Shingo Chihara

Publications (9)19.73 Total impact

• Article: Transcatheter coil embolization for patent ductus arteriosus in the elderly: report of a case and review of the published work.

  Shigeaki Aoyagi, Shingo Chihara, Shuji Fukunaga, Ryusuke Mori, Kenji Suda
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  ABSTRACT: Patent ductus arteriosus is the third most common congenital cardiovascular anomaly, however, it is rarely found in the elderly. We describe a case of patent ductus arteriosus in a 72-year-old woman in whom patent ductus arteriosus was successfully managed by transcatheter coil embolization. The patient had been diagnosed with a heart murmur for the first time 1 year earlier at the age of 71. She was asymptomatic but a continuous murmur was heard. Cardiac catheterization revealed migration of a catheter from the main pulmonary artery into the descending aorta through a patent ductus arteriosus and a significant step-up of oxygen saturation in the main pulmonary artery with a pulmonary-to-systemic flow ratio of 1.68. Aortograms demonstrated a communication between the aorta and the pulmonary artery through a patent ductus arteriosus with a minimal diameter of 3.7 mm. Transcatheter coil embolization of the patent ductus arteriosus was successfully carried out with two 0.052-inch-diameter Gianturco coils. Doppler echocardiographic study confirmed no residual shunt in the main pulmonary artery after the procedure. Non-surgical transcatheter occlusion using coil embolization appears to be an effective and minimally invasive technique for treatment of patent ductus arteriosus in the elderly.
  Geriatrics & Gerontology International 10/2009; 9(3):329-32.
• Source

  Available from: atcs.jp

  Article: Embolic myocardial infarction and left ventricular rupture due to mitral valve endocarditis.

  Eiki Tayama, Shingo Chihara, Shuji Fukunaga, Hidetoshi Akashi, Shigeaki Aoyagi, Kei-Ichiro Mizoguchi
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  ABSTRACT: A left ventricular rupture due to embolic myocardial infarction is extremely rare. A 72-year-old woman developed an acute embolic myocardial infarction and mitral regurgitation due to infective endocarditis. Two days after the infarction, a left ventricular free wall rupture occurred after transesophageal echo examination. She received an epicardial patch and mitral valve replacement. Perioperatively, an intra-aortic balloon pump and long-term antibiotics were used. The postoperative course was uneventful, and she is doing well 10 months after surgery.
  Annals of thoracic and cardiovascular surgery: official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 07/2007; 13(3):206-8. · 0.69 Impact Factor
• Article: Spontaneous coronary artery dissection causing myocardial infarction and left ventricular aneurysm.

  Tohru Takaseya, Masaru Nishimi, Takemi Kawara, Eiki Tayama, Shuji Fukunaga, Syogo Yokose, Shingo Chihara, Nobuhiko Hayashida, Shigeaki Aoyagi
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  ABSTRACT: Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial infarction (MI). A 66-year-old Japanese man, who had had an anterior wall MI caused by SCAD of the left anterior descending coronary artery, developed left ventricular aneurysm 5 years later, with depressed left ventricular function and thrombus observed on echocardiography. Left endoventricular circular patch plasty according to Dor's technique was performed without coronary artery bypass grafting, because of the absense of significant coronary artery stenosis on the preoperative coronary angiogram. The clinical course of SCAD in the late phase is generally favorable, but because the prognosis of SCAD is uncertain, patients with SCAD should be carefully followed.
  Circulation Journal 11/2002; 66(10):972-3. · 3.77 Impact Factor
• Article: Does off-pump coronary artery bypass grafting really preserve renal function?

  Nobuhiko Hayashida, Hideki Teshima, Shingo Chihara, Hiroshi Tomoeda, Tohru Takaseya, Ryouichi Hiratsuka, Takahiro Shoujima, Kazuyoshi Takagi, Takemi Kawara, Shigeaki Aoyagi
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  ABSTRACT: It is well known that the use of cardiopulmonary bypass (CPB) influences renal function and occasionally results in renal failure following cardiac surgery. Coronary artery bypass grafting (CABG) without CPB may avoid this and preserve the perioperative renal function. The present study enrolled 52 patients undergoing CABG without CPB (OPCAB group) and matched them for renal function and prognostic variables with 53 patients undergoing conventional CABG (CABG group). Perioperative renal function and early clinical results were assessed. The OPCAB group had significantly less increase in creatinine levels (0.16 +/- 0.05 vs 0.45 +/- 0.06 mg/dl; p = 0.01) and greater creatinine clearance (81.6 +/- 7.3 vs 56.3 +/- 4.8ml/min; p = 0.01) postoperatively. Postoperative recovery of free water clearance was more prompt in the OPCAB group. The duration of intubation and intensive care unit stay was significantly shorter, and the creatine kinase-MB release and blood transfusion requirements were significantly less in the OPCAB group. The OPCAB technique preserved glomerular filtration rate and prevented the increase in creatinine levels. The results suggest that the technique enables earlier patient recovery and gives superior renal protection compared with conventional CABG.
  Circulation Journal 11/2002; 66(10):921-5. · 3.77 Impact Factor
• Article: Thrombolytic therapy with tissue plasminogen activator for the treatment of nonstructural malfunction of bileaflet cardiac valve prostheses.

  Hideki Teshima, Nobuhiko Hayashida, Masaru Nishimi, Eiki Tayama, Shuji Fukunaga, Hiroshi Tomoeda, Shingo Chihara, Naofumi Enomoto, Takemi Kawara, Shigeaki Aoyagi
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  ABSTRACT: This study was conducted to determine the effect of thrombolytic therapy with tissue plasminogen activator (t-PA) for nonstructural malfunction of bileaflet cardiac valve prostheses. Twenty-seven patients with bileaflet prosthetic valve malfunction diagnosed by a combination of cineradiography and transthoracic echocardiography were treated with the administration of intravenous t-PA. The treatment resulted in complete success in 55.6% (15 of 27), partial success in 22.2% (6 of 27), and no change in 22.2% (6 of 27). In the complete success and partial success groups, the condition of the patients in 85.7% (18 of 21) of the cases improved within 24 h after the administration of t-PA. Six cases in whom thrombolytic therapy was instituted more than 1 month (ranged from 1 to 38 months, mean 14.7 months) after the diagnosis of prosthetic valve malfunction showed significantly less effectiveness of thrombolytic therapy with t-PA. Only one patient (3.7%) had a major complication (thromboembolism) after t-PA treatment. The results suggest that thrombolytic therapy with t-PA in patients with nonstructural malfunction of bileaflet cardiac valve prostheses is effective with low incidence of complication when the treatment is instituted early after the diagnosis.
  Artificial Organs 06/2002; 26(5):460-6. · 2.00 Impact Factor
• Article: Influence of colforsin daropate hydrochloride on internal mammary artery grafts.

  Nobuhiko Hayashida, Hideki Teshima, Eiki Tayama, Shingo Chihara, Naofumi Enomoto, Takemi Kawara, Shigeaki Aoyagi
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  ABSTRACT: The effect of colforsin daropate hydrochloride (colforsin), a water-soluble forskolin derivative, on blood flow in internal mammary artery (IMA) grafts was evaluated in a prospective randomized study of 26 patients undergoing coronary artery bypass grafting. Patients were randomized to receive either colforsin treatment (colforsin; n=14) or no colforsin treatment (control; n=14). Administration of colforsin (0.5mg x kg(-1) min(-1)) was started after induction of anesthesia and was continued for 6 h. IMA blood flow and hemodynamic measurements were assessed perioperatively. During cardiopoulmonary bypass (CPB), perfusion flow was adjusted to 2.5 L/m2 and IMA free blood flow was measured. IMA blood flow was also measured 1 h after CPB by an ultrasonic flow meter. Systemic vascular resistance was significantly lower in the colforsin group during and after CPB. IMA blood flow was significantly greater in the colforsin group than in the control group during (44 +/- 2 vs 33 +/- 3 ml min-1 x m(-2), p=0.02) and after CPB (38 +/- 6 vs 20 +/- 3ml x min(-1) m(-2), p=0.01). IMA blood flow 1 h after CPB correlated inversely with concurrent systemic vascular resistance (r=-0.61, p=0.001). Intraoperative administration of colforsin daropate hydrochloride caused potent vasodilation, resulting in an increase in IMA blood flow. The results indicate that the regimen can be used perioperatively in patients undergoing coronary artery bypass grafting.
  Circulation Journal 05/2002; 66(4):372-6. · 3.77 Impact Factor
• Article: Effects of supplemental sialyl Lewis(x) analogue during warm blood cardioplegia.

  Shingo Chihara
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  ABSTRACT: Effects of supplemental Sialyl Lewisx analogue, a major ligand for all three selectin family members, during warm blood cardioplegia were assessed in the blood perfused isolated rat heart. The isolated hearts were arrested for 60 min with warm blood cardioplegia given at 20-min intervals. This was followed by 60 min of reperfusion. The hearts were divided into the following two groups according to the supplemental drugs added to the cardioplegic solution. The control group (n = 6) received standard warm blood cardioplegia. The Sialyl Lewisx analogue group (n = 6) received warm blood cardioplegia supplemented with Sialyl Lewisx analogue (60 micrograms/ml). Cardiac function, endothelial function, myocardial metabolism and myocardial myeloperoxidase activity were assessed before and after cardioplegic arrest. Left ventricular developed pressure and dp/dt were significantly (p < 0.05) greater and -dp/dt was significantly (p < 0.05) lower in the Sialyl Lewisx analogue group than the control group during reperfusion. Coronary flow at 15 min of reperfusion and NO production, when acetylcholine chloride was added were significantly (p < 0.05) greater in the Sialyl Lewisx analogue group than the control group. Myeloperoxidase activity was significantly (p < 0.05) lower in the Sialyl Lewisx analogue group than the control group. The results suggest that selectin-mediated endothelial-leukocyte interactions may play an important role in myocardial ischemia and reperfusion injury. Supplementation of Sialyl Lewisx analogue during warm blood cardioplegia may provide superior myocardial protection by suppressing leukocyte-endothelial interaction during early reperfusion period.
  The Kurume Medical Journal 01/2002; 49(4):191-9.
• Article: Biological Activity of Endogenous Atrial Natriuretic Peptide During Cardiopulmonary Bypass

  Nobuhiko Hayashida, Shingo Chihara, Hideyuki Kashikie, Eiki Tayama, Shogo Yokose, Koji Akasu, Shigeaki Aoyagi
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  ABSTRACT: To evaluate the effect of cardiopulmonary bypass (CPB) on atrial natriuretic peptide (ANP) biological activity in patients undergoing cardiac operations, we conducted a prospective study. Ten patients undergoing mitral valve surgery were enrolled. Plasma levels of ANP and cyclic guanosine monophosphate (cGMP), hemodynamic variables, and renal function parameters were assessed perioperatively. The molar ratio of cGMP to ANP (as a marker for ANP biological activity) decreased significantly (p < 0.05) during CPB despite similar plasma ANP levels. The ratio correlated inversely with the duration of CPB (r = −0.85, p = 0.002). The ratio also correlated with fractional sodium excretion (r = 0.65, p = 0.04) and correlated inversely with pulmonary vascular resistance (r = −0.79, p = 0.009) and atrial filling pressure (r = −0.84, p = 0.003) postoperatively. CPB decreased the molar ratio of cGMP to ANP, which may represent ANP biological activity, such as vasodilation and natriuresis. The phenomenon may contribute to water–sodium retention and pulmonary hypertension after cardiac surgery.
  Artificial Organs 09/2000; 24(10):833 - 838. · 2.00 Impact Factor
• Article: Inhibitory effect of milrinone on cytokine production after cardiopulmonary bypass

  Nobuhiko Hayashida, Hiroshi Tomoeda, Takeshi Oda, Eiki Tayama, Shingo Chihara, Takemi Kawara, Shigeaki Aoyagi
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  ABSTRACT: Background. It has been suggested that cyclic adenosine monophosphate-elevating agents suppress cytokine production. To evaluate the effects of milrinone, a phosphodiesterase III inhibitor, on cytokine production after cardiopulmonary bypass, we conducted a prospective randomized study.Methods. Twenty-four patients undergoing coronary artery bypass grafting were randomized to receive either milrinone treatment (milrinone, n = 12) or no milrinone treatment (control, n = 12). Administration of milrinone (0.5 μg · kg−1 · min−1) was started after induction of anesthesia and was continued for 24 hours. Blood samples for determination of plasma cyclic adenosine monophosphate, tumor necrosis factor-α, interleukin-1β, interleukin-6, and interleukin-8 levels were collected perioperatively.Results. No significant differences were observed in tumor necrosis factor-α and interleukin-8 levels between the groups. Interleukin-1β and interleukin-6 levels after cardiopulmonary bypass were significantly (p < 0.05) lower in the milrinone group than in the control group. Plasma levels of cyclic adenosine monophosphate increased significantly (p < 0.05) after the administration of milrinone and the levels correlated inversely (r = −0.55, p < 0.01) with interleukin-6 levels.Conclusions. The results indicate that milrinone suppresses cytokine production by elevating cyclic adenosine monophosphate levels in patients undergoing cardiopulmonary bypass. With its positive inotropic and vasodilator activities, milrinone may have antiinflammatory effects.
  The Annals of Thoracic Surgery 11/1999; · 3.74 Impact Factor