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Biomedical subjects

F Maejima

Publications and source records attributed to F Maejima.

5 recordsLinked to original sources
PubMed1993

[A case report of BWG syndrome in an elderly patient performed with mitral valve replacement 11 years after single CABG].

A 46-year-old female who had undergone single CABG for BWG syndrome 11 years ago was referred to our hospital for paroxysmal atrial fibrillation. The roentgenogram showed slightly cardiomegaly and the enlargement of LA. Ischemic changes of ECG appeared at I, aVL, V5, V6, as inverted T wave, and low voltage R wave at V1-V4, but non Q wave. The thallium-201 emission computed tomogram at exercise revealed poor perfusion at apical region without redistribution pattern. Catheterization showed mitral regurgitation (grade III), big right coronary artery (RCA) arising from aorta, rich collateral to poor left coronary artery (LCA), and bypass graft was obstructed. The proximal end of LCA was closed, and didn't arise from both pulmonary artery and ascending aorta. In this cases, MVR only without re-CABG to LCA was selected and performed. Postoperative course was uneventful. The result of this case suggested that MVR was an effective surgical procedure for MR of BWG syndrome in the adult case and it was better to add CABG to LCA as much as possible if the ischemic region was large.

Coronary Artery Bypass↗
PubMed1993

[Late malfunction of the Björk-Shiley valve prosthesis due to Delrin disc defacement].

A 55-year-old woman eighteen years after mitral valvular replacement with Delrin disc Björk-Shiley valve prosthesis underwent a reoperation of prosthetic valve replacement for the prosthetic malfunction due to disc defacement. The patient suffered from faintness and vertigo at rest. An echocardiographic examination showed a moderate mitral insufficiency with a normal disc movement. Precise examination on the removed prosthesis revealed accelerated defacement of disc margin which made the ring-disc clearance up to 0.35 mm and strut-shaped groove formation on the inlet surface of the disc occluder. These findings suggested a pronouncedly earlier disc wear than predicted by Björk and co-workers. We concluded, therefore, that a patient undergone a valve replacement with Delrin disc Björk-Shiley valve should be examined periodically by echocardiography even though being without any symptoms.

Female↗
PubMed1993

[Scintigraphic comparison of graft patency between the left internal thoracic artery and saphenous vein graft after coronary bypass surgery].

Graft patency after coronary bypass surgery (CABG) was evaluated with stress 201-thallium scintigraphy (stress 201Tl) in 26 cases, including 13 cases using the left internal thoracic artery (LITA group) in situ and 13 cases with saphenous vein graft (SVG group). All of them had effort or unstable angina caused by LAD lesion without apparent infarction. Stress 201Tl using a symptom-limited, graded bicycle exercise test was performed before CABG and 1 month, 6 months to 1 year, 1 year to 1.5 years after surgery. Five tomographic images including the apical side of the area fed by the bypass anastomosed to LAD in short axial sections were picked out and piled up. Fan-shaped ROI was made on this area and % Tl uptake was calculated using the following formula. 201Tl counts in ROI--Background counts/Maximum counts--Background counts x 100 (%) The normal % Tl uptake calculated in the control group (n = 11) in this ROI was 68.2 +/- 4.8%. Preoperative % Tl uptake showed 49.3 +/- 0.2% in the LITA group and 54.3 +/- 13.2% in the SVG group. % Tl uptake of the SVG group 1 month after CABG was slightly higher than that of the LITA group, (62.0 +/- 7.0% vs. 56.3 +/- 7.6%). However 6 months to 1 year after, % Tl uptake of the LITA group increased to 60.8 +/- 6.4%, inspite of a tendency on the decrease of that in the SVG group, (59.0 +/- 8.5%), and further more, 1 year to 1.5 years after CABG, increased to 62.3 +/- 5.1% near the normal % Tl uptake of the control group and the SVG group decreased to 58.8 +/- 6.8%. This result suggested that arterial in situ bypass graft might have an auto-regulation and "growing property" corresponding to flow demand, and this helps the excellent long-term patency of arterial bypass grafts.

Adult↗
PubMed1992

[Clinical experience of continuous retrograde cerebral perfusion for assisted circulation during the surgical treatment of acute dissection of aorta: Stanford A type].

Surgical treatment of the dissection involving the ascending aorta or aortic arch represents one of the most complicated technical challenges. Recently continuous retrograde cerebral perfusion (CRCP) is sometimes applied in order to avoid cerebral complications. We compared two surgical groups, one of which was performed graft-replacement of ascending aorta using CRCP and another was utilized normograde cerebral circulation, about the technique of operation, total extracorporeal circulation (ECC) time, aortic clamp time, separate ECC time, total bleeding volume, and urination during operation. In the group using CRCP, separate ECC time was 53 min (mean), and intraoperative bleeding volume was only 1,170 ml. Good urination was obtained during operation. Postoperative courses were uneventful, and consciousness was smoothly and soon recovered. The new method of separate ECC has some advantages over the previously described methods, particularly for avoidance of cerebral complications. As it is not necessary to require dissecting, taping, and clamping of cephalic branches, operative procedure will be very simplified, easier and safer, leading to intraoperative bleeding is a fewer. It is our belief that this method should be widely applied in the operation of graft-replacement of ascending aorta or aortic arch in the near future.

Aged↗