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1.
Aliment Pharmacol Ther ; 44(6): 583-91, 2016 09.
Article in English | MEDLINE | ID: mdl-27464849

ABSTRACT

BACKGROUND: Vonoprazan, a potassium-competitive acid blocker, is expected to improve the healing of endoscopic submucosal dissection (ESD)-induced gastric ulcers compared with proton pump inhibitors (PPIs). AIM: To compare the healing status of ESD-induced gastric ulcers and the incidence of post-ESD bleeding between subjects treated with vonoprazan for 5 weeks and those treated with PPIs for 8 weeks. METHODS: Patients in the vonoprazan group (n = 75) were prospectively enrolled, whereas patients in the PPI group (n = 150) were selected for a 2:1 matched historical control cohort according to baseline characteristics including gastric ulcer size immediately following ESD, age, sex and status of Helicobacter pylori infection. Two controls per case of vonoprazan-treated group were matched with a margin of 20% in terms of ulcer size and a margin of 5 years in terms of their age. RESULTS: Although a higher number of completely healed ulcers was observed in the PPI group (95/150, 63.3%) than that in the vonoprazan group (14/75, 18.7%; P < 0.001), the ulcer size reduction rates, which were 96.0 ± 6.7% in the vonoprazan group and 94.7 ± 11.6% in the PPI group, were not significantly different (P = 0.373). The post-ESD bleeding incidence in the vonoprazan group (1/75, 1.3%) was less than that in the PPI group (15/150, 10.0%; P = 0.01). The factors affecting post-ESD bleeding incidence were the type of acid secretion inhibitor (P = 0.016) and use of an anti-thrombotic agent (P = 0.014). CONCLUSION: Vonoprazan significantly reduced post-endoscopic submucosal dissection bleeding compared with PPIs.


Subject(s)
Endoscopic Mucosal Resection/adverse effects , Gastrointestinal Hemorrhage/prevention & control , Postoperative Complications/drug therapy , Proton Pump Inhibitors/therapeutic use , Pyrroles/therapeutic use , Stomach Ulcer/drug therapy , Stomach Ulcer/etiology , Sulfonamides/therapeutic use , Adenoma/surgery , Aged , Aged, 80 and over , Female , Gastrointestinal Hemorrhage/etiology , Humans , Male , Middle Aged , Rabeprazole/therapeutic use , Stomach Neoplasms/surgery , Wound Healing/drug effects
2.
J Surg Case Rep ; 2012(10): 3, 2012 Oct 01.
Article in English | MEDLINE | ID: mdl-24960743

ABSTRACT

Bronchogenic cysts are relatively common mediastinal cysts. Here, we report removal of a rare paraoesophageal-type bronchogenic cyst by video-assisted thoracoscopic surgery in a 52-year-old male patient. The defect of the oesophageal wall was successfully reinforced with an intercostal muscle flap.

3.
Thorac Cardiovasc Surg ; 57(3): 180-3, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19330762

ABSTRACT

We report here 2 cases of multiple metastatic lung tumors after hysterectomy for leiomyoma. One patient was diagnosed as having a benign metastasizing leiomyoma (BML), while the other patient simultaneously developed a left pelvic tumor and multiple lung tumors, both of which were finally diagnosed as low-grade endometrial stromal sarcomas (ESSs). The metastatic potential of BML is not completely understood, but previously reported cases of BML may include low-grade ESS, which may play a significant role in the metastasis of benign uterine tumors.


Subject(s)
Endometrial Neoplasms/pathology , Leiomyomatosis/pathology , Lung Neoplasms/secondary , Pelvic Neoplasms/pathology , Sarcoma, Endometrial Stromal/secondary , Uterine Neoplasms/pathology , Biopsy , Endometrial Neoplasms/surgery , Female , Humans , Hysterectomy , Immunohistochemistry , Leiomyomatosis/surgery , Middle Aged , Pelvic Neoplasms/surgery , Sarcoma, Endometrial Stromal/surgery , Tomography, X-Ray Computed , Uterine Neoplasms/surgery
4.
Vasa ; 35(2): 115-7, 2006 May.
Article in English | MEDLINE | ID: mdl-16796012

ABSTRACT

A 76-year-old man with an abdominal aortic aneurysm (AAA) initially presented with ischemic colitis, which was improved by conservative treatment. Preoperative assessment by computerized axial tomography scanning and aortography revealed an infrarenal type AAA with mural thrombus, stenoses of the right common iliac artery and the left internal iliac artery. The patient underwent aortoiliac bypass surgery with resection of the stenoses, and reconstruction of the left internal iliac artery. No complications including bowel ischemia, were noted postoperatively. This case emphasized the potential benefits of the extraperitoneal approach to the aorta, reconstruction of both internal iliac arteries, and use of prostaglandin E1.


Subject(s)
Aortic Aneurysm, Abdominal/complications , Colitis, Ischemic/complications , Aged , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortic Aneurysm, Abdominal/surgery , Aortography , Colitis, Ischemic/diagnostic imaging , Colitis, Ischemic/surgery , Humans , Iliac Artery/diagnostic imaging , Iliac Artery/surgery , Male
5.
Thorac Cardiovasc Surg ; 54(2): 138-40, 2006 Mar.
Article in English | MEDLINE | ID: mdl-16541358

ABSTRACT

Here we report on a 55-year-old man with an abnormal anterior mediastinal shadow and multiple nodules in the thymus, which increased in size over a period of 15 months. He was diagnosed with early prostatic cancer, and treated with chemotherapy. Although no definite preoperative diagnosis was obtained, surgery was performed because of the possibility of malignant neoplasm or metastasis. Extended thymectomy was performed and pathological examination revealed that the nodules were remnant thymic tissue and not malignant lesions. Although the cause of this unusual remnant thymic tissue remains unclear, it may have been related to autoimmune or endocrinological disease.


Subject(s)
Mediastinal Neoplasms/diagnosis , Thymus Hyperplasia/diagnosis , Diagnosis, Differential , Follow-Up Studies , Humans , Male , Middle Aged , Thymectomy , Thymus Hyperplasia/surgery , Tomography, X-Ray Computed
6.
Kyobu Geka ; 56(3): 235-8, 2003 Mar.
Article in Japanese | MEDLINE | ID: mdl-12649917

ABSTRACT

A 64-year-old man was admitted to our hospital with chief complaint of chest discomfort. He received coronary artery bypass grafting utilizing the in situ left internal thoracic artery 10 years ago. Coronary and left subclavian artery angiogram revealed coronary subclavian steal syndrome and 90% stenosis in the proximal left subclavin artery. Ultrasonography of neck vessels demonstrated 75% stenosis in the bifurcation of left carotid artery. We performed axilloaxillary artery bypass grafting to avoid brain ischemia. Myocardial thallium scintigraphy on dipyridamole testing after axilloaxillary artery bypass grafting could not detect myocardial ischemia. Axilloaxillary artery bypass grafting was effective for coronary subclavian steal syndrome.


Subject(s)
Subclavian Steal Syndrome/surgery , Axillary Artery/surgery , Blood Vessel Prosthesis Implantation , Coronary Artery Bypass , Humans , Male , Middle Aged , Polytetrafluoroethylene , Vascular Surgical Procedures/methods
7.
Kyobu Geka ; 56(2): 124-8, 2003 Feb.
Article in Japanese | MEDLINE | ID: mdl-12635322

ABSTRACT

A 50-year-old woman was admitted to our hospital because of heart failure (NYHA III) due to mitral valve regurgitation (MR) with pulmonary hypertension (PH) and tricuspid valve regurgitation (TR). She had a history of chronic renal failure undergoing dialysis (peritoneal dialysis, homodialysis) since 1996. Cardiac catheterization and ultrasonic cardiography showed severe MR (Sellers III), severe TR and PH (mean pressure 33 mmHg). So we performed mitral valve replacement and tricuspid annuloplasty (DeVega). Frequent blood transfusion was needed because severe hemolytic anemia appeared after operation. Ultrasonic cardiography demonstrated moderate aortic valve regurgitation (AR) with no paravalvular prosthetic leakage. We diagnosed hemolytic anemia due to AR. We performed aortic valve replacement. Hemolytic anemia improved soon after second operation. We investigated the mechanical process of the AR. She had a very short subaortic curtain (5.9 mm) compared with the average (8.7 +/- 2.1 mm: mean +/- SD) of cardiac patients. We think that we must be very careful with suture to short subaortic curtain. In addition measurement of subaortic curtain before operation is very useful.


Subject(s)
Anemia, Hemolytic/etiology , Aortic Valve Insufficiency/etiology , Mitral Valve Insufficiency/surgery , Postoperative Complications/etiology , Aortic Valve/pathology , Aortic Valve Insufficiency/surgery , Female , Heart Valve Prosthesis Implantation , Humans , Middle Aged , Reoperation , Suture Techniques
8.
Ann Thorac Surg ; 68(3): 864-9, 1999 Sep.
Article in English | MEDLINE | ID: mdl-10509975

ABSTRACT

BACKGROUND: Optimal conditions for deep hypothermic perfusion and protective brain blood flow remain unclear. METHODS: Dogs (n = 52) underwent 120 minutes of cardiopulmonary bypass at 20 degrees C with perfusion flow rates of 2.5, 5, 10, 20, 40, and 100 mL x kg(-1) x min(-1). We examined the effect of the various flow rates and different perfusion pressures on brain blood flow, metabolism, and intracellular pH. RESULTS: The brain was ischemic and acidotic when the perfusion flow rate was less than 5 mL kg(-1) x min(-1) and pressure was less than 10 mm Hg. When perfusion pressure was higher than 10 mm Hg, cerebral cortex blood flow was more than 9 mL x 100 g(-1) x min(-1) and intracellular pH, higher than 6.95. The cerebral metabolic rate for oxygen decreased at a flow rate of 2.5 mL x kg(-1) min(-1). The cerebral metabolic ratio of glucose to oxygen and the cerebral vascular resistance were lowest when perfusion pressure was 10 to 30 mm Hg. Full-flow (100 mL x kg(-1) x min(-1)) perfusion caused paradoxical brain acidosis; a flow of 40 mL x kg(-1) x min(-1) provided the best results. CONCLUSIONS: Both extremely low-flow perfusion and excessive perfusion cause brain acidosis. Low-flow perfusion at a pressure of 20 mm Hg provides cerebral vasorelaxation and aerobic metabolism during operations at 20 degrees C.


Subject(s)
Cardiopulmonary Bypass , Cerebrovascular Circulation , Hypothermia, Induced , Animals , Blood Flow Velocity , Brain/metabolism , Cerebral Cortex/blood supply , Dogs , Glucose/metabolism , Hydrogen-Ion Concentration , Oxygen Consumption , Vascular Resistance
9.
Kyobu Geka ; 52(3): 218-23, 1999 Mar.
Article in Japanese | MEDLINE | ID: mdl-10097549

ABSTRACT

Between 1978 and 1997, 9 patients developed poststernotomy mediastinitis after coronary artery bypass grafting. Four of these patients (group A) were treated with open drainage and mediastinal irrigation or omental transfer. The other 5 patients (group B) were treated with primary wound closure by the technique of muscle flap mobilization. The purpose of this study was to compare the surgical results and graft patency of both groups. The hospital mortality of group A was 100 per cent. All patients in group B survived for 35 months of the mean postoperative periods without complaints. Postoperative coronary angiography revealed the complete graft patency in group B. We conclude that muscle flap mobilization may be a superior measure for the patient survival and graft patency as the treatment of mediastinitis after coronary artery bypass grafting.


Subject(s)
Coronary Artery Bypass , Mediastinitis/surgery , Omentum/transplantation , Postoperative Complications/surgery , Surgical Flaps , Vascular Patency , Aged , Drainage , Female , Humans , Male , Middle Aged , Treatment Outcome
10.
Ann Thorac Cardiovasc Surg ; 4(1): 41-3, 1998 Feb.
Article in English | MEDLINE | ID: mdl-9495907

ABSTRACT

This report describes a surgical approach of aortic valve replacement in a patient with a calcified ascending aorta, calcified aortic valve stenosis and coronary artery disease. The aortic valve was replaced with a 19 mm St. Jude Medical prosthetic valve through the transected aorta while the distal ascending aorta was cross-clamped at a narrow but not calcified band approximately 4.5 cm distal to the aortic anulus. These procedures were successfully done and no neurological deficit was found after surgery. The aortic valve replacement through the transected aorta may be one of the alternatives in selected patients with porcelain aortas and calcified aortic valves.


Subject(s)
Aortic Diseases/complications , Aortic Valve Stenosis/surgery , Calcinosis/complications , Coronary Disease/surgery , Heart Valve Prosthesis Implantation/methods , Aged , Aortic Diseases/diagnostic imaging , Aortic Valve Stenosis/complications , Calcinosis/diagnostic imaging , Humans , Male , Radiography
11.
Ann Thorac Cardiovasc Surg ; 4(4): 222-5, 1998 Aug.
Article in English | MEDLINE | ID: mdl-9738127

ABSTRACT

In Marfan syndrome, the most common cardiovascular abnormalities are dilatation of the aorta and aortic valve regurgitation in adult patients. Mitral valve dysfunction is the most common cause of morbidity and mortality in infants and children with Marfan syndrome, and is not frequently operated on in adult Marfan patients who undergo surgery for diseases of the aortic root and total aorta. This report describes a successfully three-staged operation for a 24 year-old man with Marfan syndrome who underwent an emergent Bentall operation and aortic arch replacement, total aortic replacement and mitral valve replacement over 2 years. Mitral valve regurgitation was mild but increased after the second operation. The graft was tightly adhesive and invasive to the sternum. Endoscopic view was helpful to avoid graft damage at resternotomy. The postoperative course was uneventful in each operation. Microscopic examination of the mitral valve leaflets showed abnormal increase of mucopolysaccharides, and disruption and fragmentation of elastic fibers.


Subject(s)
Aorta/surgery , Blood Vessel Prosthesis Implantation , Heart Valve Prosthesis Implantation , Marfan Syndrome/surgery , Mitral Valve/surgery , Adult , Aorta/abnormalities , Aortography , Echocardiography , Follow-Up Studies , Heart Valve Prosthesis Implantation/methods , Humans , Male , Marfan Syndrome/complications , Marfan Syndrome/diagnosis , Mitral Valve/abnormalities , Mitral Valve/diagnostic imaging , Mitral Valve Insufficiency/diagnosis , Mitral Valve Insufficiency/etiology , Mitral Valve Insufficiency/surgery , Tomography, X-Ray Computed
12.
Artif Organs ; 22(12): 1018-22, 1998 Dec.
Article in English | MEDLINE | ID: mdl-9876093

ABSTRACT

P-Selectin, an adhesion molecule expressed on the surfaces of activated platelets and the vascular endothelium, mediates platelet binding to monocytes and neutrophils. Monocytes and neutrophils produce superoxide anion by activated platelets through p-selectin. Aprotinin, a serine protease inhibitor, inhibits plasmin to activate platelets during cardiopulmonary bypass (CPB). A total of 25 patients were studied to clarify the effects of aprotinin on p-selectin expression during CPB. Nine patients were not given aprotinin (control group), and 16 were given aprotinin of 2 million U in the priming solution (aprotinin group). The platelet count and soluble p-selectin in the plasma, p-selectin on the surface membranes of platelets, and leukocyte-platelet conjugate levels were measured during and after CPB. The platelet count was maintained well in the aprotinin group. The increases of soluble p-selectin in the plasma, platelet surface p-selectin, and leukocyte-platelet conjugates were less in the aprotinin group than in the control group (p < 0.05). In conclusion, aprotinin in patients undergoing CPB may reduce the early inflammatory reactions induced by p-selectin.


Subject(s)
Aprotinin/pharmacology , Blood Platelets/metabolism , Cardiopulmonary Bypass , Leukocytes/metabolism , P-Selectin/blood , Serine Proteinase Inhibitors/pharmacology , Cell Adhesion , Humans , Middle Aged
13.
J Card Surg ; 13(2): 146-9, 1998 Mar.
Article in English | MEDLINE | ID: mdl-10063964

ABSTRACT

Aneurysm of the ductus diverticulum in the adult is rare and its rupture is fatal. A 75-year-old man presented with congestive heart failure that suddenly occurred with a continuous murmur. Angiography showed a left-to-right shunt through a large thrombosed aneurysm of the ductus diverticulum (6 cm), and the pulmonary-to-systemic flow ratio was 2.6. Patch closure of the orifice (3x4 cm) of the aneurysm and repair of the perforated pulmonary artery were done emergently under hypothermic cardiopulmonary bypass with selective cerebral perfusion. He recovered uneventfully. Early recognition and early intervention should be indicated in this otherwise fatal condition.


Subject(s)
Aneurysm, Ruptured/surgery , Ductus Arteriosus , Pulmonary Artery , Aged , Aneurysm, Ruptured/diagnosis , Ductus Arteriosus/diagnostic imaging , Ductus Arteriosus/surgery , Humans , Male , Pulmonary Artery/diagnostic imaging , Pulmonary Artery/surgery , Radiography
14.
J Surg Res ; 72(2): 135-40, 1997 Oct.
Article in English | MEDLINE | ID: mdl-9356234

ABSTRACT

Deep hypothermic retrograde brain perfusion is used to protect the brain during aortic arch operations. However, all experiments have failed to demonstrate retrograde blood flow in the brain tissue. We developed an experimental model of sagittal sinus and simultaneous superior vena cava perfusion. Brain tissue blood flow was mapped with colored microspheres during deep hypothermic retrograde brain perfusion in 9 dogs. Regional brain pH was mapped photometrically using neutral red as a pH-indicating dye after 90 min of retrograde brain perfusion in 28 dogs and after 60 min of circulatory arrest in 8 dogs. Cerebral surface blood flow was also measured during retrograde brain perfusion. They were analyzed as functions of driving pressure between sagittal sinus and aorta. Total brain blood flow (ml/min/100 g) was 1.4 +/- 1.3, 3.8 +/- 2.6, and 4.6 +/- 2.6 when the driving pressure was 15, 25, and 35 mmHg, respectively (P < 0.05, 15 mmHg vs 25 mmHg). Regional cerebral blood flow (ml/min/100 g) with a driving pressure of 25 mmHg was 12.1 +/- 9.4, 7.0 +/- 5.6, 4.4 +/- 2.8, and 2.2 +/- 1.4 in the frontal cortex, anterior, mid, and posterior cerebrum, respectively. Cerebral cortex pH was 6.86 +/- 0.23, 7.15 +/- 0.18, and 6.46 +/- 0.13 after 90 min of retrograde brain perfusion with driving pressure of less than 20 mmHg, after that of above 20 mmHg, and after 60 min of circulatory arrest, respectively. Brain tissue pH, blood flows measured with microspheres, and laser flowmetry were highest when driving pressure was between 25 and 35 mmHg. We conclude that retrograde brain perfusion may provide maximum brain protection with driving pressure of 25 to 35 mmHg.


Subject(s)
Brain/blood supply , Brain/physiology , Hypothermia, Induced , Perfusion/methods , Animals , Blood Pressure/physiology , Brain Chemistry , Cardiopulmonary Bypass , Cerebral Cortex/blood supply , Cerebral Cortex/physiology , Dogs , Hydrogen-Ion Concentration , Microspheres , Regional Blood Flow , Time Factors
15.
J Card Surg ; 12(2): 116-9, 1997.
Article in English | MEDLINE | ID: mdl-9271733

ABSTRACT

Children with Marfan syndrome rarely undergo surgery for annuloaortic ectasia and aortic regurgitation in the first decade. A 7-year-old girl presented with congestive heart failure due to severe aortic regurgitation associated with annuloaortic ectasia (6 cm). She also had funnel chest. She underwent a Bentall operation and sternal turn-over with a satisfactory result. Since the aortic valve cusps had rolled edges, the aortic valve was not spared. Histology of the aortic valve cusps showed myxoid degeneration and fragmentation of elastic fibers.


Subject(s)
Aorta/surgery , Aortic Valve Insufficiency/surgery , Aortic Valve/surgery , Marfan Syndrome/complications , Aorta/abnormalities , Aortic Valve/abnormalities , Aortic Valve Insufficiency/complications , Aortic Valve Insufficiency/diagnosis , Child , Female , Humans , Marfan Syndrome/diagnosis , Tomography, X-Ray Computed
17.
Kyobu Geka ; 48(11): 905-7, 1995 Oct.
Article in Japanese | MEDLINE | ID: mdl-7564011

ABSTRACT

Recently advances in early diagnosis of infective endocarditis (IE) by echocardiography provide for IE as a target disorder for valve repair. Valvulectomy without replacement might be still better operation of choice for some cases of intractable right-sided endocarditis. For our experience in 11 cases of valve repair or valvulectomy without replacement for IE, actuarial survival and reoperation-free rate at 6.8 years of mean follow-up after surgery was 81.8% and 90.9%. Persistent infection and intraoperative evaluation of the residual regurgitation was the point for postoperative management after these procedures. Although an elaborative valve repair should be applied for right-sided endocarditis, total pulmonary valvulectomy or regional tricuspid valvulectomy without prosthesis was available for destructive endocarditis.


Subject(s)
Endocarditis, Bacterial/surgery , Mitral Valve/surgery , Tricuspid Valve/surgery , Adolescent , Adult , Aged , Cardiac Surgical Procedures/methods , Female , Heart Valve Prosthesis , Humans , Male , Middle Aged , Pulmonary Valve/surgery
18.
Kyobu Geka ; 48(11): 953-6, 1995 Oct.
Article in Japanese | MEDLINE | ID: mdl-7564023

ABSTRACT

Numbness and paraplegia are uncommon complaints in patient with thoracic aortic aneurysm (TAA). The patient was a 64-year-old man. He suffered numbness and gait disturbance (paraplegia). The blood examination showed no positive findings except a Wassermann was positive. Roentgen examination of the chest showed two abnormal shadows like tumors. The CT and MRI revealed destruction of the vertebral bodies and TAAs adjacent to the spinal cord. After the graft replacement was performed, numbness and paraplegia disappeared. This suggests that in our patient the TAAs destruct the vertebral body and produce pressure on the spinal cord, causing numbness and paraplegia. We experienced a rare case of the syphilitic TAA producing bone destruction, numbness and paraplegia.


Subject(s)
Aortic Aneurysm, Thoracic/surgery , Paraplegia/complications , Syphilis, Cardiovascular/surgery , Thoracic Vertebrae , Aortic Aneurysm, Thoracic/etiology , Blood Vessel Prosthesis , Humans , Leg , Male , Middle Aged , Spinal Cord Compression/complications , Spinal Diseases/complications , Syphilis, Cardiovascular/etiology
19.
Kyobu Geka ; 48(5): 363-6, 1995 May.
Article in Japanese | MEDLINE | ID: mdl-7745857

ABSTRACT

This study was undertaken to compare postsurgical right ventricular function and the occurrence of conduction disturbances after employing cold blood antegrade or retrograde cardioplegia during open heart surgery. Thirty-four patients were divided into AC (antegrade) and RC (retrograde) groups for the difference of route for delivery of cardioplegic solutions. Preoperative evaluation of cardiac and respiratory function revealed to be equal characteristics between the groups. Postoperatively, A-aDO2 and respiratory index (RI) as functional parameters of oxygenation capacity, LVSWI, RVSWI, dosage of dopamine and conduction disturbances were monitored at 0, 3, 6, 12 hours after termination of cardiopulmonary bypass and at extubation period. Although the recovery of respiratory function and left ventricular function were similar in both groups, temporal suppression of right ventricular function was indicated in RC group during early period after surgery, and then recovered to the same values of AC group within 3 hours. In RC group, several type of conduction disturbances were detected in 28 per cent of patients. But none of the persistent conduction disturbances were remained in all patients. We suggest retrograde coronary sinus perfusion may emerge as a valuable alternative to antegrade methods for delivery of cardioplegia.


Subject(s)
Blood , Heart Arrest, Induced/methods , Heart Conduction System/physiopathology , Ventricular Function, Right , Cardiopulmonary Bypass , Female , Humans , Male , Middle Aged , Postoperative Complications , Respiration
20.
Kyobu Geka ; 48(3): 198-201, 1995 Mar.
Article in Japanese | MEDLINE | ID: mdl-7534838

ABSTRACT

This study was undertaken to compare the effects of combined aprotinin and prostaglandin E1 therapy on aortic arch replacement. Twenty patients were divided into 2 groups with (group A; n = 10) or without (group B; n = 10) the treatment (200 KIU of aprotinin and 0.01-0.02 microgram/kg/min of prostaglandin E1 during cardiopulmonary bypass (CPB) and the first postoperative day. Preoperative evaluation of respiratory function and all parameters related to CPB procedure were revealed to be equal between the groups. Postoperative A-a DO2 and respiratory index (RI) as functional parameters of oxygenation capacity, dosage of dopamine were monitored at 0, 3, 6, 12, 18 and 24 hr after termination of CPB and at extubation period. Serum creatinine, platelet numbers and blood coagulation function (PT, APTT) were also assayed postoperatively. The recovery of respiratory and cardiac function were superior in group A with treatment, but renal and blood coagulation function showed no difference in the groups. We suggest the combined therapy with aprotinin and prostaglandin E1 for aortic arch replacement may emerge as a valuable treatment to save postoperative respiratory and cardiac function.


Subject(s)
Alprostadil/administration & dosage , Aorta, Thoracic/surgery , Aprotinin/administration & dosage , Blood Vessel Prosthesis , Aortic Aneurysm, Thoracic/physiopathology , Aortic Aneurysm, Thoracic/surgery , Cardiopulmonary Bypass , Drug Therapy, Combination , Female , Humans , Male , Middle Aged , Postoperative Care , Respiration
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