THE EVALUATION OF THE MODIFIED BLALOCK-TAUSSIG SHUNT WITH A PROSTHESIS OF MICROKNITTED DACRON FOR THE TETRALOGY OF FALLOT IN EARLY INFANCY

We evaluated the surgical results of the modified Blalock-Taussig shunt (MBTS), performed with a prosthesis of microknitted Dacron, for the ductus-dependent tetralogy of Fallot (TOF) in early infancy. Nine MBTSs for eight patients, 4 with and 4 without pulmonary atresia, were performed, and one patient died. The mean age was 30 +/- 27 days, and the mean weight was 3460 +/- 770 g at the initial MBTS. In the initial two cases, the patients experienced convulsions due to severe hypoxia on account of the troubles of the preoperative administration of Prostaglandin E1 (PGE1). Thereafter, in order to prevent brain damage, we performed the MBTS following short-term administration of PGE1 (2-13 days). Consequently, we did not experience brain damage in later cases. Half of the patients with the MBTS with a 5 mm diameter prosthesis experienced postoperative congestive heart failure due to excessive pulmonary flow, and one of them died. The patients with the MBTS with a 4 mm diameter prosthesis had good postoperative courses. The suitable shunt flow in these patients was estimated to be 70-90 ml/kg/min. The MBTS with a 4 mm prosthesis obtained the lower level of this suitable shunt flow, but that a 5 mm prosthesis induced excessive shunt flow. Observing the patients' weight gain and the progress of polycythemia until two years of age, there were no differences between the MBTS with a 4 mm prosthesis and that with a 5 mm prosthesis. From these results, we recommend a 4 mm microknitted Dacron prosthesis for the MBTS of the TOF in early infancy.(ABSTRACT TRUNCATED AT 250 WORDS)

The Japanese Journal of Thoracic and Cardiovascular Surgery


New operative method for distal aortopulmonary spetal defect.


左心低形成症候群に対するmodified Norwood手術の1成功例

左心低形成症候群に対するmodified Norwood手術の1成功例


乳児期早期姑息的開心術における至適肺血流量について

乳児期早期姑息的開心術における至適肺血流量について

日本心臓血管外科学会雑誌

日本心臓血管外科学会雑誌


Microknitted Dacron Graft を用いた乳児期早期ファロー四徴症に対するmodified Blalock-Taussig手術の検討


生後5日後に，永久的ペースメーカー植え込み術を要した先天性完全房室ブロックの一例


完全房室ブロック患者のペース・メーカー植え込み術前・術後の運動時循環動態について


複合心奇形に対する新生児期手術の検討

複合心奇形に対する新生児期手術の検討

日本心臓血管外科学会雑誌

日本心臓血管外科学会雑誌


新生児期早期TGA(Ⅰ)に対するJatene手術の問題点・とくに弁上部狭窄について

日本心臓血管外科学会雑誌

日本心臓血管外科学会雑誌


新生児期早期のTGA(Ⅰ)に対する動脈スイッチ手術後の大動脈弁上部狭窄について

新生児期早期のTGA(Ⅰ)に対する動脈スイッチ手術後の大動脈弁上部狭窄について


左心低形成症候群の第一期手術について-Norwood第一期手術成功例を中心に-

左心低形成症候群の第一期手術について-Norwood第一期手術成功例を中心に-


Intraarterial lymphocyte injection therapy for lyphedema of the extremities


経静脈ペースメーカー電極を温存した三尖弁置換術症例

経静脈ペースメーカー電極を温存した三尖弁置換術症例


体肺動脈短絡術の至適短絡量の検討・特にファロー四徴症について

体肺動脈短絡術の至適短絡量の検討・特にファロー四徴症について


左心低形成症候群3例の外科治療経験

左心低形成症候群3例の外科治療経験

日本心臓血管外科学会雑誌

日本心臓血管外科学会雑誌


開心術後急性期心筋代謝におよぼすnicardipineの影響・術後冠拡張療法の指標のために

日本心臓血管外科学会雑誌

日本心臓血管外科学会雑誌


開心術後急性期心筋代謝におよぼすニトログリセリンの効果

開心術後急性期心筋代謝におよぼすニトログリセリンの効果

日本心臓血管外科学会雑誌

日本心臓血管外科学会雑誌


縦隔腫瘍と鑑別困難であった胸部大動脈瘤の1例

縦隔腫瘍と鑑別困難であった胸部大動脈瘤の1例

The Japanese Journal of Thoracic Surgery


四肢リンパ浮腫の臨床・その病態と保存的治療法

四肢リンパ浮腫の臨床・その病態と保存的治療法


ファロー四徴症根治手術後の再手術例の検討

ファロー四徴症根治手術後の再手術例の検討


右室型体心室をもつ複雑心奇形に対するFontan型手術の検討

右室型体心室をもつ複雑心奇形に対するFontan型手術の検討


甲状腺悪性リンパ腫3例の検討

甲状腺悪性リンパ腫3例の検討


後腹膜悪性線維性組織球腫の1例

後腹膜悪性線維性組織球腫の1例


A case of ureteroarterial fistula after urinary diversion

膀胱全摘術後の腸骨動脈尿管瘻の1例


パネルディスカッション2 急性肺動脈血栓塞栓症

パネルディスカッション2 急性肺動脈血栓塞栓症


Japanese Journal of Cardiovascular Surgery

日本心臓血管外科学会雑誌


Significance of Peritoneal Fluid Drainage in Management After Repair of Complex Heart Defects in Infancy --- Cytokine Dynamics In Vivo

In vivo redundancy of pro-inflammatory cytokines results in a vicious cycle of systemic inflammatory response syndrome and low cardiac output syndrome (LOS). The purpose of this study was to elucidate the influence of peritoneal fluid (PF) drainage on cytokine dynamics in vivo and the significance of early induction for infants with LOS. Seven infants, who underwent early PF drainage to manage LOS after repair of complex heart defects under cardiopulmonary bypass, were enrolled. The serum and PF levels of the pro- and antiinflammatory cytokines, interleukin (IL)-6, -8, -10 and tumor necrosis factor (TNF)-alpha, were measured during the perioperative period. Clinical outcomes were observed simultaneously. There were no cases of early or late death, or infectious complications. Drainage volume of PF peaked just after operation, and decreased completely. The amount of proinflammatory cytokines in the PF increased for 3 days after operation. Of the proinflammatory cytokines in the PF IL-6 increased the earliest and cleared the fastest. The amount of cleared IL-8 and TNF-alpha peaked on the 3rd postoperative day and resembled the course of C-reactive protein (CRP). Serum levels of CRP and proinflammatory cytokines in patients with PF drainage decreased significantly more than those without PF drainage. Early initiation of PF drainage is useful in the postoperative critical care of infants with LOS by improving cytokine dynamics in vivo, although there are differences between the severity of patients undergoing PF drainage and those who do not.


Extracorporeal perfusion of the meandering mesenteric arterial circulation for an abdominal aortic aneurysm operation eith obstructed visceral branches

主要な腹部臓器血流をmeandering mesenteric arteryから供給された腹部大動 脈瘤の1手術例

A 64 year old man underwent hemodialysis one year ago was detected an infra renal abdominalaortic aneurysm with the occluded lesion of the superior mesenteric(SMA)and the celiacarteries. Abdominal angiogrphy revealed that the branches of the SMA filled reversely from theinferior mesenteric artery through the large meandering mesenteric artery(MMA). Therefore itwas thought that a prolonged clamping time during the aortic reconstruction would possibly resultin visceral ischemic injury, the MMA was perfused by an extracorporeal circulation system duringthe aortic cross-clamping. The postoperative course was uneventful, without visceral ischemiccomplication. Consequently ischemic enterocolitis is a serious complication and a factor of poorprognosis in an operation of abdominal aortic aneurysm, it is important that understood the state ofthe visceral circulation and decided the strategy of the operation with or without the branchesrepaired for preventing ischemia.


A successful transatrial repair in redo surgery of postinfarction inferoposterior ventricular septal rupture

A successful transatrial repair in redo surgery of postinfarction posterior ventricular septal rupture (VSR) was performed after an infarct exclusion technique through left ventriculotomy incision of the infarcted area. For the infarct lesion, this approach provides excellent results with sufficient closure of the VSR and prevention of the ventricular remodeling for five years. A right atrial approach for postinfarction posterior VSR is very useful for avoiding any further ventriculotomy in an already impaired ventricle, securing a stable suture, and preserving the left ventricular geometry and function.

The Journal of Medical Investigation : JMI


末梢単核球細胞を用いた抹消動脈閉塞症に対する新たな血管新生治療の試み

末梢単核球細胞を用いた抹消動脈閉塞症に対する新たな血管新生治療の試み


胸腺内Tリンパ球の異動制御とケモカイン

胸腺内Tリンパ球の異動制御とケモカイン


肺動脈弁欠損を伴うファロー四徴症の肺動脈弁再建について

肺動脈弁欠損を伴うファロー四徴症の肺動脈弁再建について


甲状腺クリーゼを発症した緊急冠動脈バイパス術の1例

甲状腺クリーゼを発症した緊急冠動脈バイパス術の1例


四肢リンパ浮腫に対するリンパ球道注療法の作用機序

四肢リンパ浮腫に対するリンパ球道注療法の作用機序


Angiotensin as a stimulator of Na+-dependent Ca2+ efflux from freshly isolated adult rat cardiomyocytes


Roles of left atrial appendage for left atrial hemodynamics by left atrial appendage clamping during cardiac surgery.


進行性に3枝ブロックを認め，ペースメーカー治療を要した新生児例

進行性に3枝ブロックを認め，ペースメーカー治療を要した新生児例

第18回日本小児心電学会

第18回日本小児心電学会