Shin-ichi Ohki

Jichi Medical University, Totigi, Tochigi, Japan

Are you Shin-ichi Ohki?

Claim your profile

Publications (12)7.97 Total impact

  • Asian cardiovascular & thoracic annals 06/2012; 20(3):351.
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 59-year-old man with a history of ascending aorta replacement for an aortic dissection using gelatin-resorcin-formalin glue at age of 50 years presented with paroxysmal nocturnal dyspnea. An echocardiogram showed severe aortic regurgitation associated with aortic root enlargement. Chest computed tomography showed that the ascending aorta was dilated and a pseudoaneurysm was observed around the implanted prosthetic graft. Upon opening the ascending aorta, we found that the posterior wall of the proximal anastomotic portion of the implanted graft was ruptured. After replacement of the aortic root with a composite graft and reconstruction of the orifices of the right and left coronary arteries, total arch replacement by the separated graft technique was performed. The postoperative course was uneventful.
    General Thoracic and Cardiovascular Surgery 04/2012; 60(7):443-5.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: This study aimed to determine the procedure-related morbidity and mortality of infrarenal abdominal aortic aneurysm (AAA) repair, to investigate the changes in perioperative laboratory val-ues, and to clarify the specific independent predictive factors for mortality and morbidity. We retro-spectively evaluated patients who were treated in Jichi Medical University Hospital. Methods: Consecutive patients with AAA between April 2007 and August 2010 were studied. The possible predictive values of various patient-and operation-related variables on outcomes (mortality, duration of stay in hospital (>7 days), and major morbidity) were assessed by multivariate analysis. Results: Overall in-hospital mortality was 3.3%. Statistically significant differences, all in favor of endovascular aneurysm repair (EVAR), were observed in the intraoperative and post-operative data. In multivariate logistic analysis, potassium, serum creatinine and C-reactive protein levels were sig-nificantly related to outcomes. Conclusions: Open repair and EVAR can both be safely performed in patients treated for elective and emergency infrarenal AAA. EVAR has perioperative advantages of reduced blood loss and blood transfusion, as well as decreased mortality and duration of post-operative hospital stay. In particular, we identified specific independent predictive factors of serum chemistry values for mortality and renal insufficiency. Introduction An abdominal aortic aneurysm (AAA) is defined as an enlargement of the aortic diameter with at least 150% of the diam-eter at the orifice of the renal arteries [1]. Elective treatment is recommended when the AAA size reaches 55 mm in diameter because of higher rates of rupture. Open
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: This study aimed to determine the procedure-related morbidity and mortality of infrarenal abdominal aortic aneurysm (AAA) repair, to investigate the changes in perioperative laboratory val-ues, and to clarify the specific independent predictive factors for mortality and morbidity. We retro-spectively evaluated patients who were treated in Jichi Medical University Hospital. Methods: Consecutive patients with AAA between April 2007 and August 2010 were studied. The possible predictive values of various patient-and operation-related variables on outcomes (mortality, duration of stay in hospital (>7 days), and major morbidity) were assessed by multivariate analysis. Results: Overall in-hospital mortality was 3.3%. Statistically significant differences, all in favor of endovascular aneurysm repair (EVAR), were observed in the intraoperative and post-operative data. In multivariate logistic analysis, potassium, serum creatinine and C-reactive protein levels were sig-nificantly related to outcomes. Conclusions: Open repair and EVAR can both be safely performed in patients treated for elective and emergency infrarenal AAA. EVAR has perioperative advantages of reduced blood loss and blood transfusion, as well as decreased mortality and duration of post-operative hospital stay. In particular, we identified specific independent predictive factors of serum chemistry values for mortality and renal insufficiency. Introduction An abdominal aortic aneurysm (AAA) is defined as an enlargement of the aortic diameter with at least 150% of the diam-eter at the orifice of the renal arteries [1]. Elective treatment is recommended when the AAA size reaches 55 mm in diameter because of higher rates of rupture. Open
    04/2012;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: This study aimed to determine the morbidity and mortality of infrarenal ruptured abdominal aortic aneurysm (rAAA) repair, and to investigate the changes in perioperative laboratory values, as well as clarify the specific independent predictive factors for mortality and morbidity. We retrospectively evaluated patients who were treated in Jichi Medical University Hospital. Methods: A consecutive fifty-six patients with rAAA between April 2007 and August 2010 were studied. The possible predictive values of various patient-related variables on outcomes (mortality, major morbidity and renal insufficiency) were assessed by univariate and multivariate analysis. Results: The overall in-hospital mortality was 16.1%. In univariate logistic analyses, lactate dehydrogenase, alanine aminotransferase, as well as pre-operative and post-operative serum creatinine levels were significantly related to mortality. Blood transfusion volume, white blood cells and C-reactive protein levels were significantly related to major morbidity. Intraoperative blood loss, white blood cells, C-reactive protein levels, lactate dehydrogenase and pre-operative serum creatinine levels were significantly related to renal insufficiency. Conclusions: Emergency open repair can be safely performed in patients for infrarenal rAAA. In particular, we identified specific independent predictive factors of clinical examination and laboratory studies for mortality, major morbidity and renal insufficiency.
    03/2012;
  • Source
    Modern Pacemakers - Present and Future, 02/2011; , ISBN: 978-953-307-214-2
  • [Show abstract] [Hide abstract]
    ABSTRACT: We present a patient with a nine-year history of Beh├žet's disease (BD), who developed a rapidly expanding aneurysm of the aortic arch. Three-dimensional computed tomography demonstrated a saccular aortic arch aneurysm with a maximal diameter of 5 cm. No bacteria were detected by serial blood cultures. The aneurysm, however, showed a multi-lobular cavity, mimicking an infectious aneurysm. Therefore, we prescribed antibacterial agents for one week. The patient still had a high-fever and an elevated C-reactive protein level thereafter. Aortic arch replacement was performed emergently. Because we were unable to determine whether the aneurysm was caused by infection or BD, the implanted prosthetic graft and the anastomotic sites were covered with a pedicle graft of the greater omentum, and we continued to administer antibacterial agents for four weeks postoperatively. The pathological examination showed neither bacteria nor cystic medial necrosis in the resected aortic wall. Inflammatory changes with eosinophilic infiltration were recognized mainly around the adventitia near the aneurysm. The patient had a favorable postoperative course without any complications.
    Interactive Cardiovascular and Thoracic Surgery 12/2010; 12(3):502-4. · 1.11 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 57-year-old man, who was a chronic axillary crutch user as a result of childhood poliomyelitis, was referred to our hospital because of a sudden onset of right forearm ischemia. The right forearm had no pulse, and three-dimensional computed tomography (3DCT) showed an aneurysm of the right brachial artery associated with arterial occlusion. The thrombosed aneurysm of the brachial artery was resected and the brachial artery was successfully revascularized by interposing a saphenous vein graft. Postoperative 3DCT revealed an asymptomatic left brachial artery aneurysm. His postoperative course was uneventful under warfarin anticoagulation therapy.
    Interactive Cardiovascular and Thoracic Surgery 09/2009; 9(6):1038-9. · 1.11 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 59-year-old man was transferred to our hospital because of mural thrombus in the ascending aorta. He had suffered some neurological dysfunctions such as transient dysorientation. Electrocardiogram showed normal sinus rhythm without premature beats. Trans-thoracic echocardiogram and three-dimensional CT showed a mobile mural mass sticking to the ascending aortic wall. No coagulopathy was detected in the patient. The mural masses were thought to be a possible cause of the repeated cerebro-vascular symptoms. Under cardiopulmonary bypass and cardiac arrest, the masses were removed including the mass sticking to the aortic wall. Postoperative pathological findings showed the masses were organizing thrombi that had originated from the atherosclerotic aortic wall. Postoperative course was uneventful, and the patient was doing well one year after the operation without neurological dysfunction.
    Interactive Cardiovascular and Thoracic Surgery 09/2009; 9(5):899-900. · 1.11 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 42-year-old man, who 25 years previously underwent grafting of the descending aorta because of traumatic rupture after a traffic accident, was admitted to our hospital complaining of fever and hemoptysis. Computed tomography (CT) scans showed a low density area around the prosthetic graft. We diagnosed a graft infection. We undertook extraanatomical ascending-abdominal aorta bypass with stump closure of the descending aorta, with omentopexy around the stump. Postoperative course was uneventful and he has been free from infection for one year. Extraanatomical bypass was an effective strategy for treatment of a graft infection.
    Interactive Cardiovascular and Thoracic Surgery 06/2008; 7(4):646-7. · 1.11 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Recently, there has been an increase in case of repeated open-heart valve surgery and the clinical results of the second surgery are only slightly worse than those of the first surgery. However, clinical results of the third open-heart valve surgery at the same position are rarely reported. Clinical features of third open-heart valve surgery at the same position are discussed in this study. Between 1995 and 2004, 16 patients underwent third open-heart valve surgery at the same valve position under cardiopulmonary bypass. The average age of the 16 patients, 12 females and 4 males, was 56 +/- 15 years. Clinical features of the 16 cases were retrospectively analyzed. Mechanical valve nonstructural dysfunction was the most common valve malady, followed by bioprosthetic valve dysfunction. The duration of surgery from skin incision to establishment of the cardiopulmonary bypass was 94 +/- 42 minutes. Myocardial ischemia time was 137 +/- 38 minutes and extracorporeal circulation time was 212 +/- 82 minutes. Early mortality was seen in 1 patient (6.25%) and late mortality was seen in 1 patient. Mechanical valve nonstructural valve dysfunction leads to repeated valve surgery. The clinical results of the third open-heart valve surgery at the same valve position are acceptable, and the mid-term survival is excellent.
    The Japanese Journal of Thoracic and Cardiovascular Surgery 01/2006; 53(12):627-31.
  • Yoshio Misawa, Shin-ichi Ohki, Yasuhito Sakano
    Journal of Thoracic and Cardiovascular Surgery 02/2005; 129(1):236-7; author reply 237. · 3.53 Impact Factor