PubMed Health⌕ Search

Biomedical subjects

T Tahata

Publications and source records attributed to T Tahata.

At least 73 records · Page 4Linked to original sources
PubMed1988

Massive systemic venous thrombosis after Fontan operation: report of a case.

A 7 year old boy with single ventricle with pulmonary stenosis underwent a modified Fontan procedure. He had a very stormy postoperative course complicated by continued pleural effusion, hepatomegaly, and chylothorax. He eventually died after an atrial septum reopening. At autopsy, massive thrombi were found in the inferior vena cava, right atrium, and pulmonary artery. This complication was probably due to multiple factors, but a routine anticoagulation therapy may be required after Fontan procedure.

Cardiac Surgical Procedures↗
PubMed1988

Long-term results of aortic valvuloplasty for aortic regurgitation associated with ventricular septal defect.

Long-term results in 64 patients who underwent aortic valvuloplasty for aortic regurgitation associated with ventricular septal defect are presented. The average age of the patients was 10.2 years and the average cardiothoracic ratio was 0.57 at the time of operation. The average degree of aortic regurgitation, as classified by Sellers, was 2.7. The type of ventricular septal defect was subpulmonic in 31 patients, perimembranous in 20, and was a total conal defect in five patients. Valvuloplasty was performed at one end of an aortic cusp in 23 patients, at two ends in 33, at three ends in six, and at four ends in two patients. There was one operative death (1.6%). The follow-up period was 447.7 patient-years, and there were no late deaths. The actuarial survival rate was 98.3% at 5, 10, and 15 years. Postoperative cardiac catheterization was performed in 40 patients. Valvuloplasty failure was defined as the presence of a cardiothoracic ratio greater than 0.6, a loud regurgitant murmur (Levine grade 3/6 or greater), moderate or severe aortic regurgitation (Sellers grade 3 or 4), or the necessity of reoperation. There were 17 patients whose valvuloplasty failed. The freedom from valvuloplasty failure was 74.2% at 5 and 10 years and 55.3% at 15 years. Eight patients underwent reoperation because of residual aortic regurgitation, and all survived. The freedom from reoperation was 90.1% at 5 years, 80.5% at 10 years, and 63.7% at 15 years. Multiple regression analysis revealed that older age, a greater cardiothoracic ratio, perimembranous ventricular septal defect, and multiple valvuloplasties were significant contributing factors for residual regurgitation after aortic valvuloplasty.

Actuarial Analysis↗
PubMed1988

Early and late results of reconstructive operation for congenital mitral regurgitation in pediatric age group.

Sixty-six children aged between 8 months and 15 years (average age 5.5 +/- 3.8 years) underwent mitral reconstructive operations for congenital mitral regurgitation between June 1969 and February 1987. The pathologic findings of the mitral valves were annular dilatation in 37 patients, cleft of the leaflet in eight, hypoplasia of the leaflet in 44, perforation of the leaflet in one, chordal elongation in 22, chordal absence in 16, and chordal shortening in seven. The methods of repair consisted of asymmetric annuloplasty (Kay-Reed method) in 61 patients, De Vega-type annuloplasty in one, plication of redundant leaflet in 15, and closure of cleft or perforation in nine. The single operative death (1.5%) was due to heart block. Follow-up data were available over 373.8 patient-years (average 5.7 years). The four late deaths (6.0%) were due to heart failure in two patients, pneumonia in one, and hepatitis in one. The actuarial survival rate was 93.1% +/- 3.1% at 7 years and 88.4% +/- 5.1% after 17 years. Valvuloplasty failed in 19 of the long-term survivors. One of these patients underwent mitral valve replacement 11 years after initial operation. The rate of freedom from reoperation was 86% +/- 10% after 17 years. The rate of freedom from valvuloplasty failure was 80% +/- 6.7% after 5 years, 67% +/- 7.2% after 10 years, and 44% +/- 11.9% after 15 years.

Adolescent↗
PubMed1987

Usefulness of electromagnetic flowmetry in intraoperative evaluation of aortic regurgitation associated with ventricular septal defect.

In 38 patients with aortic regurgitation (AR) associated with ventricular septal defect (VSD), indications for aortic valvuloplasty (AVP) or aortic valve replacement (AVR) were investigated by assessing AR ratio, which was measured by electromagnetic flowmetry of the ascending aorta during the operation. Residual AR was evaluated by auscultation postoperatively. Patients were assigned to group A if they underwent VSD closure alone and to group B if they underwent AVP in addition to VSD closure; patients who had no postoperative AR were assigned to group I and those with persistence of AR to group II. Thus, the patients were separated into 4 subgroups; A-I (9 patients), A-II (5 patients), B-I (20 patients) and B-II (4 patients). In subgroup A-I, mean AR ratio decreased from 9% to 7% postoperatively, in A-II from 19% to 16% (p less than 0.1), in B-I from 36% to 9% (p less than 0.01) and in B-II from 44% to 20% (p less than 0.05). An AR ratio of more than 25% should be regarded as an absolute indication for AVP or AVR. If the AR ratio is between 20 and 25%, the indication of AVP is determined by inspection of the aortic valve. A good correlation was found between AR ratio and the AR rate determined by the aortic angiographic findings (Sellers classification): grade I AR corresponded to an AR ratio of 5 to 15%, grade II to 20 to 35%, grade III to 25 to 50% and grade IV to 45% or higher (r = 0.87, p less than 0.01).

Aortic Valve↗
PubMed1987

Optimal flow of aorta-pulmonary artery shunt in patients with cyanotic heart disease.

An aorta-pulmonary artery shunt with an expanded polytetrafluoroethylene (Gore-Tex) tube graft (3 to 6 mm in diameter) was done in 33 cyanotic patients with complex congenital heart disease. The patients ranged from 14 days to 22 years old. In 28, the shunt flow (QB) was measured, and the optimal QB and graft size were determined. Nine patients had severe heart failure because of an excessively large shunt. Seven of these patients died, 5 early and 2 late after operation. The QBS in these 9 patients were extremely high; the QB index and the ratio of shunt flow to systemic flow (QB/QS) were 3.86 +/- 0.91 L/min/m2 (mean +/- standard deviation) and 52.4 +/- 9.7%, respectively. The QB index and the QB/QS of patients without severe cardiac failure were 1.49 +/- 0.92 L/min/m2 and 27.2 +/- 11.4%, respectively. In conclusion, the QB index, the QB/QS, or both should be maintained in the range of 1.6 to 2.4 L/min/m2 and 30 to 40%, respectively. In infants, however, it is advisable to control the flow at less than the range just given. Analysis of graft size in relation to body weight (BW, in kilograms) and body surface area (BSA, in square meters) showed that the optimal diameter (D, in millimeters) could be calculated by the following formulas: D = 1.88 In(BW) + 1.8 (r = .86) D = 0.87 In(BSA) + 5.3 (r = .73).

Aorta, Thoracic↗
PubMed1987

A giant aneurysm of the non-coronary sinus of Valsalva.

A 54-year-old woman complained of shortness of breath. She was diagnosed to have an aneurysm of the non-coronary sinus and underwent a radical operation. The aneurysm had a diameter of 10 cm. Superior vena cava, right atrium, and right ventricle were severely compressed and deformed. The non-coronary sinus and ascending aorta were reconstructed with a 24 mm Dacron graft using the graft inclusion technique. The ostiums of both coronary arteries were skirted. The postoperative course was uneventful.

Angiocardiography↗