Kyobu geka. The Japanese journal of thoracic surgery
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Successful repair of blunt traumatic rupture of ventricle due to traffic accident is reported. Patient was a 73-year-old woman who was driving and had seated with seatbelts at the traffic accident. Arriving at our hospital, her blood pressure was under 50 mmHg and she had clouding of consciousness, although no brain injury was recognized. ⋯ The pericardiectomy was performed immediately, then blood pressure was improved to 70 mmHg. The ruptures of right ventricle were repaired without cardiopulmonary bypass via median sternotomy. Post-operative course was without trouble and patient was discharged within 2 weeks.
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Late hemodynamics following corrective surgery for congenital heart diseases were evaluated in 65 patients. The patients were divided into 4 groups due to the operative procedures including closure of ventricular septal defect (VSD group = 15 patients), repair of tetralogy of Fallot (TOF group = 20), Mustard operation (Mustard group = 19) and Fontan operation (Fontan group = 11). The postoperative period was 3.8 +/- 3.8, 1.0 +/- 0.1, 5.7 +/- 4.3 and 3.2 +/- 4.9 years in VSD, TOF, Mustard and Fontan groups, respectively. ⋯ Ejection fraction (EF) of the systemic ventricle (left ventricle) in VSD, TOF and Fontan groups were 0.66 +/- 0.06, 0.65 +/- 0.07 and 0.63 +/- 0.08, respectively. In Mustard group, EF of the systemic ventricle (right ventricle) was 0.56 +/- 0.12 and significantly less than left ventricular EF in the other 3 groups. The hemodynamic characteristics after these operative procedures should be considered for patient management.
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Tricuspid regurgitation due to non-penetrating trauma occurred in a 21-year-old male patient who had received chest trauma in a motorcycle accident. Echocardiography demonstrated prolapse of the tricuspid anterior leaflet into the right atrium and massive tricuspid regurgitation. ⋯ The chordal rupture of the anterior tricuspid leaflet was repaired using PTFE suture and annuloplasty of the dilated annulus was made using Carpentier ring. Tricuspid regurgitation was completely repaired as shown by the postoperative echocardiogram.
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A twenty eight year-old man with anomalous pulmonary venous drainage from the right lung to the inferior vena cava (scimitar syndrome) underwent surgical treatment. We have successfully modified the surgical technique that consists of using the anterior wall of the right atrium, to form a tunnel that will divert the anomalous pulmonary vein to the left atrium. After rerouting of the anomalous pulmonary vein, the anterior wall of the right atrium was reconstructed with a polytetrafluoroethylene patch. To our knowledge, this is the first time this technique has been used to correct this syndrome.