Tomomitsu Kanaya

Novel Technique for Implantation of a Cardioverter Defibrillator in Children

An 8-year-old boy with hypertrophic nonobstructive cardiomyopathy with ventricular fibrillation underwent implantation of an implantable cardioverter defibrillator. The lead was inserted through a pursestring suture in the right atrial appendage, and the tip of coil was placed in the right ventricular apex under fluoroscopic guidance. Another defibrillation coil was placed in the back of the left atrium and left ventricle by the transverse sinus. The device wrapped in a monofilament mesh sheet was placed in the intraperitoneal space. This case utilized a new technique for an implantable cardioverter defibrillator implantation in a small child.

Ectopic Atrial Tachycardia Originating from Right Atrial Appendage Aneurysms in Children: Three Case Reports

Introduction Ectopic atrial tachycardia occurs at a rate of 5%–20% among children with supraventricular tachycardia. Atrial appendages are the most frequent focus in children, differing from the situation in adults. However, ectopic atrial tachycardia originating from aneurysms of the right atrial appendage is very rare and in fact has not yet been clearly defined. We describe 3 cases of children with ectopic atrial tachycardia resulting from right atrial appendage aneurysms that proved refractory to radiofrequency catheter ablation. All 3 children were treated surgically. Written consent from the legal guardians of the patients was received for publication of the details of these cases.

Pulmonary Valve Replacement With Fresh Decellularized Pulmonary Allograft for Pulmonary Regurgitation After Tetralogy of Fallot Repair – First Case Report in Japan –

BACKGROUND Pulmonary valve replacement (PVR) is a common reoperation, typically required approximately 10 years following right ventricular outflow tract reconstruction and especially true in cases of tetralogy of Fallot. However, an improved prosthetic valve is required. METHODSANDRESULTS A fresh decellularized pulmonary allograft was used for PVR to correct pulmonary valve regurgitation in a 35-year-old man 33 years following tetralogy of Fallot repair. The postoperative course and short-term valve function were excellent. This is the first case of a decellularized pulmonary allograft in Japan. CONCLUSIONS Fresh decellularized pulmonary allografts have the potential to become a new source of material for PVR in patients who have undergone right ventricular outflow tract reconstruction.

Modified commissural patch repair in a child with active mitral endocarditis

A 9-year-old patient with massive destruction of the mitral apparatus caused by active infective endocarditis underwent mitral valve plasty using a modified commissural autologous pericardial patch repair. This procedure is a clinically relevant and feasible technique for pediatric patients with active mitral valve endocarditis.