Adult coronary artery disease secondary to Kawasaki disease in childhood.
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Adolescent↗
Biomedical subjects
K Fuse
Publications and source records attributed to K Fuse.
Subcutaneous use of erythropoietin in heart surgery.
The effect of subcutaneous administration of recombinant human erythropoietin (rHuEPO) in ameliorating anemia resulting from autologous blood donation was compared with intravenous administration of rHuEPO. Forty patients undergoing coronary artery bypass procedures were divided into three groups. Group I (12 patients) received intravenous administration of rHuEPO (100 U.kg-1.day-1) and intravenous iron preparations for 14 days before operation; group II (14 patients) had subcutaneous administration of rHuEPO (600 U/kg) on preoperative days 14 and 7 and oral iron preparations for 14 days; and group III (14 patients) received oral iron preparations alone and served as the controls. Each patient predonated 800 mL of blood in the 2 weeks before operation. The reticulocyte count increased significantly in groups I and II (p less than 0.01), but little in group III. The hemoglobin level just before operation was higher in groups I (p less than 0.01) and II (p less than 0.05) compared with group III. Four patients (29%) in group III required homologous blood transfusion versus none in groups I and II (p less than 0.05). Subcutaneous administration of rHuEPO once a week was as effective as daily intravenous administration. Preoperative autologous blood donation can be performed over a short period on an outpatient basis with subcutaneous administration of rHuEPO.
Aged↗
[Myocardial revascularization for ischemic heart disease without in situ internal thoracic artery grafting].
CABG was performed in 327 patients from 1989 to 1991. We used ITA grafts for the arterial conduit whenever this was possible. Since ITA grafting has become a routine procedure in CABG, we investigated the reasons why in situ ITA grafts were used in some of our patients. The number of CABG patients without in situ ITA grafts was 42 in 1989, 35 in 1990, and 9 in 1991. There was three main reasons for this: 1) problems with the coronary arteries or myocardium, 2) problems with the ITA grafts, and 3) problems with the patient. Although ITA grafts were not used in these cases, the indications for ITA grafting have been changed by our review. Use of ITA grafts need not be restricted for reasons of age or native coronary artery problems, but some patients will still be unsuitable for these grafts.
Aged↗
[Cryosurgery for left atrial myxoma with coronary artery bypass grafting].
This is the first report of cryoblasion of atrial myxoma which was performed in conjunction with coronary artery bypass grafting. A 63-year-old man was admitted for left atrial tumor and ischemic heart disease. Following coronary artery bypass grafting and resection of left atrial myxoma, cryosurgery was carried out for the residual tumor on atrial septum and left atrial posterior wall. Ultrasonic cardiogram after 1 year revealed no signs of recurrence. Cryoablasion was effective in preventing the recurrence of atrial myxoma.
Coronary Artery Bypass↗
[Early and late results of coronary artery bypass grafting and percutaneous transluminal coronary angioplasty].
The indication of coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA) for coronary artery disease, especially for multivessel disease, remains controversial. We examined the characteristics and outcomes of the CABG group (799 consecutive patients) and the PTCA group (944 patients) from 1984 to 1991. The proportion of 3-vessel and left main disease in the CABG group was 77% and that of single-vessel in the PTCA group was 92%. The characteristics between 2 groups were distinct. But the results were good respectively. The occurrence of hospital death was similar (1.3% vs 0%). The early graft patency rate in the CABG group was 91% and primary success rate in the PTCA group was 90%. And over a 5-year follow-up the cumulative survival rate of 3-vessel disease undergoing CABG and single-vessel disease patients undergoing PTCA was 96% versus 98%, respectively. It is concluded that PTCA is suitable for single-vessel and 2-vessel without totally occluded artery disease patients, whereas CABG for other multivessel disease patients.
Angioplasty, Balloon, Coronary↗
[A case report of isolated tricuspid valve endocarditis in a non-addicted adult person without underlying cardiac disease].
We report a rare case of isolated tricuspid valve endocarditis. A 46-year-old man who was non-addicted, non-alcoholic and had no underlying cardiac disease was admitted to our hospital for persistent pyrexia. Appropriate intravenous antibiotics therapy was unable to control the repeated infection and destruction of his tricuspid valve progressed. The patient was referred to our surgical division where on intraoperative inspection, tricuspid valve endocarditis was found to involve the entire anterior leaflet and part of the posterior leaflet. Following complete debridement of the infectious lesion, tricuspid valvuloplasty was not considered to be possible. So we performed tricuspid valve replacement using a mechanical valve (CARBOMEDICS 27 mm). His postoperative course was uneventful and he had no ventricular arrhythmia. After prophylactic antibiotic administration for 3 weeks, he was afebrile for 2 weeks without any medication. Thereafter he was discharged and has been free from any complications for over 1 year.
Endocarditis, Bacterial↗
[Evaluation of calcified ascending aorta by thoracic computed tomography and technical pitfall for coronary artery bypass grafting].
The cumulative 94 coronary bypass patients were evaluated on calcification of the ascending aorta preoperatively by computed tomography (CT). CT demonstrated the calcification of the ascending aorta in 12 patients (12.8%). In these patients with severely calcified ascending aorta, we performed femoral cannulation (6 cases), distal anastomosis without aortic cross clamp (2 cases), proximal anastomosis through single aortic cross clamp (3 cases) and non proximal anastomosis to use arterial conduits (3 cases). In this series, we did not have any embolic episode. The thoracic computed tomography is effective for evaluation of calcified ascending aorta and in this situation, operative modifications are necessary for obviation of stroke.
Aged↗
[Autologous blood transfusion with erythropoietin in heart surgery in an anemic patient].
A 78-year-old woman was diagnosed as having three-vessel coronary artery disease. A coronary artery bypass operation with autologous blood transfusion was indicated because of the irregular antibody and because homologous blood transfusion would lead to hemolytic complications. Since she had anemia (hemoglobin level, 10.7 g/dl) and autologous blood could not be collected, recombinant human erythropoietin (rHuEPO) and iron preparations were administered intravenously every day. The hemoglobin level reached 12.1 g/dl two weeks after administration, and then autologous blood was donated. The first 1200 ml of blood was stored frozen, and the last 400 ml as liquid in consideration of the blood preservation period. Surgery was performed uneventfully after 8 weeks of rHuEPO administration. No homologous blood transfusion was required during and after surgery. By using rHuEPO, it is thus possible to perform heart surgery without homologous blood transfusion even in patients with anemia, for whom blood transfusions have been considered necessary.
Aged↗
[Acute aortic dissection complicating coronary artery bypass surgery].
We experienced a patient in whom acute ascending aortic dissection appeared to develop at the site of injection of the cardioplegic solution during coronary artery bypass surgery. The patient was a woman aged 70, who was demonstrated to have calcification of the posterior wall of the ascending aorta by preoperative CT scanning. When dissection developed at the cardioplegia injection site after removal of the aortic cross clamp, the aorta was transected and teflon felt was applied to the aorta internally and externally before end-to-end anastomosis was performed. Postoperative CT scanning revealed closure of the dissecting lumen, and the patient was discharged from hospital on the 33rd postoperative day.
Aged↗
Autologous blood transfusion with recombinant human erythropoietin in heart operations.
The effects of recombinant human erythropoietin (rHuEPO) on improving the anemia associated with autologous blood collection before open heart operations and on improving the postoperative anemia were studied. The study was carried out on 18 patients undergoing coronary artery bypass operations; 400 mL of autologous whole blood was taken from each patient 2 weeks before operation and was subsequently used in the operation, and rHuEPO (100 U.kg-1.day-1) was given intravenously for 2 weeks before operation and for 1 week after operation. The group in which iron preparations were also administered intravenously was designated as group I (10 patients), and the group in which rHuEPO was given alone was designated as group II (8 patients). In group III, as a control group, 11 past patients were used in whom 400 mL of autologous whole blood was collected 2 weeks before operation but neither rHuEPO nor iron preparations were given. After autologous blood collections, the hemoglobin levels improved in group I, group II, and group III, in that order, and with significant differences among them. It was shown that rHuEPO was effective in ameliorating the anemia associated with preoperative autologous blood collection, and the effect was further enhanced with intravenous supplementing iron preparations. After operation, the anemia markedly improved while rHuEPO was administered, but the hemoglobin levels decreased rapidly when the administration was terminated. Further studies are needed regarding the use of rHuEPO after operation.
Aged↗
[Autologous blood transfusion with recombinant human erythropoietin in heart surgery--studies on the volume of preoperative donation and postoperative administration].
Recombinant human erythropoietin (rHuEPO) was administered to 42 elective heart surgery patients, and the volume of autologous blood donated within the preoperative short period and effects of improving anemia by postoperative rHuEPO administration were studied. rHuEPO (100 U/kg/day) and chondroitin sulfate-iron (40 mg/day) were given intravenously for preoperative 14 days, and each 400 ml of autologous blood was donated on the 14th and 4th day before operation. Reticulocytes increased significantly 3 days after administration (p less than 0.01). The hemoglobin level, 13.4 +/- 1.0 g/dl before the first donation, returned to 13.4 +/- 1.1 g/dl just before operation. 800 ml of autologous blood, needed for usual open heart surgery, may possibly have been donated within 14 days without making patients anemic by intravenous rHuEPO administration. For postoperative rHuEPO administration, the patients were divided into 3 groups: Group I (10 cases): given for 14 days, Group II (12 cases): for 7 days, Group III (20 cases): no administration. Reticulocytes decreased rapidly after termination of rHuEPO administration in each group, and on the 7th day after termination, they returned to the level before administration. The hemoglobin level in Group I was maintained after termination of rHuEPO, and was +2.2 +/- 1.1 g/dl on the 21st postoperative day compared with the level of 1st postoperative day. The hemoglobin level in Group II fell after termination and was +0.9 +/- 0.7 g/dl on the 21st day, this being comparable to the level of Group III. There were significant differences between Group I and II (p less than 0.05), and between Group I and III (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Aged↗
[A case report: inflammatory fibroid polyp of the jejunum].
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Female↗
[Cerebral infarction after coronary artery bypass surgery--its cause, management and prevention].
Among 535 cases of simple CABG, cerebral infarction was complicated in 5 cases (0.9%). Their mean age (65.2 years old) was high, and 80% of them had the history of hypertension or diabetes mellitus or both. The causes of the cerebral infarction were considered to be the embolism of atheromatous debris from the ascending aorta (3 cases), the cerebral hypoperfusion due to cerebral arterial disease and hypotension during cardiopulmonary bypass (1 cases), and the embolism of the left atrial thrombus formed during repeated supraventricular tachyarrhythmias (1 case). Both cases of the multiple infarctions were lost in-hospital 10 months and 21 months postoperatively. Two of the three cases of single infarction suffered from the permanent neurological deficits. To prevent cerebral infarction which might totally deprive of the efficacy of the CABG, it is important to check and properly manage the atheromatous change of the ascending aorta, the cerebral arterial disease, and also postoperative supraventricular tachyarrhythmias.
Adolescent↗
[Treatment of cases of cardiac surgery complicated with malignant neoplasms].
There were 10 (1.2%) cases of cardiac surgery complicated with malignant neoplasm among the total 863 cases of cardiac surgery in our hospital and 8 cases were treated also surgically against the neoplasms before and after the cardiac surgery. They all underwent coronary artery bypass grafting, and in one case concomitant mitral valve replacement and abdominal aortic aneurysm resection were carried out. The variety of the neoplasms in these cases were carcinomas of the stomach, pancreas, esophagus, renal pelvis, bile duct, colon and urinary bladder, and pleural mesothelioma. These patients were discharged without operative death or major complication, and there was only one evidence of recurrence among the eight cases treated surgically for the neoplasms. It was considered that patients who have critical cardiac problem also bearing neoplasmic combination could be treated excellently by means of both surgical measures.
Aged↗
Percutaneous transluminal coronary angioplasty of gastroepiploic artery graft.
The right gastroepiploic artery is being used as a third arterial conduit for coronary artery bypass surgery. Presented here is a case demonstrating successful percutaneous transluminal coronary angioplasty of the gastroepiploic artery graft. This successful accomplishment may avoid repeat surgical revascularization in case of failure of the gastroepiploic artery graft, hence may encourage people to use it more often.
Angiography↗
Coronary artery disease and internal mammary artery aneurysms in a young woman: possible sequelae of Kawasaki disease.
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Adult↗
Chronic mastitis caused by Candida maltosa in a cow.
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Animals↗
[Treatment of coronary artery disease with poor left ventricular function: comparison of medical and surgical treatments in relation to the numbers of the diseased vessel].
The operative mortality and short-term (average 20 months) survival of 100 surgically or medically treated patients, who had coronary artery disease with poor left ventricular function, were examined. One hundred patients with myocardial infarction and radionuclide-documented left ventricular dysfunction (LVEF at rest less than or equal to 40%) were subjects of this study; 85 patients among them underwent simultaneous coronary arteriography. Fifty-six patients whose average age was 59.7 years, and an average LVEF was 30.0%, were treated medically; 44 patients with an average age of 56.0 years, and an average LVEF of 30.9%, were treated surgically, 41 with bypass grafts, two with left ventricular surgery, and one with both these procedures. The medically treated patients consisted of four groups. Group I comprised 15 patients, in whom coronary angiography was contraindicated. Their average age was 67.1 and an average LVEF was 26.2%, Group II, included six patients, who had no indication for surgery because of severely diseased distal coronary arteries. This group had an average age of 57.5 years and an average LVEF of 22.5%. There were one with two-vessel disease and five with three-vessel disease. Group III included five surgical candidates who refused surgery. Their average age and an LVEF were 67.0 and 35.0%, respectively. In this group, there were one with two-vessel disease and four with three-vessel disease. Group IV, comprised 22 patients who did not need surgical therapy. Their average age was 55.3 and average LVEF was 32.5%. They included 22 with one-vessel disease, seven with two-vessel disease and one with three-vessel disease.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗