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Biomedical subjects

Tomio Abe

Publications and source records attributed to Tomio Abe.

79 records · Page 5Linked to original sources
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↗
PubMed2002

Ten year clinical experience with the CarboMedics heart valve implants.

We reviewed the histories of 144 patients who underwent heart valve replacement with the CarboMedics prosthesis from 1990 to 2000. There were 74 males and 70 females, with a mean age of 52 years, including 69 aortic valve replacements, 48 mitral valve replacements, and 27 double (aortic and mitral) valve replacements. The mean duration of follow-up was 6.5 years. Early mortality was 7.6% (11 patients). Late deaths occurred in 14 patients, including cardiac-related late deaths in 9 and valve-related deaths in 3. The survival rate including early deaths was 84.7 +/- 3.2% at 5 years and 78 +/- 4.1% at 10 years. Preoperative New York Heart Association Class IV (p = 0.0001) was found to be a significant predictor of cardiac-related late death. Freedom rate from complications at 10 years were embolism 84.7 +/- 4.2% (linearized rate 1.8% per patient year), valve thrombosis 92.7 +/- 2.7% (linearized rate 0.8% per patient year), bleeding 95.6 +/- 2.6% (linearized rate 0.4% per patient year), reoperation 85.9 +/- 4% (linearized rate 1.5% per patient year), valve endocarditis 98.7 +/- 1.3% (linearized rate 0.1% per patient year), and nonstructural dysfunction 90 +/- 3.5% (linearized rate 1% per patient year). There was no structural deterioration. The early and long-term results with the CarboMedics heart valve implantation were acceptable, but valve thrombosis remains a concern in the present study. Further investigation for optimal anticoagulation therapy is necessary to reduce the incidence of valve thrombosis as well as embolic and bleeding complications.

Adult↗
PubMed2002

Satisfactory recovery after 45 minutes of resuscitation in acute aortic dissection.

OBJECTIVES: To report the satisfactory recovery of a woman with acute aortic dissection who underwent cardiopulmonary resuscitation out of hospital and to show that there are still chances of recovery for patients with prehospital cardiopulmonary arrest even due to acute aortic dissection. DESIGN: Case report. SETTING: An adult critical care unit of a university hospital. PATIENTS: A 71-yr-old woman who had a cardiopulmonary arrest out of hospital. Cardiopulmonary resuscitation was performed before arriving at the emergency room of our hospital. INTERVENTIONS: Cardiopulmonary resuscitation, echocardiography, computed tomography, aortography, coronary angiography, ascending aortic graft replacement, and brain hypothermia. MEASUREMENT AND MAIN RESULTS: Restoration of spontaneous circulation was gained 45 mins after onset of cardiopulmonary arrest. Echocardiographic and computed tomographic images revealed cardiac tamponade caused by type A acute aortic dissection. Since involuntary movements of the extremities in response to noxious stimulation were observed at 30 mins after restoration of spontaneous circulation, we performed an ascending aortic graft replacement and postoperative mild brain hypothermia. The patient recovered satisfactorily 1 month after the operation. CONCLUSION: The results of this case indicate that there are still chances of recovery for patients with prehospital cardiopulmonary arrest, even due to acute aortic dissection. We propose that an appearance of involuntary movements of the extremities in response to noxious stimulation is one key point that should be considered when deciding whether to perform an emergency operation for this kind of patient.

Aged↗
PubMed2002

Retroperitoneal bronchogenic cyst: a case report.

A 46-year-old woman presented with a 1-year history of progressive left-arm numbness. A cyst below the left hemidiaphragm was discovered incidentally when a CT scan was performed to examine the thymus for a suspected tumor. A thymic mass was found. MRI indicated that the cyst contained proteinaceous fluid. The thymoma was approached through a median sternotomy and resected, but the cyst was found to be infradiaphragmatic. A separate, left paraspinal incision was made to access the retroperitoneum, and the cyst was resected. Histologic examination showed that the cyst was bronchogenic in origin. Retroperitoneal bronchogenic cysts are very rare, and only four cases have been reported in the English-language literature.

Bronchogenic Cyst↗
PubMed2002

Reoperation for tricuspid regurgitation after total correction of tetralogy of Fallot.

BACKGROUND: The aim of this study is to review the outcome of reoperation for severe tricuspid regurgitation after repair of tetralogy of Fallot. METHODS: Between 1972 and 2000, 12 patients underwent reoperation on the tricuspid valve after total correction of tetralogy of Fallot. The mean age at the time of reoperation was 17 years (range, 1 to 39 years). The mean interval between the initial correction and the reoperation was 7.8 years (range, 10 days to 19 years). The functional class was New York Heart Association class II in 2 patients and class III or IV in 10. Six patients underwent tricuspid valve repair, and the others underwent tricuspid valve replacement. RESULTS: Hospital mortality was 16.7% (2/12). Three patients (30%, 3/10) required a second reoperation 1.6, 9.2, and 15.6 years after the most recent reoperation with no deaths. The reasons for second reoperation were failure of the tricuspid valve repair in two and a thrombosed valve in one. There were two late deaths. Mean overall event-free actuarial survival at 10 years was 46.3%. CONCLUSION: Reoperation for severe tricuspid regurgitation after total correction of tetralogy of Fallot was associated with a high operative mortality and disappointing long-term results. Tricuspid regurgitation after corrective surgery for tetralogy of Fallot must be diagnosed promptly and cured, as tolerance is poor because of postoperative right ventricular insufficiency.

Adolescent↗
PubMedDate not supplied

Preserved atrial response to dobutamine stress after the modified maze procedure for chronic atrial fibrillation: echocardiographic assessment of atrial function.

BACKGROUND: The maze operation is effective in varying degrees for the restoration of atrial function at rest. However, the atrial mechanical function under stressed conditions has not been investigated. METHODS: Thirteen patients who regained normal sinus rhythm after the modified maze procedure for atrial fibrillation (Af) associated with valvular disease were enrolled in this study. A two-staged, low-dose protocol (at doses of 5 and 10 microg/kg/min) of dobutamine stress echocardiography (DSE) was performed to assess the probability of the appearance of atrial wave in 20 consecutive beats (Paw), the velocity of atrial filling wave (Av), and the early filling wave (Ev) with their ratio (A/E), as well as the left atrial area fraction (LAAF) which represents an ejection fraction of the left atrium. RESULTS: Under resting conditions, Paw was 72% and 50% at tricuspid (T) and mitral (M) position, respectively. During dobutamine stress (5 microg/kg/min), Paw tended to increase both at T and M position (86% and 60%, respectively). Av was significantly accelerated by dobutamine stress (10 microg/kg/min) in both T (from 0.36 to 0.54 m/s) and M (from 0.46 to 0.69 m/s) valvular flow, which was accompanied by a significant increase in A/E (from 0.69 and 0.31 to 0.87 and 0.40, respectively). Although heart rate was significantly increased during dobutamine stress, LAAF remained at the same level (0.18, 0.22 and 0.19 at rest, 5 and 10 microg/kg/min) and atrial output was expected to be enhanced by dobutamine stress. CONCLUSION: Restoration of atrial mechanical function after the maze operation is accompanied by preserved response to dobutamine stress.

Adrenergic beta-Agonists↗