Publications (12)33.18 Total impact
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Article: Reversal of acute monoparesis following thoracoabdominal aortic aneurysm repair.
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ABSTRACT: A 67-year-old man underwent surgical repair for a Crawford extent V thoracoabdominal aortic aneurysm under cerebrospinal fluid drainage and motor evoked potential monitor on distal aortic perfusion. Postoperatively, weakness of right-sided leg graded 2/5 and bladder disorder were recognized. Magnetic resonance imaging revealed hyperintensity between Th11 and L1 on T2-weighted image. Intravenous glycerin and edaravone for spinal cord ischemia had been administered. The strength of right leg resolved completely with disappearance of hyperintensity on magnetic resonance image. Finally, he could walk on foot with bladder disorder.General Thoracic and Cardiovascular Surgery 04/2013; -
Article: Late Results of Mitral Valve Repair With Glutaraldehyde-Treated Autologous Pericardium.
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ABSTRACT: BACKGROUND: Mitral valve repair is an established surgical procedure for treating severe organic mitral regurgitation. The mechanisms of mitral regurgitation due to infective endocarditis include rheumatic disease and congenital diseases such as a lack of leaflet tissue, and thus additional material is required to create a functional coaptation surface. We review our experience with 139 patients who underwent mitral valve repair with glutaraldehyde-treated autologous pericardium to treat organic mitral regurgitation between March 1992 and November 2011. METHODS: Mitral valve disease mainly consisted of infective endocarditis in 51 patients (active, n = 32; healed, n = 19) and rheumatic disease in 47. This procedure was also applied to 12 patients who required reoperation after mitral valve repair for degenerative, congenital, or rheumatic mitral regurgitation. The mean follow-up was 4.5 ± 4.3 years (maximum 19.1). RESULTS: Actuarial survival at 10 years was 84% ± 5%. Eleven reoperations proceeded at a mean of 68 months after surgery. The causes of reoperation were rheumatic disease progression (n = 4), infection (n = 3), patch dehiscence (n = 2), progressive fibrosis of the remaining mitral valve tissue after infective endocarditis (n = 1), and patch tear (n = 1). Mitral valves were replaced in 8 patients and re-repaired in 3 patients. The autologous pericardium was not calcified at the time of reoperation. The rate of freedom from reoperation was 82% ± 7% at 10 years. CONCLUSIONS: Mitral valves that might otherwise require replacement can be durably and predictably repaired using glutaraldehyde-treated autologous pericardium.The Annals of thoracic surgery 04/2013; · 3.74 Impact Factor -
Article: Reoperation for pseudoaneurysm of the thoracic aorta after cardiovascular surgery.
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ABSTRACT: PURPOSE: Pseudoaneurysms of the thoracic aorta after cardiovascular surgery are rare, but life-threatening complications. We herein describe the clinical outcomes of pseudoaneurysms of the thoracic aorta arising after cardiovascular surgery. METHODS: We retrospectively reviewed 14 patients (mean age 64 years) who underwent reoperation for a pseudoaneurysm of the thoracic aorta between January 1997 and December 2010. RESULTS: Pseudoaneurysms of the thoracic aorta were detected incidentally during routine follow-up in 11 asymptomatic patients, whereas symptoms or signs indicating an aortic pseudoaneurysm were present in three patients. The mean intervals between repeat and previous cardiovascular surgeries and the follow-up were 167 and 62 months, respectively. The aortic pseudoaneurysms were located in the proximal and distal suture lines in six patients, and at aortotomy sites in four. These locations accounted for about 70 % of all aortic pseudoaneurysms. None of the patients died in the hospital. Postoperative complications, such as a need for permanent pacemaker implantation or groin-related issues, occurred in five patients. However, no major postoperative complications, aorta-related events or a need for reoperation developed during the follow-up period. CONCLUSIONS: Regular follow-up, including imaging modalities and physical examinations, is mandatory to detect aortic pseudoaneurysms after cardiovascular surgery.Surgery Today 02/2013; · 1.22 Impact Factor -
Article: Clinical Outcomes of Redo Valvular Operations: A 20-Year Experience.
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ABSTRACT: BACKGROUND: A higher operative mortality rate has been reported after redo valvular procedures than after the primary operation. METHODS: Outcomes of 330 consecutive patients undergoing 433 redo valvular operations at our institute during a 20-year period (January 1990 to December 2010) were reviewed retrospectively. The mean follow-up was 6.4 years (range, 0.05 to 1.3 years). Logistic regression analysis was used to identify factors associated with hospital death. RESULTS: The overall hospital mortality rate was 6.7% (29 of 433 procedures). Logistic regression analysis identified only advanced New York Heart Association (NYHA) class as an independent predictor of hospital death. Overall survival at 5, 10, and 15 years was 83.6% ± 2.2%, 70.7% ± 3.4%, and 61.5% ± 4.5%, respectively. The 5-, 10-, and 15-year survivals for the first redo vs more than second redo groups were 86.5% ± 2.4% vs 74.7% ± 5.5%, 71.8% ± 3.9% vs 66.8% ± 6.6%, and 60.2% ± 5.7% vs 63.1% ± 7.2%, respectively (log-rank P = 0.505). The 5- and 10-year survivals for NYHA class I/II vs III/IV patients were 91.5% ± 2.1% vs 70.4% ± 4.5% and 77.8% ± 4.1% vs 58.5% ± 5.6%, respectively (log-rank p < 0.005). CONCLUSIONS: Redo valvular operation in NYHA class III/IV patients is associated with high hospital death and poor long-term survival. To achieve low hospital death and good long-term survival, redo operations, including more than third redo operations, should be performed in patients with lower NYHA class.The Annals of thoracic surgery 08/2012; · 3.74 Impact Factor -
Article: Tricuspid leaflet augmentation with an autologous pericardial patch for recurrent severe tricuspid regurgitation that occurred after suture annuloplasty.
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ABSTRACT: We, herein, report the use of tricuspid leaflet augmentation with an autologous pericardial patch to treat a patient with severe tricuspid regurgitation (TR) that occurred after suture annuloplasty. The patient underwent mitral valve replacement for rheumatic mitral disease and tricuspid suture annuloplasty for moderate TR 23 years ago. She developed right-sided heart failure associated with severe TR. Leaflet augmentation with an autologous pericardial patch and ring annuloplasty were applied at redo surgery. Postoperative echocardiography showed trivial TR with significant improvement of the patient's symptoms. We have now performed this technique on three cases of severe recurrent TR that occurred after suture annuloplasty, and excellent early results were obtained in each case.Surgery Today 07/2012; · 1.22 Impact Factor -
Article: Survival after simultaneous repair of bichamber cardiac and pulmonary vein rupture caused by blunt chest trauma.
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ABSTRACT: A 44-year-old woman was transferred to our institution because of blunt chest trauma. Transthoracic echocardiography revealed decompression of the right ventricle resulting from pericardial effusion. Her hemodynamic condition was worsening gradually, and the decision was made to take the patient to the operating room. After releasing a large amount of clotting blood within the pericardial cavity, catastrophic hemorrhage occurred. Under better visualization after the patient was placed on cardiopulmonary bypass, we identified a 5-cm longitudinal tear and a 2-cm tear in the right atrium (RA), a 2-mm tear in the right ventricle (RV), and a 5-mm tear in the right lower pulmonary vein (PV). Those tears were repaired successfully with 5-0 polypropylene sutures.The Annals of thoracic surgery 07/2012; 94(1):265-7. · 3.74 Impact Factor -
Article: Ortner syndrome associated with aortic pseudoaneurysm after repair of aortic coarctation 30 years previously.
Circulation 05/2012; 125(20):e937-8. · 14.74 Impact Factor -
Article: Aortic valve replacement after esophagectomy with substernal gastric tube and total laryngectomy with tracheostoma.
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ABSTRACT: A 77-year-old man successfully underwent aortic valve replacement with a bioprosthesis through a right thoracotomy. Right thoracotomy was utilized because the patient had previously undergone esophagectomy with reconstruction of a substernal gastric tube for esophageal cancer as well as total laryngectomy with tracheostoma formation for laryngeal cancer. Thus, even in a situation in which conventional median sternotomy was difficult, a good outcome for aortic valve replacement was achieved through an alternate approach. This case highlights the need to consider patient history when selecting a surgical approach.The Annals of thoracic surgery 05/2012; 94(1):271-3. · 3.74 Impact Factor -
Article: Clinical outcomes of open heart surgery in patients with atopic dermatitis.
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ABSTRACT: Atopic dermatitis is a skin condition often complicated by colonization with Staphylococcus aureus, which increases the risk of infective endocarditis, skin cellulitis and osteomyelitis. Positive cultures for Staphylococcus aureus are obtained from 70% to 80% of wounds in patients with mediastinitis. Thus sternotomy carries increased risk of mediastinitis in patients with atopic dermatitis. We retrospectively reviewed 25 patients with atopic dermatitis who underwent cardiac surgery via a median sternotomy or thoracotomy from January 1997 to September 2010 at our institution. Postoperative mediastinitis due to methicillin-resistant Staphylococcus aureus was found in 3 patients who had a median sternotomy. They were ultimately discharged in good condition. No mediastinitis occurred in patients undergoing thoracotomy. Mediastinitis may occur due to direct exposure of the bone marrow to methicillin-resistant Staphylococcus aureus in patients with atopic dermatitis whose skin is colonized with such bacteria. Thoracotomy may be a better surgical approach in patients with atopic dermatitis who require thoracic surgery.Asian cardiovascular & thoracic annals 04/2012; 20(2):137-40. -
Article: Aortic Valve-Sparing Operation after Correction of Heart Displacement due to Pectus Excavatum Using Nuss Procedure in a Marfan Syndrome Patient.
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ABSTRACT: Cardiovascular surgery in the setting of chest wall deformities is a clinical challenge. Pectus excavatum, for example, can cause heart displacement to the left thoracic cavity, following the poor operative field. This report highlights a case in which a successful aortic valve-sparing operation via conventional median sternotomy after correction of the heart displacement due to pectus excavatum using Nuss procedure in Marfan syndrome. This technique can be one surgical option in Marfan syndrome patients with pectus excavatum and thoracic aortic aneurysm under close follow up.Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia. 02/2012; 18(5):475-7. -
Article: Successful treatment for infected aortic aneurysm using endovascular aneurysm repairs as a bridge to delayed open surgery.
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ABSTRACT: Management of infected aortic aneurysms, which can be life-threatening, remains challenging. Open surgical treatments, including debridement of the infected aorta and the surrounding tissue and either in situ reconstruction or extra-anatomic bypass covering with omentum or muscle flap, are the mainstay of therapy. However, increasing advances in technology have made endovascular treatment of infected aneurysms feasible. The present study describes the first clinical report of successful treatment of an infected aneurysm using endovascular techniques in the acute phase, followed by delayed open surgery.Annals of Vascular Surgery 02/2012; 26(2):280.e5-8. · 1.03 Impact Factor -
Article: Dissecting Aneurysm in A Patient with Autosomal Dominant Polycystic Kidney Disease.
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ABSTRACT: Autosomal dominant polycystic kidney disease (ADPKD) is primarily associated with renal failure, but it also causes systemic diseases, including cysts of other systemic organs and cerebral or visceral aneurysm. To make matters worse, life-threatening aortic diseases are associated with ADPKD in some cases. However, only a few reports of ADPKD-associated with thoracic aortic dissection have been published. Herein, we present a case of dissecting aneurysm in a patient with hypertension and ADPKD. He had been followed up for type B aortic dissection for six years. Preoperative creatinine level ranged from 2.1 to 2.4 mg/dl. We performed replacement of the thoracic aorta with prosthetic graft successfully, and postoperatively, dialysis was not required.It is very important for us to recognize the relationship between ADPKD and thoracic aortic dissection, which can cause high mortality and morbidity rates.Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia. 01/2012;
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Institutions
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2012–2013
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Kobe City Medical Center General Hospital
Kōbe-shi, Hyogo-ken, Japan
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