No abstract

A 64-year-old man had been followed up under the diagnosis of chronic idiopathic thrombocytopenic purpura (ITP), and infrarenal abdominal aortic aneurysm with a maximum diameter of 85mm since August in 1998. He suffered from sudden abdominal pain in August 1999, and as impending ruptured abdominal aortic aneurysm was diagnosed based on the CT findings showing left retroperitoneal hematoma and leakage of contrast medium from the aneurysm. We decided to perform elective surgery. Since he was not in shock and had a low platelet count

IABP is in wide clinical use as an effective adjunctive means for the management of seriously impaired cardiac function.Unfortunately, however, it is an undeniable fact that this specialized circulatory support technic has so far been used in severe heart disease cases in a desultory way, with no established criteria being available for indication of elective IABP for prophylactic purposes. Under such circumstances, it was felt worthwhile to analyze data on preoperative left ventricular function from a series of open heart surgery cases (25 treated with and 94 without IABP) encountered in our hospital since 1983 (when procedure for myocardial protection was virtually standardized) in an effort to formulate acceptable criteria for indication of elective IABP. Hemodynamic parameters studied were LVESVI, LVEF and LVEDP. The results led us to conclude that scheduled IABP can be regarded as indicated for use in each of the following valvular heart diseases if at least one of the respective criteria specified below is

No abstract

The patient was a 71-year-old man who had been treated for Parkinson's disease for 21 years. He was admitted because nocturnal dyspnea occurred several times. Echocardiography revealed congestive heart failure because of combined mitral and aortic regurgitation. Double valve replacement was planned. There was a risk of the occurrence of neuroleptic malignant syndrome (NMS) if his drugs for Parkinson's disease were stopped suddenly, so careful control of drug doses was required. Although the patient developed aggravation of his Parkinson's symptoms, careful observation and adjustment of medications prevented the occurrence of NMS.