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Biomedical subjects

H Miyamura

Publications and source records attributed to H Miyamura.

107 records · Page 6Linked to original sources
PubMed1984

Congenital aortic regurgitation in a child with a tricuspid non-stenotic aortic valve.

After follow up for seven years a 10 year old boy with congenital aortic regurgitation was found to have a tricuspid non-stenotic aortic valve at operation. The right coronary cusp was dysplastic, thickened, and contracted; the gap between its free margin and aortic wall was bridged with two fibrous bands; and the left coronary and non-coronary cusps were almost normal. The aortic valve was replaced with a prosthesis (St Jude Medical No 23), and the postoperative course was uneventful.

Aortic Valve↗
PubMed1984

Successful surgical repair of left ventricular rupture after acute myocardial infarction.

A 61-year-old man with impending myocardial infarction was admitted and treated by percutaneous transluminal coronary recanalization (PTCR) therapy using Urokinase. Patient's symptoms subsided and his general condition maintained stable until the fifth hospital day, when he developed the signs of cardiac rupture. He was operated upon immediately, and the left ventricular rupture was confirmed and repaired successfully. Patient recovered from the surgery well. This report describes the rare successful surgical case of cardiac rupture secondary to acute myocardial infarction in Japan.

Cardiac Catheterization↗
PubMed1984

Duplication of the tricuspid valve with Ebstein anomaly.

Duplication of the tricuspid valve is a rare congenital cardiac anomaly. We experienced one infant case with Ebstein anomaly, who died at seven months of age. At autopsy, the clinical diagnosis was confirmed, and also the patient was found to have double tricuspid valve orifices, each of which were accompanied by subvalvular tension apparatuses. Tricuspid valve leaflets seen in Ebstein anomaly are known to have fenestrations as accessory orifices for some instances, but this case is unique and interesting in that each valve orifice has well-developed chordae tendinae and papillary muscles below it.

Ebstein Anomaly↗
PubMed1982

Surgical experience with anatomically corrected malposition of the great arteries without subpulmonary conus.

A three-year-old boy was operated on with the diagnosis of anatomically corrected malposition of the great arteries (S,D,L), ventricular septal defect, and mitral regurgitation. During the operation, it was found that the subpulmonary conus was absent. Ventricular septal defect was patch-closed, and the mitral valve was repaired. The patient was well after the surgery. This is the first case report to our knowledge of the successful surgical repair in anatomically corrected malposition of the great arteries without subpulmonary conus. Anatomically corrected malposition of the great arteries does not always have bilateral conus as once proposed, and the importance of the differentiation from the corrected transposition of the great arteries is emphasized.

Child, Preschool↗
PubMed1981

An autopsy case of erythropoietic protoporphyria with cholestatic jaundice and hepatic failure, and a review of literature.

A 43-year-old woman with a history of photosensitivity died of hepatic failure following 3 and a half months of unexplained jaundice. The liver was black, showed mild fibrosis and conspicuous pigment deposition in the cytoplasm of the hepatocytes, Kupffer cells and portal macrophages, and within dilated lumina of bile canaliculi and of ductules. The pigment disclosed a striking birefringence and numerous slender electron-dense crystals on electron microscopy. Similar crystals were also found within the cytoplasm of the ductular epithelium. Despite absence of cirrhosis observed in almost all previously described fatal cases the diagnosis of erythropoietic liver with marked protoporphyrin deposition so far have not been described in the cases observed at autopsy.

Adult↗
PubMed1981

Pulmonary artery stenosis following aortopulmonary anastomoses.

From 1965 to 1979, 44 patients with Potts and 50 with Waterston aortopulmonary anastomoses were studied angiographically. Fifty-two of the 95 shunts had been banded to limit growth of the anastomosis. Later the internal diameter of the anastomosis was measured in 34 children when the cardiac defect was repaired. On those with late measurements, growth was limited effectively in 17 of the 18 (94%) shunts that had been banded, whereas five of the 16 (31%) unbanded anastomoses grew to more than 6.5 mm internal diameter (p = 0.05). The difference in incidence of moderate or severe stenosis of the pulmonary artery near or at the anastomosis nearly reached a significant level (p = 0.07), occurring in 50% of children with banded shunts in comparison with 31% of children with unbanded shunts. Mean pulmonary artery pressures were obtained in 77 children, 36 with potts and 41 with Waterston shunts. Six of 43 with a banded anastomosis had a mean pulmonary artery pressure above 30 mm Hg, the highest being 43 mm Hg. Seven of 34 children with an unbanded anastomosis had a mean pulmonary artery pressure of 30 mm Hg or more, and in three the pressures were over 50mm Hg. In unbanded Potts or Waterston shunts the incidence of pulmonary artery stenosis was 60%. This high incidence discourages the use of these aortopulmonary anastomoses if other shunts can be constructed safely and effectively.

Aorta↗
PubMed1981

Correlation between disappearance of the intrahepatic bile ducts and histologic changes in the liver in primary biliary cirrhosis.

Statistical investigations indicate that disappearance of bile ducts, estimated by a histometric method, was more extensive in symptomatic than in asymptomatic patients with primary biliary cirrhosis. The extent and degree of intrahepatic bile duct disappearance in PBC is related to the degree of copper granule deposition in the hepatocytes, the degree of atypical ductular proliferations and the fibrous septa formation. Bile plug formation and chemically determined copper content are not so well related to the bile duct disappearance, while periportal lymphoid cell infiltration is not related to the degree or extent of bile duct disappearance at all.

Adult↗
PubMedDate not supplied

The influence of a heparin-coated oxygenator during cardiopulmonary bypass on postoperative lung oxygenation capacity in pediatric patients with congenital heart anomalies.

BACKGROUND: Cardiopulmonary bypass (CPB) causes an inflammatory response and remarkably depresses the oxygenation capacity of the lung in pediatric patients with pulmonary hypertension. Although a heparin-coated circuit is more biocompatible than an uncoated circuit, the beneficial effect of a heparin-coated circuit on the postoperative lung function in the pediatric patients remains unknown. METHODS: Sixty patients younger than 3-years-old undergoing heart operations for ventricular septal defect were divided into three groups: group I = children (n = 11) without pulmonary hypertension who underwent CPB with an uncoated oxygenator; group II = children (n = 32) with pulmonary hypertension who underwent CPB with an uncoated oxygenator; and group III = children (n = 17) with pulmonary hypertension who underwent CPB with a heparin-coated oxygenator. A respiratory index (RI) was used to assess the oxygenation capacity of the lung. RESULTS: RI in group II was significantly higher than in group I and intubation time in group II was significantly longer than in group I. There was a positive correlation between preoperative pulmonary-systemic blood pressure ratio and RI at 3 hours post-CPB. Three and six hours post-CPB, RI in group III was significantly lower than in group II, but there was no significant difference in RI between both groups at 12 hours post-CPB. CONCLUSIONS: Pulmonary hypertensive pediatric patients were vulnerable to postperfusion lung injury. Beneficial effects of a heparin-coated oxygenator in a CPB circuit was limited to the early hours post-CPB and the postoperative clinical course was not modified by the heparin-coating of a membrane oxygenator.

Cardiopulmonary Bypass↗
PubMedDate not supplied

Replacement of myocardium with a Dacron prosthesis for complications of acute myocardial infarction.

From July 1983 to April 1986, four patients (three with ventricular septal perforations and one with left ventricular free-wall rupture) underwent replacement of the myocardium with a Dacron prosthesis for complications of acute myocardial infarction. There were three males and one female, ages ranging from 53 to 70 years (mean 63.3). Three of the four patients survived; the one with the ventricular septal perforation died of severe cardiac failure five days after operation. Replacement of the infarcted myocardium with a Dacron prosthesis seems to be an excellent operative technique for the treatment of complications of acute myocardial infarction when the left ventricular cavity is predicted to be small after resection of the myocardium.

Cardiac Surgical Procedures↗
PubMedDate not supplied

Successful resection of cardiac fibroma with ventricular tachycardia.

A 22-year-old male was admitted to Niigata University Hospital complaining of palpitation. Echocardiogram, cineangiogram, and Holter electrocardiogram revealed a cardiac fibroma complicated by ventricular tachycardia (VT). The tumor extended from the interventricular septum to the anterior surface of the left ventricle, and an electrophysiological study demonstrated that the focus of the VT was situated at the tumor. The tumor was excised successfully. The patient is doing well two years after operation without any antiarrhythmic drugs, and VT has not recurred.

Adult↗