Search PubMed⌕ Search

Biomedical subjects

K Shiroma

Publications and source records attributed to K Shiroma.

At least 37 records · Page 2Linked to original sources
PubMed1991

[A case of mitral valve replacement due to mitral regurgitation after percutaneous transvenous mitral commissurotomy (PTMC)].

A 58-year-old woman, who had congestive heart failure due to mitral regurgitation after percutaneous transvenous mitral commissurotomy, underwent mitral valve replacement. It is reported that mitral regurgitation more often occurs after PTMC in patients with severely calcified mitral valve or advanced subvalvular lesion than in those without. Our experience indicated that PTMC should be carefully performed in institutions which have a surgical team ready for emergency operation.

Catheterization↗
PubMed1990

[A right atrial thrombus after Fontan procedure--a case report].

A 17-year-old male with tricuspid atresia who underwent a modified Fontan procedure died due to heart failure 4 years and 6 months after operation. At autopsy a thrombus was found in the right atrial appendage. From the experience, it might be recommended to excise the appendage when the modified Fontan procedure leaving the appendage was employed. In addition, anticoagulation therapy as well as regular echocardiographic examination for detecting thrombus formation should be considered after the operation.

Adolescent↗
PubMed1990

[Postoperative long-term quality of life at present after total correction of tetralogy of Fallot].

We performed a questionnaire study in 47 patients who underwent corrective surgery for tetralogy of Fallot (TF) more than 10 years previously. To evaluate quality of life, we used well-being score advocated by Kaplan. 12 patients whose well-being score was 1.0 were in entirely good health without any complaints. Well-being score of patients averaged 0.773 with the range from 0.58 to 1.0. The patient with high RV/LV pressure ratio or large CTR tended to have a low well-being score. Grade of Lown classification did not correlate to well-being score.

Adolescent↗
PubMed1990

[A study of the long-term graft patency using a saphenous vein graft following aorto-coronary bypass surgery].

Long term graft patency after aorto-coronary (A-C) bypass surgery has been reported in the West and the data shows a lower patency rate in saphenous vein grafts (SVG) than internal mammary artery grafts. We studied the long term SVG patency in cases of Japanese patients at our institute, and we have compared our results with those in the West. The subjects, including children, were 211 cases who received A-C bypass surgery using at least one SVG from Jan., 1975 to Sept., 1989. 182 of these cases (examination rate: 86%) received a postoperative angiography one or three months after surgery. The postoperative study took the form of either a selective coronary angiography or a digital subtraction angiography. In 81 cases, using the same two methods, graft patency was reconfirmed from one to eleven years after surgery. Early graft patency including children was 95%. Long term graft patency in the adult cases was 89% from 1 to 2 years (mean: 1.3 years), 94% from 2 to 5 years (mean: 3.2 years), 88% from 6 to 11 years (mean: 7.1 years) following the operation. Six patients died during the post operative follow up period. Two cases were sudden death, one resulted from a reoperation for recurrent angina, two were caused by malignant neoplasm and other was the result of a cerebro-vascular accident. The results correlating the long term graft patency using a SVG and long term mortality were not as negative at our institute as they have been in studies done in the West.

Adult↗
PubMed1990

[A case of a patient with the non-confluent main pulmonary artery with the left pulmonary artery after a left Blalock-Taussig shunt for tetralogy of Fallot, which underwent a successful two staged radical repair].

We report on a 14-year-old girl with tetralogy of Fallot and the non-confluent main pulmonary artery with the left pulmonary artery after a left Blalock-Taussig shunt. She underwent a left-sided classic Blalock-Taussig shunt at the age of one. However, she showed repeated dyspnea and increasing cyanosis, and cardioangiography showed the non-confluent main pulmonary artery with the left pulmonary artery. Corrective surgery of tetralogy of Fallot was done by a two-staged operation. In the first stage, a EPTFE prosthesis was grafted between the main pulmonary artery and the left pulmonary artery, and in the second stage, intracardiac operation was performed. The late postoperative status and hemodynamic results were satisfactory and we emphasize the rational for this approach.

Adolescent↗
PubMed1989

Ventricular premature contraction after repair of tetralogy of Fallot--the influence of postoperative factors, particularly the right ventricular regional wall motion.

The presence and severity of ventricular premature contraction (VPC) in 35 patients with tetralogy of Fallot (TF) were studied, 5 to 10 years after intracardiac repair (ICR), using treadmill exercise testing and 24-hour ambulatory monitoring. VPCs were observed in 24 patients (68.6%). The patients were classified into two groups according to the types of VPCs: group A (23 patients) without VPCs or with VPCs of Lown's grade 1 and group B (12 patients) with VPCs of Lown's grade 2, 3 or 4. Group B patients were found to have significantly higher right to left ventricular peak-systolic pressure ratios and higher right ventricular peak systolic pressures than those of group A. But there were no significant differences between the two groups in operative age, the time lapse between ICR and evaluation, the duration of exercise and so on. Group B patients also showed significantly decreased right ventricular regional wall motions in the right ventricular outflow tracts (ROTs), indicating akinetic or paradoxical movements than group A patients. It is thought that postoperative right ventricular hypertension and the akinetic or paradoxical wall movement of the ROT may have some effect on the genesis of postoperative VPCs after repair of TF.

Cardiac Complexes, Premature↗
PubMed1989

Postoperative core-temperature rhythm of patients who underwent cardiac surgery.

Core-temperature rhythms of 16 patients who underwent cardiac surgery were studied and tow types of rhythm pattern were recognized. One showed a non-stationary part in the rhythm whereas the other did not. The non-stationary part of the rhythm was thought to be an expression of the disturbance caused by surgical intervention. Patients who suffered from 'ICU syndrome' showed a low-amplitude rhythm.

Adult↗
PubMed1988

[Risk scores for ventricular premature contraction and exercise--performance after repair of tetralogy of Fallot].

Thirty-five patients with tetralogy of Fallot (TF), were studied for the postoperative factors which might have some effect on the presence and severity of ventricular premature contraction (VPC) and exercise performance (EP). Using the factors, we tried to make VPC- and EP-scores. Of the 35 patients, 12 (34%) showed VPCs of Lown's grade 2 or higher (group B) and 23 (66%) were free from significant VPCs (group A). Group B patients were found to have significantly higher postoperative right to left ventricular peak systolic pressure ratios (RV/LV) and higher right ventricular peak systolic pressures (RVP) than those of group A. The right ventricular regional wall motion (RVRWM) in the right ventricular outflow tracts of group B patients showed akinetic or paradoxical movements. VPC-scores using RV/LV, RVP and RVRWM showed that 11 patients, whose score were 0, were free from significant VPCs and showed that 6 of 7 patients (86%), whose score were 3, demonstrated significant VPCs. It was shown that RV/LV, left ventricular ejection fraction (LVEF), CTR and pulmonary regurgitation (PR) affected the exercise tolerance. In the case of EP-scores, using RV/LV, LVEF, CTR and PR, the endurance times of the patients who had higher scores seemed to be shorter. VPC- and EP-scores as a tool for predicting the presence of VPCs and the level of exercise performance seem to be quite useful.

Adolescent↗
PubMed1987

Postoperative deep body temperature rhythm.

The postoperative deep body temperature rhythms of fifteen patients who received aorto-coronary bypass surgery (group I), and of seven patients who received non-cardiac major surgery (group II), were studied. Postoperative patients, especially those who received aortocoronary bypass surgery, showed greatly disturbed deep body temperature rhythm. There existed infradian and ultradian rhythm in both groups, and there existed two patients in group I who did not show sinusoidal rhythm. The patients of group I also showed a longer period of rhythm than did those of group II. The mesor and amplitude of the patients in group I showed a greater individual variation than did those in group II. The acrophase of both groups deviated widely. The patients who underwent cardiac surgery needed a longer time for temperature rhythm recovery than did those who underwent general surgery.

Adult↗
PubMed1987

[Risk factors in the surgical repair of tetralogy of Fallot: analysis of preoperative factors by stepwise regression].

Fifty-one patients undergoing total repair of tetralogy of Fallot between November 1977 and June 1985 were analyzed with respect to determinants of operative mortality and postoperative right to left ventricular peak systolic pressure ratio (RV/LV). The risk factors were age, sex (Sex), previous shunting operation (Shunt), extent of right ventricular outflow tract patch (Patch), various PA-indexes, maximal left atrial volume/BSA (LA/BSA), left ventricular end diastolic volume index (LVEDVI), LVEDVI/normal-LVEDVI, RV/LV, Hb, BSA and weight. Univariate analysis indicated that RV/LV and LA/BSA were associated with operative death. A model for operative mortality with three variables emerged from the multiple stepwise regression analysis: Patch, Shunt and Sex (R = 0.421, R2 = 0.177, F = 3.37). A model for predicted RV/LV with five variables: Weight, Shunt, BSA, Patch and Sex (R = 0.602, R2 = 0.363, F = 5.12). However, it was thought difficult to predict operative mortality and postoperative RV/LV by the preoperative variables. Intra- and postoperative factors might have larger influences on operative mortality and RV/LV than the preoperative ones.

Analysis of Variance↗