum osmolarity should be done very slowly, because water intoxication should be prevented. In all five cases in this paper were recovered from delirium as the time when serum natrium level and serum osmolarity were restored to the normal state. We concluded that in order to get a good prognosis of this characteristic disorder, we have shown early recognition of serum hypernatremia and hyperosmolarity state and consequently adequate treatment mentioned above are primarily important.