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Biomedical subjects

G Satomi

Publications and source records attributed to G Satomi.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Cases of multiple ventricular septal defects].

We had 4 cases with multiple ventricular septal defects (VSDs) in complexed congenital heart disease. One of four had two separate VSDs detected by two dimensional echocardiography before operation. Second of four had additional infundibular muscular VSD which was detected by echocardiography in the intensive care unit (ICU) after patch closure of a perimembranous VSD. The third case had two additional VSDs of inlet muscular and subaortic septum detected by transesophageal and direct echocardiography during reoperation, beside a subpulmonary VSD which was originally diagnosed before Jatene operation for double outlet right ventricle. The fourth case had multiple trabecular muscular VSDs diagnosed by postoperative angiography soon after Rastelli operation. Since these additional multiple VSDs compromise the postoperative hemodynamics if those are unrecognized, it is indispensable to detect all VSDs before operation, using transthoracic and transesophageal echocardiography.

Echocardiography↗
PubMed1997

[Successful repair of a newborn case with total anomalous pulmonary venous connection presenting hemodynamically common pulmonary vein atresia].

Common pulmonary vein atresia is a very rare from of congenital cardiac anomaly in which the common chamber of pulmonary veins has no direct communication to the heart or systemic venous system. We report here on one-day-old boy with total anomalous pulmonary venous connection having severe stenosis (sized less than one millimeter in diameter) of vertical vein between common pulmonary vein and superior vena cava. His anatomic feature was considered as a spectrum between common pulmonary vein atresia and total anomalous pulmonary venous connection because of almost atretic draining vertical vein. His clinical presentation and hemodynamic characteristics were the same as common pulmonary vein atresia. He underwent an emergent anastomosis of common pulmonary vein to left atrium at 33 hours after birth under cardiopulmonary bypass, cross-sectional echocardiography and Doppler color mapping. He was discharged home two months after the surgery. Cardiac catheterization after six months revealed normal cardiac function without any evidence of pulmonary venous chamber stenosis. To improve the outcome of surgical intervention for this life-threatening cardiac anomaly, immediate the precise diagnosis using echocardiography followed by emergent surgical correction is in dispensable.

Cardiac Surgical Procedures↗
PubMed1997

[A surgical case of severe Ebstein's anomaly, pulmonary atresia in the neonate: experience of modified Starnes operation].

We report a surgical case of severe Ebstein's anomaly associated with pulmonary atresia in the neonate. The baby had remarkable cardiomegaly (CTR > or = 90%) soon after birth and presented severe respiratory distress. He underwent modified Starnes operation (closure of tricuspid valve using a perforated patch, enlargement of interatrial communication, modified Blalock shunt, and PDA ligation) at the age of 12 days. He survived the procedure and cardiopulmonary failure was improved. However, he died from arrhythmia on the 3rd postoperative day. We think this procedure is useful regard to improvement of cardiopulmonary failure due to this fatal congenital heart disease.

Cardiac Surgical Procedures↗
PubMed1996

[Assessment of Japanese patients receiving heart transplants overseas].

No heart transplants have been performed in Japan due to various obstacles since the only operation performed in 1968. Since 1981, a number of patients requiring heart transplants have been accepted by foreign transplantation centers in England, the U.S.A., and Germany. This report describes an investigation of the postoperative course of these Japanese heart transplant patients and discusses the problems regarding transplantation in Japan. Of the 21 transplant patients, the diagnosis was dilated cardiomyopathy in 17, restrictive cardiomyopathy in 1, hypertrophic cardiomyopathy in 2, and congenital muscle dystrophy in 1. All patients survived surgery but three died in the long-term period. The causes of death were acute rejection (after 3 months), chronic rejection (after 50 months) and infection (after 30 months). The actuarial survival curve of these patients was 95.0% for one-year survival and 86.4% for three-year survival. The postoperative functional class was NYHA classification I in all patients (100%). Ninety-three percent of patients returned to work. Immunosuppressive therapies included triple drug therapy in 14 patients (66.7%), double drug therapy in 4 (19.0%), ciclosporin alone in 2 (9.5%) and FK506 in 2 (5.0%). The incidence of acute rejection was 1.56 episodes per patient per year within 3 months and 2.9 episodes per patient per year within 1 year. The postoperative courses of Japanese patients who underwent heart transplantation at foreign transplantation centers were satisfactory. These results will encourage heart transplantation in Japan.

Adolescent↗
PubMed1995

[Anomalous origin of the right pulmonary artery from the ascending aorta: a case report].

We report a successful case of anomalous origin of the right pulmonary artery from the ascending aorta. A 34 days old infant, who had suffered from cardiogenic shock, underwent a direct anastomosis of the right pulmonary artery to the main pulmonary artery behind the ascending aorta under cardiopulmonary bypass. Postoperative catheterization showed no significant stenosis over the anastomosis and normalized pulmonary artery pressure. We conclude that early surgical correction is necessary in the treatment of this life threatening disease.

Anastomosis, Surgical↗
PubMed1995

[Two cases of gross E-type tracheo-esophageal fistulae associated with interruption of the aortic arch and coarctation of the aorta in early infancy].

Two cases of Gross E-type tracheoesophageal fistulae associated with interruption of the aortic arch in one and coarctation of the aorta in the other in early infancy were treated radically at Nagano Children's Hospital during the preceding 4 months until January 1994. The tracheoesophageal fistulae were noticed after the first stage surgery for the aortic arch anomalies, because of the remarkable abdominal distension under the intubated and ventilated condition of general anesthesia. Both the bronchial and esophageal optical fiber examinations were performed which proved useful to detect the fistulae. In each case, the transcervical division of the fistula was performed on an emergency basis. The external diameter of the fistula was 4 and 5 mm respectively. The fistulae dilated synchronously with ventilation. The early detection and surgical correction of the tracheoesophageal fistula can prevent serious complications such as DIC as seen in the first case probably caused by respiratory infection associated with the prolonged mechanical ventilation. Successful intracardiac repair were performed in both cases on the 25th and 7th day following the correction of the fistulae respectively.

Aorta, Thoracic↗
PubMed1995

[A case of one stage-repair of interrupted aortic arch and ventricular septal defect in neonate using a separated cardiopulmonary bypass].

We report a case of one stage-repair of interrupted aortic arch and ventricular septal defect in neonate. The operation was performed at the age of 14 days. After a median sternotomy incision, a separated cardiopulmonary bypass was commenced through the ductus and a 4 mm EPTFE graft which was anastomoted to the right subclavian artery. Cerebral circulation was maintained through the graft during reconstruction of the aortic arch. Our method is useful regarding that brain damage can be avoided which may be induced by total circulatory arrest.

Aorta, Thoracic↗
PubMed1994

Intravascular stents for management of pulmonary artery and right ventricular outflow obstruction.

This study was performed to determine the efficacy of balloon-expandable stents in the treatment of branch pulmonary artery-stenoses and conduit stenosis in children. A total of eight stainless steel stents were implanted in seven patients. Three patients had tetralogy of Fallot with pulmonary artery stenosis following total correction, one patient had conduit stenosis following correction of transposition of the great arteries, one patient had intra-cardiac conduit stenosis after septation for single left ventricle, and two patients had pulmonary artery stenosis after Fontan operation. Six stents were placed in the branch pulmonary arteries, one in the extracardiac conduit, and one in the intracardiac conduit. The mean age at implantation was 13 +/- 3 years and the mean weight 37 +/- 12 kg. Follow-up time ranged from 0.3-2 years. The diameter of pulmonary arteries with stenoses increased from 5.6 +/- 2.2 mm to 10.6 +/- 1.8 mm (n = 7). The systolic pressure gradient decreased from 56 +/- 26 mmHg to 22 +/- 16 mmHg (n = 5). No embolization or thrombotic event has been noted. One stent placed in the intracardiac conduit was compressed and fractured. These data indicate that balloon-expandable stents are useful in the treatment of pulmonary artery branch stenoses and extracardiac conduit stenosis in children. The use of stents for intracardiac stenosis may result in stent fracture.

Adolescent↗
PubMed1993

Right aortic arch with aberrant retroesophageal innominate artery: a report of 2 cases and review of the literature.

We describe two patients of right aortic arch associated with aberrant retroesophageal innominate artery. One case was associated with tetralogy of Fallot and a tortuous left common carotid artery originating from the retroesophageal innominate artery. Tetralogy of Fallot associated with this kind of aortic arch anomaly has never before been reported. The other case was associated with a perimembranous ventricular septal defect. Symptoms such as dyspnea, dysphagia and recurrent respiratory infection due to the compression by the vascular anomaly were not noted in these two cases. The morphological findings are indicative of a double aortic arch with an interruption of the left arch proximal to the common carotid artery.

Aorta, Thoracic↗
PubMed1992

Imperforate tricuspid valve with dysplasia of the right ventricular myocardium, pulmonary valve, and coronary artery: a clinicopathological study of nine cases.

Nine cases of imperforate tricuspid valve associated with dysplasia of the right ventricular myocardium, pulmonary valve, and right coronary artery are described. The mean frontal QRS axis of the electrocardiograms did not indicate left axis deviation in seven of the nine. Two-dimensional echocardiograms showed an imperforate tricuspid valve, normally aligned atrioventricular septum, and an irregular-shaped right ventricular cavity with a thin wall. In three cases with absence of the pulmonary valve, pulsed Doppler echocardiograms of the right ventricular outflow tract revealed antegrade flow during systole and retrograde flow during diastole, and selective angiography through a persistent ductus arteriosus showed retrograde filling of the blind-ended right ventricular cavity via the main pulmonary artery. Necropsy examinations showed an imperforate tricuspid valve with a thin-walled aneurysmal right ventricle in all six cases examined. Pulmonary atresia was observed in two cases, and the absence of the pulmonary valve in four. The right coronary artery was hypoplastic in four cases and absent in two. A shunt operation should be carried out in early infancy to prevent hypoxia after closure of the ductus arteriosus.

Abnormalities, Multiple↗
PubMed1992

Color Doppler and transesophageal echocardiography of vascular sling.

Three patients with vascular sling were studied by two-dimensional and color Doppler echocardiography and angiocardiography. One case was associated with atrial septal defect and another with tetralogy of Fallot and patent ductus arteriosus. The third case had no associated intracardiac anomalies. Color Doppler flow mapping was performed in all three patients, and transesophageal echocardiography was studied in two patients. Color Doppler echocardiography showed the characteristic features of this congenital anomaly in all three patients, especially in detecting the site of anomalous origin of the left pulmonary artery. A small patent ductus arteriosus was misinterpreted as the normal left pulmonary artery in one patient. Small pulmonary arteries in the patient with tetralogy of Fallot made the diagnosis difficult. Using transesophageal echocardiography, we clearly identified the trachea, esophagus, and abnormal left pulmonary artery.

Airway Obstruction↗
PubMed1991

[Echocardiographic manifestations of excessive pulmonary artery banding in patients with transposition of the great arteries without ductal or ventricular shunt].

Recently, pulmonary arterial banding (PAB) and the Blalock-Taussig shunting operation (B-T) have been performed as a preparatory procedure for Jatene's operation for patients with complete transposition of the great arteries (TGA) without patent ductus arteriosus (PDA) or ventricular septal defect (VSD). We reviewed the echocardiographic findings of 29 patients after PAB and B-T. Four cases had abnormal catheterization data after PAB and B-T (Group 1). Twenty-five control cases with successful two-stage Jatene's operation exhibited normal data (Group 2). We studied 1) the grade of distortion of the interventricular septum as the a/b ratio on two-dimensional echocardiogram (2-DE), 2) the left ventricular (LV) shortening fraction (LVSF), 3) the thickening fraction (ThF), 4) the LV posterior wall thickness in diastole (LVPWTd) on M-mode echocardiogram, and 5) the LV inflow tract (LVIT) flow pattern on pulsed Doppler echocardiogram. In Group 1, all cases revealed LVSF less than 0.19 (control group: 0.40-0.56), ThF less than 0.18 (control group: 0.43-0.81), the a/b ratio higher than 0.88 (control group: 0.53-0.79), and LVPWTd thicker than 0.67 cm (control group: 0.45-0.59 cm). These data are markedly deviated from the range of the control data (p < 0.01). All cases in Group 1 had LVIT flow lacking the rapid filling phase, which was recognized in the control group. These abnormal echocardiographic findings suggest LV failure in adaptation against excessive after-load due to very tight PAB, and these figures are very different from the control group. These unusual postoperative cardiac abnormalities can be detected noninvasively using 2-DE and Doppler echocardiography.(ABSTRACT TRUNCATED AT 250 WORDS)

Echocardiography↗
PubMed1990

Ventricular volume characteristics in double-inlet left ventricle before and after septation.

Septation is one of the surgical choices for double-inlet left ventricle, yet postoperative hemodynamics have not been well defined. We studied ventricular volume characteristics in 10 patients with double-inlet left ventricle before and after septation. Preoperative end-diastolic volume (EDV) of the ventricle was 291 +/- 111% (+/- SD) of normal and ejection fraction (EF) was 0.59 +/- 0.07. Postoperatively, EDV of the right-sided ventricle (RV) was 82 +/- 24%, and EDV of the left-sided ventricle (LV) was 153 +/- 41%. Ejection fraction of the RV was 0.77 +/- 0.10, and LVEF was 0.49 +/- 0.13. On the short-axis view of two-dimensional echocardiography, fractional change of the cross-sectional area was 0.65 +/- 0.16 for the RV and 0.23 +/- 0.11 for the LV. Fractional shortening of the septum-to-ventricular free wall axis was 0.51 +/- 0.17 in the RV and -0.05 +/- 0.09 in the LV. Analysis of the curvature of the new septum during cardiac cycle on two-dimensional echocardiography revealed that the septum shifted to the right side during systole in all patients in whom the systolic LV/RV pressure ratio was larger than 1.0. The septum shifted toward the LV during diastole in eight patients in whom end-diastolic pressure in the RV was higher than or equal to that in the LV, whereas it remained in the right side in two patients with higher left-side pressure. The cardiac index of these two patients was 2.4 and 2.6 l/min/m2, respectively, whereas it averaged 4.4 +/- 1.0 l/min/m2 in the other eight patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[A new noninvasive method for calculating pulmonary to systemic flow ratio (Qp/Qs) in patients with atrial septal defect using multigated Doppler echocardiography].

The number of patients with atrial septal defect (ASD) who undergo intracardiac repair without cardiac catheterization has been increasing. A noninvasive quantitative method to estimate the Qp/Qs ratio in this disease is therefore needed, but no simple, accurate method has yet been reported. The purpose of this study was to devise a new clinically useful method. Study materials consisted of 15 patients with ASD who were catheterized and five post-operative patients. For this study a multigated Doppler echocardiographic instrument (Fujitsu ME 120A) was used, which allowed us to ascertain Doppler shift frequency at 64 consecutive sampling volumes up to 13 cm in depth simultaneously. In the parasternal four-chamber view, the cursor was set so as to cross obliquely the right ventricular inflow tract just below the tricuspid valve and the left atrium, just above the mitral valve. Two blood flow profiles were obtained from the flow crossing the tricuspid and mitral valves. The multigated Doppler echocardiogram was recorded on videotape and then analyzed. (1) The encircling area between the profile and the base line was measured for tricuspid and mitral flow independently throughout diastole. After summing up each area of tricuspid (TA) and mitral (MA) flow profiles, the ratio TA/MA was obtained (area calculation method). (2) The flow volume passing through each tricuspid (TF) and mitral valve (MF) was calculated from the flow profile using the "ring approach" reported by Jenni, and the ratio TF/MF was obtained (flow calculation method).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Left ventricular function after Konno procedure for congenital aortic stenosis].

From February, 1984 to September, 1988, eighteen patients with congenital aortic stenosis underwent Konno procedure. There was no operative death, but one late death (5.6%). The annular diameter ranged from 9 mm to 23 mm (mean 15 mm). Preoperative left ventricular ejection fraction (LVEF) measured by cineangiography ranged from 0.59 to 0.92 (mean 0.77) and half of the patients had more than 0.80 of LVEF. Left ventricular function after the operation was evaluated at rest or during exercise by radionuclide ventriculography. Postoperative LVEF ranged from 0.59 to 0.89 (mean 0.75). Although there were no statistically significant changes between preoperative and postoperative LVEF, there was a trend that preoperative supernormal LVEF improved to normal after surgery. The response to exercise also improved in some cases after surgery. We concluded that Konno procedure can be safely undertaken with improvement of left ventricular function.

Adolescent↗
PubMed1990

[Two cases of Konno's operation for aortic stenosis developing after repair of interruption of the aortic arch with ventricular septal defect].

Two patients, 8-year-old and 7-year-old boys, underwent Konno's operation for left ventricular outflow tract obstruction, which had developed after the repair of interrupted aortic arch and ventricular septal defect. Both cases had bicuspid aortic valve and severe subaortic stenosis. The annular diameters were 15 mm and 16 mm, and pressure gradients between the left ventricle and the ascending aorta were 110 mmHg and 105 mmHg, respectively. A SJM prosthetic valve (23 mm, 25 mm) was used. Postoperative courses were good. Left ventricular outflow anomalies are frequently found in cases of interrupted aortic arch complicated with ventricular septal defect. The stenosis not infrequently develops and becomes apparent several years after primary or staged repair for interrupted arch with VSD as in the present cases. Therefore, careful observation should be carried out following the repair. Konno's operation can be safely performed for this lesion with low mortality and morbidity for valvular and subvalvular aortic stenosis even with small aortic ring.

Aorta, Thoracic↗