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Komagamine M, Nawata K, Kita S, Chiba K, Kuwata S, Akashi Y, Miyairi T. Two Cases of Surgical Correction of Recurrent Mitral Regurgitation due to Failed Catheter- Delivered Mitral Clip (MitraClip). Ann Thorac Cardiovasc Surg 2023; 29:266-269. [PMID: 35342146 PMCID: PMC10587475 DOI: 10.5761/atcs.cr.22-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/10/2022] [Indexed: 11/16/2022] Open
Abstract
From April 2018 to February 2021, 150 patients underwent MitraClip implantation for severe functional mitral regurgitation (MR) at our hospital. Two of our patients, an 85-year-old man and an 84-year-old woman, developed a single leaflet device attachment in the acute phase after the implantation and had severe residual MR requiring surgical correction. The recurrent MR was first pointed out on day 5 and day 4, and the duration between MitraClip implantation and surgery was 13 and 55 days, respectively. Due to strong adhesions with the clips and severe valve damage after MitraClip implantation, both cases underwent mitral valve replacement with a good postoperative course. In patients with a high-risk baseline profile, surgical mitral valve replacement after failed MitraClip implantation should be considered at an optimal timing, and a detailed echocardiographic follow-up is required.
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Affiliation(s)
- Masahide Komagamine
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Kan Nawata
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Shota Kita
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Kiyoshi Chiba
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Shingo Kuwata
- Department of Cardiology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yoshihiro Akashi
- Department of Cardiology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Takeshi Miyairi
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
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Ito S, Tanabe Y, Nawata K, Oshima K, Akashi YJ. Usefulness of angioscopy for intracardiac tumour biopsy in a patient with malignant lymphoma. Eur Heart J Cardiovasc Imaging 2023; 24:e272. [PMID: 37294308 DOI: 10.1093/ehjci/jead131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 06/02/2023] [Indexed: 06/10/2023] Open
Affiliation(s)
- Shingo Ito
- Department of Cardiology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Yasuhiro Tanabe
- Department of Cardiology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Kan Nawata
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Kumi Oshima
- Department of Hematology and Oncology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Yoshihiro J Akashi
- Department of Cardiology, St. Marianna University School of Medicine, Kanagawa, Japan
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Yamada T, Nomura S, Amiya E, Katoh M, Inoue S, Hatsuse S, Fujita K, Ito M, Fujita T, Bujo C, Tsuji M, Ishida J, Ko T, Yamada S, Katagiri M, Sassa T, Kinoshita O, Nawata K, Tobita T, Satoh M, Ishiwata J, Daimon M, Tatsuno K, Fukuda S, Kashimura T, Minamino T, Hatano M, Ono M, Aburatani H, Komuro I. LMNA Mutations and Right Heart Failure in Cardiomyopathy Patients With Left Ventricular Assist Devices. J Card Fail 2023; 29:855-857. [PMID: 36871612 DOI: 10.1016/j.cardfail.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 03/07/2023]
Affiliation(s)
- Takanobu Yamada
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Seitaro Nomura
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Manami Katoh
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Shunsuke Inoue
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Hatsuse
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kanna Fujita
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masamichi Ito
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takanori Fujita
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Chie Bujo
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaki Tsuji
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junichi Ishida
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toshiyuki Ko
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shintaro Yamada
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mikako Katagiri
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tatsuro Sassa
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Osamu Kinoshita
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kan Nawata
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Takashige Tobita
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Masahiro Satoh
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan; Cardiovascular Medicine Division, Brigham and Women's Hospital, Boston, USA
| | - Jumpei Ishiwata
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masao Daimon
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Tatsuno
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Shiro Fukuda
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Takeshi Kashimura
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Aburatani
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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Chiba K, Nishimaki H, Ogawa Y, Tomita M, Nakamura R, Kinebuchi S, Kita S, Komagamine M, Nawata K, Chikada M, Miyairi T. Midterm Results of Thoracic Endovascular Aortic Repair with Reentry Closure for Chronic Type B Aortic Dissection with Aneurysmal Dilatation. Ann Vasc Dis 2022; 15:308-316. [PMID: 36644254 PMCID: PMC9816023 DOI: 10.3400/avd.oa.22-00065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/13/2022] [Indexed: 11/26/2022] Open
Abstract
Objectives: This study aims to discuss the midterm results of thoracic endovascular aortic repair (TEVAR) with reentry closure for chronic type B aortic dissection (CTBAD). Materials and Methods: This retrospective study analyzed 13 patients with CTBAD who underwent TEVAR with reentry closure between July 2014 and December 2020. We evaluated the false lumen (FL) cross-sectional area using computed tomography images of the descending aorta at the level of the bronchial bifurcation, Valsalva sinus, celiac artery, and infrarenal abdominal aorta pre- and postoperation. The study endpoints were technical and clinical success rates, freedom from additional aortic reintervention or surgery, and survival. Results: Technical success was obtained in 12 patients (92.3%) with no hospital mortality and neurological complications. The postoperative observation period was 49.2±21.5 months. The clinical success rate was 76.9% (10 cases), and a postoperative reduction of the FL cross-sectional area was obtained in 53.8% of patients. The 5-year overall survival rate was 64.8% with no aortic-related deaths while the 5-year freedom from additional aortic surgery rate was 66.7%. Conclusions: TEVAR with reentry closure suggests preventing FL dilatation or rupture in CTBAD, but the revision of our devices and further research with more patients and longer follow-up periods are required.
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Affiliation(s)
- Kiyoshi Chiba
- Department of Cardiovascular Surgery, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan,Corresponding author: Kiyoshi Chiba, MD, PhD. Department of Cardiovascular Surgery, St Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan Tel: +81-44-977-8111, Fax: +81-44-976-5792, E-mail:
| | - Hiroshi Nishimaki
- Department of Cardiovascular Surgery, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yukihisa Ogawa
- Department of Radiology, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Masahiro Tomita
- Department of Cardiovascular Surgery, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Ryuji Nakamura
- Department of Cardiovascular Surgery, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Satoshi Kinebuchi
- Department of Cardiovascular Surgery, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Shota Kita
- Department of Cardiovascular Surgery, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Masahide Komagamine
- Department of Cardiovascular Surgery, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Kan Nawata
- Department of Cardiovascular Surgery, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Masahide Chikada
- Department of Cardiovascular Surgery, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Takeshi Miyairi
- Department of Cardiovascular Surgery, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
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Chikada M, Chiba K, Nawata K, Tomita M, Nakamura R, Kinebuchi S, Kita S, Komagamine M, Kogo M, Nishimaki H, Miyairi T. Longterm Followup of a Pediatric Patient with Congenital Abdominal Aortic Aneurysm with Coarctation. Ann Vasc Dis 2022; 15:341-343. [PMID: 36644269 PMCID: PMC9816021 DOI: 10.3400/avd.cr.22-00067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/27/2022] [Indexed: 11/05/2022] Open
Abstract
Congenital abdominal aortic aneurysm (AAA) with coarctation has been considered an extremely rare condition. In this study, we present a 3-year-old boy, who was diagnosed by chance with congenital AAA at first operation. We replaced the AAA+coarctation with a 6-mm polytetrafluoroethylene (PTFE) graft. Histological examination of the aortic wall revealed no particular abnormalities. Collateral vessels were noted to develop over 14 years of followup. Good blood flow to both lower limbs and no intermittent claudication were observed. After growth, at the age 17, he underwent extra-anatomical bypass using a 12-mm PTFE graft. This is the first report of successful treatment of congenital AAA+coarctation with longterm followup.
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Affiliation(s)
- Masahide Chikada
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan,Corresponding author: Masahide Chikada, MD. Department of Cardiovascular Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan Tel: +81-44-977-8111, Fax: +81-44-976-5792, E-mail:
| | - Kiyoshi Chiba
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Kan Nawata
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Masahiro Tomita
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Ryuji Nakamura
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Satoshi Kinebuchi
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Shota Kita
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Masahide Komagamine
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Misa Kogo
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Hiroshi Nishimaki
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Takeshi Miyairi
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
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Suzuki H, Kita S, Komagamine M, Tomimoto D, Chiba K, Nawata K, Miyairi T. A Case of Acute Type A Aortic Dissection after Coronary Artery Bypass Grafting. Ann Thorac Cardiovasc Surg 2022. [DOI: 10.5761/atcs.cr.21-00193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Hirotoshi Suzuki
- Department of Cardiothoracic Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Shota Kita
- Department of Cardiothoracic Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Masahide Komagamine
- Department of Cardiothoracic Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Daijun Tomimoto
- Department of Cardiothoracic Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Kiyoshi Chiba
- Department of Cardiothoracic Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Kan Nawata
- Department of Cardiothoracic Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Takeshi Miyairi
- Department of Cardiothoracic Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
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Chiba K, Ogawa Y, Murakami K, Kita S, Suzuki H, Komagamine M, Nawata K, Chikada M, Nishimaki H, Miyairi T. Emergent Transcatheter Arterial Embolization via a Transpopliteal Approach for Internal Iliac Artery Injury during Lumbar Disk Surgery in the Prone Position. Ann Vasc Dis 2020; 13:441-443. [PMID: 33391567 PMCID: PMC7758584 DOI: 10.3400/avd.cr.20-00074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This report describes a successful case of transcatheter arterial embolization for a critical vascular injury during lumbar disk surgery that resulted in a large retroperitoneal hematoma in a 72-year-old woman. A 4-Fr long sheath was inserted via the right popliteal artery in the prone position. Pelvic angiography revealed a pseudoaneurysm in the right internal iliac artery, which was managed with coil embolization. The patient underwent laparotomy because of abdominal compartment syndrome and was discharged in good condition after rehabilitation. The transpopliteal endovascular approach in the prone position may thus provide the best chance to treat this rare but critical condition.
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Affiliation(s)
- Kiyoshi Chiba
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yukihisa Ogawa
- Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Kenji Murakami
- Diagnostic Radiology, Hakodate Goryokaku Hospital, Hakodate, Hokkaido, Japan
| | - Shota Kita
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Hirotoshi Suzuki
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Masahide Komagamine
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Kan Nawata
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Masahide Chikada
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Hiroshi Nishimaki
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Takeshi Miyairi
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
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Nawata K, D’Agostino RS, Habib RH, Kumamaru H, Hirahara N, Miyata H, Motomura N, Takamoto S, Shahian DM, Grover FL. First Database Comparison Between the United States and Japan: Coronary Artery Bypass Grafting. Ann Thorac Surg 2020; 109:1159-1164. [DOI: 10.1016/j.athoracsur.2019.07.095] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/24/2019] [Accepted: 07/29/2019] [Indexed: 11/30/2022]
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Tsuji S, Nawata K, Shimada S, Hirata Y, Ono M. A superior vena cava to right pulmonary artery shunt for severe right ventricular outflow tract stenosis caused by an unresectable cardiac tumor. J Cardiol Cases 2020; 21:97-100. [PMID: 32153682 DOI: 10.1016/j.jccase.2019.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/21/2019] [Accepted: 10/22/2019] [Indexed: 11/15/2022] Open
Abstract
We report the case of a 47-year-old man who was diagnosed with severe right ventricular outflow tract (RVOT) stenosis due to a space-occupying lesion; the diagnosis was made using computed tomography. He underwent mass reduction, pulmonary valve replacement, and RVOT reconstruction with a bovine pericardial patch. The pathological diagnosis was undifferentiated pleomorphic sarcoma originating from the myocardium. As the mass resection was incomplete, he received heavy particle therapy. He did not want to receive adjuvant chemotherapy. Four months later, severe RVOT stenosis recurred because the residual mass had invaded the prosthetic valve in the pulmonic position and one of the cusps was fixed in the closed position. He presented with dyspnea and marked lower leg edema. We performed superior vena cava (SVC) to right pulmonary artery (RPA) shunting as a palliative operation to improve his heart failure symptoms. After surgery, his symptoms improved; his hemodynamics have been stable for one year. SVC-RPA shunting is a palliative operation but can be used to effectively treat severe RVOT stenosis caused by unresectable cardiac tumors. <Learning objective: Malignant primary cardiac tumors commonly recur after complete surgical resection and they have the potential to obstruct intracardiac blood flow. The superior vena cava to right pulmonary artery shunt may be useful for treating right ventricular outflow tract stenosis due to unresectable cardiac tumors.>.
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Affiliation(s)
- Shigeto Tsuji
- Department of Cardiovascular Surgery, Iwate Medical University, Shiwa-gun, Iwate, Japan
| | - Kan Nawata
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Shogo Shimada
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - Yasutaka Hirata
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
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Izumisawa Y, Endo H, Ichihara N, Takahashi A, Nawata K, Shiraishi H, Miyata H, Motomura N. Association between prehospital transfer distance and surgical mortality in emergency thoracic aortic surgery. J Thorac Cardiovasc Surg 2020; 163:28-35.e1. [DOI: 10.1016/j.jtcvs.2020.03.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 03/09/2020] [Accepted: 03/14/2020] [Indexed: 11/26/2022]
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Takeda N, Inuzuka R, Maemura S, Morita H, Nawata K, Fujita D, Taniguchi Y, Yamauchi H, Yagi H, Kato M, Nishimura H, Hirata Y, Ikeda Y, Kumagai H, Amiya E, Hara H, Fujiwara T, Akazawa H, Suzuki JI, Imai Y, Nagai R, Takamoto S, Hirata Y, Ono M, Komuro I. Impact of Pathogenic FBN1 Variant Types on the Progression of Aortic Disease in Patients With Marfan Syndrome. Circ Genom Precis Med 2019; 11:e002058. [PMID: 29848614 DOI: 10.1161/circgen.117.002058] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Marfan syndrome can cause life-threatening aortic complications. We investigated the relationship between FBN1 genotype and severe aortopathy (aortic root replacement, type A dissections, and related death). METHODS We evaluated 248 patients with pathogenic or likely pathogenic FBN1 variants. The variants were classified as haploinsufficient type (HI, n=93) or dominant-negative type (DN, n=155) based on their location and predicted amino acid alterations, and we examined the effects of the FBN1 genotype on severe aortic events (aortic root replacement, type A dissections, and related death). RESULTS The cumulative event-free probability was significantly lower in the HI group than in the DN group (adjusted hazard ratio, 2.1; 95% confidence interval, 1.4 -3.2; P<0.001). CONCLUSIONS DN-CD+HI patients should be monitored more carefully than DN-nonCD patients for rapid development of aortic root aneurysms.
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Affiliation(s)
- Norifumi Takeda
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.),
| | | | - Sonoko Maemura
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.)
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.)
| | - Kan Nawata
- Department of Cardiac Surgery (K.N., H. Yamauchi, M.O.)
| | - Daishi Fujita
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.)
| | | | | | - Hiroki Yagi
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.)
| | - Masayoshi Kato
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.)
| | - Hiroshi Nishimura
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.)
| | | | - Yuichi Ikeda
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.)
| | - Hidetoshi Kumagai
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.).,Department of Advanced Clinical Science and Therapeutics (H.K., J.-i.S.)
| | - Eisuke Amiya
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.)
| | - Hironori Hara
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.)
| | - Takayuki Fujiwara
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.)
| | - Hiroshi Akazawa
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.)
| | - Jun-Ichi Suzuki
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.).,Department of Advanced Clinical Science and Therapeutics (H.K., J.-i.S.)
| | - Yasushi Imai
- The University of Tokyo Hospital, Tokyo, Japan. Division of Clinical Pharmacology, Department of Pharmacology (Y. Imai).,Division of Cardiovascular Medicine, Department of Internal Medicine (Y. Imai)
| | - Ryozo Nagai
- Jichi Medical University, Shimotsuke, Tochigi, Japan. Jichi Medical University, Shimotsuke, Tochigi, Japan (R.N.)
| | | | | | - Minoru Ono
- Department of Cardiac Surgery (K.N., H. Yamauchi, M.O.)
| | - Issei Komuro
- Department of Cardiovascular Medicine (N.T., S.M., H.M., D.F., H. Yagi, M.K., H.N., Y. Ikeda, H.K., E.A., H.H., T.F., H.A., J.-i.S., I.K.)
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12
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Bujo C, Amiya E, Hatano M, Tsuji M, Maki H, Hosoya Y, Fujii E, Kamon T, Kojima T, Nawata K, Kinoshita O, Kimura M, Ono M, Komuro I. Clinical impact of newly developed atrial fibrillation complicated with longstanding ventricular fibrillation during left ventricular assist device support: A case report. BMC Cardiovasc Disord 2019; 19:151. [PMID: 31226943 PMCID: PMC6588891 DOI: 10.1186/s12872-019-1132-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 06/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Continuous-flow left ventricular assist devices (LVADs) improve survival and morbidity in patients with stage D heart failure. Management of LVADs for longer durations is necessary in some clinical settings, and a better understanding of the hemodynamics of patients using LVADs is warranted. Arrhythmia, including atrial (AA) and ventricular (VAs) arrhythmias, is a modifying factor of hemodynamics that is highly prevalent among patients with LVADs. However, the clinical impact of arrhythmias in various clinical settings in patients with LVAD, in which the hemodynamic load is likely to present as worsening of right heart failure, remains to be completely elucidated. CASE PRESENTATION We describe the case of a patient under sustained ventricular fibrillation for extraordinarily long duration who was stabilized using LVAD support and in whom newly developed atrial fibrillation led to a significant worsening of right heart failure while using an LVAD. CONCLUSION This case demonstrates the substantial clinical impact of AAs in the management of right heart failure using an LVAD.
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Affiliation(s)
- Chie Bujo
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaki Tsuji
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hisataka Maki
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yumiko Hosoya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Emi Fujii
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tatsuya Kamon
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toshiya Kojima
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kan Nawata
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Osamu Kinoshita
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mitsutoshi Kimura
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
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13
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Shimada S, Nawata K, Kinoshita O, Ono M. Mechanical circulatory support for the right ventricle in combination with a left ventricular assist device. Expert Rev Med Devices 2019; 16:663-673. [PMID: 31216915 DOI: 10.1080/17434440.2019.1635006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Right heart failure (RHF) in patients with a left ventricular assist device (LVAD) carries a poor prognosis although the treatment strategy including mechanical circulatory support for the failing right ventricle (RV) has not been well established. Areas covered: In this review, we describe an overview of RHF post-LVAD implant including natural history, prevalence, pathophysiology, outcomes, and challenges to predict RHF post-LVAD implant. Then, we focus on right ventricular assist devices (RVADs) and their clinical outcomes. Recently developed percutaneous RVADs are the major advance in this field. Finally, we discuss future perspectives to overcome limitations of the current treatment options. Expert opinion: In the absence of dedicated RVAD system RHF post-LVAD implant may have been undertreated. Now that dedicated percutaneous RVADs have emerged, surgeons are encouraged to use these new devices to improve outcomes of LVAD therapy. As experience accumulates, we should be able to establish the best possible strategy to treat early RHF post-LVAD implant. Late RHF is another form of RHF post-LVAD implant and has been underappreciated. Further research is mandatory to clarify the mechanism and risk factors. There are still unmet needs for a dedicated implantable RVAD for a subset of patients who need long-term RV support.
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Affiliation(s)
- Shogo Shimada
- a Department of Cardiac Surgery, The University of Tokyo Hospital , Tokyo , Japan
| | - Kan Nawata
- a Department of Cardiac Surgery, The University of Tokyo Hospital , Tokyo , Japan
| | - Osamu Kinoshita
- a Department of Cardiac Surgery, The University of Tokyo Hospital , Tokyo , Japan
| | - Minoru Ono
- a Department of Cardiac Surgery, The University of Tokyo Hospital , Tokyo , Japan
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14
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Minegishi S, Kinoshita O, Hoshino Y, Komae H, Kimura M, Shimada S, Yamauchi H, Nawata K, Ono M. Long-term support by left ventricular assist device for arrhythmogenic right ventricular cardiomyopathy. Artif Organs 2019; 43:909-912. [PMID: 31066907 DOI: 10.1111/aor.13482] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/08/2019] [Accepted: 05/02/2019] [Indexed: 11/27/2022]
Abstract
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a heart muscle disorder characterized by right ventricular enlargement, right heart failure (HF), and ventricular arrhythmias which lead to sudden death especially in young adults. Current recommendations for management of patients with ARVC are antiarrhythmic medications, catheter ablation, and implantable cardioverter defibrillator therapy to prevent sudden cardiac death. However, despite these treatments, few patients suffer from recurrent ventricular arrhythmias or HF unresponsive to conventional management. Heart transplantation (HTx) is a preferred treatment for these cases, but because of a persistent donor heart shortage in Japan, ventricular assist device (VAD) support has become an important option for a management of the end-stage ARVC. Previous articles reported 4 cases of a successful management by left ventricular assist device (LVAD), but the longest interval of LVAD support was only 333 days. We present 3 cases of ARVC patients who were successfully managed by LVAD implantation for more than a year. These 3 cases are unconventional examples of ARVC patients, considering the nature of the disease. The novelty of these cases should be taken in the context of the extremely long waiting period for HTx in Japan.
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Affiliation(s)
- Sachito Minegishi
- Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Osamu Kinoshita
- Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Yasuhiro Hoshino
- Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Hyoe Komae
- Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Mitsutoshi Kimura
- Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Shogo Shimada
- Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Haruo Yamauchi
- Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Kan Nawata
- Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan
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15
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Harada S, Aoki K, Okamoto K, Kinoshita O, Nawata K, Ishii Y, Tateda K, Sasaki M, Saga T, Doi Y, Yotsuyanagi H, Moriya K, Ono M. Left ventricular assist device-associated endocarditis involving multiple clones of Staphylococcus aureus with distinct antimicrobial susceptibility patterns. Int J Infect Dis 2019; 84:44-47. [PMID: 31075509 DOI: 10.1016/j.ijid.2019.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/30/2019] [Accepted: 05/01/2019] [Indexed: 10/26/2022] Open
Abstract
The case of a patient with left ventricular assist device (LVAD)-associated endocarditis involving multiple clones of Staphylococcus aureus is presented. Different clones with distinct colony morphology were identified from blood cultures collected on the same day and showed diverse antimicrobial resistance patterns. In addition, a difference in antimicrobial susceptibility was observed even within an identical clone recovered 400 days apart due to the loss of SCCmec for methicillin and modification of the 23S rRNA target site for linezolid during a long-term treatment course.
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Affiliation(s)
- Sohei Harada
- Department of Infectious Diseases, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan; Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan.
| | - Kotaro Aoki
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan
| | - Koh Okamoto
- Department of Infectious Diseases, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Osamu Kinoshita
- Department of Cardiac Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kan Nawata
- Department of Cardiac Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Yoshikazu Ishii
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan
| | - Kazuhiro Tateda
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan
| | - Masakazu Sasaki
- Department of Clinical Laboratories, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Tomoo Saga
- Central Laboratory Division, Akita University Hospital, 1-1-1 Hondo, Akita 010-8543, Japan
| | - Yohei Doi
- Department of Infectious Diseases, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Hiroshi Yotsuyanagi
- Department of Infectious Diseases, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kyoji Moriya
- Department of Infectious Diseases, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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16
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Itoda Y, Kimura M, Kinoshita O, Yamauchi H, Nawata K, Ono M. Total Replacement of Implantable Left Ventricular Assist Device for Pump Pocket/Device Infection. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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17
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Tsuji M, Amiya E, Hatano M, Nitta D, Maki H, Bujo C, Saito A, Hosoya Y, Minatsuki S, Hara T, Nemoto M, Kagami Y, Endo M, Kimura M, Kinoshita O, Nawata K, Morita H, Ono M, Komuro I. Abdominal skeletal muscle mass as a predictor of mortality in Japanese patients undergoing left ventricular assist device implantation. ESC Heart Fail 2019; 6:526-535. [PMID: 30929311 PMCID: PMC6487708 DOI: 10.1002/ehf2.12429] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 02/15/2019] [Indexed: 12/25/2022] Open
Abstract
Aims We assessed preoperative muscle wasting in patients undergoing left ventricular assist device (LVAD) implantations using abdominal skeletal muscle images on computed tomography (CT) and explored the associations between the preoperative muscle wasting and clinical outcomes after LVAD implantation. Methods and results We retrospectively examined the records of 111 patients who underwent continuous‐flow LVAD implantations as bridge‐to‐transplant therapy from January 2010 to December 2016 at our institution. After 33 patients were excluded, the study cohort consisted of 78 individuals. CT images used to calculate the skeletal muscle index (SMI) at the third lumbar vertebra level were obtained before the LVAD implantation procedures. Patients were classified as having muscle wasting if their SMI fell into the lowest gender‐based tertile. The median SMI for the study patients was 37.6 cm2/m2. The SMI cut‐off values for the lowest tertiles were 36.7 cm2/m2 for men and 28.2 cm2/m2 for women, resulting in 26 patients (33.3%) with muscle wasting in this study. During the mean follow‐up of 738 ± 379 days, there were 10 deaths (12.8% mortality). Seven of the 26 patients with muscle wasting (26.9%) died, and 3 of the 52 patients without muscle wasting (5.8%) died. The times to all‐cause mortality were significantly different between patients with and without muscle wasting (P = 0.0094). Muscle wasting was found to be associated with mortality in univariate and multivariate Cox analyses (hazard ratio: 4.32; 95% CI: 1.19–20.2). Conclusions Preoperative muscle wasting was associated with a higher mortality in patients with LVAD. Assessment of the abdominal skeletal muscle area on CT prior to LVAD implantation can help predict mortality.
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Affiliation(s)
- Masaki Tsuji
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Therapeutic Strategy for Heart Failure, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Daisuke Nitta
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hisataka Maki
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Chie Bujo
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Akihito Saito
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yumiko Hosoya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shun Minatsuki
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toru Hara
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mariko Nemoto
- Department of Organ Transplantation, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yukie Kagami
- Department of Organ Transplantation, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Miyoko Endo
- Department of Organ Transplantation, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mitsutoshi Kimura
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Osamu Kinoshita
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kan Nawata
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
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18
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Tsuji M, Nitta D, Minatsuki S, Maki H, Hosoya Y, Amiya E, Hatano M, Takimoto E, Kinoshita O, Nawata K, Ono M, Komuro I. Emergency percutaneous coronary intervention for left main trunk thrombus following orthotopic heart transplantation. ESC Heart Fail 2019; 6:575-578. [PMID: 30854779 PMCID: PMC6487697 DOI: 10.1002/ehf2.12422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 01/27/2019] [Indexed: 11/09/2022] Open
Abstract
Heart transplantation (HTx) is the gold standard therapy to improve quality and quantity of life in end‐stage heart failure patients. However, recipients are at risk of experiencing allograft rejection and post‐transplant complications, in the acute as well as chronic phase. A 43‐year‐old man with a history of left ventricular non‐compaction underwent orthotopic HTx. On Day 7, transthoracic echocardiography showed a sudden decrease in cardiac function with hypokinesis in a left ventricular anterior wall distribution. Coronary angiography revealed a large thrombus in the left main trunk. With intra‐aortic balloon pump support, emergency percutaneous coronary intervention was performed. Endomyocardial biopsy showed no rejection. A left main trunk thrombus is rare in the early phase after HTx, but it can be a life‐threatening complication. Transthoracic echocardiography is well known to be important in the management of heart transplant recipients, and coronary angiography as well as myocardial biopsy should be considered when left ventricular wall motion is impaired.
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Affiliation(s)
- Masaki Tsuji
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Daisuke Nitta
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shun Minatsuki
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hisataka Maki
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yumiko Hosoya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Therapeutic Strategy for Heart Failure, The University of Tokyo, Tokyo, Japan
| | - Eiki Takimoto
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Osamu Kinoshita
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kan Nawata
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
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19
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Hara H, Takeda N, Fujiwara T, Yagi H, Maemura S, Kanaya T, Nawata K, Morita H, Komuro I. Activation of TGF-β signaling in an aortic aneurysm in a patient with Loeys-Dietz syndrome caused by a novel loss-of-function variant of TGFBR1. Hum Genome Var 2019; 6:6. [PMID: 30701076 PMCID: PMC6338757 DOI: 10.1038/s41439-019-0038-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/16/2018] [Accepted: 12/09/2018] [Indexed: 11/09/2022] Open
Abstract
Loeys-Dietz syndrome (LDS) is caused by variants of transforming growth factor-β (TGF-β)-related genes and is characterized by aortic aneurysm and dissection. We report an LDS patient with a de novo missense variant of TGFBR1 [c.1126A>G, p.(Lys376Glu)] in which active TGF-β signaling was observed in the aorta, despite the in vitro demonstration that the loss-of-function mutation lies within the serine/threonine kinase domain. The mechanism underlying this TGF-β paradox in LDS aortopathy should be further investigated.
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Affiliation(s)
- Hironori Hara
- 1Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 Japan
| | - Norifumi Takeda
- 1Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 Japan
| | - Takayuki Fujiwara
- 1Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 Japan
| | - Hiroki Yagi
- 1Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 Japan
| | - Sonoko Maemura
- 1Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 Japan
| | - Tsubasa Kanaya
- 1Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 Japan
| | - Kan Nawata
- 2Department of Cardiac Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 Japan
| | - Hiroyuki Morita
- 1Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 Japan
| | - Issei Komuro
- 1Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 Japan
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20
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Kimura M, Kohno T, Makino S, Okuda S, Nawata K, Yanagisawa R, Kojima H, Nishiyama T, Aizawa Y, Yuasa S, Murata M, Maekawa Y, Okamoto K, Shimizu H, Fukuda K. A tale of two sisters with hypertrophic cardiomyopathy and recurrent embolism: When is the optimal timing of the intervention for left atrial appendage? Heart Lung 2018; 48:198-200. [PMID: 30253876 DOI: 10.1016/j.hrtlng.2018.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 08/15/2018] [Accepted: 08/22/2018] [Indexed: 10/28/2022]
Abstract
Hypertrophic cardiomyopathy (HCM) is an extremely heterogeneous genetic disease that affects the left ventricle (LV) and has a varied clinical course and phenotypic expression. Here, we report a case of two sisters with HCM who developed a massive refractory left atrial appendage (LAA) thrombus and recurrent embolism. The older sister, who was at a high surgical risk due to progressive LV systolic dysfunction with an ejection fraction of 19%, underwent LAA plication in combination with implantation of an LV assist device after progression to treatment-refractory heart failure at the age of 49. The younger sister underwent surgical thrombectomy, LAA plication, and Maze surgery before deterioration of heart failure at the age of 47. She was free from embolism and atrial fibrillation for 2years after surgery. Individualized therapeutic approaches targeting the LAA at a relatively early stage are required in the subgroups of HCM patients with left atrial dysfunction.
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Affiliation(s)
- Mai Kimura
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Kohno
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
| | - Shinji Makino
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Shigeo Okuda
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Kan Nawata
- Department of Cardiac, Surgery, University Tokyo Hospital, Tokyo, Japan
| | - Ryo Yanagisawa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Hidenori Kojima
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Takahiko Nishiyama
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Yoshiyasu Aizawa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Shinsuke Yuasa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Mitsushige Murata
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Yuichiro Maekawa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuma Okamoto
- Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hideyuki Shimizu
- Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
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21
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Hasumi E, Fujiu K, Kojima T, Kinoshita O, Nawata K, Yamauchi H, Ono M, Komuro I. Novel extraction technique of retained pacemaker and defibrillator lead during heart transplantation. PLoS One 2018; 13:e0203172. [PMID: 30188917 PMCID: PMC6126868 DOI: 10.1371/journal.pone.0203172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 08/15/2018] [Indexed: 12/24/2022] Open
Abstract
Background Removal of cardiac implantable electronic devices (CIEDs) by manual traction during orthotopic heart transplantation (OHT) sometimes results in retained lead fragments. Moreover, abandoned leads and retained lead fragments are a contraindication for magnetic resonance imaging (MRI) and may be a cause of CIED infection. Objective To eliminate complications of retained lead fragments, we completely removed residual leads using an excimer laser sheath technique during OHT. We report our clinical experience and high success rate of lead extraction using the excimer laser sheath compared with manual traction during OHT. Methods and results We obtained data on 84 consecutive patients receiving OHT between August 2007 and August 2017. Thirty-nine of 84 patients had undergone CIED implantation before OHT and removal of all their leads was attempted during OHT. From 2007 to 2014, defibrillator and pacemaker leads were extracted by manual traction in all patients (N = 22). After 2015, all leads were extracted with the excimer laser sheath, and surgical assistance was prepared for the procedure (N = 17). Complete procedural success was achieved in 100% of patients in the excimer laser group and 77% of patients in the manual traction group. Conclusion Extraction of abandoned leads using the excimer laser sheath system during OHT is novel and safe technique, and has a higher success rate than extraction using manual traction during OHT.
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Affiliation(s)
- Eriko Hasumi
- Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- * E-mail: (EH); (KF)
| | - Katsuhito Fujiu
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Advanced Cardiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- * E-mail: (EH); (KF)
| | - Toshiya Kojima
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Osamu Kinoshita
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kan Nawata
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Haruo Yamauchi
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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22
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Nawata K, Ono M. [Implantable Ventricular Assist Device]. Kyobu Geka 2018; 71:827-832. [PMID: 30310034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
For patients with "stage D refractory heart failure" as stated by the The Japanese Circulation Society (JCS) 2017/The Japanese Heart Failure Society (JHFS) 2017 Guidelines for Diagnosis and Treatment of Acute and Chronic Heart Failure, extensive therapeutic methods including implantation of ventricular assist device (VAD) and/or heart transplantation, as well as terminal care. An implantable VAD is a device designed to support patients for a long term of several years. This device has its most part buried in the body with its driveline penetrated out through the skin to connect with a controller and butteries. In Japan, implantable VADs started to be used in 2011, and now 3 devices are available in a commercial basis, that is, EVAHEART 2, HeartMate II and Jarvik 2000. They are available when a patient has been listed as a candidate for heart transplantation, and recently the usage of implantable VAD as destination therapy that is applied for patients who are not eligible for heart transplantation but would get benefit from circulatory support, enough to be free from hospital-bound status and enjoy high quality of life. If this device can prove to improve heart failure patients' symptoms, resulting in decreasing medical expense, surely it would be widely accepted as a promising therapy to treat heart failure.
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Affiliation(s)
- Kan Nawata
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
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23
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Nitta D, Kinugawa K, Imamura T, Amiya E, Hatano M, Kinoshita O, Nawata K, Ono M, Komuro I. A Useful Scoring System For Predicting Right Ventricular Assist Device Requirement Among Patients with a Paracorporeal Left Ventricular Assist Device. Int Heart J 2018; 59:983-990. [DOI: 10.1536/ihj.17-487] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Daisuke Nitta
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Koichiro Kinugawa
- Department of Internal Medicine 2, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | | | - Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Masaru Hatano
- Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo
| | - Osamu Kinoshita
- Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo
| | - Kan Nawata
- Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo
| | - Minoru Ono
- Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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24
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Yoshitake S, Kinoshita O, Nawata K, Hoshino Y, Itoda Y, Kimura M, Yamauchi H, Ono M. Single-center experience of the bridge-to-bridge strategy using the Nipro paracorporeal ventricular assist device. J Artif Organs 2018; 21:405-411. [DOI: 10.1007/s10047-018-1053-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/18/2018] [Indexed: 11/28/2022]
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25
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Yoshitake S, Kinoshita O, Nawata K, Hoshino Y, Itoda Y, Kimura M, Yamauchi H, Ono M. Novel driveline route for prevention from driveline infection: Triple tunnel method. J Cardiol 2018; 72:363-366. [PMID: 29731190 DOI: 10.1016/j.jjcc.2018.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/12/2018] [Accepted: 04/03/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND The most prevalent and serious infection related to left ventricular assist devices (LVADs) is driveline infection (DLI). From 2014, we employed a revised surgical technique (triple tunnel method), which deployed a longer subfascial driveline (DL) route. METHODS AND PATIENTS We retrospectively analyzed 34 patients fitted with either of the two types of axial pumps: HeartMate II (n=23) and Jarvik 2000 (n=11). Prior to 2014, the DL proceeded from the pump pocket just above the posterior sheath of the rectus muscle toward a vertical skin incision at the right lateral border of the rectus muscle. Then, DL was turned leftward into the subcutaneous tissue to redirect its exit to the left side [subcutaneous tissue group (Group S): n=14]. From 2014, we made an additional skin incision below the umbilicus with the aim of lengthening the subfascial DL route [muscle group (Group M): n=20]. RESULTS DLI occurred in 10 patients (71.4%) in Group S and in 1 patient (5%) in Group M (p<0.05, Chi-square test). The freedom rate from re-admission at 1 year due to DLI was 64% in Group S and 95% in Group M, respectively (p=0.021, log-rank test). Furthermore, logistic regression analysis revealed that DL route was significantly associated with DLI (odds ratio, 10.1; 95% confidence interval, 1.15-275.3). CONCLUSION Although a longer follow-up period will be needed, the triple tunnel method may be beneficial in the prevention of DLI.
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Affiliation(s)
- Shuichi Yoshitake
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan.
| | - Osamu Kinoshita
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - Kan Nawata
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - Yasuhiro Hoshino
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - Yoshifumi Itoda
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - Mitsutoshi Kimura
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - Haruo Yamauchi
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan.
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26
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Abstract
Coronary stent fracture (SF) is rare as a complication of percutaneous coronary intervention (PCI), and its adverse events are increasingly being recognized with the development in devices of PCI. The major adverse events caused by SFs are in-stent restenosis due to neointimal overgrowth caused by poor drug delivery.1,2) A coronary artery aneurysm (CAA) is a rare complication of SF, but may lead to lethal events such as acute coronary syndrome or rupture of the CAA further leading to cardiac tamponade.3-5) However, the management of CAAs is controversial with or without SF.6) Herein, we report a case of a CAA caused by an SF and discuss the management of CAA complicated with SF, along with a literature review. We suggest that surgical treatment should be considered the higher-priority strategy in the cases of CAA with SF as compared to CAA without SF.
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Affiliation(s)
- Tsukasa Oshima
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Shun Minatsuki
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Masahiro Myojo
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Satoshi Kodera
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Kan Nawata
- Department of Cardiac Surgery, The University of Tokyo Hospital
| | - Jiro Ando
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Hiroshi Akazawa
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Masafumi Watanabe
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Minoru Ono
- Department of Cardiac Surgery, The University of Tokyo Hospital
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
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27
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Adachi Y, Kinoshita O, Hatano M, Shintani Y, Naito N, Kimura M, Nawata K, Nitta D, Maki H, Ueda K, Amiya E, Takimoto E, Komuro I, Ono M. Successful bridge to recovery in fulminant myocarditis using a biventricular assist device: a case report. J Med Case Rep 2017; 11:295. [PMID: 29061186 PMCID: PMC5654049 DOI: 10.1186/s13256-017-1466-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 09/20/2017] [Indexed: 12/03/2022] Open
Abstract
Background Fulminant myocarditis is a life-threatening disease, and myocardial damage expands the right ventricle as well as the left ventricle in some cases. There is a mortality rate of over 40% in patients with fulminant myocarditis who need mechanical circulatory support by peripheral venoarterial extracorporeal membrane oxygenation. Case presentation We report a case of a 27-year-old Japanese woman who was successfully bridged to recovery by using a biventricular assist device. She was diagnosed with fulminant myocarditis, and peripheral venoarterial extracorporeal membrane oxygenation was established on the same day. Her left ventricular ejection fraction rapidly decreased from 40% to 5% in 3 days and weaning from venoarterial extracorporeal membrane oxygenation was deemed difficult. Therefore, we performed a ventricular assist device implantation on day 4. A left ventricular assist device was implanted first. However, adequate blood flow did not circulate to the left side of her heart because of right-sided heart failure. Thus, an additional implant of a right ventricular assist device was performed during the operation. Her left ventricular ejection fraction recovered to 50% on day 10. The biventricular assist device was successfully removed on day 14. She has not experienced worsening of biventricular function during her follow-ups for 4 years. Conclusions Ventricular assist device therapy should be considered if there is no improvement in cardiac function in patients with fulminant myocarditis regardless of several days of support by venoarterial extracorporeal membrane oxygenation. A right ventricular assist device should always be implemented when necessary because biventricular involvement is not uncommon in fulminant myocarditis. Electronic supplementary material The online version of this article (doi:10.1186/s13256-017-1466-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yusuke Adachi
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Osamu Kinoshita
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukako Shintani
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Noritsugu Naito
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mitsutoshi Kimura
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kan Nawata
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Daisuke Nitta
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hisataka Maki
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazutaka Ueda
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Ubiquitous Preventive Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Eiki Takimoto
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Advanced Translational Research and Medicine in Management of Pulmonary Hypertension, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
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28
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Nitta D, Kinugawa K, Amiya E, Hatano M, Kinoshita O, Nawata K, Ono M, Komuro I. B-type Natriuretic Peptide Before Discharge after Left Ventricular Assist Device Implantation Is Associated With Subsequent Hospitalization due to Cardiac Causes. J Card Fail 2017. [DOI: 10.1016/j.cardfail.2017.08.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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Komae H, Nawata K, Kinoshita O, Hoshino Y, Kimura M, Yamauchi H, Amiya E, Hosoya Y, Hatano M, Ono M. 2 Case Reports of Successful Treatment by Central ECMO with LV Venting for Severe Heart Failure Complicated with Alveolar Hemorrhage. J Card Fail 2017. [DOI: 10.1016/j.cardfail.2017.08.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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30
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Nakatani T, Sase K, Oshiyama H, Akiyama M, Horie M, Nawata K, Nishinaka T, Tanoue Y, Toda K, Tozawa M, Yamazaki S, Yanase M, Ohtsu H, Ishida M, Hiramatsu A, Ishii K, Kitamura S. Japanese registry for Mechanically Assisted Circulatory Support: First report. J Heart Lung Transplant 2017; 36:1087-1096. [PMID: 28942783 DOI: 10.1016/j.healun.2017.08.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 08/03/2017] [Accepted: 08/09/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In Japan, ventricular assist devices (VADs) have been used for patients with severe heart failure as a bridge to transplantation (BTT) since 1992. However, it was not until 1997, when the Organ Transplant Law was enacted, that medical devices received approval by the national health insurance system for that use. To encourage research and development of innovative medical devices, the Pharmaceuticals and Medical Devices Agency has established a public-private partnership in collaboration with academic societies, hospitals and manufacturers. METHODS The Japanese registry for Mechanically Assisted Circulatory Support (J-MACS) is a prospective registry designed to be harmonized with the Interagency Registry of Mechanically Assisted Circulatory Support (INTERMACS). Participation in J-MACS is mandatory for device manufacturers to meet the conditions of approval as well as for hospitals to obtain authorization for reimbursement from the national health insurance system. RESULTS From June 2010 to April 2015, 476 patients were registered at 31 hospitals. Of these, analysis of primary VAD patients (n = 332) revealed that their overall 360-day survival was 91% (implantable 93%, extracorporeal 84%). CONCLUSIONS This initial report from J-MACS focuses on patients' demographics, device types, survival, competing outcomes, adverse events and successful examples of system failure detection.
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Affiliation(s)
- Takeshi Nakatani
- Principal Investigator, Chair, J-MACS Operating Committee, Maki Hospital, Osaka, Japan.
| | - Kazuhiro Sase
- Co-principal Investigator, J-MACS Operating Committee, Juntendo University, Tokyo, Japan
| | - Hiroaki Oshiyama
- Co-principal Investigator, J-MACS Operating Committee, Medical Technology Association of Japan, Tokyo, Japan
| | - Masatoshi Akiyama
- Investigator, J-MACS Operating Committee, Tohoku University, Miyagi, Japan
| | - Masao Horie
- Investigator, J-MACS Operating Committee, Nipro Corporation, Osaka, Japan
| | - Kan Nawata
- Investigator, J-MACS Operating Committee, The University of Tokyo, Tokyo, Japan
| | - Tomohiro Nishinaka
- Investigator, J-MACS Operating Committee, Tokyo Women's Medical University, Tokyo, Japan
| | - Yoshihisa Tanoue
- Investigator, J-MACS Operating Committee, Kyushu University, Fukuoka, Japan
| | - Koichi Toda
- Investigator, J-MACS Operating Committee, Osaka University, Osaka, Japan
| | - Masao Tozawa
- Investigator, J-MACS Operating Committee, Century Medical, Inc., Tokyo, Japan
| | - Shunichi Yamazaki
- Investigator, J-MACS Operating Committee, Sun Medical Technology Research Corp. Nagano, Japan
| | - Masanobu Yanase
- Investigator, J-MACS Operating Committee, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hiroshi Ohtsu
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Michiko Ishida
- Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | | | - Kensuke Ishii
- Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Soichiro Kitamura
- Chair, J-MACS Steering Committee, National Cerebral and Cardiovascular Center, Osaka, Japan
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31
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Sayama S, Takeda N, Iriyama T, Inuzuka R, Maemura S, Fujita D, Yamauchi H, Nawata K, Bougaki M, Hyodo H, Shitara R, Nakayama T, Komatsu A, Nagamatsu T, Osuga Y, Fujii T. Authors' reply re: Peripartum type B aortic dissection in patients with Marfan syndrome who underwent aortic root replacement: a case series study. BJOG 2017; 125:502-503. [DOI: 10.1111/1471-0528.14778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Seisuke Sayama
- Department of Obstetrics and Gynecology; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
| | - Norifumi Takeda
- Department of Cardiovascular Medicine; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
| | - Takayuki Iriyama
- Department of Obstetrics and Gynecology; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
| | - Ryo Inuzuka
- Department of Pediatrics; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
| | - Sonoko Maemura
- Department of Cardiovascular Medicine; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
| | - Daishi Fujita
- Department of Cardiovascular Medicine; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
| | - Haruo Yamauchi
- Department of Cardiovascular Surgery; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
| | - Kan Nawata
- Department of Cardiovascular Surgery; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
| | - Masahiko Bougaki
- Department of Anesthesiology and Pain Relief Center; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
| | - Hironobu Hyodo
- Department of Obstetrics and Gynecology; Tokyo Metropolitan Bokutoh Hospital; Sumida-ku Tokyo Japan
| | - Rieko Shitara
- Department of Obstetrics and Gynecology; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
| | - Toshio Nakayama
- Department of Obstetrics and Gynecology; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
| | - Atushi Komatsu
- Department of Obstetrics and Gynecology; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
| | - Takeshi Nagamatsu
- Department of Obstetrics and Gynecology; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
| | - Tomoyuki Fujii
- Department of Obstetrics and Gynecology; Faculty of Medicine; University of Tokyo; Bunkyo-ku Tokyo Japan
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32
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Sayama S, Takeda N, Iriyama T, Inuzuka R, Maemura S, Fujita D, Yamauchi H, Nawata K, Bougaki M, Hyodo H, Shitara R, Nakayama T, Komatsu A, Nagamatsu T, Osuga Y, Fujii T. Peripartum type B aortic dissection in patients with Marfan syndrome who underwent aortic root replacement: a case series study. BJOG 2017; 125:487-493. [PMID: 28294527 DOI: 10.1111/1471-0528.14635] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate pregnancy outcomes, especially the risk of pregnancy-related aortic dissection (AD), in patients with Marfan syndrome (MFS) after prophylactic aortic root replacement (ARR). DESIGN Retrospective case series study. SETTING Tertiary perinatal care centre at a university hospital. POPULATION Pregnant women fulfilling the revised Ghent nosology (2010) criteria for MFS who were managed at our institute. METHODS The pregnancy outcomes of all patients with MFS managed at our institute between 1982 and September 2016 were reviewed retrospectively based on medical records. MAIN OUTCOME MEASURES Obstetrical management and complication including the incidence of AD throughout the peripartum period. RESULTS Among 22 patients (28 pregnancies) who had been managed as potential MFS or related disorders, 14 (17 pregnancies) fulfilled the revised Ghent nosology (2010) criteria for MFS and were enrolled in this study. Five patients (five pregnancies) had received ARR before conception: three (60%) developed type B aortic dissection [AD(B)] during the peripartum period, compared with only one of 10 patients (12 pregnancies) without ARR (P < 0.05, Chi-square test). CONCLUSIONS Our study results suggest that MFS patients after prophylactic ARR are still at high risk of AD(B) during the peripartum period. Careful pre-pregnancy counselling and multidisciplinary care throughout the peripartum period are essential for the management of MFS, even after surgical repair of an ascending aortic aneurysm. TWEETABLE ABSTRACT MFS patients after prophylactic ARR are still at high risk of type B aortic dissection during the peripartum period.
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Affiliation(s)
- S Sayama
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - N Takeda
- Department of Cardiovascular Medicine, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - T Iriyama
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - R Inuzuka
- Department of Pediatrics, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - S Maemura
- Department of Cardiovascular Medicine, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - D Fujita
- Department of Cardiovascular Medicine, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - H Yamauchi
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - K Nawata
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - M Bougaki
- Department of Anesthesiology and Pain Relief Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - H Hyodo
- Department of Obstetrics and Gynecology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - R Shitara
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - T Nakayama
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - A Komatsu
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - T Nagamatsu
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Y Osuga
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - T Fujii
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
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Nitta D, Kinugawa K, Imamura T, Iino J, Endo M, Amiya E, Hatano M, Kinoshita O, Nawata K, Ono M, Komuro I. Association of the Number of HLA-DR Mismatches With Early Post-transplant Acute Cellular Rejection Among Heart Transplantation Recipients: A Cohort Study in Japanese Population. Transplant Proc 2017; 49:125-129. [PMID: 28104119 DOI: 10.1016/j.transproceed.2016.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Although many risk factors are reported about graft rejection after heart transplantation (HTx), the effect of HLA mismatch (MM) still remains unknown, especially in the Japanese population. The aim of the present study was to investigate the influence of HLA MM on graft rejection among HTx recipients in Japan. METHODS We retrospectively investigated the association of the number of HLA MM including class I (A, B) and class II (DR) (for each locus MM: 0 to 2, total MM: 0 to 6) and the incidence of moderate to severe acute cellular rejection (ACR) confirmed by endomyocardial biopsy (International Society for Heart and Lung Transplantation grade ≥ 3A/2R) within 1 year after HTx. RESULTS Between 2007 and 2014, we had 49 HTx cases in our institute. After excluding those with insufficient data and positive donor-specific antigen, finally 35 patients were enrolled. Moderate to severe ACR was observed in 16 (45.7%) patients. The number of HLA-DR MM was significantly associated with the development of ACR (ACR+: 1.50 ± 0.63, ACR-: 1.11 ± 0.46, P = .029). From univariate analysis, DR MM = 2 was the only independent risk factor for ACR episodes (P = .017). The frequency of ACR within 1 year was significantly higher in those with DR MM = 2 (DR MM = 0 to 1: 0.3 ± 0.47, DR MM = 2: 1.17 ± 1.34 times, P = .007). CONCLUSIONS The number of HLA-DR MMs was associated with the development and recurrence of ACR episodes among HTx recipients within 1 year after transplantation in Japanese population.
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Affiliation(s)
- D Nitta
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - K Kinugawa
- Department of Internal Medicine 2, The University of Toyama, Toyama, Japan.
| | - T Imamura
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - J Iino
- Department of Blood Transfusion, The University of Tokyo, Tokyo, Japan
| | - M Endo
- Department of Organ Transplantation, The University of Tokyo, Tokyo, Japan
| | - E Amiya
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - M Hatano
- Department of Therapeutic Strategy for Heart Failure, The University of Tokyo, Tokyo, Japan
| | - O Kinoshita
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - K Nawata
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - M Ono
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - I Komuro
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
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Kitahara H, Nawata K, Kinoshita O, Itoda Y, Shintani Y, Fukayama M, Ono M. Implantation of a Left Ventricular Assist Device for Danon Cardiomyopathy. Ann Thorac Surg 2017; 103:e39-e41. [PMID: 28007270 DOI: 10.1016/j.athoracsur.2016.07.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/12/2016] [Accepted: 07/05/2016] [Indexed: 10/20/2022]
Abstract
This is the first report of Danon cardiomyopathy managed with a left ventricular assist device (LVAD). Danon disease is an X-linked dominant inheritance disorder. Heart failure with Danon cardiomyopathy results in a poor prognosis, and heart transplantation is the treatment of choice. We present two cases of successful implantation of an LVAD for Danon cardiomyopathy. Patient 1 was in the dilatated phase of hypertrophic cardiomyopathy (HCM) with Danon cardiomyopathy, and she underwent LVAD implantation. She is waiting for transplantation. Patient 2 had dilatated cardiomyopathy with Danon cardiomyopathy and received transplantation 990 days after LVAD implantation without myopathy or intellectual disability.
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Affiliation(s)
- Hiroto Kitahara
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - Kan Nawata
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan.
| | - Osamu Kinoshita
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - Yoshifumi Itoda
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - Yukako Shintani
- Department of Pathology, The University of Tokyo, Tokyo, Japan
| | | | - Minoru Ono
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
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35
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Okamura K, Nawata K, Kimura M, Kinoshita O, Masuzawa A, Yamauchi H, Hirata Y, Owada Y, Oshiro Y, Okamoto H, Ohkohchi N, Ono M. The Prevalence of Hepatitis E Virus Serum Antibodies and RNA in Heart Transplant Recipients. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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36
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Matsuda J, Fujiu K, Roh S, Tajima M, Maki H, Kojima T, Ushiku T, Nawata K, Takeda N, Watanabe M, Akazawa H, Komuro I. Cardiac Sarcoidosis Diagnosed by Incidental Lymph Node Biopsy. Int Heart J 2017; 58:140-143. [PMID: 28123162 DOI: 10.1536/ihj.16-218] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cardiac involvement in systemic sarcoidosis sometimes provokes life-threatening ventricular tachyarrhythmia. Steroid administration is one of the fundamental anti-arrhythmia therapies. For an indication of steroid therapy, a definitive diagnosis of sarcoidosis is required.1) However, cases that are clearly suspected of cardiac sarcoidosis based on their clinical courses sometimes do not meet the current diagnostic criteria and result in the loss of an appropriate opportunity to perform steroid therapy.Here we report a case that was diagnosed as sarcoidosis by incidental biopsy of an inguinal lymph node during cardiac resuscitation for cardiac tamponade.2) While the inguinal lymph node was not swollen on computed tomography, a specimen obtained from an incidental biopsy during the exposure of a femoral vessel for the establishment of extracorporeal cardio-pulmonary resuscitation showed a non-caseating granuloma.This findings suggest a non-swelling lymph node biopsy might be an alternative strategy for the diagnosis for sarcoidosis if other standard strategies do not result in a diagnosis of sarcoidosis.
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Affiliation(s)
- Jun Matsuda
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
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37
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Kimura M, Nawata K, Kinoshita O, Yamauchi H, Itoda Y, Imamura T, Hatano M, Kinugawa K, Ono M. Cerebrovascular Accident Rate Is Different Between Centrifugal and Axial-Flow Pumps, but Survival and Driveline Infection Rates Are Similar. Transplant Proc 2017; 49:121-124. [DOI: 10.1016/j.transproceed.2016.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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38
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Itoda Y, Nawata K, Yamauchi H, Kinoshita O, Kimura M, Ono M. Central aortic valve closure successfully treated aortic insufficiency of the patient with Jarvik 2000 continuous flow left ventricular assist device: a case report. J Artif Organs 2016; 20:99-101. [DOI: 10.1007/s10047-016-0929-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 10/06/2016] [Indexed: 11/30/2022]
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39
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Imamura T, Kinugawa K, Murasawa T, Kawasaki H, Yoshida M, Kashiwa K, Kinoshita O, Nawata K, Ono M. Optimal Device Selection to Reduce Driveline Infection During Ventricular Assist Device Therapy—Relationship Between Feature of Driveline and Driveline Infection. J Card Fail 2016. [DOI: 10.1016/j.cardfail.2016.06.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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40
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Imamura T, Kinugawa K, Nitta D, Kinoshita O, Nawata K, Ono M. Reversible Decline in Pulmonary Function During Left Ventricular Assist Device Therapy. J Card Fail 2016. [DOI: 10.1016/j.cardfail.2016.06.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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41
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Imamura T, Murasawa T, Kawasaki H, Kashiwa K, Kinoshita O, Nawata K, Ono M. Correlation between driveline features and driveline infection in left ventricular assist device selection. J Artif Organs 2016; 20:34-41. [PMID: 27448017 DOI: 10.1007/s10047-016-0923-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 07/13/2016] [Indexed: 01/10/2023]
Abstract
Although the survival rate for left ventricular assist device (LVAD) therapy has improved, device-related complications are an unpredictable threat to the patient's quality of life. We focused on driveline infection, and aimed to determine whether specific features of drivelines affect the frequency of infection. We enrolled patients who underwent LVAD implantation and were followed-up at our institute between 2007 and 2015. We counted the occurrences of driveline infection requiring any antibiotic therapy over a 2-year study period. Furthermore, we experimentally measured and compared the outer diameters and stiffness of three devices. Of all, 72 patients received an LVAD during the enrollment period. LVADs were HeartMate II (n = 32), EVAHEART (n = 22), and DuraHeart (n = 18). The outer diameters and stiffness were measured in five of each device. HeartMate II group had the highest driveline infection-free rate among all three devices during the study period (p = 0.042). The driveline of the HeartMate II LVAD had a significantly smaller outer diameter and lower stiffness than that of the other two devices (p < 0.05 for both). In conclusion, device-specific driveline features may affect the development of driveline infection during LVAD therapy.
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Affiliation(s)
- Teruhiko Imamura
- Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
| | - Takahide Murasawa
- Department of Medical Engineering, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | | | - Koichi Kashiwa
- Department of Medical Engineering, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Osamu Kinoshita
- Department of Cardiac Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Kan Nawata
- Department of Cardiac Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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42
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Nawata K, Ono M. [Beating-heart Mitral Valve Surgery]. Kyobu Geka 2016; 69:599-602. [PMID: 27440017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Cardiac surgeries have become complicated, although the procedures have been sophisticated as well as anesthetic management and postoperative care. Cardiac surgery team's main concerns include how to preserve cardiac function after aortic cross-clamp and chemical cardiac arrest, which cause myocardial edema and reperfusion injury. These days beating-heart surgery for mitral valve diseases is reported. Patients of mitral disease with low cardiac function due to ischemic cardiomyopathy or dilated cardiomyopathy as well as patients of mitral disease with functional coronary bypass graft might be good candidates for beating-heart mitral valve surgery, via either median sternotomy or right thoracotomy approach. Beating-heart surgery with aortic cross-clamp and coronary perfusion and that without aortic cross-clamp are available. Of great importance during beating-heart surgery without aortic crossclamp is to vent the left ventricle enough and maintain aortic root pressure, resulting in constant closure of aortic valve. The equivalent results are reported compared to conventional mitral valve surgery with cardiac arrest, and the beating- heart mitral surgery could be an alternative for patients with low ejection fraction and patients with previous sternotomy.
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Affiliation(s)
- Kan Nawata
- Department of Cardiothoracic Surgery, The University of Tokyo, Tokyo, Japan
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43
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Nakatani T, Sase K, Oshiyama H, Akiyama M, Horie M, Nawata K, Nishinaka T, Tanoue Y, Toda K, Tozawa M, Yanase M, Yamazaki S, Ishida M, Hiramatsu A, Kitamura S. Report of Japanese Registry for Mechanically Assisted Circulatory Support (J-MACS) - Non-Pulsatile Implantable LVAS vs. Extracorporeal LVAD as Bridge to Transplantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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44
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Yamauchi H, Nawata K, Nakao T, Daimon M, Kawata T, Hirokawa M, Kinoshita O, Itoda Y, Kimura M, Komuro I, Ono M. LONG-TERM OUTCOMES AND AORTIC VALVE MOTION AFTER REIMPLANTATION TECHNIQUES OF VALVE SPARING AORTIC ROOT REPLACEMENT, USING GRAFTS WITH PSEUDOSINUSES OF VALSALVA. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)32201-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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45
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Nawata K, Kinoshita O, Kimura M, Yamauchi H, Itoda Y, Yoshitake S, Hoshino Y, Ono M. Outcomes of Heart Transplantation after Long-Term Circulatory Support by Ventricular Assist Devices with Driveline/Pump Infection. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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46
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Imamura T, Kinugawa K, Nitta D, Hatano M, Itoda Y, Kimura M, Kinoshita O, Yamauchi H, Nawata K, Ono M. Novel Effect of Everolimus in Heart Transplant Recipients - Attenuation of Myocardial Hypertrophy and Improvement of Diastolic Function. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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47
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Imamura T, Kinugawa K, Nitta D, Kinoshita O, Nawata K, Ono M. Everolimus Attenuates Myocardial Hypertrophy and Improves Diastolic Function in Heart Transplant Recipients. Int Heart J 2016; 57:204-10. [PMID: 26973270 DOI: 10.1536/ihj.15-320] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Everolimus (EVL), one of the mammalian targets of rapamycin, is a next generation immunosuppressant that may have accessory anti-proliferative effects in heart transplant (HTx) recipients. However, little is known about the clinical relationship between EVL and regression of cardiac hypertrophy. A total of 42 HTx recipients received EVL therapy at post-HTx 150 days on median and had been followed at our institute for > 1 year between 2008 and 2014 [EVL (+) group]. We also observed 18 patients without EVL from post-HTx 150 days for 1 year [EVL (-) group]. There were no significant differences in baseline variables between the two groups. Left ventricular mass index (LVMI) and the ratio of early transmitral filling velocity to the peak early diastolic mitral annular motion velocity (E/e') decreased significantly during 1-year EVL treatment compared with the EVL (-) group. There were no differences in blood pressure and medications between the 2 groups. Improvement of LVMI and the E/e' ratio was not associated with trough levels of calcineurin inhibitors or EVL, but correlated with each baseline value. In conclusion, this EVL-incorporated immunosuppressant regimen attenuated cardiac hypertrophy as well as diastolic dysfunction in HTx recipients.
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Affiliation(s)
- Teruhiko Imamura
- Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo
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48
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Imamura T, Kinugawa K, Nitta D, Kinoshita O, Nawata K, Ono M. Fontan-Like Hemodynamics Complicated With Ventricular Fibrillation During Left Ventricular Assist Device Support. Int Heart J 2016; 57:515-8. [DOI: 10.1536/ihj.16-008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Teruhiko Imamura
- Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo
| | | | - Daisuke Nitta
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Osamu Kinoshita
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo
| | - Kan Nawata
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo
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49
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Nitta D, Kinugawa K, Imamura T, Endo M, Amiya E, Hatano M, Takahashi Y, Iriyama T, Kinoshita O, Nagamatsu T, Nawata K, Ono M, Komuro I. Successful Pregnancy and Delivery in a Heart Transplantation Recipient. Int Heart J 2016; 57:383-5. [DOI: 10.1536/ihj.15-414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Daisuke Nitta
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Koichiro Kinugawa
- Second Department of Internal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Teruhiko Imamura
- Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo
| | - Miyoko Endo
- Department of Organ Transplantation, Graduate School of Medicine, The University of Tokyo
| | - Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Yuko Takahashi
- Department of Obstetrics & Gynecology, Graduate School of Medicine, The University of Tokyo
| | - Takayuki Iriyama
- Department of Obstetrics & Gynecology, Graduate School of Medicine, The University of Tokyo
| | - Osamu Kinoshita
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo
| | - Takeshi Nagamatsu
- Department of Obstetrics & Gynecology, Graduate School of Medicine, The University of Tokyo
| | - Kan Nawata
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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50
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Takeda N, Yagi H, Hara H, Fujiwara T, Fujita D, Nawata K, Inuzuka R, Taniguchi Y, Harada M, Toko H, Akazawa H, Komuro I. Pathophysiology and Management of Cardiovascular Manifestations in Marfan and Loeys–Dietz Syndromes. Int Heart J 2016; 57:271-7. [DOI: 10.1536/ihj.16-094] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Norifumi Takeda
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Hiroki Yagi
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Hironori Hara
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Takayuki Fujiwara
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Daishi Fujita
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Kan Nawata
- Department of Cardiovascular Surgery, The University of Tokyo Hospital
| | - Ryo Inuzuka
- Department of Pediatrics, The University of Tokyo Hospital
| | - Yuki Taniguchi
- Department of Orthopedic Surgery, The University of Tokyo Hospital
| | - Mutsuo Harada
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Haruhiro Toko
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Hiroshi Akazawa
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
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