Search PubMed⌕ Search

Biomedical subjects

H Hirose

Publications and source records attributed to H Hirose.

At least 469 records · Page 26Linked to original sources
PubMed1984

Total cavopulmonary shunt operation in complex cardiac anomalies. A new operation.

Four patients with presently uncorrectable cyanotic cardiac anomalies underwent a new operation, "total cavopulmonary shunt operation" or "total right heart bypass operation." These anomalies included single ventricle, single atrium, common atrioventricular valve with or without regurgitation, pulmonary stenosis, and most important, absent inferior vena cava with azygos or hemiazygos continuation. All patients had had previous systemic-pulmonary shunts. The new operation consisted of end-to-side anastomosis between the superior vena cava with azygos or hemiazygos continuation and the confluent pulmonary artery, division or ligation of the pulmonary artery trunk, and replacement of the common atrioventricular valve when regurgitation was present. Thus total venous return, except for hepatocardiac venous and coronary sinus flow, drains directly into the pulmonary artery, bypassing the right atrium and ventricle. Three patients survived the operation, and two of the three patients are now alive 4 years, 8 months and 2 years, 6 months after the operation. The two long-term survivors are in significantly improved condition, both clinically and hemodynamically. We believe that this new operation is promising in the treatment of the otherwise uncorrectable complex cardiac anomalies associated with azygos or hemiazygos continuation of the inferior vena cava. A longer follow-up is certainly mandatory before final conclusions can be reached.

Adult↗
PubMed1983

Velar Movements during speech in two Wernicke aphasic patients.

The articulatory gestures of the velum in two Wernicke aphasic patients were examined to compare their performances with those of an apraxic patient by means of the fiberoptic technique. In contrast to the marked variability in the apraxic performance in terms of velum height and segmental duration, the two fluent aphasic subjects showed a relatively high degree of consistency in velar movements throughout several repetitions of nonsense syllables and meaningful words. In addition, both patients exhibited a normal pattern of anticipatory coarticulation. Analyses of the velar movement patterns during the speech-sound error processes of both patients suggested that these errors were not due to an impairment at the level of articulatory programming but to an error in the selection of a target phoneme.

Aged↗
PubMed1983

Surgery for coronary heart disease due to mucocutaneous lymph node syndrome (Kawasaki disease). Report of 6 patients.

Early and late surgical results in 6 patients with coronary heart disease secondary to mucocutaneous lymph node syndrome (MLNS) (Kawasaki disease) are presented. There were 5 male patients and 1 female patient, ranging in age from 2.5 to 26 years at the time of operation. They had severe coronary artery narrowings, obstructions, and aneurysms with or without mitral regurgitation. Previous myocardial infarction was documented in 5 patients. Aortocoronary bypass grafting utilizing the autologous saphenous vein was performed in 5 patients; in the remaining patient, mitral valve replacement was carried out. No operative or late deaths have been encountered. A long-term bypass graft patency was demonstrated in patients aged 26, 17, and 10 years with resulting clinical, angiographic, or scintigraphic improvements, or a combination of these. However, the graft that had been patent in a 4-year-old boy was found completely obstructed 3 years after surgery without any symptomatic changes. The formation of rich collateral channels was found. The risk of saphenous vein graft closure may be high in young growing children. In older children or adolescents, however, coronary vein bypass grafting for this specific inflammatory coronary artery lesion has been effective with long-term graft patency. Severe mitral regurgitation is also an indication for surgery, but poor left ventricular function associated with mitral regurgitation, probably secondary to myocarditis, persists after surgery and may give rise to future problems.

Adolescent↗
PubMed1983

Operative results in patients with pseudotruncus arteriosus.

Total repair was carried out in 18 patients with pseudotruncus arteriosus. Age at the time of operation ranged from 1 to 25 years and averaged 9 years. Operative methods were transannular patch reconstruction for the relief of pulmonary atresia in 4 patients (no deaths) and reconstruction with a valved external conduit from the right ventricle to the pulmonary arteries in 14 patients (5 deaths). The overall operative mortality was 28%. An average cross-sectional area of the right and left pulmonary arteries (PA area) was calculated using angiograms and compared with the cross-sectional area of the normal right pulmonary artery (N-rPA area) in all patients. The PA area ranged from 0.06 to 2.60 cm2 and averaged 1.02 cm2; the PA area/N-rPA area ratio ranged from 0.03 to 1.05, with an average of 0.54. Three patients who died of hypoplastic right and left pulmonary arteries had a PA area/N-rPA area ratio less than 0.20. These patients had a right-to-left ventricular peak systolic pressure ratio (pRV/LV) greater than 1.0 after total repair. Fifteen patients had a PA area/N-rPA area ratio greater than 0.20, and 13 survived corrective procedures. One patient died of lung edema, which was due to failure to ligate the large bronchial collateral artery properly, and the other died of pulmonary vascular obstructive disease. Our results show that a PA area/N-rPA area ratio greater than 0.20 is a necessity in performing total repair of pseudotruncus arteriosus.

Adolescent↗