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Biomedical subjects

H Manabe

Publications and source records attributed to H Manabe.

At least 145 records · Page 8Linked to original sources

[Operative results of atrioventricular canal defect].

Partial Atrioventricular Canal Defect ( PAVC ) The operative results of this anomaly is generally acceptable. Between 1978 and 1982, 32 patients with PAVC underwent intracardiac repair. Two operative deaths occurred in 41 and 42 years old patients who were in NYHA class 4 preoperatively. Postoperative mitral insufficiency was either nil or mild except in one patient with mitral valve prolapse which was left unrepaired. Complete Atrioventricular Canal Defect ( CAVC ) Our operative procedures for the repair of CAVC are as follows, 1) all of accessory chordae are cut off and the bridging leaflet is incised into mitral and tricuspid components. 2) Ventricular septum, atrioventricular valve and atrial septum are constructed with our designed endocardial cushion prosthesis (Dacron prosthesis with pericardial brim of 3-4 mm width in each side). Between 1978 and 1982, 20 patients with CAVC containing 16 infants less than 2 years old underwent intracardiac repair using this prosthesis. Thirteen patients had no severe associated anomalies and only one death occurred in this group. Three patients were combined with tetralogy of Fallot (one died) and two patients with double outlet right ventricle (one died). The other two patients had either coarctation of the aorta (died) or interruption of the aortic arch (survived).

Adult↗

Surgical treatment of giant left atrium combined with mitral valvular disease. Plication procedure for reduction of compression to the left ventricle, bronchus, and pulmonary parenchyma.

Giant left atrium associated with mitral valvular disease frequently produce postoperative problems with regard to hemodynamical and respiratory management. A new procedure of para-annular and superior plication combined with the conventional right-side plication with trimming of the left atrial wall was devised to relieve compression induced by the giant left atrium. A total of 40 patients with giant left atrium underwent operation. Ten had the valvular procedure only and 30 had the valvular and plication procedures. The plication procedure resulted in a significant decrease in the incidence of low-output syndrome and respiratory failure postoperatively, as well as a marked decrease in mortality. We conclude that the plication procedure is an effective means of relieving compression in the presence of giant left atrium.

Adult↗

A trial procedure to prevent aneurysm formation of the coronary arteries by steroid pulse therapy in Kawasaki disease.

Sixty patients with Kawasaki disease in the acute phase were studied using a two-dimensional echocardiography. Coronary lesions in Kawasaki disease were characterized echocardiographically by an increase of echo density of the coronary artery and by dilatation or aneurysm of the coronary artery. These findings appeared in the sequence mentioned above in patients who were studied serially. In the group treated with corticosteroid, 62% of the patients showed a disappearance or an improvement of the coronary dilatation or aneurysm, while only 33% of untreated patients showed such an improvement. In patients with coronary aneurysms on the initial echocardiogram, 53% of the pulse therapy group showed an improvement, but none of the untreated group did. A similar result was obtained by an analysis of its therapeutical effect, according to the number of vessels involved. Thus, corticosteroid pulse therapy was shown to be effective for the prevention of coronary arterial aneurysms in Kawasaki disease, if it was given in a sufficient dose in the acute phase of this disease.

Adrenal Cortex Hormones↗

Surgical treatment on mitral valvular disease with giant left atrium-the effect of para-annular plication on left atrium.

In severe mitral valvular disease with a giant left atrium, there occur such abnormal findings as the compression and bending of the basal portion of the posterior wall of the left ventricle accompanied by its paradoxical movement. Following mitral valve replacement in this group of patients, it was found that the strut of the artificial valve is apt to lean against the ventricular septum and the inflow stream of blood was directed toward outflow tract of the left ventricle, appearing to be obstructed by the ventricular septum. Here, we devised a new surgical method, para-annular plication, for patients with a giant left atrium. By this procedure, the compression and bending of the basal portion of the posterior wall of the left ventricle and the paradoxical movement were all relieved. The abnormal angle of the mitral valvular ring was corrected, the strut of the artificial valve was free from contact with the ventricular septum and the inflow stream of blood was directed toward the apex of the ventricle in usual manner. The overall operative result for giant left atrium has been markedly improved by this procedure.

Cardiomegaly↗