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Biomedical subjects

R Omoto

Publications and source records attributed to R Omoto.

At least 73 records · Page 4Linked to original sources
PubMed1995

[Clinical result of left ventricular free wall rupture resulting from acute myocardial infarction].

We have treated 10 patients of left ventricular free wall rupture (LVFWR) resulting from acute myocardial infarction (AMI) in our intensive care unit (ICU) from Oct. 1984 to Dec. 1993. Nine of 10 patients underwent surgical repair, however, one patient was treated with pericardocentetesis in ICU and fibrin-glue was infused into the pericardial space (fibrin-glue therapy:FG therapy). The survival rate of surgical repair was only 33% (3/9), especially that was only 17% (1/6) when cardiopulmonary bypass (CPB) was required. One patient (49-year-old, male) suffered from cardiogenic shock following AMI in the posterior wall was performed coronary angioplasty (PTCA) in emergency and IABP support was required. Fourth day after PTCA, a sudden hemodynamical collapse had occurred on this patient due to cardiac tamponade. This patient was treated with pericardiocentetesis in ICU and FG therapy was performed, because all surgical teams were occupied in their operations. After FG therapy hemodynamical stability was obtained, the patient was survived and discharged at 2 months after LVFWR. In conclusion, the surgical result of LVFWR is still not good, especially when CPB was utilized. FG therapy was successful in one patient, suggesting FG therapy can be an alternative therapy for LVFWR when surgical team is not available.

Aged↗
PubMed1995

[Usefulness of intracardiac echocardiography for guidance of transseptal puncture procedure].

The clinical usefulness of intracardiac echocardiography (ICE) for the guidance of transseptal puncture procedure during percutaneous left heart bypass support (PLHBS) and percutaneous transvenous mitral commissurotomy (PTMC) was investigated to replace intraoperative transesophageal echocardiography monitoring which requires mild sedation and causes patient discomfort. The ICE procedure was assessed in 3 patients with PLHBS and 18 with PTMC using a 10 MHz rotating 8 French probe system especially developed for the purpose. Transseptal puncture procedure was observed by intraoperative ICE monitoring in the right atrium. The ICE images showed the transseptal puncture (Brokenbrough) needle as a point casting an acoustic shadow. By moving the ICE probe up and down, the excursion of the needle and its approach to the septal wall could be clearly observed. If the puncture needle is forced into the intra-atrial septum, the septal wall was clearly observed to protrude into the left atrium (tent-formation). In a tent-formation the puncture site could be determined by ICE alone. Intracardiac echocardiography guidance was useful and may improve the safety and reliability of the transseptal puncture procedure in PLHBS and PTMC.

Adult↗
PubMed1994

Evaluation of ventricular septal defect by transesophageal echocardiography: intraoperative assessment.

The miniaturization of transesophageal echocardiography (TEE) probes, together with the development of the capability for biplane imaging from the esophagus, have increased the use of TEE in pediatric cardiology. The aim of this study was to evaluate the TEE findings in patients with ventricular septal defect (VSD) before and after closure primarily by means of pediatric biplane probes. This study group included 69 patients who underwent VSD closure as an isolated repair or as a part of a definitive repair of a more complicated lesion. Ages ranged from 6 days to 15.6 years (median 1 year, 4 months), with operative weights ranging from 2.9 kg to 68 kg (median 10 kg). Preoperative and follow-up transthoracic echocardiograms (TTE) were also performed. Intraoperative TEE was performed without complication in all 69 patients. Preoperative results: (1) anatomic findings: Two muscular VSDs were detected by matrix TEE but could not be observed by TTE. A patient with preoperative TTE diagnosis of an ostium primum ASD was found to have atrioventricular (AV) canal by TEE. In three of six AV canal type VSDs, both TTE and TEE demonstrated left ventricular-right atrial shunting (2) aortic regurgitation associated with VSD: Aortic regurgitation as a result of right coronary cusp prolapse was detected in one of five supracristal VSDs in which the biplane or matrix TEE was used.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Thoracoscopic surgery of spontaneous pneumothorax and partial lung resection].

Fourty-five thoracoscopic operations were done from April 1992 to November 1993. There were 27 cases of pneumothorax, 13 cases of partial lung resection (8 lung biopsies, 3 resection of metastatic lesions, 2 benign lung tumors), 2 cases of mediastinal tumor and 3 other lesions. All procedures were performed under general anesthesia using a double lumen endobronchial tube, and the patient was positioned for a lateral or an axillary thoracotomy as in a standard operation. We operated through three or four trocar wounds of 5 to 12 mm. In case of pneumothorax, we basically used Nd-YAG laser ablation of the bullae but in a few cases that shrinkage of the bullae was not obtained by laser ablation alone we resected them by endoscopic stapler. All cases of partial lung resection were done using endoscopic stapler. Five patients(11.1%) were converted to standard thoracotomy. All the postoperative courses were uneventful and 8 patients(17.7%) did not use any drugs for pain postoperatively. Thoracoscopic surgery is a usefull procedure and has many advantages compared with conventional thoracotomy. However, if the procedure could result incomplete, thoracotomy should be followed without hesitation.

Endoscopy↗
PubMed1994

[Effects of subcutaneous administration of erythropoietin on autologous blood predonation in open heart surgery: Japanese multicenter double-blinded dose-study].

The effects of subcutaneous administration of recombinant human erythropoietin (EPO) on harvesting autologous blood predonation (ABP) and decreasing homologous blood transfusion (HBT) in open-heart surgery were examined prospectively in 132 patients treated in a 32-institute multicenter study. Single doses of 6000, 12,000, 18,000 and 24,000 unit (IU) of EPO with intravenous iron (40 mg) were administered once a week for 3 weeks with ABP (400 ml/week) before surgery. ABP volume (ml), change of blood hemoglobin level (C-Hb), preoperative net blood hemoglobin increase (delta Hb [g/dl] including ABP, perioperative blood loss (ml), and HBT rate, were as follows; [table: see text] Preoperative reduction of Hb (C-Hb) was less in administration dose of 18,000 IU and 24,000 IU than 6000 IU (p < 0.05). The increase of delta Hb was highest in 18,000 IU and HBT rate was lowest in administration dose of 24,000 IU, however, there was no statistical difference. In conclusion, both 18,000 IU and 24,000 IU of EPO treatment is effective to minimize the progression of anemia according to ABP for open heart surgery.

Blood Transfusion, Autologous↗
PubMed1993

Variomatrix--a newly developed transesophageal echocardiography probe with a rotating matrix biplane transducer. Technological aspects and initial clinical experience.

The recently developed multiplane transesophageal echocardiography (TEE) probes cannot provide real-time synchronous biplane imaging. We have developed a new "Variomatrix" probe that combines the advantages of the rotating mechanism of the multiplane probe with the capability of providing simultaneous, side-by-side imaging. Its advantages are: (1) easy manipulation to obtain the optimal planes; (2) avoidance of excessive movement of the probe inside the esophagus; (3) assessment of oblique planes that are not viewed with the usual biplane probe; (4) better understanding of the continuity of structures by the simultaneous, side-by-side biplane, rotating images, providing clearer three-dimensional conception; and (5) shorter examination time by providing a 180 degrees imaging range by rotating the transducer just 90 degrees .

Echocardiography, Doppler↗
PubMed1993

Reduction of reperfusion injury by recombinant human superoxide dismutase administered intravenously just prior to reperfusion.

The reduction of reperfusion injury by intravenous administration of recombinant human superoxide dismutase (r-hSOD) was evaluated in a dog model. Two hours of left anterior coronary artery clamping were followed by 30 min of partial reperfusion and 30 min of full reperfusion. In the SOD group, r-hSOD (100,000 U/kg) was given intravenously 5 min before reperfusion. Measured left ventricular (LV) segments were classified thermographically by temperature drop into central (> or = 2 degrees C) and marginal (< 2 degrees C) areas. The regional LV functions were evaluated by percentages of both segmental (%SS) and active (%AS) shortening. In the central area, the %SS values after reperfusion were -9% in the control group and -3% in the SOD group (p < 0.05). The respective %AS values were 6 and 29% (p < 0.01). In the marginal area, both groups had %SS values of -3% and respective %AS values of 34 and 22% (all not significant) after reperfusion. In the central area, there was significantly better LV function recovery in the SOD group than in the control group.

Animals↗
PubMed1993

[Balloon atrioseptostomy under color flow Doppler echocardiography guidance].

The clinical effectiveness and safety of balloon atrioseptostomy (BAS) under color flow mapping Doppler echocardiography (CFM) guidance was evaluated in 21 BAS procedures performed on 19 patients with cyanotic heart disease (d-TGA 15, PA 1, TA 2, Ebstein's anomaly PA + supramitral ring 1) in the cardiac catheterization laboratory (16 patients) or in the intensive care unit (ICU 3 patients). The indication for BAS was established based on CFM diagnosis. BAS was performed with combined CFM and X-ray guidance on 16 patients prior to cardiac catheterization, and with CFM guidance only on 3 patients in the ICU. A series of BAS was performed until satisfactory interatrial opening was obtained and a complete hemodynamic study was performed by CFM and catheterization after BAS, if possible. In all 19 patients BAS was performed very safely with positioning of balloon in the left atrium, selection of appropriate size of balloon, and the confirmation of the effect of BAS provided by CFM guidance at each step. The size of the interatrial opening was significantly increased from 2.6 to 8.1 mm (p < 0.01) after a series of BAS and the arterial oxygen saturation was significantly increased from 44 to 75% (p < 0.01). CFM provides effective diagnosis and guidance for BAS in severely cyanotic neonates with congenital heart disease, and should significantly contribute to the speed, efficacy, and safety of the procedure.

Catheterization↗