Search PubMed⌕ Search

Biomedical subjects

N Nishiwaki

Publications and source records attributed to N Nishiwaki.

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

[A case of combined septal perforation and cardiac rupture after acute myocardial infarction].

We experienced a rare surgical case of combined septal perforation and cardiac rupture after acute myocardial infarction. The patient was a 78-year-old woman, who had an extensive acute anterior myocardial infarction and underwent emergency PTCR and PTCA successfully. One hour later, she collapsed in a state of electro-mechanical dissociation and was transferred to the operating room. Emergency operation confirmed the diagnosis of free wall rupture of the left ventricle combined with septal perforation, which was successfully repaired. She recovered well during four weeks postoperatively, however she died due to septic shock following pneumonia on 32nd postoperative day. This report describes a clinical features of this rare case, and also reviews another six cases previously reported in the literature.

Aged↗
PubMed1990

[Experience of perioperative myocardial infarction with graft patency following coronary artery bypass graft surgery].

Coronary artery bypass graft surgery, with current operative mortality rates of one to three percent, is now an accepted treatment for coronary artery disease. However, perioperative myocardial infarction (PMI) is not a rare complication of this procedure, and the precise mechanism of its occurrence is not well elucidated. We experienced a case of 70-year-old man who had transmural hemorrhagic PMI in the distribution of the grafted vessel and died due to low output syndrome in spite of vigorous treatment. All five grafts were found to be well patent at autopsy. In this case, the cause of PMI was supposed to be inadequate intraoperative myocardial protection and reperfusion injury.

Aged↗
PubMed1990

[Abrasion perforation of two intra-aortic balloons].

We report two patients whose intra-aortic balloons exhibited delayed perforation caused by prolonged contact of the balloon against calcific atheromatous plaque. Perforation was diagnosed by the presence of blood in the tube connecting the balloon. Leak detection systems were useless to diagnose this complication. We believe that the balloon immediately should be removed at the presence of blood in the tube.

Aged↗
PubMed1989

[A case report of intravenous leiomyomatosis of the uterus with extension into the right pulmonary artery].

Intravenous leiomyomatosis (IVL) is a rare neoplastic disease which is defined as the extension into venous channels of histologically benign smooth muscle tumors arising either from a uterine myoma or from the walls of a uterine vessel. We report a case of IVL originating from the uterus, growing up in the inferior vena cava, and extending into the right pulmonary artery. The patient was a 42-year-old woman, who was admitted to our hospital with clinical signs of right-side heart failure and syncope in December 1987. Her medical history included a total hysterectomy in August 1986. On examination, two dimensional echocardiography showed a freely floating tumor in the right atrium and right ventricle, which protruded via the inferior vena cava. Cavography confirmed the above findings. Because of the clinical disability caused by the tumor localized in the right heart, emergency operation was performed, extracorporeal circulation was instituted through the femoral vein, the superior vena cava, and the femoral artery. Opening the right atrium confirmed that a white sausage-like mass quite free from the wall extended into the right ventricle, and the head of the tumor was adherent to the right pulmonary artery. After detaching the head of the tumor from the right pulmonary artery, the remaining tumor in the inferior vena cava was also successfully pulled out. The operative specimen was measured 55 cm in length, but the basal end of the tumor was supposed to be left in place. Two months later, the second-stage operation for the remaining tumor was carried out through a median laparotomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
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↗
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↗