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Biomedical subjects

K Esato

Publications and source records attributed to K Esato.

At least 253 records · Page 14Linked to original sources
PubMed1989

[Congenital coronary artery fistula draining into the superior vena cava with giant saccular aneurysm--report of a case].

A 42-year-old woman who had a coronary artery fistula, associated with a giant coronary saccular aneurysm was reported. The coronary artery fistula originated from the proximal portion of the right coronary artery drained into the superior vena cava. The chief complaint was heart murmur which was detected at the 2nd intercostal space of the right sternal border. No other symptoms were present. The aneurysm was approximately 5 X 7 cm in size. In the operation using cardiopulmonary bypass, the proximal and distal portions of the coronary artery fistula were ligated successfully without aneurysmorrhaphy. The postoperative conditions was even without any complications. Congenital coronary artery fistulas with a giant saccular aneurysm should be surgically treated as soon as possible because of potential risk of aneurysmal rupture.

Adult↗
PubMed1989

[Early operation for postinfarction ventricular septal perforation; report of three cases].

Three patients underwent surgery for postmyocardial infarction ventricular septal perforation (VSP) within 3 to 21 days after onset of infarction. The hemodynamic stabilization was not obtained despite aggressive medical treatment including Intra-aortic Balloon Pumping (IABP) in one patient. The others had sudden hemodynamic deterioration during IABP support. In two of the three cases, the VSP were closed via transinfarct ventriculotomy with double Dacron patch, and ventricular wall reconstruction was performed to sandwich the double septal patch between ventricular free walls with Dacron felt strips. Two of the three patients survived. Our experience suggests that early surgical intervention is essential unless medical therapy results in clinical improvement and the double patch method may provide a successful operative repair and comeout.

Adult↗
PubMed1989

[Changes in postoperative colloid oncotic pressures after open heart surgery especially in relation to recovery of the hemodynamic and respiratory status].

In order to evaluate the relationship among the changes of colloid oncotic pressure (COP), hemodynamic and respiratory recovery after open heart surgery, cardiac index (CI), pulmonary capillary wedge pressure (PCWP), (A-a)DO2, urine output and COP were measured in 33 patients during 48 hours after the cardio-pulmonary bypass (CPB). The patients were divided into three groups according to COP values at 3 and 24 hours after CPB. Twenty three patients whose COP values were normal (COP greater than or equal to 19 mmHg) at 3 hours after CPB maintained stable hemodynamic and respiratory status. Cardio-respiratory status were deteriorated in the 6 patients whose COP values were below normal both 3 and 24 hours after CPB. On the other hand, 4 patients with normal (A-a)DO2 and low COP values at 3 hours after CPB demonstrated rapid recovery of COP values and improvement of cardiac function. It is concluded that the patients with both cardiac and respiratory dysfunction have low COP values during 48 hours after CPB, but the patients with normal (A-a)DO2 and low COP at 3 hours after CPB demonstrate the recovery of COP values with rapid improvement of cardiac function until 24 hours after open heart surgery.

Cardiopulmonary Bypass↗
PubMed1989

[Surgical considerations after patch closure of atrial septal defect with tricuspid annuloplasty].

Two patients with complications of embolism during the early postoperative period after patch closure of atrial septal defect with tricuspid annuloplasty were reported. Case 1: A 58-year-old woman underwent closure of an atrial septal defect and tricuspid annuloplasty by means of Kay's technique for tricuspid regurgitation. She had an episode of thromboembolism in the bilateral common femoral arteries 7 days after surgery. Thromboembolectomy was performed successfully using Fogarty's embolectomy catheter. Case 2: A 49-year-old woman underwent closure of an atrial septal defect and the tricuspid annuloplasty using Carpentier ring for tricuspid regurgitation. The patient had transient left hemiparesis on the 5th postoperative day. Both patients had atrial fibrillation and mild pulmonary hypertension before surgery. In relatively old patients (over 40 years old) with atrial septal defect, tricuspid regurgitation and atrial fibrillation, anticoagulant therapy should be started immediately after surgery to prevent thromboembolism.

Female↗
PubMed1988

[Levels of plasma cyclic AMP in cardiac surgery].

The actions of hormones such as catecholamines, vasopressin and growth hormones are mediated by a common intracellular second messenger, cyclic AMP (adenosine 3',5'-monophosphate). The effects of cardiac surgery on plasma cyclic AMP were studied in 32 adults patients with aorta-coronary bypass or with valvular disease. Blood specimens were obtained before operation, at the beginning and at the end of the cardiopulmonary bypass, 1, 3, 6, 9, 12, 24, 48, 72, 168 hours after surgery. The plasma cyclic AMP level during cardiac operation was elevated above the preoperative level. High levels of plasma cyclic AMP were found both in the aorta-coronary bypass and in the valvular disease immediately after the end of cardiopulmonary bypass. The plasma cyclic AMP level in patients undergoing aorta-coronary bypass with aortic clamping time more than 60 minutes was 38.6 +/- 11.7 pmol/ml, compared to 25.6 +/- 6.6 pmol/ml with aortic clamping time less than 60 minutes immediately after the end of cardiopulmonary bypass. In patients undergoing valve replacement and/or commissurotomy with aortic clamping time more than 60 minutes, the plasma cyclic AMP level immediately after the end of cardiopulmonary bypass was 113 +/- 63.3 pmol/ml, compared to 45.4 +/- 10.3 pmol/ml with aortic clamping time less than 60 minutes (p less than 0.01, Student's t test). During 24 hours after cardiac surgery, the plasma cyclic AMP concentration returned to normal range. It is considered that the plasma cyclic AMP level reflects the risk of cardiac surgery in response to homeostatic derangement.

Cardiac Surgical Procedures↗
PubMed1986

[Surgical approach to abdominal aortic aneurysm with malignant alimentary tract tumor: report of three cases].

The clinical courses of three cases with various alimentary tract malignant lesions coincidental with abdominal aortic aneurysm were reported. Of those three patients, a simultaneous resection of the malignant lesion and aneurysm was carried out in two patients, while an secondary abdominal aneurysmectomy following the resection of the malignant lesion was done in one patient. A 70-year-old man with cancer of the cecum and an infra-renal abdominal aneurysm, was diagnosed preoperatively, and a simultaneous right hemicolectomy and aneurysmectomy were carried out. In the other patient, a 77-year-old man, presence of the gastric cancer was incidentally found at laparotomy and a 75 percent gastrectomy and an aneurysmectomy were carried out. In the third patient, both gastric cancer and an abdominal aneurysm were detected preoperatively. Distal partial gastrectomy was performed first because of severe epigastralgia and an asymptomatic aneurysm. The abdominal aneurysmectomy was carried out six months later. All patients were treated by daily administration of Cefazolin sodium or cefalotin sodium (4-10 g) and Dibekacin sulfate (200 mg) for seven to ten days postoperatively. In the case of second look operation, however, Fosfomycin 2-4 g/day was added to the above mentioned drug following the aneurysmectomy. All tolerated surgery well without any signs of infections. The first patient died on the 57th postoperative day from panperitonitis carcinomatosa following an episode of intestinal obstruction. Selection of the operative approaches for patients having both an alimentary tract malignant tumor and an abdominal aortic aneurysm was difficult, although the initial surgical intervention for the more life threatening lesion would be better justified.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1986

[Methods of suppression of a myonephropathic metabolic syndrome after infra-renal aortic occlusion].

Acute arterial occlusion of the extremities may result in severe and complex metabolic derangement. In order to evaluate the development and means of therapeutic control of metabolic derangements following the acute arterial occlusion of extremities, 32 adult mongrel dogs weighing between 7 and 15 kg underwent acute arterial occlusion by cross-clamping the infrarenal aorta. The experimental animals were divided into two groups: an untreated group, and treated group. The former was divided into three groups--12, 24 and 48 hour's arterial occlusive groups and the latter into two groups with 48 hour's arterial occlusion--tris (hydroxymethyl) aminomethane (THAM) and perfusion groups. Biochemical and electrolyte analyses were measured before occlusion, immediately before, and 1, 3, 12, 24 and 48 hours after the release of the occlusion. The SGOT, CPK, aldolase, creatinine and blood urea nitrogen levels rose after the release of the occlusion and were significantly higher in the 48 hour's group than in the 12 and 24 hour's occlusive groups. Among these enzymatic changes, the creatinine and urea nitrogen levels were high 48 hours after the release of the occlusion, though the others decreased with time after the occlusion release. The blood pH level fell after the occlusion in the untreated groups and these levels increased slowly after the release of the occlusion. However, there were no significant differences in the blood pH among the untreated groups. The acute arterial occlusion by cross-clamping the infra-renal aorta caused severe renal damage among the various organs. In the groups treated with THAM and perfusion, the SGOT, CPK, aldolase, creatinine and blood urea nitrogen levels remained almost at preocclusion levels after the release of the occlusion. There were statistically significant differences in these enzymatic changes between the treated group and the 48 hour's occlusive group without treatment. The blood pH levels in the treated groups showed minimal changes after the release of the occlusive, although there were no significant differences in the blood pH between the treated groups and the 48 hour's occlusive group without treatment. It was concluded that the intravenous administration of THAM and peripheral washing were effective against untoward metabolic changes occurring in the ischemic extremities.

Acute Disease↗
PubMed1985

Aneurysms of the descending aorta: surgical experience with three methods of adjunct procedures.

Thirteen patients were surgically treated for the repair of aneurysms of the descending aorta, using three different types of adjunct procedures--an external temporary bypass with a vascular prosthesis, a tridodecylmethylammonium chloride (TDMAC) or a partial cardiopulmonary bypass. There was no operative death, though one patient died 73 days following surgery. Significant intraoperative morbidity occurred in 3 patients: one had ventricular fibrillation and the other two massive hemorrhages. There was no instance of paraplegia or renal failure. The only significant complication that developed was pulmonary insufficiency in two patients with a pump bypass. The mean operative time and the mean aortic occlusion time in patients with the TDMAC shunt were shorter than the times in patients with the vascular prosthetic shunt or the pump bypass. TDMAC shunt required no special equipment and cannulation was simpler and safer.

Adult↗
PubMed1984

Depression of host-defence mechanisms following cardiac surgery.

The purpose of the present study was to determine the effects of open-heart surgery on host-defence mechanisms, by studying serial changes in serum immunoglobulins, circulating lymphocyte function in patients undergoing open-heart surgery. Serum proteins and immunoglobulins were significantly depressed immediately after operation and these depressions were correlated to the degree of the durations of cardiopulmonary bypass and associated hypothermia. White cell counts in peripheral blood increased significantly after operation. In contrast, total circulating lymphocytes were depressed postoperatively. The depression of circulating lymphocytes was mainly due to a marked decrease in the number of T-cells. Mitogen responses of lymphocytes stimulated by phytohemagglutinin were also depressed postoperatively. The quantitative and qualitative depression of cell-mediated immunity following open-heart surgery was observed. However, these depressions returned to preoperative levels in one week and had no clinical significance.

Adult↗
PubMed1984

[A comparison with Dardik graft and Mindich graft on arterial bypass].

Arterial reconstruction using human umbilical cord vein graft as a vascular prosthesis was carried out in 24 patients, 26 legs, with arteriosclerosis obliterans. Dardik grafts were used in 13 legs and Mindich grafts in 13 legs. Twenty-six operations were divided into two groups; one with the proximal anastomosis above the femoral artery (proximal group) and the other with the proximal anastomosis below the femoral artery (distal group). Postoperative evaluation of all patients was performed at intervals of one to twenty-two months. To make the determination of graft patency, at least, it was required that the graft pulse was palpable. Cumulative patency rates were 54% and 69% in the Mindich grafts and Darkik grafts, respectively. In the proximal group, patency rates were 60% and 50% in Mindich grafts and Dardik grafts, respectively. While in the distal group, patency rates were 37.5% and 78% in Mindich grafts and Dardik grafts, respectively. The causes of the graft obstruction were as follows: 1) graft infection in 4 (2 with Mindich and 2 with Dardik grafts) 2) pseudointimal hyperplasia of the distal anastomosis in 4 with Mindich graft, 3) progression of atherosclerosis in one case with Dardik graft, and 4) substandard Dardik graft in one. It was concluded that Dardik graft should be used as first choice when compared with Mindich graft and these grafts should not be used easily, since these grafts were apt to be infected.

Aged↗