Biomedical subjects

M Chikada

Publications and source records attributed to M Chikada.

25 records · Page 2Linked to original sources

PubMed1993

Ultrasonic angioplasty for ostial stenosis of the left coronary artery.

Coronary artery bypass grafting is the first-choice treatment for lesions of the left main trunk, but this procedure is associated with the problem of long-term graft patency. Some surgeons thus prefer to perform patch angioplasty for such lesions; however, the safety of this operation is not well established. Operative angioplasty using an ultrasonic aspiration system in a patient with ostial stenosis of the left coronary artery was successfully performed. This is the first report of the application of ultrasonic angioplasty to coronary artery disease.

Cardiac Catheterization↗

PubMed1993

[Anomalous origin of the left coronary artery from the pulmonary artery: a case report in an adult].

A 37-year-old female with anomalous origin of the left coronary artery from the pulmonary artery was surgically treated by creation of intrapulmonary aorto-coronary tunnel. Postoperative cardiac catheterization showed a minimal pulmonary stenosis at the baffle. But the remarkable preoperative ST-depression in a treadmill exercise test disappeared completely after operation and the normograde blood flow of the left coronary artery was detected from the ascending aorta.

Adult↗

PubMed1992

[Percutaneous transvenous, mitral commissurotomy versus open mitral commissurotomy].

Effects of PTMC (percutaneous transvenous mitral commissurotomy) were evaluated retrospectively in 34 patients with mitral stenosis and compared with those of OMC (open mitral commissurotomy) in 28 patients. PTMC resulted in a decrease in transmitral pressure gradient from 11 +/- 6 to 6 +/- 4 mmHg (p < 0.001) and an increase in cardiac index from (2.4 +/- 0.4 to 2.7 +/- 0.5 L/min.m2 and mitral valve area from 1.0 +/- 0.3 to 1.7 +/- 0.4 cm2 (p < 0.001). Mitral valve area remained increased (1.6 +/- 0.4 cm2) after a mean follow-up period of 19 +/- 11 months. Death, cerebro-vascular accident, or sever mitral regurgitation (> III degrees) did not occur. NYHA class improved from 2.28 +/- 0.63 to 1.44 +/- 0.50 (p < 0.001). OMC resulted in a greater increase in mitral valve area (from 1.1 +/- 1.4 to 2.0 +/- 0.5 cm2, p < 0.001) and greater improvement of NYHA class (2.25 +/- 0.65 to 1.11 +/- 0.34, p < 0.001). Thus OMC surpasses PTMC in hemodynamic effects and symptomatic improvement. However, PTMC may still be the first choice for the treatment of mitral stenosis because of its excellent safety and efficacy.

Adult↗

PubMed1992

[Surgical treatment of acute aortic dissection in the aged: a case report].

A 77-year-old woman with Stanford type A acute aortic dissecting aneurysm was successfully treated by the sutureless technique using arringed intraluminal graft. A month after the operation, re-dissection to the distal abdominal aorta occurred. Because of the poor condition of the patient and her great age, we chose an antihypertensive therapy instead of a reoperation. Two years after the operation this patient leads a sound life without any symptoms. In a case of acute aortic dissection of the aged, special consideration may be allowed to a surgical method and a decision-making for a reoperation.

Acute Disease↗

PubMed1992

[A case report of surgical treatment in acute aortic dissection: efficacy of retrograde cerebral perfusion and pitfall of image diagnosis].

A 76-year-old man with acute aortic dissection of Stanford type A underwent aortic arch replacement using retrograde cerebral perfusion for 105 minutes. By the preoperative IADSA an entry was detected in the distal arch. There were no neurological complications. But the postoperative IADSA showed that the surgically closed entry was another one from that diagnosed before operation. This case shows us efficacy of retrograde cerebral perfusion which allows more time for arch repair than the technique of deep hypothermia with circulatory arrest and importance of careful and precise evaluation by preoperative image diagnosis.

Aged↗

PubMed1991

[Single lung allotransplantation of Japanese monkeys--an immunohistological appraisal of the acute rejection].

Eleven orthotopic single lung allotransplantations of Japanese monkeys (Macaca fuscata) were done without immunosuppression. In the 7 monkeys acute rejection was obvious on chest X-ray and hematoxyline-eosin (HE) staining of the biopsied specimen. On the chest X-ray film, progressive interstitial shadow of the grafts became apparent at the third postoperative day, and they turned out completely radiopaque at the 6th- or 7th postoperative day. The HE staining revealed prominent perivascular edema at the second postoperative day. Perivascular round cell infiltration appeared at the third day and the massive round cell infiltration was observed in the perivascular region, vascular wall and alveolar wall with the thickening of the alveolar wall. Immunostaining with human antilymphocyte monoclonal antibodies was also performed. CD8 positive cells (suppressor/cytotoxic T cell) were observed in the perivascular region at the second postoperative day, and CD8 positive cells and CD4 positive cells increased in number as the rejection progressed. Judging from the positive immunological cross reactivity between Japanese monkey and human, the early diagnosis of the acute rejection of the grafted lung may be possible by detecting the perivascular CD8 cells, even in the human-beings.

Animals↗

PubMed1990

[Quadricuspid aortic valve: case reports].

Two cases of quadricuspid aortic valve with aortic regurgitation are reported. Case 1, a 66-year-old woman was operated on because of aortic regurgitation, and an aortic valve replacement with a bioprosthesis was performed. When the valve was exposed during the operation, it showed four cusps, three of which were of equal size and one smaller cusp which was interposed between the right and left coronary cusp. Case 2, a 46-year-old man was diagnosed, using echocardiography and aortography before surgery, as suffering from aortic regurgitation because of a quadricuspid aortic valve. During surgery, two larger cusps and two smaller cusps and a displacement of the right coronary artery ostium, (which was placed in a lower position and close to the commissure between the right coronary and the right posterior cusps) were found. The four cusps were excised and replaced by a tilting disc prosthesis. In both cases, the postoperative recovery was uneventful. Using the 24 cases from the literature and two of our own cases, the correlation between the size or the position of the accessory cusp and the occurrence of aortic regurgitation was analyzed. The larger the accessory cusp was, the higher the incidence of aortic regurgitation occurred (p less than 0.05).

Aged↗