Yoshimi Takeuchi

MALIGNANT HEMANGIOENDOTHELIOMA OF THE HEART WITH HEMATOLOGICAL DISORDERS

An autopsy case of a 30‐year‐old house wife with malignant hemangioendothelioma of the heart was reported. This case was also accompanied by marked anemia, thrombocytopenia, leukoerythremoid reaction and hypofibrinogenemia. The spread of tumor was so wide that only the alimentary tract and the skin were free from metastases of the tumor. Many of the metastatic foci showed marked hemopoiesis intra tumori. A short discussion was made on the hematological abnormalities associated with vascular tumors.

Reviews of corrective surgery in 126 csses of tetralogy of Fallot

One hundred and twenty-six cases , 68 male and 58 female, with tetralogy of Fallot (TF) were operated upon in this period, and 19 patients were less than 5 years of age, 52 being between 6 and 10 years of age, 37 being between 11 and 15 years of age and 18 being older than 16 years of age (Table 1). The Blalock-Taussigs systemic-pulmonary-artery anastomosis had been previously performed in 39 patients who were distributed in all age groups. Almost a l l patients but 12 showed cyanosis at rest and/or i n exercise. Of 126 cases, 17 demonstrated hemoglobin-levels were below 15 g/100 mL, 69 from 15 to 18 g/ 100 ml. and 40 more than 18 g/100 ml., respectively (Table 2). In all patients, a median sternotomy was used. A disc oxygenator was u~ed for the first 75 cases, but since 1969, cardiopulmonary bypass has been accomplished with a disposable bubble oxygenator and roller pumps utilizing the hemodilution technique. Flow rate was usually about 2.2 L/Min/M 2 and mild hypothermia from 33 to 29 degrees centigrade was applied. A transverse or a longitudinal right ventriculotomy was used according to the anatomical findings on t h e right ventricular outflow-tract, described later, and the course of the right coronary artery branches. Infundibular stenosis was removed by division and resection of the hypertrophied muscles and dilatation of the pulmonary annulus with a Tubbs-type dilator. Valvular stenosis was routinely corrected through the ventriculotomy by careful commissurotomy: However, the patients with a small pulmonary annulus and/or a hypoplastic pulmonary trunk received various types of the outflow patch, including the small Teflon fabric patch, the small or large pericardial patch and the valve retaining homoor heterologous pulmonary artery patch 2 (Fig. 1). A large ventricular septal defect was closed with a Teflon fabric patch fixed by interrupted and buttressed mattress-sutures and a specially designed clamp 5 was

Different response of left ventricular dimensions to nitroglycerin in patients with artificial pacemaker: a possible significance of reflex tachycardia for the reduction of LV cavity after nitroglycerin

The effects of nitroglycerin (NTG) on cardiac function can be evaluated by echocardiography. In this paper, we discuss the effects of NTG on cardiac function in two groups of subjects, one with artificial pacemakers implanted with a fixed heart rate, and the other examined as the control group. Left ventricular dimension was obtained in the standard manner using the electronic sector scanning system of Toshiba SSH-11A. Left ventricular end-diastolic and end-systolic dimensions (Dd and Ds) were obtained in each case and the ejection fraction was calculated. After the sublingual administration of NTG (0.6 mg), the blood pressure decreased in both groups. The ventricular rate was fixed in the pacemaker group but increased significantly in the control group. Dd and Ds were found to decrease only in the control group. The ejection fraction showed an increase in the majority of the control group but remained unchanged in the pacemaker group. Heart rate change therefore may play a role in dimensional change and pumping function of heart after NTG.