[Clinical Outcomes of Cardiovascular Surgery in Jehovah's Witness Patients].

Cardiovascular surgery in Jehovah's Witness is challenging for surgeons on the ground that they refuse blood transfusion. We report 11 cases of cardiovascular surgery. All of the patients underwent elective surgery with cardiopulmonary bypass.

Stanford type A aortic dissection which ruptured into the left atrium: report of a case.

A Stanford type A aortic dissection ruptures usually into the pericardial space or the mediastinal space. We herein report the rare surgical case of a Stanford type A aortic dissection which ruptured into the left atrium. The patient had a previous history of mitral valve replacement.

[Long-term results of aortic arch replacement using combination of deep hypothermic circulatory arrest and retrograde cerebral perfusion; comparison of result for atherosclerotic aneurysm and aortic dissection].

Between 1992 and 2001, 73 patients with aortic arch lesion underwent surgical treatment. The aneurysm was characterized by atherosclerosis in 54 patients (TAA) and by aortic dissection in 19 patients (DAA). All patients received graft replacement under combination of deep hypothermic circulatory arrest and retrograde cerebral perfusion.

Effects of sarpogrelate hydrochloride on platelet aggregation, and its relation to the release of serotonin and P-selectin.

Inhibitory effects of sarpogrelate hydrochloride (sarpogrelate), a 5-HT2 receptor antagonist, on platelet aggregation was examined as well as the relationship to serotonin and P-selectin, a platelet alpha-granule membrane glycoprotein. Platelet aggregation was induced by simultaneous addition of collagen (0.06-0.

Clinical experience of 473 patients with the omnicarbon prosthetic heart valve.

Background And Aim Of The Study: The long-term clinical experience of patients receiving Omnicarbon heart valve prostheses between January 1985 and December 1996 was investigated.

Methods: In total, 473 patients (255 males, 218 females; mean age 57.5 +/- 10.

Ultrasonic evaluation of congestive liver after tricuspid annuloplasty.

To assess the effect of tricuspid annuloplasty (TAP), the authors measured the size of the liver by using echography in the patients undergoing tricuspid annuloplasty. From April 1989 to August 1996, 18 patients underwent TAP. The authors measured preoperatively and postoperatively the hepatic index (HI) by echography, defined as follows: HI=L x D/BSA (L: the top-to-bottom length of the left hepatic lobe; D: the front-to-back length of the left hepatic lobe; BSA: body surface area).

Influence of preoperative nutritional state on inflammatory response after surgery.

To investigate whether the preoperative nutritional state influences the postoperative inflammatory reaction and immunity, we grouped patients whose postoperative nutritional support was performed by total parenteral nutrition into the good nutritional state group (group I) and the latent protein-calorie malnutrition suggested group (group II) based on the preoperative rapid turnover protein (RTP). Nutritional markers markedly decreased after surgery and recovered almost to preoperative levels on postoperative day (POD-) 7 in groups I and II. Nutritional markers on POD-7 in group II were significantly lower than those in group I (RTP, P < 0.

Inhibitory effects of H2-receptor antagonists on platelet function in vitro.

To evaluate in vitro inhibitory effects of four types of histamine H2-receptor antagonist (H2-receptor antagonists), famotidine, roxatidine, cimetidine and ranitidine, on platelet function, we examined aggregating potency and P-selectin levels with agonist-induced aggregation. Ranitidine and cimetidine inhibited, in concentration of 0.35 mM, the secondary aggregation induced by 5 microM adenosine diphosphate (ADP), the aggregation induced by 1 microg/mL collagen and 3 microM arachidonic acid.

Myxoma of mitral valve associated with infective endocarditis.

A 20-year-old man was hospitalized for persistent fever, embolism, and syncopal attack. Echocardiography demonstrated a tumor on the mitral posterior leaflet. It was removed under extracorporeal circulation following extirpation of thrombus in the right common like artery.

Repair of an acute type A dissection: fate of the remnant false lumen and preserved aortic valve.

From January 1992 through March 1997, 75 patients (DeBakey type I/II = 56/19) underwent a surgical repair of a type A acute dissection. The patients included 37 men and 38 women ranging in age from 23 to 83 years with a mean of 65 years. All patients were admitted to our hospital with a mean interval of 2.

[Two cases of mitral restenosis occurring eight years after percutaneous balloon mitral commissurotomy (PTMC)].

A 63-year-old man and a 49-year-old man who underwent PTMC eight years before were admitted in our hospital because of regurgitation and restenosis of the mitral valve. Both of them had ulcer like lesion on the anterior leaflet near the commissure of the mitral valve. These changes were made by PTMC and likely caused thrombosis.

Congenital bicuspid aortic valve: analysis of 63 surgical cases.

Background And Aims Of The Study: This study reports the clinicopathologic characteristics of congenital bicuspid aortic valves necessitating surgical intervention.

Methods: Among 374 aortic valve procedures during the past 15 years, 63 cases of bicuspid aortic valve were encountered. Patients included 45 males and 18 females; mean age was 53 years (range: 14 to 76 years).

[Late results of emergency operation in acute type A dissection].

77 cases of acute type A dissection underwent emergency operation during 5 years were studied. There were 37 men and 40 women, and 58 cases in type I, 19 cases in type II on DeBakey type. The grafting for the aorta including the tear was basically performed under selective brain perfusion and deep hypothermic circulatory arrest.

Pedicle transposition of the greater omentum for sternal osteomyelitis and mediastinitis after cardiac operation.

Three patients underwent pedicle transposition of the greater omentum for sternal osteomyelitis and mediastinitis after cardiac operation. These patients were previously operated on with coronary artery bypass grafting, aortic valve replacement and redo Fontan operation in each. This procedure was carried out on 4, 6, 8, and 14th postoperative day.

Intramural hematoma of the thoracic aorta.

Objective: This study was designed to clarify the optimal treatment mode of patients with intramural hematoma (IMH) of the thoracic aorta.

Methods: From 1992 through 1997, 51 patients underwent surgical repair or medical treatment of IMH of the thoracic aorta. There were 36 male and 15 female patients, aged between 49 and 79 years with a mean of 67 years.

[Preoperative autologous donation of blood in cardiac surgery--age related factors].

We have studied influence of the age related factors on preoperative autologous donation (PAD) of blood in cardic surgery. PAD was undertaken in 246 cases of elective cardiac surgery by means of simple or leap-frog method, starting at approximately 4.5 weeks before operation.

Infected atherosclerotic ulcer of the abdominal aorta as a cause of mycotic aneurysm treated by in-situ prosthetic graft reconstruction: report of a case.

A 68-year-old man with an infrarenal mycotic aneurysm underwent successful in-situ graft reconstruction using a woven Dacron graft. A tissue culture taken from the excised aortic wall revealed Staphylococcus epidermidis, and histological study subsequently showed penetrating atherosclerotic ulcers (PAU) involving all layers of the aortic wall and marked neutrophilic infiltration with abscess formation inside the ulcer. Atherosclerotic aortic lesions such as PAU are considered susceptible to bacterial infection, which may lead to the formation of an aneurysm after destruction of the vessel wall.

Penetrating atherosclerotic ulcers in an abdominal aortic aneurysm: report of a case.

We report the case of a 74-year-old man found to have an extensive intramural hematoma (IMH) in the infrarenal abdominal aorta during a follow-up imaging study performed after repair of a DeBakey type II aortic dissection with an aortic arch true aneurysm. Enhanced computed tomographic scan and angiography revealed an extensive IMH and multiple penetrating atherosclerotic ulcers in the abdominal aorta. The patient underwent a successful replacement of the affected abdominal aorta using a collagen-impregnated woven Dacron graft.

[Temporary extracorporeal axillofemoral venous bypass--a beneficial device in operation for superior vena caval syndrome due to intrathoracic malignancies].

Life-threatening complications can occur unexpectedly during general anesthesia in operations for superior vena caval (SVC) syndrome due to intrathoracic tumors. To prevent such sequelae, we have placed a temporary extracorporeal axillofemoral venous bypass graft with satisfactory results. In six patients (malignant mediastinal tumor, four; lung cancer, two), under local anesthesia before induction of general one, the cannulas, each appropriately sized in accordance with the diameter of the axillary and femoral veins, were directly introduced into the corresponding veins after systemic heparinization.

Inhibitory effects of antibiotics on platelet aggregation in vitro.

1. We evaluated in vitro inhibitory effects of six types of antibiotic, aztreonam (AZT), cefamandole (CMD), cefmetazole (CMZ), cefotiam (CTM), flomoxef (FMOX) and latamoxef (LMOX), on platelet aggregation, using healthy volunteers' blood. Four types--FMOX, LMOX, CTM and CMD--inhibited, in concentration of 2500 micrograms/ml, the secondary aggregation induced by 3.

[Composite valve graft replacement in patients with type A aortic dissection--a modified cabrol procedure].

Composite valve graft replacement of the ascending aorta and aortic valve is indicated for a variety of conditions affecting the aortic root. However, a major drawback in this operation is bleeding from the proximal suture line and coronary anastomosis especially in patient with friable root tissue involved by aortic dissection. We describe here a modified technique to take advantage of the aortic button and cabrol techniques to reattach the coronary artery ostia.

Acute type A aortic dissection following intramural hematoma of the aorta. A case report.

A seventy-three-year-old woman had symptoms of aortic dissection. Initial computed tomographic (CT) scan and angiography showed an extensive intramural hematoma (IMH) of the aortic segment from the ascending aorta to the bulk of the descending aorta without intimal tear or false lumen. Two weeks later the patient's symptoms recurred.

Retrohepatic cavoatrial shunt with a ringed polytetrafluoroethylene graft for the Budd-Chiari syndrome. A case report.

This report describes a patient with Budd-Chiari syndrome who was operated on successfully by means of shunt formation with polytetrafluoroethylene graft between the inferior vena cava (IVC) and right atrium. The patient is a sixty-two-year-old woman suffering from persistent edema of the lower limbs for four years. The examination disclosed complete obstruction of the IVC at the level of the diaphragm with a patent right inferior hepatic vein.