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Biomedical subjects

M Ohmi

Publications and source records attributed to M Ohmi.

119 records · Page 7Linked to original sources
PubMed1979

Surgical treatment for hypoplastic left heart syndrome: case reports.

A 58-day-old girl with hypoplastic left heart syndrome underwent bypass grafting from the pulmonary artery to the descending aorta, ligation of the ductus arteriosus, and banding of the main pulmonary artery distal to the graft. Anastomoses of the graft were performed by partial clamping of the arteries under moderate surface hypothermia. The patient tolerated the procedure well and was discharged from the intensive care unit on the eleventh postoperative day, but she died on the twentieth day of metabolic derangement. Our total experience with this anomaly includes three other infants, and a summary of these patients and applied surgical procedures are presented. Surgical and diagnostic considerations for this anomaly based on our experiences are discussed.

Aorta, Thoracic↗
PubMed1978

Surgical treatment of annuloaortic estasia: experience in 7 consecutive patients.

Seven patients with annuloaortic ectasia were treated according to the method described by Bentall and De Bono. A Björk-Shiley valve in a composite graft was the prosthesis of choice and was used in all patients except 1, who received a Starr-Edwards valve. Profound topical cooling without selective coronary perfusion was applied in 5 patients for myocardial preservation during aortic occlusion. The was 1 operative death and 1 late death, the latter from cerebral thromboembolism. Five survivors have been followed from 1 year 5 months to 2 years 10 months with an average follow-up of 2 years. Excellent results were obtained in all survivors, their physical capabilities putting them in Class I of the New York Heart Association Functional Classification. Postoperative aortograms showed no signs of kinking or compression of vascular prostheses nor abnormalities of prosthetic calves. A modified technique to secure graft fixation is discussed.

Adolescent↗
PubMedDate not supplied

Hemodynamic performance in a heterotopically transplanted dog heart: proposal of techniques for working left heart model of heterotopic (abdominal) heart transplantation.

To study hemodynamics together with various aspects of rejection after experimental heart transplantation, we developed a technique to produce a working left heart model of heterotopic (abdominal) heart transplantation. The interatrial septum and tricuspid valve of the donor heart are removed. The pulmonary arterial trunk, pulmonary veins, and inferior vena cava are ligated, and the stumps of the donor aorta and superior vena cava are anastomosed in an end-to-side fashion to the recipient abdominal aorta and inferior vena cava, respectively. Arterial blood from the recipient abdominal aorta thus perfuses the donor myocardium through the coronary artery, and the donor left ventricle receives venous blood from the recipient inferior vena cava as preload. In this model, the donor left ventricle does not pump out enough venous blood to desaturate the recipient femoral arterial blood but does generate approximately the same pressure as the recipient's heart. This model is reproducible, easy to manage, and can be applied to heterotopic heart transplantation in various experimental animals including rats.

Abdomen↗
PubMedDate not supplied

Superior mesenteric artery aneurysm secondary to infectious endocarditis.

A case of superior mesenteric artery aneurysm secondary to infectious endocarditis is presented. Although selective angiography was necessary to detect the shape and precise location of the aneurysm, non-invasive diagnostic techniques including ultrasonography and computed tomography were also useful in detecting the aneurysm and planning the management of this unusual condition. Mitral valve replacement and aneurysmorrhaphy with bypass grafting of the superior mesenteric artery were successfully performed.

Aneurysm, Infected↗
PubMedDate not supplied

Myocardial tissue blood flow in allotransplanted rat heart with a special reference to acute rejection.

To evaluate the severity of acute rejection of the homologous heart, myocardial tissue blood flow was measured after a heterotopic heart transplantation in rats. The autograft group (Lewis to Lewis) and the allograft group (DA to Lewis) were compared by graft survival time, myocardial tissue blood flow, myocardial water content, and degrees of histologic alterations. Average graft survival times were longer than 100 days in the autograft group and 5.9 +/- 0.4 days in the allograft group. In the autograft group, myocardial tissue blood flows on postoperative days 1 and 5 were 206 +/- 12 and 189 +/- 18 ml/min/100 gm myocardial wet weight in the left ventricle and 205 +/- 11 and 188 +/- 12 ml/min/100 gm myocardial wet weight in the right ventricle, respectively. In the allograft group, myocardial tissue blood flows on postoperative days 1, 3, and 5 were 222 +/- 30, 164 +/- 22, and 141 +/- 49 ml/min/100 gm myocardial wet weight in the left ventricle and 202 +/- 17, 156 +/- 15, and 147 +/- 46 ml/min/100 gm myocardial wet weight in the right ventricle, respectively. Myocardial tissue blood flows in both ventricles showed significant decreases on days 3 and 5 as compared with those on day 1. Myocardial water content did not alter significantly by day 5 in the autograft group, registering 77.9% +/- 0.6% and 78.4% +/- 1.6%. Myocardial water contents in the allograft group increased significantly as rejection progressed.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMedDate not supplied

Leakage across the premoulded dacron baffle used for correction of transposition of the great arteries.

The use of a pre-moulded dacron baffle, as described by Dillard, and used as an interatrial baffle in transposition of the great arteries resulted in an extensive leakage of blood through the baffle for several days. Pre-clotting of the baffle on one occasion only was ineffective in preventing the leakage. But complete sealing was effected by pre-clotting three times according to the method of Sauvage. These clinical findings were confirmed by microscopic analysis. A porous baffle way will be an advantage in patients with pulmonary hypertension when it would act as a safety valve.

Angiocardiography↗
PubMedDate not supplied

Successful surgical correction in two patients with tricuspid atresia using autologous pericardial valve-bearing tube graft.

A modification of the Fontan procedure has been used successfully to correct tricuspid atresia in two children who had severe hypoplasia of pulmonary artery. In the first patient (who had functioning Gleen anastomosis) the hypoplastic left pulmonary artery was widened by an angioplasty, and then a Dacron external conduit containing an autologous pericardial valve (an autologous pericardial valve-bearing tube graft) was positioned to lead from the right atrial appendage to the left pulmonary artery. A large secondum type atrial septal defect was closed by a Dacron patch. In the 2nd patient, a Dacron external conduit without any valve was placed between the right appendage and the hypoplastic right ventricle and then the pulmonary outflow tract was widened by using an autologous pericardial valve patch, which was an extension of the external conduit. The ventricular and atrial septal defects were closed with patches. Both patients made a satisfactory recovery and doing well 4 months after the operation. This type of modification of the Fontan procedure may provide a more effective functional correction for patients with tricuspid atresia who are accompanied with severe pulmonary hypoplasia.

Bioprosthesis↗
PubMedDate not supplied

Proposal of a working left heart model with a heterotopic transplantation technique in rats.

BACKGROUND: A heterotopically transplanted rat heart model described by Ono and Lindsey in 1969 has been widely used as a fundamental animal model of heart transplantation. However this "nonworking" model is greatly different from the orthotopic heart in view of left ventricular work, in which the experimental results obtained may not always reflect the clinical setting with an orthotopic transplanted "working" heart. We herein propose a new "working" left heart model in rats using a heterotopic abdominal transplantation technique by modifying the method of Ono and Lindsey. METHODS: First, a donor heart graft and a recipient were prepared in the conventional fashion. Second, the donor heart was tailored by the ligation of main pulmonary artery and the removal of tricuspid valve and interatrial septum. Third, the ascending aorta and right atrium of the donor heart were anastomosed to the infrarenal abdominal aorta and to the inferior vena cava of the recipient, respectively. Consequently, the left atrium and ventricle of heart graft were loaded with the blood from the right atrium through the interatrial communication. RESULTS: This surgical procedure required an average of 58 minutes and had negligible operative risk. The donor left ventricle produced a systolic blood pressure almost equal to the recipient's aortic pressure and maintained vigorous beat. CONCLUSIONS: This model is easily reproducible and would be useful for various studies on heart transplantation.

Animals↗
PubMedDate not supplied

Effects of cyclosporine and 15-deoxyspergualin on coronary arteriosclerosis after heart transplantation in the rat.

The development of graft coronary arteriosclerosis remains a serious consequence after heart transplantation and may limit long-term survival. The purpose of this study was to evaluate the effects of 15-Deoxyspergualin on graft coronary arteriosclerosis after heterotopic heart transplantation in a rat model and compare the effects to those of cyclosporine treatment. Two groups of Lewis rats (n = 7 each group) underwent heterotopic heart transplantation from Fischer 344 donors and were treated with either cyclosporine (10 mg/kg/day) or 15-Deoxyspergualin (3 mg/kg/day). Histologic evaluations of rejection (scale: 0 = none, 3 = severe) and graft coronary arteriosclerosis (scale: 0 = normal, 4 = occluded) were made 60 days after transplantation. No significant difference was found between the two groups with respect to the degree of rejection (2.0 +/- 0.7 in the cyclosporine-treated group versus 2.0 +/- 0.5 in the 15-Deoxyspergualin-treated group). However, the extent of graft coronary arteriosclerosis in the 15-Deoxyspergualin-treated group was significantly less than that seen in the cyclosporine-treated group (1.11 +/- 0.34 versus 1.71 +/- 0.24, p < 0.01). Furthermore, the incidence of diseased vessels among all observed vessels was significantly lower in the 15-Deoxyspergualin-treated group compared with the cyclosporine-treated group (63% +/- 12% versus 76% +/- 7%, p < 0.05). Although the protective mechanism of 15-Deoxyspergualin is unknown, it most likely possesses a different immunosuppressive mechanism of action from cyclosporine. We concluded that 15-Deoxyspergualin is superior to cyclosporine in preventing graft coronary arteriosclerosis after heart transplantation.

Abdomen↗