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Yoshikawa K, Shibata T, Iba Y, Ogura K, Misumi S, Kawaharada N. Simultaneous delineation of collateral circulation to Adamkiewicz artery via internal thoracic artery and endoleak with an ultrahigh-resolution computed tomography. J Vasc Surg 2024; 79:1233-1234. [PMID: 37777941 DOI: 10.1016/j.jvs.2023.08.115] [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] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 10/02/2023]
Affiliation(s)
- Kenta Yoshikawa
- Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan.
| | - Tsuyoshi Shibata
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Keishi Ogura
- Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Shogo Misumi
- Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
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Shibata T, Mitsuoka H, Iba Y, Hashizume K, Hongo N, Yasuhara K, Kuwada N, Katada Y, Hashiguchi H, Uzuka T, Murai Y, Nakajima T, Nakazawa J, Kawaharada N. Mid-term outcomes of physician-modified endograft therapy for complex aortic aneurysms. Interdiscip Cardiovasc Thorac Surg 2024; 38:ivae044. [PMID: 38490250 PMCID: PMC11001489 DOI: 10.1093/icvts/ivae044] [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] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 03/13/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVES Our goal was to evaluate early and mid-term outcomes of physician-modified endografting for pararenal and thoraco-abdominal aortic aneurysms from 10 Japanese aortic centres. METHODS From January 2012 to March 2022, a total of 121 consecutive adult patients who underwent physician-modified endografting for pararenal and thoraco-abdominal aortic aneurysms were enrolled. We analysed early and mid-term postoperative outcomes, including postoperative complications and mortality. RESULTS The pararenal and thoraco-abdominal aortic aneurysm groups included 62 (51.2%) and 59 (48.8%) patients, respectively. The overall in-hospital mortality rate was 5.8% (n = 7), with mortality rates of 3.2% (n = 2) and 8.5% (n = 5) in pararenal and thoraco-abdominal aortic aneurysm groups, respectively (P = 0.225). Type IIIc endoleaks occurred postoperatively in 18 patients (14.9%), with a significantly higher incidence (P = 0.033) in the thoraco-abdominal aortic aneurysm group (22.0%, n = 13) than in the other group (8.1%, n = 5). Major adverse events occurred in 7 (11.3%) and 14 (23.7%) patients in pararenal and thoraco-abdominal aortic aneurysm groups (P = 0.074), respectively. The mean follow-up period was 24.2 months. At the 3-year mark, both groups differed significantly in freedom from all-cause mortality (83.3% and 54.1%, P = 0.004), target aneurysm-related mortality (96.8% and 82.7%, P = 0.013) and any reintervention (89.3% and 65.6%, P = 0.002). Univariate and multivariate regression analyses demonstrated that ruptures, thoraco-abdominal aortic aneurysms and postoperative type IIIc endoleaks were associated with an increased risk of all-cause mortality. CONCLUSIONS The mid-term outcomes of physician-modified endografting for pararenal and thoraco-abdominal aortic aneurysms were clinically acceptable and comparable with those in other recently published studies. Notably, pararenal and thoraco-abdominal aortic aneurysms represent distinct pathological entities with different postoperative outcomes.
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Affiliation(s)
- Tsuyoshi Shibata
- Department of Cardiovascular Surgery, Sapporo Medical University, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Hiroshi Mitsuoka
- Department of Cardiovascular Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Kenichi Hashizume
- Department of Cardiovascular Surgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Norio Hongo
- Department of Radiology, Oita University, Oita, Japan
| | - Kiyomitsu Yasuhara
- Department of Cardiovascular Surgery, Isesaki Municipal Hospital, Isesaki, Japan
| | - Noriaki Kuwada
- Department of Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshiaki Katada
- Department of Radiology, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
| | - Hitoki Hashiguchi
- Department of Cardiovascular Surgery, Hokkaido Prefectural Kitami Hospital, Kitami, Japan
| | - Takeshi Uzuka
- Department of Cardiovascular Surgery, Sunagawa City Medical Center, Sunagawa, Japan
| | - Yuta Murai
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan
| | - Tomohiro Nakajima
- Department of Cardiovascular Surgery, Sapporo Medical University, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Junji Nakazawa
- Department of Cardiovascular Surgery, Sapporo Medical University, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
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Nakajima T, Iba Y, Shibata T, Arihara A, Kawaharada N. Huge, Infected Pancreatic Necrosis After Total Arch Replacement in a Patient With Immunoglobulin G4-Related Syndrome. Cureus 2024; 16:e56805. [PMID: 38654774 PMCID: PMC11036144 DOI: 10.7759/cureus.56805] [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] [Accepted: 03/24/2024] [Indexed: 04/26/2024] Open
Abstract
A 77-year-old male patient with immunoglobulin (Ig)G4-related disease was diagnosed with a 60-mm aortic arch aneurysm and atherosclerosis of the aorta advanced throughout the body. Aortic arch replacement surgery was performed with circulatory arrest at 28°C. One week later, the patient developed acute pancreatitis, followed by encapsulated necrosis in the chronic phase. After debridement surgery, the patient's condition improved.
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Affiliation(s)
| | - Yutaka Iba
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Tsuyoshi Shibata
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Ayaka Arihara
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
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Tsushima S, Iba Y, Nakajima T, Nakazawa J, Shibata T, Ohkawa A, Hosaka I, Arihara A, Kawaharada N. Mitral valve repair for infective endocarditis after esophageal reconstruction: a case report. Surg Case Rep 2024; 10:37. [PMID: 38332244 PMCID: PMC10853120 DOI: 10.1186/s40792-024-01836-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/02/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND In patients with retrosternal neo-esophageal conduit after right thoracotomy, the approach to cardiac surgery could be challenging. Particularly, in patients with infective endocarditis, there is a risk of injury to the conduit through standard median sternotomy. Moreover, right lung adhesions could be predicted. Herein, we present a case of successful mitral valve repair in a patient with infective endocarditis through a redo right thoracotomy after esophageal reconstruction. CASE PRESENTATION A 66-year-old male patient was diagnosed with infective endocarditis and a large anterior mitral leaflet vegetation after a previous esophageal reconstruction via right thoracotomy for esophageal cancer. Due to the retrosternal esophageal reconstruction, we performed a mitral valve repair through a redo right thoracotomy. After resecting the vegetation, the defect was closed with a fresh autologous pericardial patch. Mitral valve annuloplasty was performed. Postoperatively, antibiotics controlled the infection. The patient was discharged on postoperative day 30. CONCLUSIONS Successful mitral valve repair was performed for infective endocarditis through a redo right thoracotomy after esophageal reconstruction.
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Affiliation(s)
- Shingo Tsushima
- Department of Cardiovascular Surgery, Sapporo Central Hospital, Minami-9, Nishi-10, Chuo-Ward, Sapporo-City, Hokkaido, 064-0809, Japan.
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Central Hospital, Minami-9, Nishi-10, Chuo-Ward, Sapporo-City, Hokkaido, 064-0809, Japan
| | - Tomohiro Nakajima
- Department of Cardiovascular Surgery, Sapporo Central Hospital, Minami-9, Nishi-10, Chuo-Ward, Sapporo-City, Hokkaido, 064-0809, Japan
| | - Junji Nakazawa
- Department of Cardiovascular Surgery, Sapporo Central Hospital, Minami-9, Nishi-10, Chuo-Ward, Sapporo-City, Hokkaido, 064-0809, Japan
| | - Tsuyoshi Shibata
- Department of Cardiovascular Surgery, Sapporo Central Hospital, Minami-9, Nishi-10, Chuo-Ward, Sapporo-City, Hokkaido, 064-0809, Japan
| | - Akihito Ohkawa
- Department of Cardiovascular Surgery, Sapporo Central Hospital, Minami-9, Nishi-10, Chuo-Ward, Sapporo-City, Hokkaido, 064-0809, Japan
| | - Itaru Hosaka
- Department of Cardiovascular Surgery, Sapporo Central Hospital, Minami-9, Nishi-10, Chuo-Ward, Sapporo-City, Hokkaido, 064-0809, Japan
| | - Ayaka Arihara
- Department of Cardiovascular Surgery, Sapporo Central Hospital, Minami-9, Nishi-10, Chuo-Ward, Sapporo-City, Hokkaido, 064-0809, Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Central Hospital, Minami-9, Nishi-10, Chuo-Ward, Sapporo-City, Hokkaido, 064-0809, Japan
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Miura S, Kurimoto Y, Maruyama R, Nojima M, Sasaki K, Masuda T, Nishioka N, Iba Y, Kawaharada N, Naraoka S. Initial two-day blood pressure management after endovascular aneurysm repair improves midterm outcomes by reducing the incidence of early type II endoleak. J Vasc Surg 2024; 79:251-259.e2. [PMID: 37827245 DOI: 10.1016/j.jvs.2023.10.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate midterm outcomes of our novel strategy of postoperative initial 2-day blood pressure management (BPM) after endovascular aneurysm repair (EVAR) for the prevention of subsequent type II endoleak (T2EL) in a single-center series. METHODS Between 2008 and 2014, 137 patients who underwent EVAR for abdominal aortic aneurysm (AAA) were reviewed. Starting from 2013, the mean blood pressure was maintained between 75 and 90 mmHg for the initial 24 hours after EVAR followed by systolic pressure controlled below 120 mmHg during the next 24 hours in the treatment group (n = 76). The incidence of T2EL detected at 7 days, reintervention, and AAA sac diameter up to 5 years after EVAR were compared with those of the control group comprising of 60 consecutive patients who underwent standard EVAR without BPM prior to 2013. RESULTS Between the treatment group and the control group, significant differences were achieved in the incidence of T2EL at 7 days (19.7% vs 40.0%; P = .009), a mean decrease of AAA sac diameter at 1-year (-5.1 ± 4.9 vs -2.2 ± 6.7 mm; P = .013) and 2-year (-5.4 ± 7.7 vs -1.7 ± 10.8 mm; P = .045). In addition, there was a significant decrease in the incidence of T2EL detected at 7 days with the use of the Gore Excluder with 22.7% in the treatment group vs 80.0% in the control group (P < .001), which resulted in a significant decrease in the aneurysm sac diameter up to 4 years after EVAR. Survival rate without AAA sac enlargement at 5 years after EVAR (83.0% vs 70.0%; P = .021) in the treatment group was significantly higher than that of the control group, whereas no significant differences were observed in the freedom rates of reintervention, T2EL-related reintervention, and all-cause mortality between the groups. CONCLUSIONS Postoperative initial 2-day BPM had a preventive effect on AAA sac enlargement until midterm periods, by reducing the incidence of T2EL at 7 days after EVAR. The usage of Gore Excluder under BPM was especially associated with sustained positive effects until the midterm follow-up.
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Affiliation(s)
- Shuhei Miura
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan.
| | - Yoshihiko Kurimoto
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Ryushi Maruyama
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Masanori Nojima
- The Institute of Medical Science Hospital, University of Tokyo, Tokyo, Japan
| | - Keita Sasaki
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Takahiko Masuda
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Naritomo Nishioka
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University, Sapporo, Japan
| | - Syuichi Naraoka
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
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Nakajima T, Iba Y, Shibata T, Ohkawa A, Kawaharada N. Identification of a Dissection Site in the Internal Thoracic Artery Using Fluorescence Imaging: A Case Report. Cureus 2024; 16:e55199. [PMID: 38558681 PMCID: PMC10980908 DOI: 10.7759/cureus.55199] [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] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
A 66-year-old man with a history of type 2 diabetes mellitus who was undergoing hemodialysis presented with angina. Coronary angiography revealed triple-vessel coronary artery disease. He underwent multiple percutaneous coronary interventions due to recurrent restenosis and was referred for coronary artery bypass grafting (CABG). The left internal thoracic artery and bilateral saphenous veins were harvested under general anesthesia. Four CABGs were performed: left internal thoracic artery to the left anterior descending artery; saphenous vein graft to the obtuse marginal branch of the circumflex artery; and saphenous vein graft to two sites in the right coronary artery. Intraoperative assessment with transit-time flow measurements showed no abnormalities, and the surgery was completed. On postoperative day seven, coronary and graft angiography revealed dissection of the left internal thoracic artery at its midportion with restricted flow. On postoperative day eight, a surgical intervention was performed to excise the dissected segment of the left internal thoracic artery. The dissection site was identified by fluorescence imaging. The dissected segment was excised, and the artery was re-anastomosed. The postoperative course was uneventful, and graft angiography performed on postoperative day 22 confirmed good blood flow. Fluorescence imaging was valuable in identifying the dissection site in the left internal thoracic artery.
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Affiliation(s)
| | - Yutaka Iba
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Tsuyoshi Shibata
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Akihito Ohkawa
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
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Nakajima T, Iba Y, Naraoka S, Shibata T, Sugita S, Kawaharada N. Scattered Media Elastic Fibers from the Aortic Root to the Ascending Aorta in a 30-Year-Old Marfan Syndrome Patient. Ann Thorac Cardiovasc Surg 2024; 30:22-00044. [PMID: 35584950 PMCID: PMC10851445 DOI: 10.5761/atcs.cr.22-00044] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022] Open
Abstract
We present a case report of a 30-year-old Marfan syndrome patient who underwent a David procedure for severe aortic valve insufficiency and Valsalva aneurysm. Harvested aortic walls were examined by pathologists. Although the tunica media of the ascending aorta contained aligned elastic fibers, the aortic root media lacked aligned elastic fibers.
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Affiliation(s)
- Tomohiro Nakajima
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Syuichi Naraoka
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Tsuyoshi Shibata
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
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Nakajima T, Iba Y, Shibata T, Tsushima S, Arihara A, Hosaka I, Ohkawa A, Nakazawa J, Kawaharada N. Multivariate analysis of the factors affecting medical students' decision to join the cardiovascular surgery department. Gen Thorac Cardiovasc Surg 2023:10.1007/s11748-023-01995-8. [PMID: 38117430 DOI: 10.1007/s11748-023-01995-8] [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: 07/24/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE The purpose of this study was to statistically analyze the factors that influence cardiovascular surgery recruitment. METHODS Fifth- and sixth-year medical students and first-year residents who participated in cardiovascular surgery-related events at our university over a 10-year period from April 2013 to August 2022 were included. The primary endpoint was admission to the department of cardiovascular surgery. Gender, participation in sixth-year elective clinical training, participation in national academic conferences, participation in cardiovascular surgery summer school, and the cost of participation in these events (airfares and lodging) were included as analytic factors. RESULTS Fifty-three participants attended cardiovascular surgery events during the study period. The sample included 48 males (84%) and 9 females (16%), and 3 fifth-year medical students (5%), 45 sixth-year students (79%), and 9 students in their first year of clinical training (16%). Eighteen (32%) of the participants eventually joined the department. Gender, participation in national academic conferences, cardiovascular surgery summer school, and cost of participation were not significantly related to the decision to join the department, but participation in elective clinical training was significantly positively related to the decision to join the department for sixth-year students (p < 0.01). CONCLUSIONS We statistically analyzed the factors involved in the recruitment of students and initial clinical residents to the department of cardiovascular surgery. The results showed that participation in elective clinical training was significantly positively associated with the decision to join the department, suggesting that efforts to encourage participation in elective clinical training are important.
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Affiliation(s)
- Tomohiro Nakajima
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-Ku, Sapporo, 060-8543, Japan.
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-Ku, Sapporo, 060-8543, Japan
| | - Tsuyoshi Shibata
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-Ku, Sapporo, 060-8543, Japan
| | - Shingo Tsushima
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-Ku, Sapporo, 060-8543, Japan
| | - Ayaka Arihara
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-Ku, Sapporo, 060-8543, Japan
| | - Itaru Hosaka
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-Ku, Sapporo, 060-8543, Japan
| | - Akihito Ohkawa
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-Ku, Sapporo, 060-8543, Japan
| | - Jyunji Nakazawa
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-Ku, Sapporo, 060-8543, Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-Ku, Sapporo, 060-8543, Japan
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Akatsuka M, Nakajima T, Miyagishima S, Iba Y, Masuda Y. Diaphragmatic paralysis following open-heart surgery in an adult. Oxf Med Case Reports 2023; 2023:omad140. [PMID: 38145262 PMCID: PMC10735543 DOI: 10.1093/omcr/omad140] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/26/2023] Open
Affiliation(s)
- Masayuki Akatsuka
- Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Tomohiro Nakajima
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Saori Miyagishima
- Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Yoshiki Masuda
- Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
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Nakajima T, Shibata T, Miura S, Mukawa K, Mizuno T, Nakanishi K, Arihara A, Nakazawa J, Iba Y, Kawaharada N. Coronary Artery Bypass Grafting Using the No-Touch Great Saphenous Vein Graft Harvesting Technique: A Retrospective Study. Cureus 2023; 15:e50777. [PMID: 38239525 PMCID: PMC10795560 DOI: 10.7759/cureus.50777] [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] [Accepted: 12/16/2023] [Indexed: 01/22/2024] Open
Abstract
Background We focused on coronary artery bypass grafting using the great saphenous vein and compared the no-touch great saphenous vein and conventional great saphenous vein. Methods Coronary artery bypass grafting using the great saphenous vein was performed at our hospital over a 15-year period from 2007/04 to 2022/08. The primary endpoint was the patency of the great saphenous vein at discharge, and secondary endpoints were delayed healing of the great saphenous vein harvest wound, delayed healing of the mid-thoracic wound, and factors related to coronary artery bypass surgery. Results There were 183 patients who underwent coronary artery bypass surgery using the great saphenous vein during the study period. There were 131 male patients (72%) and 52 female patients (28%) with a mean age of 69 years (38-94 years). The method of harvesting the great saphenous vein was a no-touch great saphenous vein graft (NT-SVG) in 29 cases (16%) and conventional SVG in 154 cases (84%). Patients were divided into two groups: the NT-SVG group and the standard-collection saphenous vein graft (SVG) group. We compared graft patency at discharge, healing failure of the lower leg wound, healing failure of the mid-thoracic wound, and flow by transit-time flow measurement (TTFM). Conclusion There were no significant differences in perioperative outcomes between the NT-SVG and conventional SVG groups in this study.
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Affiliation(s)
| | - Tsuyoshi Shibata
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Shuhei Miura
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Kei Mukawa
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Takakimi Mizuno
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | | | - Ayaka Arihara
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Junji Nakazawa
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Yutaka Iba
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
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Nakajima T, Arihara A, Mukawa K, Iba Y, Kawaharada N. Pathological Characteristics of the Vascular Septum in Chronic Aortic Dissection: A Case Report. Cureus 2023; 15:e48910. [PMID: 38106796 PMCID: PMC10725306 DOI: 10.7759/cureus.48910] [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] [Accepted: 11/16/2023] [Indexed: 12/19/2023] Open
Abstract
A 46-year-old male developed a Stanford type B aortic dissection. At age 48, he underwent left open thoracic descending aorta replacement because of the enlargement of the descending thoracic aorta. At 51 years old, he underwent abdominal aorta replacement because of ischemia in the right lower extremity and the enlargement of an abdominal aortic aneurysm. The septum between the true and false lumens was submitted to histopathological examination, which revealed bilateral intimal tissue with the tunica media lying in between.
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Affiliation(s)
| | - Ayaka Arihara
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Kei Mukawa
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Yutaka Iba
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
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12
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Nakajima T, Iba Y, Shibata T, Kawaharada N. A case of multiple median sternotomy for infection and expanding hematoma in 10 years. Egypt Heart J 2023; 75:80. [PMID: 37801192 PMCID: PMC10558406 DOI: 10.1186/s43044-023-00411-z] [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: 08/01/2023] [Accepted: 09/30/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND After a median sternotomy, mediastinitis may develop, necessitating reopening of the chest. Rarely, reoperation due to hematoma after cardiovascular surgery is experienced. In the present case, we experienced a patient who initially had mediastinitis, but later developed a chronic hematoma and underwent multiple surgeries. CASE PRESENTATION The patient was a 40-year-old man who underwent aortic valve replacement for a bicuspid aortic valve and a graft for a dilated ascending aorta. Postoperatively, he developed hematoma in the anterior mediastinum on multiple occasions with repeated episodes of infection that required multiple median sternotomies. CONCLUSIONS We reported our experience with a rare case of multiple median sternotomies. In the early stage, mediastinitis due to infection was observed, and in the late stage, mediastinal dilatation due to hemorrhage was observed.
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Affiliation(s)
- Tomohiro Nakajima
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Tsuyoshi Shibata
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
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13
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Nakajima T, Iba Y, Ogura K, Kawaharada N. Partial arch replacement of type A aortic dissection after thoracic endovascular aortic repair for type B dissection. Egypt Heart J 2023; 75:81. [PMID: 37801163 PMCID: PMC10558405 DOI: 10.1186/s43044-023-00412-y] [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: 08/01/2023] [Accepted: 09/30/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Stent graft-induced new entry (SINE), defined as the stent graft-induced formation of a new entry point for blood to enter an area, is increasingly being observed after thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection worldwide. We herein describe a case of Stanford type A aortic dissection due to proximal SINE after TEVAR for Stanford type B dissection. CASE PRESENTATION This case involved a 58-year-old man with type A aortic dissection due to SINE. Six years previously, he had developed severe back pain and was diagnosed with type B aortic dissection after computed tomography examination. Because the primary entry was positioned at the descending aorta, we conducted TEVAR for exclusion of the entry with a GORE TAG conformable thoracic aortic graft. He was thereafter followed by our hospital. Six years later, he developed jaw pain and was examined at another hospital. He was transferred to our hospital because of the possibility of type A dissection. Computed tomography revealed type A aortic dissection with proximal site SINE. Emergency partial arch replacement was conducted, and he was discharged on postoperative day 27. Because the entry was at the lesser curve of the arch, we excluded the entry and conducted partial arch replacement. CONCLUSIONS In this case, proximal SINE occurred 6 years after TEVAR. Because SINE may occur even in the long term after TEVAR, careful follow-up is necessary.
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Affiliation(s)
- Tomohiro Nakajima
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Keishi Ogura
- Division of Radiology and Nuclear Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
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14
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Nakajima T, Iba Y, Shibata T, Tsushima S, Arihara A, Hosaka I, Okawa A, Nakazawa J, Kawaharada N. The impact of postoperative cerebrospinal fluid drainage on neurological improvement following thoracic aortic and thoracoabdominal aortic surgery. J Thorac Dis 2023; 15:4787-4794. [PMID: 37868881 PMCID: PMC10586974 DOI: 10.21037/jtd-23-631] [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] [Received: 04/15/2023] [Accepted: 08/11/2023] [Indexed: 10/24/2023]
Abstract
Background Various preventive measures and treatment methods exist to prevent paraplegia during thoracic aortic surgery. Postoperative cerebrospinal fluid drainage (CSFD) is one of the treatment options when paraplegia occurs. This study aimed to evaluate the neurological efficacy of postoperative CSFD in patients undergoing thoracic aortic and thoracoabdominal aortic surgery. Methods We analyzed perioperative data from 85 patients who underwent perioperative CSFD for thoracic and thoracoabdominal aortic surgery between January 2006 and December 2022, focusing on neurological changes. A total of 61 patients (72%) received preoperative CSFD, and 24 patients (28%) received postoperative CSFD. Perioperative neurological data were analyzed with a focus on perioperative changes. Results In the postoperative CSFD group, the manual muscle test (MMT) score before CSFD was 0.8, that just after CSFD was 2.4, and that at discharge was 3.0. Therefore, postoperative CSFD improved MMT scores compared with preoperative CSFD. The mean time between surgery completion and postoperative CSFD implantation was 9.8 hours. However, 6 (25%) of the patients who developed postoperative paraplegia and underwent early postoperative CSFD remained paraplegic without any improvement. In the preoperative CSFD group, there was only one case (2%) of postoperative paraplegia. Conclusions Postoperative CSFD improved the neurological prognosis of individuals undergoing thoracic aortic and thoracoabdominal aortic surgery. However, 25% of the patients remained paraplegic despite postoperative CSFD.
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Affiliation(s)
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tsuyoshi Shibata
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shingo Tsushima
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ayaka Arihara
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Itaru Hosaka
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Akihito Okawa
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Junji Nakazawa
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
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15
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Iba Y, Kawaharada N. Patient Factors and Pathological Mechanisms Influencing the Effects of Fluoroquinolones Among Patients With Aortic Aneurysm and Dissection. Circ J 2023; 87:1173-1174. [PMID: 36967131 DOI: 10.1253/circj.cj-23-0130] [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] [Indexed: 06/18/2023]
Affiliation(s)
- Yutaka Iba
- Department of Cardiovascular Surgery, School of Medicine, Sapporo Medical University
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, School of Medicine, Sapporo Medical University
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16
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Murakami Y, Nishigori M, Yagi H, Osaki T, Wakabayashi M, Shirai M, Son C, Iba Y, Minatoya K, Kusano K, Tomita T, Ishibashi-Ueda H, Matsuda H, Minamino N. Serum proteomic identification and validation of two novel atherosclerotic aortic aneurysm biomarkers, profilin 1 and complement factor D. Proteome Sci 2023; 21:11. [PMID: 37543598 PMCID: PMC10403969 DOI: 10.1186/s12953-023-00212-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/26/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND Effective diagnostic biomarkers for aortic aneurysm (AA) that are detectable in blood tests are required because early detection and rupture risk assessment of AA can provide insights into medical therapy and preventive treatments. However, known biomarkers for AA lack specificity and reliability for clinical diagnosis. METHODS We performed proteome analysis of serum samples from patients with atherosclerotic thoracic AA (TAA) and healthy control (HC) subjects to identify diagnostic biomarkers for AA. Serum samples were separated into low-density lipoprotein, high-density lipoprotein, and protein fractions, and the major proteins were depleted. From the proteins identified in the three fractions, we narrowed down biomarker candidates to proteins uniformly altered in all fractions between patients with TAA and HC subjects and evaluated their capability to discriminate patients with TAA and those with abdominal AA (AAA) from HC subjects using receiver operating characteristic (ROC) analysis. For the clinical validation, serum concentrations of biomarker candidates were measured in patients with TAA and AAA registered in the biobank of the same institute, and their capability for the diagnosis was evaluated. RESULTS Profilin 1 (PFN1) and complement factor D (CFD) showed the most contrasting profiles in all three fractions between patients with TAA and HC subjects and were selected as biomarker candidates. The PFN1 concentration decreased, whereas the CFD concentration increased in the sera of patients with TAA and AAA when compared with those of HC subjects. The ROC analysis showed that these proteins could discriminate patients with TAA and AAA from HC subjects. In the validation study, these candidates showed significant concentration differences between patients with TAA or AAA and controls. PFN1 and CFD showed sufficient area under the curve (AUC) in the ROC analysis, and their combination further increased the AUC. The serum concentrations of PFN1 and CFD also showed significant differences between patients with aortic dissection and controls in the validation study. CONCLUSION PFN1 and CFD are potential diagnostic biomarkers for TAA and AAA and measurable in blood samples; their diagnostic performance can be augmented by their combination. These biomarkers may facilitate the development of diagnostic systems to identify patients with AA.
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Affiliation(s)
- Yusuke Murakami
- Fundamental Research Laboratory, Research and Development Division, Eiken Chemical Co., Ltd., 143 Nogi, Nogimachi, Shimotsuga-gun, Tochigi, 329-0114, Japan
- Omics Research Center, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Mitsuhiro Nishigori
- Omics Research Center, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
- Department of Molecular Pharmacology, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
- Department of Chemistry, Faculty of Science, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Hiroaki Yagi
- Department of Molecular Pharmacology, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
- FCM Business Development, HUP Business, Sysmex Corporation, 1-6-23 Goinoikemachi, Nagata-ku, Kobe, 653-0851, Japan
| | - Tsukasa Osaki
- Department of Molecular Pharmacology, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
- Department of Biochemistry and Molecular Biology, Graduate School of Medical Science, Yamagata University, 2-2-2 Iidanishi, Yamagata, 990-9585, Japan
| | - Masaki Wakabayashi
- Omics Research Center, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Manabu Shirai
- Omics Research Center, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Cheol Son
- Omics Research Center, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
- Department of Diabetes and Endocrinology, Kobe City Nishi-Kobe Medical Center, 5-7-1 Kojidai, Nishi-ku, Kobe, 651-2273, Japan
| | - Yutaka Iba
- Department of Vascular Surgery, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
- Department Cardiovascular Surgery, Sapporo Medical University School of Medicine, 291 Nishi 16-chome Minami 1-jo, Chuo-ku, Sapporo, 060-8543, Japan
| | - Kenji Minatoya
- Department of Vascular Surgery, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
- Department Cardiovascular Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Tsutomu Tomita
- National Cerebral and Cardiovascular Center Biobank, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Hatsue Ishibashi-Ueda
- Department of Pathology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Hitoshi Matsuda
- Department of Vascular Surgery, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Naoto Minamino
- Omics Research Center, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan.
- Department of Molecular Pharmacology, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan.
- Present address: Department of Biochemistry, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan.
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17
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Nakajima T, Iba Y, Shibata T, Kawaharada N. A Case of Takotsubo Cardiomyopathy After Mitral Valvuloplasty. Cureus 2023; 15:e43175. [PMID: 37692607 PMCID: PMC10484754 DOI: 10.7759/cureus.43175] [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] [Accepted: 08/08/2023] [Indexed: 09/12/2023] Open
Abstract
We present a case of an 82-year-old male patient with a history of severe mitral regurgitation, severe aortic regurgitation, chronic atrial fibrillation, and suicide attempts due to depression. The patient underwent mitral valvuloplasty and aortic valve replacement for mitral valve regurgitation and aortic valve regurgitation. The patient was extubated on the morning of the sixth postoperative day, but he was reintubated in the evening because of hypotension and an unstable respiratory status. Echocardiography revealed Takotsubo cardiomyopathy development, and the patient was treated with intra-aortic balloon pump (IABP) implantation, which was removed on postoperative day 11.
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Affiliation(s)
| | - Yutaka Iba
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Tsuyoshi Shibata
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
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18
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Nakajima T, Shibata T, Mukawa K, Nakanishi K, Mizuno T, Arihara A, Miura S, Nakazawa J, Iba Y, Kawaharada N. Outcomes of Vascular Surgery Performed Jointly With Other Departments. Cureus 2023; 15:e43833. [PMID: 37736440 PMCID: PMC10509632 DOI: 10.7759/cureus.43833] [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] [Accepted: 08/20/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE The purpose of this study is to evaluate the results of vascular surgery performed at our hospital, a tertiary emergency general hospital, in patients undergoing surgery in other departments. The results of the study were reviewed. METHODS The study included cases in which cardiovascular surgery was performed at the request of other departments over a 15-year period from January 2006 to October 2022. Patient backgrounds, departments that requested surgery, surgical procedures, use of extracorporeal circulation, and surgical techniques were reviewed. Patients with femoral artery exposure or ECMO removal during transcatheter aortic valve implantation (TAVI) requested by cardiology were excluded. RESULTS There were 58 vascular surgery cases requested by other departments during the study period. The age was 63±14 years, 43 (74%) were male and 15 (26%) were female. The departments of the patients were urology in 29 (50%), gastroenterology in 18 (31%), orthopedics in seven (12%), emergency department in three (5%), and obstetrics and gynecology in one (2%). The following surgical procedures were performed: tumor resection and reconstruction due to tumor invasion of the inferior vena cava in 27 cases (47%), bypass to secure intraperitoneal arterial blood flow in 15 cases (26%), bypass during resection of the femoral tumor in four cases (7%), hemostasis due to trauma in three cases (5%), intraperitoneal hemostasis in three cases (5%), thrombectomy in two cases (3%), and others in four cases (7%). Extracorporeal circulation was used in six (10%) of the patients. CONCLUSION A 15-year case study of vascular surgery supports operations requested by other departments at our hospital. All reconstructed sites were open at the time of discharge.
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Affiliation(s)
| | - Tsuyoshi Shibata
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Kei Mukawa
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | | | - Takakimi Mizuno
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Ayaka Arihara
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Shuhei Miura
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Junji Nakazawa
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Yutaka Iba
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
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19
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Nakajima T, Shibata T, Ogura K, Iba Y, Kawaharada N. A Case of a Giant Hemangioma of a Primary Cardiac Tumor. Cureus 2023; 15:e43818. [PMID: 37736442 PMCID: PMC10509032 DOI: 10.7759/cureus.43818] [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] [Accepted: 08/20/2023] [Indexed: 09/23/2023] Open
Abstract
We report a case of a 71-year-old female with a primary cardiac tumor. The patient had undergone surgery for uterine cancer 10 years ago and presented to a nearby clinic complaining of dyspnea on exertion. Chest X-ray revealed cardiac enlargement, prompting further investigations, which revealed a massive tumor protruding into the left atrium and extending toward the outer wall of the left ventricle. The patient was referred to a cardiac surgery department for myocardial biopsy. The tumor biopsy confirmed a diagnosis of a vascular tumor. Due to the tumor's large size and the difficulty in achieving complete resection, a conservative approach was chosen as the patient expressed a preference for non-surgical treatment. This is an extremely rare case of a large primary cardiac tumor, and we report it accordingly.
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Affiliation(s)
| | - Tsuyoshi Shibata
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | - Keishi Ogura
- Division of Radiology and Nuclear Medicine, Sapporo Medical University, Sapporo, JPN
| | - Yutaka Iba
- Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
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20
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Nakajima T, Iba Y, Shibata T, Hosaka I, Nakazawa J, Kawaharada N. Ten-year follow-up study of a young woman with loeys-dietz syndrome: a case report. J Cardiothorac Surg 2023; 18:209. [PMID: 37403153 DOI: 10.1186/s13019-023-02322-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 06/28/2023] [Indexed: 07/06/2023] Open
Abstract
We herein report the 10-year surgical course of a 27-year-old woman who underwent two surgeries after being diagnosed with Loeys-Dietz syndrome. As described in previous cases, this patient developed ectopic arterial enlargement. We followed her temporal changes over a 10-year period, including the changes in computed tomography, pathology, and surgery.
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Affiliation(s)
- Tomohiro Nakajima
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Tsuyoshi Shibata
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Itaru Hosaka
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Jyunji Nakazawa
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
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21
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Shibata T, Iba Y, Shingaki M, Yamashita O, Tsubakimoto Y, Kimura F, Hatada A, Kasashima F, Ueno K, Nakanishi K, Morishita K, Nakajima T, Nakazawa J, Ohkawa A, Hosaka I, Arihara A, Tsushima S, Kawaharada N. One Year Outcomes of Zilver PTX Versus Eluvia for Femoropopliteal Disease in Real-World Practice: REALDES Study. J Endovasc Ther 2023:15266028231179861. [PMID: 37291881 DOI: 10.1177/15266028231179861] [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] [Indexed: 06/10/2023]
Abstract
PURPOSE This multicenter, prospective, observational study aimed to compare Zilver PTX and Eluvia stents in real-world settings for treating femoropopliteal lesions as the differences in the 1-year outcomes of these stents have not been elucidated. MATERIALS AND METHODS Overall, 200 limbs with native femoropopliteal artery disease were treated with Zilver PTX (96 limbs) or Eluvia (104 limbs) at 8 Japanese hospitals between February 2019 and September 2020. The primary outcome measure of this study was primary patency at 12 months, defined as a peak systolic velocity ratio of ≤2.4, without clinically-driven target lesion revascularization (TLR) or stenosis ≤50% based on angiographic findings. RESULTS The baseline clinical and lesion characteristics of Zilver PTX and Eluvia groups were roughly comparable (of all limbs analyzed, approximately 30% presented with critical limb-threatening ischemia, approximately 60% presented with Trans-Atlantic Inter-Society Consensus II C-D, and approximately half had total occlusion), except for the longer lesion lengths in the Zilver PTX group (185.7±92.0 mm vs 160.0±98.5 mm, p=0.030). The Kaplan-Meier estimates of primary patency at 12 months were 84.9% and 88.1% for Zilver PTX and Eluvia, respectively (log-rank p=0.417). Freedom from clinically-driven TLR rates were 88.8% and 90.9% for Zilver PTX and Eluvia, respectively (log-rank p=0.812). CONCLUSIONS The results of the Zilver PTX and Eluvia stents were not different regarding primary patency and freedom from clinically-driven TLR at 12 months after treating patients with femoropopliteal peripheral artery disease in real-world settings. CLINICAL IMPACT This is the first study to reveal that the Zilver PTX and Eluvia have similar results in real-world practice when the proper vessel preparation is performed. However, the type of restenosis in the Eluvia stent may differ from that in the Zilver PTX stent. Therefore, the results of this study may influence the selection of DES for femoropopliteal lesions in routine clinical practice.
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Affiliation(s)
- Tsuyoshi Shibata
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo-shi, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo-shi, Japan
| | - Masami Shingaki
- Department of Cardiovascular Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Osamu Yamashita
- Department of Surgery, Yamaguchi Prefectural Grand Medical Center, Yamaguchi, Japan
| | | | - Fumiaki Kimura
- Department of Cardiovascular Surgery, Kushiro Kojinkai Memorial Hospital, Kushiro, Japan
| | - Atsutoshi Hatada
- Department of Cardiovascular Surgery, Nishinomiya Watanabe Cardiovascular Center, Nishinomiya, Japan
| | - Fuminori Kasashima
- Department of Cardiovascular Surgery, Kanazawa Medical Center, National Hospital Organization, Kanazawa, Japan
| | - Kyohei Ueno
- Department of Cardiovascular Surgery, Southern Tohoku General Hospital, Kouriyama, Japan
| | - Keitaro Nakanishi
- Department of Cardiovascular Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Kiyofumi Morishita
- Department of Cardiovascular Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Tomohiro Nakajima
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo-shi, Japan
| | - Junji Nakazawa
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo-shi, Japan
| | - Akihito Ohkawa
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo-shi, Japan
| | - Itaru Hosaka
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo-shi, Japan
| | - Ayaka Arihara
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo-shi, Japan
| | - Shingo Tsushima
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo-shi, Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo-shi, Japan
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22
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Shibata T, Iba Y, Nakajima T, Nakazawa J, Ohkawa A, Hosaka I, Arihara A, Tsushima S, Ogura K, Yoshikawa K, Kawaharada N. Initial Outcomes of Physician-Modified Inner Branched Endovascular Repair in High-Surgical-Risk Patients. J Endovasc Ther 2023:15266028231169183. [PMID: 37102596 DOI: 10.1177/15266028231169183] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
PURPOSE To report the initial outcomes of physician-modified inner branched endovascular repair (PMiBEVAR) for pararenal aneurysms (PRAs), thoracoabdominal aortic aneurysms (TAAAs), and aortic arch aneurysms in high-surgical-risk patients. MATERIALS AND METHODS A total of 10 patients (6 men; median age, 83.0 years) treated using PMiBEVAR were enrolled in this retrospective, single-center study. All patients were at high surgical risk because of severe comorbidities (American Society of Anesthesiologists physical status score≥3 or emergency repair). End points were defined as technical success per patient and per vessel (successful deployment), clinical success (no endoleaks postoperatively), in-hospital death, and major adverse events. RESULTS There were 3 PRAs, 4 TAAAs, and 3 aortic arch aneurysms with 12 renal-mesenteric arteries and 3 left subclavian arteries incorporated by inner branches. The technical success rate was 90.0% (9/10) per patient and 93.3% (14/15) per vessel. The clinical success rate was 90% (9/10). There were 2 in-hospital deaths, unrelated to aneurysms. Paraplegia and shower emboli occurred separately in 2 patients. Three patients experienced prolonged ventilation for 3 days after surgery. Aneurysm sac shrinkage occurred in 4 patients, and aneurysm size stabilized in 1 patient during follow-up, more than 6 months later. None of the patients required intervention. CONCLUSION PMiBEVAR is a feasible approach for treating complex aneurysms in high-surgical-risk patients. This technology may complement the existing technology in terms of improved anatomical adaptability, no time delay and practicability in many countries. However, long-term durability remains undetermined. Further large-scale and long-term studies are needed. CLINICAL IMPACT This is the first clinical study to investigate outcomes of physician-modified inner branched endovascular repair (PMiBEVAR). PMiBEVAR for treating pararenal aneurysm, thoracoabdominal aortic aneurysm, or aortic arch aneurysm is a feasible procedure. This technology is likely to complement existing technology in terms of improved anatomical adaptability (compared to off-the-shelf devices), no time delay (compared to custom-made devices), and the potential to be performed in many countries. On the other hand, surgery time varied greatly depending on the case, suggesting a learning curve and the need for technological innovation to perform more consistent surgeries.
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Affiliation(s)
- Tsuyoshi Shibata
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo Medical University, Sapporo-shi, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo Medical University, Sapporo-shi, Japan
| | - Tomohiro Nakajima
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo Medical University, Sapporo-shi, Japan
| | - Junji Nakazawa
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo Medical University, Sapporo-shi, Japan
| | - Akihito Ohkawa
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo Medical University, Sapporo-shi, Japan
| | - Itaru Hosaka
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo Medical University, Sapporo-shi, Japan
| | - Ayaka Arihara
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo Medical University, Sapporo-shi, Japan
| | - Shingo Tsushima
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo Medical University, Sapporo-shi, Japan
| | - Keishi Ogura
- Department of Radiology and Nuclear Medicine, Sapporo Medical University, Sapporo-shi, Japan
| | - Kenta Yoshikawa
- Department of Radiology and Nuclear Medicine, Sapporo Medical University, Sapporo-shi, Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University Hospital, Sapporo Medical University, Sapporo-shi, Japan
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Yoshikawa Y, Maeda M, Ohno S, Takahashi K, Sawashita Y, Hirahata T, Iba Y, Kawaharada N, Edanaga M, Yamakage M. Validity and Utility of Early Parameters in TEG6s Platelet Mapping to Assess the Coagulation Status During Cardiovascular Surgery With Cardiopulmonary Bypass. Cureus 2023; 15:e38044. [PMID: 37228566 PMCID: PMC10208008 DOI: 10.7759/cureus.38044] [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] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
Background The aim of this retrospective observational study was to explore the early predictive parameters for maximum amplitudein the kaolin with heparinase (HKH) assay (MAHKH) of TEG6s Platelet Mapping in cardiovascular surgery including cardiopulmonary bypass (CPB) period. The relationship between each parameter of the assay and laboratory data was also assessed. Methods We included the patients who underwent TEG6s Platelet Mapping during cardiovascular surgery under CPB between November 2021 and May 2022. The correlation between MAHKH and the early parameters was assessed. The association between each parameter of Platelet Mapping and a combination of fibrinogen concentration > 150 mg/dL and platelet count > 100,000µL was also evaluated by the receiver operating characteristic (ROC) curve. Results In 23 patients who underwent TEG6s Platelet Mapping during the study period, 62 HKH assay data including 59 pairs of data (HKH assay and laboratory data) were analyzed. K and angle, but not R, were significantly correlated with MAHKH (r [95% CI]: -0.90 [-0.94, -0.83], p < 0.0001 for K, and 0.87 [0.79, 0.92], p < 0.0001 for angle). Furthermore, ROC curves suggested that these parameters predicted a combination of fibrinogen concentration > 150 mg/dL and platelet count > 100,000/µL with high accuracy. Similar results were confirmed in the heparinized blood samples obtained during CPB. Conclusion These findings suggest that not only MAKHK but also K and angle, which are early parameters in the HKH assay, provide clinically significant information that will facilitate rapid decision-making regarding coagulation strategies during cardiovascular surgery including the CPB period.
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Affiliation(s)
- Yusuke Yoshikawa
- Department of Anaesthesiology, Sapporo Medical University, Sapporo, JPN
| | - Makishi Maeda
- Department of Anaesthesiology, Sapporo Medical University, Sapporo, JPN
| | - Sho Ohno
- Department of Anaesthesiology, Sapporo Medical University, Sapporo, JPN
| | - Kanako Takahashi
- Department of Anaesthesiology, Sapporo Medical University, Sapporo, JPN
| | - Yasuaki Sawashita
- Department of Anaesthesiology, Sapporo Medical University, Sapporo, JPN
| | - Tomoki Hirahata
- Department of Anaesthesiology, Sapporo Medical University, Sapporo, JPN
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN
| | | | - Mitsutaka Edanaga
- Department of Anaesthesiology, Sapporo Medical University, Sapporo, JPN
| | - Michiaki Yamakage
- Department of Anaesthesiology, Sapporo Medical University, Sapporo, JPN
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24
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Mikami T, Furuhashi M, Numaguchi R, Hosaka I, Sakai A, Tanaka M, Ito T, Maeda T, Sakurada T, Muraki S, Yanase Y, Sato H, Fukada J, Tamiya Y, Iba Y, Kawaharada N. Comparison of Phenotypes in Subcutaneous Fat and Perivascular Adipose Tissue Surrounding the Saphenous Vein in Coronary Artery Bypass Grafting. Circ J 2023; 87:791-798. [PMID: 36740256 DOI: 10.1253/circj.cj-22-0740] [Citation(s) in RCA: 1] [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] [Indexed: 02/05/2023]
Abstract
BACKGROUND The saphenous vein (SV) is used as an essential conduit in coronary artery bypass grafting (CABG), but the long-term patency of SV grafts is a crucial issue. The use of the novel "no-touch" technique of harvesting the SV together with its surrounding tissue has been reported to result in good long-term graft patency of SV grafts. We recently showed that perivascular adipose tissue (PVAT) surrounding the SV (SV-PVAT) had lower levels of metaflammation and consecutive adipose tissue remodeling than did PVAT surrounding the coronary artery. However, the difference between SV-PVAT and subcutaneous adipose tissue (SCAT) remains unclear.Methods and Results: Fat pads were sampled from 55 patients (38 men, 17 women; mean [±SD] age 71±8 years) with coronary artery disease who underwent elective CABG. Adipocyte size was significantly larger in SV-PVAT than SCAT. The extent of fibrosis was smaller in SV-PVAT than SCAT. There were no significant differences between SCAT and SV-PVAT in macrophage infiltration area, quantified by antibodies for CD68, CD11c, and CD206, or in gene expression levels of metaflammation-related markers. Expression patterns of adipocyte developmental and pattern-forming genes differed between SCAT and SV-PVAT. CONCLUSIONS The properties of SV-PVAT are close to, but not the same as, those of SCAT, possibly resulting from inherent differences in adipocytes. SV-PVAT has healthy expansion with less fibrosis in fat than SCAT.
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Affiliation(s)
- Takuma Mikami
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine.,Department of Cardiovascular Surgery, National Hospital Organization, Obihiro Hospital
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Ryosuke Numaguchi
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine
| | - Itaru Hosaka
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine
| | - Akiko Sakai
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Marenao Tanaka
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Toshiro Ito
- Department of Cardiovascular Surgery, Hokkaido Ohno Memorial Hospital
| | - Toshiyuki Maeda
- Department of Cardiovascular Surgery, Sapporo Central Hospital
| | - Taku Sakurada
- Department of Cardiovascular Surgery, Sapporo Central Hospital
| | - Satoshi Muraki
- Department of Cardiovascular Surgery, Sapporo Central Hospital
| | - Yousuke Yanase
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital
| | - Hiroshi Sato
- Department of Cardiovascular Surgery, Otaru City General Hospital
| | - Joji Fukada
- Department of Cardiovascular Surgery, Otaru City General Hospital
| | - Yukihiko Tamiya
- Department of Cardiovascular Surgery, Otaru City General Hospital
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine
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25
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Sato H, Iba Y, Kawaharada N, Fukada J, Iwashiro Y, Tsushima S, Hosaka I, Okawa A, Shibata T, Nakazawa J, Nakajima T, Hasegawa T, Tamiya Y. Temperature analysis of aortic repair with hypothermic circulatory arrest to quantify the injury by cooling. Interdiscip Cardiovasc Thorac Surg 2023; 36:6976074. [PMID: 36802248 PMCID: PMC9931076 DOI: 10.1093/icvts/ivac282] [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] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/14/2022] [Accepted: 12/07/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES We analyzed the temperature in proximal aortic repair with moderate hypothermic circulatory arrest (HCA) and evaluated the effect of the cooling status on postoperative outcomes. METHODS A total of 340 patients who underwent elective ascending aortic replacement or total arch replacement with moderate HCA from December 2006 to January 2021 were studied. The change in body temperature trends recorded during surgery was shown graphically. Several parameters, such as the nadir temperature, cooling speed and the degree of cooling (cooling area), which was the area under curve of inverted temperature trends from cooling to rewarming as calculated by the integral method, were analyzed. The relationships between these variables and a major adverse outcome (MAO) postoperatively defined as prolonged ventilation (>72 h), acute renal failure, stroke, reoperation for bleeding, deep sternal wound infection or in-hospital death were evaluated. RESULTS An MAO was observed in 68 patients (20%). The cooling area was larger in the MAO group than in the non-MAO group (1668.7 vs 1383.2°C min; P < 0.0001). A multivariate logistic model showed that old myocardial infarction, peripheral vascular disease, chronic renal dysfunction, cardiopulmonary bypass time and the cooling area were independent risk factors for an MAO (odds ratio = 1.1 per 100°C min; P < 0.001). CONCLUSIONS The cooling area, which indicates the degree of cooling, shows a significant relationship with an MAO after aortic repair. This finding indicates that the cooling status with HCA can affect clinical outcomes.
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Affiliation(s)
- Hiroshi Sato
- Corresponding author. Department of Cardiovascular Surgery, Otaru General Hospital, 1-1-1 Wakamatsu, Otaru 047-8550, Japan. Tel: +81-0134-25-1211; fax: +81-0134-25-1600; e-mail: (H. Sato)
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Joji Fukada
- Department of Cardiovascular Surgery, Otaru General Hospital, Otaru, Japan
| | - Yuu Iwashiro
- Department of Cardiovascular Surgery, Otaru General Hospital, Otaru, Japan
| | - Shingo Tsushima
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Itaru Hosaka
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Akihito Okawa
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tsuyoshi Shibata
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Jyunji Nakazawa
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tomohiro Nakajima
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takeo Hasegawa
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yukihiko Tamiya
- Department of Cardiovascular Surgery, Otaru General Hospital, Otaru, Japan
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26
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Hosaka I, Shibata T, Iba Y, Kawaharada N. Abscess Formation Requiring Extraluminal Arterial Graft Explantation and Bypass Surgery. Circ J 2022; 87:153. [PMID: 36288958 DOI: 10.1253/circj.cj-22-0550] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Itaru Hosaka
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine
| | - Tsuyoshi Shibata
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine
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27
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Akatsuka M, Yama N, Iba Y, Masuda Y. Pulmonary torsion due to omentopexy after replacement of the descending aorta and esophagectomy. Oxf Med Case Reports 2022; 2022:omac122. [DOI: 10.1093/omcr/omac122] [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] [Received: 05/09/2022] [Revised: 07/19/2022] [Accepted: 09/23/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- Masayuki Akatsuka
- Sapporo Medical University School of Medicine Department of Intensive Care Medicine, , Sapporo, Hokkaido, Japan
| | - Naoya Yama
- Sapporo Medical University School of Medicine Department of Diagnostic Radiology, , Sapporo, Hokkaido, Japan
| | - Yutaka Iba
- Sapporo Medical University School of Medicine Department of Cardiovascular Surgery, , Sapporo, Hokkaido, Japan
| | - Yoshiki Masuda
- Sapporo Medical University School of Medicine Department of Intensive Care Medicine, , Sapporo, Hokkaido, Japan
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28
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Miura S, Shichinohe R, Iba Y. Successful Treatment of Recurrent Thoracic Aortic Prosthetic Graft Infection after Omentopexy by Free-latissimus Dorsi and Rectus Abdominis Muscle Flap. Eur J Cardiothorac Surg 2022; 62:6696715. [PMID: 36099031 DOI: 10.1093/ejcts/ezac460] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/24/2022] [Accepted: 09/12/2022] [Indexed: 11/14/2022] Open
Abstract
A 50-year-old patient, who underwent total aortic arch replacement for acute type A aortic dissection, developed recurrent thoracic prosthetic graft infection after omentopexy for the treatment of initial postoperative graft infection of ascending aorta and transverse aortic arch. We report a successful treatment of the disastrous complication by covering the prosthetic graft with free latissimus dorsi muscle flap coupled with pedicled rectus abdominis myocutaneous flap for the reduction of mediastinal dead space, following the surgical disinfection with partial graft reconstruction.
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Affiliation(s)
- Shuhei Miura
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Ryuji Shichinohe
- Department of Plastic and Reconstructive Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan.,Department of Cardiovascular Surgery, Sapporo Medical University, Sapporo, Japan
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29
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Shibata T, Iba Y, Nakajima T, Hosaka I, Kawaharada N. Pararenal aortic aneurysm repair using a physician-modified stent-graft with inner branches. J Vasc Surg Cases Innov Tech 2022; 8:356-357. [PMID: 35898570 PMCID: PMC9309584 DOI: 10.1016/j.jvscit.2022.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/26/2022] [Indexed: 11/25/2022] Open
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30
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Hasegawa T, Iba Y, Naraoka S, Nakajima T, Hashimoto S, Murohashi T, Umeta R, Hosaka I, Ohkawa A, Yasuda N, Shibata T, Kawaharada N. Improvement of predicted hematocrit values after the initiation of cardiopulmonary bypass in cardiovascular surgery. J Artif Organs 2021; 25:117-124. [PMID: 34689296 DOI: 10.1007/s10047-021-01295-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 09/22/2021] [Indexed: 11/24/2022]
Abstract
Hematocrit (Hct) values after the initiation of cardiopulmonary bypass (CPB) must be maintained appropriately to avoid perioperative complications. Therefore, an accurate prediction is required. However, the standard prediction equation often results in actual values that are lower than the predicted values. This study aimed to clarify the limits of agreement (LOA) and bias of the prediction equations and investigate better the prediction equations. A retrospective study was performed on adult patients between April 2015 and December 2020. Study 1 included 158 patients, and Study 2 included 55 patients. The primary outcomes were the LOA and bias between the predicted and measured Hct values after the initiation of CPB, and two studies were conducted. In Study 1, total blood volume (TBV) was estimated, and the new blood volume index (BVI) was calculated. BVI was also evaluated for the overall value and gender differences. Therefore, the patient's background was compared by gender differences. In, Study 2 the conventional predicted equation (Eq. 1), the predicted equation using the new BVI (Eq. 2), and the predicted equation using the new BVI including physiological factors in the TBV equation (Eq. 3) were compared. In Study 1, BVI was 53 (44-67) mL/kg. In Study 2, bias ± LOA was - 2.5 ± 6.8% for Eq. 1, 0.1 ± 6.6% for Eq. 2, and 0.4 ± 6.2% for Eq. 3. The new equation is expected to predict the Hct value after the initiation of CPB with better LOA and bias than the conventional equation.
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Affiliation(s)
- Takeo Hasegawa
- Department of Clinical Engineering, Sapporo Medical University Hospital, West-16, South-1, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, West-16, South-1, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
| | - Shuichi Naraoka
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, West-16, South-1, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Tomohiro Nakajima
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, West-16, South-1, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Syuichi Hashimoto
- Department of Clinical Engineering, Sapporo Medical University Hospital, West-16, South-1, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Takao Murohashi
- Department of Clinical Engineering, Sapporo Medical University Hospital, West-16, South-1, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Riko Umeta
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, West-16, South-1, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Itaru Hosaka
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, West-16, South-1, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Akihito Ohkawa
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, West-16, South-1, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Naomi Yasuda
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, West-16, South-1, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Tsuyoshi Shibata
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, West-16, South-1, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, West-16, South-1, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
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31
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Koike M, Doi T, Iba Y, Yuda S. Edwardsiella tarda Native Valve Infective Endocarditis in a Young and Non-Immunocompromised Host: A Case Report. Am J Case Rep 2021; 22:e932387. [PMID: 34625525 PMCID: PMC8515497 DOI: 10.12659/ajcr.932387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 11/29/2022]
Abstract
Patient: Female, 28-year-old
Final Diagnosis: Infective endocarditis
Symptoms: Fever
Medication: —
Clinical Procedure: —
Specialty: Cardiology • Infectious Diseases
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Affiliation(s)
- Masamichi Koike
- Department of Cardiology, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Takahiro Doi
- Department of Cardiology, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Satoshi Yuda
- Department of Cardiology, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
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32
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Shibata T, Kawaharada N, Iba Y, Nakajima T, Yasuda N, Ohkawa A, Hosaka I, Umeda R. Usefulness of Minimally Invasive Simplified Hybrid Therapy for Continuous Obstructive Lesions Including the Common Femoral Artery. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.06.106] [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: 12/01/2022]
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33
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Nishioka N, Iba Y, Bochimoto H, Tsukagoshi J, Masuda T, Yanase Y, Maruyama R, Hatta E, Kurimoto Y, Yamada A. Ultrastructural Features of the Aortic Wall in a Patient with Kommerell Diverticulum. Ann Vasc Surg 2021; 74:525.e1-525.e6. [PMID: 33831520 DOI: 10.1016/j.avsg.2021.02.036] [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: 10/20/2020] [Revised: 02/05/2021] [Accepted: 02/15/2021] [Indexed: 10/21/2022]
Abstract
We report on the ultrastructural features of the aortic wall in a patient with Kommerell diverticulum. A 70-year-old woman with a right aortic arch, aberrant left subclavian artery, and Kommerell diverticulum underwent a successful total arch replacement plus the frozen elephant trunk procedure with anatomical left subclavian artery reconstruction. Small pieces of the ascending aorta, distal arch, right common carotid artery, and left subclavian artery were investigated ultrastructurally. In the ascending aortic wall, multiple cystic cavities were observed in the subintimal region of the media by scanning electron microscopy. Changes in organelles, including mild dilation of rough-surfaced endoplasmic reticulum and mitochondrial swelling and degrading, were also observed in all specimens by transmission electron microscopy. These ultrastructural features may indicate the fragility or stress of the aortic wall and are useful when considering the early surgical intervention of a patient with Kommerell diverticulum.
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Affiliation(s)
- Naritomo Nishioka
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Hokkaido, Japan.
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Hokkaido, Japan
| | - Hiroki Bochimoto
- Division of Aerospace Medicine, Department of Cell Physiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Junji Tsukagoshi
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Hokkaido, Japan
| | - Takahiko Masuda
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Hokkaido, Japan
| | - Yohsuke Yanase
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Hokkaido, Japan
| | - Ryushi Maruyama
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Hokkaido, Japan
| | - Eiichiro Hatta
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Hokkaido, Japan
| | - Yoshihiko Kurimoto
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Hokkaido, Japan
| | - Akira Yamada
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Hokkaido, Japan
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Nishioka N, Iba Y, Masuda T, Yanase Y, Maruyama R, Hatta E, Yamada A, Kurimoto Y. [Surgical Strategy for Aortic Arch Aneurysm Depending on the Patient's Condition:Proper Selection of Open Surgery or Thoracic Endovascular Repair]. Kyobu Geka 2021; 74:271-280. [PMID: 33831887] [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: 06/12/2023]
Abstract
OBJECTIVES We investigated the validity of the surgical strategy for aortic arch aneurysm depending on the patient's condition. METHODS Between 2014 and 2019, 70 patients underwent total arch replacement (TAR) and 14 patients underwent fenestrated thoracic endovascular aortic repair( fTEVAR) for aortic arch aneurysm. We selected the surgical strategy on the basis of the patient's condition with or without frailty and if surgical risks including cancer or a respiratory condition precluded open surgery. RESULTS The preoperative average ages were 73.3±7.8 years in the TAR group and 73.9±6.1 years in the fTEVAR group (p=0.93). EuroSCORE Ⅱ was 4.3±3.6 in the TAR group and 6.0±3.3 in the fTEVAR group (p=0.03). Frailty was observed in 11 patients (15.7%) in the TAR group and fivepatients (35.7%) in the fTEVAR group (p=0.08). In the fTEVAR group, there were three patients (21.4%) with cancer and three patients (21.4%) with a respiratory condition that precluded open surgery. The overall 30-day mortality rate was 0% for both groups, and the in-hospital mortality rate was 2.9% in the TAR group and 0% in the fTEVAR group (p=0.52). The incidence of stroke was 2.9% (two patients) in the TAR group and 7.1%( one patient) in the fTEVAR group( p=0.43). However, all stroke patients were able to walk at discharge. The cumulative survival rate was 88.9% and 83.5% in the TAR group and 85.1% and 68.1% in the fTEVAR group at two and five years, respectively (p=0.173). There were both 98.1% of patients in the TAR group and 85.7% and 75.0% of patients in the fTEVAR group who were free from reoperations at two and five years, respectively( p<0.01). CONCLUSIONS Our surgical strategy and outcomes for aortic arch aneurysm were generally appropriate. It is important to select open surgery or TEVAR depending on the patient's condition.
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Affiliation(s)
- Naritomo Nishioka
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
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Mikami T, Furuhashi M, Sakai A, Numaguchi R, Harada R, Naraoka S, Kamada T, Higashiura Y, Tanaka M, Ohori S, Sakurada T, Nakamura M, Iba Y, Fukada J, Miura T, Kawaharada N. Antiatherosclerotic Phenotype of Perivascular Adipose Tissue Surrounding the Saphenous Vein in Coronary Artery Bypass Grafting. J Am Heart Assoc 2021; 10:e018905. [PMID: 33779243 PMCID: PMC8174366 DOI: 10.1161/jaha.120.018905] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Perivascular adipose tissue (PVAT) is associated with metabolically driven chronic inflammation called metaflammation, which contributes to vascular function and the pathogenesis of vascular disease. The saphenous vein (SV) is commonly used as an essential conduit in coronary artery bypass grafting, but the long‐term patency of SV grafts is a crucial issue. The use of the novel “no‐touch” technique of SV harvesting together with its surrounding tissue has been reported to result in good long‑term graft patency of SV grafts. Herein, we investigated whether PVAT surrounding the SV (SV‐PVAT) has distinct phenotypes compared with other PVATs of vessels. Methods and Results Fat pads were sampled from 48 patients (male/female, 32/16; age, 72±8 years) with coronary artery disease who underwent elective coronary artery bypass grafting. Adipocyte size in SV‐PVAT was significantly larger than the sizes in PVATs surrounding the internal thoracic artery, coronary artery, and aorta. SV‐PVAT and PVAT surrounding the internal thoracic artery had smaller extents of fibrosis, decreased gene expression levels of fibrosis‐related markers, and less metaflammation, as indicated by a significantly smaller extent of cluster of differentiation 11c–positive M1 macrophage infiltration, higher gene expression level of adiponectin, and lower gene expression levels of inflammatory cytokines, than did PVATs surrounding the coronary artery and aorta. Expression patterns of adipocyte developmental and pattern‐forming genes were totally different among the PVATs of the vessels. Conclusions The phenotype of SV‐PVAT, which may result from inherent differences in adipocytes, is closer to that of PVAT surrounding the internal thoracic artery than that of PVAT surrounding the coronary artery or that of PVAT surrounding the aorta. SV‐PVAT has less metaflammation and consecutive adipose tissue remodeling, which may contribute to high long‐term patency of grafting when the no‐touch technique of SV harvesting is used.
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Affiliation(s)
- Takuma Mikami
- Department of Cardiovascular Surgery Sapporo Medical University School of Medicine Sapporo Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University School of Medicine Sapporo Japan
| | - Akiko Sakai
- Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University School of Medicine Sapporo Japan
| | - Ryosuke Numaguchi
- Department of Cardiovascular Surgery Sapporo Medical University School of Medicine Sapporo Japan
| | - Ryo Harada
- Department of Cardiovascular Surgery Sapporo Medical University School of Medicine Sapporo Japan
| | - Syuichi Naraoka
- Department of Cardiovascular Surgery Sapporo Medical University School of Medicine Sapporo Japan
| | - Takeshi Kamada
- Department of Cardiovascular Surgery Sapporo Medical University School of Medicine Sapporo Japan
| | - Yukimura Higashiura
- Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University School of Medicine Sapporo Japan
| | - Marenao Tanaka
- Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University School of Medicine Sapporo Japan
| | - Shunsuke Ohori
- Department of Cardiovascular Surgery Hokkaido Ohno Memorial Hospital Sapporo Japan
| | - Taku Sakurada
- Department of Cardiovascular Surgery Sapporo Central Hospital Sapporo Japan
| | - Masanori Nakamura
- Department of Cardiovascular Surgery Sapporo City General Hospital Sapporo Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery Teine Keijinkai Hospital Sapporo Japan
| | - Joji Fukada
- Department of Cardiovascular Surgery Otaru City General Hospital Otaru Japan
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine Sapporo Medical University School of Medicine Sapporo Japan
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery Sapporo Medical University School of Medicine Sapporo Japan
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Tsukagoshi J, Iba Y, Kurimoto Y, Maruyama R, Yanase Y, Nishioka N, Masuda T, Yamada A. Hybrid Repair of Kommerell Diverticulum and Aberrant Subclavian Artery with Compressive Symptoms and a New Strategy: Case Report. Ann Vasc Dis 2021; 14:60-63. [PMID: 33786102 PMCID: PMC7991711 DOI: 10.3400/avd.cr.20-00129] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Surgical indication and treatment for patients with Kommerell diverticulum and aberrant subclavian artery are still not well established. A patient with esophageal and tracheal compression resulting from these anatomical abnormalities was successfully treated with a hybrid approach of total arch replacement, frozen elephant trunk technique, aberrant left subclavian artery transection, and left subclavian artery reconstruction through median sternotomy. Compressive symptoms were relieved without resecting the enlarged diverticulum. In this case, the importance of preoperative investigation for the main cause of compressive symptoms is illustrated and a novel treatment strategy is outlined.
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Affiliation(s)
- Junji Tsukagoshi
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Yoshihiko Kurimoto
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Ryushi Maruyama
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Yosuke Yanase
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Naritomo Nishioka
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Takahiko Masuda
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Akira Yamada
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
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Yanase Y, Kurimoto Y, Maruyama R, Masuda T, Iba Y, Yamada A. Intra-abdominal Aortic Aneurysm Sac Angiography After Endovascular Aortic Repair Predicts Type II Endoleak. J Vasc Surg 2020. [DOI: 10.1016/j.jvs.2020.04.165] [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: 11/29/2022]
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Yanase Y, Kurimoto Y, Maruyama R, Masuda T, Iba Y, Yamada A. Comparison of Endovascular Repair Outcome for Common and Internal Iliac Artery Aneurysms. J Vasc Surg 2020. [DOI: 10.1016/j.jvs.2020.04.166] [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: 10/24/2022]
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Miura S, Kurimoto Y, Ujihira K, Masuda T, Yanase Y, Iba Y, Maruyama R, Yamada A. Emergency Endovascular Aneurysm Repair Coupled with Staged Omentopexy for Primary Aorto-Duodenal Fistula. Ann Vasc Dis 2020; 13:183-186. [PMID: 32595797 PMCID: PMC7315232 DOI: 10.3400/avd.cr.19-00104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 11/27/2022] Open
Abstract
A primary aorto-duodenal fistula (ADF), a rare, spontaneous development of a communication between the aorta and duodenum, is a disastrous complication of an abdominal aortic aneurysm. A 73-year-old patient with primary ADF underwent emergent endovascular aneurysm repair (EVAR), followed by staged omentopexy, without removing a stent graft (SG). The patient received long-term treatment with antibiotics, and there has been no evidence of infection during a follow-up period of three years. Emergency EVAR coupled with omentopexy, may be a treatment option for primary ADF, even when it means leaving the SG in a potentially infectious site.
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Affiliation(s)
- Shuhei Miura
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Yoshihiko Kurimoto
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Kosuke Ujihira
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Takahiko Masuda
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Yohsuke Yanase
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Ryushi Maruyama
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Akira Yamada
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
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Yagi H, Nishigori M, Murakami Y, Osaki T, Muto S, Iba Y, Minatoya K, Ikeda Y, Ishibashi-Ueda H, Morisaki T, Ogino H, Tanaka H, Sasaki H, Matsuda H, Minamino N. Discovery of novel biomarkers for atherosclerotic aortic aneurysm through proteomics-based assessment of disease progression. Sci Rep 2020; 10:6429. [PMID: 32286426 PMCID: PMC7156426 DOI: 10.1038/s41598-020-63229-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 11/14/2019] [Accepted: 03/25/2020] [Indexed: 01/21/2023] Open
Abstract
Since aortic aneurysms (AAs) are mostly asymptomatic, but they have a high mortality rate upon rupture, their detection and progression evaluation are clinically important issues. To discover diagnostic biomarkers for AA, we performed proteome analysis of aortic media from patients with thoracic atherosclerotic AA (TAAA), comparing protein levels between the aneurysm and normal tissue areas. After hierarchical clustering analysis of the proteome analysis data, tissue samples were classified into three groups, regardless of morphological features. This classification was shown to reflect disease progression stage identified by pathological examination. This proteomics-based staging system enabled us to identify more significantly altered proteins than the morphological classification system. In subsequent data analysis, Niemann-Pick disease type C2 protein (NPC2) and insulin-like growth factor-binding protein 7 (IGFBP7) were selected as novel biomarker candidates for AA and were compared with the previously reported biomarker, thrombospondin 1 (THBS1). Blood concentrations of NPC2 and IGFBP7 were significantly increased, while THBS1 levels were decreased in TAAA and abdominal atherosclerotic AA patients. Receiver operating characteristic analysis of AA patients and healthy controls showed that NPC2 and IGFBP7 have higher specificity and sensitivity than THBS1. Thus, NPC2 and IGFBP7 are promising biomarkers for the detection and progression evaluation of AA.
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Affiliation(s)
- Hiroaki Yagi
- Department of Molecular Pharmacology, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan
| | - Mitsuhiro Nishigori
- Department of Molecular Pharmacology, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan.,Omics Research Center, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yusuke Murakami
- Omics Research Center, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tsukasa Osaki
- Department of Molecular Pharmacology, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan
| | - Sayaka Muto
- Omics Research Center, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.,Department of Pathology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yutaka Iba
- Department of Vascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kenji Minatoya
- Department of Vascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshihiko Ikeda
- Department of Pathology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hatsue Ishibashi-Ueda
- Department of Pathology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Takayuki Morisaki
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan
| | - Hitoshi Ogino
- Department of Vascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hiroshi Tanaka
- Department of Vascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hiroaki Sasaki
- Department of Vascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hitoshi Matsuda
- Department of Vascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Naoto Minamino
- Department of Molecular Pharmacology, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan. .,Omics Research Center, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
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Miura S, Kurimoto Y, Iba Y, Maruyama R, Hatta E, Yamada A. Quantitative evaluation of superior mesenteric artery calcification in hemodialysis patients undergoing aortic valve replacement. Gen Thorac Cardiovasc Surg 2020; 68:1252-1259. [PMID: 32277347 DOI: 10.1007/s11748-020-01352-z] [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: 02/03/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Postoperative acute mesenteric ischemia (AMI) in the long-term hemodialysis (HD) patients could be a disastrous complication leading to high mortality. The objective is to evaluate the association between the presence of superior mesenteric artery calcification (SMAC) and early and late outcomes after aortic valve replacement (AVR) in HD patients. METHODS Between April 2003 and December 2018, the enrolled 46 HD patients (19 women; mean age 72 years) who underwent AVR for severe aortic valve stenosis were retrospectively reviewed. 25 patients (54.3%) who had severe calcifications of superior mesenteric artery (SMA) were defined as the SMAC group, and the calcification extent of SMA was evaluated on preoperative non-contrast CT using Agaston calcium score [calcification area (cm2) × max CT value (HU)]. The operative outcomes were compared with those of the non-SMAC group comprising 21 patients (45.7%). RESULTS The following factors in SMAC group were statistically higher compared with those of the non-SMAC group: age (73.6 ± 7.2 vs 69.3 ± 7.1 years; p = 0.04), celiac artery calcification (76.4% vs 17.6%; p < 0.001), calcium score of SMA (692.3 ± 300.0 vs 123.5 ± 180.7; p < 0.001), the incidence of AMI (24.0% vs 4.7%; p = 0.001), and hospital mortality (16.0% vs 0%; p = 0.02). In multivariate analysis, the presence of SMAC was significantly associated with AMI (OR 3.8, p = 0.05) and hospital mortality (OR 2.4, p = 0.02). Calcium score of SMA in patients complicated with AMI was significantly higher than those without AMI (815.7 ± 300.5 vs 366.9 ± 351.2; p < 0.01). CONCLUSION Quantitative evaluation of SMAC could be a predictive marker of incidence of AMI after AVR in HD patients.
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Affiliation(s)
- Shuhei Miura
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan.
| | - Yoshihiko Kurimoto
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan
| | - Ryushi Maruyama
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan
| | - Eiichiro Hatta
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan
| | - Akira Yamada
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan
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Miura S, Kurimoto Y, Maruyama R, Masuda T, Yanase Y, Iba Y, Nojima M, Yamada A. Endovascular Aortic Aneurysm Repair without Type 2 Endoleak Using Concomitant N-Butyl-2-Cyanoacrylate Injection into the Abdominal Aortic Aneurysm Sac. Ann Vasc Surg 2019; 66:110-119. [PMID: 31863949 DOI: 10.1016/j.avsg.2019.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/27/2019] [Accepted: 12/06/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The aim of this study was to evaluate our new method to occlude target lumber arteries using N-butyl-2-cyanoacrylate (NBCA) during endovascular aneurysm repair (EVAR) for prevention of type 2 endoleak (T2E). METHODS AND RESULTS Between 2013 and 2018, 176 patients who underwent EVAR for abdominal aortic aneurysm (AAA) were reviewed. Starting from October 2015, 83 patients (treatment group) underwent NBCA injection into the aneurysmal sac during EVAR. The incidence of T2E at 7 days and AAA sac diameter 12 months after EVAR were compared with those of the control group comprising 93 consecutive patients who underwent EVAR alone before 2015. The incidence of T2E at 7 days was significantly lower in the treatment group (2.4%) than in the control group (22.6%) (P < 0.001). AAA sac diameter at 12 months in the treatment group had a mean decrease of 6.6 mm as compared with the mean 4.4 mm in the control group (P = 0.026). In multivariate analysis, NBCA injection was significantly related to the reduction of incidence of T2E at 7 days (odds ratio = 11.8, P < 0.001) and a decrease in AAA sac diameter at 12 months (P < 0.001). There was no NBCA injection-related complication and reintervention in the treatment group. CONCLUSIONS NBCA injection might be safe and useful to reduce the incidence of T2Es and to prevent AAA sac expansion.
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Affiliation(s)
- Shuhei Miura
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan.
| | - Yoshihiko Kurimoto
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Ryushi Maruyama
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Takahiko Masuda
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yohsuke Yanase
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Masanori Nojima
- The Institute of Medical Science Hospital, University of Tokyo, Tokyo, Japan
| | - Akira Yamada
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
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Iba Y, Yamada A, Kurimoto Y, Hatta E, Maruyama R, Miura S. Perioperative Outcomes of Minimally Invasive Aortic Arch Reconstruction with Branched Grafts Through a Partial Upper Sternotomy. Ann Vasc Surg 2019; 65:217-223. [PMID: 31678130 DOI: 10.1016/j.avsg.2019.10.078] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/14/2019] [Accepted: 10/14/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Ministernotomy has been advocated over recent years as an alternative technique for different cardiovascular surgical procedures to reduce the surgical trauma associated with conventional full sternotomy. In recent years, several reports have addressed minimally invasive approaches to the proximal aorta and aortic arch through a partial upper sternotomy (PUS). We reviewed our experience of minimally invasive open aortic arch reconstruction with a branched graft through a PUS. METHODS Between February 2016 and December 2018, 22 patients underwent open arch repair through a PUS. Moderate hypothermic circulatory arrest and antegrade selective cerebral perfusion were used for organ protection. The median patient age was 76 years (range, 65-86). Renal insufficiency was observed in 14 patients (64%) and chronic lung disease, in 11 (50%). Total arch replacement was performed in 20 patients (91%), while the remaining 2 (9%) received partial arch replacement with reconstruction of two supraaortic vessels. Aortic valve replacement with a tissue valve or aortic valve repair was each performed concomitantly in one patient (5%) as a concomitant procedure. The median durations of cardiopulmonary bypass, aortic cross-clamping, and circulatory arrest were 214, 109, and 50 min, respectively. RESULTS No early deaths, permanent neurological deficits, or spinal cord injuries occurred. One patient (5%) required intraoperative conversion to full sternotomy because of bleeding caused by a venting cannula injury. Three patients (14%) required re-exploration because of bleeding. Prolonged ventilation occurred in 2 patients (9%) with severe chronic obstructive pulmonary disease. CONCLUSIONS Minimally invasive aortic arch reconstruction with branched grafts through a PUS can be safely performed with satisfactory perioperative outcomes.
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Affiliation(s)
- Yutaka Iba
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-40 1-12 Maeda, Teine-ku, Sapporo, Hokkaido, Japan.
| | - Akira Yamada
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-40 1-12 Maeda, Teine-ku, Sapporo, Hokkaido, Japan
| | - Yoshihiko Kurimoto
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-40 1-12 Maeda, Teine-ku, Sapporo, Hokkaido, Japan
| | - Eiichiro Hatta
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-40 1-12 Maeda, Teine-ku, Sapporo, Hokkaido, Japan
| | - Ryushi Maruyama
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-40 1-12 Maeda, Teine-ku, Sapporo, Hokkaido, Japan
| | - Shuhei Miura
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-40 1-12 Maeda, Teine-ku, Sapporo, Hokkaido, Japan
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Miura S, Yamada A, Iba Y, Maruyama R, Hatta E, Kurimoto Y. Surgical treatment of isolated right ventricular metastasis from renal cell carcinoma. Surg Case Rep 2019; 5:162. [PMID: 31664692 PMCID: PMC6820637 DOI: 10.1186/s40792-019-0733-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 07/26/2019] [Accepted: 10/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiac metastasis from renal cell carcinoma is an exceptional event, particularly when there is lack of inferior vena cava involvement. Only a few cases have been reported worldwide so far. CASE PRESENTATION We presented a case of a 58-year-old man diagnosed with isolated right ventricular metastasis of renal cell carcinoma in the absence of direct inferior vena cava extension, who underwent surgical tumor resection using cardiopulmonary bypass. CONCLUSIONS Surgical resection of the cardiac mass with an understanding of the pathology is needed to prevent sudden death from acute heart failure or tumor embolism and improve the patient's quality of life.
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Affiliation(s)
- Shuhei Miura
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan.
| | - Akira Yamada
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan
| | - Ryushi Maruyama
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan
| | - Eiichiro Hatta
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan
| | - Yoshihiko Kurimoto
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan
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Saito K, Yagi H, Maekawa K, Nishigori M, Ishikawa M, Muto S, Osaki T, Iba Y, Minatoya K, Ikeda Y, Ishibashi-Ueda H, Ogino H, Sasaki H, Matsuda H, Saito Y, Minamino N. Lipidomic signatures of aortic media from patients with atherosclerotic and nonatherosclerotic aneurysms. Sci Rep 2019; 9:15472. [PMID: 31664168 PMCID: PMC6820727 DOI: 10.1038/s41598-019-51885-4] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 10/07/2019] [Indexed: 11/09/2022] Open
Abstract
Aortic aneurysms are associated with fatal aortic rupture. Current therapeutic approaches are limited to implantation of aortic prostheses and stent-grafts; no effective drugs are available because the pathogenic mechanisms of aortic aneurysms remain unclear. Here, we aimed to elucidate the molecular mechanisms of the initiation and progression of aortic aneurysm by lipidomics. We performed lipidomics analyses of lipids in the aortic media of normal, border, and aneurysm areas from patients with thoracic atherosclerotic aortic aneurysm (N = 30), thoracic nonatherosclerotic aortic aneurysm (N = 19), and abdominal atherosclerotic aortic aneurysm (N = 11) and from controls (N = 8) using liquid chromatography and mass spectrometry. Significant alterations were observed in the lipid profiles of patients with atherosclerotic aortic aneurysms and to a lesser extent in those with nonatherosclerotic aneurysms. Increased triacylglycerols (TGs) and decreased ether-type phosphatidylethanolamines (ePEs) were observed throughout the normal, border, and aneurysm areas of thoracic and abdominal atherosclerotic aortic aneurysms. Prostaglandin D2 increased, but ePEs and TGs decreased in normal areas of thoracic atherosclerotic aortic aneurysms and thoracic nonatherosclerotic aortic aneurysms compared with the control tissues. These findings expand our knowledge of metabolic changes in aortic aneurysms and provide insights into the pathophysiology of aortic aneurysms.
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Affiliation(s)
- Kosuke Saito
- Division of Medical Safety Science, National Institute of Health Sciences, Kanagawa, Japan
| | - Hiroaki Yagi
- Department of Molecular Pharmacology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Keiko Maekawa
- Division of Medical Safety Science, National Institute of Health Sciences, Kanagawa, Japan
| | - Mitsuhiro Nishigori
- Department of Molecular Pharmacology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan.,Omics Research Center, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masaki Ishikawa
- Division of Medical Safety Science, National Institute of Health Sciences, Kanagawa, Japan
| | - Sayaka Muto
- Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tsukasa Osaki
- Department of Molecular Pharmacology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Yutaka Iba
- Department of Vascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kenji Minatoya
- Department of Vascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yoshihiko Ikeda
- Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | | | - Hitoshi Ogino
- Department of Vascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hiroaki Sasaki
- Department of Vascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hitoshi Matsuda
- Department of Vascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yoshiro Saito
- Division of Medical Safety Science, National Institute of Health Sciences, Kanagawa, Japan.
| | - Naoto Minamino
- Department of Molecular Pharmacology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan. .,Omics Research Center, National Cerebral and Cardiovascular Center, Osaka, Japan.
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46
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Miura S, Kurimoto Y, Maruyama R, Wada T, Konno M, Iba Y, Hatta E, Yamada A. Thoracic Endovascular Aortic Repair on Zone 2 Landing for Type B Aortic Dissection. Ann Vasc Surg 2019; 60:120-127. [DOI: 10.1016/j.avsg.2019.02.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/16/2019] [Accepted: 02/17/2019] [Indexed: 01/10/2023]
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Miura S, Wada T, Konno M, Iba Y, Maruyama R, Hatta E, Yamada A, Kurimoto Y. Modified Isolation Selective Cerebral Perfusion Technique for Intracardiac Disease with Mobile Atheroma. Ann Vasc Dis 2019; 12:222-224. [PMID: 31275478 PMCID: PMC6600107 DOI: 10.3400/avd.cr.18-00146] [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
Isolation selective cerebral perfusion (ISCP) technique is reportedly an effective method for preventing brain complications during the treatment of arch aneurysms. Here we present the case of a patient with intracardiac disease complicated by mobile atheroma in the proximal aorta. In this patient, not only the arterial cannulation of the ascending aorta might have posed a high risk of brain stroke but also the original ISCP technique could not be applied. We applied the ISCP technique for non-aortic disease without using circulatory arrest to prevent aortogenic brain embolism. The patients who underwent treatment using this technique were discharged without neurologic complications.
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Affiliation(s)
- Shuhei Miura
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Takuya Wada
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Mitsuhiko Konno
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Ryushi Maruyama
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Eiichiro Hatta
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Akira Yamada
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Yoshihiko Kurimoto
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
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48
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Nakajima T, Yokota T, Shingu Y, Yamada A, Iba Y, Ujihira K, Wakasa S, Ooka T, Takada S, Shirakawa R, Katayama T, Furihata T, Fukushima A, Matsuoka R, Nishihara H, Dela F, Nakanishi K, Matsui Y, Kinugawa S. Impaired mitochondrial oxidative phosphorylation capacity in epicardial adipose tissue is associated with decreased concentration of adiponectin and severity of coronary atherosclerosis. Sci Rep 2019; 9:3535. [PMID: 30837669 PMCID: PMC6401184 DOI: 10.1038/s41598-019-40419-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 11/06/2018] [Accepted: 02/14/2019] [Indexed: 11/09/2022] Open
Abstract
Epicardial adipose tissue (EAT), a source of adipokines, is metabolically active, but the role of EAT mitochondria in coronary artery disease (CAD) has not been established. We investigated the association between EAT mitochondrial respiratory capacity, adiponectin concentration in the EAT, and coronary atherosclerosis. EAT samples were obtained from 25 patients who underwent elective cardiac surgery. Based on the coronary angiographycal findings, the patients were divided into two groups; coronary artery disease (CAD; n = 14) and non-CAD (n = 11) groups. The mitochondrial respiratory capacities including oxidative phosphorylation (OXPHOS) capacity with non-fatty acid (complex I and complex I + II-linked) substrates and fatty acids in the EAT were significantly lowered in CAD patients. The EAT mitochondrial OXPHOS capacities had a close and inverse correlation with the severity of coronary artery stenosis evaluated by the Gensini score. Intriguingly, the protein level of adiponectin, an anti-atherogenic adipokine, in the EAT was significantly reduced in CAD patients, and it was positively correlated with the mitochondrial OXPHOS capacities in the EAT and inversely correlated with the Gensini score. Our study showed that impaired mitochondrial OXPHOS capacity in the EAT was closely linked to decreased concentration of adiponectin in the EAT and severity of coronary atherosclerosis.
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Affiliation(s)
- Takayuki Nakajima
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takashi Yokota
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
| | - Yasushige Shingu
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Akira Yamada
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Kosuke Ujihira
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Satoru Wakasa
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Tomonori Ooka
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shingo Takada
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ryosuke Shirakawa
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takashi Katayama
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takaaki Furihata
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Arata Fukushima
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ryosuke Matsuoka
- Division of Clinical Cancer Genomics, Hokkaido University Hospital, Sapporo, Japan
| | - Hiroshi Nishihara
- Division of Clinical Cancer Genomics, Hokkaido Cancer Center, Sapporo, Japan
| | - Flemming Dela
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Geriatrics, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark
| | - Katsuhiko Nakanishi
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yoshiro Matsui
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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49
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Sumitomo-Kondo M, Ukai Y, Iba Y, Ohshima N, Miura K, Takasaki A, Kurosawa Y, Kurosawa G. Isolation of human monoclonal antibodies that bind to two different antigens and are encoded by germline V H and V L genes. Biochem Biophys Res Commun 2018; 503:1141-1147. [PMID: 29944883 DOI: 10.1016/j.bbrc.2018.06.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 06/23/2018] [Indexed: 10/28/2022]
Abstract
This paper reports isolation of two monoclonal antibodies (mAbs) that bind to both a membrane protein and a cytoplasmic protein. Most Abs established as markers for autoimmune disease bind to cytoplasmic or nuclear substances. However, it remains unknown how these Abs are produced. On the other hand, there were examples where clones originally isolated as Abs that bind to membrane proteins also showed binding activity to cytoplasmic or nuclear substances. Based on these results, the following hypothesis has been proposed. The Abs that had been originally produced against a membrane protein showed cross-reactivity against cytoplasmic or nuclear substances. In the present study we reported isolation of Abs that bound to both a membrane protein, CADM1, and a cytoplasmic protein, α-actinin-4. The method adopted in the present study could be generally applicable to isolation of Abs showing such dual specificity. Firstly, we constructed a huge human Ab library using various organs including naïve B-cell-rich organs such as bone marrow and umbilical cords. Then, we developed a comprehensive screening method for isolation of Abs that bound to cell surface antigens. Through extensive screenings with many kinds of cell we newly obtained a library composed of around 4000 independent clones that bind to membrane proteins. We screened this library with α-actinin-4 and succeeded in isolating two Abs. They bound to α-actinin-4 and a membrane protein CADM1. Furthermore, they are encoded by naïve heavy and light chain variable genes (VH & VL). These results suggested that cross-reactive Abs to both a membrane protein and a cytoplasmic protein could be present in germline repertoire of Ab in humans. This methodology adopted in the present study could be applied to isolation of cross-reactive Abs possibly involved in autoimmune diseases.
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Affiliation(s)
- M Sumitomo-Kondo
- Center for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan; Perseus Proteomics Inc., Tokyo, Japan
| | - Y Ukai
- Center for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan; Perseus Proteomics Inc., Tokyo, Japan
| | - Y Iba
- Center for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan
| | - N Ohshima
- Center for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan
| | - K Miura
- School of Health Sciences Fujita Health University, Toyoake, Japan
| | - A Takasaki
- Department of Medical Technology School of Health Sciences, Gifu University of Medical Science, Gifu, Japan
| | - Y Kurosawa
- Center for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan
| | - G Kurosawa
- Center for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan.
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50
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Miura S, Iba Y, Yamada A. Type A aortic dissection with pulmonary hypertension caused by pulmonary artery compression and acute mitral regurgitation. Eur J Cardiothorac Surg 2018; 54:404. [PMID: 30010878 DOI: 10.1093/ejcts/ezy085] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 02/06/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Shuhei Miura
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Akira Yamada
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
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