Masanao Ohba

Publications (4)9.45 Total impact

• Source

  Available from: Koichi Sughimoto

  Article: Fontan completions over 10 years after Glenn procedures.

  Koichi Sughimoto, Kozo Matsuo, Koichiro Niwa, Yasutaka Kawasoe, Shigeru Tateno, Takeaki Shirai, Masashi Kabasawa, Masanao Ohba
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  ABSTRACT: Objective: Despite the broadened indications for Fontan procedure, there are patients who could not proceed to Fontan procedure because of the strict Fontan criteria during the early period. Some patients suffer from post-Glenn complications such as hypoxia, arrhythmia, or fatigue with exertion long after the Glenn procedure. We explored the possibility of Fontan completion for those patients. Methods: Between 2004 and 2010, five consecutive patients aged between 13 and 31 years (median 21) underwent Fontan completion. These patients had been followed up for more than 10 years (10 to 13, median 11) after Glenn procedure as non-Fontan candidates. We summarise these patients retrospectively in terms of their pre-operative physiological condition, surgical strategy, and problems that these patients hold. Results: Pre-operative catheterisation showed pulmonary vascular resistance ranging from 0.9 to 3.7 (median 2.2), pulmonary to systemic flow ratio of 0.3 to 1.6 (median 0.9), and two patients had significant aortopulmonary collaterals. Extracardiac total cavopulmonary connections were performed in three patients, lateral tunnel total cavopulmonary connection in one patient, and intracardiac total cavopulmonary connection in one patient, without a surgical fenestration. Concomitant surgeries were required including valve surgeries - atrioventricular valve plasty in three patients and tricuspid valve replacement in one patient; systemic outflow tract obstruction release - Damus-Kaye-Stansel procedure in two patients and subaortic stenosis resection in one patient; and anti-arrhythmic therapies - maze procedure in two patients, cryoablation in two patients, and pacemaker implantation in two patients. All patients are now in New York Heart Association category I. Conclusion: Patients often suffer from post-Glenn complications. Of those, if they are re-examined carefully, some may have a chance to undergo Fontan completion and benefit from it. Multiple lesions such as atrioventricular valve regurgitation, systemic outflow obstruction, or arrhythmia should be surgically repaired concomitantly.
  Cardiology in the Young 03/2013; · 0.76 Impact Factor
• Source

  Available from: Koichi Sughimoto

  Article: Intra-atrial rerouting and maze procedure for an adult patient in cor triatriatum, persistent left superior vena cava, and atrial fibrillation.

  Koichi Sughimoto, Kozo Matsuo, Masanao Ohba
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  ABSTRACT: A combination of cor triatriatum and persistent left superior vena cava without communication to the coronary sinus is uncommon. A 62-year-old male with this diagnosis in conjunction with atrial fibrillation underwent successful intracardiac repair done with a unique method. After a maze procedure and enlargement of the route from the pulmonary veins to the mitral valve, a GoreTex graft was used to reroute the left superior vena cava into the right atrium and to close two thirds of the circumference of the patient's atrial septal defect; the rest of the defect was closed with another GoreTex patch.
  The Annals of thoracic surgery 06/2012; 93(6):2056-8. · 3.74 Impact Factor
• Article: Intracardiac total cavopulmonary connection in an asplenic adult male 12 years after Glenn procedure for total anomalous pulmonary venous return (1b).

  Koichi Sughimoto, Kozo Matsuo, Masanao Ohba
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  ABSTRACT: Although indications for a Fontan procedure have broadened, some patients, in the past, were ineligible for the Fontan completion after a Glenn procedure and thus suffered the limitations of the Glenn procedure-namely desaturation, arrhythmia and reduced quality of life. If examined more closely, however, completion may yet be feasible for such patients. We present here a complex case of asplenia, dextrocardia and total anomalous pulmonary venous return (1b) where the Fontan procedure was successfully completed 12 years after the Glenn procedure. A unique surgical strategy incorporating intra-atrial total cavopulmonary connection and atrioventricular valve repair contributed to our success.
  European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 02/2012; 42(1):182-4. · 2.40 Impact Factor
• Source

  Available from: Koichi Sughimoto

  Article: Intracardiac total cavopulmonary connection in an asplenic adult male 12 years after Glenn procedure for total anomalous pulmonary venous return (1b)

  Koichi Sughimoto, Kozo Matsuo, Masanao Ohba
  [show abstract] [hide abstract]
  ABSTRACT: Although indications for a Fontan procedure have broadened, some patients, in the past, were ineligible for the Fontan completion after a Glenn procedure and thus suffered the limitations of the Glenn procedure—namely desaturation, arrhythmia and reduced quality of life. If examined more closely, however, completion may yet be feasible for such patients. We present here a complex case of asplenia, dextrocardia and total anomalous pulmonary venous return (1b) where the Fontan procedure was successfully completed 12 years after the Glenn procedure. A unique surgical strategy incorporating intra-atrial total cavopulmonary connection and atrioventricular valve repair contributed to our success.
  European Journal of Cardio-Thoracic Surgery 02/2012; · 2.55 Impact Factor