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Biomedical subjects

Shigeyasu Takeuchi

Publications and source records attributed to Shigeyasu Takeuchi.

5 recordsLinked to original sources

Temporary perfusion for mesenteric ischemia with acute type A aortic dissection.

We report advantages of a temporary mesenteric perfusion method for bowel ischemia with acute type A aortic dissection. The perfusion catheter was inserted from the branch of the superior mesenteric artery. This technique was found to be useful in certain cases that require prompt visceral organ perfusion and proximal aortic repair, which enabled a simultaneous treatment for both lesions and a blood pressure evaluation.

Acute Disease↗

Ascending aortic aneurysm following aortico-ventricular tunnel repair.

Aortico-left ventricular tunnel is a very rare congenital anomaly. An 18-year-old boy had undergone tunnel closure at 3 years of age. A moderate degree of aortic regurgitation remained postoperatively. Seven years later, aortic valve replacement for aortic regurgitation was performed. Eight years later, the ascending aortic aneurysm had grown to 63 mm in diameter. This dilatation became an operative indication. Ascending aortic replacement was performed with a Dacron graft. Pathological examination of the resected aortic wall revealed cystic medial degeneration. We report a rare case of ascending aortic aneurysm following surgical repair of the aortico-left ventricular tunnel and aortic valve replacement.

Adolescent↗

Cognitive dysfunction following cardiovascular surgery.

OBJECTIVE: The aim of this study was the evaluation of perioperative cognitive dysfunction in patients undergoing cardiovascular surgery with or without cardiopulmonary bypass (CPB) and identification of the risk factors. SUBJECTS AND METHODS: Between July 2001 and October 2003, we performed cognitive examinations in 192 patients (mean age 65.5 +/- 7.6 years) who underwent elective cardiovascular surgery with or without CPB. The cognitive examinations (Hasegawa dementia scale) were done both pre- and postoperatively. Forty-six patients who had developed cognitive dysfunction postoperatively were included in Group A. The remaining 146 patients were placed in the control group (Group B). RESULTS: The patients in Group A were noted to be significantly older than those in Group B (69.8 +/- 7.4 vs. 64.1 +/- 7.2, p < 0.05). The number of patients who at risk for cerebrovascular disease was significantly higher in Group A than in Group B (p < 0.05). Among intraoperative variables, there were no significant differences between the two groups concerning the presence or absence of CPB, CPB duration, and operation duration. The length of postoperative hospitalization of the Group A patients was greater. Age was identified as the only predictor of postoperative cognitive dysfunction in multivariate analysis. CONCLUSION: In the present study, it is possible that CPB did not play a significant role in the genesis of cognitive dysfunction after cardiovascular surgery. Age appears to be the only significant predictor of postoperative cognitive dysfunction.

Age Factors↗

Long-term evaluation of bovine pericardial bioprostheses in young women: influence of pregnancy.

OBJECTIVES: To avoid the fetal and maternal risks associated with anticoagulant therapy during pregnancy, the use of bioprostheses has been advocated for young women with cardiac valve disease during the childbearing years. Several reports have suggested the probability of pregnancy-related accelerated structural valve deterioration (SVD). The aim of this study was to assess the effect of pregnancy and delivery on bovine pericardial bioprostheses. METHODS: Between 1986 and 2004, 13 female patients received 14 bioprostheses. The women were segregated into two groups based on whether pregnancy occurred during follow-up: eight in the Pregnant Group (Group P) (including one case who underwent two operations), and six in the Nonpregnant Group (Group NP). RESULT: Early mortality was not observed. Late mortality was 12.5% for Group P and 16.7% for Group NP. There were a total of ten valve-related reoperations (seven in Group P and three in Group NP); the major reason was SVD in 64.3% of the cases. Freedom from valve-related reoperation at nine years was 28.6% in Group P and 33.3% in Group NP (p=0.338). Overall time from primary surgery to reoperation was 111 +/- 24.7 months, with no significant difference between the two groups (p=0.615). The Group P of eight patients had 12 pregnancies: ten deliveries and two abortions. There were no maternal or neonatal deaths. CONCLUSION: Pregnancy did not significantly influence the incidence of SVD and reoperation. The bioprostheses appears to provide female patients with more opportunity for uncomplicated pregnancies, deliveries and normal children than mechanical valves.

Adolescent↗

Mitral stenosis after mitral valve repair using the duran flexible annuloplasty ring for degenerative mitral regurgitation.

The case is presented of a 47-year-old woman who had undergone mitral valve repair using the Duran annuloplasty ring four years earlier, and who was diagnosed with mitral stenosis owing to fibrous tissue overgrowth. In this patient, dense whitish fibrous tissue covered the annuloplasty ring and extended onto both leaflets of the mitral valve, narrowing its orifice and rendering the leaflets stiff and immobile. The pannus covering the mitral valve could not be stripped off without damaging the leaflets, making mitral valve replacement necessary. Mitral valve replacement with a St. Jude Medical mechanical heart valve prosthesis was successfully performed, and no major perioperative complications were encountered.

Female↗