H Nagato

Publications (8)0 Total impact

• Article: [Preservation of aortic root with severe destruction in Stanford type A acute aortic dissection].

  Kozo Kaneda, N Nishiwaki, S Yokoyama, S Nagasaka, S Hirao, D Heima, A Morishima, Y Yoshida, H Nagato
  [show abstract] [hide abstract]
  ABSTRACT: From November 1999 to December 2008, 197 patients with Stanford type A acute aortic dissection underwent the surgical treatment on an emergency basis. In 19 cases, we preserved the severely destroyed aortic root using gelatin-resorcin-formalin (GRF) glue avoiding aortic root replacement. We examined the indication and limitation of repair of the destroyed aortic root. The 19 patients were classified into 3 groups (A, B and C). Group A consisted of 7 patients who had no aortic regurgitation (AR). Group B consisted of 6 patients who had moderate to severe AR. Group C consisted of 6 patients who had coronary involvement. We preserved the broken aortic root in group A and group B. But it seemed to be rather difficult to repair the destroyed aortic root in some cases of group C.
  Kyobu geka. The Japanese journal of thoracic surgery 10/2009; 62(11):966-70.
• Article: [Surgical treatment for acute type A aortic dissection; for better postoperative quality of life].

  Kozo Kaneda, N Nishiwaki, H Nagato, S Hirao, D Heima, A Morishima
  [show abstract] [hide abstract]
  ABSTRACT: From November 1999 to December in 2005, 114 patients with acute type A aortic dissection underwent surgical treatment on an emergency basis. The overall in-hospital mortality was 7.9% (9 patients). Four were rupture cases before cardiopulmonary bypass. De novo postoperative stroke rate was 3.5% (4 patients). But all of them were discharged on foot. There were 6 rupture cases before operation. Unfortunately only 2 patients survived. Preoperative stroke due to malperfusion occurred in 19 cases (16.7%). Among them, those with clear consciousness had tendency to better social rehabilitation than those with drowsiness. We had experienced 2 vegetable states in the group of drowsiness after the operations. For better outcome, we must avoid rupture before operation and reconsider the timing of operation in the case of brain ischemia.
  Kyobu geka. The Japanese journal of thoracic surgery 05/2007; 60(4):273-8.
• Article: Surgical repair of double-orifice of the mitral valve in cases with an atrioventricular canal defects.

  N Ohta, K Sakamoto, M Kado, H Nagato, M Nishioka, Y Fujimoto, M Yokota
  [show abstract] [hide abstract]
  ABSTRACT: A Double-orifice in the mitral valve is an uncommon congenital cardiac lesion which occurs as an isolated anomaly or in association with other cardiac malformation. This report deals with our surgical experience of a double-orifice of the mitral valve in cases with an atrioventricular canal defect. From 1991 through 1999, ten patients were diagnosed to have a double-orifice of the mitral valve at Shizuoka Children's Hospital. Each patient had associated major cardiac malformations, among which atrioventricular canal defect underwent surgical management, with five of these undergoing complete correction with or without previous pulmonary artery banding. Of these 10, the five cases were enrolled in this study. Two of these had a complete type, and the other three had a partial type. The cleft in the left-sided atrioventricular valve was closed partially in four and left untouched in one. Bridging tissue, when present, was left intact. There was no regurgitation from any accessory orifice and no repair for an accessory orifice was needed. There was no late death and no replacement of the valve with prosthesis. During follow-up ranging from 1 to 4 years, none of the patients developed severe stenosis or progressive regurgitation in the left-sided atrioventricular valve. Meticulous surgical management of a double-orifice in the mitral valve in association with atrioventricular canal defect an achieve an acceptable midterm result without developing severe dysfunction in the left-sided atrioventricular valve.
  The Japanese Journal of Thoracic and Cardiovascular Surgery 12/2001; 49(11):656-9.
• Article: [The repair of congenital coronary artery fistula in the neonatal period].

  H Nagato, M Yokota, K Sakamoto, M Kado, M Nishioka, K Fujimoto, A Ikai
  [show abstract] [hide abstract]
  ABSTRACT: We operated on 10 cases diagnosed as congenital coronary artery fistula, including 2 critical neonates. Such neonates needed special care for perfusion pressure drop at the beginning of cardiopulmonary bypass and imperfect delivery of cardioplegia. This phenomenon is likely to depend on the shunt size of a fistula, that is much larger in such neonates than in older patients who could be operated on electively. It was helpful in the situation to crossclamp the main PA, compress the fistula and crossclamp the aorta quickly for a standstill. We prefer the closure of a fistula in the recipient chamber especially when an important area is supplied distally to the origin of the fistula. However, if a ventricle is a recipient chamber, the closure through coronary incision should be done as the neonates in our series. There were two hospital deaths due to vascular leakage syndrome and hypoxia, respectively. Aortic regurgitation (AR) got worse in two after the operation. They were found to have more dilatation and distortion in the Valsalva's sinus which appeared to affect the aortic annulus to some extent. It is likely due to long-standing larger shunt. Contrary to them, the patient operated on during neonatal period was followed by no increase of AR, though she had the largest shunt of our series. We have an impression it could be prevented by earlier operation.
  Kyobu geka. The Japanese journal of thoracic surgery 12/1999; 52(12):975-8; discussion 979-82.
• Article: [Reoperation after correction of total anomalous pulmonary venous connection: particularly for postoperative pulmonary vein stenosis].

  M Yokota, K Sakamoto, A Ikai, M Kado, H Nagato, M Nishioka, T Tsuda
  [show abstract] [hide abstract]
  ABSTRACT: Postoperative pulmonary vein stenosis is a major complication after the correction of the total anomalous pulmonary venous connection. Six patients developed this complication 2 to 3 months after surgery. Five underwent reoperation (3 had the third operations) with only one survivor. Risk factors for developing the stenosis were 1. small common pulmonary vein with small branches occurring in the patients with the ages at the operation below 2 days and accordingly with the infradiaphragmatic connection and 2. Y-shaped common pulmonary vein with the confluence situated far below the left atrium. Turbulence seemed the major cause of the intimal thickening occurring in the common pulmonary vein shortly distant from the orifices of the branches. Typically the anastomotic orifice was not narrowed. Relief of the stenosis was done by the excision of the hypertrophied intimal tissue frequently cutting into the branches. Severe stenosis recurred in 4 patients necessitating another operation in 3 patients which was fatal in two. Prevention is important. Creation of a large anastomosis with the incision not extending into the branches and the use of the absorbable suture materials were effective. In the infradiaphragmatic connection incorporation of the divided stump of the descending vein into the anastomosis and a T-shaped incision of the left atrium were also important.
  Rinshō kyōbu geka = Japanese annals of thoracic surgery 07/1994; 14(3):211-8.
• Article: [Extended aortic arch anastomosis for coarctation of the aorta and interruption of the aortic arch in early infancy].

  H Mizuhara, M Yokota, K Sakamoto, A Ikai, H Niwa, H Nagato, T Tsuda, H Kado
  [show abstract] [hide abstract]
  ABSTRACT: We performed extended aortic arch anastomosis, which was so called EAA procedure, for Coarctation of the Aorta (CoA) with hypoplastic aortic arch (HAA) and interruption of the aortic arch (IAA) in 17 infants under three months of age. The proximal anastomosis site was extended into ascending aorta in order that we could make non-obstructive pathway of systemic flow. During anastomosis, we employed mild systemic hypothermia and topical cooling of head and lumber lesion. Satisfactory anastomoses were performed without any neurological and renal complications except one case. Postoperative Doppler echographic evaluation revealed that the mean peak flow velocities at anastomotic site were under 2.0 m/sec at 1 and 2 years after surgery. We concluded that EAA procedure was useful for CoA with HAA and IAA in early infancy.
  Kyobu geka. The Japanese journal of thoracic surgery 05/1994; 47(4):259-63; discussion 264-7.
• Article: [Relief of pulmonary venous obstruction for asplenia syndrome associated with total anomalous pulmonary venous connection in neonates and infants].

  H Mizuhara, M Yokota, K Sakamoto, A Ikai, M Kado, H Niwa, H Nagato
  [show abstract] [hide abstract]
  ABSTRACT: Five patients of asplenia syndrome with pulmonary venous obstruction underwent TAPVC repair in the period of neonates (4 patients) and infant (1 patient). They also underwent associated procedures to reconstruct or adjust pulmonary blood flow (systemic-pulmonary shunts in 2, bilateral PDA banding in 1, pulmonary artery banding in 1) in accordance with individual anatomy of the pulmonary arteries. In four of them, they required subsequent surgical procedures for reduction of pulmonary blood flow because of intractable heart failure due to increase in pulmonary blood flow mostly at the early postoperative period. The increasing pulmonary blood flow was successfully controlled by early reduction procedures (1 patient: extrathoracically adjustable PA banding, 1 patient: tightening of shunt graft) in two patients. However, one patient died in the early postoperative period because of moribund preoperative condition. The remaining one patient underwent PA banding three month after the first operation, but died in late period due to heart failure. These results suggest that the adjustment of pulmonary blood flow is critically important for management of the patients of asplenia syndrome with TAPVC after the operation, and early decision of PA band re-adjustment (or other procedures to decrease pulmonary blood flow) is mandatory to improve the results.
  [Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai 04/1994; 42(3):379-84.
• Article: [Postoperative management in neonate after open cardiac surgery].

  H Mizuhara, M Yokota, K Sakamoto, A Ikai, M Kado, H Niwa, H Nagato
  [show abstract] [hide abstract]
  ABSTRACT: Recent advances in diagnostic method and preoperative care have allowed us to perform surgical repair in neonate. Important to the successful outcome of open cardiac surgery in neonate is cautious management in postoperative period. So we investigated the hemodynamics in the first 72 hours following open heart surgery for TAPVC, TGA and PAIVS. The hemodynamics in acute period are different according to patient age. Especially, early neonates under 14 days present low systemic blood pressure and high central venous pressure. So we must manage them according to their hemodynamic characteristics.
  Kyobu geka. The Japanese journal of thoracic surgery 12/1992; 45(12):1039-43; discussion 1043-6.