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Biomedical subjects

K Haneda

Publications and source records attributed to K Haneda.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Surgical management of open lung biopsy in Eizenmenger's syndrome].

Three of 254 patients with Eizenmenger's syndrome had complications, namely bleeding during and after surgery of open lung biopsy. Histopathologic study of the lung in patients suffering from complications revealed that destruction of the collateral vessels characterized by wide lumen and weak walls is responsible for the postoperative bleeding. Such complications can be prevented by using the TA stapler which cuts off the lung tissue with little or no damage to the other lung tissues.

Adult↗
PubMed1990

[A case of massive hemoglobinuria due to patch dehiscence--following patch closure of ventricular septal defect].

A three-month-old baby with persistent intravascular hemolytic anemia following patch closure of subpulmonic ventricular septal defect was reported. Mechanical hemolysis was diagnosed by the presence of blood cell fragments and schistocytes in peripheral blood smear. It was thought that destruction of red cells developed by turbulent flows and direct contact of red blood cells with bared rough surfaces of the teflon patch at the site of dehiscence. When the cause of severe hemolysis was attributed to inadequate intracardiac repairs, immediate second surgical intervention should be performed.

Female↗
PubMed1989

Indications for surgery based on lung biopsy in cases of ventricular septal defect and/or patent ductus arteriosus with severe pulmonary hypertension.

Pathologic obstruction of the proximal lumen and secondary atrophy of the media of the peripheral small pulmonary arteries were absolute operative contraindications in cases of VSD and/or PDA with severe pulmonary hypertension. Such patients who were operated on died with no decrease in pulmonary arterial pressure. The index of pulmonary vascular disease (IPVD), a composite and quantitative evaluation of the severity of pulmonary vascular disease, was introduced to determine the operability of other patients. An IPVD rating of 2.2 in Down's syndrome and 2.1 without the syndrome were regarded as the upper permissible limits for surgical intervention based on results of 23 autopsies and 26 lung biopsies of patients operated on before 1981. Open lung biopsy was performed in 51 patients to determine applicability of our operative indications. Twenty-nine cases were considered operable by our criteria, and 28 underwent surgical correction without operative or late death. Twenty-two cases thought inoperable remain under observation. Comparative analysis of the pathology and preoperative hemodynamic data suggested that lung biopsy should be carried out to determine operability in cases with pulmonary vascular resistance greater than 8 units.m2.

Biopsy↗
PubMed1989

[An inordinate elevation in pacing threshold after myocardial electrode implantation].

An inordinate elevation in pacing threshold beyond a maximal output of the pulse generator was observed in 4 patients during the acute interval following permanent pacemaker implantation using a myocardial electrode. Pacemaker implantation was performed in these patients (9 months, 11 months, 5 years and 32 years of age) for the treatment of brady-arrhythmias (complete A-V block or atrial fibrillation) developed following open heart surgery. In two infants, hypopotassemia caused transient pacing failure due to an increase in threshold over 5 volt. In other two patients, threshold increased to levels more than 10 volt within 36 and 12 days probably due to unsuitable pacing site, and then the pulse generators were removed. It is important to measure threshold periodically after permanent pacemaker implantation and to consider the possibility of an inordinate elevation in threshold.

Adult↗
PubMed1989

[Pulmonary vascular disease in shunted and nonshunted patients with tetralogy of Fallot].

Histometric analysis of pulmonary vascular disease was performed in 21 nonshunted patients and in 13 shunted patients with tetralogy of Fallot and in 29 normal controls. There was no significant difference in the medial thickness of the small pulmonary arteries between cases of tetralogy of Fallot and normal controls. However, the media in the shunted cases of tetralogy of Fallot gave the impression of being thicker than these in the nonshunted cases. Intimal fibrosis, regarded as organized thrombi, and thrombi of small pulmonary arteries were observed generally after 4 years of age in shunted and nonshunted cases of tetralogy of Fallot. Intimal proliferation of musculoelastosis which was formed longitudinal smooth muscle bundles and elastic fibers was characteristic in shunted patients, especially after the central palliation procedure, Waterston anastomosis and modified Blalock-Taussig (B-T) anastomosis using a Gore-Tex tube graft. However, musculoelastosis was not usually seen in the B-T anastomosis cases. Unexpected pulmonary hypertension due to shunt operation is thought to be the cause of musculoelastosis, because musculoelastosis was observed even in a patient with pulmonary hypertension 3 weeks following surgery. We, therefore, recommend original B-T anastomosis as the shunt procedure. When considering use of the other shunt operations which entail pressure load on the pulmonary vascular bed, attention must be given to the size of the anastomosis or artificial tube graft.

Adolescent↗
PubMed1989

[Clinical experience of autotransfusion system (ATS)--changes in free hemoglobin and haptoglobin].

This study was done to evaluate the usefulness of ATS and the administration of haptoglobin, and is comprised of 15 patients following open heart surgery. Shed mediastinal blood was retransfused during 4-6 hours after open heart surgery. Plasma free Hb (F-Hb) value of the shed blood was 647 mg/dl. But plasma F-Hb of patient did not significantly increase after retransfusion of shed blood without administration of haptoglobin. Plasma F-Hb of patient decreased significantly from 12 mg/dl to 3.3 mg/dl when haptoglobin was given. (p less than 0.05). There was no serious complication associated with the use of ATS, and could save 300 ml of homologous blood. It is concluded that ATS can be used safely for saving homologous blood after open heart surgery and haptoglobin is effective for decreasing of plasma F-Hb.

Blood Transfusion, Autologous↗
PubMed1989

[Surgical experience in patients with Marfan's syndrome and cardiovascular disease].

10 patients with Marfan's syndrome and cardiovascular disease were operated at Tohoku University Hospital from 1971 to 1988. Surgery included composite valve graft replacement of ascending aortic aneurysm with aortic regurgitation in 5 patients and prosthetic mitral valve replacement in three patients; two had resection of aneurysm with Dacron tube replacement. Operative mortality was 10%. Two late death occurred (22%). It was suggested that regular follow-up examination is important in these patients to detect new lesions and to evaluate known lesion.

Adolescent↗
PubMed1989

[Effects of exocorpol and haptoglobin on hemolysis during ECC].

This study was performed to evaluate the effects of Exocorpol and Haptoglobin on hemolysis during ECC. We measured free hemoglobin (F-Hb) and free haptoglobin (F-Hp) at pre- and post-ECC. Patients were divided four groups: Group C, 5 patients undergoing no treatment; Group Ex, 5 patients undergoing treatment of Exocorpol; Group Hp, 5 patients undergoing treatment of Haptoglobin; Group Ex + Hp, 5 patients undergoing treatment of Exocorpol and Haptoglobin. F-Hb of pre- and post-ECC in four groups were 0 mg/dl: 85 mg/dl (Group C, p < 0.01), 0 mg/dl: 2 mg/dl (Group Ex, NS), 0 mg/dl: 1 mg/dl (Group Hp, NS), 0 mg/dl: 0 mg/dl (group Ex + Hp, NS). F-Hp of pre- and post-ECC in four groups were 143 mg/dl: 9 mg/dl (Group C, p < 0.02), 133 mg/dl: 25 mg/dl (Group Ex, p < 0.05), 186 mg/dl: 195 mg/dl (Group Hp, NS), 66 mg/dl: 163 mg/dl (Group EX + Hp, p < 0.05). There was no significant difference in F-Hb and F-Hp of pre-ECC among four groups. F-Hb of post-ECC in Group C was significantly higher than that of Group Ex, Hp and Ex + Hp (p < 0.01), and F-Hp of post-ECC in Group Hp and Ex + Hp was significantly higher than that of Group C and Ex.(p < 0.01, p < 0.02). We concluded that Exocorpol and Haptoglobin were effective on hemolysis during ECC, and combination of these was more effective.

Extracorporeal Circulation↗
PubMed1988

Double-outlet left atrium with intact ventricular septum.

The clinical course and surgical repair of double-outlet left atrium with intact ventricular septum in a 13-year-old girl are presented. The only outlet of the right atrium was a secundum atrial septal defect, and the left atrium drained into both ventricles through two atrioventricular valves. To our knowledge, there has been only one other published report of repair of double-outlet left atrium.

Echocardiography↗
PubMed1988

Assessment of left ventricular function in patients with mitral regurgitation: value of the forward ejection fraction.

This study was aimed at assessing the value of preoperative forward ejection fraction (FEF) and corrected forward ejection fraction (CFEF) as an index of postoperative myocardial function. Utilizing 34 patients with mitral regurgitation, usefulness of the preoperative FEF and CFEF was evaluated with special reference to incidence of postoperative low output syndrome (LOS) and improvement in the New York Heart Association (NYHA) classification, comparing other indices of left ventricular function such as cardiac index (CI), stroke index (SI), left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index (LVESVI). There was a significant correlation between FEF and CI, SI, LVEDVI or LVESVI, and between CFEF and CI, SI, LVEDVI or LVESVI. The FEF and CFEF, however, were better indicators for predicting the occurrence of postoperative LOS than EF. Postoperative improvements in the NYHA classification were parallel to that of the FEF and CFEF changes, but did not coincide with that of the EF. Based on these findings, it is concluded that FEF and CFEF are more useful indicators than EF for evaluation of left ventricular myocardial performance in patients with mitral regurgitation.

Adult↗
PubMed1988

Surgical closure of ventricular septal defect in the first year of life: forty-three consecutive successful cases.

Forty-three infants (less than 12 months of age) underwent VSD closure without operative mortality between June 1982 and December 1987. Average age and body weight at the operation were 6.9 months and 5.3 kg, respectively. Associated cardiac anomalies were PDA (11 patients), ASD (5) and PS (1). Preoperative pulmonary to systemic peak pressure ratio (Pp/Ps), resistance ratio and flow ratio, and pulmonary vascular resistance were 0.79 +/- 0.15, 0.29 +/- 0.16, 2.52 +/- 0.60 and 3.05 +/- 1.94 unit.m2, respectively. VSD was closed under combined surface/perfusion hypothermia with total circulatory arrest in 25 patients and standard cardiopulmonary bypass in 18. All patients were discharged from the hospital in good condition, but there was one late death due to pneumonia. Postoperative Pp/Ps decreased to 0.39 +/- 0.11. Most of the patients demonstrated satisfactory body weight gain after VSD closure. These results support our current policy of aggressive surgical intervention for refractory VSD in the early stage of life.

Cardiac Surgical Procedures↗
PubMed1987

Secundum atrial septal defect with severe pulmonary hypertension. Open lung biopsy diagnosis of operative indication.

In 14 of 15 patients ranging in age from 1 to 62 years (mean of 34) with secundum atrial septal defect (ASD) and pulmonary hypertension over 60 mm Hg peak pressure, operative indication was determined by morphometric diagnosis of open biopsy of lung specimens. In one patient, open lung biopsy was also performed during corrective surgery. Pulmonary arterial changes in the 15 patients were grouped into four classifications as follow: (1) plexogenic pulmonary arteriopathy (six patients); (2) thromboembolism in small pulmonary arteries (three patients); (3) "musculoelastosis," intimal proliferation of longitudinal smooth muscle bundles and elastic fibers (three patients); and (4) combinations of (1), (2) or (1), (3) (three patients). We conclude concerning the operative indication that group 2 patients are operable in all cases and group 1 patients with Yamaki's index of pulmonary vascular disease of 2.2 or less; group 3 patients with the absence of complete occlusion of the small pulmonary arterial lumen are operable, and patients with clear evidence of severe plexogenic pulmonary arteriopathy in group 4 are not operable. Comparative analysis of pulmonary pathology and hemodynamic performance revealed that open lung biopsy should be performed to determine operative candidacy in cases with a pulmonary vascular resistance greater than 8 unit X m2, which is considered to represent the borderline of operability.

Adult↗
PubMed1987

Long-term results of open heart repair of ventricular septal defect.

Long-term follow-up results of 321 patients who underwent open heart repair of ventricular septal defect in our institute and have lived for more than five years were analyzed using questionnaires. The follow-up period was up to 24 years with an average of 12.9 years. The questionnaire mainly concerned the patient's state of health. Beside this, IQ was measured in 52 children, ECG was analyzed in 92 patients and heart catheterization was performed on 21 patients with preoperative severe pulmonary hypertension (PH). From this survey, it was ascertained that no deaths resulted from cardiac disorders; physical activity and development were satisfactory in nearly all patients; the scholastic achievement score was within the normal range in nearly all school children; among 30 live births from 24 adult female patients, two babies with simple cardiac anomalies were found and there remained very few patients suffering from residual PH, residual shunt or conduction disturbances. IQ as tested by individual intelligence tests was within the normal range in all children. On ECG, complete right bundle branch block with left anterior hemiblock was found in 9% and complete atrioventricular block in 7%. Amelioration of PH was achieved especially in those who underwent operations in their younger years.

Adolescent↗