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Biomedical subjects

M Hachida

Publications and source records attributed to M Hachida.

At least 19 recordsLinked to original sources
PubMed1992

[A case report on the sliding commissuroplasty for mitral regurgitation due to posterior commissural chordal rupture].

We have performed a mitral valve reconstruction on a 31-year-old man who suffered from infective endocarditis four years ago. Severe mitral regurgitation and posterior commissural chordal rupture were noted. The mitral valve was repaired by Carpentier's sliding commissuroplasty and ring annuloplasty. The postoperative course was uneventful, and mitral regurgitation completely disappeared. It appears that Carpentier's sliding commissuroplasty is a superior new reconstructive technique for mitral regurgitation due to commissural chordal rupture.

Adult↗
PubMed1992

[A clinical assessment of efficacy in continuous retrograde cerebral perfusion method].

From November 1990 to June 1991, 8 patients underwent surgical repair using continuous retrograde cerebral perfusion (CRCP). We evaluated the effect of CRCP from these 8 cases. As a method of CRCP, we perfused with oxygenated blood from SVC canulae with a internal jugular vein pressure of 30-40 cmH2O. Simultaneously systemic perfusion from femoral arterial canulae was performed. At nasopharyngeal temperature of 15-21 degrees C, CRCP time was 46-115 minute. SVC perfusion flow was 280-900 ml/min, and femoral arterial perfusion flow was 450-1,200 ml/min. At 30 minute after starting CRCP, oxygen tension of the blood which was returned to aortic arch was 11-23 mmHg, whereas oxygen tension of the SVC perfusion blood was 210-398 mmHg. In only one patient, transient involuntary movement was seen after operation, but prolonged emergence from anesthesia was not seen. In conclusion, CRCP is considered as an useful method in the operation of the aortic arch.

Aorta, Thoracic↗
PubMed1992

[A case report: an elderly patient surviving conservative surgical repair of ventricular septal perforation (VSP) with using Swan-Ganz catheter in order to close VSP temporarily].

A 81-year-old female was referred to our hospital for VSP. Preoperative catheterization showed that pulmonary arterial pressure (PAP) was 50 mmHg over in systole, and L-R shunt rate was 63.4%. In spite of any medications under intraaortic balloon pumping, hemodynamics was gradually worsened. And so Swan-Ganz catheter was inserted into right ventricle via VSP retrogradely in order to close VSP with the balloon of the catheter. PAP decreased to about 40 mmHg in systole and L-R shunt rate became to 49.7% by this method. This treatment could conserve the surgical repair for 5 days and the operation was performed on 22 days after the onset of VSP. It is very important to be able to conserve VSP operation by using Swan-Ganz catheter to close VSP temporarily.

Aged↗
PubMed1992

[Surgical repair of distal aortic arch aneurysm using "elephant trunk" technique].

We present a surgical case of 61-year-old man with distal aortic arch aneurysm. Under selective cerebral perfusion in deep hypothermia, we approached to the aneurysm through median sternotomy. Dilated distal aortic arch and proximal descending aorta with mural thrombus in the aneurysmal lumen were found. The aortic occlusion balloon catheter was inserted into the descending aorta. A Cooley woven Dacron graft (26 mm in diameter) was anastomosed at 5 cm above its distal end loosely to the descending aorta with five interrupted mattress sutures, and the distal portion of the graft was pushed down into the distal aorta ("elephant trunk" technique). Postoperative course was uneventful and the dead space around the graft in aneurysm was filled with thrombus. Six months later, however, emergent operation was performed because of compression of the bronchus and the esophagus by enlargement of the aneurysm due to leakage. The second operation was approached through 5th left intercostal thoracotomy and median sternotomy. The aneurysm was opened, and the thrombus was amounted to 500 g. The distal end of the graft was anastomosed end-to-end to the mid-portion of the descending thoracic aorta. Postoperative course was uneventful and the patient was discharged. It is concluded that Elephant trunk technique is effective and the postoperative control of hypertension is very important.

Aorta, Thoracic↗
PubMed1992

[Classification of congenitally bicuspid aortic valve and its angiographic and surgical significance].

From January, 1978 to December, 1990, 85 patients with congenital bicuspid aortic valve underwent aortic valve replacements (AVR) with St. Jude Medical valve prosthesis. We classified congenital bicuspid aortic valve into four types. Type I (44.7%): Two cusps are situated right and left, a coronary artery arises from each related sinus of valsalva. Type II (22.4%): Type I + raphe in the right cusp. Type III (3.5%): one cusp is located anteriorly, the other posteriorly and both coronary arteries arise from anterior cusp. Type IV (29.4%): Type III + raphe in the anterior cusp. Regarding to preoperative diagnosis, aortic stenosis dominated in Type I (78.8%) and aortic regurgitation dominated in Type IV (72.0%). Implanted valve sizes were 22.2 +/- 1.8 (Type I), 23.4 +/- 1.6 (Type II) and 24.0 +/- 2.2 (Type IV). There was a significant difference between Type I and Type II, same as Type I and Type IV. Babb's method and outflow measurement method were utilized to predict the aortic annular size. However, both of them were not reliable for estimating the size of the aortic annulus in cases of aortic stenosis undergoing AVR with a 21 mm prosthesis.

Adolescent↗
PubMed1991

Percutaneous transaortic closure of postinfarctional ventricular septal rupture.

We report a case of successful closure of a postinfarctional ventricular septal defect by means of the transaortic approach with a balloon catheter. This method brought about substantial improvement in cardiopulmonary function before an elective operation and made it possible to successfully perform the operation on the patient, an 81-year-old woman, on the 22nd day of admission.

Aged↗
PubMed1991

[Recanalization of saphenous vein graft occlusion after CABG using a newly designed coronary wire].

A 57-year-old male underwent coronary bypass grafting, consisting of sequentially grafting of saphenous vein grafts to the diagonal and left descending arteries and the right coronary artery. On the 12th postoperative day, he had chest pain and ECG showed significant ST elevation on the V1-5 leads. Subsequently, PTCR was performed, however, the occlusion of the graft between the diagonal artery and the left descending artery remained. Then, a coronary boring wire we designed was inserted into the left descending artery and coronary recanalization was successfully achieved.

Angioplasty, Balloon↗
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↗
PubMed1991

[Orthotopic heart transplantation with sinus venosus incision of right atrium in dogs--preservation of sinus node and original right atrium].

Orthotopic heart transplantation with sinus venosus incision of right atrium was aimed to preserve the sinus node, terminal crista, sinus node artery and whole right atrial muscle of the transplanted heart. This transplant procedure was performed in eight mongrel dogs and electrocardiogram was followed up to five postoperative months. Direct cross circulation technique was employed as an alternative of cardiopulmonary bypass. Donors and recipients were 6 to 8 kg mongrel puppies, and 19 to 25 kg adult dogs supported the cross circulation. Myocardial protection of the donor heart was carried out by low-flow continuous potassium cardioplegia and topical cooling. Right atrial incision of the donor heart was made longitudinally in the posterior wall of sinus venosus. After a median sternotomy, ascending aorta and superior and inferior venae cavae of the recipient were cannulated and connected respectively with carotid artery and jugular vein of the cardiopulmonary support dog. Electrocardiogram, arterial pressure and central venous pressure of the recipient were monitored, and an electro-magnetic flow meter was employed for measuring the blood flow of direct cross circulation. The native heart was resected after aortic cross-clamping, and left atrium and atrial septum were sutured continuously. Sinus venosus incision of the donor heart was anastomosed to the recipient's right atrium. Ascending aorta and pulmonary trunk were reconstructed in the standard fashion. Aortic cross-clamp time was less than one hour and sinus rhythm of the transplanted heart was continued in all cases. Five of the eight dogs were alive postoperatively for one week to five months.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

[A new multiple organ preservation-assessment of viability after the heart and lung preservation using UCLA formula].

The difficulty in obtaining suitable organs for the transplantation is a major problem in Japan. In this study, we assessed the suitable procedure for multiple organ preservation and evaluated organ viabilities after preservation with an unique technique. The heart and lung were preserved with UCLA Formula alone and the liver was preserved with Euro-Collins' solution. The mean ischemic times of the heart, lung and liver were 4.3 hours, 7.5 hours, and 6 hours, respectively. The viability of the heart graft following orthotopic transplantation was evaluated with cardiac output and Left Ventricular End-Diastolic Pressure (LVEDP) under the constant pre-load (CVP 7 mmHg). Cardiac outputs (ml/min.) were 4.01 +/- 1.36 before operation, 3.26 +/- 0.26 at 1 hour after transplantation, 3.24 +/- 0.26 at 4 hours after transplantation (NS). LVEDP (mmHg) was 7.1 +/- 0.8 before operation, 6.5 +/- 0.86 at 1 hour, and 7.4 +/- 1.2 at 4 hours after transplantation (NS). The viability of transplanted lung was evaluated with pressure-tidal volume curve and arterial oxygen tension (PO2) when right pulmonary artery and bronchus were occluded. There was no statistical difference in pressure-volume curve and PO2 tension between the phases of pre- and post-transplantation. After liver transplantation, ICG test (15 min.) showed a sufficient value of 35-40%. In conclusion, the procedures of multiorgan preservation using UCLA Formula and Euro-Collins' solution were successfully performed and its viability of grafts after transplantation remained sufficient.

Animals↗
PubMed1990

[Increase of surfactant and protein contents in the alveolar space after lung preservation].

This study is to describe the pathophysiological change in the alveolar space due to reperfusion injury in the lung. Six pigs, weighing 20-22 kg, were used. Through the left lateral thoracotomy, both sides of pulmonary artery (PA) and bronchus (Br) were exposed and occluded the left side of PA and Br. Left lung was perfused with 200 ml of UCLA Formula and preserved in room temperature (27 degrees C) for 3 hours. After the clamps were released, right side of PA and Br were clamped and pulmonary artery pressure (PAP) and static lung compliance were measured in ischemic lung. Then, animals were sacrificed and alveolar wash was performed. With the fluid taken from the alveolar wash, the surfactant and protein content in the alveolar space were measured using Malate's method and Lowry's method, respectively. As the results, PAP (mmHg) was significantly increased after the reperfusion, from 34.0 +/- 8.1, to 85.4 +/- 8.7 (p less than 0.001). Lung Compliance (ml/cmH2O) was decreased, from 0.52 +/- 0.07 to 0.31 +/- 0.1 after the reperfusion (p less than 0.001). The content of surfactant in the left lung described as a ratio (left/right) was 252.5 +/- 87.8% of that in right side. The content of protein in the left lung was 289.5 +/- 137% of that in right side. We concluded that both contents of surfactant and protein were increased in alveolar space after the reperfusion.

Animals↗
PubMed1989

[Assessment of cardiac rejection following heart and lung transplantation (I)].

To diagnose the cardiac rejection after the heart and lung transplantation, the histopathological assessment is the most reliable method at the present time. In this study, the heterotopic heart and lung transplantation was performed using rat model and the rejection process of heart allograft was sequentially examined at 1 day, 4 days, 7 days, and 12 days after the transplantation. The gross finding of both ventricles were observed to investigate the development process of the rejection. Then, the most typical findings in each period were analysed using a microscope with our criteria including three components, which are 1. Perivascular findings 2. Interstitial findings, 3. Myocyte degeneration. This study demonstrates that allograft rejection after heart and lung transplantation initiates from right ventricular free wall and spreads into outer layer of left ventricle as same fashion as orthotopic cardiac transplantation. The assessment of these 3 components using the indicators shown in this study might be very useful method to objectively determine the grades of rejection after the heart and lung transplantation.

Animals↗
PubMed1989

[Assessment of cardiac rejection following heart and lung transplantation (II)].

To investigate the histologic consequence of combined heart and lung transplantation, 15 transplanted hearts were obtained from heterotopic heart and lung transplantation using rat model. The allografts were randomly obtained between 1 and 13 days after the transplantation without use of any immunosuppressants. Based upon our criteria established in our previous study, the degree of cardiac rejection was evaluated using rejection score, independently at seven segments in both ventricles, which are 1) Right Ventricle Free Wall (RVFW), 2) Transient zone between RVFW and Septum (RVFW-SEP), 3) Septum (RVSEP), 4) Left Ventricle (Right outer layer) (LVRO), 5) Left Ventricle (Left outer layer) (LVLO), 6) Left Ventricle (Right inner layer) (LVRI), 7) Left Ventricle (Left inner layer)(LVLI). The degree of cardiac rejection in each segment shows differently and the rejection initiates from RVFW and spreads into RVFW-SEP and outer layers of left ventricle. The segments of RVSEP and inner layers of left ventricle remained normal longer than other segments, and were thought to be less sensitive to diagnose the rejection in early phase. Significant correlation between post-transplanted days and the degree of rejection was observed in all segments except RVSEP. In conclusion, this study demonstrates that the myocardial biopsy obtained from RVFW, RUVF-SEP and LVRO after the combined heart and lung transplantation might be more sensitive than any other segments including RVSEP.

Animals↗
PubMed1989

A new solution (UCLA formula) for lung preservation.

In previous studies, we revealed the beneficial effects of verapamil and glucose-insulin-potassium solution in lung preservation. In this study, we composed a new solution (UCLA formula) containing both of these factors and compared it with Collins-Sachs solution in a canine autotransplantation model. A total of 15 dogs were used. The animals were assigned randomly to the two study groups. The left lungs of seven dogs were perfused with the UCLA formula and the left lungs of eight dogs with Collins-Sachs. Both solutions were at 4 degrees C. After 6 hours of preservation, the left lungs in both groups were autotransplanted. In the UCLA formula group, seven of seven dogs (100%) survived for the entire period of 2 weeks after the operation. In contrast, two of eight dogs in the Collins-Sachs group (25%) survived for longer than 24 hours. Pulmonary artery resistance (dyne.sec.cm-5) after transplantation was 499.8 +/- 144.8 in the UCLA group and 780.9 +/- 174.5 in the Collins-Sachs group (p less than 0.01). Pulmonary artery resistance was also ascertained with the right pulmonary artery occlusion test and showed 539.5 +/- 95.4 in the UCLA group and 1469.3 +/- 573.6 in the Collins-Sachs group (p less than 0.01). Oxygen tension (mm Hg) after lung transplantation was 74.1 +/- 10.6 in the UCLA group and 35.9 +/- 3.5 in the Collins-Sachs group (p less than 0.01). Postoperative oxygen tension with the right pulmonary artery occlusion test was measured daily for 7 days. Two survivors in the Collins-Sachs group showed significant deterioration of oxygen tension from the third postoperative day. Also, the relationship between the airway pressure and tidal volume showed a significant reduction in the Collins-Sachs group (p less than 0.01). In conclusion, the transplanted lung in which UCLA solution was used demonstrated improved lung function after 6 hours of preservation in comparison with function in lungs preserved with Collins-Sachs solution.

Animals↗
PubMed1989

Lung function after prolonged lung preservation.

Our previous study revealed significant improvement in lung preservation with a new solution, the UCLA formula, which contains verapamil and is based on a glucose-insulin-potassium solution. In this study, we extended the preservation time up to 12 hours and, using various parameters, compared lung function after 12 hours' preservation with that after 6 hours' preservation. The left lung of 15 dogs was perfused with 300 ml of the UCLA formula (4 degrees C) and preserved for 6 hours in eight dogs (group A) and for 12 hours in the other seven dogs (group B). The preserved left lung was then autotransplanted and pulmonary function was evaluated during the following 2 weeks. The oxygen tension was monitored at 2 and 12 hours postoperatively, then daily for 1 week, and on the fourteenth postoperative day. The right pulmonary artery was temporarily occluded to assess the function of the preserved left lung alone. Oxygen tension in group A was maintained within the normal range. By contrast, in group B transient deterioration in oxygen tension was observed from the third to the fourth postoperative day (p less than 0.01), improving toward the normal range by the seventh day. Pulmonary vascular resistance was significantly elevated after transplantation in group B, improving to the normal range by the fourteenth postoperative day. Lung compliance, according to the airway pressure-tidal volume curve, also deteriorated significantly in group B (p less than 0.01), improving to the normal range within 2 weeks. Lung perfusion scintigraphy with technetium-labeled macroaggregated albumin was performed on the fourth day after the operation. The ratio of left to right pulmonary flow on the fourth postoperative day was 57.1 +/- 8.5% in group A and 52.2% +/- 12.3% in group B (no significant difference). In conclusion, temporary deterioration of lung function was observed after 12 hours of lung preservation, manifested by impaired oxygen exchange and loss of compliance.

Animals↗
PubMed1988

A comparison of solutions for lung preservation using pulmonary alveolar type II cell viability.

Many special solutions have been developed to protect the ischemic lung in preparation for transplantation. To determine an effective solution, we isolated pulmonary alveolar type II cells from rat lungs. These cells play an important role in sodium transport and the production of surfactant; thus, they are crucial to the respiratory physiology of the lung. In this study, we examined in vitro the effect of various solutions such as Collins' solution, Collins-Sacks solution, and glucose-insulin-potassium solution on alveolar type II cell viability. The cell viability was examined with a trypan blue dye exclusion test and [3H]thymidine uptake proliferation assay after 24 and 72 hours of incubation. The alveolar type II cells in the glucose-insulin-potassium solution had greater viability compared with cells cultured in either Collins' or Collins-Sacks solution. This study demonstrates that glucose-insulin-potassium solution has the least toxic effect on isolated alveolar type II cells compared with other preserving solutions.

Animals↗