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ABSTRACT: A 41-year-old male patient was diagnosed acute myocardial infarction. An intra-aortic balloon pump was inserted to treat heart failure, and off-pump coronary artery bypass surgery was performed. Postoperative cardiac catheterization revealed occlusion of all the 3 bypass grafts, and percutaneous coronary intervention (PCI) was performed. Thrombosis due to heparin-induced thrombocytopenia (HIT) occurred during PCI, which was completed after switching to argatroban based on the possible HIT. Cardiopulmonary arrest occurred suddenly after PCI, and the patient died. Undetected HIT may have caused the sudden change. HIT should be suspected and aggressively treated when thrombocytopenia occurs even during assisted circulation.
General Thoracic and Cardiovascular Surgery 05/2012; 60(8):511-3.
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ABSTRACT: The waffle procedure is performed in patients with marked thickening and calcification of the epicardium and no substantial improvement in hemodynamic parameters after pericardiectomy. We retrospectively investigated the efficacy of the waffle procedure in 6 of 11 patients who underwent pericardiectomy. These 6 patients showed no improvement in central venous pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, or cardiac index after pericardiectomy. After the waffle procedure, all hemodynamic parameters improved, and there were no significant differences compared to those of the 5 patients who did not require the waffle procedure, despite higher pulmonary capillary wedge pressure and lower cardiac index values preoperatively in the waffle group. The waffle procedure was considered effective in patients with persistent epicardial constriction.
Asian cardiovascular & thoracic annals 04/2011; 19(2):115-8.
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ABSTRACT: Various techniques have been used for repair of ventricular septal perforation complicating inferior myocardial infarction, but no standard method has been established. An effective technique for closing ventricular septal perforation using double patches via a right atrial approach is described. In our experience, no residual shunt was observed after repair using this procedure.
Asian cardiovascular & thoracic annals 02/2010; 18(2):185-7.
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ABSTRACT: Between May 2000 and December 2002, 10 neonates underwent arch reconstruction without circulatory arrest. Age at surgery ranged from 1 to 18 days, and body weight ranged from 1.62 to 3.38 kg. The diagnosis was interrupted aortic arch in 4, hypoplastic left heart syndrome in 3, and coarctation complex in 3. A 3 mm polytetrafluoroethylene graft was anastomosed to the innominate artery, and the brain was perfused via this graft while the aortic arch was reconstructed. Regional cerebral oxygen saturation and the right and left radial artery pressures were monitored. There were 2 deaths: one because of low cardiac output syndrome after a Norwood operation; another from multiple organ failure due to preoperatively undetected congenital biliary atresia. Regional cerebral oxygen saturation was kept constant at over 40% during regional cerebral perfusion. There were no neurologic sequelae observed postoperatively. It was concluded that the regional cerebral perfusion technique can be safely applied during neonatal aortic arch reconstruction, and deep hypothermic circulatory arrest should be avoided.
Asian cardiovascular & thoracic annals 01/2006; 13(4):337-40.
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ABSTRACT: Complete closure is most important when attempting acute-phase closure of a ventricular septal perforation following acute myocardial infarction. Here, we present a case of a 76-year-old male with a ventricular septal perforation following acute myocardial infarction. The ventricular septal perforation was repaired by stitching small and large bovine pericardial patches onto the affected septum from the side of the left ventricle, then cementing the two patches together with gelatin resorcine formol glue injected into the space between them. Complete closure of the ventricular septal perforation was accomplished. Simultaneously, right coronary artery bypass grafting was performed using a saphenous vein. The postoperative course was uneventful, and the patient was discharged, with a favorable post-discharge course for 24 months to date after surgery.
The Japanese Journal of Thoracic and Cardiovascular Surgery 08/2002; 50(7):294-7.
