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Biomedical subjects

E Suenaga

Publications and source records attributed to E Suenaga.

23 records · Page 2Linked to original sources
PubMed1994

[Total aortic arch graft replacement: strategy for shortening the duration of cardiac ischemic arrest].

Between August 1991 and November 1993, five patients underwent total aortic arch graft replacement in a manner which placed emphasis on myocardial protection. All operations were performed with the use of extracorporeal circulation and selective cerebral perfusion. Oxygenated warm blood was infused at a flow rate of 300 ml/min. via a catheter inserted proximal to the site of occlusion of the ascending aorta or replaced graft of the ascending aorta. After the beating of the heart was resumed under left venting, aortic arch was replaced using a prosthetic graft with three branches. Concomitant operations were reconstructions of the aortic root with composite graft (Bentall's technique) in two patients of Marfan's syndrome and type A aortic dissection. All patients were easily taken off cardiopulmonary bypass and postoperative course was uneventful. We believe that shortening of the duration of ischemic cardiac arrest is important if surgical results of total aortic arch replacement are to be further improved, above all in patients at high risk for surgery, such as elderly subjects whose organ function is often compromised.

Adult↗
PubMed1994

[Traumatic transection of the descending thoracic aorta--2 successful case reports].

We report two cases of acute traumatic transection of the descending thoracic aorta that were successfully treated. Case 1 (a 24-year-old male) was admitted to our hospital because of unconsciousness with multiple severe injuries including pelvic fracture, hepatic laceration, brain contusion, and multiple fractures in the extremities. An emergency operation was performed to control the active bleeding from the hepatic laceration and the transluminal arterial embolisation of the internal iliac arteries for the pelvic fractures. Since the condition of the patient was very serious, we had to wait the repairment of the thoracic aorta for 3 weeks. The operation was successful using extracorporeal circulation. Case 2 (a 22-year-old female) suffered traumatic transection of the descending thoracic aorta without other injuries and received an emergency operation, which was successful. The strategy for the treatment of an aortic transection is difficult, especially when involving multiple injuries. However provided the decision to operate takes careful account of the general condition of the patient, then a successful result might be obtained even in a very severe case.

Adult↗
PubMed1994

[Successful repair of acute traumatic rupture of the thoracic aorta].

We report four male patients (from 18 to 36 years in age) with acute traumatic rupture of the aortic isthmus due to blunt chest trauma caused by motor vehicle accident in three patients and a full in one patient. Of these patients, 3 underwent segmental replacements of the descending thoracic aorta with vascular prosthesis using cardiopulmonary bypass, and an additional patient underwent the same procedure using left heart bypass. All patients survived without the development of any serious complications. Since traumatic rupture of the thoracic aorta due to blunt trauma frequently occurs in the relatively young, some form of assisted circulation is necessary to prevent the ischemic spinal cord injury from cross clamping of the aorta during repair of the rupture. We prefer cardiopulmonary bypass as a most appropriate support in emergency situations, because extensive mediastinal hematoma or sudden hemorrhage could make dissection extremely hazardous without it. However, cardiopulmonary bypass requires systemic heparinization, which predisposes the patients with associated multiple injuries to a tendency of bleeding. Thus, a thorough investigation of the preoperative status, including the severity of multiple injuries, should be undertaken, and appropriate therapeutic measures instituted before the start of cardiopulmonary bypass. The determination of the timing of operation is crucial to success in the treatment of acute traumatic ruptures of the thoracic aorta.

Adolescent↗