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Masateru Onaka

Publications and source records attributed to Masateru Onaka.

4 recordsLinked to original sources

Radionuclide study of mid-term left ventricular function after endoventricular circular patch plasty.

OBJECTIVE: Although the early result of endoventricular circular patch plasty (EVCPP) has been reported, few are seen about the long-term results. We studied left ventricular (LV) function in the early and mid-term periods after EVCPP with electrocardiographic-gated single photon emission computed tomography (Gated SPECT). METHODS: Consecutive 14 patients with LV asynergy after myocardial infarction, who had the EVCPP procedure, were studied by Gated SPECT. Mean age of patients was 67+/-10 years. Gated SPECT images were obtained and LV end-diastolic volume index (EDVI), LV end-systolic volume index (ESVI) and ejection fraction (EF) were studied with QGS(+) program. Gated SPECT study was performed before surgery, early (23 days) and mid-term periods (32 months) after surgery. RESULTS: EDVI changed significantly from preoperative value to early postoperative value (107+/-39 to 72+/-37 ml/m(2), P < 0.01). There was no significant difference between early and mid-term postoperative values. ESVI also changed significantly from preoperative value to early postoperative value, and from early value to mid-term postoperative value (78+/-37 to 51+/-34 to 47+/-35 ml/m(2), P < 0.05, respectively). EF increased significantly from preoperative value to early postoperative value, and from early value to mid-term postoperative value (30+/-10 to 35+/-13 to 45+/-18%, P < 0.05, respectively). CONCLUSIONS: Direct influence of EVCPP brought significant improvement of LV function in early period. Further decrease of ESVI and increase of EF were noticed from early period to mid-term period. This result suggest that the effect of EVCPP sustains long and yields reverse LV remodeling.

Aged↗

Open heart surgery for posttraumatic inferior vena caval thrombosis.

A 40-year-old woman was diagnosed as intrahepatic hematoma after blunt abdominal trauma. One month later computed tomography (CT) revealed the inferior vena caval thrombus extending into the right atrium. Emergency thrombectomy was performed under cardiopulmonary bypass. We believe that the thrombus, which was derived from laceration of the hepatic vein, extended through the inferior vena cava into the right atrium, and was the eve of pulmonary embolization. CT study should be repeated, once the intrahepatic hematoma was recognized. We emphasize that we should recognize the existence of such complication to prevent the catastrophic result.

Abdominal Injuries↗

Comparison of volume study by left ventriculography and gated SPECT in endoventricular circular patchplasty.

Although quantitative gated SPECT (QGS) is widely used for left ventricular (LV) volume study, its accuracy is not established for those who have a large myocardial infarction scar or who had endoventricular circular patch plasty (EVCPP). Therefore, we compared LV volumes and LVEF calculated by QGS and those calculated by left ventriculography (LVG) before and after EVCPP. Sixteen patients (13 men and 3 women, mean age 67 +/- 9.5 years) were treated with EVCPP for postinfarction LV dyskinetic and/or akinetic scar. All patients were evaluated with both QGS and LVG before and after surgery. QGS was performed using eight frames per cardiac cycle, 1 hour after 740 MBq (99 m)Tc-tetrofosimin was administered. LVG images were acquired at a frame rate of 30 frames per second in the right anterior oblique 30-degree projection. We compared LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), and LV ejection fraction (LVEF) between QGS and LVG. There was an excellent linear correlation between QGS and LVG in LVEDV (preoperative; r = 0.87, postoperative; r = 0.94), LVESV (preoperative; r = 0.95, postoperative; r = 0.89), and LVEF (preoperative; r = 0.73, postoperative; r = 0.81) before and after EVCPP. However, both preoperative LV volumes and postoperative LVEF calculated from QGS gave a smaller value than those calculated from LVG. Postoperative volume data by QGS was much close to LVG. The present study indicated that volume study by QGS is very useful to evaluate the LV function after EVCPP. However, we should pay attention to those facts.

Aged↗

Surgical treatment of multiple coronary artery fistulas with an associated small saccular aneurysm--a case report.

Coronary angiography (CAG) of a 57-year-old woman with anterior chest discomfort revealed no stenosis of the coronary arteries but multiple coronary artery fistulas (CAFs). The sites of origin for the CAFs were the right coronary artery, left main coronary artery, left anterior descending coronary artery, and ascending aorta. The only site for drainage was the main pulmonary artery. Furthermore, a small saccular aneurysmal formation was detected. Surgical treatment was considered better than conservative treatment or coil embolization, and ligation and division of the CAFs were performed during cardiopulmonary bypass. Using a Harmonic Scalpel to expose fistulous arteries was very effective. CAG performed immediately after surgery demonstrated that all CAFs were repaired. The postoperative course was uneventful.

Aorta↗