[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Aug 1997
[Three-dimensional transesophageal echocardiographic assessment for prosthetic valves].
We evaluated three-dimensional transesophageal echocardiographic assessment of the implanted mechanical valves by rotational scanning method. Patients were 7 mitral valve replacement and one aortic valve replacement, 2 mitral and aortic valve replacement. In 2 cases of 7 mitral valve replacement, the prosthetic valve regurgitation was evaluated using by color Doppler echocardiography. ⋯ In this study, this system has some problems, for example real-time evaluation is impossible, aortic valve and ball valve cases cannot be reconstructed. However, we think that this new technology is suitable for evaluating valve thrombus, valve dysfunction and paravalvular leakage. In conclusion, the three-dimensional echo-cardiography demonstrated, reliable and accurate examination, and it can evaluate various complications of prosthetic valve.
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Nihon Kyobu Geka Gakkai Zasshi · Jul 1997
Case Reports[Monitoring for spinal cord ischemia by the use of the motor evoked potentials, the evoked spinal cord potential and the segmental evoked spinal cord potential during thoracoabdominal aortic surgery--a case report].
A 55-year-old woman, who was detected an enlargement of the aorta with body CT, was admitted to our hospital. Preoperative examination revealed that the aneurysm was expanded from ascending aorta to the abdominal aorta above the celiac artery. She underwent total arch replacement using elephant trunk technique. ⋯ During the operation, the monitor showed no remarkable change, even while the aorta was cross clamped. Her postoperative course was uneventful without any spinal cord damage. Combined use of MEP, ESCP, and S-ESCP was useful for monitoring spinal cord injury during thoracoabdominal aneurysmal repair.
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Nihon Kyobu Geka Gakkai Zasshi · Jun 1997
Case Reports[A case of total arch replacement for traumatic aortic arch rupture].
We report a case of aortic arch rupture due to blunt chest trauma. A 64-year-old woman was crushed under a wood when she was working. On her arrival to our hospital, she was in shock state due to cardiac tamponade. ⋯ As the intimal disruption was found to be extended to three fourths of the circumference of aortic arch, total arch replacement was performed. In this case, the TEE was useful for the immediate diagnosis of the aortic rupture. This was the first successful case of total arch replacement for a traumatic arch rupture.
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Nihon Kyobu Geka Gakkai Zasshi · Jun 1997
Randomized Controlled Trial Clinical Trial[Clinical evaluation of heparin concentration and activated clotting time monitoring (HEPCON HMS) system].
The HEPCON HMS system provides both activated clotting time (ACT) and accurate whole blood heparin concentration measurements. We evaluated the impact of heparin and protamine administration using this system on the incidence and treatment of bleeding after performing a cardiopulmonary bypass. Patients were randomly divided into two groups. ⋯ There were no statistical differences in the coagulation factor, the postoperative chest tube drainage or the blood products used between the two groups. Patients in Group H received a higher dosage of heparin and a lower dosage of protamine compared with Group A. By facilitating the maintenance of a therapeutic heparin concentration and by determining an appropriate protamine dosage, the HEPCON HMS system may be useful in managing extracorporeal circulation.
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Nihon Kyobu Geka Gakkai Zasshi · Apr 1997
Review Case Reports[Two cases of tracheal injuries secondary to blunt trauma].
We present two cases of injury to the cervical trachea and the tracheal bifurcation due to blunt trauma. A 20-year-old man sustained complete disruption of the cervical trachea during a traffic accident. He underwent end-to-end anastomosis of the disrupted trachea. ⋯ He sustained a longitudinal laceration about 3 cm from the tracheal over the membranous portion during a traffic accident. The laceration was successfully repaired by interrupted sutures with absorbable materials. Our experiences emphasize the importance of debridement of the injured cartilageous portion during treatment of tracheal injury due to blunt trauma and the difficulty in managing complete disruption of the cervical trachea with bilateral paralysis of the recurrent nerve.