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Biomedical subjects

S Komatsu

Publications and source records attributed to S Komatsu.

At least 343 records · Page 19Linked to original sources
PubMed1985

[A long-term prognosis of ventricular septal defect associated with aortic regurgitation].

Fifty-one cases of ventricular septal defect associated with aortic regurgitation (VSD and AR) were examined for past twenty-two years. Only VSD closure was performed for AR cases under Sellers II regurgitation. After the average of 11.6 years' follow-up, 14 cases retained over 60 mmHg of diastolic pressure and belonged to NYHA functional class 1. VSD closure and aortic cusp suspension were performed for AR cases over Sellers II regurgitation. Three cases operated before 1969 died of cardiac failure and one case recently died of infectious endocarditis (IE). Because of residual AR, one case was performed re-aortic cusp suspension one year after the operation and another case was scheduled for re-aortic cusp suspension after three years and eight months. Eighteen cases with malfunctioned valve caused by calcification, etc. underwent the aortic valve replacement. Early death was due to low cardiac output syndrome (LOS). Five cases were followed up for eleven years on the average. Two cases were found atrial fibrillation and myocardial infarction, respectively. Four cases were VSD + AR with the past history of IE and one died of LOS after surgery. Two cases were postoperative IE. One died three months after the operation and the other is doing well after the re-surgery by translocation. A long-term finding of SV1 + RV5 by electrocardiogram showed a significant decrease in left ventricular overload. Significant decrease of cardiothoracic ratio was observed in AR group under Sellers II regurgitation. Pulse pressure was significantly decreased as well.

Adolescent↗
PubMed1985

[Current status of cardiac valve prosthesis].

Cardiac valve replacement has been clinically applied for the final therapeutic management of valvular heart disease for the last over 20 years. Cardiac valve prostheses are mainly divided into mechanical and biological valves. As mechanical valve, tilting disc valve or bi-leaflet center opening valve made of antithrombogenic and durable pyrolytic carbon are now widely used. As biological valve, porcine aortic valve or bovine pericardial valve treated with glutaraldehyde-tanning for maintenance of cusp durability and pliability are exclusively used at the present time. However, valve related complications such as thrombus formation, embolic event, infection, hemolysis and valve sound in mechanical valve and valve failure and infection in biological valve are unavoidable clinical problems. Therefore, the cardiac valve prostheses should be selected on the basis of patients medical, social and geographical conditions. It is still necessary to develop the ideal prosthesis without the late complications in connection with decision of optimum surgical timing, and technological improvement of materials and structural design.

Bioprosthesis↗
PubMed1984

Successful surgical treatment of prosthetic valve endocarditis and aortic root abscesses.

Repeated aortic prosthetic valve endocarditis and aortic root abscesses were successfully treated by implantation of a valved conduit into the ascending aorta and by placement of saphenous vein grafts to the aorta distal to the conduit and to the right and left anterior descending coronary arteries. This procedure provides several advantages, and six months after operation, the patient was in a satisfactory hemodynamic state and free from infection.

Abscess↗
PubMed1984

[Indications of extracorporeal surgery (autotransplantation) for upper urinary tumors and renal calculi].

Renal preservation and cure of bilateral occurrence of renal tumors or stones as well as occurrence in solitary kidney put all urologists on the thorns of dilemma. Application of extracorporeal surgery resulting in autotransplantation of the kidney for such complicated cases seems useful. Case 1 was a bilateral renal Wilms' tumors in a 17-month-old boy, case 2 and 3 were undiagnosed tumors in renal pelvis and ureter. Extracorporeal surgery enables an accurate partial nephrectomy and yet helps to avoid not only the dissemination of tumor cells, but also undesired nephrectomy in case of benign origin. On the contrary, bilateral nephrectomy followed by dialysis or homo-transplantation will result in an immunosuppressive state and the radicality may only be temporary. Besides, the 5-year survival of dialysis therapy is in the range of 60-65%. Thus the indication of autotransplantation was signified in the tumor situation of case 1. For the 2nd and 3rd cases, this method seems to be the best in satisfying the dilemma in discussion. Likewise, the complicated renal calculi could be completely removed without further deterioration of renal function if they were extracorporeally treated and autotransplanted. We proved that 83% of the difficult stones can be completely removed under hypothermia in situ. For application of autotransplantation to the calculous disease, we feel observation of contraindication is essential for better results at this stage.

Adult↗