[Report of a successful repair, in a 3-year-old girl, of innominate artery stenosis associated with aortic coarctation, using cardiopulmonary bypass].
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Biomedical subjects
Publications and source records attributed to T Tahata.
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Five patients underwent reoperations because residual or recurrent aortic regurgitation occurred after aortic valvuloplasty for aortic regurgitation associated with ventricular septal defect. The mean age at reoperation was 22 years old, and the mean time interval between initial and second operation was 6 years, 10 months. The pathological findings of the aortic valves showed tears and perforation of repaired leaflets in four patients and a giant pseudoaneurysm of the Valsalva sinus in one. Aortic valvuloplasties were performed again in three patients, and aortic valves were replaced with prosthetic valves in two. Slight to moderate regurgitant murmurs are still audible in patients who underwent these valvuloplasties. Ventricular septal defects should be closed before aortic regurgitation develops. If it has developed, however, valvuloplasty should be considered as a first choice in young patients. For adult patients, aortic valve replacement is recommended.
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As a result of mass-screening, a 7-year-old girl was noted to have an abnormal shadow and was subsequently diagnosed as having a pericardial cyst. During surgery, we discovered that the cyst originated from the epicardium, and only its free wall was resected with the cyst left open to the pericardial cavity. The postoperative course was uneventful. This is presumed to be the first case of epicardial cyst ever reported in Japan. In diagnosing the epicardial cyst, the use of chest films, echocardiography and computed tomography assist angiography in making a differential diagnosis from intracardiac lesion. In treatment, surgical resection is advised. Even though the cyst may be asymptomatic, the possible compression on the surrounding organs and possible rupture into the pericardial cavity must be avoided.
A 57-year old man with severe aortic regurgitation was found to have a quadricuspid aortic valve. Aortic valve replacement was performed successfully with a St. Jude Medical prosthetic valve. On histological examination, the resected cusps showed fibrotic thickening with calcification.
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