1.A Case of Aortic Valve Blood Cyst with CoA Complex
Hiroshi Masuhara ; Katsunori Yoshihara ; Yoshinori Watanabe ; Noritsugu Shiono ; Hiroki Yokomuro ; Tsukasa Ozawa ; Takeshiro Fujii ; Shinichi Wada ; Nobuya Koyama ; Yoshinori Takanashi
Japanese Journal of Cardiovascular Surgery 2005;34(1):40-43
A 2-month-old girl had been urgently seen on postnatal day 10 due to poor weight gain and tachypnea. Echocardiography showed congenital valvular aortic stenosis (AS), ventricular septal defect (VSD), atrial septal defect (ASD), and aortic valve dysplasia, but no cyst image was seen at the aortic valve level. Aortography revealed a dysplastic aortic valve along with coarctation of aorta (CoA) and patent ductus arterious (PDA). Balloon aortic valvotomy (BAV) was performed on day 53. Ballooning was satisfactory, but there was no change in gradient. Operation was performed on day 70 under a diagnosis of congenital AS and CoA complex. After cardiopulmonary bypass was established, the ascending aorta was transected. The blood cyst originated from the center of the anterior leaflet and was resected. The pressure gradient at the aortic valve decreased to 22.5mmHg. The patient was discharged 25 days after surgery.
2.Effect of Cryopreservation of Human Heart Cells on Cell Proliferation
Hiroki Yokomuro ; Noritsugu Shiono ; Tsukasa Ozawa ; Takeshirou Fujii ; Muneyasu Kawasaki ; Yoshinori Watanabe ; Katsunori Yoshihara ; Nobuya Koyama ; Mitsumasa Okada
Japanese Journal of Cardiovascular Surgery 2006;35(1):14-20
Preservation is essential for successful cell transplantation. 1) Control group (n=13); Cells isolated from human right atrial tissues were cultured for 15 days. 2) Cell-cryopreservation (C. P.) group (n=23), Tissue-C. P. group (n=29); Human heart cells and minced tissues were cryopreserved in freezing medium containing 70% IMDM, 20% FBS, and 10% DMSO at a rate of 1°C/min. to -80°C by a programmed freezer and stored in liquid nitrogen (-196°C) for 1 week. After cryapreservation, the tissues and cells were thawed rapidly at 37°C. The cells, cryopreserved cells and cells isolated from cryopreserved tissues were cultured as passage 1, 2, and 3 for 15 days each. Cell proliferation was compared with a control group by determining growth curves, and 2-day proliferation rates. A growth factor, biochemical features and cell cycle were measured pre and post-cryopreservation. The cryopreserved group proliferated much more than the control group within 15 days at passage 1, 2, and 3 (1.7, 2.1, and 3.1 times, p<0.0001) respectively. The 2-day proliferation rates of cryopreservation group were higher than the control group in 15 days (p<0.05). The bFGF release after cryopreservation was on average 46.8 and 6.8 times greater than before cryopreservation for the Cell-C. P. and Tissue-C. P. groups, respectively. The TGF-β1 release was also accelerated by cryopreservation (Cell-C.P. group: 1.78 times, Tissue-C. P. group: 1.45 times in average) after cryopreservation. The cell cycle of human heart cells shifted to G2+M from the G1+G0 period by cryopreservation. Human atrial tissues and cells can be cultured and cryopreserved. The cryopreserved cells and cells isolated from cryopreserved tissue proliferate much more than non-cryopreserved cells at all cell ages. Cryopreservation enables human tissues and cells to proliferate more because of the greater release of growth factors and changing cell cycle.
3.A Case of Re-reoperation for Ventricular Septal Perforation after Myocardial Infarction.
Sumio KANO ; Keiiti TOKUHIRO ; Yoshinori WATANABE ; Tsuyoshirou FUJII ; Noritsugu SHIONO ; Naohito SUZUKI ; Katsunori YOSHIHARA ; Nobuya KOYAMA ; Yoshinori TAKANASHI ; Hisashi KOMATSU
Japanese Journal of Cardiovascular Surgery 1992;21(6):579-582
Operations were performed 3 times on ventricular septal perforation after acute myocardial infarction which exhibited cardiogenic shock, and the patient's life was saved successfully. The case was a female aged 64. Ventricular septal perforation developed in 6 hours after onset of acute myocardial infarction, and an emergency operation was performed because the patient exhibited cardiogenic shock. Intraventricular re-shunt was observed on the postoperative 5th day, and second operation was performed on the postoperative 7th day because a trend of cardiac insufficiency was intensified. Intraventricular re-shunt was observed again on the 5th day of the second operation, but third operation with a principle that further operation is to be performed awaiting regeneration of the tissue on the perforated margin to occur since the circulatory kinetics were seen to have been stabilized. The postoperative course was favorable, and the patient was discharged on 53 rd day of the third operation with the symptom alleviated. It was considered that our policy is to have to repeat operation when the patient's movement of circulation deteriorate at re-shunt from our experience of this time.