Biomedical subjects

Kiyozo Morita

Publications and source records attributed to Kiyozo Morita.

6 recordsLinked to original sources

PubMed2006

Double switch operation for congenitally corrected transposition of the great arteries after two-staged pulmonary artery banding.

We describe a case of congenitally corrected transposition of the great arteries (cc-TGA) successfully performed by the double switch operation after two-staged pulmonary artery banding (PAB). An eleven-year old boy diagnosed with cc-TGA underwent the first PAB at that age, followed by the second PAB one year later. Because of severe ventricular dysfunction and arrhythmia of the anatomic left ventricle, the intension of one-stage PAB was abandoned. Cardiac catheterization data from after the adequate second PAB provided the surgical indication for the anatomical correction and double switch operation (Senning+Jatene procedure) and this was successfully performed at age 14. Although cardioversion was required to treat supraventricular tachycardia in the early period after surgery, the patient was discharged from hospital and remains in good clinical condition at the last follow-up at 5 years with normal sinus rhythm and good biventricular function.

Adolescent↗

PubMed2005

Long-term assessment of mitral valve reconstruction with resection of the leaflets: triangular and quadrangular resection.

BACKGROUND: The procedure of quadrangular resection and suture for prolapsed posterior leaflet of the mitral valve is a reliable and reproducible method that achieves excellent long-term results. However, triangular resection and suture of a prolapsed anterior leaflet is not widely supported and different techniques have been advocated. The aim of this study was to review our experience of mitral valve repair in which resection of the anterior and/or posterior leaflets was performed. METHODS: Between October 1991 and September 2003, 105 patients with mitral regurgitation underwent mitral valve reconstruction with leaflet resection, including 55 patients with quadrangular resection of the posterior leaflet (P), 32 patients with triangular resection of the anterior leaflet (A), and 18 patients with resection of both leaflets (A+P). RESULTS: The mean follow-up period was 63.6 (1 to 139) months. Reoperation was required in 2 patients, each after resection of the anterior or posterior leaflet. The freedom from reoperation rates at 10 years in 93% +/- 5% of patients after triangular resection of the anterior leaflet, 96% +/- 3% after quadrangular resection of the posterior leaflet, and 100% after resection of both leaflets. There were no significant differences of survival or risk of reoperation among these three groups. The postoperative mitral valve area was significantly smaller than the preoperative area in all three groups, but remained large enough (A: 2.84 +/- 1.07; P: 2.6 +/- 0.87; A+P: 3.09 +/- 1.20 cm2) for adequate valve function. CONCLUSIONS: Triangular resection of a prolapsed anterior mitral leaflet is a reliable, reproducible, and durable procedure, like quadrangular resection of a prolapsed posterior leaflet.

Actuarial Analysis↗

PubMed2004

Extracardiac rerouting of the persistent left superior vena cava in the left isomerism heart.

The left isomerism heart is common to have various forms of the systemic and pulmonary venous connections, for which numerous reparative methods have been proposed. This report describes a successful extracardiac rerouting of the persistent left superior vena cava of a 6-year-old girl patient having the isomerism heart, bilateral superior vena cava, partial anomalous pulmonary venous connection, and partial form of the atrioventricular septal defect. Intraatrial rerouting of the left superior vena cava was found unfeasible, since this procedure had a potential hazard to obstruct the systemic and/or pulmonary venous drainage. The patient recovered uneventfully and is leading a normal life 6 years after the surgery.

Anastomosis, Surgical↗

PubMed2002

Staged Fontan procedure for mitral atresia associated with severe tricuspid regurgitation, pulmonary hypertension, and pulmonary artery distortion.

Optimal initial palliation and a subsequent staged approach is mandatory for high-risk Fontan candidates. We describe the case of mitral atresia with severe tricuspid regurgitation and pulmonary hypertension successfully managed by repeated palliation from the neonatal period and 2-stage Fontan surgery. A 1-month-old boy diagnosed with mitral atresia and double-outlet right ventricle underwent pulmonary artery banding at 1 month of age, followed by repeated pulmonary artery banding accompanied by tricuspid annuloplasty and atrial septal defect enlargement at 6 months. Because of the presence of pulmonary artery distortion, right ventricular dysfunction, and borderline pulmonary vascular resistance, a hemi-Fontan procedure was conducted with extended pulmonary artery plasty when the boy was 3 years and 8 months old. Cardiac catheterization done 3 months after showed improvement in risk factors, and the final Fontan operation (total cavopulmonary connection) was successfully done in conjunction with repeated tricuspid annuloplasty when the boy was 4 years and 5 months old. The patient remains in excellent clinical condition at the last follow-up 5 years after the final Fontan procedure with sinus rhythm and good ventricular function.

Fontan Procedure↗

PubMed2002

Partial anomalous pulmonary venous connection of singular form.

We have recently experienced a rare case of partial anomalous pulmonary venous connection, in a 3-year-old female. The case was diagnosed preoperatively as anomalous left superior pulmonary venous connection with atrial septal defect. Surgery, however, revealed that only the right superior pulmonary vein returned to the left atrium, while the other three pulmonary veins returned to the coronary sinus or innominate vein. No associated atrial septal defect was found. An enlarged coronary sinus was observed. In the present case, three of the four pulmonary veins were found to have anomalous connections, and were hemodynamically close to being total anomalous pulmonary venous connection. We performed unique radical surgery using autologous tissue for multiple anomalous pulmonary venous connections and here report the results, with a short discussion of the literature.

Cardiac Surgical Procedures↗

PubMed2002

[Dynamic cardiomyoplasty].

Dynamic cardiomyoplasty is a surgical procedure that uses electrically stimulated skeletal muscle to augment left ventricular function in the treatment of chronic heart failure. This procedure has been performed in more than 1000 patients worldwide since the first clinical trial in 1985. Despite the lack of evidence that it improves long-term survival, this procedure remains a promising alternative in the treatment of end-stage heart failure, as it improves patients' functional status and quality of life score in 75-80% of survivors. This review comprises data from multicenter studies from a worldwide database (Medtronic Dynamic Cardiomyoplasty Clinical Database 1996) and from a randomized clinical trial and seeks to update the current clinical results of dynamic cardiomyoplasty and to describe the clinical role of this procedure.

Cardiomyoplasty↗