The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai zasshi
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Jpn. J. Thorac. Cardiovasc. Surg. · Feb 1998
Randomized Controlled Trial Comparative Study Clinical Trial[Clinical benefits of normothermic cardiopulmonary bypass on postoperative systemic metabolism].
To evaluate the influence of body temperature during cardiopulmonary bypass (CPB) on postoperative systemic metabolism, 32 patients undergoing elective cardiac surgery were randomly assigned to either hypothermia (n = 16) or normothermia (n = 16). Serial hemodynamic parameters and blood samples were obtained after surgery. CPB and operation times were significantly shorter and the platelet reduction ratio during CPB [ = (platelets before CPB-platelets after CPB)/platelets before CPB] was significantly lower in normothermic patients than in hypothermic patients. ⋯ There were no differences between 2 groups in postoperative hepatic and renal functions, changes in oxygen consumption, arterial-venous PCO2 or arterial-venous pH gradient. This study suggested a beneficial influence of normothermic CPB on postoperative hemodynamics. Normothermic CPB was not associated with adverse effects on postoperative metabolic recovery.
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Jpn. J. Thorac. Cardiovasc. Surg. · Feb 1998
Case Reports[Two surgical cases of right parasternal minimal incision for aortic valve replacement].
Although median sternotomy has been used as a good approach to all cardiac valves and coronary arteries, advantages of the minimal invasive cardiac operation have been reported recently. We employed the right parasternal minial incision, reported by Cosgrove et al. for two cases of aortic valve replacement. In the first case, we were able to get a good operation field and easily implanted a mechanical prosthesis. ⋯ Moreover, the operation field was restricted because we left several rib cartilages to preserve the right internal thoracic artery. The cannula had to be inserted via the right atrium as we failed to insert it in the right femoral vein, and the aortic root deviated more medially than usual. From these experiences, it is important to check the position of aortic root, and if the cannula cannot be inserted in the femoral vein, cannulation via the right atrium can ve utilized in the minimal invasive cardiac operation.
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Jpn. J. Thorac. Cardiovasc. Surg. · Feb 1998
Case Reports[Combined rupture of trachea and esophagus following blunt trauma--a case report].
A 49-year-old man was involved in a motor vehicle crash and was admitted to a local hospital. The following day, he was transferred to our hospital because of worsening dyspnea. Initial examination revealed no subcutaneous emphysema, and chest computed tomography (CT) demonstrated no mediastinal air. ⋯ The perforated anterior esophageal wall was sutured in layers and reinforced with a fifth intercostal muscle flap. A gastrostomy tuve was placed for feeding access. Within 6 weeks, the patient recovered completely.
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Jpn. J. Thorac. Cardiovasc. Surg. · Feb 1998
[Open heart surgery without blood transfusion for cyanotic congenital cardiac defects].
Between November 1994 and January 1997, 42 cases of cyanotic congenital cardiac defects underwent definitive surgery at Matsudo Municipal Hospital. We evaluated 30 cases, each weighing from 7 to 20 kg. The procedures were performed at the age of 9 months to 6 years (mean age-2.4 years). ⋯ In all groups, hemodynamics were stable. Retrospectively, it is thought that blood transfusion was not necessary in Group C and the use of the plasma protein fraction was not needed in Group B. In conclusion, the open heart surgery can be performed safely without blood transfusion for cyanotic congenital cardiac defects.