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Biomedical subjects

A Furuse

Publications and source records attributed to A Furuse.

At least 127 records · Page 7Linked to original sources
PubMed1994

[Hypothermic cardiopulmonary bypass with circulatory arrest of the lower half of the body and selective perfusion of the upper and lower half of the body for thoracic aortic aneurysm operation].

A 62-year-old man with thoracoabdominal aortic aneurysm of Crawford type IA and a 61-year-old woman with triple descending thoracic aortic aneurysms were operated on under total cardiopulmonary bypass with hypothermic circulatory arrest of the lower half of the body (rectal temperature of 17-19 C) and low flow selective perfusion of the upper and lower half of the body. Low porosity woven Dacron UBE grafts without preclotting were used for the replacement of the aorta. Postoperative courses were uneventful without paraplegia and angiographic examination revealed excellent hemodynamic results.

Aortic Aneurysm, Thoracic↗
PubMed1994

[Usefulness of mixed venous oxygen saturation as a monitor of hemodynamic state during pulmonary resection].

We studied the relation between SVO2 and other hemodynamic parameter during lung resection in 28 patients. SVO2, SaO2, CI, Hb and VO2 were measured using a fiberoptic pulmonary artery catheter. SaO2 decreased significantly after collapse of a nondependent lung because of shunt effect, whereas SVO2 remained stable. VO2 and CI increased remarkably and SVO2 decreased gradually after restoration of two lung ventilation suggesting imbalance of auto-regulatory mechanism. SVO2 remained significantly low after extubation in patients whose blood loss of more than 1,000 ml was replaced by stored blood transfusion. We think that the constant number 1.38 in Fick equation should be reset below 1.38 according to the volume of transfused blood, if blood loss was replaced by stored blood.

Adult↗
PubMed1994

[Effects of subcutaneous administration of erythropoietin on autologous blood predonation in open heart surgery: Japanese multicenter double-blinded dose-study].

The effects of subcutaneous administration of recombinant human erythropoietin (EPO) on harvesting autologous blood predonation (ABP) and decreasing homologous blood transfusion (HBT) in open-heart surgery were examined prospectively in 132 patients treated in a 32-institute multicenter study. Single doses of 6000, 12,000, 18,000 and 24,000 unit (IU) of EPO with intravenous iron (40 mg) were administered once a week for 3 weeks with ABP (400 ml/week) before surgery. ABP volume (ml), change of blood hemoglobin level (C-Hb), preoperative net blood hemoglobin increase (delta Hb [g/dl] including ABP, perioperative blood loss (ml), and HBT rate, were as follows; [table: see text] Preoperative reduction of Hb (C-Hb) was less in administration dose of 18,000 IU and 24,000 IU than 6000 IU (p < 0.05). The increase of delta Hb was highest in 18,000 IU and HBT rate was lowest in administration dose of 24,000 IU, however, there was no statistical difference. In conclusion, both 18,000 IU and 24,000 IU of EPO treatment is effective to minimize the progression of anemia according to ABP for open heart surgery.

Blood Transfusion, Autologous↗
PubMed1993

Retrograde gastric varices in a patient with total cavopulmonary shunt.

Gastric varices formed in a patient who had undergone a total cavopulmonary shunt operation 7 years previously. The varices were found to be due to development of collaterals from high-pressure systemic vein to low-pressure portal vein. Bleeding gastric varix can be a late complication of total cavopulmonary shunt.

Arteriovenous Shunt, Surgical↗
PubMed1993

Analysis of cardiac assistance by latissimus dorsi cardiomyoplasty with a time varying elastance model.

OBJECTIVE: The clinical use of skeletal muscle cardiomyoplasty is limited because of its inadequate haemodynamic benefits. To facilitate experimental and clinical efforts to improve the efficacy of this technique, a mathematical model was proposed and its validity was tested in acute experiments. METHODS: The model was based on the assumption that the skeletal muscle wrapped around the heart behaves as a time varying elastance that is connected in series with another time varying elastance representing the native heart. From this model two predictions were made: (1) Skeletal muscle augments the contractility of the heart by increasing the slope (Ees) of the end systolic pressure-volume relation; (2) time varying elastance of the skeletal muscle chamber (Es(t)) can be estimated from that of the assisted heart. These predictions were examined in experiments. In nine anaesthetised, open chest dogs, preconditioned latissimus dorsi muscle was transposed to wrap the heart. Left ventricular pressure (catheter tipped micromanometer), and volume (conductance catheter) were measured while reducing the preload by vena caval occlusion to evaluate Ees with 1:2 (stimulation:heart beat ratio) stimulation of the skeletal muscle. RESULTS: With the stimulation of latissimus muscle, the end systolic pressure-volume relation was linear and Ees increased from 8.6(SEM 2.4) to 11.9(SEM 3.4) mm Hg.ml-1. Estimated Es(t) reflected the stimulation pattern and could account for the mechanism of the cardiac assistance. CONCLUSIONS: Skeletal muscle cardiomyoplasty improved the haemodynamic variable (Ees) as predicted by a mathematical model.

Animals↗
PubMed1993

Experimental creation of complete A-H block.

A new technique to block conduction from both atria to the atrio-ventricular node (A-V node) was devised through anatomical considerations of the junctional area. To assess the validity of the technique, a series of experiments were performed in mongrel dogs. Under cardiopulmonary bypass, the interatrial septum was incised along the tendon of Todaro, followed by cryosurgical ablation of the approach to the A-V node. Postoperative electrophysiological studies revealed complete conduction block between both atria and the A-V node. A spontaneous A-V nodal rhythm was produced. Initial activation was proved to be within the junctional area. This technique may lead to improved surgical management for atrial fibrillation and other supra-ventricular tachyarrhythmias.

Animals↗
PubMed1993

Ultrasonic angioplasty for ostial stenosis of the left coronary artery.

Coronary artery bypass grafting is the first-choice treatment for lesions of the left main trunk, but this procedure is associated with the problem of long-term graft patency. Some surgeons thus prefer to perform patch angioplasty for such lesions; however, the safety of this operation is not well established. Operative angioplasty using an ultrasonic aspiration system in a patient with ostial stenosis of the left coronary artery was successfully performed. This is the first report of the application of ultrasonic angioplasty to coronary artery disease.

Cardiac Catheterization↗
PubMed1993

[Thoracoscopic partial resection of the lung by use of Nd-YAG laser and standard suturing technique].

The patient was a 62-year-old woman who was referred to our department for bilateral diffuse abnormal shadows along with a sigmoid colon cancer that had been resected one month previously. Thoracoscopic partial resection of the left S8 region was performed. Nd-YAG laser with a contact tip was used for the resection. Hemostasis at the bed of the resection was assured by applying a free laser beam to oozing and non-coagulated surface. Additionally, the resected end was closed by standard continuous double over-and-over sutures in order to minimize the air leakage. Endo-Bulldog clamp facilitated the operation, minimizing hemorrhage from the resected end. This device can clamp any part of the lung and save one percutaneous puncture site necessary for thoracoscopic procedures. Postoperative course was uneventful. Pathological diagnosis was reported as an alveolar cell carcinoma of the lung.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1993

[Successful surgical repair of emphysematous giant bullae of the elderly with severely depressed pulmonary function].

A 71-year-old male was admitted to an emergency hospital owing to severe dyspnea of sudden onset. Bilateral tension pneumothorax with two giant bullae occupying more than the third of the right lung was disclosed on the chest X-ray. Bilateral chest drainages and cardiopulmonary resuscitation were performed. He could be freed from ventilatory support several days after tracheostomy and was referred to our hospital. The pulmonary function was severely depressed: VC (%) 1.20 l (40%) and FEV1.0 (%) 0.55 l (46%). In spite of oxygen inhalation he could not keep sitting due to dyspnea (Hugh-Jones grade V). Right multiple bullectomy was performed successfully and his postoperative course was uneventful. He was discharged eight weeks later. Seven months after surgery his pulmonary function was remarkably improved: VC (%) 2.05 l (64%) and FEV1.0 (%) 0.94 l (46%). He became to walk almost equally with a healthy man one year later (Hugh-Jones grade II).

Aged↗
PubMed1993

[Surgical treatment of patients with congestive heart failure].

Surgical intervention is a treatment of choice in chronic congestive heart failure from long standing myocardial ischemia or old myocardial infarction. Right sided heart failure is a higher risk factor for surgery than a left sided one. Hemodynamic instability following acute myocardial ischemia in spite of medical treatment is an indication for urgent surgery. Hemodynamic deterioration from acute valvular lesions, such as infectious endocarditis, malfunction of the prosthetic valve, and trauma, are also indications for urgent surgery. Although surgical results are correlated with NYHA classification, chronic right sided heart failure increases the morbidity. Dynamic cardiomyoplasty is a new treatment for otherwise uncorrectable congestive heart failure. Multicenter trial reported 40% of mortality and an average improvement of NYHA class from 3.5 to 2.1.

Cardiomyopathies↗
PubMed1993

[Myocardial protection during aortic cross-clamping for more than 240 minutes].

The efficacy of cold crystalloid cardioplegia (St. Thomas II solution) during aortic cross-clamping more than 240 minutes was evaluated in 5 patients with non-coronary diseases undergoing heart surgery. The ischemic time ranged from 257 to 302 minutes with the mean of 274 minutes. As the technique of myocardial protection, multidose antegrade crystalloid cardioplegia was used at an interval of 20 minutes. These patient were compared with another patient group with clamping time 120-180 minutes. There was no difference between the two groups in terms of mortality, cardiac index, CK, CK-MB, GOT, LDH. These findings suggest that cold crystalloid cardioplegia provided clinically satisfactory myocardial protection during the aortic cross-clamping for more than 240 minutes.

Adult↗
PubMed1993

[A role of valvuloplasty in surgical treatment of isolated tricuspid regurgitation].

Seven surgical cases of isolated tricuspid regurgitation were reviewed. From pathological point of view, the patients were classified into three groups. Two were due to abnormalities of subvalvular system, four to annular dilatation and one to anomalous leaflet. Among four cases of annular dilatation, two were diagnosed as dilated cardiomyopathy. In one, it was very rare myopathy confined to right ventricle. Three cases, two subvalvular and one leaflet abnormalities, underwent valvuloplasty which included chordal reconstruction using Gore-Tex suture. Among annular dilatation group, three underwent valve replacement (two with mechanical valve and one with bioprosthetic valve), while fourth underwent annuloplasty. When We look at 89 surgical patients with secondary tricuspid regurgitation, thrombosed mechanical valve was seen in two cases, one of them necessitating re-valve replacement. On the other hand, late results of tricuspid annuloplasty with Carpentier-Edwards ring was excellent without re-operation. Although isolated tricuspid regurgitation has very complicated pathological features, we now think it very important to manage to repair regurgitant tricuspid valve utilizing all available techniques including redundant valve tissue resection, chordal reconstruction, and annuloplasty, thus avoiding valve replacement especially with mechanical valve.

Adolescent↗
PubMed1993

[A case of mediastinal neurinoma originated from the left vagal nerve].

A 46-year-old man was admitted to our hospital because of an abnormal shadow on the chest roentgenogram. The operation was performed through left posterolateral thoracotomy. A tumor mass, 4.5 x 2.5 x 2.5 cm in size, was found and its origin was the left main vagal nerve 0.5 cm distal the branching root of the recurrence nerve. The tumor and a part of the left vagal nerve was resected en bloc. Pathological study revealed tha the tumor was neurinoma of Antoni A+B. Postoperative course was uneventful. This is the 34th reported case in Japanese literature of neurinoma with its origin from the intrathoracic vagal nerve.

Cranial Nerve Neoplasms↗
PubMed1993

[Curative surgery for lung cancer invading the aorta with bilateral emphysematous giant bullae: a case report].

A 56-year-old male patient who had been suffered from giant emphysematous bullae in both lungs was referred to our hospital because of newly developing left lung abnormal shadow, which was adjacent to the aorta on chest X-ray. Lung cancer invading the aorta was suspected on CT scanning and curative operation was scheduled. At left thoracotomy there were large bullae in the upper lobe, part of which covered on and stuck to the tumor mass on the aortic wall. We performed left upper lobectomy, combined with the partial resection of the aortic wall and repaired it with dacron patch using partial extracorporeal circulation with cannulations into the main pulmonary artery and the descending aorta. Pathological diagnosis was large cell carcinoma. Lung cancer invading the aorta can be safely excised using assisting circulatory devices such as extracorporeal circulation. We expect this type of operation will be widely accepted and make better results.

Aorta↗