Biomedical subjects

Ryuji Koshima

Publications and source records attributed to Ryuji Koshima.

3 recordsLinked to original sources

PubMed2006

Aortic valve myxoma mimicking vegetation: report of a case.

We report a case of cardiac myxoma of the aortic valve. To our knowledge, this represents only the seventh such case ever documented. A 61-year-old woman underwent an echocardiography to screen for hypertensive-diabetic cardiac complications, which showed a mass on her aortic valve. Although she had not experienced a fever, the mass closely resembled a vegetation, resulting in an initial diagnosis of infective endocarditis. We extirpated the mass and repaired the aortic valve with the patient under cardiopulmonary bypass. The postoperative course was uneventful. Histological examination confirmed that the mass was a myxoma.

Aortic Valve↗

PubMed2006

Initial clinical experience with the Heartstring.

OBJECTIVE: The Heartstring is one of the devices that enable proximal anastomosis without clamping the aorta. We have applied the device not only to low-risk patients with normal aortas but also to high-risk patients with diseased aortas. The purpose of this study was to investigate the initial outcomes of using this device. METHODS: The Heartstring was used on 87 patients between January and December 2004. The patients comprised 62 men and 25 women 48-86 years old (mean 68.4 +/- 8.4 years). The ascending aorta was evaluated by computed tomography (CT) scanning before surgery. If a patient's aorta was severely calcified, epiaortic echocardiography was performed. The aortas were ranked into four grades, and the preoperative patient's status were evaluated by the EuroSCORE. Angiography was performed on the third postoperative day. RESULTS: CT scanning revealed that 74 patients had no calcification in the ascending aorta, 10 patients had scattered calcification, and 3 patients had plate-like calcification. The EuroSCORE was 6.86 +/- 1.03. We performed 93 proximal anastomoses and 149 distal anastomoses. The average distal anastomosis was 1.6 +/- 0.6 sites per graft. Of the distal anastomoses, 74.2% were to the circumflex artery territory. Postoperative coronary angiography revealed that all grafts were patent. CONCLUSION: The Heartstring facilitates safe proximal anastomosis, even in high-risk patients. Their short-term outcome was good. The device assists in bypassing circumflex artery territory. Long-term follow-up is necessary.

Aged↗

PubMed2002

Hypothermia with heparin-coated circuits and low dose systemic heparinization in neurosurgery.

The purpose of this study was to evaluate the safety of profound hypothermic circulatory arrest with heparin-coated circuits and low dose systemic heparinization in the treatment of cerebral aneurysms. Surgery for giant intracranial aneurysms not operable using standard neurosurgical techniques was performed in 8 patients. All patients were placed on cardiopulmonary bypass using the closed-chest technique, except for the first patient who underwent open-chest bypass. Heparin was administered systemically (3,000 IU) and into the circuit (1,500 IU). Total circulatory arrest was begun at 20 degrees C. The D-dimer, alpha2 plasmin inhibitor-plasmin complex, thrombin-antithrombin III, and beta-thromboglobulin concentrations were measured to evaluate the changes in the coagulation and fibrinolytic systems during bypass. There were no neurologic or cardiac complications. None of the indicators of platelet activation, coagulation, or fibrinolysis were elevated. Hypothermic circulatory arrest combined with heparin-coated circuits and low dose systemic heparinization is safe for use in neurosurgery.

Adult↗