Language：Japanese   Publisher：(一社)日本腹部救急医学会  

症例は86歳,女性。外出中に屋外で倒れこみ,通行人によって救急要請,意識障害を主訴として当院救命センターに搬入された。バイタルサインは保たれていたが,腹部エコーで腹腔内出血と腹部大動脈瘤を認めたため,造影CTを施行し,腹部大動脈瘤破裂の診断となった。初療室へ帰室直後に心肺停止となり開胸心臓マッサージおよび下行大動脈を遮断した後,ただちに初療室内で心臓血管外科による緊急人工血管置換術が施行された。術後合併症の残存はあったものの,リハビリテーションを目的に転院に至った。高齢者の心肺停止を伴う破裂性腹部大動脈瘤症例に対して救急救命医と心臓血管外科医のすみやかな連携で救命の可能性がもたらされることが示唆された。(著者抄録)

researchmap

Publishing type：Research paper (scientific journal)   Publisher：The Editorial Committee of Annals of Vascular Diseases  

DOI： 10.3400/avd.oa.24-00031

researchmap

Language：Japanese   Publisher：(NPO)日本血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本血管外科学会  

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Ventricular tachycardia originating from the left ventricular summit region, the most superior region of the left ventricle surrounded by the major coronary arteries and veins, is frequently refractory to pharmacological therapies and endocardial and epicardial catheter ablation. METHODS: Eleven patients with an age from 31 to 79 (median 56) years old, underwent map-guided surgery for left ventricular summit ventricular tachycardia. All patients had undergone one to 5 unsuccessful sessions of catheter ablation for incessant ventricular tachycardia, preoperatively. Five patients had suffered ventricular tachycardia storm and 1 had a history of cardiopulmonary resuscitation. Four patients had implanted with a defibrillator. Epicardium to endocardium transmural cryothermia was applied at the ventricular tachycardia origin determined by intraoperative epicardial mapping with electro-anatomical mapping system. Harmonic scalpel was used to remove the epicardial fat and cryothermia was applied directly to the myocardium, avoiding thermal or mechanical injuries to the coronary vessels. Additional endocardial cryothermia at the ventricular tachycardia origin was performed by a cryoprobe introduced into the left ventricular cavity through an aortotomy. RESULTS: There was no surgical mortality or long-term mortality related to ventricular tachycardia during a median follow-up period of 60 months (IQR: 34-82). Five-year freedom from preoperatively documented left ventricular summit ventricular tachycardia and non-documented ventricular tachycardia was 91% and 73%, respectively. All the patients with postoperative ventricular tachycardia underwent successful catheter ablation. Other patients were free from ventricular tachycardia during the follow-up period. CONCLUSIONS: Epicardial to endocardial transmural cryothermia at the ventricular tachycardia origin guided by intraoperative electro-anatomical mapping with a close collaboration with electrophysiologists was crucial in successful surgery for left ventricular summit ventricular tachycardia.

DOI： 10.1093/ejcts/ezad323

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Essential thrombocythemia (ET) is a chronic myeloproliferative disorder characterized by an elevation of platelet counts with a tendency for thrombosis and hemorrhage. The perioperative management of cardiovascular surgery of an ET patient is complicated. There is limited literature on the perioperative management of patients with ET undergoing cardiovascular surgery, particularly those requiring multiple procedures. CASE PRESENTATION: An 85-year-old woman with a history of essential thrombocythemia (ET), which resulted in an abnormally high platelet count, was diagnosed with aortic valve stenosis, ischemic heart disease and paroxysmal atrial fibrillation. She underwent aortic valve replacement, coronary artery bypass grafting, and pulmonary vein isolation. The postoperative course was uneventful, nor hemorrhage and thrombosis. CONCLUSIONS: We represent a case of perioperative management and successful treatment of three combined cardiac surgery for an octogenarian ET patient who is the oldest case ever reported.

DOI： 10.1186/s40792-023-01682-z

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

We present the case of an 86-year-old woman with a ruptured left coronary artery aneurysm associated with coronary-pulmonary artery fistula. She was transferred to our hospital with complaints of chest discomfort. Echocardiography revealed cardiac tamponade, and subsequently, a bloody pericardial effusion was drained. Coronary angiography and computed tomography revealed a ruptured left coronary artery aneurysm originating from a branch of the proximal left anterior descending artery and a coronary-pulmonary artery fistula. In the emergency operation, under cardiopulmonary bypass, the inlet and outlet vessels were ligated, and the aneurysm was plicated without arresting the heart. By utilising cardiopulmonary bypass, the pulmonary trunk was easily decompressed, and dissection around the aneurysm and identification of the inlet and outlet vessels were facilitated without cardiac arrest. Thus, to conclude, an on-pump beating-heart technique should be considered in such cases.

DOI： 10.1093/icvts/ivad067

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Intracardiac thrombus is relatively rare in patients with coronavirus disease 2019 (COVID-19). However, if it occurs, thrombotic complications are likely to develop. In this case, we performed a successful thrombectomy on a patient who developed left ventricular thrombus after COVID-19 infection without complications. CASE PRESENTATION: A 52-year-old man sought medical care due to fever, dyspnea, and abnormalities in the taste and smell that persisted for 2 weeks. The patient was diagnosed with COVID-19 and was treated with remdesivir, baricitinib, and heparin. Three weeks after hospitalization, electrocardiogram revealed angina pectoris, and cardiac catherization showed left anterior descending coronary artery stenosis. In addition, global hypokinesis and a thrombus at the left ventricular apex were observed on echocardiography. Left ventricular reconstruction concomitant with coronary artery bypass grafting was performed. A thrombus in the left ventricle was resected via left apical ventriculotomy, and the bovine pericardium was covered and sutured on the infarction site to exclude it. The patient was extubated a day after surgery and was transferred to another hospital for recuperation after 20 days. He did not present with complications. CONCLUSIONS: Thrombotic events could be prevented via thrombectomy with left ventricular reconstruction using an intraventricular patch to exclude the residual thrombus.

DOI： 10.1186/s13019-023-02108-5

PubMed

researchmap

Publishing type：Research paper (scientific journal)   Publisher：The Editorial Committee of Annals of Vascular Diseases  

DOI： 10.3400/avd.cr.22-00120

researchmap

Publishing type：Research paper (scientific journal)   Publisher：The Editorial Committee of Annals of Vascular Diseases  

DOI： 10.3400/avd.cr.22-00044

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Scoliosis is one of the symptoms manifested by patients with Marfan syndrome (MFS). Deformity of the thoracic cavity due to severe scoliosis may cause difficulty during cardiac surgery in terms of the surgical approach and instrument manipulation; however, only a few reports have been available regarding the surgical case of MFS with severe scoliosis. Here, we report a case of combined aortic valve replacement and left atrial appendage closure in a patient with MFS who had severe scoliosis using lower hemisternotomy. CASE PRESENTATION: A 62-year-old female with MFS was referred to our hospital after being diagnosed with severe aortic regurgitation and paroxysmal atrial fibrillation with a history of cerebral thromboembolism. The aortic valve showed severe insufficiency due to cusp prolapse, whereas the aortic root was moderately dilated (42 mm). Echocardiography revealed severe regurgitation with reduced left ventricular ejection function (32%) and massive left ventricular diastolic dimension (88 mm). Moreover, combined aortic valve replacement and left atrial appendage closure was indicated. However, the patient had chest deformity due to severe scoliosis. Thus, conventional full sternotomy or thoracotomy was considered an inappropriate surgical approach. Lower hemisternotomy was selected on the basis of three-dimensional reconstruction imaging of the aorta, left atrial appendage, sternum, and rib. Sternal elevation and rib retraction with the costal arch folded back provided enough surgical field for the combined procedures to be safely conducted. The postoperative course was uneventful, except for predicted prolonged mechanical ventilation with the assistance of intraaortic balloon pumping. Thereafter, the patient has been free from any cardiac and cerebrovascular event. CONCLUSIONS: Lower hemisternotomy can be useful for combined cardiac surgery in MFS with severe scoliosis.

DOI： 10.1186/s40792-022-01504-8

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Residual shunt after the closure of an inferior sinus venosus defect (ISVD) is a rare complication with a high rate of reintervention. CASE PRESENTATION: Here, we report a rare case of a patient with a recurrent defect identified 22 years after the closure of ISVD. The 25 × 10-mm defect was situated at the inferior vena cava-right atrial junction and was closed directly at 5 years of age. No residual shunt was detected, and when the patient reached 12 years of age, follow-up was discontinued. However, the residual atrial septal defect shunt was detected incidentally at 27 years of age. During the second surgery, the lower end of the original defect was opened and then closed using an expanded polytetrafluoroethylene patch. CONCLUSIONS: In light of the high rate of reintervention for residual shunt after ISVD closure, patch closure appeared to be a better option to reduce the tension in the inferior-posterior border. Moreover patients with this profile should be followed up closely at least in their childhood, including assessment by echocardiography.

DOI： 10.1272/jnms.JNMS.2023_90-301

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Chronic mesenteric ischemia (CMI) involving occlusion and/or stenosis of multiple mesenteric arteries is rare. We report our experience with a 66-year-old man who presented with a more than 3 months history of abdominal pain and vomiting/diarrhea. A diagnosis of CMI due to occlusion of the superior mesenteric artery (SMA) and severe stenosis of the celiac artery by median arcuate ligament syndrome was made. Complete revascularization through iliac artery-SMA bypass grafting and arcuate ligament dissection assisted with staged-catheter intervention successfully alleviated the patient's symptoms. The patient has maintained a normal daily diet for 6 months postoperatively.

DOI： 10.3400/avd.cr.21-00109

PubMed

researchmap

Language：English  

A 69-year-old male patient with a history of percutaneous coronary intervention (PCI) to the proximal left anterior descending coronary artery (LAD) underwent another PCI to the stenosis of the medium LAD as part of therapy for angina pectoris. Interruption of stent delivery because of past stent led to stent entrapment and a stuck guidewire. A snare catheter device was applied to retrieve the stent; however, the device lost mobility. Surgical removal and coronary artery bypass grafting (CABG) were required. We herein report some surgical techniques for resolving this complication of PCI. <Learning objective: Despite the recent advancements in devices and/or technical skills, the complications of PCI will never be eliminated. This case report provides a suggestive lesson with regard to open heart surgery for PCI complication; furthermore, only a few reports have described details concerning these PCI complications from the viewpoint of a surgeon. Physicians and surgeons should learn the emergent surgical techniques for resolving PCI complications.>.

DOI： 10.1016/j.jccase.2021.03.001

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Postoperative pain management in thoracotomy patients often is difficult. Furthermore, pediatric patients present more challenges because of their inability to effectively communicate their pain intensity. The purpose of this study was to evaluate the use of continuous field block through intercostal muscles as postoperative pain management in pediatric thoracotomy. METHODS: Between 2014 and 2018, 11 patients underwent an ASD closure using a cardiopulmonary bypass via a mini-right thoracotomy through the fourth intercostal space. At the time of chest closure, a single-shot field block via the fourth intercostal muscles was performed with levobupivacaine (0.6 mg/kg). The first five patients were only given the single-shot field block (Single group). The remaining six patients were given levobupivacaine continuously (0.1 mg/kg/hr) through an indwelling catheter until the chest tube removal (Continuous group). The groups' vital signs, total amounts of acetaminophen used, postoperative courses were compared. RESULTS: Although the heart rate did not differ between the groups, the respiratory rate was significantly higher in the Single group versus the Continuous group at 16 and 32 hr post-surgery (35.6±9.7/min vs. 18.5±4.7/min; p=0.007, 43.0±10.4 vs. 25.3±3.1; p=0.042, respectively). The accumulated dosage of acetaminophen given by postoperative day 2 was significantly higher in the Single group versus the Continuous group (55.3±22.1 mg/kg vs. 7.8±17.4 mg/kg; p=0.012). CONCLUSIONS: Continuous field block via intercostal muscles after ASD closure via a mini-right thoracotomy in children was effective to stabilize the vital signs and reduce the analgesic medication use.

DOI： 10.1272/jnms.JNMS.2021_88-507

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: Apicoaortic bypass has double outlets and its graft design is similar to that of a left ventricular assist device (LVAD). The left ventricular apex to the descending aorta (LV-DsAo) bypass is widely used in apicoaortic bypass. In contrast, the left ventricular apex to the ascending aorta (LV-AsAo) bypass is standard in LVAD surgery. This study aimed to evaluate the graft designs of apicoaortic bypass and their effects on flow distribution and energy loss (EL). METHODS: A simulation study using computational fluid dynamics was performed on the geometry and hemodynamics data obtained from a 30-year-old patient who underwent a LV-DsAo bypass. The ratio of the cardiac output (CO) through the ascending aorta (AsAo) and apicoaortic conduit was set at 50:50, 30:70, and 10:90. Regional blood flow (RBF) and EL were calculated for the different distribution ratios. As an alternative to the LV-DsAo bypass, a virtual LV-AsAo bypass surgery was performed, and each parameter was compared with that of the LV-DsAo bypass. RESULTS: At a distribution ratio of 50:50, the RBF to the head and EL were 16.4% of the total CO and 62.0 mW in the LV-DsAo bypass, and 32.3% and 81.5 mW in the LV-AsAo bypass, respectively. The RBF to the head decreased with the CO through the AsAo in the LV-DsAo bypass, but it was constant in the LV-AsAo bypass. The EL increased inversely with the CO through the AsAo in both graft designs. CONCLUSION: The regional blood flow distribution was different, but the trend of the EL which increased inversely with the CO through the AsAo was similar between the LV-DsAo and LV-AsAo bypasses.

DOI： 10.1007/s11748-020-01527-8

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: To investigate mid- to long-term morbidity and mortality after the repair of partial anomalous pulmonary venous connections (PAPVCs). METHODS: We retrospectively analyzed the cases of 29 consecutive patients who underwent surgery in 1991-2010 at Tokyo Women's Medical University Hospital. Median follow-up period: 9.9 years. Median age at operation: 7.4 years. Median body weight: 22.4 kg. Right PAPVC (n = 23), left-PAPVC (n = 5), and mixed PAPVC (n = 1) were identified. RESULTS: In the 14 patients with a right upper pulmonary vein (PV) connected to the superior vena cava (SVC) and/or cavo-atrial junction, the following were performed: single-patch diversion (n = 6), double-patch diversion (n = 4), Warden procedure (n = 1), and atrial septation with the atrial wall (n = 3). In the nine patients with a right anomalous PV connected to the right atrium (RA) and/or coronary sinus, intra-atrial rerouting was performed (n = 7) and translocation of the atrial septum (n = 2). Intra-atrial rerouting of the left upper and lower PVs to the coronary sinus (n = 1) and direct anastomosis of the left upper PV to the left atrial appendage (n = 4) were performed. Double-patch diversion and direct anastomosis of the left upper PV to the left atrial appendage was performed in a patient with mixed PAPVC. There were no post-operative deaths or reoperations, although transient sinus node dysfunction occurred (n = 2 with atrial septation and intra-atrial rerouting), while mild stenosis of the SVC occurred (n = 1 with double-patch diversion). CONCLUSIONS: The various methods which we used for PAPVC repair all appear to have reasonable outcomes, although rhythm disturbance and stenotic complications were confirmed in a few patients.

DOI： 10.1007/s11748-020-01429-9

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Complete tumor resection is a standard strategy in the surgical treatment of ventricular tachycardia (VT) associated with cardiac tumors. Recently, an intraoperative electroanatomic mapping system (CARTO) has enabled surgeons to target the localized arrhythmogenic substrate for partial resection and/or cryoablation in nonresectable cardiac tumors. OBJECTIVE: The purpose of this study was to evaluate the surgical procedures and late outcomes of the treatment of VT associated with cardiac tumors. METHODS: We examined six patients (age 1-65 years) who had undergone surgical treatment of VT associated with cardiac tumors between 2010 and 2016. The 4 pathologies of the cardiac tumors were lipoma 2, fibroma 2, hemangioma 1, and lymphoma 1. Intraoperative epicardial mapping using CARTO was performed in 5 patients(80%). Surgical procedures and long-term outcomes were evaluated. RESULTS: Arrhythmogenic substrates with abnormal electrograms, such as fractionated or late potential, were identified locally or circumferentially beside the tumor in every patient. Complete tumor resection with cryoablation was performed in 3 patients. Two patients underwent partial tumor resection with cryoablation. Cryoablation without tumor resection was performed in 1 patient. No mortality and morbidity occurred. Additional catheter ablation was required in 2 patients to treat occurrence of nonclinical VT and induction of clinical VT during hospital stay. Mean follow-up time was 90 ± 52.5 months. There was no recurrence of clinical VT. CONCLUSION: The outcomes of surgical treatment of VT associated with cardiac tumors were excellent. Intraoperative CARTO mapping was beneficial to eliminate the VT substrates associated with nonresectable cardiac tumors.

DOI： 10.1016/j.hrthm.2019.08.025

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: A right aortic arch is a congenital vascular anomaly that is present in up to 0.1% of pregnancies. The anomaly observed by fetal ultrasonography was recently reported to indicate vascular and chromosomal abnormalities that may complicate postnatal management. CASE PRESENTATION: We report the successful resection of a Kommerell's diverticulum with left subclavian artery transfer to the left carotid artery in a 5-month-old Japanese boy. The patient was prenatally diagnosed as having a right aortic arch, and a vascular ring was confirmed at 4 months of age with enhanced computed tomography. The pathology of the resected aortic wall revealed severe disruption and fragmentation of elastic fibers associated with a disarray of smooth muscle cells in the tunica media, and cystic medial necrosis with mucoid extracellular matrix deposition. CONCLUSION: These abnormal pathological findings supported the resection of Kommerell's diverticulum at this point of time, and division of the ligamentum arteriosus alone was not recommended. Early intervention in this condition once the diagnosis is made may thus be advocated. The fetal diagnosis of a right aortic arch may provide a clue to the possibility of a vascular ring.

DOI： 10.1186/s40792-019-0726-2

PubMed

researchmap

DOI： 10.1177/2150135118755984

PubMed

researchmap

Language：English   Publisher：ELSEVIER SCIENCE INC  

We report the successful primary anatomic correction of an atrioventricular septal defect with transposition of the great arteries and pulmonary stenosis in a 4-year-old girl with left isomerism by common atrioventricular valve division, Mustard-type atrial septation, and a Rastelli operation with ventricular septal defect enlargement. To the best of our knowledge, this is the first report of total correction for this combination of cardiac anomalies. (C) 2017 by The Society of Thoracic Surgeons.

DOI： 10.1016/j.athoracsur.2016.09.080

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

The algorithm for the physiological control provided by left ventricular assist devices (LVADs) has been controversial. In particular, little is known about the physiological control algorithm (such as for achieving physiological circadian rhythms) in continuous-flow LVADs. To investigate the existence of circadian variation, we retrospectively evaluated the LVAD flow-correlated motor current of patients supported by continuous-flow LVADs. The motor current and the pump speed were collected from the external controller every 10 min after device implantation, and the data were divided for every 30-day period, which began on midnight on the first post-operative day. The subjects were 18 patients (mean age 37.7, mean body surface area 1.71 m(2) at the time of operation) with dilated cardiomyopathy or dilated phase of hypertrophic cardiomyopathy. As of August 1, 2013, the patients' median support duration was 889 days. The mean calculated dominant period of motor current variation was 24.0 h and the mean amplitude was 11.7 mA for the entire duration. The amplitude of the motor current circadian variation tended to be increased until around the fifth month. The motor current had a tendency to be relatively low during the night time and high during the day time. A significant difference was found between the night-time and day-time mean motor current for the entire duration (p &lt; 0.05). In conclusion, the circadian variation of the motor current could be observed over long term in patients with fixed rotation speed continuous-flow LVAD support.

DOI： 10.1007/s10047-014-0762-4

Web of Science

PubMed

researchmap

Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society for Cardiovascular Surgery  

DOI： 10.4326/jjcvs.42.141

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Background. Surgical results for functional univentricular heart with total anomalous pulmonary venous connection (TAPVC) have been unsatisfactory to date.
Methods. During a 25-year period until December 2009, 207 TAPVC patients underwent surgical repair at our institute, including 56 with a univentricular heart. The 10-year survival rate was 51.1% with univentricular heart and 84.7% with biventricular heart (p &lt; 0.0001; log-rank, 27.6). Surgical outcomes and risk factors for early and late death after TAPVC repair in univentricular hearts were retrospectively analyzed.
Results. Patients were aged 3.8 +/- 4.3 years and weighed 12.3 +/- 10.7 kg at operation. Preoperative diagnoses included heterotaxy syndrome in 55, asplenia in 48, preoperative pulmonary venous obstruction in 35, and pulmonary atresia in 20. TAPVC was classified as I in 22, II in 26, III in 5, and IV in 3. Concomitant procedures included Fontan procedure in 29, bidirectional Glenn procedure in 5, systemic-pulmonary shunt in 11, and pulmonary artery banding in 5. There were 17 hospital deaths and 11 late deaths. Fontan completion was undertaken in 31 (55.3%). Postoperative pulmonary venous obstruction was found in 15. Multivariate analysis identified TAPVC III and IV and pulmonary atresia as risk factors for hospital death. Univariate analysis identified postoperative pulmonary venous obstruction and concomitant systemic-pulmonary shunt as risk factors for hospital and late death.
Conclusions. TAPVC III, IV, and pulmonary atresia are risk factors for early postoperative death. Intensive intervention, including perioperative management and operation, is required in these complex patients. (Ann Thorac Surg 2012;93:606-13) (C) 2012 by The Society of Thoracic Surgeons

DOI： 10.1016/j.athoracsur.2011.09.038

Web of Science

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.11312/ccm.32.95

researchmap

Bicuspid aortic valve (BAV) is a common congenital heart disease, and it is well known to be a risk factor for ascending aortic dilatation and dissection. We here report a case of 34-year-old woman who underwent Ross procedure with ascending aortic replacement under the diagnosis of subaortic stenosis and ascending aortic aneurysm. She was pointed out to have heart murmur soon after the birth diagnosed as patent ductus arteriosus. The ductus was ligated when she was 3-years-old, however, heart murmur remained. Further examinations revealed that she also had aortic stenosis with BAV. During her 20-year-follow-up, subaortic stenosis and ascending aorta ectasia were also progressed. Pathological examinations of resected ascending aortic wall showed mucoid degeneration and laceration of collagen fibers, suggesting the fragility of dilated aortic wall with BAV.

Scopus

PubMed

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.11312/ccm.29.159

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：(一社)日本外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本腹部救急医学会  

researchmap

Language：Japanese   Publisher：(一社)日本成人先天性心疾患学会  

researchmap

Language：Japanese   Publisher：(NPO)日本血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本血管外科学会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：(一社)日本胸部外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本胸部外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本胸部外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本血管外科学会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：(一社)日本胸部外科学会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：(一社)日本胸部外科学会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：(一社)日本胸部外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本胸部外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本血管外科学会  

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：(公社)日本小児科学会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：(公社)日本皮膚科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：日本成人先天性心疾患学会  

researchmap

Language：Japanese   Publisher：日本成人先天性心疾患学会  

researchmap

Language：Japanese   Publisher：(NPO)日本血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本血管外科学会  

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：Japanese   Publisher：(NPO)日本血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本血管外科学会  

researchmap

Language：Japanese   Publisher：医学図書出版(株)  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：(一社)日本外科学会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本血管外科学会  

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：(NPO)日本血管外科学会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

researchmap

J-GLOBAL

researchmap

Language：Japanese   Publisher：(NPO)日本冠疾患学会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(株)南江堂  

34歳女性。患者は3歳時に大動脈ニ尖弁(BAV)、大動脈狭窄症と診断され、経過観察中であった。今回、労作時息切れが出現したため、精査加療目的に入院となった。精査の結果、上行大動脈拡張を伴ったBAVおよび大動脈弁下狭窄症と診断され、Ross手術および上行弓部大動脈部分置換術が施行された。その結果、本症例では病理組織所見において、広範囲の膠原線維の断裂とムコイド変性の散在が確認され、大動脈壁の脆弱性と上行大動脈の拡張の原因の一つと考えられた。尚、術後は経過良好であった。

CiNii Books

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2009016932

Language：Japanese   Publisher：社団法人日本循環器学会  

CiNii Books

researchmap

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

researchmap

Language：English   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：English   Presentation type：Poster presentation  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：English   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Poster presentation  

researchmap

Language：English   Presentation type：Poster presentation  

researchmap

Language：Japanese   Presentation type：Poster presentation  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

researchmap

Language：Japanese   Presentation type：Poster presentation  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Poster presentation  

researchmap

Language：Japanese   Presentation type：Poster presentation  

researchmap

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

researchmap

Language：Japanese   Presentation type：Poster presentation  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Poster presentation  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Oral presentation (invited, special)  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：English   Presentation type：Poster presentation  

researchmap

Language：English   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Poster presentation  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Language：Japanese  

researchmap

Language：English   Presentation type：Oral presentation (general)  

researchmap

Language：English   Presentation type：Oral presentation (general)  

researchmap

Presentation type：Oral presentation (general)  

researchmap

Presentation type：Poster presentation  

researchmap

Presentation type：Oral presentation (general)  

researchmap