Newly designed extracardiac direct total cavopulmonary connection with merged connection and mixing route.
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Child, Preschool↗
Biomedical subjects
Nobuyuki Ishibashi
Publications and source records attributed to Nobuyuki Ishibashi.
Intraventricular rerouting for transposition of the great arteries with posterior aorta: ventricular septal defect creation and total resection of the infundibular septum.
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Cardiac Surgical Procedures↗
Successful extensive enlargement of a non-committed ventricular septal defect in double outlet right ventricle.
We performed an arterial switch operation in a patient with double outlet right ventricle with non-committed ventricular septal defect, and abnormal insertion of the tension apparatus of the tricuspid valve which produced moderate tricuspid regurgitation. This required extensive enlargement of the ventricular septal defect between the attachments of the cords of the tricuspid valve so as to create the interventricular rerouting that made possible the arterial switch operation. Postoperatively, we produced a straight, unobstructed, left ventricular outflow tract, improved the extent of tricuspid regurgitation, and achieved low right atrial pressures. Enlargement of the interventricular communication can set the scene for biventricular repair in this particular subset of patients with both arterial trunks arising from the morphologically right ventricle.
Abnormalities, Multiple↗
Mechanism of hemolysis after mitral valve repair and new surgical management: prosthetic annuloplasty ring covered with autologous pericardium.
BACKGROUND AND AIMS OF THE STUDY: Hemolysis after mitral valve repair is a rare occurrence, but is one of the complications leading to reoperation. Since 1999, mitral valve repair at the authors' institution has been performed using a prosthetic annuloplasty ring covered with autologous pericardium to prevent this complication. The study aims were to investigate the mechanism of hemolysis after mitral valve repair and to describe the surgical management of this complication. METHODS: This retrospective study comprised 204 consecutive patients who underwent mitral valve repair using an annuloplasty ring between October 1991 and April 2000 at the authors' institution. Patients were allocated to the non-covered ring group (n = 174) and the covered ring group (n = 30), and compared for the degree of mitral regurgitation (MR), serum levels of lactate dehydrogenase (LDH), and occurrence of hemolysis. The degree and flow pattern of MR, and patient prognoses were described for hemolytic patients. RESULTS: Postoperative MR and serum LDH were not significantly high in either group. A total of seven patients presented with hemolysis; postoperative echocardiography revealed MR to be mild in two patients, moderate in three and severe in two. Collision of the regurgitant jet into the artificial ring was evident in all seven patients. A beta-blocker proved effective in treating hemolysis in three patients, mitral re-repair was performed in three, and a prosthetic mitral valve was inserted in one patient. None of the patients in the covered ring group presented with hemolysis. CONCLUSION: The major cause of hemolysis after mitral repair was collision of the regurgitant jet into the artificial ring. The simple technique used herein prevented contact of the regurgitant jet with the rough surface of the ring, and may in turn have prevented hemolysis. In selected patients, hemolysis was improved by beta-blocker administration.
Adolescent↗
When should pulmonary artery angioplasty be performed for Fontan candidates with pulmonary coarctation? Two cases of pulmonary artery angioplasty with the Blalock-Taussig shunt on pump in neonates.
We performed concomitant pulmonary artery angioplasty and the Blalock-Taussig shunt under median sternotomy and cardiopulmonary bypass at the neonatal stage in Fontan candidates with pulmonary coarctation to obtain optimum pulmonary circulation. This surgical strategy realized appropriate early growth of the pulmonary artery necessary for the Fontan operation.
Abnormalities, Multiple↗
Double switch operation in a young infant.
We performed a combined Senning and arterial switch operation on a 2-month-old patient with congenitally corrected transposition, Ebstein's malformation producing severe tricuspid regurgitation, ventricular septal defect, pulmonary hypertension, and congestive heart failure. The tricuspid regurgitation was improved. The double switch operation has the advantage of improving the function of the systemic atrioventricular valve, especially in newborns or young infants in whom the outcome of the valvar repair is poor.
Cardiac Surgical Procedures↗