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Biomedical subjects

K Haneda

Publications and source records attributed to K Haneda.

108 records · Page 6Linked to original sources
PubMed1979

Surgical treatment for hypoplastic left heart syndrome: case reports.

A 58-day-old girl with hypoplastic left heart syndrome underwent bypass grafting from the pulmonary artery to the descending aorta, ligation of the ductus arteriosus, and banding of the main pulmonary artery distal to the graft. Anastomoses of the graft were performed by partial clamping of the arteries under moderate surface hypothermia. The patient tolerated the procedure well and was discharged from the intensive care unit on the eleventh postoperative day, but she died on the twentieth day of metabolic derangement. Our total experience with this anomaly includes three other infants, and a summary of these patients and applied surgical procedures are presented. Surgical and diagnostic considerations for this anomaly based on our experiences are discussed.

Aorta, Thoracic↗
PubMed1978

Surgical treatment of annuloaortic estasia: experience in 7 consecutive patients.

Seven patients with annuloaortic ectasia were treated according to the method described by Bentall and De Bono. A Björk-Shiley valve in a composite graft was the prosthesis of choice and was used in all patients except 1, who received a Starr-Edwards valve. Profound topical cooling without selective coronary perfusion was applied in 5 patients for myocardial preservation during aortic occlusion. The was 1 operative death and 1 late death, the latter from cerebral thromboembolism. Five survivors have been followed from 1 year 5 months to 2 years 10 months with an average follow-up of 2 years. Excellent results were obtained in all survivors, their physical capabilities putting them in Class I of the New York Heart Association Functional Classification. Postoperative aortograms showed no signs of kinking or compression of vascular prostheses nor abnormalities of prosthetic calves. A modified technique to secure graft fixation is discussed.

Adolescent↗
PubMed1977

Glucose, insulin and somatostatin infusion for the determination of insulin sensitivity.

Glucose, insulin and somatostatin infusion over 2 hours effectively suppressed endogenous secretion of insulin, glucagon and growth hormones. Steady state plasma glucose level (SSPG) which should be inversely proportional to insulin sensitivity was obtained. In 6 adult-onset non-obese untreated diabetics, mean value of insulin sensitivity indices was significantly reduced compared with normal. In 5 insulin-treated diabetics and in 5 subjects with borderline glucose tolerance including 2 obese subjects, insulin sensitivity for glucose utilization was also significantly diminished.

Blood Glucose↗
PubMedDate not supplied

Surgical treatment for isolated hypoplasia of the right ventricle.

Four patients with isolated hypoplasia of the right ventricle who underwent intracardiac repair are described. An atrial septal defect (ASD) was successfully closed in 3 patients with mild hypoplasia of the right ventricle. The remaining patients underwent ASD closure and right atrium-to-pulmonary artery connection with a conduit with a bovine pericardial valve because of severe hypoplasia of the right ventricle and tricuspid valve. Postoperative angiocardiogram in the last patient demonstrated two-channel pathways from the right atrium to the pulmonary artery via both the right ventricle and external conduit. At long-term follow-up studies, 3 patients had developed arrhythmias and/or sinus node dysfunction, and one had died, probably because of arrhythmia, 13 years postoperatively. The right ventricular ejection fractions were below normal levels at 11 and 12 years postoperatively in 2 patients who underwent closure of ASD. It was concluded that the mild form of hypoplasia of the right ventricle should be surgically corrected by ASD closure, while right atrium-to-pulmonary artery connection or Fontan's operation should be chosen for cases of severe hypoplasia. Arrhythmias and hypofunction of the right ventricle are long-term problems after intracardiac repair of this anomaly.

Adolescent↗
PubMedDate not supplied

The significance of colloid osmotic pressure during induced hypothermia.

Colloid osmotic pressure (COP) during hypothermia with and without total circulatory arrest was evaluated in 20 adult mongrel dogs (average body weight = 18.6 kg). All animals were surface-cooled to 20 degrees C (rectal temperature) under halothane-diethyl ether azeotrope anesthesia and divided into 4 equal groups. In Groups I (non-arrest) and II (60 minute-arrest) 10% low molecular weight dextran (LMWD; 1 gm/kg = 10 ml/kg) was administered during cooling. Physiological saline (10 ml/kg) was given in Groups III (non-arrest) and IV (60 minute-arrest) during cooling. COP in LMWD groups increased significantly during cooling and was consistently higher than it was in the saline groups during rewarming. There were no significant differences in heart rate (HR), mean arterial pressure (MAP), central venous (CVP) and pulmonary artery wedge pressures (PAW) between the 4 groups during cooling. The increase in hematocrit (Hct) in animals that received saline was significant at the end of cooling and during rewarming. Hct was not significantly changed in Group I throughout the procedure, whereas in Group II (60 minute-arrest) it increased significantly during rewarming despite the administration of LMWD. Rewarming time in Group II was significantly shorter than in Group IV (144.2 +/- 9.6 min vs 193.2 +/- 32.6 min, respectively). We conclude that the administration of LMWD effectively reduces hemoconcentration and is also beneficial for maintaining better peripheral circulation.

Animals↗
PubMedDate not supplied

The importance of appropriate concentrations of inspired carbon dioxide on induced hypothermia under halothane-ether azeotrope anesthesia.

Thirty adult mongrel dogs were divided into 3 equal groups and studied to define the optimal PCO2 level with azeotrope (halothane-diethyl ether) anesthesia under surface hypothermia (Groups I, II and III = F1CO2 0%, 5% and 10%, respectively). All animals were cooled to 18-20 degrees C and were subjected to 30 (Group I) or 60 minutes (Groups II and III) of total circulatory arrest. Group I animals had frequent arrhythmic episodes during cooling and postoperative motor disturbances occurred in 80% despite only 30 minutes of circulatory arrest. By contrast Group II animals were less arrhythmic during cooling; were easily resuscitated following 60 minutes of arrest and only 30% developed moderate reversible motor disturbances postoperatively. Hemodynamics were similar between Groups II and III during cooling but resuscitation using an F1CO2 of 10% (Group III) was extremely difficult and required massive cardiotonic support throughout rewarming. Furthermore, two dogs in Group III died within the first two postoperative days. However, none of the 8 survivors displayed neurological abnormalities. On balance, a ventilatory regimen utilizing 5% CO2 during surface-induced hypothermia under azeotrope anesthesia resulted in optimum intraoperative management and a satisfactory postoperative course and although some CNS disturbance (high-stepping gait) was noted, all animals recovered completely.

Acid-Base Equilibrium↗
PubMedDate not supplied

Prolongation of the safe interval of hypothermic circulatory arrest: 90 minutes.

Twenty-nine adult mongrel dogs were subjected to profound hypothermia and 90 minutes of total circulatory arrest. Pure surface (Group I) hypothermia and combined surface/perfusion techniques with bubble (Group II) and membrane (Group III) oxygenator systems were employed. Circulation was arrested at average esophageal temperatures of 18.4 degrees, 11.9 degrees and 8.5 degrees C in Groups I, II and III, respectively. Three animals in Group I failed to resuscitate. All survivors in the pure surface series developed postoperative gait (hypermetria) disturbances. One intraoperative death occurred in Group II and four of eight dogs arrested at esophageal temperatures above 10 degrees C but less than 15 degrees C developed motor disturbances during a three week neurologic evaluation period. Animals arrested below 10 degrees C (esophageal) did not display postoperative neurological abnormalities. Three dogs in Group III died from a hemorrhagic diathesis of uncertain etiology. None of the survivors (5) that were cooled and arrested below esophageal temperatures of 10 degrees C developed motor or sensory disturbances. We conclude that in the canine model the central nervous system can be protected for 90 minutes of total circulatory arrest at esophageal temperatures less than 10 degrees C.

Animals↗
PubMedDate not supplied

Successful surgical correction in two patients with tricuspid atresia using autologous pericardial valve-bearing tube graft.

A modification of the Fontan procedure has been used successfully to correct tricuspid atresia in two children who had severe hypoplasia of pulmonary artery. In the first patient (who had functioning Gleen anastomosis) the hypoplastic left pulmonary artery was widened by an angioplasty, and then a Dacron external conduit containing an autologous pericardial valve (an autologous pericardial valve-bearing tube graft) was positioned to lead from the right atrial appendage to the left pulmonary artery. A large secondum type atrial septal defect was closed by a Dacron patch. In the 2nd patient, a Dacron external conduit without any valve was placed between the right appendage and the hypoplastic right ventricle and then the pulmonary outflow tract was widened by using an autologous pericardial valve patch, which was an extension of the external conduit. The ventricular and atrial septal defects were closed with patches. Both patients made a satisfactory recovery and doing well 4 months after the operation. This type of modification of the Fontan procedure may provide a more effective functional correction for patients with tricuspid atresia who are accompanied with severe pulmonary hypoplasia.

Bioprosthesis↗