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Biomedical subjects

K Minami

Publications and source records attributed to K Minami.

At least 307 records · Page 17Linked to original sources
PubMed1985

Ventricular arrhythmias late after aortic and/or mitral valve replacement.

Since it is not yet known whether ventricular arrhythmias in patients with valve replacement are associated with an increased risk of sudden death, as in patients with coronary artery disease, a total of 46 patients who were long-term survivors of aortic and/or mitral valve replacement were examined with 24-hour ambulatory electrocardiographic monitoring, and the factors influencing the occurrence of ventricular arrhythmias were analyzed. The significance of ventricular arrhythmias in the prognosis of valve replacement is discussed. The occurrence of ventricular arrhythmias was significantly higher: 1) in patients with aortic stenosis than in those with aortic regurgitation, 2) in patients with multiple valve surgery than in those with single valve replacement and 3) in patients with larger heart size. Pre- and postoperative hemodynamics, including left ventricular function, were not significantly related to the incidence of ventricular arrhythmias. A review of the patients who died suddenly, late after valve replacement suggests that frequent ventricular arrhythmias and thromboembolism are the most important factors in the late mortality of these patients. The prognostic significance of postoperative ventricular arrhythmias in patients with valve replacement requires additional study.

Adolescent↗
PubMed1984

[Reoperation following correction of partial defects of the endocardial cushion (indication, incidence, results)].

In the period between 1955 and 1982, 297 patients underwent surgical correction of a partial AV-canal. Closure of the ostium primum defect was performed either by direct suture or by patch (prosthetic material or pericardium). Only in cases with severe mitral incompetence was the cleft in the anterior leaflet of the mitral valve surgically treated. At an average of 6 years (range: 3 months - 22 years) after the initial procedure 21 patients (7.8 per cent) underwent reoperation. In 20 patients reoperation was necessary for hemodynamic reasons (recurrence of ASD: n = 8; severe AV-valve regurgitation: n = 3; or both: n = 9). One patient with moderate mitral valve incompetence suffered from severe "patch-hemolysis" due to direction of the blood-jet towards the prosthetic patch. Residual or recurrent atrial septal defects were closed by using a patch in cases with previous direct suture (39 patients - 8 reoperations) or by reinsertion or enlargement of the present patch (258 patients - 13 reoperations). AV-valve incompetence could be treated in all cases but two with reconstructive methods. In two patients implantation of a prosthetic valve was necessary. In the single case with "patch-hemolysis" the previous prosthetic patch was replaced by a pericardial one, together with a suture of the mitral cleft 3 months after operation. Mortality of reoperation was 14.5 per cent (3 early deaths). Major complications in the surviving patients did not occur, with one exception: one patient with postoperative total AV-block received a permanent pacemaker.

Adolescent↗
PubMed1983

Comparative study of Kay-Boyd's, DeVega's and Carpentier's annuloplasty in the management of functional tricuspid regurgitation.

In a total of 38 operative survivors who underwent tricuspid annuloplasty for functional tricuspid regurgitation, Kay-Boyd's, DeVega's and Carpentier's methods were compared using a newly developed radioisotope technique together with routine examinations. Carpentier's ring method was most effective for all grades and types of regurgitation. Kay-Boyd's method usually left some residual regurgitation and DeVega's semicircular annuloplasty had unpredictable results. Although the results of tricuspid annuloplasty are influenced by the quality of the repair of the primary lesion as well as the technique of tricuspid annuloplasty itself, we recommend Carpentier's method in the first place. However, further study is mandatory for a definite conclusion.

Child↗
PubMed1983

Echocardiographic evaluation of aortic cusp prolapse in children with ventricular septal defect.

Echocardiograms were obtained from 48 Japanese children with ventricular septal defect (16 having aortic cusp prolapse, Group I, and 32 without it, Group II). In the case of right coronary cusp prolapse, the right coronary sinus protrudes anteriorly into the right ventricular outflow tract, and thus, the anteroposterior diameter of the aortic root increases. In the case of non-coronary cusp prolapse, the non-coronary sinus bulges posteriorly into the right ventricle, and thus, the aortic root increases in size. For evaluating the degree of these prolapses quantitatively, we measured the aortic root diameter echocardiographically and expressed them as a percent of a normal one. In Group I the aortic root diameter was 131 +/- 9% (mean +/- SD) and in Group II it was 105 +/- 7%, and the difference between the 2 groups was statistically significant (p less than 0.001). In Group I 14 of the 16 patients had a value greater than 120%, while all 32 patients of Group II had a value smaller than 120%. Thus, in children with ventricular septal defect, an aortic root diameter greater than 120% of normal suggests the presence of aortic cusp prolapse. Systolic semiclosure of the aortic valve was found in 8 patients of Group I (50.0%) and in 2 of Group II (8.7%). Coarse systolic fluttering of the pulmonary valve with an amplitude of greater than 3 mm was detected in 6 of Group I (40.0%) and in 3 of Group II (10.0%). Therefore, semiclosure of the aortic valve and fluttering of the pulmonary valve are considered to be also useful for evaluating aortic cusp prolapse qualitatively.

Adolescent↗