Rinsho kyobu geka = Japanese annals of thoracic surgery最新文献_第6页

[A case report of aortic valve replacement after 16 years from repair of ruptured sinus Valsalva aneurysm]. 【Valsalva窦性动脉瘤破裂修复16年后主动脉瓣置换术1例报道】。

Rinsho kyobu geka = Japanese annals of thoracic surgery Pub Date : 1994-08-01

T Akimoto, M Fujimura, S Nishiya, M Toshima, S Uchita

引用次数: 0

[Reoperation for valvular heart diseases]. 【瓣膜性心脏病再手术】。

Rinsho kyobu geka = Japanese annals of thoracic surgery Pub Date : 1994-08-01

H Shintani, H Matsuda

{"title":"[Reoperation for valvular heart diseases].","authors":"H Shintani, H Matsuda","doi":"","DOIUrl":"","url":null,"abstract":"To elucidate the limitation of mitral valve reconstruction, 53 mitral disease patients (Mitral stenosis: 29, Mitral regurgitation: 24) undergoing reoperation late after valve reconstruction were studied, taking account of valvular lesions at initial operation. Reoperation rate after open mitral commissurotomy for mitral stenosis was higher in the patients with valvular regurgitation at initial operation than in those with severe subvalvular lesions or calcified valve. Reoperation rate for mitral regurgitation after mitral valvuloplasty was higher in the patients with stenotic fibrous degeneration or dilated annulus at initial operation than in those with torn chorda. Thus, these findings suggest that combined lesion of stenosis and regurgitation at initial operation may affect the reoperation rate in patients undergoing mitral valve reconstruction for either mitral stenosis or mitral regurgitation. Different approaches to the mitral valve through the left atrium and various techniques of the atriotomy have been practiced according to the need for a particular patients. The left atrium and the mitral valve can be exposed through median sternotomy followed by biatrial atriotomy or transplant approach. A correct approach and good exposure plays a key role in the success of redo surgical procedure for mitral valve disease.","PeriodicalId":79253,"journal":{"name":"Rinsho kyobu geka = Japanese annals of thoracic surgery","volume":"14 4","pages":"297-300"},"PeriodicalIF":0.0,"publicationDate":"1994-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20350552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Allograft (homograft) valve surgery: current status in Japan]. [同种异体(同种异体)瓣膜手术:日本的现状]。

Rinsho kyobu geka = Japanese annals of thoracic surgery Pub Date : 1994-08-01

S Kitamura, K Niwaya, K Kawachi, R Morita, T Kawata, S Kobayashi, M Fukutomi, J Hasegawa, Y Yoshida, H Sakaguchi

引用次数: 0

[Reoperations on valvular disease: an analysis of outcome]. 再手术治疗瓣膜性疾病的疗效分析

Rinsho kyobu geka = Japanese annals of thoracic surgery Pub Date : 1994-08-01

M Hachida, A Toyama, K Ihashi, M Kitamura, S Aomi, H Nishida, M Endo, A Hashimoto, H Koyanagi

{"title":"[Reoperations on valvular disease: an analysis of outcome].","authors":"M Hachida, A Toyama, K Ihashi, M Kitamura, S Aomi, H Nishida, M Endo, A Hashimoto, H Koyanagi","doi":"","DOIUrl":"","url":null,"abstract":"To evaluate risks and complications of reoperation on valvular disease, we reviewed data on 186 patients who underwent reoperations because of prosthetic valve malfunctions, pregression of valvular disease after open mitral commissulotomy and previous valvular replacement. Overall hospital mortality was 4.8% (9/186 patients). The common causes of death was low cardiac output syndrome (3 pts.) and respiratory failure (3 pts.) and others (3 pts). Hospital mortality was different according to the risk factors. There was no significant difference between the operative procedures; AVR (6.2%), MVR (3.2%), DVR (8%), TVR (0%) and MVR + TVR (9%). Furthermore, advanced age, valve position, renal failure, preoperative %FS, LVDd and diagnosis of prosthetic valve malfunction did not appear to be significant risk factor. However, preoperative respiratory failure and emergency operation showed significant increase of hospital mortality in comparison with other factors. On the basis of this reports, hospital mortality and late survival indicated that reoperation should be performed early as the potentially safe condition.","PeriodicalId":79253,"journal":{"name":"Rinsho kyobu geka = Japanese annals of thoracic surgery","volume":"14 4","pages":"292-6"},"PeriodicalIF":0.0,"publicationDate":"1994-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20350551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Reoperations for prosthetic heart valves: operation techniques and determinant factors of operative mortality]. 人工心脏瓣膜再手术:手术技术及手术死亡率的决定因素。

Rinsho kyobu geka = Japanese annals of thoracic surgery Pub Date : 1994-08-01

S Aoyagi, K Ohishi

{"title":"[Reoperations for prosthetic heart valves: operation techniques and determinant factors of operative mortality].","authors":"S Aoyagi, K Ohishi","doi":"","DOIUrl":"","url":null,"abstract":"Between 1982 and 1993, 93 patients underwent reoperation for prosthetic heart valves at our hospital. There were 41 male and 52 female patients who ranged in age 2 to 70 years with a mean age of 47 years. Twenty-four patients were in New York Heart Association (NYHA) functional class II, 52 in class III, and 17 in class IV, preoperatively. The indications of reoperative valve surgery were primary tissue failure of a bioprosthesis in 57 patients, valve thrombosis in 10, nonstructural valve dysfunction in 12, cloth wear of a ball valve in 5, endocarditis in 5, and others in 4. In reoperation, the heart was not mobilized from the pericardium to prevent tearing the heart and great vessels. All operative procedures were performed through the pericardium which adhered tightly to the heart. Adequate myocardial protection was obtained without total dissection of the heart with cold crystalloid cardioplegic solution and topical cooling which was accomplished by filling the left pleural space with cold saline. The operative mortality was 7 of the 93 patients (7.5%), falling from 4/36 (11.1%) in 1982 through 1987 to 3/57 (5.3%) in 1988 through 1993. Advanced New York Heart Association functional class, prolonged cardiopulmonary bypass and aortic cross clamping times were the determinant factors of operative mortality. These results suggest that reoperation for dysfunctioning prosthetic heart valves should be performed before deterioration of the hemodynamic condition of the patient.","PeriodicalId":79253,"journal":{"name":"Rinsho kyobu geka = Japanese annals of thoracic surgery","volume":"14 4","pages":"301-5"},"PeriodicalIF":0.0,"publicationDate":"1994-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20350553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Present status of extracorporeal membrane oxygenation for adult respiratory failure]. 体外膜氧合治疗成人呼吸衰竭的现状

Rinsho kyobu geka = Japanese annals of thoracic surgery Pub Date : 1994-06-01

K Kobayashi

{"title":"[Present status of extracorporeal membrane oxygenation for adult respiratory failure].","authors":"K Kobayashi","doi":"","DOIUrl":"","url":null,"abstract":"In 1970s, survival rate in patients undergoing extracorporeal membrane oxygenation (ECMO) for acute respiratory failure was some around 10% even in sophisticated institutions. Most of them were treated by veno-arterial bypass along with mechanical ventilation with high air way pressure. Problems seen in this treatment modality were; difficulty in controlling bleeding and superimposed infection, mechanical problems of equipment (membrane lung, pumps, bypass circuit etc.), inadequate understanding of pathophysiology of respiratory failure. Lung injuries were also caused by high air way pressure and high fraction of inspired oxygen used in these patients. Above experience induced Kolobow and Gattinoni to use veno-venous bypass to extract metabolically produced carbon dioxide through membrane lungs and to supply oxygen through patient's own lung which is mechanically ventilated several times per minute with minimum concentration of inspired oxygen. Thus, lung damage caused by high air way pressure and oxygen can be preventable by giving lung time to rest and to heal. This treatment modality is called low frequency positive pressure ventilation with extracorporeal carbon dioxide removal (LFPPV-ECCO2R). The LFPPV-ECCO2R contributed much to raise the survival rate from 10% to 50%. Also better understanding of pathophysiology of acute respiratory failure and use of biocompatible materials like heparin-coated membrane lung and bypass circuit to minimize bleeding problem help much for better result. Successful cases are seen in younger patients with short duration of respiratory failure with reversible lung diseases. Bypass time is shorter in successful cases than that in unsuccessful cases. ECMO has revisited as Bartlett says.","PeriodicalId":79253,"journal":{"name":"Rinsho kyobu geka = Japanese annals of thoracic surgery","volume":"14 3","pages":"179-83"},"PeriodicalIF":0.0,"publicationDate":"1994-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20352048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Reoperation after correction of total anomalous pulmonary venous connection: particularly for postoperative pulmonary vein stenosis]. 【全肺静脉连接异常矫正后再手术:特别是术后肺静脉狭窄】。

Rinsho kyobu geka = Japanese annals of thoracic surgery Pub Date : 1994-06-01

M Yokota, K Sakamoto, A Ikai, M Kado, H Nagato, M Nishioka, T Tsuda

{"title":"[Reoperation after correction of total anomalous pulmonary venous connection: particularly for postoperative pulmonary vein stenosis].","authors":"M Yokota, K Sakamoto, A Ikai, M Kado, H Nagato, M Nishioka, T Tsuda","doi":"","DOIUrl":"","url":null,"abstract":"Postoperative pulmonary vein stenosis is a major complication after the correction of the total anomalous pulmonary venous connection. Six patients developed this complication 2 to 3 months after surgery. Five underwent reoperation (3 had the third operations) with only one survivor. Risk factors for developing the stenosis were 1. small common pulmonary vein with small branches occurring in the patients with the ages at the operation below 2 days and accordingly with the infradiaphragmatic connection and 2. Y-shaped common pulmonary vein with the confluence situated far below the left atrium. Turbulence seemed the major cause of the intimal thickening occurring in the common pulmonary vein shortly distant from the orifices of the branches. Typically the anastomotic orifice was not narrowed. Relief of the stenosis was done by the excision of the hypertrophied intimal tissue frequently cutting into the branches. Severe stenosis recurred in 4 patients necessitating another operation in 3 patients which was fatal in two. Prevention is important. Creation of a large anastomosis with the incision not extending into the branches and the use of the absorbable suture materials were effective. In the infradiaphragmatic connection incorporation of the divided stump of the descending vein into the anastomosis and a T-shaped incision of the left atrium were also important.","PeriodicalId":79253,"journal":{"name":"Rinsho kyobu geka = Japanese annals of thoracic surgery","volume":"14 3","pages":"211-8"},"PeriodicalIF":0.0,"publicationDate":"1994-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20351904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Palliation for univentricular hearts]. [缓解单心室心脏]。

Rinsho kyobu geka = Japanese annals of thoracic surgery Pub Date : 1994-06-01

Y Shimazaki

引用次数: 0

[A case report of coronary artery bypass graft surgery and subsequent chemotherapy for the patient with unstable angina and small cell lung cancer]. 【不稳定型心绞痛合并小细胞肺癌行冠状动脉搭桥手术并化疗1例报道】。

Rinsho kyobu geka = Japanese annals of thoracic surgery Pub Date : 1994-06-01

A Nabuchi, A Amano, H Suma, F Hojo

引用次数: 0

[Thoracotomy for patients with bronchial asthma]. 【支气管哮喘患者的开胸术】。

Rinsho kyobu geka = Japanese annals of thoracic surgery Pub Date : 1994-06-01

H Kodama, I Yoshida, S Ishikawa, A Ohtaki, T Takahashi, Y Satoh, O Kawashima, Y Morishita

引用次数: 0