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Biomedical subjects

H Rikukawa

Publications and source records attributed to H Rikukawa.

At least 19 recordsLinked to original sources

[A case report of true palmar aneurysm].

True palmar aneurysm is a rare disease of the hand. Only 12 cases of true palmar aneurysm have been reported in Japan. This occurs commonly in the hypothenar region. We experienced a 12-year-old boy who had a aneurysm of the left palmar hand successfully treated by surgery. The clinical diagnosis was established by ultra sound. Vascular reconstruction by end to end anastomosis was performed after excision of aneurysm. Pathology revealed this was true aneurysm.

Anastomosis, Surgical↗

[Surgical treatment of the prosthetic valves in reoperation].

Surgical treatment and problems in patients required reoperation for malfunctioning prosthetic valves are reviewed in our institute. The cinefluoroscopy and pulse doppler echocardiography were helpful for diagnosis of artificial valve dysfunction. In recent two decades valve replacement were performed in 382 cases and number of re-implanted valve were 469. Among them the cases of reoperation were 21 and reimplanted valves were 25 (5.6%); 4.7% in aortic, 5.0% in mitral, 6.7% in tricuspid position. Three cases of those patients had three operations. Main causes of reoperation were primary tissue failure in Carpentier-Edwards porcine xenograft (6 cases, 23%) and cloth wear in Starr-Edwards ball valve (9 cases, 38%) and thrombosis in St. Jude Medical bi-leaflet valve (3 cases, 15%). In most cases St. Jude Medical valve were chosen for the alternative prosthetic valve in reoperation. We applied IABP support to seven patients for severe low cardiac output syndrome after the operation and overall mortality was 24% in reoperation. It concluded that St. Jude Medical valve may be most reliable because of low incidence of postoperative complication in our institute.

Adult↗

[The results of surgical treatment of post-infarction left ventricular aneurysms].

The surgical results of post-infarction left ventricular aneurysmectomy have been evaluated in 24 patients approximately 1 year after operation. In 20 patients coronary artery bypass grafting (CABG) was also carried out. In 8 patients mechanical circulatory assist such as intra-aortic balloon pump (IABP) or left ventricular assist device (LVAD) was undertaken for the purpose of weaning from cardiopulmonary bypass. Postoperative left ventricular function, such as ejection fraction and cardiac index, and classification of the New York Heart Association were improved significantly after aneurysmectomy. However, postoperative improvement of these parameters was not remarkable in cases of poor preoperative left ventricular function. Preoperative left ventricular function revealed to be poor in multiple vessel disease, and concomitant coronary artery bypass grafting with aneurysmectomy can be performed with good long-term results and significant improvements of postoperative cardiac function. In patients that had showed the end-diastolic perimeter more than 40% and the shortening rate of transverse axis at the left ventricular base less than 20%, postoperative improvement of cardiac function revealed unsatisfactory. Mechanical circulatory assist showed lifesaving effect, but in cases that required IABP or LVAD postoperative cardiac function has not improved significantly.

Adult↗