Biomedical subjects

K Eishi

Publications and source records attributed to K Eishi.

90 records · Page 5Linked to original sources

PubMed1990

[A case of modified Fontan operation for complete atrioventricular canal of right dominance with double-outlet right ventricle, common atrioventricular valve regurgitation].

A 6-year-old boy was diagnosed to have complete atrioventricular canal (CAVC) with double-outlet right ventricle (DORV), common atrium and common atrioventricular valve regurgitation. The atrioventricular junction predominantly connected to the right ventricle (right dominance) and the left ventricle was hypoplastic (LVEDV = 64% of normal). The combination of DORV with right dominant CAVC makes more difficult to make intra-ventricular rerouting. A modified Fontan procedure, atrial partition and DeVega's annuloplasty were successfully performed. It is concluded that Fontan procedure might be preferable rather than intra-ventricular rerouting in this case.

Child↗

PubMed1989

[Surgical repair and late problem for Ebstein's anomaly--surgical cases with severe tricuspid stenosis or regurgitation].

In this report, we described our surgical experiences of Ebstein's anomaly with severe tricuspid stenosis (TS) or regurgitation (TR). Long-term clinical assessments and late problems of the treatment were also mentioned. From 1953 to 1988, a total of 2850 patients with congenital heart malformation underwent surgery in our hospital. During this period, 32 patients with Ebstein's anomaly were admitted, and surgical treatment was performed in 10 of these patients. Thus, the surgical treatment of Ebstein's anomaly took only 0.35% of total surgeries of congenital heart diseases. According to Takayasu's classification of Ebstein's anomaly, 6 of our these patients were classified into TS, and 4 into TR type. The operative methods were shunt operation in 3 patients, plication in 2 patients and tricuspid valve replacement (TVR) in 5 patients. One patient was died during the operative course of Glenn's procedure. Other 9 patients are alive and the longest follow-up period is 18 years at this moment. In the remaining two patients with shunt operation, Blalock-Taussig's procedure completely diminished their polycythemia. In the cases of TVR, the replaced valve was sutured to the right atrium in 2 patients with TS, true annulus in 2 patients with TR, valve remnant in one patient with TR type. Delayed cardiac tamponade occurred in 2 patients and calcification of Xenograft valve was observed at 8 years after the surgery in one patient with TVR. Although the hemodynamics did not improve immediately just after open heart surgery, cardio-thoracic ratio reduced and clinical symptoms were improved remarkably throughout the long-term follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1989

Pulmonary flow-resistance relationships in allografts after single lung transplantation in dogs.

To evaluate the applicability of single lung transplantation as a treatment of pulmonary hypertension, we investigated the relationships between the pulmonary blood flow and resistance in allografts 10 days after single lung transplantation in dogs. In eight surviving recipients and five healthy dogs (control group), pulmonary flow-resistance relationships were investigated at flows in the range of 0.3 to 2.0 L/min at 0.1 L/min increments. Resistance decreased from 2585 to 746 dyne.sec.cm-5 in the successful group (five allografts receiving complete studies) and 2400 to 891 in the control group with an increase of flow. Lung water content of the successful group was 2.0 times that of the control group (successful group, 95.6 +/- 16.7 gm; control group, 47.8 +/- 7.5 gm), and water content of the other allografts (unsuccessful group), including allografts of dogs that died before investigations, was 2.2 times that of the successful group (unsuccessful group, 211.0 +/- 89.6 gm). The chest roentgenograms of the successful group showed mild or moderate consolidations, whereas those of the unsuccessful group showed severe consolidations, but no difference was found in pulmonary flow-resistance relationships between the successful and the control groups. These results show that the allografts, which have about twice the water content of normal lung, maintain adequate pulmonary vascular function. We concluded that single lung transplantation could be an effective treatment for pulmonary hypertension.

Animals↗

PubMed1989

[Clinical study on the effects of assist bypass on left ventricular contractility].

This study was undertaken to evaluate the effects of circulatory support on cardiac function in 7 patients. They were 2 men and 5 women with of age 34-54 years; Six patients underwent mitral valve replacement and one had mitral valve plasty. End-systolic pressure/volume (ESP/ESV) representing left ventricular contractility was measured just before ECC starting and after cardiac beating began in the process of rewarming. Measurements were repeated at every, interval of 10 minutes up to 60 minutes. ESP/ESV (mmHg/ml) [% of that before ECC] were as following; before ECC: 1.69 +/- 0.68 (mean +/- SD) [100], after 10 minutes; 0.40 +/- 0.24 [25.1 +/- 13.8], after 20 minutes; 0.52 +/- 0.26 [31.5 +/- 12.9], after 30 minutes; 0.77 +/- 0.28 [47.6 +/- 10.5], after 40 minutes; 0.97 +/- 0.26 [60.5 +/- 11.3], after 50 minutes; 1.18 +/- 0.46 [70.6]8.0], after 60 minutes; 1.36 +/- 0.56[80.4 +/- 12.7]. It took 39.6 minutes to recover up to 69% of that before ECC. These data suggested that the myocardial ischemia associated with aortic cross clamping continued for at least 60 minutes after cardiac beating resumed. We concluded that assist bypass should be applied to those who could not be weaned from ECC despite adequate use of catecholamine and volume loading.

Adult↗

PubMed1989

[Selection of candidates for a ventricular assist device as a bridge to heart transplantation].

This study was undertaken to see how many people could receive the ventricular assist device (VAD) as a bridge to heart transplantation and to get selection criteria of the recipient. From January 1984 to December 1987, 9916 patients were admitted to our institute and 399 cases of them were dead. All dead cases were examined in terms of age, heart disease, other organ function, infection, and so on. There were 42 possible candidates for VAD, 31 men and 11 women. The average age was 50 years with a range from 22 to 63 years. Ten cases (23.8%) of them had the indication for VAD bridge to transplantation. The criteria for transplantable patients included the following three categories: I) Cardiogenic shock: Irreversible left or double ventricular failure with or without life-threatening dysrhythmia during IABP therapy--4 cases. II) End-stage valvular heart disease; Operation under VAD stand-by--2 cases. III) Postoperative refractory ventricular pump failure: Failure to wean from assist circulation after IABP trial or sustained ventricular failure under IABP support--4 cases. It was indicated that continuous precise evaluation of the deteriorating hemodynamics and the intensive care for major organ functions (renal, pulmonary, neurologic, hepatic, coagulation, etc.) were important to select the candidate for VAD bridge to heart transplantation.

Adult↗

PubMed1989

[Successful repair of tetralogy of Fallot with severe right ventricular dysfunction using veno-arterial bypass in an adult].

A 35-year-old male with tetralogy of Fallot, who had undergone left Blalock-Taussig shunt at ten year old, developed severe dysfunction of right ventricle with decreased right ventricular ejection fraction of 25% and frequent premature ventricular contractions of right ventricular origin. Following intracardiac procedure, the venoarterial assist circulation was successfully employed for 9 hours, until his hemodynamic conditions were improved. This experience reemphasized the importance of right ventricular protection and mechanical circulatory assist in the surgical treatment of Fallot's tetralogy in older children and adults who developed severe right ventricular dysfunction as a natural history of this disease.

Adult↗

PubMed1988

[Pulmonary flow-resistance relation in allografts ten days after single lung transplantation in dogs].

In order to evaluate the applicability of single lung transplantation as a treatment of pulmonary hypertension, I investigated the relationships between the pulmonary flow and its resistance in allografts ten days after single lung transplantation in dogs. Fourteen dogs underwent single lung transplantation. All dogs received azathioprine (50 mg; given orally) and methylprednisolone sodium succinate (125 mg; given intravenously) every day after operation. Eight dogs survived up to ten days after operation. In the survived recipients and the five healthy dogs, pulmonary flow-resistance relations were investigated. Pulmonary flow was exactly regulated by the pump system, which drained from both cavae and returned to right atrium via azygos vein. The pulmonary artery of native lung or right lung was clamped prior to the measurement. Pulmonary vascular resistance was recorded with the increase of pulmonary flow at the range from 0.3 L/min. to 2.0 L/min. by 0.1 L/min. Lung water was measured by means of Wood's method. Radiographical and pathological examinations were appended. The five allografts received complete studies (successful group) were twice lung water of the healthy lungs (control group) (successful group; 95.6 +/- 16.7 g, control group; 47.8 +/- 7.5 g), and chest roentgenograms of successful group showed mild or moderate consolidation. The other allo-grafts (unsuccessful group), including ones died before investigations, were four times lung water of control group (unsuccessful group; 211.0 +/- 89.6 g), and the chest roentgenograms showed severe consolidation. But any difference was not found in any pulmonary flow between the pulmonary resistance in successful group and in control group. These results show that the allografts, which is under about twice lung water of normal lung, maintains enough pulmonary vascular function, and I concluded that single lung transplantation can be an effective treatment for pulmonary hypertension.

Animals↗

PubMed1988