Removal of Transvenous Pacemaker Electrodes under Cardiopulmonary Bypass

We report a patient in whom removal of transvenous pacemaker electrodes under cardiopulmonary bypass was successfully performed. The patient was a 75-year-old man who had undergone unsuccessful surgical treatments eight times followed by development of skin necrosis and wound dehiscence. The post operative course was uneventful. This procedure is safe and could be preferable in complex cases

Surgical Treatment of Acquired Tricuspid Regurgitation with Carpentier\u27s Ring

Between 1976 and 1982, nine patients underwent tricuspid annuloplasty with use of CARPENTIER\u27s ring for acquired tricuspid regurgitation associated with mitral valvular diseases or ruptured aneurysm of the sinus VALSALVA. Of these, one patient died of low cardiac output and respiratory failure. Postoperative cardiac functions were evaluated on remaining eight patients by physical examinations, findings of roentgenogram and contrast echogram. No postoperative regurgitation of the tricuspid valve was detected by contrast echogram in any of the five patients who received this examination after operation. In six of the eight patients, postoperative physical activity improved to grade I of the classification of NYHA, whereas the improvement was limited to grade II in two other patients in whom some forms of the left side cardiac lesions (e. g. mitral regurgitation) still seemed to remain

Ulceration of Leg Associated with Therapeutic Femoral Arteriovenous Fistula

We treated a rare case of stasis ulceration of the leg due to surgically induced femoral arteriovenous fistula. The patient is a 24-year-old Japanese man who had poliomyelitis in his infancy and had a sequela of short left lower limb. At ten years of age he underwent surgical creation of a femoral arteriovenous fistula at another hospital to accelerate the bone growth. Although the operation was effective on the growth of the impaired extremity, stasis signs progressed in the left leg and an ulceration developed 14 years after operation. We closed the fistula restoring the arterial and venous continuities, which was followed by a rapid healing of the ulcer

Trends in the seroprevalence of HTLV-1 in Japanese blood donors in Nagasaki Prefecture, 2000-2006.

Human T cell leukemia virus type-1 (HTLV-1) is the established cause of adult T cell leukemia/lymphoma. Monitoring time trends in HTLV-1 seroprevalence in blood donors is important to assess the safety of the blood supply in the viral endemic area. We analyzed changes in HTLV-1 seroprevalence in 48415 first-time blood donors who donated blood from 2000 to 2006 in Nagasaki prefecture, an endemic area in Japan. The donors were divided into 10-year birth cohorts: before 1950, 1951-1960, 1961-1970, 1971-1980, and 1981-1990. Among the first-time blood donors, 622 were tested positive for HTLV-1 [overall seroprevalence: 1.28%, (95% CI 1.19-1.39)]. Seroprevalence was significantly high in the birth cohort of before 1950 (6.22%) and declined with birth-year. The time trend of the birth-cohort-specific seroprevalence showed almost no change within each birth cohort, except for the birth cohort of 1981-1990 that showed a significantly declining trend (P for trend = 0.006). Among the birth cohort of 1981-1990, the seroprevalence was stable among those born during 1981-1986 (0.66-0.83%), but was lower among those born during 1987-1990 (0-0.38%). Detail analyses showed that HTLV-1 seroprevalence among blood donors clearly declined in those born after 1987

Operation for Descending Thoracic Aortic Aneurysm without Blood Transfusion

The purpase of the study was to aim at no-blood transfusion in the operation of descending thoracic aortic aneurysm. This policy was suported by means of the assist devices and techniques as follows ; 1. Heparin-coated left heart bypass or inter-arterlal shunt sets with pomp (5 cases) and without pump (5 cases). 2. Autotransfusion of the blood (Average 867 ml). 3. Geratin pre-cortet artificial prosthesis. 4. One-lung ventilation cannula. 5. Hypothermmic anesthesia (Average of the body temperature 33.3℃) and 6. Use of Erythropoietin after operation. Ten patients with true descending thoracic aortic aneurysms were electively operated. The average age was 61 years, and seven of them were male. The aorta was closs-clamped (mean 101 min.) and graft replacement was performed. The average blood loss during operation was 948ml. No blood transfusion was done in 3 cases. All the patients were discharged after uneventful courses This desease would be operated without blood transfusion in future

Operation for Descending Thoracic Aortic Aneurysm without Blood Transfusion

The purpase of the study was to aim at no-blood transfusion in the operation of descending thoracic aortic aneurysm. This policy was suported by means of the assist devices and techniques as follows ; 1. Heparin-coated left heart bypass or inter-arterlal shunt sets with pomp (5 cases) and without pump (5 cases). 2. Autotransfusion of the blood (Average 867 ml). 3. Geratin pre-cortet artificial prosthesis. 4. One-lung ventilation cannula. 5. Hypothermmic anesthesia (Average of the body temperature 33.3℃) and 6. Use of Erythropoietin after operation. Ten patients with true descending thoracic aortic aneurysms were electively operated. The average age was 61 years, and seven of them were male. The aorta was closs-clamped (mean 101 min.) and graft replacement was performed. The average blood loss during operation was 948ml. No blood transfusion was done in 3 cases. All the patients were discharged after uneventful courses This desease would be operated without blood transfusion in future