Biomedical subjects
Publications and source records attributed to M Aoshima.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A cardioplegic solution containing blood with a low level of ionic calcium was prepared independent of pump-oxygenator perfusate blood, so as to contain a constant concentration of each component at any given time. Using this solution, Jatene's anatomic repair under prolonged periods of aortic cross-clamping ranging from 117 to 184 minutes (mean: 149 min) was performed on seven young infants with simple complete transposition. The ages of the patients ranged from 34 days to 3 months, with a median age of 2 months. Four patients, aged 39 days, 41 days, 2 months and 3 months, survived and showed uneventful postoperative hemodynamics. Two of the three non-survivors were considered retrospectively to have been unsuitable candidates for Jatene's anatomic repair due to their low left ventricular pressure (LV/RV pressure ratio less than 0.60 in both). The remaining infant who died had TGA with a large ventricular septal defect of the muscular type and developed a postoperative residual shunt. It was considered unreasonable to attribute the cause of death in this case to inadequate myocardial protection. Judging from our experience with these four survivors who underwent prolonged aortic clamping ranging from 117 to 160 minutes, our cardioplegic solution and the technique of its administration were considered to be effective and promising for heart surgery in young infants and neonates.
The Blalock-Taussig (BT) shunt was performed in two infants with simple transposition of the great arteries (TGA) after poor response to septostomy not only to improve hypoxia but also in expectation of preparing the left ventricle for later anatomic correction. One patient had adequate muscle mass and pressure of the left ventricle after the shunt and underwent successful anatomic correction. The other patient developed intractable heart failure following the shunt. Anatomic correction was performed with success in this patient after pulmonary artery banding and takedown of the BT shunt. Based on these experiences, if heart failure does not develop or is controllable after BT shunt, there may be a possibility of later anatomic correction. However, if uncontrollable failure occurs, the shunt should be taken down and arterial or venous switch correction should be performed as soon as possible.
Three cases of tumor thrombus that originated from a hepatocellular carcinoma in the liver and extended into the right atrium are described. All patients had received both resection of the tumor thrombus and lobectomy of the liver either simultaneously or independently within a short interval. Surgical order and extracorporeal circulation system were varied depending on the thrombus extension. Two of the patients died within 4 months of surgery due to different reasons and the other is doing well at 24 months after surgery.