1.Leaflet Extension Aortic Valvuloplasty and Mitral Valve Replacement for Congenital Bicuspid Aortic Stenosis with Severe Mitral Regurgitation in a Child
Akito Imai ; Yuji Hiramatsu ; Shinya Kanemoto ; Chiho Tokunaga ; Muneaki Matsubara ; Hideyuki Kato ; Yoshie Kaneko ; Yuzuru Sakakibara
Japanese Journal of Cardiovascular Surgery 2010;39(5):269-272
A baby girl with a low birth weight was given a diagnosis of congenital bicuspid aortic stenosis and mitral valve prolapse. At the age of 40 days, she underwent balloon aortic valvotomy, but significant aortic regurgitation appeared afterwards. Another surgical intervention became necessary by the age of 20 months (weight, 5.7 kg), because of intractable heart failure mostly caused by exacerbated mitral regurgitation. We performed a leaflet extension valvuloplasty for the small bicuspid aortic valve using an autologous pericardium treated by glutaraldehyde. The mitral valve was replaced with an ATS-16AP valve. Although her postoperative course was complicated with mitral paravalvular leakage and poor left ventricular function, she was discharged from hospital 6 months post operatevely. Leaflet extension valvuloplasty is a surgical option for infants with a small aortic annulus, but the procedure could be the only solution in cases when Konno or Ross techniques are not suitable.
2.Experience of the Nursing Students Who Took Charge of End-of-life Cancer Patients in Clinical Practice of Gerontological Nursing
Yoshie IMAI ; Chiemi ONISHI ; Takae BANDO
Palliative Care Research 2020;15(1):1-8
In this study, we clarify the experiences of students through providing nursing care for end-of-life cancer patients and examine the guidance of clinical practice necessary to link the experiences with the result of learning. We conduct interview survey of 15 nursing third graders who take care of terminal older cancer patients in clinical practice in gerontological nursing. The students’ experience was classified into six categories ; “Repentance for doing nothing”, “Involvement actively with patients”, “Awareness of life preciousness”, “Concentration on daily nursing”, “Repentance for insufficient care”, “Respect for patients’ own lives”. The student’s experience focused on the terminal stage situation, and it was an experience to learn the importance of making them live with dignity, reflecting on their own care. It was suggested that widening students’ view of patients’ individual lives was quite useful to consider terminal care based on the characteristics of people.
3.Experience of Recurrent/Advanced Cancer Patients Receiving Outpatient Cancer Rehabilitation
Utae KATSUSHIMA ; Yoshie IMAI ; Rieko HASHIMOTO ; Emi MIKI ; Hiromi ARAHORI ; Yuta INOUE ; Kimitaka HASE
Palliative Care Research 2022;17(4):127-134
The aim of this study was to clarify the experience of recurrent/advanced cancer patients receiving outpatient cancer rehabilitation and evaluate true endpoints of cancer rehabilitation. The study was conducted by semi-structured interviews of 13 recurrent/advanced patients undergoing cancer rehabilitation during cancer chemotherapy. Six categories were extracted: [Finding the physical condition suitable for me] [Being unable to find movements that I can effectively utilize myself] [Being able to continue normal everyday life] [Showing people around me that I can still move] [Having fun actively moving my body] [Gives meaning to my present “living”]. Cancer rehabilitation is considered to give patients with recurrent/advanced cancer a chance to adapt to their present predicament by helping them re-establish the meaning, value, and objective of living. These results suggest that acquiring mastery can be a new endpoint of cancer rehabilitation.