Masatoshi Kawata

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Publications (4)2.05 Total impact

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    Article: Open heart surgery in a paraplegic patient.
    Yasuyuki Shimada, Masatoshi Kawata, Yasushi Iwasaki, Hideshi Itoh, Hideyuki Kawachi
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    ABSTRACT: We operated on a patient who had been paraplegic since sustaining a spinal cord injury 11 years ago. We made a reversed L-shaped sternum incision and cannulated all tubes for the cardiopulmonary bypass through a wound window. This provided an excellent surgical view without restricting the patient's upper limbs (needed for wheel chair operation), and recovery was good. Just after surgery, however, it was difficult to control blood pressure and the loss of serum albumin. We believe this is the first report of open-heart surgery undertaken in a paraplegic patient and that the reversed L-shaped incision and careful monitoring of hemodynamics each played an important role in the successful outcome. We hope that this report will help in the treatment of other paraplegic patients who need open-heart surgery.
    Annals of thoracic and cardiovascular surgery: official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 11/2004; 10(5):304-6. · 0.69 Impact Factor
  • Article: A novel technique for removal of permanent pacemaker leads.
    Yasuyuki Shimada, Masatoshi Kawata, Yasushi Iwasaki, Hideyuki Kawachi, Hitoshi Yaku, Nobuo Kitamura
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    ABSTRACT: We removed from 4 patients pacemaker leads that had migrated or become infected. Case 1: A 62-year-old man developed uncontrollable infection of the pacing leads. Case 2: A 78-year-old man, whose infected pacemaker was removed, had a second one implanted in the contralateral side; the pacing lead infection from the first procedure, however, was uncontrollable. Case 3: A 56-year-old woman presented with dyspnea and hepatomegaly subsequent to the second implantation of a pacemaker; the pacing leads from the first procedure caused severe stenosis in both the superior and inferior vena cavae. Case 4: A 60-year-old woman had a ruptured and migrated pacing lead in the right ventricle. We operated using a cardiopulmonary bypass and a specially designed plastic tube for removal of the leads. Although Case 2 required reconstruction of the vena cavae, all patients recovered. When removal of pacing leads is necessary, it should be done as soon as possible with cardiopulmonary bypass.
    The Japanese Journal of Thoracic and Cardiovascular Surgery 03/2004; 52(2):75-7.
  • Article: Sudden death under successful medical management of sick sinus syndrome after cardiac pacing discontinuation.
    Satoru Okumura, Masatoshi Kawata, Satoshi Niu, Koichi Ohga
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    ABSTRACT: Bacterial infection is a serious complication of permanent pacemaker implantation. A 52-year-old woman with sick sinus syndrome and vasospastic angina developed pacemaker infection 4 years after implantation, with methicillin-resistant Staphylococcus aureus detected in arterial blood cultures. We treated the septicemia with antibiotics and removed the infected pacemaker. We treated sick sinus syndrome with intravenous nitroglycerin followed by oral maintenance isosorbide mononitrate. After cardiac pacing was discontinued following removal of the infected permanent pacemaker, the patient remained well, until her sudden death 3.5 years later. Although the precise cause of death was not clear, we suspected sick sinus syndrome or vasospastic angina, and now consider the outcome may have been more favorable if we had reimplanted a permanent pacemaker before she died.
    The Japanese Journal of Thoracic and Cardiovascular Surgery 11/2002; 50(10):448-50.
  • Article: An operative case of inferior vena cava stenosis due to fibrosis around permanent pacemaker leads.
    Yasuyuki Shimada, Hitoshi Yaku, Masatoshi Kawata, Katsuhiko Oka, Keisuke Shuntoh, Takahisa Okano, Akiyuki Takahashi, Atsushi Fukumoto, Kyoko Hayashida, Nobuo Kitamura
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    ABSTRACT: A 56-year-old woman presented with general fatigue, dyspnea on exercise, and hepatomegaly subsequent to secondary implantation of a pacemaker. On admission, cardiac echo examination showed tricuspid valve regurgitation due to a migrated looped lead. At surgery, there was evidence of severe stenosis at both orifices of the superior and inferior vena cavae due to fibrous tissue around the leads. We removed the fibrous tissue, pacing leads, and generator. New leads were anchored onto the epicardium and a generator was inserted under the rectus muscle. The postoperative course was satisfactory and the symptoms disappeared.
    Pacing and Clinical Electrophysiology 03/2002; 25(2):223-5. · 1.35 Impact Factor
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