T Shichijo

Okayama University, Okayama, Okayama, Japan

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Publications (15)7.11 Total impact

  • Osami Honjo, Keiji Yunoki, Takeshi Shichijo, Osamu Oba
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    ABSTRACT: Since aneurysms in patients with Behçet's disease are often pseudoaneurysmal and adjacent arteries are highly inflammatory, there is not only a risk of rupture but also a high incidence of late surgical complications at anastomotic sites. Furthermore, there is no consensus on perioperative medical therapeutic strategy in patients with active vasculo-Behçet's disease who require surgery. Herein, we present two cases of active Behçet's disease, a 51-year-old male with rupture of the left internal iliac artery who required emergent operation and a 31-year-old male with a rapidly developed pseudoaneurysm in the right superficial femoral artery. Surgical and perioperative therapeutic strategies are also discussed.
    Annals of Vascular Surgery 10/2006; 20(5):664-8. · 0.99 Impact Factor
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    ABSTRACT: We report a case of co-existent coronary and peripheral vascular disease with collaterals to the lower extremities in a 72-year-old female. The patient had triple-vessel coronary artery disease, an occlusion of the bilateral iliac arteries, and the left internal mammary-inferior epigastric artery collateral pathway was a major route to the lower extremities. Coronary artery bypass grafting and right axillo-bifemoral bypass were performed. The well-developed left inferior epigastric artery was used as a conduit to the circumflex artery.
    Asian cardiovascular & thoracic annals 01/2005; 12(4):366-8.
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    ABSTRACT: Surgical treatment of aortic regurgitation due to Behçet's disease is difficult. A 57-year-old male with Behçet's disease underwent aortic valve replacement with a mechanical valve for aortic regurgitation in 1995. Due to prosthetic valve detachment, 5 months thereafter he underwent a Bentall type operation with a composite graft. Due to complication of the left ventricle to pulmonary arterial fistula, 6 months later a third operation was performed for closure of the fistula. He is doing well at present 5 years after the third operation. Left ventricle to pulmonary arterial fistula is an exceedingly rare complication and has not been reported in the literature.
    The Japanese Journal of Thoracic and Cardiovascular Surgery 04/2004; 52(3):135-8.
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    ABSTRACT: A 16-year-old girl presented with dyspnea 15 years after the Mustard operation for transposition of the great arteries with intact ventricular septum. An echocardiogram revealed secondary pulmonary hypertension due to pulmonary venous obstruction. Cardiac catheterization showed the left (pulmonary) ventricular pressure was over the systemic level. We performed a successful one-stage switch conversion. The patient is doing well 1 year after the switch conversion.
    The Annals of Thoracic Surgery 04/2002; 73(3):975-7. · 3.45 Impact Factor
  • Masahiro Inoue, Osamu Oba, Takeshi Shichijo, Keiji Yunoki
    Japanese Journal of Cardiovascular Surgery. 01/2002; 31(2):128-131.
  • K Nakanishi, T Shichijo, G Kato, M Nakai, O Oba
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    ABSTRACT: Open heart surgery without homologous blood transfusion remains difficult in children. The introduction of vacuum-assisted cardiopulmonary bypass circuits to reduce priming volume for pediatric patients has improved the percentage of transfusion-free operations. We retrospectively analyzed blood transfusion risk factors to further reduce blood transfusion requirements after vacuum-assisted circuit introduction. From March 1995 to June 1996, 49 patients weighing between 5 and 20 kg underwent cardiac surgery with cardiopulmonary bypass at our institution, excluding hospital deaths. We retrospectively analyzed risk factors influencing blood use in 37 patients with no blood priming in cardiopulmonary bypass after introducing a vacuum-assisted system. Factors selected for univariate analysis were age, body weight, cyanosis, preoperative Hb, operation time, cardiopulmonary bypass time, aortic cross-clamping time, and intraoperative and postoperative bleeding volume. Correlation between total bleeding volume/body weight and cardiopulmonary bypass time was studied by regression analysis. As risk factors, univariate analysis identified cyanotic disease, longer operation time (> 210 minutes), longer cardiopulmonary bypass time (> 90 minutes), longer aortic cross-clamping time (> 45 minutes), greater intraoperative bleeding volume/body weight (> 4 ml/kg), and greater postoperative bleeding volume/body weight (> 15 ml/kg). Regression analysis showed a significant positive correlation between total bleeding volume/body weight and cardiopulmonary bypass time. Cyanotic disease and long bypass time are risk factors in reducing blood transfusion requirements in pediatric open heart surgery after introduction of vacuum-assisted circuits. Further efforts are needed, however, to reduce blood transfusion requirements, particularly in these children.
    The Japanese Journal of Thoracic and Cardiovascular Surgery 09/2001; 49(9):564-9.
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    ABSTRACT: Open-heart surgery without homologous blood transfusion is still difficult in children because priming volume in cardiopulmonary bypass circuit results in extreme hemodilution. Vacuum-assisted cardiopulmonary bypass circuit has the benefit of improving venous return and results in lowering priming volume. We introduced vacuum-assisted cardiopulmonary bypass circuit in order to reduce priming volume for pediatric patients in March 1995. A retrospective study was made on the efficacy of vacuum-assisted circuit for pediatric open-heart surgery in reducing homologous blood transfusion. Patients weighing from 5 to 20 kg who underwent surgery between January 1991 and June 1996 were divided into two groups, group A comprised 128 patients before introduction of this circuit and group B comprised 49 patients after introduction, and their clinical course was compared. Vacuum-assisted circuit was used in 27 patients of group B. The percentage of transfusion-free operations was significantly higher in group B than in group A (33.6% in group A vs. 53.1% in group B, P = 0.014), and particularly this percentage in patients weighing less than 10 kg significantly increased (0% in group A vs. 42.9% in group B, P < 0.01). The amount of homologous blood transfusion was significantly lower in group B than in group A (374 +/- 362 ml in group A and 212 +/- 287 ml in group B, P < 0.01). The rate of complications and the duration of respiratory support did not differ between the two groups. The duration of hospital stay was lower in group B than in group A. The findings of this study indicate that vacuum-assisted circuit is useful for pediatric open-heart surgery in reducing homologous blood transfusion.
    European Journal of Cardio-Thoracic Surgery 09/2001; 20(2):233-8. · 2.67 Impact Factor
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    ABSTRACT: A 63-year-old woman complicated with liver cirrhosis and pancytopenia was admitted for aortic and mitral valve replacement. As laboratory findings at time of admission showed pancytopenia with Hb of 7.3 g/dl, WBC of 2,200/mm3, and platelet of 6.2 x 10(4)/mm3, splenectomy was first conducted and the blood cells and platelet increased in number. At 27 days after splenectomy, double vale replacement was performed without blood transfusion and her postoperative course was unevenfull. It is considered that preoperative splenectomy is useful in management of patients complicated with hypersplenism and pancytopenia.
    Kyobu geka. The Japanese journal of thoracic surgery 09/2000; 53(9):784-6.
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    ABSTRACT: We performed combined operation for patients who have both ischemic heart disease and valvular heart disease in 21 cases from January 1991 to October 1999. This operation was 3.1% of 682 cases of coronary artery bypass grafting and 5.0% of 416 cases of operation for valvular heart disease during that period. The mean age of these patients was 67.9 +/- 9.1 years. The average number of grafts in the coronary artery bypass grafting was 1.5 +/- 0.6. Aortic valve replacement was performed in 6 cases, mitral valve replacement in 10 cases and mitral valve plasty in 5 cases. Together with this combined operation, ascending aorta and aortic arch replacement was done in 1 case and abdominal aortic replacement in 2 cases. Three patients died due to postoperative aortic rupture, cerebral infarction or excessive surgical intervention in ascending aorta and aortic arch replacement. Combined operation for ischemic heart diseases and valvular heart diseases can safely performed, but it appears necessary to pay attention to arteriosclerotic lesions.
    Kyobu geka. The Japanese journal of thoracic surgery 08/2000; 53(8 Suppl):663-6.
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    ABSTRACT: A total of 121 patients aged 75 years or older underwent cardiac operation or thoracic aortic operation at our hospital between 1988 and February 1997. They were composed of 74 cases of ischemic heart disease, 22 cases of valvular disease, 1 case of myxoma, and 24 cases of thoracic aortic disease. Operative mortality rate was 13.5% in ischemic heart disease, 4.2% in valvular disease and myxoma, and 25% in thoracic aortic disease. In ischemic heart disease, the operative mortality rate was especially high in emergency operation for acute myocardial infarction. In thoracic aortic operation, further improvement should be made with regard to preoperative and intraoperative management.
    Kyobu geka. The Japanese journal of thoracic surgery 08/1997; 50(8 Suppl):714-7.
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    ABSTRACT: Study was made on the operative results, risk factors, and late results of coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI) conducted at our hospital. The subjects of the present study were 70 cases of AMI who underwent CABG during a period of five years from January 1991 to December 1995. They were composed of 61 males and 9 females whose mean age was 61.9 years. LMT disease was observed in 13 cases and preoperative shock in 18 cases. The mean aortic cross-clamp time was 64 minutes with the mean extracorporeal circulation time being 134 minutes and the mean number of grafts being 2.5. The mean preoperative-postoperative peak creatine kinase was 4479 IU/L. The number of operative deaths was 14 with a mortality rate of 20%. When compared with elective cases of CABG conducted during the same period with a mortality rate of 2.7%, the operative result of AMI was poor. The mortality rate by risk factor was 40% for age of 70 years or more, 46.2% for complication of LMT disease, 52.9% for preoperative shock, 58.3% for preoperative C.I. of less than 2.0, 80% for postoperative C.I. of less than 2.0, 28.2% for conduct of postoperative circulatory support, and 42.1% for peak creatine kinase of 5000 IU/L or more. Aortic cross-clamp time and reperfusion time (interval from onset of AMI to aortic declamp) were found not to be risk factors. Late death accounted for 5 cases including one case of cardiac death due to suspected AMI. Survival rate excluding operative deaths and hospital deaths was 98% in one year and 83.9% in five years. When compared to non cardiacevent cases, the survival rate of positive cardiac event cases was significantly poor. The operative results of severe myocardial ischemia cases represented by cases of complication of LMT disease were poor and it is considered that improvement of intraoperative myocardial protection and aggressive use of postoperative circulatory support are necessary in the future. The survival cases of those who could endure surgery was comparatively satisfactory, but when cardiac event developed, prognosis was poor and thus more rigid follow-up is considered to be necessary.
    [Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai 08/1997; 45(7):950-7.
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    ABSTRACT: For 13 years between 1980 and 1992, 23 patients needed pacemaker (PM) implantation because of bradyarrhythmia, 21 of atrial fibrillation and two of complete A-V block, after valve surgery. Five of 88 survivors (5.7%) after OMC, 11 of 227 (4.8%) after MVR, one of 169 (0.6%) after AVR, five of 67 (7.4%) after MVR + AVR and one of 15 (6.7%) after TVR underwent PM implantation in postoperative period. Two cases who had heart failure was implanted PM in early postoperative period. In late period, the mean duration between previous valve surgery and PM implantation was 6.4 years in 12 cases after initial valve surgery and 2.3 years in nine after second valve surgery. Postoperative course after PM implantation was almost good, but one case was died due to critical arrhythmia. And one case underwent re-MVR because of mitral bioprosthesis dysfunction and one, without anticoagulant after OMC, was complicated cerebral infarction.
    Rinshō kyōbu geka = Japanese annals of thoracic surgery 01/1995; 14(6):497-500.
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    ABSTRACT: Pacemaker malfunction was attributed to the increasing in impedance to current flow caused by a pocket of air separating the anodal contact plate of a unipolar generator from the overlying connective tissue (so-called dry pocket). Lack of capture was noted just after replacement of pulse generator. The malfunction was permanently corrected by bediside infusion of saline to pacemaker pocket.
    [Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai 11/1994; 42(10):1981-3.
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    ABSTRACT: A 82-year-old female was admitted to our department with complaint of hoarseness. Retrograde aortogram revealed an aneurysm arising from distal aortic arch. The aorta including the aneurysm was resected and replaced with woven Dacron graft under partial cardiopulmonary bypass. An Aneurysm of the diverticulum of the ductus arteriosus is rare in adult and because of its high fatality it should be resected.
    Kyobu geka. The Japanese journal of thoracic surgery 05/1994; 47(4):299-301.
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    ABSTRACT: A case, 31-year-old female with aortic regurgitation and ostial obstruction of left coronary artery, was reported. Her chief complaint was effort angina. The coronary angiography showed obstruction of left coronary ostium with intact main stem and its branches, perfused from right coronary artery and the aortogram revealed aortic regurgitation of grade 3-4. Left Valsalva sinus was obstructed by adhesion of left coronary cusp. Each coronary cusps were resected, and aortic valve replacement with 23 mm SJM valve and coronary arterial bypass by means of in-situ graft of left internal thoracic artery underwent successfully. The pathological findings of aortic cusps were healed valvulitis without specific inflammation as syphilis or aortitis syndrome.
    Rinshō kyōbu geka = Japanese annals of thoracic surgery 05/1994; 14(2):141-3.