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Biomedical subjects

Y Wanibuchi

Publications and source records attributed to Y Wanibuchi.

At least 109 records · Page 6Linked to original sources
PubMed1984

Prolonged Veno-Arterial Bypass with membrane oxygenator for profound cardiogenic shock following cardiac surgery experience in 13 cases.

As a mechanical cardiac support, prolonged (over 5 hrs) Veno Arterial Bypass (VAB) with membrane oxygenator was indicated to 13 patients who was profound cardiogenic shock following open heart surgery, among 1700 cases of cardiac surgery (0.8%). In 12 of 13 cases, cardiopulmonary bypass could not be weaned after intracardiac repair, despite maximal pharmacological management with or without IABP support. Another one case was intractable ventricular fibrillation in ICU, two days after operation. Six of 13 patients who were supported by prolonged VAB, survived and discharged from the hospital. In survivors, mean of VAB flow was 900 +/- 265 ml/min/m2, in died 7 cases, mean of VAB flow was 1450 +/- 550 ml/min/m2 (p less than 0.05). The longest duration of VAB in survivors was less than 28 hrs. Improvements of anticoagulation and VAB circuits make it safer to manage prolonged VAB. For profound cardiogenic shock, prolonged VAB is an easy and safe mechanical cardiac support not only in surgical cases but in internal medical cases.

Adolescent↗
PubMed1983

[Are foreign body calcifications late reactions following augmentation mammaplasty?].

We describe 47 patients aged 20 to 63 years in whom a mammaplasty had been performed (43 by an injection method, four by surgery). Calcification round the foreign body occurred in 71.5% of the paraffin group (ten out of 14 cases) and in 17% of the silicone group (eight out of 33 cases). The interval between implantation and calcification is fairly constant in the paraffin group; of 11 patients whose implant was older than 15 years, ten showed calcification. In the silicone group, only one out of ten cases showed calcification. In the silicone group, the material itself is thought to be responsible since (with the exception of one case done in 1956) all cases treated between 1966 and 1971 showed calcification irrespective of the interval.

Adult↗
PubMed1983

Recent results and problems in the surgical treatment of acquired valvular heart disease.

From June, 1977 to August, 1981, 388 patients underwent open heart surgery for acquired valvular heart diseases. The over-all surgical mortality rate during this period was only 4%, but a high incidence of postoperative complications (26% for major complications) was still observed. It is an urgent concern for all cardiac-surgeons to reduce postoperative complications in order to obtain better surgical results. Even with improved techniques in modern cardiac surgery, 28 patients with a giant left atrium were still in the high risk group, with an over-all mortality rate of 29% and with a high incidence (68%) of postoperative complications. This seemed to be attributable mainly to deteriorated conditions such as cardiac cachexia, but not necessarily to impaired pulmonary function. Therefore, more careful considerations should be paid not only for their circulatory and pulmonary conditions, but also for the improvement of their general condition, including nutrition and metabolism. On the other hand, 27 patients with infective endocarditis showed a remarkable improvement after prosthetic valve replacement in spite of their seriously deteriorated preoperative condition. There were 4 hospital deaths (15% mortality). All transferred to our institution in a far advanced stage of the disease. Early surgical intervention for intractable cardiac failure should be strongly recommended for these patients.

Adolescent↗
PubMed1982

Etiology of mitral regurgitation in secundum atrial septal defect.

Non-rheumatic mitral regurgitation was found in 9.1% (27 patients) of all patients with secundum atrial septal defect (298 patients) who were operated on during a 13-year period at the Mitsui Memorial Hospital. This combined lesion was more frequent in female (12.3%, 19 patients) than male (5.6%, 8 patients), and the incidence tended to increase with age. Inspection at operation revealed a marked fibrous thickening of the anterior and posterior mitral valve leaflets with a localized bulging into the left atrium in the posteromedial commissural area. Similar, but less prominent change was found in nearly all patients above 20 years of age with mitral regurgitation, although the small area where the commissural chordae were attached was not involved. A friction between anterior and posterior mitral leaflets due to abnormal left ventricular motion secondary to the right ventricular volume overload might be responsible to the genesis of this lesion. Mitral annuloplasty was performed on 21 of 27 patients with a satisfactory result without operative mortality. Except one case of early death from cerebral thromboembolism they were all restored to a functional status of class I by NYHA standard within one year after operation, and there were no late death during a follow-up period of as long as 12 years. We propose a new entity "ASD, MR complex" for this combined lesion, as it demonstrates a specific pathophysiology, and necessitates a different procedure for surgical correction from that of a secundum atrial septal defect without other anomalies.

Adolescent↗
PubMed1981

[Scinti-angiographic investigation of aortic dissection (author's transl)].

We perform scinti-angiography regularly in suspected cases of dissecting aneurysms. In our experience, the dissection is well demonstrated by this method. In correctly selected cases, scinti-angiography is a method which is well tolerated by the patient and which carries very little risk, since the complications due to contrast media are absent.

Aortic Dissection↗