1.The Surgical Experiences of Triple Shunts (VSD+ASD+PDA). The Report of Three Cases.
Yasuyuki SUZUKI ; Akira SAKAI ; Eizou KUBO ; Masaki NIE ; Mikio OOSAWA
Japanese Journal of Cardiovascular Surgery 1992;21(6):609-613
We experienced three cases of triple shunts (VSD+ASD+PDA) for past ten years. All three cases admittied with cardiac failure and respiratory distress early in the infant period. Ligation of PDA, suture closure of ASD and patch closure of VSD were performed in the two cases. Another case was performed ligation of PDA because of low body weight (1, 700g). Triple shunts were correctly diagnosed in only one case. Another two cases were diagnosed VSD and PDA at operative period. The patient with low body weight was lost at 38 days after operation. Post operative course were uneventfull in the two cases of total repair. Triple shunts should be repaired in the same time. But two staged operations are consider to perform in the low body weight infant and patients with major general pediatric surgical disease.
2.Surgery for Bilateral Atrial Thromboses Detected in a Cancer Patient with Cerebral Infarction
Nobuyuki Yamamoto ; Masaki Nie ; Akihiro Sasahara ; Kuniyoshi Ohara
Japanese Journal of Cardiovascular Surgery 2015;44(4):221-223
A 74-year-old man had been taking warfarin for atrial fibrillation, but warfarin was discontinued due to upper gastrointestinal bleeding. One week later, left hemiplegia occurred, and cranial magnetic resonance imaging revealed multiple cerebral infarctions. Systemic examination revealed thrombi in both atria as well as duodenal cancer. Because all of the thrombi in both atria were larger than 30 mm in diameter, the risk of embolism or sudden death was assumed to be high. Although the use of cardiopulmonary bypass for cancer patients is controversial, bilateral atrial thrombectomy was performed 4 weeks after cerebral infarction onset because reasonable survival duration was expected with surgery for duodenal cancer after thrombectomy and further treatment. The timing of and indications for surgery in this case are discussed.
3.A Case of Mitral Papillary Muscle Rupture during Catheter Ablation
Akihiro SASAHARA ; Yoshihiko ONISHI ; Ko SHIBATA ; Masaki NIE ; Kuniyoshi OHARA
Japanese Journal of Cardiovascular Surgery 2025;54(2):57-60
Acute mitral regurgitation caused by papillary muscle rupture (PMR) is a severe complication often associated with acute myocardial infarction. A 41-year-old male developed acute mitral regurgitation due to posterior papillary muscle rupture during catheter ablation for supraventricular tachycardia. The rupture likely occurred when the chordae tendineae became entangled during catheter manipulation. The patient, a Jehovah's Witness, refused blood transfusion but accepted diluted autologous blood, a cell saver, and cardiopulmonary bypass. The ruptured posterior papillary muscle and anterior leaflet (A2) were excised, and mitral valve replacement was performed using a mechanical valve. Postoperatively, the patient recovered without mechanical circulatory support or blood transfusion and was discharged in good condition. This case highlights the rare complication of papillary muscle rupture during catheter ablation.