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Biomedical subjects

M Naganuma

Publications and source records attributed to M Naganuma.

At least 55 records · Page 3Linked to original sources
PubMed1984

[Surgical treatment of pulmonary atresia (PA) and critical pulmonary stenosis (PS) with intact ventricular septum (IVS)].

Patients with PA: IVS and critical PS: IVS tend to have hypoplastic right ventricles and tricuspid valves. There is a large range of hypoplasia, but the relationship between the size of the right ventricle cavity and the size of tricuspid valve ring were found to be statistically significant. Pulmonary valvotomy alone is usually not adequate for the first stage operation and a systemic-pulmonary shunt procedure often become necessary. Use of PGE1 improved the overall clinical prognosis of these patients. The appropriate operative method for the second stage operation should be determined by measuring right ventricle volume and evaluating the degree of hypoplasia of the right ventricle, tricuspid valve and pulmonary artery. In three patients with right ventricle and tricuspid hypoplasia, we performed the Glenn procedure in addition to right ventricle outflow reconstruction and obtained good surgical results.

Child, Preschool↗
PubMed1983

[Surgical treatment of total anomalous pulmonary venous connection].

Surgical experience of 70 patients with TAPVC between 1966 and 1982 were reviewed. Their age ranged from 2 days to 13 years. Fifty-two patients (74%) were below 6 months of age, 36 (51) below 3 months and 17 (24%) were neonates, respectively. Thirty-seven patients (56%) were with supracardiac type, 14 (20%) were with cardiac type and 12 (17%) were with intracardiac type. Results of operation below 6 months of age were unsatisfactory. Only 10 patients including 3 neonates out of 52 survived. However, 16 of 18 patients over 6 months of age survived. Early referral and emergency intracardiac repair is important in small babies as well as precise operation and fine bypass technique. Patients with supersystemic pulmonary hypertension immediately after surgery showed poor prognosis. Long-term results with 26 survivors were satisfactory. Eighty-one % of them showed sinus rhythm and %LVEDV and LVEF were within normal range in 6 patients investigated. In recent years, surgery without angiocardiography is recommended as the diagnostic ability of UCG developed. However, care must be taken as to some rare complicated pulmonary venous connection and associated cardiac anomaly such as VSD. Also, it should be recognized that pulmonary venous beds in neonates and early infancy demonstrated various degree of mascularization , medial hypertrophy and endothelial cell proliferation in intraacinar pulmonary veins. They were more marked in cases with intracardiac type TAPVC .

Adolescent↗
PubMed1981

Case histories of neonates with congenital heart disease.

The rate of extracardiac malformation (ECM) associated with congenital heart disease (CHD) is high in neonates. 108 cases of 212 neonates with CHD had ECM (50.9%). Main ECMs were digestive system anomalies (36.1%), chromosomal aberrations (26.8%), respiratory system anomalies (21.3%), CNS anomalies (13.0%), and other (2.7%). Single lesion of left to right shunt accounted for 77.2% (61/79) of CHD with ECM from other than chromosomal aberrations. The prognosis of neonates with CHD without ECM was also studied. Total anomalous pulmonary venous connection, pure pulmonary atresia (PPA), pulmonary stenosis (PS), hypoplastic left heart syndrome are not generally associated with ECM, but the prognosis is poor. Coarctation complex which is sometimes associated with ECM has a poor prognosis in neonates. There is an increase of the survival rate in the patients with hypoxemia, such as PPA or severe PS, extreme tetralogy of Fallot, and tricuspid atresia, which can be managed with prostaglandin E1. PDA associated with respiratory distress syndrome is ideally treated with indomethacin. In recent years, mortality from PDA has decreased in neonates. The mortality rate during the neonatal period was 46.8% (51/109): 37.5% (30/80) died before surgical interventions and 72.4% (21/29) died during or after surgery. Half of neonatal deaths from CHD occurred within 3 days of admission. Thus, early detection, early diagnosis, and early treatment of neonates with CHD is most important.

Abnormalities, Multiple↗
PubMed1978

Chromosomal aberrations and congenital heart diseases.

The incidence of chromosomal aberration with CHD is 10.5% in the autopsy cases. 2. The characteristic major cardiac malformations associated with chromosomal aberration are conal abnormality, abnormal septation and cardiac valve abnormalities. 3. The characteristic association of chromosomal aberration and CHD is CAVO in Down syndrome, triple shunts and multivalvular disease in 18 trisomy, shunts in delition syndrome and coarctation of the aorta in Turner syndrome. 4. Minor cardiac anomalies associated with chromosomal aberration are valve dysplasia such as bicuspid semilunar cusps, parachute A-V valve, thickning, deformity and insufficient differentiation of valve and of chordae tendinae and hypoplastic or immature papillary muscles. 5. Primary target in cardiovascular involvement by chromosomal aberration might be a cement property of the connective tissue which is expected to conseal the foramens and shunts and to develop valve structures in embryonic heart.

Chordae Tendineae↗