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

researchmap

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

OBJECTIVE: This study aimed to investigate whether St. Thomas' Hospital No. 2 solution (STH2) is equally effective in both young and aged aquaporin-7-knockout (AQP7-KO) mice and the mechanisms by which the intra-myocardial adenosine triphosphate (ATP) content is altered during ischemia without aquaporin-7. METHODS: In study 1, isolated hearts of male wild-type (WT) and AQP7-KO mice (< 12 weeks old) were Langendorff perfused with 5-min STH2 prior to a 20-min global ischemia (GI) or 25-min GI without STH2. Similarly, in Study 2, hearts from WT and AQP7-KO mice (≥ 24 weeks old) were subjected to 2-min STH2 infusion prior to GI. In study 3, intra-myocardial ATP content was compared before (sham) and after (control or STH2) ischemia in mature WT and AQP7-KO mice. RESULTS: In study 1, troponin T levels (ng/g wet weight) of WT and AQP7-KO hearts were significantly lower in the STH2 groups (75.6 ± 45.9 and 80.2 ± 52.2, respectively) than in the GI groups (934.0 ± 341.1 and 1089.3 ± 182.5, respectively). In Study 2, troponin T levels in aged WT and AQP7-KO mice were 566.5 ± 550.0 and 547.8 ± 594.3, respectively (p = 0.9561). In Study 3, ATP levels (μmol/g protein) in the sham, control, and STH2 AQP7-KO mice groups were 4.45, 2.57, and 3.37, respectively(p = 0.0005). CONCLUSIONS: The present study revealed the cardio-protective efficacy of STH2 in an experimental model of isolated AQP7-KO young and aged murine hearts. Further, STH2 preserved intra-myocardial ATP during ischemia with Krebs-Henseleit buffer perfusion in the Langendorff setting.

DOI： 10.1007/s11748-023-01975-y

PubMed

researchmap

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

researchmap

Language：English   Publisher：(一社)日本循環器学会  

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：(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：(一社)日本外科感染症学会  

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：日本医科大学医学会  

72歳女性。胸背部痛を主訴に救急要請し、ドクターヘリにて当院へ搬送された。胸腹部CTにて急性大動脈解離と診断され、選択的順行性脳灌流下に4分枝付人工血管を用いて腕頭動脈まで部分弓部大動脈人工血管置換術が行われた。術後2日で抜管し、3日より経口摂取を開始したが、心嚢ドレーン排液の白濁化が持続しており、その排液は胸腔ドレーンからでなく、心嚢内の傍人工血管に留置したドレーンからの排液であったことから、乳糜心嚢液の合併と診断された。そこで、無脂肪食とソマトスタチンアナログ製剤の皮下注射を行ったところ、ドレーン排液量はやや減少したものの、100mL/日以上は流出が持続した。第7病日にリンパ管造影検査を施行した結果、リンパ管損傷部は大動脈弓部小彎に位置し、術中の大動脈壁剥離時に損傷した可能性が考えられた。胸管の結紮が必要と思われたが、リンパ管造影検査後からはドレーン排液量は著明に減少し、第17病日にドレーン抜去が可能となり、第27病日に軽快退院となった。

researchmap

Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J04260&link_issn=&doc_id=20220831380010&doc_link_id=%2Fcw1nimed%2F2022%2F001803%2F012%2F0294-0298%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcw1nimed%2F2022%2F001803%2F012%2F0294-0298%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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：(一社)日本外科学会  

researchmap

Language：English   Publisher：(一社)日本循環器学会  

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：English   Publisher：(一社)日本循環器学会  

researchmap

Authorship：Lead author   Language：Japanese  

researchmap

Language：Japanese   Publisher：(一社)日本人工臓器学会  

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

Isolated internal iliac artery aneurysms are rare, and there are no reports of human immunodeficiency virus (HIV)-related vasculitis in Japan. We report our experience with a 51-year-old man diagnosed with acquired immunodeficiency syndrome, discovered during the postoperative course when the patient exhibited remittent fever and susceptibility to infection after emergency interventional radiology therapy for a right isolated internal iliac artery aneurysm. The patient had positive treponema pallidum particle agglutination test result before admission, and tests for sexually transmitted disease showed positive results for HIV H-1 antibodies. The repeated fevers were attributed to HIV infection-related susceptibility.

DOI： 10.3400/avd.cr.20-00139

PubMed

researchmap

Language：English  

In the present report, we have described the case of a 79-year-old woman who presented with acute right lower limb ischemia and was diagnosed with bilateral persistent sciatic arteries and a right persistent sciatic artery aneurysm. Concomitant widespread thrombotic occlusion was present, extending from the orifice of the right internal and external iliac arteries to the below-the-knee popliteal artery. These complicated lesions were successfully treated using only percutaneous endovascular procedures, including stent-graft placement, bare metal stent implantation, and thrombolysis. Our report illustrates how a combination of techniques can achieve total endovascular repair of a persistent sciatic artery aneurysm accompanied by occlusion of the internal and external iliac arteries.

DOI： 10.1016/j.jvscit.2020.09.012

PubMed

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：(一社)日本外科感染症学会  

researchmap

Language：Japanese   Publisher：(一社)日本脈管学会  

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：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Spatial dispersion of atrial activation is a cause of postoperative atrial fibrillation (PoAF) after cardiac surgery. This study evaluated whether temporal dispersion of atrial activation causes PoAF after surgery in a clinical setting. METHODS: Nineteen patients were enrolled. Postoperative atrial activation was evaluated by 24-hour Holter electrocardiography, with atrial pacing wires on the right atrium, for 5 days after cardiac surgery. No patient received antiarrhythmic drugs, including beta-blockers. The cycle length of 15 continuous atrial beats was measured at 4 time points: (i) earlier than 12 hours before PoAF, as a control, (ii) just before PoAF onset, (iii) during PoAF, and (iv) just before cessation of PoAF. Inhomogeneity of atrial activation was quantified by using the variation coefficient for a cycle length of 15 atrial beats during each phase. RESULTS: The median inhomogeneity index of atrial activation (interquartile range) was 0.102 (0.046-0.136) in controls, 0.943 (0.582-1.610) just before PoAF onset (vs. control; p=0.009), 0.966 (0.631-1.117) during PoAF, and 0.471 (0.138-0.645) just before cessation of PoAF. CONCLUSIONS: Dispersion of atrial activation significantly increased just before PoAF onset. Temporal dispersion of atrial activation is a precursory variation of PoAF.

DOI： 10.1272/jnms.JNMS.2020_87-402

PubMed

researchmap

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

researchmap

Language：English  

We present a case of an 85-year-old woman with bilateral limb-threatening ischemia caused by acute-on-chronic occlusion of the infrarenal aorta. The patient once underwent endovascular recanalization using nitinol and stainless-steel bare-metal stent implantation; however, the stainless-steel stent collapsed 3 months later. In the second endovascular therapy, "Squid-Capture" modified in situ stent-graft fenestration technique followed by stent-in-stent implantation with stent graft and bare-metal stent was successfully applied, and it can be regarded as a promising treatment option for the repair of abdominal aortic occlusive disease in some limited anatomical conditions.

DOI： 10.1016/j.avsg.2019.12.021

PubMed

researchmap

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

PURPOSES: To retrospectively evaluate the effect of negative-pressure sternal wound closure (NPSWC) with a subcutaneous closed drain tube on the sternal surgical site infection (SSI) incidence. METHODS: After propensity score matching of 231 patients undergoing coronary artery bypass grafting (CABG), we compared 104 pairs in the NPSWC and historical control groups. In the molecular analysis, the interleukin-6 (IL-6), basic fibroblast growth factor (b-FGF), and transforming growth factor β1 (TGF-β1) levels in the wound fluid were measured using two different reservoir types at postoperative days 2 and 7. RESULTS: NPSWC significantly reduced the SSI incidence from 10.6 to 2.9%. No mediastinitis occurred in the NPSWC group. A multivariate logistic regression analysis identified female sex (p = 0.0040) and no NPSWC (p = 0.0084) as significant risk factors for sternal SSI development. The Negative-pressure value was 49.4 ± 4.1 and 115.5 ± 15.2 mmHg in the standard-type (SSR) and bulb-type suction reservoirs (BSR), respectively. Given that growth factors were affected by the difference in negative pressure, the IL-6, b-FGF, and TGF-β1 levels were significantly higher in the BSR than in the SSR. CONCLUSIONS: NPSWC using a subcutaneous closed drain tube was effective in preventing sternal SSI after CABG and may accelerate wound healing even when both internal thoracic arteries are harvested. CLINICAL REGISTRATION NUMBER: University Hospital Medical Information Network Clinical Trials Registry, registration number: UMIN000037060.

DOI： 10.1007/s00595-019-01912-8

PubMed

researchmap

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

PURPOSE: To present long-term results obtained with endovascular abdominal aortic aneurysm (AAA) repair (EVAR) using the Zenith AAA endovascular graft from a single institution. MATERIALS AND METHODS: Between 2007 and 2013, 95 consecutive patients (median age 77 years) underwent EVAR using Zenith. Data were prospectively collected and retrospectively analyzed until 2019. Primary outcomes were overall survival, freedom from AAA rupture, and freedom from AAA-related death. Secondary outcomes were freedom from late (> 30 days) re-intervention and surgical conversion, and freedom from aneurysm sac growth (> 5 mm). RESULTS: The initial technical success rate was 96.8%. There were no deaths or intraoperative conversions. Overall survival at 1, 3, 5, and 10 years was 90.8%, 81.7%. 74.3%, and 57.2%, respectively. AAA rupture occurred in one patient (1.1%). Freedom from AAA-related death was 100% during the follow-up period. Freedom from aneurysm sac growth at 1, 3, 5, and 10 years was 98.8%, 86.4%, 76.9%, 53.0%, respectively. Freedom from late re-intervention and open surgical conversion at 1, 3, 5, and 10 years was 98.9%, 88.9%, 86.7, and 57.9%, respectively. CONCLUSION: EVAR with Zenith endografts represents a safe and durable means of AAA repair, and risk of rupture and aneurysm-related death are low.

DOI： 10.1007/s11604-019-00892-6

PubMed

researchmap

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

researchmap

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

researchmap

Language：English   Publisher：EUROPA EDITION  

DOI： 10.4244/EIJ-D-16-00067

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICAL TRIBUNE INC  

This report describes a case of surgical treatment for a coronary artery saccular aneurysm of the left main bifurcation. A coronary artery saccular aneurysm (7 mm x 10 mm) and three vessel disease, including the left main trunk, were diagnosed by coronary angiography. A surgical resection and saphenous vein patch repair of the left main coronary artery aneurysm was performed concomitantly with coronary artery bypass grafting. The pathological findings of the aneurysm clarified that the aneurysm wall was atrophic and extremely thin because of a collapsed trilaminar arterial structure due to atherosclerosis. A coronary computed tomographic scan revealed no aneurysmal formation in the patent left main trunk and patent grafts 3 years after surgery.

DOI： 10.5761/atcs.cr.16-00064

Web of Science

PubMed

researchmap

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

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICAL ASSOC NIPPON MEDICAL SCH  

Objective: Although recent progress has expanded the indications for thoracic aortic surgery to include elderly patients, the procedure remains extremely invasive. We performed a chart review to determine the early and late outcomes of thoracic aortic surgery using hypothermic circulatory arrest (HCA) and antegrade selective cerebral perfusion (ASCP) in octogenarians.
Materials and Methods: Of 79 patients who underwent surgery for thoracic aortic aneurysms from April 2007 through December 2012, 8 patients 80 years or older were selected for analysis. Mean age at the time of surgery was 84.3 +/- 1.39 years. The diagnoses were aortic dissection in 5 patients and degenerative thoracic aneurysm in 3 patients. All patients underwent surgery with HCA. The lowest body temperature was 25 degrees C. ASCP was used as an additional brain-protection technique. Emergency operations were performed in 5 patients (62.5%).
Results: The mean duration of HCA was 60.4 +/- 19.7 minutes, that of aortic cross-clamping time was 143.0 +/- 30.4 minutes, and mean pump time was 207.8 +/- 44.4 minutes. The hospital mortality rate was 0%. Major postoperative complications occurred in 3 (37.5%) patients: stroke, temporary neurologic dysfunction, and paraparesis in 1 patient each. No patients required temporary dialysis for new-onset renal dysfunction. There were no deaths during the 65-month follow-up period.
Conclusion: The early and late outcomes after thoracic aortic surgery at our hospital using RCA with ASCP in octogenarians are acceptable. The operations are performed with an acceptable operative risk, even under emergency situations, including acute aortic dissection.

DOI： 10.1272/jnms.81.12

Web of Science

PubMed

researchmap

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

Mediastinal teratoma generally arises in the anterior mediastinum. Posterior mediastinal teratomas have been rarely reported to date, especially in adults. We report a case of posterior mediastinal teratoma in a 57-year-old woman. The pre-operative diagnostic work-up revealed a posterior mediastinal tumor with calcification and fluid components. The tumor, adhering to the descending aorta, was radically removed through video-assisted thoracic surgery. Histological examination was concluded for a mature teratoma with cystic change. The imaging features of posterior mediastinal teratomas are identical to those in the anterior mediastinum, except for their location. To be different from anterior mediastinal teratomas, benign teratomas in the posterior mediastinum are often involved with a major surrounding structure, including aorta, chest wall, and esophagus. When a posterior mediastinal tumor has the typical features of a mature teratoma in the pre-operative findings, the adhesion to the surrounding structure should be considered. © 2012 The Japanese Association for Thoracic Surgery.

DOI： 10.1007/s11748-012-0168-2

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICAL TRIBUNE INC  

An infected aortic arch aneurysm is a rare but life-threatening condition. Moreover, surgical treatment for patients with severe calcified aorta is challenging and needs a well-planned strategy. We report a patient with an infected aortic arch aneurysm concomitant with severe calcification of the aorta in whom good results were obtained with open stent grafting in combination with a trifurcated graft.

DOI： 10.5761/atcs.cr.12.01932

Web of Science

PubMed

researchmap

Language：English   Publisher：ELSEVIER SCIENCE INC  

DOI： 10.1016/j.jacc.2012.08.1040

Web of Science

PubMed

researchmap

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

Thymoma has malignant potential and is the most common anterior mediastinal tumor. Video-assisted thoracic surgery (VATS), which is less invasive surgical procedure, is a good option for resecting Masaoka stage I tumors. Whether VATS is appropriate, depends on the surgeon's judgment and accurate imaging diagnosis. We introduce a technique involving a combination of video-assisted thoracoscopic thymectomy (VAT-T) and lateral thoracotomy for stage II and some stage III thymomas that have locally invaded the lung and/or pericardium.

DOI： 10.5761/atcs.nm.11.01816

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：EDIZIONI MINERVA MEDICA  

Aim. Atrial fibrillation is one of the most common postoperative arrhythmias following cardiac surgery. Despite many clinical studies, there is still no consensus on the most appropriate prevention strategy for atrial arrhythmia. A randomized prospective trial was conducted to determine the efficacy of intravenous landiolol administration in the early period after off-pump coronary artery bypass grafting (CABG) followed by treatment with carvedilol for prevention of atrial fibrillation.
Methods. Seventy consecutive patients were enrolled in the study prospectively. Patients in the treated group received landiolol intravenously (5 mu g/kg/min) in the ICU immediately after surgery. Heart rate was maintained at 60-80 bpm and intravenous landiolol was continued at 0-10 mu g/kg/min until oral drug administration was possible. All patients received oral carvedilol (2.5-5 mg/day) after extubation and this was continued postoperatively. The primary endpoint was the overall development of postoperative atrial fibrillation.
Results. Postoperative atrial fibrillation occurred in 4 (11.1%) of the 36 patients in the landiolol group, compared with 11 (32.3%) of the 34 patients in the control group, indicating that development of atrial fibrillation was significantly inhibited by landiolol (P=0.042). No major postoperative complications occurred in the landiolol group.
Conclusions. Postoperative intravenous landiolol therapy followed by oral carvedilol may be more effective than oral carvedilol alone for prevention of atrial fibrillation after off-pump CABG. We also found that intravenous landiolol is well tolerated after cardiac surgery.

Web of Science

researchmap

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

In this report, a 27-year-old woman with a solitary pulmonary nodule is described. Because computed tomography-guided biopsy could not confirm the diagnosis, surgical treatment was performed by video-assisted thoracic surgery. Histological findings showed cytotrophoblasts and syncytiotrophoblasts, suggesting choriocarcinoma. However, there were no abnormal findings on gynecological examination, including ultrasonography, magnetic resonance imaging, and positron-emission tomography. Choriocarcinoma is a malignant neoplasm and can arise after a pregnancy, as a component of germ cell tumors, or in association with a poorly differentiated somatic carcinoma. Our patient, a young female with an antecedent gestation, has no recurrence after surgery. There were tumor emboli in pulmonary arteries and no component of primary lung carcinoma on histological examination. These findings indicate that the lesion was a metastasis of gestational choriocarcinoma. A rare case of a patient with metastatic gestational choriocarcinoma of a solitary pulmonary nodule without any uterine abnormality is presented. © The Japanese Association for Thoracic Surgery 2012.

DOI： 10.1007/s11748-012-0009-3

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMJ Publishing Group  

DOI： 10.1136/bcr-2012-006843

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN SOC INTERNAL MEDICINE  

A 70-year-old man presented with sudden onset of global aphasia and right hemiplegia. Brain MRI revealed occlusion of the left middle cerebral artery. He was diagnosed as having a hyperacute cerebral infarction. Intravenous thrombolytic therapy was started, and the neurological symptoms were resolved after 11 h. Echocardiography showed a mobile mass in the left atrium, suspicious of a myxoma. The tumor was resected and pathologically diagnosed as a myxoma. In this patient, intravenous thrombolytic therapy was effective, and no adverse effects were observed. This suggests that, even with complications of myxoma, thrombolytic therapy can be considered if there are no contraindications.

DOI： 10.2169/internalmedicine.50.5545

Web of Science

PubMed

researchmap

Language：Japanese   Publisher：The Japanese Association for Chest Surgery  

A 38-year-old female was referred to our hospital because of an anterior mediastinal tumor identified by computed tomography (CT). Chest CT and MRI showed a cystic shadow in the anterior mediastinum. We suspected that the tumor was a thymic cyst, lymphangioma, or malignant lymphoma. The tumor was completely resected. Regarding pathological findings, the tumor was a thymic MALT lymphoma. We report a surgical case of thymic MALT lymphoma in the anterior mediastinum.

DOI： 10.2995/jacsurg.24.804

CiNii Books

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2010290536

Language：English   Publishing type：Research paper (scientific journal)   Publisher：OXFORD UNIV PRESS  

Cardiopulmonary bypass (CPB) has been implicated as a cause of acute lung injury (ALI) in cardiac surgical patients. We used a bronchoscopic microsampling (BMS) probe to examine alveolar biochemical constituents and evaluated the effect of sivelestat sodium hydrate, a novel synthesized polymorphonuclear (PMN) neutrophil elastase inhibitor, on ALI induced by CPB. Twelve patients undergoing aortic valve replacement were treated with either sivelestat 0.2 mg/kg/h (sivelestat group, n=6) or 0.9% saline (control group, n=6) from the start of surgery. Samples were collected by the BMS probe at three time points: after tracheal intubation, 1 h after CPB introduction, and 3 h after CPB termination. Pulmonary function was assessed perioperatively. There were no differences in baseline characteristics. The concentration of PMN elastase was significantly suppressed in the sivelestat group, compared with the control group (P=0.001). The sivelestat group also had lower levels of interleukin-6 and interleukin-8. Alveolar-arterial oxygen difference markedly increased, and a worsening of the PaO2/FiO(2) ratio indicated severe impairment after CPB. However, sivelestat attenuated the pattern of physiological deterioration of gas exchange. Sivelestat may attenuate neutrophil elastase or proinflammatory cytokines, and improve pulmonary dysfunction in patients undergoing CPB. (C) 2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

DOI： 10.1510/icvts.2009.225243

Web of Science

PubMed

researchmap

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

We report a rare case of venous hemangioma (VH) of the anterior mediastinum in a 56-year-old man admitted to our hospital because of hematemesis. Systemic examinations were performed and chest computer tomography (CT) revealed a 1.5-cm sized small nodule with contrast enhancement in the thymus. Both CT and magnetic resonance imaging (MRI) suggested a solid tumor such as a thymoma or neurogenic tumor rather than a vascular neoplasm. A partial thymectomy including this nodule by video-assisted thoracic surgery (VATS) was performed. Histological examination showed VH. There was no recurrence with no further treatment.

DOI： 10.1272/jnms.77.115

Scopus

PubMed

researchmap

Language：Japanese   Publisher：The Japanese Association for Chest Surgery  

A 40-year-old male was referred to our hospital because of an abnormal shadow on a chest radiograph. Ten years ago, he underwent an operation for an immature teratoma arising in the anterior mediastinum. During follow-up, chest CT showed a homogenous tumor of 6.0 cm in diameter in the anterior mediastinum without calcification, adjacent to the three vessels branching from the aortic arch. The tumor showed fibrous adhesion around the vessels, and was completetely resected. Pathological examination revealed a cavernous hemangioma. We report a surgical case of cavernous hemangioma of the anterior mediastinum, with a review of the literature.

DOI： 10.2995/jacsurg.24.206

CiNii Books

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2010149085

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

Sivelestat, a neutrophil elastase inhibitor, has been shown to attenuate pulmonary injury during ischemia and reperfusion by improving microcirculation and may be effective as a cardioprotective agent. Isolated rat hearts were Langendorff-perfused (constant pressure, 75 mmHg) with oxygenated Krebs-Henseleit bicarbonate buffer (KHB). The optimal sivelestat concentration at 19 μmol/l was revealed because left ventricular developed pressure (LVDP) recovery in 19 μmol/l sivelestat was highest among 0.19, 1.9, 19, 190, and 1900 μmol/l sivelestat (26±10, 33±7, 56±5*, 35±2, and 15±5%, respectively
*P&lt
0.01). In order to examine the optimal administration timing, sivelestat was administered at pre- and post-ischemic phases. LVDP recovery and troponin-T were observed in pre-, post-ischemic sivelestat groups and control. After 60 min-reperfusion, LVDP recoveries were 42±10*, 45±19*, and 14±5%, respectively (*P&lt
0.01 compared to control), and troponin-T values were 4±1, 2±1**, and 8±2, respectively (**P&lt
0.05 compared to control). Acetylcholine-induced increase in coronary flow was also investigated to examine the sivelestat's cardioprotective mechanism. Ischemia-reperfusion (I/R) impaired the acetylcholine-induced increase in coronary flow (maximal changes: sham, 125±11%
I/R, 98±3
P&lt
0.01) and this impairment was attenuated by sivelestat-perfusion at reperfusion (maximal change: 112±7%
P&lt
0.05 vs. I/R). Sivelestat attenuates coronary endothelial ischemia-reperfusion injury and improves myocardial protection even when administered at the reperfusion period. This suggests a role for sivelestat in the preservation of coronary endothelial function enhancing myocardial protection. © 2009 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

DOI： 10.1510/icvts.2008.195933

Scopus

PubMed

researchmap

Language：English   Publisher：JAPANESE SOCIETY FOR VASCULAR SURGERY  

Aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysm (AAA) involving fewer than 1% of all AAAs. ACF through a contained ruptured aortic aneurysm is an extremely uncommon complication following ruptured abdominal aortic aneurysm. ACF may cause severe hemodynamic disturbance due to a left-to-right shunt. We report here a case of ACF secondary to a contained ruptured abdominal aortic aneurysm, in a 65-year-old woman, which to our knowledge has not been reported in the literature before. Its diagnosis and treatment are presented in this article.

DOI： 10.11401/jsvs.16.777

CiNii Books

researchmap

Language：English  

PubMed

CiNii Books

researchmap

Language：English   Publisher：(資)医薬出版  

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN HEART JOURNAL, SECOND DEPT OF INTERNAL MED  

We report a rare case of massive left atrial lipoma occupying pericardal space. A 52-year-old male was admitted because of cardiomegaly of unknown etiology. Computed tomography showed a large epicardial mass located along the anterior surface of the heart, from the diaphragm level through the aortic arch level. The mass showed an attenuation value identical with that of subcutaneous adipose tissue and contained some areas with high density. The mass was not enhanced by contrast media. Histologic examination of the specimen obtained by percutaneous biopsy demonstrated mature adipose tissue. An encapsulated adipose mass weighing 620 which originated from the left atrium without any invasion to the pericardium, was completely excised. Microscopic examination revealed mature adipose tissue with partial necrosis confirming the diagnosis of lipoma.

DOI： 10.1536/jhj.45.715

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (international conference proceedings)   Publisher：Japanese Association for Thoracic Surgery  

Two patients in whom myocardial infarction in the inferior wall occurred after off-pump coronary artery bypass grafing (OPCAB) are described. In both patients, the right coronary artery had no critical lesion and was not grafted. There was no ischemic episode during operation. Coronary artery spasms and/or intracoronary thrombus formation may have been causes of these events. To our knowledge, this is the first report on perioperative myocardial infarction in OPCAB.

DOI： 10.1007/BF02719476

Scopus

PubMed

researchmap

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

Background. Observation during open heart surgery in patients with chronic atrial fibrillation (AF) showed that the activation sequence of the left atrium was regular and that of the right atrium chaotic in most patients. We speculate that the left atrium plays a role as an important electrical driving chamber for AF and by mapping preoperatively, optimal sites for the cryoablation can be determined to minimize the extensiveness of the cryolesions.
Methods. Forty patients who underwent cardiac surgery and cryoablation guided by epicardial mapping data to eliminate AF originating from the left atrium were included in this study.
Results. Sustained reentrant movement or repetitive firing from foci located in the right atrium was never observed. Foci or reentry circuits located in the left atrium were clearly identified in 11 cases. Nine of the 11 cases resumed sinus rhythm by placing cryolesions at these sites. Two cases needed a pacemaker implantation. The exact site had not been identified in the 29 remaining cases. In these 29 cases a left atrial posterior longitudinal linear cryoablation was placed. Sinus rhythm resumed in 22 cases. Six cases still remained in AF and a pacemaker was implanted in 1 case. Ultimately, in this series of operations sinus rhythm was resumed in 31 of 40 cases; AF remained in 6 of them and pacemaker implantation was required in 3 cases.
Conclusions. Mapping was useful to distinguish the two etiologies of the AF to facilitate optimal placement of the cryolesions. Sustained reentrant movement or repetitive firing from foci located in the right atrium was never observed and the left atrium played an important role as the electrical driving chamber for AF.

DOI： 10.1016/S0003-4975(02)03696-2

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MOSBY, INC  

Objective: We previously showed that arrest with multidose infusions of high-dose (1 mmol/L) esmolol (an ultra-short-acting beta-blocker) in oxygenated Krebs-Hensleit buffer (esmolol cardioplegia) provided complete myocardial protection after 40 minutes of normothermic (37degreesC) (global ischemia in isolated rat hearts. In this study we investigated the importance of oxygenation for protection with esmolol cardioplegia, compared it with that of St Thomas' Hospital cardioplegia, and determined the protective efficacy of multidose esmolol cardioplegia for extended ischemic durations.
Methods: Isolated rat hearts (n = 6/group) were perfused in the Langendorff, mode at constant pressure (75 mm Hg) with oxygenated Krebs-Henseleit bicarbonate buffer at 37degreesC. The first part of the first Study had four groups: (i) multidose (every 15 minutes) oxygenated (95% oxvoen/5% ( carbon dioxide) Krebs-Henseleit buffer during 60 minutes of global ischemia, (ii) multidose deoxygenated (95% nitrogen/5% carbon dioxide) Krebs-Henseleit buffer during 60 minutes of global ischemia, (iii) multidose oxygenated esmolol cardioplegia during 00 minutes of global ischemia, and (iv) multidose deoxygenated esmolol cardioplegia during 60 minutes of global ischemia, The second part of the first study had three groups: (v) multidose St Thomas' Hospital solution during 60 minutes of global ischemia. (vi) multidose oxygenated St Thomas' Hospital solution during 60 minutes of global ischemia, and (vii) multidose oxygenated esmolol cardioplegia during 60 minutes of global ischemia. In the second study. hearts were randomly assigned to 60, 75, 90, or 120 minutes of global ischemia and at each ischemic duration were subjected to multidose oxygenated constant flow or constant pressure infusion of (i) Krebs-Henseleit buffer (constant flow), (ii) Krebs-Henseleit buffer (constant pressure), (iii) esmolol cardioplegia (constant flow). or (iv) esmolol cardioplegia (constant pressure). All hearts were reperfused for 60 minutes, and recovery of function was measured.
Results: Multidose infusion of oxygenated esmolol cardioplegia completely protected the hearts (97% +/- 5%) after 60 minutes of 37degreesC global ischemia. Deoxygenated esmolol cardioplegia was significantly less protective (45% +/- 8%). Oxygenation of St Thomas' Hospital solution did not alter its protective efficacy in this study (70% +/- 4% vs 69% +/- 7%). Infusion of esmolol cardioplegia at constant pressure provided complete protection for 60. 75, and 90 minutes (104% +/- 5%, 95% +/- 5%, and 95% +/- 3%. respectively), whereas protection with constant-flow esmolol cardioplegic infusion was significantly decreased at ischemic durations longer than 60 minutes. This decrease in efficacy of constant-flow esmolol cardioplegia was associated with increasing coronary perfusion pressure leading to myocardial injury.
Conclusions: Oxygenation of esmolol cardioplegia (Krebs-Henseleit buffer plus 1.0 mmol/L esmolol) was essential for optimal myocardial protection. Multidose infusion of oxygenated esmolol cardioplegia provided good myocardial protection during extended periods of normothermic ischemia. Esmolol cardioplegia may provide an efficacious alternative to hyperkalemia.

DOI： 10.1067/mtc.2002.121976

Web of Science

PubMed

researchmap

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

Background. With the T graft configuration, multiple arterial revascularization can be accomplished using bilateral internal thoracic arteries. However, concern remains about the flow capacity of the main stem of the left internal thoracic artery (LITA).
Methods. Forty patients who underwent multiple revascularization of the entire territory of the left coronary system with a T graft were investigated. Six months after the operation, they were examined angiographically. During the same period, dobutamine stress echocardiography was performed to evaluate the adequacy of the myocardial blood supply from the T graft. The T graft revascularized two branches in 5 patients, three branches in 23, four branches in 11, and five branches in 1 of the left coronary system. Other conduits were used if revascularization was required for the right coronary system.
Results. Complete revascularization. was achieved in the left coronary territory in all patients. The LITA main stem showed a wide lumen in all patients. Luminal narrowing was present in the distal segment of the LITA in 3 patients. The right internal thoracic artery (RITA) was patent in all patients, whereas luminal narrowing was observed in the distal segment of the RITA in 5 patients. No patient exhibited ischemic wall motion abnormality in the anteroseptal, lateral, or posterolateral region of the left ventricle where the T graft revascularized. Eight patients showed ischemic response in the inferoposterior region, that is, the territory of the right coronary artery.
Conclusions. The LITA main stem, forming a T-graft configuration with the free RITA, has an adequate flow reserve to supply at least the entire left coronary arterial system with sufficient blood. Therefore, multiple coronary revascularization using the T-graft technique is feasible. (C) 2001 by The Society of Thoracic Surgeons.

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MOSBY, INC  

Objective: During myocardial revascularization, some surgeons (particularly in the United Kingdom) use intermittent crossclamping with fibrillation as an alternative to cardioplegia. We recently showed that intermittent crossclamping with fibrillation has an intrinsic protection equivalent to that of cardioplegia. In this study we hypothesized that arrest, rather than fibrillation, during intermittent crossclamping may be beneficial. Because esmolol, an ultra-short-acting P-blocker, is known to attenuate myocardial ischemia-reperfusion injury, we compared the protective effect of esmolol arrest with that of intermittent crossclamping with fibrillation and conventional cardioplegia (St Thomas'Hospital solution).
Methods: Isolated rat hearts were Langendorff perfused at either constant flow (14 mL/min) or constant pressure (75 mm Hg) with oxygenated Krebs-Henseleit bicarbonate buffer (37 degreesC, and left ventricular developed pressure was assessed. In study I (constant flow perfusion) 8 groups (n = 6 hearts per group) were studied: (1) 40 minutes of global ischemia; (2) 2 minutes of St Thomas' Hospital infusion and 40 minutes of ischemia; (3) multidose (every 10 minutes) infusions of St Thomas' Hospital solution during 40 minutes of ischemia; (4) 2 minutes of esmolol infusion and 40 minutes of ischemia; (5) multidose (every 10 minutes) esmolol infusions during 40 minutes of ischemia; (6) continuous infusion of esmolol for 40 minutes during coronary perfusion; (7) intermittent (4 x 10 minutes) ischemia with ventricular fibrillation; and (8) intermittent (4 x 10 minutes) ischemia preceded by intermittent esmolol administration. All protocols were followed by 60 minutes of reperfusion. Further experiments (study 2) examined the esmolol administration method in hearts perfused by constant pressure.
Results: An optimal arresting dose of 1.0 mmol/L esmolol was established. In study I recovery of left ventricular developed pressure (expressed as percentage of preischemic value) was 7% +/- 4%, 28 % +/- 8 %, 70% +/- 5 %, 8 % +/- 1%, 90% +/- 4%, 65 % +/- 3%, 71% +/- 5%, and 76% +/- 5% in groups 1 to 8, respectively. Intermittent esmolol arrest with global ischemia provided equivalent myocardial protection to intermittent crossclamping with fibrillation, continuous esmolol. perfusion, and multidose St Thomas' Hospital solution. Surprisingly, multidose esmolol infusion was more protective than all other treatments. In further experiments (study 2) optimal recovery was obtained with multiple esmolol infusions (by constant flow or constant pressure), but continuous esmolol infusion (at constant flow) was less effective than constant pressure infusion.
Conclusions: Intermittent arrest with esmolol did not enhance protection of intermittent crossclamping with fibrillation; however, multiple esmolol infusions during global ischemia provided improved protection. Administration (constant flow or constant pressure) of arresting solutions influenced outcome only during continuous infusion. Multidose esmolol arrest may be a beneficial alternative to intermittent crossclamping with fibrillation or conventional cardioplegia.

Web of Science

researchmap

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

Background. Only a few studies have been done on sequential grafting using the right gastroepiploic artery (GEA).
Methods. Forty patients (35 males, ages 36 to 74 years) who underwent sequential grafting of the GEA were reviewed. Angiography of the GEA was performed preoperatively in all patients. GEAs with a luminal diameter greater than 2 mm at the presumptive distal anastomosis on the angiogram were used. The dissected GEA was led into the pericardial cavity through the antegastric route. We used GEAs to graft 89 branches (2.2 per patient) in the inferoposterior region.
Results. In 24 patients who had angiographic examinations, all the GEAs were patent, although luminal narrowing was noted in the segment between the two anastomoses in 3 patients. Eight-year actuarial survival was 92.5% and the cardiac-related event-free rate was 95%.
Conclusions. Sequential grafting of the GEA can be performed effectively in selected patients. Performing preoperative angiography to assess the size of the GEA for sequential grafting is strongly recommended. (C) 2001 by The Society of Thoracic Surgeons.

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MOSBY, INC  

Objective: During coronary artery revascularization, some surgeons favor intermittent crossclamping with ventricular fibrillation in preference to cardioplegic ischemic arrest for myocardial protection. It is unclear, however, whether intermittent crossclamping with fibrillation is equally protective or whether ischemic injury is reduced as a consequence of shorter cumulative ischemia.
Methods: We used isolated, Langendorff-perfused rat hearts, measured preischemic function (left ventricular developed pressure) with an intraventricular balloon, and then subjected the hearts to either (1) 40 minutes of global ischemia, (2) a 2-minute infusion of cardioplegic solution and 40 minutes of ischemia, (3) multidose (every 10 minutes) infusions of cardioplegic solution during 40 minutes of ischemia, (4) continuous ventricular fibrillation during 40 minutes of ischemia, (5) intermittent (4 x 10 minutes) ischemia with 10 minutes of reperfusion, (6) intermittent (4 x 10 minutes) ischemia preceded by intermittent cardioplegia, (7) intermittent (4 x 10 minutes) ischemia with ventricular fibrillation, (8) continuous (40 minutes) ventricular fibrillation during coronary perfusion, or (9) intermittent (4 x 10 minutes) ventricular fibrillation (with perfusion). All protocols were followed by 60 minutes of reperfusion.
Results: After 60 minutes of reperfusion, the percentage recovery of left ventricular developed pressure for groups 1 through 9 was as follows: 32% +/- 2%, 57% +/- 6%, 82% +/- 3%, 19% +/- 3+/-, 73% +/- 3%, 70% +/- 3%, 78% +/- 4%, 55% +/- 2%, and 57% +/- 3%, respectively. No significant differences were identified among groups 3, 5, and 7, but the percentage recovery of developed pressure in group 3 was significantly higher than that in group 6; the degree of recovery in groups 3 and 5 to 7 was significantly (P &lt; .05) higher than in groups 1, 3, 4, 8, and 9. Early recovery was significantly (P &lt; .05) more rapid in groups 3 acid 5 to 9, reaching a plateau (of 55%-800%) by 10 minutes of reperfusion; in groups 1, 2, and 4, the recovery plateau occurred after 50 minutes. Left ventricular end-diastolic pressure was elevated in groups 1, 2, and 4 but was almost unchanged from baseline in the other groups.
Conclusions: A similar level of myocardial protection was achieved with multidose (intermittent) cardioplegia or intermittent crossclamping (with or without fibrillation), indicating that intrinsic preservation by intermittent crossclamping with fibrillation does not exacerbate ischemic injury.

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：FUTURA PUBL CO  

AF in Mitral Valve Disease. Introduction: Patients with mitral valve disease frequently have atrial fibrillation (AF), and the left atrium is presumed to be the primary atrium that develops AF. However, it is still not clear whether the electrophysiologic abnormalities responsible for AF are confined to the left;atrium in this subset of patients.
Methods and Results: To examine the AF vulnerability of each atrium, we measured the wavelength and inhomogeneity of the conduction at the lateral right atrium, lateral left atrium, and Bachmann's bundle after defibrillation of AF in seven patients undergoing the maze procedure and mitral valve surgery for AF and isolated mitral valve disease, respectively (AF group). The data were compared with five coronary surgery patients in sinus rhythm (SR group). The wavelength in the AF group was significantly shorter (P &lt; 0.05) than in the SR group not only at the lateral left atrium (225 +/- 62 vs 285 +/- 36 mm) but also at the lateral right atrium (214 +/- 54 vs 254 +/- 34 mm). The variation coefficient of the local maximum activation phase difference in the AF group (1.9 +/- 0.8 art the right atrium, 2.1 +/- 0.8 at the lateral left atrium, and 2.0 +/- 0.6 at Bachmann's bundle) was significantly greater (P &lt; 0.05) than in the SR group at all atrial regions.
Conclusion: AF vulnerability was not confined to the left atrium immediately after defibrillation in AF patients with isolated mitral valve disease. Electrical remodeling resulting from perpetuation of AF, pathological changes extending to the right atrium, geometric changes caused by the atrial interactions occurring across the interatrial septum, or a combination of these may explain the results.

Web of Science

researchmap

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

This study was designed to clarify the clinical significance of and indications for performing preoperative internal thoracic artery (ITA) angiography in patients undergoing coronary artery bypass surgery. A total of 300 possible candidates for coronary artyery bypass grafting (CABG) underwent ITA angiography during diagnostic catheterization. Semi-selective angiography of bilateral ITAs were performed by injecting contrast medium manually with a 5-F right Judkins coronary catheter The posteroanterior view of the arteriograms was recorded on a 35-mm cine film or a cut-film. Unusual angiographic findings of the ITAs were observed in nine patients (3%). These findings included: an atrophic ITA in three patients with ipsilateral subclavian artery occlusions; enlarged ITAs giving collaterals to the lower extremities in one patient with extensive aortoiliac occlusive disease; occluded ITAs in one patient with Takayasu's arteritis and two patients with a history of CABG; and a small but nonsclerotic ITA in one patient, Atherosclerotic occlusive ITAs mere found in only one patient. Thus, we concluded that routine preoperative angiography of the ITA is not necessary because it is rarely affected by atherosclerosis. However, it should be performed for any of the following reasons: a cervical or supraclavicular bruit; an upper extremity blood pressure difference of greater than 20 mmHg; an extensive aortoiliac occlusion; and certain disorders such as Takayasu's arteritis or Kawasaki disease, or a history of open heart surgery.

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：EDIZIONI MINERVA MEDICA  

A superior-septal approach was used for mapping and cryoablation of the left ventricular endocardium over the mitral annulus in a patient with ventricular tachycardia associated with an inferior myocardial infarction without a ventricular aneurysm. This approach provides an excellent view of the mitral valve, and allows safe, adequate mapping and cryoablation of the left ventricular endocardium without the necessity of a ventriculotomy.

Web of Science

researchmap

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

We performed surgical correction and treatment of a common atrium and chronic impure flutter using a computerized mapping system in a 49-year-old man. A reentrant circuit was observed to exist around the left atrial appendage. In contrast to the regular activation in the left atrium, the activation sequence of the right atrium was extremely chaotic. Cryolesions were applied to the area of the reentrant pathway. After the operation, sinus rhythm was restored. (C) 1997 by The Society of Thoracic Surgeons.

Web of Science

researchmap

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

Background. Subclavian artery occlusive lesion, although rare, is sufficiently important to consider before coronary artery bypass grafting because it can cause not only symptoms of the lesion per se, but also the postoperative coronary-subclavian steal phenomenon.
Methods. Four patients undergoing coronary artery bypass grafting received simultaneous reconstruction of the subclavian artery. During aortic cross-clamping, an 8-mm ring-reinforced polytetrafluoroethylene graft was attached to the aorta perpendicularly. The prosthetic graft was led to the proximal segment of the axillary artery through the second intercostal space and anastomosed to the inferior surface of the artery.
Results. Three patients received unilateral reconstruction of the subclavian artery, whereas another received bilateral reconstruction. There were no complications related to the subclavian reconstruction procedure. Postoperative angiograms revealed excellent patency of the prosthetic grafts. All of the patients have been asymptomatic with follow-up periods ranging from 9 to 50 months.
Conclusions. To perform simultaneous subclavian artery reconstruction along with coronary artery bypass grafting, the aortoaxillary bypass procedure using an 8-mm polytetrafluoroethylene graft may be the method of choice because it has lower potential for complications and is less technically demanding. (C) 1997 by The Society of Thoracic Surgeons.

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MOSBY-YEAR BOOK INC  

Web of Science

researchmap

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

A 72-year-old woman with acute aortic dissection as a complication of percutaneous coronary angioplasty was successfully treated. She received a graft replacement of the ascending aorta as well as triple coronary artery bypass grafts. The dissection had extended from the left coronary artery. Although acute aortic dissection is a rare complication of percutaneous coronary angioplasty, physicians and cardiac surgeons should keep its potential occurrence in mind.

Web of Science

researchmap

Language：Japanese   Publisher：特定非営利活動法人 日本呼吸器外科学会  

DOI： 10.2995/jacsurg.10.324_4

researchmap

Language：Japanese   Publisher：特定非営利活動法人 日本呼吸器外科学会  

DOI： 10.2995/jacsurg.9.378_3

researchmap

Language：Japanese   Publisher：特定非営利活動法人 日本小児外科学会  

DOI： 10.11164/jjsps.26.2_467_1

researchmap

researchmap

researchmap

researchmap

researchmap

researchmap

researchmap

researchmap

researchmap

researchmap

researchmap

researchmap

researchmap

researchmap

researchmap

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

researchmap

Language：Japanese   Publisher：日本臨床麻酔学会  

researchmap

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

researchmap

Language：Japanese   Publisher：特定非営利活動法人 日本心臓血管外科学会  

&lt;p&gt;A 69-year-old male complained of intermittent claudication of the right leg. Computed tomography revealed a right femoral artery stenosis with severe calcification and intimal thickening extending to the superficial and deep femoral arteries. Femoral endarterectomy and decalcification was carried out using the Cavitron Ultrasonic Surgical Aspirator (CUSA). All arteries were repaired by an ePTFE Y-shaped patch. Postoperative CT showed no stenosis and progressive calcification of the common, superficial and deep femoral arteries 2 years after surgery.&lt;/p&gt;

DOI： 10.4326/jjcvs.46.97

researchmap

Language：Japanese   Publisher：日本医療安全学会  

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：特定非営利活動法人 日本心臓血管外科学会  

&lt;p&gt;A 61-year-old woman presented with loss of consciousness. Echocardiography revealed a hypoechoic, round mass of 12×13 mm with a smooth border in the left ventricular outflow tract, leading to a diagnosis of loss of consciousness caused by left ventricular outflow tract obstruction, and surgical excision of the mass was performed. The mass, with a smooth, elastic soft surface and filled with yellow, creamy contents, was observed within a range from the subannular region of the left coronary cusp to the anterior mitral leaflet. Pathological examination showed central degeneration and liquefaction, as well as cystic, coarse-granular calcium deposition surrounded by inflammatory cell infiltration and fibroblast proliferation. No tumor cells were seen. Abscess was excluded by preoperative clinical presentations, hematologic data, and culture testing, and thus the mass was considered as caseous calcification of the mitral annulus. Here, we report a case of caseous calcification of the mitral annulus, a rare nonneoplastic lesion thought to be a variant of mitral annular calcification, with literature review.&lt;/p&gt;

DOI： 10.4326/jjcvs.45.272

researchmap

Language：Japanese   Publisher：(一社)日本心臓病学会  

researchmap

Language：Japanese   Publisher：(一社)日本救急医学会  

多発外傷に伴う急性呼吸不全に対するvenovenous extracorporeal membrane oxygenation(VV-ECMO)の使用は出血の増加などのリスクを伴うため確立された指針がない。我々は2011〜2014年に当院に搬送された多発外傷症例のうちVV-ECMO使用例を診療録から抽出し、有用性と安全性について検討した。対象は5例でいずれも人工呼吸で管理困難な低酸素血症を有した。呼吸不全の原因は肺挫傷3例、ARDS2例であった。転帰は3例がECMO離脱に成功し生存、2例は離脱できず死亡した。ECMO導入後は全例でP/F ratioの上昇、PaCO2の低下を認めた。全症例でヘパリン全身投与を行ったが、出血性合併症は3例に生じた。うち1例は胸壁からの出血が制御困難となり大量輸血と開胸下止血術を要した。1例はventilator-induced lung injuryによると思われる肺胞損傷部からの出血が制御困難となり死亡した。また、2例で膜型人工肺に血栓を認め、交換を要した。VV-ECMOは外発外傷症例でもガス交換能の改善と換気条件の緩和に有用と考えられ、とくに肺挫傷例では良好な転帰を得た。受傷早期の導入は出血のリスクが高いため抗凝固薬の投与量を最小限にすべきであるが、実際の用量については今後の検討課題である。(著者抄録)

DOI： 10.1002/jja2.12079

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)日本人工臓器学会  

researchmap

Language：Japanese   Publisher：(一社)日本人工臓器学会  

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：日本胸部外科学会-関東甲信越地方会  

researchmap

Language：Japanese   Publisher：(株)メディカルレビュー社  

開心術後は、人工心肺の使用による血管透過性の亢進のため間質への水分貯留が起こりやすく、さらに術中・術後の多量の輸液や輸血により水分バランスは過剰負荷となりがちである。心臓血管外科領域においても選択的バソプレシンV2受容体拮抗薬であるトルバプタンの使用報告が徐々に増え、開心術症例の水分管理においてその安全性や有用性についての報告が散見されるようになった。しかし、第III相試験であるQUEST試験のサブ解析ではトルバプタンの効果はeGFRに依存し、65歳未満が急性効果の予測因子の1つとして挙げられている。われわれの検討では、腎機能低下を認める高齢者に対してもトルバプタンの低用量(7.5mg)の内服治療は腎機能を悪化させることなく尿量を増加させ、血清Na値の改善や水分バランス管理に有効であり、開心術後の水分貯留に対する有用な選択肢となりうることが示唆された。今後は至適投与量や投与時期など、使用法の確立が必要である。(著者抄録)

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2015015826

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：The Japanese Society for Cardiovascular Surgery  

&quot;Depolarized arrest&quot;, induced by hyperkalemic (moderately increased extracellular potassium) cardioplegia is the gold standard to achieve elective temporary cardiac arrest in cardiac surgery. Hyperkalemic cardioplegic solutions provide good myocardial protection, which is relatively safe, and easily and rapidly reversible. However, this technique has detrimental effects associated with ionic imbalance involving sodium and calcium overload of the cardiac cell induced by depolarization of the cell membrane. Hence, the development of an improved cardioplegic solution that enhances myocardial protection is anticipated as an alternative to hyperkalemic cardioplegia. In this review, we assess the suitability and clinical potential of cardioplegic agents to induce &quot;non-depolarized arrest&quot; from the viewpoint of rapid cardiac arrest, myocardial protection, reversibility, and toxicity. &quot;Magnesium cardioplegia&quot; and &quot;esmolol cardioplegia&quot; have been shown to exert superior protection with comparable safety profiles to that of hyperkalemic cardioplegia. These alternative techniques require further examination and investigation to challenge the traditional view that hyperkalemic arrest is best. Endogenous cardioprotective strategies, termed &quot;ischemic preconditioning&quot; and &quot;ischemic postconditioning&quot;, may have a role in cardiac surgery to provide additional protection. The elective nature of cardiac surgery, with the known onset of ischemia and reperfusion, lends it to the potential of these strategies. However, the benefit of preconditioning and postconditioning during cardiac surgery is controversial, particularly in the context of cardioplegia. The clinical application of these strategies is unlikely to become routine during cardiac surgery because of the necessity for repeated aortic crossclamping with consequent potential for embolic events, but offers considerable potential especially if &quot;pharmacological&quot; preconditioning and postconditioning could be established.

DOI： 10.4326/jjcvs.43.239

researchmap

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

researchmap

Language：English   Publishing type：Research paper, summary (international conference)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Web of Science

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器内視鏡学会  

DOI： 10.18907/jjsre.35.Special_S148_2

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

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

researchmap

Language：English   Publishing type：Research paper, summary (international conference)   Publisher：KARGER  

Web of Science

researchmap

Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

researchmap

Language：Japanese   Publisher：日本臨床外科学会  

researchmap

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

researchmap

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

researchmap

Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

researchmap

Language：Japanese   Publisher：鳥居薬品(株)  

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(一社)日本脈管学会  

researchmap

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

J-GLOBAL

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

Language：Japanese   Publisher：一般社団法人日本外科学会  

CiNii Books

researchmap

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

researchmap

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

researchmap

Language：English   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  

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

researchmap

Language：Japanese   Publisher：鳥居薬品(株)  

researchmap

Language：Japanese   Publisher：(NPO)小切開・鏡視外科学会  

ブタの右上縦隔と前縦隔を用いて、セクレアを血管下に留置することによる血管鞘剥離操作の補助効果や、術野の狭い空間にセクレア挟み込むことで発揮されるスポンジの弾力・反発力を利用した空間形成効果などについて検討した。ブタ右縦隔の血管や気管の剥離操作は、ヒト肺癌手術での右縦隔リンパ節郭清手技操作のシミュレーションに非常に適していた。右上縦隔リンパ節郭清時に奇静脈下や上大静脈と気管とのスペースにセクレアを留置することで、体外からの血管テープやコットンダイセクターなどの操作を代用するプロダクトになりうることが示唆された。また、前縦隔腫瘍に対する鏡視下手術の際、セクレアを上大静脈、左腕頭静脈下に留置することによって作られたワーキングスペースが術者のストレス軽減に寄与する可能性が示唆された。さらに、セクレア自体を把持して胸壁と肺の癒着に対する剥離子として利用したり、脆弱な腫瘍への愛護的圧排などに利用することも可能と考えられた。

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2012266805

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

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

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(NPO)小切開・鏡視外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本外科感染症学会  

【緒言】われわれは開心術後の正中創感染予防に独自の閉胸法(ASSI法)を実践しているが、冠動脈バイパス術後の胸骨正中創感染の危険因子を分析する。【対象・方法】冠動脈バイパス術後の200例(従来法100例、ASSI法100例)において創感染の危険因子と考えられる、年齢、性別、肥満、心機能、糖尿病の合併、腎機能障害の合併、末梢血管病変の合併、両側内胸動脈使用の有無、術式の違い(off pumpかon pump)、手術時間、輸血量、創閉鎖法の12項目について検討を行った。【結果】多変量解析では、女性(p=0.0016、Odds比5.651)、肥満(p=0.0368、Odds比3.370)、創閉鎖法(p=0.0431、Odds比0.283)が独立した危険因子として抽出された。【結論】冠動脈術後の胸骨正中創感染には女性、肥満が危険因子であったが、堅固な胸骨固定と皮下ドレインによる持続吸引システムを組み合わせたASSI法による創閉鎖は感染予防に有効である。(著者抄録)

CiNii Books

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2010299536

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

researchmap

Language：Japanese   Publisher：(一社)日本不整脈心電学会  

researchmap

Language：Japanese   Publisher：一般社団法人日本外科学会  

CiNii Books

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  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

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)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(一社)日本不整脈心電学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

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

CiNii Books

researchmap

Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

researchmap

Language：Japanese   Publisher：日本臨床外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本外科感染症学会  

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(一社)日本脈管学会  

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

DOI： 10.2995/jacsurg.22.380_2

researchmap

Language：English   Publisher：(一社)日本不整脈心電学会  

researchmap

Language：Japanese   Publisher：(一社)日本循環器学会  

researchmap

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

CiNii Books

researchmap

Language：Japanese   Publisher：(NPO)日本呼吸器外科学会  

researchmap

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

J-GLOBAL

researchmap

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

DOI： 10.4326/jjcvs.37.329

researchmap

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

researchmap

Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

researchmap

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

An 80-year-old man died of rupture of the thoracic aorta 3 months after surgery for abdominal aortic aneurysm. Autopsy revealed that multiple penetrating atherosclerotic ulcers with intramural hematoma had resulted in psudoaneurysm of the abdominal aorta and dissection of the thoracic aorta. Differentiation from common aortic aneurysm or classic aortic dissection is important because pseudoaneurysm and aortic dissection related to penetrating atherosclerotic ulcer have a higher risk of rupture.&lt;br&gt;

DOI： 10.1272/manms.3.187

researchmap

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

80歳男性。患者は他院にて腹部大動脈瘤を指摘され、手術目的で著者らの施設へ紹介入院となった。多発したpenetrating atherosclerotic ulcer(PAU)に伴う腹部大動脈瘤に対し人工血管置換術が施行されたが、敗血症を発症し、術後3ヵ月で死亡となった。病理解剖所見では多発PAUに起因する胸部大動脈破裂が死因と考えられ、更に腹部大動脈には仮性瘤の形成がみられた。

DOI： 10.1272/manms.3.187

researchmap

Language：Japanese   Publisher：(一社)日本循環器学会  

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(一社)日本外科感染症学会  

著者らの施設における開心術後Surgical Site Infection(SSI)予防対策について検討した。対象は2005年10月〜2006年4月までに独自の閉胸法(anti SSI閉胸法:ASSI法)で閉胸した単独冠動脈バイパス術41例(ASSI群)で、2004年7月末〜2005年1月までの41例を対照に比較した。その結果、SSI発症はASSI群1例(2.4%:表層感染による創離開)、対照群6例(14.6%:表層感染による創離開2例、胸骨に達する深部感染2例、縦隔洞炎2例)で、スコア化した両群の比較では、ASSI群で有意に低値であった。尚、縦隔洞炎の2例はいずれも起因菌がMRSAであり、糖尿病を合併した透析患者であった。以上、十分な洗浄に加え、ワイヤと固定ピンを用いた強固な胸骨固定法と皮下ドレインによる低圧持続吸引システムを組み合わせたASSI法は、SSI対策として有効と考えられた。

CiNii Books

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2008050694

Language：Japanese   Publisher：(NPO)日本呼吸器内視鏡学会  

DOI： 10.18907/jjsre.29.4_260_6

researchmap

Language：English   Publishing type：Research paper, summary (international conference)   Publisher：ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD  

DOI： 10.1016/j.yjmcc.2007.03.619

Web of Science

researchmap

Language：Japanese   Publisher：日本外科系連合学会  

J-GLOBAL

researchmap

Language：English   Publishing type：Research paper, summary (international conference)   Publisher：ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD  

DOI： 10.1016/j.yjmcc.2007.03.618

Web of Science

researchmap

Language：English   Publishing type：Research paper, summary (international conference)   Publisher：ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD  

DOI： 10.1016/j.yjmcc.2007.03.635

Web of Science

researchmap

Language：Japanese   Publisher：(一社)日本不整脈心電学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本不整脈心電学会  

researchmap

Language：Japanese   Publisher：(一社)日本不整脈心電学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本不整脈心電学会  

J-GLOBAL

researchmap

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

CiNii Books

researchmap

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

researchmap

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

J-GLOBAL

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  

J-GLOBAL

researchmap

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

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)日本冠疾患学会  

J-GLOBAL

researchmap

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

J-GLOBAL

researchmap

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

Off-pump CABG(OPCAB)における動脈グラフトによる多枝血行再建術の戦略を報告した。対象は動脈グラフとのみで多枝(3枝以上)血行再建を行った150例(男性119例、女性31例・平均年齢68.7歳)で、グラフトデザインを検討した。平均吻合枝数は3.7本で、14例はin-situ graftのみ、136例はcomposite graftを用いた。1)Inflow sourceに左内胸動脈(LITA)を用いた再建は左前下行枝(LAD)領域122例、回旋枝(Cx)領域44例、右冠動脈(RCA)領域10例、右内胸動脈(RITA)を用いた再建はLAD領域31例、Cx領域66例、RCA領域40例、右胃大網動脈(RGEA)を用いた再建はCx領域8例、RCA領域51例であった。2)術後早期グラフト開存率はLITA 95.4%、RITA 94.4%、GEA 89.1%、橈骨動脈(RA)93.7%、グラフトデザイン別ではin-situ graft 95.2%、composite graft 93.2%であった。3)OPCABでは、skeletonizeされた動脈グラフトを用い、composite graftの組み合わせで多枝血行再建は可能と考えられた。

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本外科感染症学会  

researchmap

Language：Japanese   Publisher：(一社)日本人工臓器学会  

DOI： 10.11392/jsao1972.35.2_S55

researchmap

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

14歳男児。患者は13歳時に右冠動脈(RCA)の巨大瘤前後で狭窄病変を認め、再CABGを施行した。上腹部正中切開で右胃大網動脈(GEA)をskeletonization法にて採取したが、右心室前面が胸骨裏面と強固な癒着を認めたため、胸骨下方5cmの切開にて横隔膜を縦切開し心下面を露出、off-pump下にGEA-RCA#3を吻合した。術後経過は順調で、集中治療室帰室1時間後に人工呼吸器を離脱できた。尚、トレッドミル運動負荷検査では虚血性変化は認めず、術後合併症もなく第9病日目に独歩退院となった。術後3ヵ月目のグラフト造影では良好な開存が確認された。

researchmap

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

冠状動脈バイパス再手術(redo CABG)に対する術式の工夫として、胸骨再切開を回避するoff-pump CABG(OPCAB)の手術成績を検討した。対象はredo CABGを行った25例(男性14例、女性11例・平均年齢69.9歳)で、初回手術からの期間は平均7年4ヵ月、15例(60%)に開存グラフトを認めた。バイパス枝数は平均1.6枝、開存グラフトを合わせて平均2.3枝で、完全血行再建は18例(72%)に施行された。周術期心筋梗塞例や長期人工呼吸器管理例はなく、12例で無輸血手術が可能であった。合併症は、1例で右室損傷でpump conversionを要し、手術死亡例はなかった。術後造影を19例(30枝)に行い、グラフト開存率は100%であった。再手術のアプローチは胸骨正中切開3例、剣状突起下小切開6例、左開胸8例、左開胸+剣状突起下小切開8例で、計23例(88%)で胸骨正中切開を回避できた。以上、本術式は開存グラフトを有するハイリスク再手術例に対し有効と考えられた。

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

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：シュプリンガー・ジャパン(株)  

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

J-GLOBAL

researchmap

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

J-GLOBAL

researchmap

Language：English   Publishing type：Research paper, summary (international conference)   Publisher：ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD  

DOI： 10.1016/j.yjmcc.2006.03.115

Web of Science

researchmap

Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

DOI： 10.11477/mf.4426900696

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本不整脈心電学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本不整脈心電学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本不整脈心電学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本不整脈心電学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本不整脈心電学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本不整脈心電学会  

researchmap

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

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本不整脈心電学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本不整脈心電学会  

J-GLOBAL

researchmap

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

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本循環器学会  

researchmap

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

J-GLOBAL

researchmap

Language：Japanese   Publisher：(NPO)日本医工学治療学会  

researchmap

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

J-GLOBAL

researchmap

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

J-GLOBAL

researchmap

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

J-GLOBAL

researchmap

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

researchmap

J-GLOBAL

researchmap

Language：Japanese   Publisher：一般社団法人 日本人工臓器学会  

DOI： 10.11392/jsao1972.35.2_S55

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：(NPO)日本冠疾患学会  

researchmap

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

researchmap

Language：Japanese   Publisher：(一社)日本脈管学会  

J-GLOBAL

researchmap

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

DOI： 10.1272/manms.1.211

J-GLOBAL

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

J-GLOBAL

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

J-GLOBAL

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

J-GLOBAL

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

J-GLOBAL

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

J-GLOBAL

researchmap

Language：English   Publishing type：Research paper, summary (international conference)   Publisher：ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD  

Web of Science

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：日本外科系連合学会  

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)日本医工学治療学会  

researchmap

Language：Japanese   Publisher：(一社)日本循環器学会  

researchmap

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

researchmap

Language：Japanese   Publisher：(NPO)日本不整脈学会  

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：(一社)日本集中治療医学会  

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  

J-GLOBAL

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  

DOI： 10.4326/jjcvs.34.243

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

J-GLOBAL

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

J-GLOBAL

researchmap

Language：English   Publisher：シュプリンガー・ジャパン(株)  

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

J-GLOBAL

researchmap

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

researchmap

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

CiNii Books

researchmap

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

researchmap

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

心室細動はCCUやICUなどに収容され,24時間の心電図モニターが行われかつ体外式の電気的除細動器が常備されている場合を除いてその救命は困難である.1960年代後半にMirowskiによって提唱された体内植込み式の除細動器の概念は体内に植込まれた除細動器が常に心室細動の発症を監視し,ひとたびその発生を感知すると自動的に電気的治療を行うという,病院外で発症した致死性心室性不整脈の治療に対して画期的なものであった.臨床応用されるまでに更に10数年の期間を要するが,1980年米国で世界初の植込み型除細動器の臨床使用が行われ,以来医用工学的な急速な進歩と共にハード及びソフトの両面で改良が進んでいる.更に1990年代に行われた多くの大規模臨床試験によりその治療効果が明らかにされ,現時点では,心室細動の治療法として第一選択と位置づけられている

CiNii Books

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2004004826

Language：Japanese   Publisher：医学図書出版  

CiNii Books

researchmap

Language：English   Publishing type：Research paper, summary (international conference)   Publisher：INT PEDIATRIC RESEARCH FOUNDATION, INC  

Web of Science

researchmap

Language：Japanese   Publisher：(一社)日本脈管学会  

researchmap

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

1997年4月〜2001年11月に施行したOPCAB 168例中3枝病変例49例(男30例女19例,平均72.3歳)を対象に,off-pump CABG(OPCAB)の役割について検討した.原則として胸骨切開で手術を施行した.可及的に両側ITAを含む動脈グラフトを使用し,free graftのinflow sourceはITAとして,aorta notouchを原則とした.その結果,死亡2例はAMI後緊急手術例であった.初回手術41例での再建枝数は平均2.8枝,総再建枝数114枝のうち,70枝,60%が左前下行枝,対角枝,右冠動脈近位部を占めるが,44枝38%が回旋枝・右冠動脈末梢枝であった.21例に行った術後造影でのグラフト開存率は良好であった

researchmap

Language：Japanese   Publisher：特定非営利活動法人 日本心臓血管外科学会  

A 26-year-old man with Marfan&#039;s syndrome suffered aortic dissection repeatedly during hospitalization. He was admitted with a diagnosis of annuloaortic ectasia with severe aortic regurgitation. A type A aortic dissection occurred after diagnostic angiography. Three weeks after the onset of the dissection, an aortic root replacement in combination with a total arch replacement was performed. Eight months later, residual dissection in the descending thoracic aorta was replaced with distal perfusion by a temporary bypass from the left subclavian artery to the descending thoracic aorta. At the termination of the operation, abdominal aortic dissection occurred with acute bilateral limb ischemia, which was treated with abdominal aortic intimal fenestration. He recovered uneventfully and was discharged 3 weeks after operation. In light of our experience, because of vascular fragility, great care should be taken in treating patients with Marfan&#039;s syndrome to avoid iatrogenic aortic dissection.

DOI： 10.4326/jjcvs.31.282

CiNii Books

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  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本循環器学会  

researchmap

Language：Japanese   Publisher：(一社)日本循環器学会  

researchmap

Language：Japanese   Publisher：(NPO)日本不整脈学会  

researchmap

Language：Japanese   Publisher：(NPO)日本不整脈学会  

researchmap

Language：Japanese   Publisher：(NPO)日本不整脈学会  

researchmap

Language：English   Publisher：Japanese Circulation Society  

CiNii Books

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

researchmap

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

researchmap

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

CiNii Books

researchmap

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

CiNii Books

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

researchmap

Language：Japanese   Publisher：(株)中外医学社  

researchmap

Language：Japanese   Publisher：日本循環制御医学会  

CiNii Books

researchmap

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

researchmap

Language：Japanese   Publisher：日本低温医学会  

researchmap

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

researchmap

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

researchmap

Language：Japanese   Publisher：(一社)日本循環器学会  

researchmap

Language：Japanese   Publisher：日本臨床外科学会  

researchmap

Language：Japanese   Publisher：日本低温医学会  

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

researchmap

Language：English   Publisher：シュプリンガー・ジャパン(株)  

researchmap

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

researchmap

Language：Japanese   Publisher：(NPO)日本不整脈学会  

researchmap

Language：Japanese   Publisher：(一社)日本循環器学会  

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：一般社団法人日本外科学会  

CiNii Books

researchmap

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

researchmap

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

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

researchmap

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

CiNii Books

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：English   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：English   Publisher：シュプリンガー・ジャパン(株)  

researchmap

Language：English   Publisher：シュプリンガー・ジャパン(株)  

researchmap

Language：English   Publisher：シュプリンガー・ジャパン(株)  

A seventy-year-old man was admitted to hospital for ischemic heart disease and abdominal aortic aneurysm. In the cardiac procedure, we employed a technique for conversion from minimally invasive coronary artery bypass grafting. This technique entailed cardiopulmonary bypass using standard instruments and technique, and the exposure for grafting was the same as for the simple minimally-invasive coronary artery bypass grafting. Moreover, the incision we reported in this case was simply extendable even to a full sternotomy if necessary.

DOI： 10.1007/BF03218132

Scopus

PubMed

researchmap

Language：Japanese   Publisher：(NPO)日本不整脈学会  

researchmap

Language：Japanese   Publisher：(NPO)日本不整脈学会  

ガイドラインにしたがって植込まれたペースメーカー(PM)患者の,外来フォロー時の低ペーシング率症例及び房室ブロック(AVB)改善例を検討し,遠隔期におけるPMの非適応例を調査した.対象は,洞不全症候群(SSS)48例,AVB49例,SSS+AVB 3例の計100例で,絶対適応90例,術後観察期間は平均2年9ヵ月(2ヵ月〜5年10ヵ月)であった.ペーシング率2%以下の症例は5例(SSS 4例,AVB 1例)で,SSSが多かった.この5例のHolter心電図では,ペーシング率2%の症例は深夜を中心に日中にも,1%の症例は深夜にのみ作動を認めた.0%の症例では,作動は認めなかった.AVBの改善例は8例あり,現時点ではPMの適応とはならなかった.PM植込み後遠隔期では,PMの非適応症例は比較的多く,注意深い外来フォローが必要と考えられた

CiNii Books

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

researchmap

Language：Japanese   Publisher：シュプリンガー・ジャパン(株)  

researchmap

Language：Japanese   Publisher：(株)メジカルビュー社  

researchmap

Language：Japanese   Publisher：(一社)日本心臓病学会  

researchmap

Language：English  

CiNii Books

researchmap

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

CiNii Books

researchmap

Language：Japanese  

CiNii Books

researchmap

Language：Japanese   Publisher：金原出版(株)  

researchmap

Language：Japanese   Publisher：(株)診断と治療社  

researchmap

Language：Japanese   Publisher：(NPO)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：(公財)日本心臓財団  

心房細動を示す二次孔欠損型心房中隔欠損症(61歳男)と,心房粗・細動を示す不完全型ECD(心内膜床欠損症)(49歳男)の2症例で,心内修復手術と共に術中の心房マッピング解析を併用した不整脈治療を同時に行った.不完全型ECDの心電図はImpure flutterを示す稀な症例であった.2症例共左心耳と左肺静脈間に規則的な興奮伝播が記録された.同部位を凍結凝固することにより,術後洞調律に復帰させることが可能であった

DOI： 10.11281/shinzo1969.29.Supplement3_19

researchmap

Language：Japanese   Publisher：(NPO)日本不整脈学会  

researchmap

Language：Japanese   Publisher：(株)総合医学社  

researchmap

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

CiNii Books

researchmap

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

researchmap

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

CiNii Books

researchmap

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

CiNii Books

researchmap

Language：Japanese   Publisher：(一社)日本自己血輸血学会  

無輸血開心術達成にはより丹念な止血操作と体外循環時間の短縮や体外循環中の冷却温度に留意することが重要である

researchmap

Language：Japanese   Publisher：Japan Heart Foundation  

DOI： 10.11281/shinzo1969.29.Supplement3_19

researchmap

Language：Japanese   Publisher：一般社団法人 日本人工臓器学会  

DOI： 10.11392/jsao1972.26.Supplement_S87

researchmap

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

researchmap