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T. ABE, T. TANAKA, O. IZUMIYAMA, T. YAMAGUCHI, Y. ASAI, K. SUGIKI, S. ...
1984 Volume 13 Issue 1 Pages
187-189
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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We have evaluated the surgical management of right ventricular outflow tract (RVOT) recorstruction in 40 patients after total correction of tetralogy of Fallot between April, 1980 and July, 1983. The reconstruction of RVOT was performed by four surgical procedures; Group I: Infundibulect omy (Inf) and pulmonary valvotomy in 3 patients, Group II: Inf and RV reconstruction with a EPTFE patch in 4, Group III; Inf. and Rygg pericardium with monocup and Group IV: a valved autopericardium with RV EPTFE patch. There were three surgical deaths in 40 patients or 7.5% mortality. The most favorable postoperative hemodynamic results were obtained in Group IV: and we have no surgical death in 28 patients since last two years and 26 of whom were in Group IV.
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K. IMACHI, I. FUJIMASA, M. NAKAJIMA, S. TSUKAGOSHI, K. MABUCHI, [in Ja ...
1984 Volume 13 Issue 1 Pages
190-193
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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FPU has the microphase separated structure which composed of hydrophilic domains of hydrocarbon chains and hydrophobic domains of fluorocarbon chains. This polymer was evaluated as an AH pump material from the view points of blood compatibility, durability and moldability. Blood coagulation time of FPU in Lee-White test shoewd 67-91 minutes. As an AH pump, FPU could be coated on PVC paste pump surface and showed enough strength of coated film by three times coating. The pump was used in goat for 41 days with no anticoagulant. No thrombus and calcification was found inside the pump with SEM and x-ray microanalyser inspection. As conclusion, FPU would be expected as a new AH pump material.
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H. MATSUMOTO, N. FURUTA, T. TAKAYAMA, K. YAGUU, M. KAWAUCHI, F. MIYAWA ...
1984 Volume 13 Issue 1 Pages
194-195
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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We newly made a tubed pledget made of microporous EPTEE for the prevention of the myocardial tissura ruptures at the sites of the edges of the ventricular septal defects, and of the annular ring of the mitral and aortic valves. Our pledgets were included the microporous EPTEE tubes with 1) 0.8mm ID, 1.8mm OD and 2) 0.8mm ID, 1.5mm OD. Though more than 2, 000 pieces of this pledgets with the length of 3 or 4mm. have been used in the treatment of VSD, ECD, TF and AVR since September 1981, we have no complication such as canalization and thromboembolism. Concerned with fraying, bending, twisting, suturing, and installation, usefulness of microporous EPTEE pledgets is clinically noted to have many advantages over the commercially available ones.
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[in Japanese]
1984 Volume 13 Issue 1 Pages
196
Published: February 15, 1984
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S. TANAKA, [in Japanese], [in Japanese], [in Japanese], [in Japanese]
1984 Volume 13 Issue 1 Pages
197-200
Published: February 15, 1984
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H. YAMAMOTO, Y. MITAMURA, Y. SUZUKI, H. MAKINO, T. TACHIKI, T. MIKAMI
1984 Volume 13 Issue 1 Pages
201-204
Published: February 15, 1984
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The influence of the time interval between the start of left ventricular assist pump (LVAP) and coronaty artery occlusion on the salvage of ischemic heart was investigated. Max dp/dt representing cardiac contractility returned to control value when LVAP was started within 60 minutes after ligation, but did not return when LVAP was applied after 120 minutes following ligation. Myocardial carbon gas tension, index of myocardial anaerobic condition, was kept high when LVAP was started within 60 minutes. But myocardial carbon gas tension decreased when LVAP was started after 120 minutes. It can be concluded that the ischemic heart is salvaged if pumping is started whithin 60 minutes after ligation.
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K. IMACHI, I. FUJIMASA, M. NAKAJIMA, S. TSUKAGOSHI, K. MABUCHI, A. MIY ...
1984 Volume 13 Issue 1 Pages
205-208
Published: February 15, 1984
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An easier method to observe the morphological abnormality of erythrocyte during AH pumping was developed, in which glass capillary with 200×20um rectangular cross section was used as an observation chamber for microscope. It became clear that erythrocyte deformation did not occur by usual AH pumping such as in TAH or assist heart. However, strong morphological abnormalities of erythrocytes were occured when AH animal fell into circulatory insufficiencies. Especially, the condition of extracorporial circulation during surgical operation for TAH replacement related to the generation of erythrocyte deformation.
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Naondo TAKIDO, Iwao FUJIMASA, Kou IMACHI, Akira MIYAMOTO, Masaharu NAK ...
1984 Volume 13 Issue 1 Pages
209-212
Published: February 15, 1984
Released on J-STAGE: December 02, 2011
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In this paper, analysing the animal experiments of Artificial Heart (AH), in the groups that have not beating natural heart ((Fibrillated heart type AH (FTAH) & Total Replacement AH (TRAH)), postoperative hypothyroidism progressed gradually and it was revealed that this hypo thyroidism was one of the causes of the postoperative anemia in those AH animal experiments. On the contrally, in the groups that have beating natural heart, postoperative hypothyroidism and anemia were slight and recovered soon.
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S. TSUKAGOSHI, I. FUJIMASA, K. IMACHI, M. NNAKAJIMA, K. MABUCHI, A. MI ...
1984 Volume 13 Issue 1 Pages
213-217
Published: February 15, 1984
Released on J-STAGE: December 02, 2011
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To clarify the hemodynamic effects of AH circulation, morphological appearance of the circulatory disorders in autopsy materials of TAH animals were studied. Circulatory disorders, such as centrilobular necrosis of liver in 80%, passive congestion of renal medulla and spleen in 50%, and pulmonary edema in 26%, were observed. Pathophysiologically, abnormality of distribution of liver blood flow was considered to be the cause of the liver lesions in addition to longstanding high venous pressure.
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[in Japanese]
1984 Volume 13 Issue 1 Pages
218
Published: February 15, 1984
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K. MABUCHI, I. FUJIMASA, K. IMACHI, M. NAKAJIMA, A. MIYAMOTO, N. TAKID ...
1984 Volume 13 Issue 1 Pages
219-223
Published: February 15, 1984
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An automatic right pump output control system for total artificial heart has been designed. In the system right pump output is maintained and left pump is regulated to operate in accordance with “Starling's law”. The driving unit is pneumatic one. In experiments using mock circulatory system, this control system shows satisfactory performance.
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Y. KATAHIRA, S. NITTA, A. TAKAHASHI, M. TANAKA, Y. KAGAWA, T. HONGO, T ...
1984 Volume 13 Issue 1 Pages
224-227
Published: February 15, 1984
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An analysis of the inflow side blood flow pattern which was measured by an EMF or a doppler flowmetry was carried out to have an adequate automatic control system for an artificial heart. The peak value of the inflow pattern is determined by the inflow resistance, the negative driving pressure and the venous pressure. Therefore, it is thought that the inflow resistance can be presumed by analyzing the inflow pattern. We might conclude that the analysis of the inflow pattern is a very useful information for the automatic control of an artificial heart.
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S. TAGAMI, T. HASEGAWA, S. FUKUNAGA, J. MURASHITA, T. HIRONAKA, T. SEU ...
1984 Volume 13 Issue 1 Pages
228-231
Published: February 15, 1984
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An automatic controller system for activation of roller pump based on microcomputer has been developed and evaluated by in vitro and in vivo tests. The following results were obtained. 1) It was possible to maintain the left atrial pressure at a desired level constantly during left heart bypass in calves. 2) When the pressure sensor detects the trapping of cannula, the automatic controller with prestored soft wear made the roller pump stop immediately and evolves to untrap the cannula, then the roller pump starts slowly and gradually increases the R. P. M. up to 85-98% of the previous driving condition. Thus, an ideal soft wear to control the above mentioned regulation mechanics was constructed. 3) The effectiveness of the automatic controller system including doppler air bubble detector and immediate stop of the roller pump has been proven for the safer activation in ventricular bypass.
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S. NITTA, Y. KAGAWA, Y. KATAHIRA, A. TAKAHASHI, M. TANAKA, T. HONGO, T ...
1984 Volume 13 Issue 1 Pages
232-235
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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An automatic control system for LHAD has been developed to obtain a safe LHAD driving in a clinical use and evaluated in experiments conducted on a mock circulatory system as well as in a series of acute and chronic animal experiments. A digital blood volume integrater caliculates every inflow blood volume instantenously from a electromagnetic or ultrasound doppler method and permits to have a next output signal if there is a certain inflow volume more than set up value in an emergency status. The algorithm developed here in is based upon a mean flow volume per mini computation of a inflow index and systolic and diastolic driving pressure and/or systolic time intervals is an attempt to minimize this index. The results suggest that this automatic control system allows the steady and safe LHAD pumping even in the various circulatory conditions.
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[in Japanese]
1984 Volume 13 Issue 1 Pages
236
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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T. BEPPU, Y. FUKUI, K. TSUCHIYA, Y. IMAI, Y. TAKANASHI, K. SOEJIMA, K. ...
1984 Volume 13 Issue 1 Pages
237-240
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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Assisted circulation for an infant requires precise control of blood perfusion. This paper discribes the newly developed artificial heart-lung system, which has the following features. Computer controlled arterial blood infusion can be synchronized with ECG or arterial pressure under variable assisted rate, delay time and stroke volume. Venous blood withdrawal is also under computer control to follow the change of blood infusion and to control CVP within the optimum range.
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Y. TAENAKA, H. TAKANO, T. NAKATANI, M. UMEZU, T. MATSUDA, H. IWATA, T. ...
1984 Volume 13 Issue 1 Pages
241-244
Published: February 15, 1984
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Two sizes of air-driven and diaphragm type VADs have been newly developed for pediatric use. Their stroke volumes were designed to be 20ml and 40ml. With mock loop test, sufficient output for pediatric use was obtained. In animal experiment using dogs weighing from 10 to 20kg, the conduit could be smoothly inserted into the left atrium and easily sutured to the aorta. During past 2 years and 9 months, 10 clinical cases after open heart surgery were thought to be the candidates of these VADs retrospectively.
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--BEDSIDE UNIT AND ELECTRIC WHEEL CHAIR UNIT--
I. FUJIMASA, K. IMACHI, A. MIYAMOTO, K. ATSUMI
1984 Volume 13 Issue 1 Pages
245-248
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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Two intermediary applicable air driven artificial heart driving devices are being developed for clinical and rehabilitative use. The bedside unit is 70cm width, 40cm depth and 100cm height in size and 140kg in weight. The electric wheel chair unit is assembled into a compact driving unit of 40cm cubic in size and an electric wheel chair can maintain both heart driving and transportation for 30min.
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S. FUKUNAGA, T. HASEGAWA, S. TAGAMI, J. MURASHITA, T. HIRONAKA, T. SUE ...
1984 Volume 13 Issue 1 Pages
249-252
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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Two types of energy converter ithplantable in a chest cavity with total artificial heart were developed, and tested extracorporeally and intracorporeally in calves. One of them is a rather flat axis type in shape (S type EC) and the other long axis (0 type EC). The S type EC is fabricated with flat type brushiess DC motor and impeller vanes of axial flow pump placed on the periphery of the motor and also the stationary inducer and diffuser vanes. The 0 type EC is composed by the long axis brushless DC motor and small axial flow pump in one shaft. The overall efficiency of motor and pump was the maximum value of 53%, which was achieved by the improved 0 type EC measured using a hydraulic test circuit. Mock test with the artificial heart showed that the 0 type EC was superior because of the less rotor inertia when it was repeated CW and CCW rotation in accordance with the heart rate. The increase in silicone oil temperature was 33°C after 2 hours CW and CCW repeated running even by the most efficient improved 0 type EC.
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[in Japanese]
1984 Volume 13 Issue 1 Pages
253
Published: February 15, 1984
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A. MIYAMOTO, K. TANOI, S. KITAMURA, K. KAWANO, H. HAGIWARA, K. TAKAHAS ...
1984 Volume 13 Issue 1 Pages
254-257
Published: February 15, 1984
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Two post operative cases with Low Cardiac Output Syndrome were treated by Left Ventricular Assist Device (LVAD). The device consists of a pneumatic pump and cannulae which were newly designed for clinical use. Case 1 could not be weaned from C-P bypass, but she weaned even from the LVAD after three hours. The LVAD was applied to Case 2 from just after surgery until 5th POD. They died on the 2nd and on the 17th POD respectively, though they could be weaned from the LVAD. The effect of the LVAD was remarkable but the various problems have been relieved in the practical use of the LVAD.
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H. YOSHIZU, S. TANAKA, K. TAKAGI, K. KASE, K. MUNEOKA, S. SUZUKI, Y. K ...
1984 Volume 13 Issue 1 Pages
258-261
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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A 30F cannula which has half area side holes of tip hole is created for a assist circulation. In dog experiments, under control mechanical ventilation, a sternotomy is performed and this 30F cannula is inserted through the right atruum. A tip hole of this cannula is placed in the left atrium for the drainage of blood and side holes are placed in the right atrium for the. drainage of blood. A biventricular bypass from both atrium to right femoral artery starts by means of suction method, using a roller pump. In this experiment, the biventricular bypass is possible up to 60 percent of cardiac cutput, considering the blood gas analysis.
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I. YADA, M. KUSAGAWA, R. YOZU, N. SATO, H. HARASAKI, S. KOIKE, Y. NOSE ...
1984 Volume 13 Issue 1 Pages
262-265
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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The ability of chronic nonpulsatile perfusion to maintain systemic organ function has been shown in 12 calf experiments of 6 to 99 days. Possible adverse effects of this modality on animal physiology, however, remains a subject of controversy. The optimal flow and pressure with depulsed circulation are still to be defined. The effects of depulsation on circulatory physiology, major organs' function, and morphology were studied in 5 chronic calves tested for 34 to 99 days. With right and left pump flows adjusted to maintain atrial pressures within physiological limits, systemic and pulmonary arterial pressures and resistances were in normal ranges. The RPF ranged from 70-110ml/kg/min and was 30% averaged less than LPF. At RPF which maintained RAP less than 10mmHg (90ml/kg/min), renal and hepatic functions were normal; RAPs were inversely related with RPF lower than this level caused high RAP (10mmHg); increase in circulating blood volume (14.8%); decrease in PVO
2 (6.7-21.5%); increase in SaO
2 (9.3-19.1%). Histological studies disclosed no pathological findings due to depulsation in the liver, kidney. These results suggest that 90ml/kg/min flow in the depulsed state may be the lower limit for maintenance of organ function.
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H. MATSUKURA, S. UZAWA, T. GODA, H. TAKEDA, K. SAKAI, T. KAWAKAMI, T. ...
1984 Volume 13 Issue 1 Pages
266-269
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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An experimental study of extracorporeal circulation by the centrifugal pump (Bio-pump) was undertaken to compare with the standard rollar pump in the aspect of hemodynamic and metabolic changes. The following results were obtained: (1) This centrifugalpump system was safely and simply operated due to the automatic flow control in auto-flow mode with the alam device. (2) perfusion pressure and perfusion flow by the centrifugal pump were maintained similar to the rollar pump. (3) Serum free hemogrob in during ext racorporeal circulation by the centrifugal pump was less in amount than that rollar pump. (4) metabolis changes suggested that extracorporeal cirulation by the centrifugal pump had influence as same as using the rollar pump.
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G. TAKEZAWA, T. HASEGAWA, J. MURASHITA, S. FUKUNAGA, S. TAGAMI, T. SUE ...
1984 Volume 13 Issue 1 Pages
270-273
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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In this study, surgical technique for instant shift between nonpulsatile ventricular assist device (np-VAD) and pulsatile ventricular assist device (p-VAD) was developed and evaluated hemodynamically in calves. Following results were obtained. 1) Instant shift between np-VAD and p-VAD could be performed within a few minutes. 2) In induced heart failure, the effect of instant shift from np-VAD to p-VAD was obvious omits hemodynamics (increasing coronary flow, easy defibrillation, etc). 3) When the failing heart evolves to recover, the p-VAD was shifted to np-VAD again and the bypass flow was gradually decreased. Thus weaning from a circulatory support could be carried out safely.
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[in Japanese]
1984 Volume 13 Issue 1 Pages
274
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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T. KIJIMA, T. AKAMATSU, T. SHIROYAMA, K. TAKAGI, H. FUKUMASU
1984 Volume 13 Issue 1 Pages
275-278
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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For a pulsatile blood pump, a ducted ball valve has been developed. As concerns water hummer effect at the instant of valve closure, this ducted ball valve was tested in a pulse duplicator and compaired with tilting disc valves. The results indicate that water hummer effect is dominated by velocity drop of the fluid in the valve seat at the instant of valve closure. An improvement on a duct contour of ducted ball valve was made. A newly designed ducted ball valve was tested and compaired with an old one and two types of tilting disc valves in a steady flow and in a pulsatile flow. This new ducted ball valve proved to be further low in pressure loss and in regurgitation at the instant of valve closure than an old one
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K. YAGYU, T. TAKAYAMA, K. WAKE, M. KAWAUCHI, H. MAKUUCHI, H. MATSUMOTO ...
1984 Volume 13 Issue 1 Pages
279-282
Published: February 15, 1984
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Paravalvular leakages after prosthetic valve replacement were examined on five cases by M mode scanning with UCTG. Normalization of septal movement, and volumeload of LV after the prosthetic valve replacement suggest paravalvular leakage, and reoperation should be planned as soon as possible.
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N. FUJII, M. UMEZU, T. TANAKA, K. KAWAZOE, Y. KITOH, Y. KOSAKAI, T. FU ...
1984 Volume 13 Issue 1 Pages
283-286
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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The hydrodynamic characteristics of nine mital valve prostheses weere tested under the condition of irregular rhythm (atrial fibrillation) and regular rhythm (sinus rhythm) using our origiml simulation system. The effective orifice areas were compared changing frcia atrial fibrillation to sinus rhythm. The result of present study showed that the effective orifice areas had a tendency to increase more in Hancock pericard valve, St. Jade Medical valve and Ionescu pericard valve than in Björk valve and porcine xenografts, when the condit ion changed from sinus rhythm to atrial fibrillation.
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K. HASHIMOTO, S. SUZUKI, T. KOZUKUE, T. SASAKI, S. KIUCHI, A. MIZUNO, ...
1984 Volume 13 Issue 1 Pages
287-290
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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Preoperative and postoperative cardiac function was evaluated from 19 patients with aortic insufficiency. Left ventricurography was used to determine left ventricular performance and left ventricular segmental wall motion. The effect of AVR on LV volume and function was excellent. LVEDVI fell from a preop value of 149.4±31.6ml/m to 90.7±15.1ml/m at the tiise of postop study. The ejection fraction and mVCF both increased up to the normal range. (EF: 0.56±0.12→0.68±0.7, mVCF: 1.07±0.52→1.89±0.74circ/sec) The depressed left ventricular function was largely reversible after surgery.
The segmental wall motion before AVR for volume overload was grossly impaired with same regional difference. The ease to impair on LV segment was segment 1, 3, 2: 4, 5 in order. The improvement of wall motion after AVR was excellent on segment 2, 4, 5, but remained impaired on segment 1, 3. The reversibility of LV impaired contractility was independent on Preop EF, but persistent postoperative LV functional impairment was found in the patients with severe preop LV dilatation.
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H. MINAMITANI, A. WATANABE, K. WATANABE, Y. EBISAWA, T. INOUE, Y. SOMA ...
1984 Volume 13 Issue 1 Pages
291-294
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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The opening and closing characteristics of tilting disc valves and the turbulent, eddy as well as stagnant flow formations were investigated by using a cardiovascular mock system and the flow visualization technique. In the aortic region the flow patterns produced by a tilting disc valve depended on the orientation of the valve in the aorta. In the upper region of aortic arch large eddy formation was observed however no stagnation or stasis was observed near the valve. For mitral valves especially anterior-oriented, flow stagnation was markedly observed behind the valve disc, that would lead to increasing the thrombo-formation.
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-The Evaluation of Chronic Intravascular Hemolysis-
K. SHIOI, T. ABE, M. MURASE, M. TANAKA, M. KAWAMURA, H. NOGAKI, E. TAK ...
1984 Volume 13 Issue 1 Pages
296-299
Published: February 15, 1984
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Although the measurement of serum haptoglobin (S-Hp) is of great use for the evaluation of trace intravascular hemolysis, it is not applicable in patients with mechanical prosthetic valves because S-Hp is almost absent in them. We tried to administer haptoglobin preparation to eight patients with aortic prosthetic valves and measured the serum haptoglobin levels periodically. By this manuver, the maximum haptoglobin level, haptoglobin reducing rate and expected haptoglobin disappearing time were calculated. These three indices correlated with serum LDH which is the most reliable laboratory parameter for intravascular hemolysis. Based on the results obtained, it is considered that this haptoglobin administration test is a very useful method for the evaluation of intravascular hemolysis.
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T. SAKURADA, T. OKUBO, H. ATSUMI, S. SEKINE, M. ISHII, S. SAITO, T. AB ...
1984 Volume 13 Issue 1 Pages
300-302
Published: February 15, 1984
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Clinical and hemodynamic results of valve replacement using bicer-val prosthetic valve in 20 patients (10 cases of AVR, 9 of MVR and one of double valve replacement) were presented. There was no operative death, but two late sudden deaths in group of AVR were encountered. Although hemodynamic improvements were obtained in most of cases, syncope attacks were continued in two cases of MVR due to fixation of prosthetic disc into metallic ring, so-called “stuck-valve”, in which re-MVR with the other prosthetic valve was needed. Our experience indicates that bicer-val prosthetic valve should be excluded in our decision-making concerning valve choices.
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H. OHTEKI, S. ONISHI, M. HARADA, K. EISHI, K. MATSUO, K. SHIMAZU, T. F ...
1984 Volume 13 Issue 1 Pages
303-306
Published: February 15, 1984
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A clinical experience of Bicer-Val valve was reported. Bicer-Val valve were used for 40 patients; 27 on mitral position and 18 on aortic position. Postoperatively 2 patients died in the acute phase and 2 patients died in the late phase. An apparent valve malfuncttion was found in 1 patients, and it was suspected in another patient. Post-operative catheterization data showed good hemodynamic results, and post-operative mitral valve pressure gradient was 5.7 mmHg. The valve prosthesis was also evaluated for response to tachyarrhythmia under pacing status. And the results showed a good response in the mitral position but a poor response in the aortic position at the heart rate of 120 per minute.
It is concluded that Bicer-Val valve might have some clinical problems.
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M. MATSUMOTO, S. MIKI, K. KUSUHARA, Y. UEDA, Y. OHKITA, T. TAHATA, M. ...
1984 Volume 13 Issue 1 Pages
307-310
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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To clarify the characteristics of St. Jude Medical prosthesis (SJM) and Omni-Science prosthesis (O-S) in the mitral position 34 patients (8 with SJM and 26 with O-S) were evaluated using echocardiography and phonocardiographyo Following measurements were obtained: 1) Q-completion of valve closure (Q-MVC) was 65+8 msec for SJM and 74+9 msec for O-S; 2) A2-onset of valve opening (A2-MVO) 68+14 msec for SJM and 78+18 msec for O-S; 3) Rate of valve opening 339+102mm/sec for SJM and 267+63mm/sec for O-S; 4) Rate of valve closure 916+541mm/sec for SJM and 645+215mm/sec for O-S. Q-MVC interval was significantly shortened with SJM compared to O-S. Four patients with paravalvular regurgitation had significantly shortened A2-MVO interval (63+20msec) compared to patients with normally functioning valve (79+17 msec).
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Kageharu K., Osamu K., Mitsuru A., Yasushi O., Hiroshi S., Fujio I., K ...
1984 Volume 13 Issue 1 Pages
311-315
Published: February 15, 1984
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One hundred fifteen patients (June 1979 through Aug. 1983) underwent mitral (MVR), aortic (AVR) or double (DVR) valve replacement with the St. Jude Medical (SJM) prosthesis. Operative mortarity for the entire group was 4.4%. There were no cases of mechanical failure. The incidence of thromboembolism was 1.11%/100pationtyears for the all groups. Postoperative catheterization studies in 14 patient revealed normal cardiac funtion. The SJM Cardiac Valve is a useful alternative in the surgical therapy of valvular heart disease.
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[in Japanese]
1984 Volume 13 Issue 1 Pages
316
Published: February 15, 1984
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S. ISHIMARU, H. HINO, M. KONISHI, H. YAMAGUCHI, M. KITAMURA, K. FURUKA ...
1984 Volume 13 Issue 1 Pages
317-320
Published: February 15, 1984
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Functional propert of the convexoconcave Björk Shiley valve implanted in the mitral position of 18 patients was investiqated by cineradiography. The maximum opening angle of the tilting disc was 57°±2°, and was not affected by atrial fibrillation nor by tachycardia up to 160bpm. Well correlation between shortning of the disc opening time and increase in pulse rate suggegts good adaptation of this prosthesis for tachycardia. However, atrial fibrillation causes time delay in disc closure immediately after prolonged R-R interval. Disc rotation alleviating disc wear was observed in all the patients. Dysfunction of the disc opening can be readily determined not only by measuring the maximum disc opening angle, but also from observation of the characteristic movement of the internal rim disc marker towards the small strut delineating the small valve opening area.
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Y. OKAMOTO, K. YAMADA, A. AWAZU, K. NAKAYAMA, Y. KAZINO, N. HANEDA, S. ...
1984 Volume 13 Issue 1 Pages
321-324
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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The follw-up studies from 1 month up to 31 months were performed who underwent reconstruction of pulmonary and right ventricular outflow tract using Porcine Pericardium Monocusp Ventricular Outflow Patch (MVOP, polystan). They consisted of eleven patients with severe tetralogy of Fallot. Post-operative function of MVOP was evaluated by means of phonocardiography, echocardiography, cardiac catheterization and cineangiography. Right outflow patchs were well maintained. But the function of monocusp bearing in patch was not con-petent. Cardiac catheterization and angiographic studies about 1 year after surgery revealed moderate grade of pulmonary insufficiency. Echocardiography showed monocusps were moving unsatisfactory. An autopsy showed complete disappearance of monocusp but no calcification. These results suggest that the monocus mounted on outflow patch could not maintained for long periods.
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
1984 Volume 13 Issue 1 Pages
325-328
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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Ninety-two procine valves were implanted into 83 patients between 1975 and 1981. Malfunction of the valve was encountered in 5 during 3 to 6 postoperative years. They were 2 of calcified, one of torn and two of infected valves. The latest 2 died of prosthetic valve endocarditis with fungus invasion into the prosthetic leaflet. Remaining three recovered with reimplantation of the mechanical valves.
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-from the point of view of the cardiac xenograft-
M. ENDO, T. MISAKI, M. KAWASUJI, T. IWA
1984 Volume 13 Issue 1 Pages
329-332
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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Cardiac xenograf is and SJM valves have been implanted on 105 and 51 cases of acquired valvular disease from 1974. Our long-term follow up study provided a very satisfactory durability of the xenograft. Continuation of the using xenograft for the indicated case is justified.
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Noriyasu WATANABE, Norio INOUE, Tamotsu YAMAGUCHI, Hideo YOKOYAMA, Yut ...
1984 Volume 13 Issue 1 Pages
333-336
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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The hemodymanic studies at rest and during exercise were performed in the patients, who had mitral valve replacement using L-LPB valve. The valve function of L-LPB valve estimated by MVA & MVG was almost the same as that of Hancock valve. The mild stenotic condition across the both bioprosthesis was exaggerated by exercise. Considering the occupancy space of biological valve in the left ventricular cavity, L-LPB valve is a suitable prosthesis for the patient with small left ventricular cavity. However, the long term-follow is mandatory to evaluate the durability of L-LPB valve.
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[in Japanese]
1984 Volume 13 Issue 1 Pages
337
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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M. MURASE, K. SATO, T. ABE, M. TANAKA, E. NOGAKI, E. TAKEUCHI, M. KAWA ...
1984 Volume 13 Issue 1 Pages
338-341
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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Detailed analysis of atrial endocardial electrograms was performed in 28 patients (SSS 19, AVB 9). Comparing by unipolar and bipolar leads, the amplitude, slew rate, and pulse width of atrial deflections were not significantly different. Amplitude and slew rate in AVB were significantly higher than in SSS. Amplitude of atrial deflections in cases with only retrograde P wave was remarkably low. Significant differences were observed in amplitude of ventricular deflections and P/R ratio between from unipolar and bipolar leads. These data suggest that bipolar pacing configuration might be preferable in physiological pacing.
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S. SAKAKIBARA, N. YAMATE, S. TANAKA, M. IKESHITA, T. SUZUKI, F. SAITO, ...
1984 Volume 13 Issue 1 Pages
342-345
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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Postoperative change of lead impedance and pacing threshold were measured in pacemakers with telemetry system. The pacing threshold increase during two weeks in a postoperative period, with gradual decrease thereafter. The lead impedance decreased in a week postoperatively, and then gradually increased to the initiallevel. During the long term follow up, there has been no remarkable change in either the pacing threshold or the lead impedance. These trend concerning the change of the threshold and the lead impedance can be seen nod only in the endocardial electrode but also myocardial electrode. In the cases of generator replacement, however, these values shows little change from the beginning. The lower lead impedance, the higher battery energy consumption. Therefore, the lead impedance should be set up around 500Ω or higher for longer battery longevity. It is useful to measure the postoperative change of lead impedance for early detection of electrode mulfunction. There seems some limitation, however, to predict the increase of the threshold by the lead impedance.
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A. NAKAMURA, Y. KANKI, T. IWAMOTO, S. SATOH, M. KADOWAKI, Z. S. ZHENG, ...
1984 Volume 13 Issue 1 Pages
346-349
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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In 70 cases of 239 paced patients with bradyarrhytInia, hemodynamic investigations in early stage were performed. Cardiac index increased between 50 and 70 BPM (p<0.02) and reached a plateau as the rate increase. Stroke index showed a lineal decrease as pacing rate increases. Right atrial mean pressure had the minimum at the pacing rate of 70 BPM. LVWI increased between 50 and 60 BPM of the pacing rate (p<0.001), and formed a plateau as the rate increases. The change of TSR made a concave form. Conclusions: In early stage of ventricular pacing, good hemodynamical result was obtained in the rate of 70 BPM.
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-Comparison of normal heart and ischemic heart-
S. KAIMOTO, A. FUKUMOTO, T. NISHIMOTO, K. KONDO, H. KISHIDA, L. OZEKI, ...
1984 Volume 13 Issue 1 Pages
350-353
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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Hemodynamically, atrial pacing was more effective than ventricular pacing. On the atrial pacing, myocardial metabolism was maintained in good conditions by increase of coronary sinus flow with mechanical work. On the ventricular pacing, lactate extraction rate decreased and oxygen extraction rate increased especially ischemic heart because coronary sinus flow was insufficient due to decrease of coronary parfusion pressure and nonphysiological ventricular systole. Cardiac pumping efficiency was higher with atrial pacing than ventricular pacing.
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[in Japanese]
1984 Volume 13 Issue 1 Pages
354
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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S. HORIKOSHI, S. SUZUKI, S. MIYAZAWA, H. FURUKAWA, A. MIZUNO, T. ARAI
1984 Volume 13 Issue 1 Pages
355-358
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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In the management of patients, it is crucial to consider the appropriate time of the pacemaker replacement. The authors have experienced some cases in which it was dangerous to decide the replacement time of the pacemaker considering only the pacing rate and the pulse width. Then, we attempted to predict the lifetime of the pacemaker by means of measuring the lead impedance. As a result, we made these findings:
(1) The lead impedance showed stable levels after a time lapse, especially after one and a half years. (2) The lead impedance has a close correlation with decreases of the magnet rate but a loose correlation with the battery consumption rate. This suggests that measuring the lead impedance may be useful to determine the extent of battery consumptton.
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H. MAKINO, K. KAZAMA, Y. SAITO, Y. ARAI, Y. MITAMURA, T. MIKAMI
1984 Volume 13 Issue 1 Pages
359-362
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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A stand-by pacemaker which monitors cardiac arrest within safe time period has been newly developed. The optimal escape interval is decided by the electrical blood pressure simulator and the pacing rate is automatically controlled by a microcomputer (80C39). During stand-by mode, the longest escape interval was determined, and following that, pacing was started in the physiological rate to recover ischemia in organ tissues. To prevent overdrive suppression to the heart, pacing rate was gradually decreased and stopped until the next cardiac arrest.
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