Biomedical subjects

K Ihashi

Publications and source records attributed to K Ihashi.

23 records · Page 2Linked to original sources

PubMed1993

[Myocardial revascularization with bovine internal thoracic artery graft (BIOFLOW): a case report].

Bovine internal thoracic artery graft (BIOFLOW) was used for coronary artery bypass grafting (CABG). A 64-year-old woman who had undergone triple CABG with saphenous vein five years ago was referred to our hospital again with anginal attack. Coronary angiogram showed the obstruction of the graft for LAD and new stenosis at right coronary artery (RCA). Gastroepiploic artery was not available because the patient had a history of gastric ulcer several times, and saphenous vein had harvested initial operation. We planned re-CABG for LAD with left internal thoracic artery and RCA with BIOFLOW. But at the operation, LAD was not graftable because of severe calcification. So that we performed single CABG to RCA with BIOFLOW. The BIOFLOW was patent at the 28 th postoperative day. From our experience, BIOFLOW can be expected as a graft for CABG when saphenous vein, internal thoracic artery and gastroepiploic artery are not available.

Aged↗

PubMed1993

[A case report: surgical repair of bilateral coronary artery-pulmonary artery fistula associated with mitral regurgitation, tricuspid regurgitation and severe renal dysfunction].

The patient was a 72-year-old female who was admitted with evaluation of dyspnea on effort. On cardiac catheterization, coronary angiography showed the fistula from both RCA and LAD to the pulmonary artery and L-R shunt ratio was 37.4%, and MR and TR were found. The preoperative examination showed renal dysfunction, BUN: 61.6 mg/ml, Cr: 21. mg/ml, 24 hr Ccr: 15.2 ml/min. At the operation, the fistula was closed from the inside of the pulmonary artery and MVR (27 SJM) and TAP (Kay-Reed method) were performed associated with the intra-operative hemodialysis. The peritoneal dialysis was used for 9 days after the operation. The hemodynamics and the urination were well controlled. A successful surgical repair of bilateral coronary artery-pulmonary artery fistula associated with valvular disease and severe renal dysfunction was reported.

Aged↗

PubMed1993

[Blood purification after aorto-coronary bypass grafting for dialysis patients].

Four dialysis patients received aorto-coronary bypass grafting (CABG) at Fukuyama cardiovascular hospital from April 1989 to March 1992. We employed continuous ambulatory peritoneal dialysis (CAPD) in two cases, hemodialysis with extracorporeal ultrafiltration method (ECUM + HD) in one case and hemodiafiltration with continuous veno-venous hemofiltration (CVVHF + HDF) in one case for perioperative management. In each cases, intermittent HD was undergone during 4 days before operation. Intraoperatively, HD was used together with extracorporeal circulation. Blood pressure in the postoperative course changed more frequently in CAPD cases than ECUM + HD or CVVHF + HDF case. Especially, CVVHF + HDF stabilized the movement of circulation and kept balance of serum BUN, Cr after the operation (BUN; 27.2 +/- 6.3, Cr; 5.0 +/- 0.6). We concluded that CVVHF + HDF would be the most favorable method to maintain the fluid balance stably for the uremic patients after CABG.

Adult↗

PubMed1992

[Clinical experience of continuous retrograde cerebral perfusion for assisted circulation during the surgical treatment of acute dissection of aorta: Stanford A type].

Surgical treatment of the dissection involving the ascending aorta or aortic arch represents one of the most complicated technical challenges. Recently continuous retrograde cerebral perfusion (CRCP) is sometimes applied in order to avoid cerebral complications. We compared two surgical groups, one of which was performed graft-replacement of ascending aorta using CRCP and another was utilized normograde cerebral circulation, about the technique of operation, total extracorporeal circulation (ECC) time, aortic clamp time, separate ECC time, total bleeding volume, and urination during operation. In the group using CRCP, separate ECC time was 53 min (mean), and intraoperative bleeding volume was only 1,170 ml. Good urination was obtained during operation. Postoperative courses were uneventful, and consciousness was smoothly and soon recovered. The new method of separate ECC has some advantages over the previously described methods, particularly for avoidance of cerebral complications. As it is not necessary to require dissecting, taping, and clamping of cephalic branches, operative procedure will be very simplified, easier and safer, leading to intraoperative bleeding is a fewer. It is our belief that this method should be widely applied in the operation of graft-replacement of ascending aorta or aortic arch in the near future.

Aged↗

PubMed1991

[Surgical treatment of ruptured descending aortic aneurysm to the right extra thoracic space: a case report].

A fifty-nine year-old woman was emergently admitted to our hospital for the aneurysm in descending aorta. She complained of severe back pain and dysphagia, and showed extreme hypotension. Aortic angiography was performed immediately. It revealed the aneurysm of descending aorta (phi 7.2 cm) and abdominal aorta (phi 3.5 cm), and also showed obstruction of bilateral common iliac arteries. On chest X-ray, a diffuse shadow of the right-sided chest was found. Through chest drainage, fresh blood was let out from extrapleural space. On the next day, the drainage blood markedly increased. Subsequently, emergent operation was performed. The operation consists of resection of aortic aneurysm with grafting and aortofemoral bypass with a Y shaped graft. The patient survived the operation and was discharged without any disability.

Aorta, Abdominal↗