[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Nov 1990
Case Reports[Successful repair of an acute type A dissection during pregnancy].
We report a successful repair of an acute type-A aortic dissection during pregnancy. A 29-year-old pregnant woman in the 32 weeks of gestation with Marfan Syndrome was admitted to our hospital for the treatment of anterior chest and back pains. An urgent aortogram through pulmonary artery revealed an aortic dissection beginning from the ascending aorta to the aortic bifurcation. ⋯ During the weaning from the CPB, a retrograde aortic dissection developed and the heart became arrested. Therefore we immediately converted the aortic perfusion cannula from the right external iliac artery to graft of the ascending aorta, and the operation was completed successfully with a good recovery of the heart. The mother and her child have been alive and well for 3 years and 5 months after the operation.
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Nihon Kyobu Geka Gakkai Zasshi · Oct 1990
Case Reports[Valve replacement in infective endocarditis with mycotic aneurysm].
We successfully performed craniotomy and mitral valve replacement on a patient with bacterial endocarditis and ruptured intracranial aneurysm. A 15-year-old woman with fever and heart murmur was admitted to another hospital. Infective endocarditis and mitral valve regurgitation was diagnosed and treated with antibiotics. ⋯ We therefore began treatment using a different antibiotic but, in spite of this, 10 days later the aneurysm had enlarged dramatically. As conservative treatment was ineffective, a clipping operation was done to prevent re-rupture at the time of mitral valve replacement which could not be delayed much longer. 10 days later, cerebral 4 vessel study was done which showed no abnormality. Mitral valve replacement was then done and the patient was discharged in good health 64 days after the valve replacement.
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Nihon Kyobu Geka Gakkai Zasshi · Sep 1990
Case Reports[Coronary artery bypass in dextrocardia with situs inversus totalis--a case report].
A 71-year-old woman was admitted to our hospital by ambulance, because of right chest pain and hypotension. Chest X-ray and standard 12-lead ECG showed mirror-image dextrocardia with situs inversus totalis. ECG with right-left reversal of all leads showed acute inferior myocardial infarction. ⋯ Mirror-image dextrocardia with situs inversus totalis is very unusual. But the patients are believed to have normal longevity, and presumably have an incidence of atherosclerotic coronary artery disease similar to the general population. To our knowledge, this is the first case of coronary bypass surgery on a patient with mirror-image dextrocardia in Japan.
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Nihon Kyobu Geka Gakkai Zasshi · Sep 1990
Case Reports[Three cases of familial dissecting aortic aneurysm].
The occurrence of aortic dissection in 2 or more family members is rare. Such occurred, however, in the brothers and elder sister described herein. Case 1: A 54-year-old male had chronic Type I dissecting aortic aneurysm with severe aortic insufficiency and abdominal aortic aneurysm. ⋯ Their parents are cousins. It is, therefore, likely that the occurrence of dissecting aneurysm in the above three cases was due to an underlying hereditary disease. Thus familial dissecting aneurysm is suggested.
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Nihon Kyobu Geka Gakkai Zasshi · Sep 1990
Case Reports[A case of anomalous right pulmonary venous drainage to high segment of superior vena cava with intact atrial septum--surgical repair by cavoatrioplasty avoiding injury to the sinoatrial node and its feeding artery].
Surgical repair of anomalous right pulmonary venous drainage to the high segment of the superior vena cava (SVC) with intact atrial septum in a 5-year-old girl by cavoatrioplasty avoiding injury to the sinoatrial (SA) node and its feeding artery is described. The procedure was composed of #1: an oblique incision at the anterior wall of SVC above the anomalous right pulmonary veins (ARPVs) and closure of the lower end of the SVC, making the lower segment of SVC the ARPV channel, #2: a fan-shaped incision at the base of the right atrial (RA) appendage and suturing the cephalad flap over a created atrial septal defect, diverting the ARPV flow through the SVC into the left atrium, and #3: reconstruction of continuity between the cephalad end of the SVC and the RA by suturing the RA appendage flap over the lower segment of SVC. ⋯ Angiography one month after operation showed no stenosis of the SVC and pulmonary venous pathways. The method reported here was considered to have following advantages: It employs simple and short incisions, avoids injury to the SA node its feeding artery, and achieves wide and nonobstructive pathways of both SVC and pulmonary venous return without using foreign material.