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Biomedical subjects

M Kawasuji

Publications and source records attributed to M Kawasuji.

At least 145 records · Page 8Linked to original sources
PubMed1984

Coronary artery steal via a large anastomosis between the coronary and bronchial arteries successfully treated by surgical division.

A 56-year-old woman is presented with a large coronary-artery-to-bronchial-artery anastomosis associated with aortitis syndrome. Her angina, which was the result of a coronary artery steal, was relieved by surgical division of the anastomotic vessel. Pulmonary artery obstruction, as a pulmonary lesion of aortitis syndrome, might increase the collateral flow from the coronary artery through the bronchial artery to the pulmonary circulation.

Angina, Unstable↗
PubMed1984

Noninvasive evaluation of aortocoronary bypass graft patency by contrast-enhanced computed tomography: incrementation mode and dynamic mode.

Fourty-three coronary bypass graft patients were examined with contrast-enhanced computed tomography (CT) to evaluate bypass graft patency. Six 4.8-second sequential scans with 1.4-second interscan intervals were obtained during the injection of a bolus of a contrast medium into a peripheral vein. The sequential dynamic mode and the rapid incrementation mode were used for scanning with contrast enhancement. CT diagnosis correlated with angiographic assessment of graft patency in 36 out of 36 grafts to the left anterior descending artery, in 4 out of 4 grafts to the diagonal branch, in 19 out of 20 grafts to the left circumflex artery, and 6 out of 7 grafts to the right coronary artery. Overall, CT correctly identified 62 out of the 64 patent graft (sensitivity 96.9%), and 3 out of the 3 occluded grafts (specificity 100%). The sensitivity of the incrementation mode alone to detect the bypass graft was 93.0% and that of the dynamic mode was 88.6%. The sensitivity of CT with both modes was 100%. Although CT does not have sufficient resolution to define graft stenosis, it is a noninvasive and clinically useful technique to evaluate bypass graft patency with high accuracy.

Adult↗
PubMed1982

Aortic valve replacement and ascending aorta replacement in ankylosing spondylitis: report of three surgical cases and review of the literature.

Out of 887 consecutive patients who underwent aortic valve replacement between January 1976 and December 1981 at Hannover Medical School Hospital, 3 patients had severe aortic valve insufficiency associated with ankylosing spondylitis (Morbus Bechterew). One of them had huge aneurysmatic dilatation of the ascending aorta and successfully underwent replacement of the ascending aorta by a vascular prosthesis. Microscopical examination of the resected aortic wall showed characteristic findings of aortitis in ankylosing spondylitis. The 3 patients are in good clinical condition at 5 and 6 months, and 2 1/2 years, respectively, after uneventful surgery. It is concluded that aortic valve replacement in patients with ankylosing spondylitis can be performed feasibly and clinical results have been satisfactory. The risk of aneurysmatic dilatation of the ascending aorta resulting from aortitis associated with ankylosing spondylitis is emphasized.

Aorta↗
PubMed1981

Surgical treatment of the Wolff-Parkinson-White syndrome in infants and children.

Eleven pediatric Wolff-Parkinson-White (WPW) syndrome patients underwent surgery. Four had left, 5 right cardiac type and 2 had right septal type WPW syndrome. Two patients had 2 accessory conduction pathways (ACP). Ebstein's anomaly and secundum type atrial septal defect were the association congenital cardiac diseases in one patient each. Indications for surgery included repeated and/or long-lasting paroxysmal supraventricular tachycardia (PSVT), ineffective drug therapy, cardiac failure due to frequent tachycardia, short effective refractory period of the ACP, and simultaneous surgery for associated congenital cardiac diseases. Pre- and intra-operative examinations, including ECG, VCG, UCG, body surface mapping, intracavitary recording by catheter electrodes, computerized epicardial mapping, and endocardial mapping, were performed for the precise localization of the ACP. The surgical method was basically the same as is used for adults. Anterior median stermotomy was used primarily in right cardiac and right septal type and left anterior thoracotomy was used in 3 of 4 cases of the left cardiac type. Eight of 11 cases, two of which had 3 ACPs, were completely cured and in 3 there was evidence of postoperative pre-excitation. However, the PSVT attacks disappeared almost completely and drug therapy is not required at present.

Adolescent↗
PubMed1981

Complete occlusion of the left main coronary artery: report of three surgical cases and review of the literature.

Out of 75 consecutive patients with left main coronary artery (LMCA) obstruction who underwent coronary revascularization between January and October 1980, 3 patients had total occlusion of the LMCA. All 3 patients were suffering from severe angina pectoris preoperatively. On cardiac catheterization they had shown extensive collaterals from the right coronary artery and relatively well-preserved left ventricular function. In addition to intercoronary anastomoses a relatively high extracoronary collateral blood flow was measured at operation. Postoperatively the 3 patients remained free of angina (class I NYHA) at 5, 20 and 50 months after uneventful surgery. It is concluded that patients with adequate intercoronary and extracoronary collaterals may well survive complete occlusion of the LMCA. Surgery appears to carry a low risk no greater than that involved in conservative treatment of LMCA stenosis and the postoperative clinical status of the patients continues to be satisfactory.

Adult↗
PubMed1980

Interruption of multiple accessory conduction pathways in the Wolff-Parkinson-White syndrome.

Of 35 patients with Wolff-Parkinson-White syndrome operated on, 5 were seen with two accesory conduction pathways each; all of these were successfully interrupted. In one patient, one accessory conduction pathway each was located in the right and left side of the heart; in the other 4, both pathways were confined to the right side. In 2 patients with unilateral (right side) multiple accessory conduction pathways, Ebstein's anomaly was also present. In 1 patient with Ebstein's anomaly, the second unilateral accessory conduction pathway was discovered intraoperatively and was successfully interrupted. The remaining 4 patients required a second operation to interrupt the other pathway. A delta wave completely different from the preoperative one appeared 4 to 10 days after interruption of the first major pathway, and the second operation was performed 14 days, 42 days, four months, or five years after the first operation. All 5 patients survived, and long-term follow-up revealed no signs of morbidity.

Adolescent↗
PubMed1980

Localization and interruption of accessory conduction pathway in the Wolff-Parkinson-White syndrome.

We operated upon 36 patients with Wolff-Parkinson-White (WPW) syndrome between 1969 and July, 1979. The relationship between the electrocardiogram (ECG), particularly the delta wave, and localization of the accessory conduction pathway (ACP) was analyzed, and the value of preoperative examinations such as vectorcardiography, echocardiography, body surface mapping, intracavitary potential study, and cardiac pacing were demonstrated. Epicardial mapping was indispensable as an intraoperative study and represented the most effective method for localizing the ACP. In some cases, endocarial potential study was found to be efficacious. Detachment of the atrium from the ventricle by an incision along the anulus at the area of earliest pre-excitation, resulted in complete correction in 26 of 28 patients operated upon between 1973 and July, 1979. In five patients multiple ACPs was corrected, although four of them required a second operation. The surgical indications in the WPW syndrome should be expanded in view of the high success rate and the safety of the operation.

Adolescent↗