All issues
Volume 24, Issue 2
Displaying 1-15 of 15 articles from this issue
- |<
- <
- 1
- >
- >|
-
Tadashi Kinefuchi, Tuneo Ookuma, Akira Sato, Hiroyuki Kaneda, Mituhiro ...1995 Volume 24 Issue 2 Pages 71-79
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSThere is still considerable risk when performing anastomotic procedures in the aorta and artificial vessels. The wrapping method is occasionally used as an alternative to solve the problems of hemostasis and reinforcement of the anastomotic portion, however, few data are available on the results of long-term follow up after anastomosis in this area. To define the long-term results for the wrapping method, we evaluated changes in the vascular walls of set intervals. The purpose of this study was to analyze the influence of technical factors and to sutisfy the prerequisites for an ideal wrapping method. A total of 26 mongrel dogs of both sexes were used in this study. We examined changes of the aortic walls microscopically of set intervals after a wrapping method using woven Dacron materials for 4 weeks and 4 months. Another 2 groups (Mesh group and E-PTFE group) were also included in this study. The cause of thinning phenomena of the aortic walls appears to be compression of the anastomotic portion. Wrapping materials resulting in excessively small diameters may cause deleterious compressions of the anastomotic site. Wrapping methods with materials ensuring a larger diameter may play an important role after anastomotic operations for reinforcement and hemostasis.View full abstractDownload PDF (3167K) -
Jun Hihara, Masato Furuyama, Sadanori Takeo, Koji Ikejiri1995 Volume 24 Issue 2 Pages 80-84
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSIn arteriosclerosis obliterans (ASO), diabetic patients were about 5-years younger in average than non-diabetic patients and showed severe ischemic change of the lower extremities. In many cases of ASO with diabetes, arteriography of the lower extremities and pulse wave form of the toes revealed poor peripheral arterial circulation and amputation of the lower extremities was the final outcome. The diabetic patients who showed high glucohemoglobin (GHb) value on hematochemistry test had more severe ischemic symptom, therefore hyperglycemia state seemed to promote arteriosclerosis. However, no correlation was found between the method of diabetic treatment and frequency of amputation, and between period of diabetes and the amputation ratio. These results suggest that on treatment of ASO with diabetes it is best to control diabetes first and secondly perform arterial reconstruction aggressively.View full abstractDownload PDF (547K) -
Toru Ishizaka, Motomi Ando, Mitsuru Nakaya, Seiji Adachi, Shinichi Tak ...1995 Volume 24 Issue 2 Pages 85-88
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSBetween 1988 and 1991, 231 patients underwent surgical repair for abdominal aortic aneurysm. Among them 132 patients underwent isolated Y graft replacement electively. They were divided into two groups, according to the operative procedure; transperitoneal approach (n=51) and retroperitoneal approach (n=81), and the surgical results were compared retrospectively. There was no significant difference in operative time, amount of operative bleeding, operative transfusion, total transfusion, autotransfusion, duration of intubation, total use of analgesia or length of postoperative stay in the two groups. The amount of fluid drained from the nasogastric tube was significantly greater in the transperitoneal group. The initiation of drinking and eating were both significantly prolonged in the transperitoneal group. The transperitoneal approach is indicated for cases with thoracic or thoracoabdominal aneurysm which may be operated on in the future, cases of bilateral common iliac aneurysms and cases with heart disease. Otherwise it is preferable to select the retroperitoneal approach as the first choice for elective surgical treatment of abdominal aortic aneurysm, because the retroperitoneal approach is superior in terms of the recovery of gastro-intestinal movement.View full abstractDownload PDF (559K) -
Kenichiro Azuma, Hajime Hirose, Kouji Matsumoto1995 Volume 24 Issue 2 Pages 89-94
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSThe arm ergometer exercise test (Arm E) was performed in 24 patients with arteriosclerosis obliterans of the lower extremities (ASO) to detect ischemic heart disease (IHD). All patients underwent coronary arteriography. IHD was detected in 16 patients (67%) with ASO. Sensitivity for diagnosis of IHD was 94%, specificity was 75% and accuracy was 88%. The severity of coronary artery disease was graded by the coronary score (CS) proposed by Leaman, et al. and the scores were compared with the mode of surgical treatment. In 3 patients with a CS between 16 and 22, the revascularization of both coronary arteries (CABG) and of peripheral arteries were performed in one stage. In 12 patients with CS below 5.5, only arterial revascularization of the lower extremities was performed without complications from the associated IHD. These results suggest that Arm E is a useful screening test to detect IHD in patients with ASO for surgery.View full abstractDownload PDF (812K) -
Makoto Funami, Masahiro Aiba, Takashi Narisawa, Hiroshi Kazuma, Hiroyu ...1995 Volume 24 Issue 2 Pages 95-100
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSA gelatin-sealed knitted Dacron graft which has zero-porosity at implantation and does not require preclotting preparation has been developed. Gelatin-sealed aortic grafts were implanted into 39 patients and vascular surgery reconstruction was performed for thoracic aortic aneurysm (TAA) in 10, abdominal aortic aneurysm (AAA) in 19, and arteriosclerosis obliterans (ASO) and other conditions in 10. A total of 39 bifurcated or straight grafts were inserted. The Gelseal Dacron graft had superior handling characteristics and biocompatibility in comparison to conventional graft. There was no measurable blood loss from the body of the sealed graft at the time of implantation. The gelatin-sealed Dacron graft (n=10) was compared with an Intervascular Micron® graft (n=10) implanted into the abdominal aorta. No problems were evident with regard to intraoperative bleeding, allogenic and autologous transfusion volume and blood parameters between the two groups. These results suggested that the Gelseal Dacron graft sealed with gelatin was a safe, zero-porosity implantable prosthesis for clinical use.View full abstractDownload PDF (803K) -
Masahisa Machida, Kenji Otaki, Makoto Takahira1995 Volume 24 Issue 2 Pages 101-103
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSWe report a case of PDA with post aortic left innominate vein (PALIV). A 3-year-old boy was admitted to our department for surgical treatment of PDA. Preoperative UCG and venography demonstrated PALIV clearly. It was possible to observe PALIV directly during the operation for PDA.View full abstractDownload PDF (1226K) -
Hideyuki Kawachi, Takafumi Hashimoto, Akiteru Nakamura, Susumu Nakaji1995 Volume 24 Issue 2 Pages 104-107
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSSplenic artery aneurysm is considered to be a relatively uncommon disease. It is difficult to diagnose asymptomatic cases of splenic artery aneurysm when the physician does not recognize the presence of this disease. The recent development of diagnostic imaging technology has resulted in an increasing number of reported asymptomatic cases of splenic artery aneurysm using ultrasonography and computed X-ray tomography. An asymptomatic case of a 44-year-old woman who had an abdominal mass around the splenic hilus detected with ultrasonography is reported. Color-coded Doppler ultrasonography led to a preoperatively confirmed diagnosis of splenic artery aneurysm with the detection of intraluminal arterial flow in the mass. The aneurysm was a semispherical mass, 20×16×13mm in size. At operation, only aneurysmectomy was carried out and splenectomy was not performed. The patient was discharged with a complete cure on the 18th postoperative day. Color-coded Doppler ultrasonography is extremely effective in the diagnosis of abdominal splanchnic artery aneurysms.View full abstractDownload PDF (2243K) -
Tetsuro Takayama, Takeshi Miyairi, Kenji Koseni, Nobuhiro Nagata1995 Volume 24 Issue 2 Pages 108-111
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSIn 4 children (2.4-10.9 y.o) with mitral valve regurgitation, prosthetic valve replacement was done using warm heart surgery. Three of them had previously received 1-3 times valve repair operations and the other one was accompanied by endocarditis. The condition of 3 children were in NYHA grade 4 and received dopamine preoperatively. At the esophageal temperature of 34 degree, aorta was cross clamped for 79-216min. with continuous coronary perfusion of 3ml/kg/min, however, no child showed postoperative low output syndrome, and the maximum use of dopamine was 2-6μg/kg/min and the CK-MB at 1POD was within the normal range in all cases. Warm heart surgery showed better myocardial protection for pediatric mitral valve replacement.View full abstractDownload PDF (971K) -
Hitoshi Matsuda, Toshiaki Ota, Syuichi Kozawa, Masayoshi Okada1995 Volume 24 Issue 2 Pages 112-116
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSA 73-year-old woman complaining of increased dyspnea, but no shock, was admitted under an echographic diagnosis of right atrial tumor. Echo-cardiogram at the time of admission did not reveal the right atrial tumor, and a massive pulmonary embolus was detected a pulmonary arteriography. After the infusion of tissue plasminogen activator and heparin, pulmonary arterial systolic pressure was decreased from 66 to 43mmHg, and dyspnea was improved. However, repeated pulmonary arteriograms showed no change of the pulmonary embolus, thus emergency pulmonary embolectomy was indicated. Massive thrombi, which were suspected to have moved from the lower extremities, were successfully removed. During operation, the following critical events were encountered; shock during IVC taping and severe hypoxia immediately after the pulmonary revascularization. These problems were successfully controlled by partial extracorporeal circulation. Pulmonary pressure decreased to 25mmHg postoperatively and she is doing well with anticoagulant therapy.View full abstractDownload PDF (2396K) -
Hiroshi Ito, Haruhiko Okada, Kazuhiro Suzuki, Kazuya Nishida, Kimikazu ...1995 Volume 24 Issue 2 Pages 117-120
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSCase 1 was a 42-year-old woman who was admitted because of infective endocarditis. Pulmonary embolism occurred during medical treatment for infective endocarditis. Despite the acute infectious phase, surgical treatment was successfully performed. Case 2 was a 50-year-old man who was admitted because of infective endocarditis. Cardiac catheterization showed ventricular septal defect and atrial septal defect. Surgical treatment was performed successfuly. In both cases, and the postoperative courses were unventful.View full abstractDownload PDF (2030K) -
Yuichi Ono, Takeshi Momokawa, Souhei Suzuki, Hisaaki Koie1995 Volume 24 Issue 2 Pages 121-124
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSThe patient was a 44-year-old male, who had undergone hemodialysis for these 13 years. He underwent combined aortic and mitral valve replacement for aortic and mitral regurgitation due to infectious endocarditis. Operative findings included torn chorda of the mitral valve associated with perivalvular abscess and perforation of a non-coronary aortic cusp. Double valve replacement was performed with mechanical prosthetic valves. We used continuous hemodiafiltration (CHDF) for his perioperative renal management. Nafamostat mesilate was applied to the CHDF circuit as anti-coagulant therapy. Serum creatinin, urea nitrogen and potassium were maintained at the optimal level. CHDF was continued until the twelfth day after operation, and maintainace hemodialysis was re-started thereafter. CHDF is widely accepted for blood purification in the intensive care unit, and applied safely even in patients with unstable hemodynamic conditions. we considered that CHDF might have helped to avoid multiple organic failure in this case.View full abstractDownload PDF (499K) -
Masanao Imai, Masahiro Yamaguchi, Hidetaka Ohashi, Yoshihiro Oshima, T ...1995 Volume 24 Issue 2 Pages 125-129
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSCase 1 was a 2-year-old girl who underwent mitral valve replacement with a St. Jude Medical valve for severe mitral regurgitation 14 days following common atrioventricular canal defect correction. The postoperative course was uneventful, but an unilateral thrombosed leaflet of a St. Jude Medical valve was observed 3 times by echocardiography and fluoroscopy. Thrombolytic therapy with urokinase was done each time and the thrombus was successfully dissolved. Case 2 was a 1-year-old girl who underwent closure of ventricular septal defect and mitral valve replacement with a St. Jude Medical valve for ventricular septal defect, severe mitral regurgitation and pulmonary hypertension. Unilateral thrombosed leaflet of the St. Jude Medical valve and poor left ventricular function were found by echocardiography 11 days after the operation. Thrombolytic therapy with urokinase was successfully performed without any complications. Thrombolytic therapy with urokinase was considered to be effective treatment for unilateral thrombosed leaflet of a mechanical bileaflet valve prosthesis in a child. Poor left ventricular function might be one of the causative factors of unilateral thrombosed leaflet of a mechanical bileaflet valve prosthesis.View full abstractDownload PDF (1058K) -
Hiroshi Hata, Manabu Okabe, Masaki Matsuoka, Sigeyuki Makino1995 Volume 24 Issue 2 Pages 130-132
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSA 74-year-old man had a right common iliac aneurysm perforating into his inferior vena cava. He showed a pulsating abdominal mass, claudication of the right leg and swelling of both legs. The fistula was preoperatively diagnosed by aortography. The fistula was closed with two interrupted 3-0 monofilament sutures with pledgets within the aneurysm, by clamping all vessels communicating to it. The aneurysm was replaced with a Y-shaped Dacron graft. The postoperative course was uneventful and the patient was discharged on the 17th postoperative day without any leg claudication or swelling of the legs. This complication is rare, with only 7 such reports in Japan. It should be surgically managed as soon as the diagnosis is confirmed. Clamping all vessels communicating to the fistula in closing it is a safe and reliable approach.View full abstractDownload PDF (1178K) -
Kenji Ariizumi, Kazuo Kanabuchi, Shunichi Inamura, Shigetoh Odagiri, S ...1995 Volume 24 Issue 2 Pages 133-135
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSA 60-year-old male was transferred to a critical care medical center with a complaint of sudden back pain. He already had suffered severe back pain 22 years previously when he was 38-year-old), but was not diagnosed then. On admission thoracic CT scan revealed a three-channeled structure in the descending aorta. The preoperative diagnosis was an acute redissection of a DeBakey III b dissecting aortic aneurysm. An emergency graft replacement of the descending aorta confirmed the three-channeled structure of the aorta. The remaining of media of the aorta, which occurred in the re-dissected lumen, was thin and weak. The patient was alive and well twenty-five months following the operation.View full abstractDownload PDF (2015K) -
Takashi Hachiya, Hiroshi Kaneko, Hiroshi Mitsuoka, Satoshi Nakamura, S ...1995 Volume 24 Issue 2 Pages 136-139
Published: March 15, 1995
Released on J-STAGE: April 28, 2009
JOURNAL FREE ACCESSUlcer developed on the left leg of a 47-year-old man, in 1989, and phlebography showed deep vein thrombosis extending from the politeal to the common femoral vein. Subfascial ligation of the perforators achieved healing of the ulcers. In November 1991, at the age of 52 years the patient noticed a pulsatile mass on the right side of his neck. CT scanning showed a carotid artery aneurysm 4cm in diameter. Angiography indicated that the aneurysm was located at the bifurcation of the carotid artery. In February 1992, reconstructive surgery was performed with a Dacron graft, but an anterile abscess developed around the graft. In September 1992, the graft was removed and the carotid artery was ligated. Only seven cases of carotid aneurysm associated with Behçet's disease have previously been reported in Japan. Five of them underwent reconstructive surgery and two of them underwent carotid ligation due to complications. Because of the clinical course of Behçet's disease, carotid aneurysmectomy without reconstructive surgery may be the procedure of choice.View full abstractDownload PDF (1674K)
- |<
- <
- 1
- >
- >|