Masayoshi Yokoyama

Long-Term Follow-up of Artificial Valves in Patients under 15 Years Old

Forty-nine artificial cardiac valves implanted in 44 patients less than 15 years old were reviewed. Out of 49 valves, 16 were mechanical and 33 were xenografts. Average follow-up was 2 years 5 months. Marked valvular stenosis developed in 11 out of the 33 xenografts, an incidence of 15% per patient-year. In patients with a xenograft valve, the incidence of sepsis was found to be 4% per patient-year and brain accidents, 4% per patient-year. In patients with mechanical valves, the incidence of stenosis was only 2% per patient-year and brain accidents, 2% per patient-year. There was no sepsis. From these follow-up results, mechanical valves seem to be superior to xenografts when used in patients less than 15 years old.

The tricuspid pouch in endocardial cushion defect

Summary A tricuspid pouch was found in 15 out of 118 patients with ECD diagnosed either clinically by left ventriculography or at autopsy. The incidence demonstrated clinically with left ventriculography was 12 per cent; at autopsy, 18 per cent. The pouch is found exclusively in Grade II of ECD. Therefore, presence of the pouch in the lateral view of a left ventriculogram strongly indicates the possibility of Grade II malformation. The pouch resembles membranous septal aneurysm in its etiology and appearance in left ventriculograms. However, in the majority of cases, it was found that the former protrudes toward the inflow portion while the latter protrudes toward the outflow portion of the right ventricle.

P wave changes on exercise in patients with isolated mitral stenosis

Abstract Patients with mitral stenosis usually showed a marked increase in the P negativity following exercise. The P terminal force in Lead V 1 in 20 cases with isolated mitral stenosis was −0.090 mm. sec. before exercise, which changed to −0.177 mm. sec. following the single Master two-step test. Normal adults never showed such changes on exercise. The phenomenon was considered to be due to the posterior rotation of the P wave vector in the horizontal plane, which was induced by the enlargement of the left atrial wall on exercise.

The location of the coronary sinus orifice in endocardial cushion defects

Abstract Forty-six human hearts with an ECD malformation were studied, particularly examining the anatomical location of the coronary sinus ostium. The sinus opened in the right atrium in 22 cases, and in the left side in 18 cases. Six cases showed no definite coronary sinus ostium. In most cases with a left-side ostium, the posteroinferior position of the atrial septum was absent. The failure of the union of the posteroinferior primum septum with the left atriovenous fold is considered to result in left-side coronary sinus orifices. The mean frontal electrical axis of ECGs showed no relationship with the location of the coronary sinus orifice.

Placement of Left Atrial Pressure Monitoring Catheter: Use of an Elastic Surgical Suture

Placement of left atrial monitoring catheters during cardiac surgery may be complicated by hemorrhage following the removal of the catheters. The use of an elastic surgical suture made of polyurethane can prevent hemorrhage is used around inserted catheters, because the elastic suture automatically shrinks to close the catheter hole on the left atrial wall when the catheter is removed.

Blood Flow Measurements in Internal Mammary Artery Implanted into the Myocardium

Abstract Of 30 dogs that underwent a Vineberg procedure, 7 survived five months and another 7 survived two months following operation. The implant was patent in 12 of these 14 dogs. No significant changes occurred in cardiac output, aortic pressure, or the electrocardiogram (ECG) with alternate patency and occlusion of the internal mammary artery implant. No flow was demonstrable by electromagnetic flowmeter. The retrograde pressure was about 70 or 80% of the systemic in both systole and diastole. Because a driving pressure of 20 or 30 mm. Hg cannot expel that amount of coronary blood, we conclude that flow following a Vineberg procedure is near 0, even on a long-term basis.

New electrodes for chest lead electrocardiogram.

臨床で使用されている心電図胸部誘導用電極は一般に吸着型である.この電極の欠点として, 6本の電極コードが絡みやすい, 装着に時間を要する.患者皮膚に皮内出血斑をつくりやすい, などがある.著者らは患者胸壁上にのせる1枚の基板とアームを考案し, これに6個の胸部誘導電極を装着した.従来のように吸着によって電極を患者皮膚に接着するのでなく, 圧迫によって胸部誘導電極を胸壁皮膚に圧着する.これによって容易にしかも短時間に6個の胸部誘導用電極をつけ得るようになり, 皮内出血も生じなくなった.

Ebstein's anomaly associated with a definite atrial left to right shunt—Case report

A case with Ebsteins anomaly associated with large left to right atrial shunt was operated upon. The patient did not demonstrate any tricuspid insufficiency in spite of the downward displacement of the septal and posterior leaflets of tricuspid valve. The surgical closure of the atrial septal defect relieved the impending heart failure. The pulmonary congestion disappeared but the cardiomegaly persisted after the operation.