[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Jan 1997
Case Reports[A case of extracardiac noncoronary sinus Valsalva aneurysm associated with aortic regugitation].
A case of extracardiac noncoronary sinus Valsalva aneurysm was reported. A 11-year-old male with history of mild AR was admitted to the hospital due to severe AR. Echocardiography revealed that the severe AR and an aneurysm in the posterior part of the ascending aorta. ⋯ Then, valve repair composed by commissuroplasty and commissural suspension was carried out. And intraluminal patch closure technique in which the longitudinal diameter of patch was half of that of the aneurysm was effective on suspension of the valvular ring. Postoperative echocardiography showed decreasing of AR.
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Nihon Kyobu Geka Gakkai Zasshi · Jan 1997
Case Reports[Urgent replacement of aortic arch and descending aorta following replacement of ascending aorta for Stanford a aortic dissection--a case report].
A 37-year-old male who was on chronic dialysis regimen for IgA nephropathy developed acute Stanford A type aortic dissection. Replacement of the ascending aorta was performed with the aid of extracorporeal circulation, selective cerebral perfusion, and open distal anastomosis technique. The site of the intimal tear in the ascending aorta was resected and the gelatin-resorcin-formaldehyde (GRF) glue was applied to both stumps. ⋯ Continuous veno-venous hemofiltration was initiated immediately after both operations and the water balance was maintained well. The patient was discharged 1 month postoperatively. It was suggested that the inside of the dissected aortic wall should be also reinforced even when the GRF glue was used in patients who have a fragile intimal flap and a wide tear.
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Nihon Kyobu Geka Gakkai Zasshi · Jan 1997
Case Reports[A surgical case report--rare association of tetralogy of Fallot with cor triatriatum, unroofed coronary sinus and persistent left superior vena cava].
We experienced the rare association of Tetralogy of Fallot with cor triatriatum, unroofed coronary sinus and persistent left superior vena cava. Only one case of this association has ever been reported in the literature. ⋯ Cardiac catheterization 6 months after operation demonstrated the smooth drainage from LSVC into the right atrium without pressure gradient. His postoperative course has been uneventful.
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Nihon Kyobu Geka Gakkai Zasshi · Dec 1996
Comparative Study Clinical Trial[Cerebral oxygen desaturation during rewarming in retrograde cerebral perfusion with total circulatory arrest].
To evaluate cerebral oxygen desaturation during retrograde cerebral perfusion with total circulatory arrest (RCP), we measured cerebral oxygen extraction (O2 Ext), and arterio-venous oxygen differences (AV DO2) during and after RCP and compared the results with usual cardiopulmonary bypass (CPB) using continuous jugular blood saturation (SjO2) monitoring. In the RCP group, 7 patients underwent aortic arch replacement with RCP and in the CPB group, 4 patients underwent valvular surgery with CPB. A 5.5 Fr oximetric catheter was placed in the jugular bulb and cerebral venous and radial arterial blood were sampled. ⋯ In conclusion, continuous SjO2 measurements reflected cerebral oxygen desaturation during and after rewarming in RCP. In RCP, significantly greater desaturation during and after rewarming was detected than in CPB. Therefore we suggest that relatively slow rewarming, higher PaCO2, and more acidic pH strategies were advantageous for preventing desaturation during and after rewarming in RCP.
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Nihon Kyobu Geka Gakkai Zasshi · Dec 1996
Case Reports[Traumatic injuries of the thoracic aorta--report of five cases].
Five cases of traumatic aneurysm of the thoracic aorta associated with blunt chest trauma are described. Although we lost one case, four cases were successfully treated. Case 1, This was a 22-year-old female who underwent surgery for graft replacement of the descending thoracic aorta under extracorporeal circulation two days after injury. ⋯ Vessel injury may be more widespread than preoperative radiographic findings demonstrates. Blunt chest trauma is usually accompanied by multisystem injury. Therefore, it is imperative to determine the first priority of treatment based on further preoperative examination in cases having associated injuries.