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Biomedical subjects

S Hayase

Publications and source records attributed to S Hayase.

At least 19 recordsLinked to original sources
PubMed1995

[Surgical treatment for ischemic mitral regurgitation in patients with poor left ventricle].

Results of CABG with and without mitral valve surgery were analyzed retrospectively in 81 patients with ischemic mitral regurgitation (MR) to determine the effects of severity of MR and surgical treatment on survival. Seven of 81 patients had severe MR (more than Sellers III degrees/IV). Of these 7 patients, 5 patients underwent mitral valve replacement and 1 patient underwent mitral annuloplasty. Only one patient did not undergo valve surgery. This patient had slight improvement of the functional classification after CABG, but died of congestive heart failure 5 years after surgery. There were 3 hospital deaths and 5 late deaths in 81 patients. Among the 29 patients with poor left ventricle (EF < or = 0.3), there were 3 hospital deaths and 2 late deaths. Postoperatively, 12 patients had Sellers II degrees/IV or III degrees/IV MR. In 4 patients of these 12, the severity of MR was aggravated in comparison with the preoperative severity. Three of these 4 patients had perioperative myocardial infarction (PMI). IABP was utilized preoperatively in patients with poor left ventricle to keep the stable hemodynamics and prevent PMI. In these patients, there were no PMI, no hospital death, or no aggravation of MR. In conclusion, patients with Sellers I degree/IV or II degrees/IV MR require CABG only, whereas those with Sellers III degrees/IV or IV degrees/IV MR need CABG combined with mitral valve surgery. Preoperative use of IABP is useful for preventing PMI and aggravation of MR in patients with poor left ventricle.

Aged↗
PubMed1995

[Experience of modified Bentall's procedure for annulo-aortic ectasia].

To reduce the incidence of false aneurysm formation at the suture lines, a known complication with the inclusion technique such as Bentall's procedure or Cabrol's procedure, modified Bentall's procedure (Carrel patch technique), which is identical to Inberg's procedure, has been selected as treatment for annulo-aortic ectasia since 1991. This operation was carried out in 6 consecutive patients with annulo-aortic ectasia from July 1991 to August 1992. The aortic valve and the aneurysm were resected, the coronary ostia were dissected free, mobilized, and then implanted to the composite graft. It was necessary for one patient to undergo coronary artery bypass grafting for myocardial ischemia due to injury of the right coronary ostium. Thereafter, the button of coronary ostium was cut into a big size and then trimmed just before the implantation to the composite graft in order to prevent injury of the button of the coronary ostium. There was no hospital mortality. No pseudo-aneurysm at the coronary ostia or the distal aortic anastomosis was observed at control aortography carried out 1 month after surgery. One patient died 1 year after the first operation because of low cardiac output after the re-operation for pseudo-aneurysm at the proximal aortic anastomosis and infection of the composite graft. All the other patients have been symptom free during follow-up. The use of gelatin impregnated dacron graft and the reinforcement of the suture lines by Teflon felt strips minimized bleeding. One patient underwent this operation without blood transfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Invasive treatment of ischemic events after coronary artery bypass grafting].

PTCA or reCABG was performed for ischemic events after CABG in 32 patients. Since 6 patients were operated on initially elsewhere, the incidence of reCABG among our own patients was 1.2% and that of PTCA was 4.5%. Only one patient of 15 patients, in whom internal thoracic artery (ITA) was utilized at the initial CABG, underwent reCABG and the other patients were treated by PTCA. The use of ITA reduced the necessity for re-CABG because of the superior long-term patency of ITA. PTCA was performed for 32 lesions (19 in saphenous vein grafts (SVG), 4 in ITA grafts, and 9 in native coronary arteries) of 23 patients with success rate of 88%. The rate of restenosis was 36%. There were no complications following PTCA. No patients were referred for emergent surgery. Intracoronary thrombolysis and PTCA for total occlusion of SVG were performed successfully if they were done early after the occurrence of ischemic events. Coronary angiography should be performed as soon as possible. Ten patients underwent re-CABG utilizing ITA in 9 patients and gastro-epiploic artery (GEA) in 3. One patient died of arrhythmia due to spasm. The other 9 patients were discharged and class I or II of NYHA functional classification. The coronary angiography, which was performed at the late follow-up period, showed occlusion of SVG and patency of ITA. The arterial conduits should be applied for reCABG because of the low long-term patency of SVG.

Adult↗
PubMed1994

[Repeated valvular surgery with minimal heart dissection].

Between April 1989 and March 1994, sixteen patients underwent the reoperation for valvular disease. In early years, complete heart dissection performed during operation (group A, n = 7). And recently, minimal necessary dissection was applied (group B, n = 9). In group B, dissection was limited to the ascending aorta, both vena cavae and right upper pulmonary vein. If the adhesion would be dense, pleural cavity would be widely opened and both caval cannula and left atrial vent tube would be cannulated through pleural adhesion. Operation time of group B was significantly decreased in comparison with group A. (group A: 569 +/- 91 min, group B: 347 +/- 65 min, p < 0.01). Post-operative course of group B was considered to be better than group A. These result suggested that minimal necessary heart dissection would be extremely effective during the repeated valvular surgery.

Dissection↗
PubMed1992

Comparison of thallium-201 and technetium-99m teboroxime myocardial single photon emission tomography with coronary arteriography.

Myocardial single photon emission tomography (SPET) using technetium-99m teboroxime (teboroxime) was studied and the results compared with those of thallium-201(thallium) SPET and coronary arteriography in 19 patients. Resting teboroxime SPET was performed initially. Two hours later, exercise teboroxime SPET was performed. Exercise ergometer tests for both teboroxime and thallium were carried out in a supine position. The levels of exercise achieved for both tests were similar. Agreement for the identification of myocardial segments between thallium SPET and teboroxime SPET was 147/171(86%) (NS). When a significant stenosis was defined as greater than or equal to 75% or greater than or equal to 50%, agreement between two radiopharmaceuticals for the detection of diseased vessels was 89% (NS, k = 0.601) or 88% (NS, k = 0.713), respectively. In only 2/19 cases were inferior and posterior segments (3/171) difficult to interpret in teboroxime SPET due to hepatic activity. Thus, teboroxime SPET with a short data acquisition time resulted in a rapid completion for each study and had a good correlation with thallium SPET.

Adult↗
PubMed1992

[Extrapleural approach for patent ductus arteriosus and coarctation of the aorta].

During the period of 1989 to 1990, 6 consecutive children with patent ductus arteriosus or coarctation of the aorta underwent operative therapy. Ligation or division of patent ductus arteriosus or subclavian flap angioplasty for coarctation of the aorta were performed by extrapleural approach with axillary or posterolateral incision. Patients' ages ranged from 9 days to 8 years. Weights ranged from 3 to 30 kg. It was very easy to have better operative field and beneficial to protect the lung against mechanical injury. Extrapleural approach was not so easy in an 8-year-old patient with firm connective tissue. Therefore, this procedure is considered to be suitable for younger children.

Aortic Coarctation↗
PubMed1992

[Staged sternal closure for the case of postoperative severe cardiac failure: a convenient method in the intensive care unit].

A convenient method of staged sternal closure in the intensive care unit for a patient with severe cardiac failure was reported. According to the patient's cardiac function, optimal intersternal space can be adjusted. When using this method on a infant, the adjustment has shown to be very easy and take only a short time. However we have no experience on adults with stronger sternum.

Cardiac Output, Low↗
PubMed1992

[Carpentier's procedure for Ebstein's anomaly: successful and failed cases].

Two adult cases of Ebstein's anomaly underwent Carpentier's procedure. In the first case longitudinal plication limited to free wall of atrialized ventricle was performed and postoperative course was uneventful. In the second case preoperative echocardiography showed apparently restricted movement of anterior leaflet of the tricuspid valve which was compatible with intraoperative findings. That is, inferior edge of anterior leaflet was partly adherent to ventricular wall and systolic bulging of leaflet was significantly impaired which was left untouched but should be repaired by additional procedure. Six days after operation the tricuspid valve replacement was required for persistent right heart failure due to residual tricuspid regurgitation. In the same case longitudinal plication of atrialized ventricle reported by Carpentier and colleagues resulted in excessively small annulus. Therefore we had to reduce the plication and did not perform following atrial plication to avoid direct injury to conduction system or disturbing coronary venous return. In conclusion exact preoperative evaluation of anterior leaflet of the tricuspid valve especially subvalvular anatomy is essential to Carpentier's procedure, as Carpentier and colleagues emphasized, and conservative longitudinal plication of the atrialized ventricle limited to free wall is favorable when excessively small annulus might be concerned.

Cardiac Surgical Procedures↗
PubMed1991

[A case of cardiac lipoma in the ventricular septum].

A 45-year-old man was admitted because of systolic murmur after routine medical checking. Echocardiography and cardiac catheterization revealed a large mass in the ventricular septum which bulged into right ventricular cavity with pressure gradient of 29 mmHg. The diagnosis of cardiac lipoma was made by CT scanning which showed the mass with attenuation values of -94 Hounsfield units. MR imaging demonstrated the mass with high signal intensity which corresponded to that of subcutaneous fatty tissue. The tumor was resected through the right ventricular incision with the use of cardiopulmonary bypass. It was yellow, elastic soft, sized 6.5 x 4.3 x 3.5 cm, and weighed 44.7 g. On histological examination, the tumor was composed of mature fatty tissues contained with myocardial fibers. After operation, he had split of the ventricular septum, which was closed primarily after removal of the lipoma, and left-to-right shunt. Patch reinforcement was performed at the right ventricular side of the septum on the postoperative 18th day. Postoperative electrocardiogram showed left axis deviation and complete right bundle branch block. This finding seems to be resulted from injury to the anterior branch of left bundle. The postoperative course was uneventful. This patient is the second case of removal of cardiac lipoma in the ventricular septum on review of the literature in Japan.

Heart Neoplasms↗
PubMed1991

[Analysis of factors influencing early patency of saphenous vein grafts].

To determine factors affecting early patency of saphenous vein grafts, 140 grafts in 65 patients were studied angiographically within 2 months after operation. Twenty of the 140 grafts were occluded. Sixteen variables were extracted from the angiographic findings, intraoperative measurements, clinical characteristics, and biochemical data. The univariate and multivariate analyses were performed to assess their predictive value. Of 16 variables, 3 (coronary artery internal diameter, graft flow, and coronary artery resistance) correlated significantly with graft patency in the univariate analysis. The multivariate analysis selected coronary artery resistance, coronary artery internal diameter, and degree of proximal stenosis as predictors of early graft patency. Of these 3 factors, the coronary artery resistance influenced graft patency mostly. Therefore, the coronary artery resistance was considered to be the most reliable predictor of early graft patency.

Adult↗
PubMed1991

[A case of completely unroofed coronary sinus with persistent left superior vena cava].

A 34-year-old female presented with exertional dyspnea. Investigation by echocardiography and cardiac catheterization showed completely unroofed coronary sinus with persistent left superior vena cava (PLSVC) (coronary sinus atrial septal defect, absence of the coronary sinus, and PLSVC-left atrium connection) combined with tricuspid valve regurgitation. Angiocardiography made by injection into the PLSVC demonstrated that the PLSVC was connected to the hemiazygos vein before it drained into the left atrium and the left innominate vein was absent. Although jugular vein pressure rose up to 18 mmHg when the PLSVC was temporarily occluded, it remained unchanged. Therefore, simple ligation of the PLSVC was selected for therapy. Patch closure of the atrial septal defect, tricuspid valve repair, and ligation of the PLSVC was performed successfully.

Adult↗
PubMed1990

[Two cases of HTLV-I associated myelopathy (HAM) after cardiac operation].

Sixty-one and 51-year-old males had progressive walk disturbance after cardiac operations at the intervals of 1 and 2 years. They had received blood transfusion at their operations. Physical examination revealed spastic paraparesis, sensory disturbance of the lower and rectobladder disorder. High titers of anti-Human T-lymphotrophic Virus type-I (HTLV-I) antibody were found in sera and CNF in both cases. They were diagnosed as HTLV-I associated myelopathy (HAM). Because they lived in Aichi Prefecture where the virus is non-epidemic, they were possibly infected through the blood transfusion at their operations. For prevention of HAM, the anti-HTLV-I antibody of all donor blood should be checked before transfusion.

Heart Valve Prosthesis↗
PubMed1990

[A case of concomitant repair of aortic regurgitation due to congenital aortic quadricuspid valve and coronary artery occlusive disease].

A case of rare congenital anomaly of quadricuspid aortic valve and coexisting coronary artery occlusive disease of a 60-year-old female was presented. She was admitted to our hospital for heart murmur and angina pectoris. The echocardiography and aortography showed quadricuspid aortic valve and aortic valve regurgitation. The coronary arteriography revealed the presence of triple vessels disease. Successful aortic valve replacement and Coronary bypass grafting were performed simultaneously.

Aortic Valve↗
PubMed1990

[A case of ruptured azygos vein and diaphragmatic hernia due to blunt chest trauma].

A 47-year-old female was admitted to the emergency room following an automobile accident. She was shocked complaining of respiratory difficulty and chest pain. A chest X-ray showed right hemothorax which drained 2.5 liters of blood on insertion of chest tube. Emergency operation revealed rupture of azygos vein. The bleeding was controlled by the ligation of the azygos vein. Postoperative chest X-ray showed obscuration of the left diaphragma, and herniated stomach was identified by the gastrography. Second operation was performed and ruptured diaphragma was repaired. Her postoperative recovery was good. She was discharged from hospital at 7th week.

Azygos Vein↗
PubMed1990

[Application of an extended aortic arch anastomosis for staged repair of type A interruption: a case report of a 13-day-old neonate].

A 2-day-old girl was found to have a type A interruption of aortic arch, ventricular septal defect and patent ductus arteriosus with severe metabolic acidosis. Following aggressive medical treatment with Prostaglandin E1 and inotropic agents, she underwent arch reconstruction by extended aortic arch anastomosis and pulmonary arterial banding on her 13th day. Six months after first stage repair, a subarterial infundibular VSD was closed transpulmonary and reconstruction of pulmonary artery was done by end-to-end anastomosis. She shows normal development, strong femoral pulse and no neurologic sequelae after 8 months postoperatively.

Aorta, Thoracic↗
PubMed1990

[Case report of a saccular aneurysm of the thoracic aorta in childhood].

A five-year-old boy with a large saccular aneurysm of the thoracic descending aorta extending rightward in the mediastinum underwent operation. Through a left thoracotomy descending aorta was clamped during partial femoro-femoral bypass and a examination of somatosensory evoked potential of the spinal cord. Placing a vertical incision on the aorta, a orifice of the aneurysm was closed with a xenograft pericardial patch. The aneurysm was left untouched. Nine months after operation the aneurysm was not recognized on chest X-ray and computed tomography. Etiology was unknown.

Aorta, Thoracic↗
PubMed1989

[Vasodilator therapy utilizing nitroprusside and nitroglycerin after coronary artery surgery].

The hemodynamic effects of combined therapy utilizing sodium nitroprusside (SNP) and nitroglycerin (TNG) were compared with those of TNG therapy in patients who underwent coronary artery bypass grafting (CABG). Of 58 patients who received catecholamine infusion to maintain hemodynamics after CABG, 17 had perioperative myocardial infarction (PMI (+) cases) and the other 41 had not PMI (PMI (-) cases). 26 of 41 patients (PMI (-) cases) received nitroglycerin therapy (NTG group) and the other 15 patients received combined therapy (SNP + NTG group). 11 of 17 patients (PMI (+) cases) received NTG therapy and the other 6 patients received combined therapy. The hemodynamic valuables, which were studied, were as follows; cardiac index, stroke volume index, left ventricular stroke work index, systemic vascular resistance index, pulmonary vascular resistance index, and deep core temperature. SNP + TNG group revealed significantly lower systemic vascular resistance index and pulmonary vascular resistance index than TNG group in PMI (-) cases. In PMI (+) cases, SNP + TNG group revealed significantly higher cardiac index, stroke volume index, left ventricular stroke work index, and significantly lower pulmonary vascular resistance index than TNG group. These findings demonstrate that combined therapy can obtain more secure vasodilation than TNG therapy.

Cardiac Output, Low↗