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Biomedical subjects

S Sugimura

Publications and source records attributed to S Sugimura.

At least 19 recordsLinked to original sources
PubMed1995

[A case of tricuspid regurgitation due to blunt chest trauma].

A case of tricuspid regurgitation due to blunt chest trauma is presented. A 35-year-old man was in good health until he sustained blunt chest trauma in a traffic accident 17 years ago (in 1972). After that easy fatiguability developed. In 1977, slight tricuspid regurgitation was detected, but he was clinically well and no treatment seemed necessary. In October 1989, he was admitted due to right heart failure. The chest X-ray film showed marked cardiomegaly and ECG revealed atrial fibrillation and complete right bundle branch block. Two-dimensional echocardiogram showed a flail anterior leaflet of the tricuspid valve and severe tricuspid regurgitation. In December 1989, he underwent tricuspid valve replacement with Carpentier-Edwards bioprosthesis. The chordae tendineae to the anterior leaflet of the tricuspid valve were ruptured. Furthermore, an artificial cardiac pacemaker was implanted because of slow atrial fibrillation. His postoperative course was uneventful.

Accidents, Traffic↗
PubMed1992

[A case of tricuspid valvular myxoma in a child].

A six-year old boy had hospitalization because of cardiac murmur and syncope attack. Laboratory data including immunoglobulin and erythrocyte sedimentation rate were normal, but echocardiography and cardioangiography indicated tricuspid valvular myxoma in the right atrium. The tumor was successfully removed with the septal tricuspid valve using the cardiopulmonary bypass. The tumor was 18 x 20 x 12 mm in size and pathological findings showed a myxoma originated from tricuspid valve. Now he shows normal cardiac function and no recurrent sign of tumor. There has been reported a few cases of valvular myxoma in Japan. However, this is the first case which was successfully resected by surgery.

Child↗
PubMed1989

[Pure pulmonary atresia complicated by major sinusoidal-coronary artery communication--a case report].

The current treatment of pure pulmonary atresia consists of early initiation of prostaglandins followed by a combination of surgical procedures according to the right ventricular morphology. Major right ventricular sinusoidal-coronary artery communications (SCAC) occasionally present in patients with hypoplastic right ventricle may remain as coronary artery-right ventricular fistulae after right ventricular decompression, which may in turn be the cause for poor surgical results after pulmonary valvotomy in neonates with the SCAC. Herein, a case of this anomaly is reported with a review of literature. A 2-month-old infant underwent an aorto-pulmonary artery shunt operation using Gore-Tex graft for an emergency treatment of pure pulmonary atresia with major SCAC. The catheterization and ventriculography performed 6 months later disclosed suprasystemic right ventricular pressure and more extended SCAC. Then, right ventricular outflow tract was constructed utilizing Gore-Tex patch across the pulmonary valve under cardiopulmonary bypass. The aortico-pulmonary artery shunt was left functioning. After another 6 months, cardiac catheterization and ventriculography were repeated. Right ventricular pressure decreased to the systemic level, right ventricular ejection fraction improved, and the SCAC was not visualized by ventriculography. The decreased inter-ventricular pressure difference and improved right ventricular emptying after the second operation may have played a role in the disappearance of the SCAC. For the neonates with pure pulmonary atresia and sinusoidal-coronary artery communications, we still advocate systemic-pulmonary shunt procedure with concomitant or slightly delayed pulmonary valvotomy as the initial procedure. Unless the tricuspid valve is critically small or stenotic, there may still be a chance for the growth of the right ventricle even in this type of case.

Coronary Vessel Anomalies↗
PubMed1989

[Development and usefulness of dynamic respiratory scanning by fast CT].

Dynamic Respiratory Scanning (DRS) was developed in order to get a series of respiring chest image during the period from maximum inspiration to maximum expiration by using fast CT. The image of different respiratory phase was selected and displayed successively under the control of a track ball. We could recognize the relation of the visceral and parietal pleura as the relative position of the ribs and peripheral pulmonary vessels. The DRS was useful for the diagnosis of pleural adhesion.

Adolescent↗
PubMed1989

[Systemic origin of the sole artery to the basal segments of the left lung without pulmonary sequestration].

A sixty-one year-old man with squamous cell carcinoma of the left upper lobe had an aberrant systemic artery to the left basal segments without pulmonary sequestration. Physical examination revealed neither cardiac murmur nor any sign of heart failure, which was at variance with reported cases in the literature. Chest X-ray film showed no abnormal density suggesting sequestrated lung. Bronchogram disclosed obstruction of the left upper lobar bronchus by the tumor and normal segmental bronchi of the lower lobe. Left pulmonary angiogram showed normal arterial distribution of the left upper lobe and the superior segment of the lower lobe, but the basal segmental arteries were not visualized. The aberrant pulmonary artery arising from the descending aorta was visualized by computed tomography. Following dissection of the abnormal vessel pneumonectomy was performed. Pathological examination of the left basal segments revealed prominent atheromatous changes in the aberrant systemic intrapulmonary artery and irreversible obstructive lesions in its tributaries. These arterial lesions in this patient would have precluded plastic operations such as transfer of the origin of the aberrant vessel to the left pulmonary artery even if other circumstances had been favorable for preservation of the left lower lobe.

Arteriosclerosis↗
PubMed1987

[Aortocoronary bypass in patient with chronic renal failure].

Aorto-coronary bypass surgery was performed successfully for an anuric patient who had been on hemodialysis three times a week for ten years because of chronic renal failure. Hemodialysis was performed up to twenty-four hours prior to the operation. Cardiopulmonary bypass was done using a bubble oxygenator primed with 2000 ml of homologous blood and 500 ml of osmotic diuretic and electrolytes. Peritoneal dialysis started immediately after the surgery followed by routine chronic hemodialysis from the 5th postoperative day. This patient recovered uneventfully and is now relieved from severe chest pain.

Coronary Artery Bypass↗
PubMed1986

[Myocardial infarction due to thrombi in coronary aneurysms in a young woman with systemic lupus erythematosus].

Acute myocardial infarction (AMI) is relatively rare in systemic lupus erythematosus (SLE), although other cardiac complications, such as pericarditis and myocarditis, occur frequently in this disease. A 20-year-old woman with documented SLE experienced a transmural anterior AMI due to thrombi in saccular aneurysms of the left main coronary artery and the proximal portion of the left anterior descending coronary artery. There were also saccular and fusiform aneurysms in the right coronary artery, but thrombi were not observed in them. Aorto-coronary bypass surgery was performed to salvage the viable myocardium and to prevent recurrent myocardial infarction and rupture or infection of these coronary aneurysms. Postoperative coronary angiography revealed a new small saccular aneurysm in the mid-portion of the right coronary artery. During this period, there was no immunological evidence of active SLE. It is important to ascertain whether such coronary aneurysms resulted from atherosclerosis or arteritis, because of the choice of the different therapeutic interventions. In this case, however, it was difficult to determine. It was speculated that these coronary aneurysms arose from an arteritic process, because the saccular aneurysm in the mid-portion of the right coronary artery was formed in less than three months, there were no coronary risk factors, and any microscopic evidence of atherosclerosis was not obtained in the aortic specimen during aortocoronary bypass surgery. Serial coronary angiographic studies are necessary for accurately diagnosing coronary artery disease. Anticoagulant therapy and antiinflammatory medication may be necessary to prevent myocardial infarction in patients with SLE, even if there is no immunological evidence of active SLE.

Adult↗
PubMed1985

[A case of aortoenteric fistula with iliac embolization].

A sixty-eight year-old woman complained of acute hematemesis and numbness of the right lower extremity. Physiocal examination on amission demonstrated revealed a pulsating mass in the midabdomen, absence of pulsation of the right femoral artery and cold pale skin of the right leg. The diagnosis of abdominal aneurysm with aortoenteric fistula and embolization embolectomy to the right iliac artery was mode by computed tomography although the fistula was not clearly visualized. The abdominal aneurysm was replaced with a Y-graft after embolectomy and the fistula to the duodenum was completely closed. Early diagnosis and emergency surgery are necessary to save the patient with this rare disease.

Aged↗