Kyobu geka. The Japanese journal of thoracic surgery
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Between may 1993 and march 2001, 2 patients with tetralogy of Fallot and an anomalous coronary artery crossing the right ventricular outflow tract underwent intracardiac repairs. The anomalous coronary arteries included the left anterior descending from the right coronary artery (case 1), and the right coronary artery from the left coronary artery (case 2). ⋯ In case 2, we underwent transpulmonary-transatrial repair and placed a transannular patch along by the left coronary artery. Right ventricular outflow tract reconstruction was successful in 2 cases.
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A 56-year-old female admitted with severe back pain, and her chest computed tomography demonstrated non-dissecting sclerotic aneurysm of the ascending aorta. Aortography and echocardiography showed marked dilatation of the ascending aorta and the Valsalva sinuses resulting in disappearance of the sinotubular junction. ⋯ A woven Dacron double-veloured graft (Hemashield) of 22 mm in diameter was used for reconstruction of the ascending aorta and its root. Postoperative aortography figured the new sinotubular junction and the new Valsalva-like sinus composed by the graft, and aortic regurgitation was controlled to grade one.
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Conotruncal repair for tetralogy of Fallot consists of (1) precise closure of the VSD with the membranous flap and (2) reconstruction of the right ventricular outflow tract (RVOT) by a short transannular patch (< 30% of the RV length) with a wide PTFE monocusp. This report describes the mid-term results in 46 patients with tetralogy of Fallot who underwent conotruncal repair with PTFE monocusped transannular patch and have been followed up for 4 years or more. There was no early and late death and no patient required reoperation. ⋯ The mobility of the PTFE monocusp was echocardiographically detected in 86% over a mean follow-up period of 84 +/- 34 months and % freedom from pulmonary regurgitation (> II) was 85.9% at 10 years postoperatively. Excellent long-term durability of the PTFE monocusp provided the normal right vent performance with RVEDV of 91.8 +/- 29.5% of normal and a central venous pressure of 5 +/- 1 mmHg. In conclusion, conotruncal repair with a wide and short transannular patch has provided good mid-term results with the excellent long-term durability of PTFE monocusp.
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Review Case Reports
[Surgical treatment for pulmonary arterial injury caused by sewing needles].
A 41-year-old woman was found lying in her home, which was on fire, and was brought to our hospital by ambulance. Her complaint was severe dyspnea, and a respirator was needed. Contusion and abrasion were present on her anterior chest. ⋯ Through a median sternotomy approach, the pericardium was opened. About 200 ml of blood was pooled in the pericardium cavity, and a needle was found in the main pulmonary artery. The needle was removed and the bleeding point was closed using suturing with 5-0 prolene without cardiopulmonary bypass.
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Case Reports
[Simultaneous mitral and aortic valvuloplasty using rasping procedure for combined valvular disease: a case report].
We reported a case of successful simultaneous mitral and aortic valvuloplasty using rasping procedure. A 55-year-old woman with combined valvular disease received this operation. Postoperatively, the mitral valve area increased from 1.15 cm2 to 2.03 cm2. ⋯ Ejection fraction (EF) also increased from 60% to 82%. The postoperative course was uneventful. Excellent postoperative results of this procedure may be expected, not only in single valvular disease but also in combined valvular disease.