[Re-evaluation of persistent arrhythmia following surgery of atrial septal defect].
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Adolescent↗
Biomedical subjects
K Koja
Publications and source records attributed to K Koja.
[Antihemolytic effect of alpha-tocopherol(vitamin E) during extracorporeal circulation].
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Adult↗
Late complications in traumatic coronary artery fistula: report of a case requiring surgical repair after 8 years.
We report the unusual case of a patient with traumatic coronary artery fistula who had been free of symptoms for more than 4 years, but who ultimately required surgical repair 8 years after the trauma due to late complications including angina pectoris, atrial flutter and fibrillation, congestive heart failure, and tricuspid regurgitation. Our findings suggest that early surgical repair should be undertaken in cases of traumatic coronary artery fistula, even if the shunt is minimal and early symptoms are mild. The persistence of, or a slow increase in, shunt flow over the years greatly increases the risk of the ultimate development of life-threatening complications.
Angina Pectoris↗
Popliteal artery entrapment syndrome. Report of two cases.
We treated two patients with popliteal artery entrapment syndrome. In one, the popliteal artery was entrapped and obstructed in its abnormal course around the medial head of the gastrocnemius muscle, which was inserted into the femur laterally and cephalad (type II in Delaney's classification). In the other patient, the popliteal artery followed a normal course but was compressed laterally by the medial head of the gastrocnemius muscle, which was aberrantly inserted into the femur considerably higher and more lateral than usual, and was occluded. This could not be fitted into Delaney's or Insua's classification. Arterial reconstruction was successful with an autovein graft in the former case and an in situ bypass graft in the latter. We suggest a modification of type IV in Delaney's classification, so that when the popliteal artery is compressed by an aberrant muscular or tendinous structure in the popliteal fossa it can be included.
Adult↗
Crural artery bypass with adjunctive arteriovenous fistula. A modification in distal anastomosis.
We carried out crural artery bypass with an adjunctive arteriovenous fistula in 8 lower extremities of 7 patients with severe ischemic symptoms and poor distal run-off. Mean blood flow rates in the implanted grafts ranged from 43 to 340 ml/min and those of the reconstructed crural arteries from 20 to 100 ml/min. A stenotic lesion was noted on postoperative angiogram in one patient and stasis symptoms caused by downward blood flow into the distal veins in another. The other patients have remained well with good function of the grafts 1-5 years after surgery. We modified the distal corner of the anastomosis as follows: three additional interrupted simple sutures were made on the anterior wall of the concomitant arteriotomy and venotomy incisions after making the common posterior wall of the vessel incisions. A vascular pocket formed at the distal corner of the anastomosis prevents stricture at the anastomosis. The vein is finally ligated just distal to the fistula to intercept downward blood flow into the distal veins. This modification in technique is recommended to prevent stricture of the distal anastomosis and postoperative stasis symptoms.
Aged↗
Antithrombotic and vasodilating effects of OP-41483, a prostacyclin derivative.
Anti-platelet and vasodilating actions of OP-41483, a derivative of prostacyclin, were studied experimentally and clinically. The ADP-induced human platelet aggregation was significantly inhibited in vitro, the rate being 59% with a dose of 3 micrograms/ml, 75% with 6 micrograms/ml and over 90% with 18 micrograms/ml or more. A significant reduction in deposition of platelet and mural thrombi on the chemically injured luminal surface of the canine femoral vein was observed by treatment with topical administration of the solution (10 micrograms/ml) and/or intravenous infusion (10 ng/kg/min). The blood flow rate of the normal canine femoral artery and the anterior or posterior tibial artery of patients with peripheral arterial occlusive disease at the ankle was moderately increased in cases of intravenous infusion of the compound at a rate of 10 ng/kg/min.
Adenosine Diphosphate↗
Tibial artery autogenous in situ vein bypass with adjunctive arteriovenous fistula.
A man suffering from severe intermittent claudication of the right calf and foot was successfully treated by femoro-tibio-peroneal trunk autogenous vein bypass with adjunctive arteriovenous fistula. Prior to operation, he was unable to walk more than 50 meters without resting. Preoperative arteriography revealed extensive occlusion of the popliteotibial arteries, except for indistinct visualization of the tibio-peroneal trunk, in which conventional reconstructive surgery seemed not to be feasible because of poor distal run-off. An autogenous vein bypass graft between the distal superficial femoral artery and tibio-peroneal trunk was successfully made "in-situ", creating an adjunctive arteriovenous fistula. Postoperatively, the ankle pressure index of the posterior tibial artery was considerably increased from 0 to 0.65, and Doppler flow wave could be recorded. The patient can now walk more than 1,500 meters without resting.
Arteriovenous Shunt, Surgical↗