[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Jun 1990
Case Reports[Radical correction of paracardiac type IIb of total anomalous pulmonary venous connection using pedicled flaps of right atrium and atrial septum].
Surgical results of total anomalous pulmonary venous connection (TAPVC) has been improved in recent years, however, late development of pulmonary venous obstruction was our concern in its total correction in early infancy. In the cardiac type of TAPVC, in which the pulmonary veins were connected to the right lateral wall, prosthetic patch is conventionally used in diversion of pulmonary venous flow into left atrium. It seemed favorable to repair this subset without using prosthesis. ⋯ The second flap was made in the middle of the lateral atrial wall and was used to create a tunnel from the recess to the atrial septal defect. The defect in the right atrial wall was closed directly and no prosthetic patch was used. Postoperative course was uneventful and echocardiogram showed wide pulmonary venous channel draining into the left atrium.
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Nihon Kyobu Geka Gakkai Zasshi · Apr 1990
[Effects of ulinastatin on plasma polymorphonuclear leukocyte elastase activity and respiratory function in patients undergoing cardiopulmonary bypass].
Plasma polymorphonuclear leukocyte elastase (PMNE) activity is known to increase during cardiopulmonary bypass (CPB), and is considered to mediate pulmonary tissue damage causing postoperative respiratory failure. We made a clinical study in order to clarify the effects of ulinastatin (Miraclid), a proteolytic enzyme inhibitor, on plasma PMNE activity and respiratory function. Twenty adult patients undergoing coronary artery bypass grafting were divided into 2 groups; 10 to group U and 10 to group C. ⋯ There was a significant correlation between the leukocyte reduction and the rate of increase of beta-glucuronidase activity were diminished in group U compared to preoperative values (p less than 0.05). The recovery of the oxygenation index (PaO2/F1O2), which was used for evaluation of the respiratory function, was worse in group C (p less than 0.01). These results suggest that the administration of ulinastatin in patients undergoing CPB is useful for the prevention of the deleterious effects of PMNE on the lung.
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Nihon Kyobu Geka Gakkai Zasshi · Mar 1990
Case Reports[A case report of epicardial cryoablation in a five-month-old infant with WPW syndrome].
A five month old boy was referred to us with recurrent episodes of tachycardia and heart failure due to WPW syndrome. ECG and electrophysiological studies revealed a left lateral wall accessory conduction pathway. ⋯ Tachyarrhythmia and delta wave disappeared immediately following the operation and the patient had uneventful postoperative recovery. In this paper, the usefulness of epicardial cryoablation with left lateral thoracotomy for infants with a proved left accessory conduction pathway is stressed.
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Nihon Kyobu Geka Gakkai Zasshi · Mar 1990
Case Reports[Ruptured aneurysms of sinus of Valsalva with bicuspid aortic valve--a case report of an aged patient (72 years old)].
A 72-year-old man with ruptured aneurysms of the sinus of Valsalva and a bicuspid aortic valve was operated. Ruptured aneurysms were found in the noncoronary sinus region, and they were opened to the commissure between the anterior cusp and septal cusp of the tricuspid valve. ⋯ Ruptured aneurysm of Valsalva is very rare in a aged patient. In this case, it is considered that the bicuspid aortic valve associated with malformations of the aortic cusp caused a weakness of the sinus wall, and this region gradually became aneurysmal.