Hitoshi Ogino

Tokyo Medical University, Edo, Tōkyō, Japan

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Publications (200)425.09 Total impact

  • Toshiya Nishibe · Tomoaki Iwasaki · Hitoshi Ogino
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    ABSTRACT: Little is known regarding the consequences of bifurcation patency loss after failed crossover superficial femoral artery (SFA) stenting. We report on two cases concerning patients presenting with acute and chronic symptoms of critical limb ischemia after failed crossover SFA stenting and undergoing open surgical repair. We discuss the risk and management of failed crossover SFA stenting.
    No preview · Article · Dec 2015 · Annals of Vascular Surgery
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    ABSTRACT: The treatment of femoropopliteal artery disease remains controversial, without clear guidelines specifying the indications for endovascular therapy (EVT). Accordingly, we retrospectively examined our experience of using EVT to treat femoropopliteal artery disease. A total of 91 limbs in 82 patients underwent EVT for the treatment of femoropopliteal artery disease. Percutaneous transluminal angioplasty alone was performed in 20 limbs, and additional stenting was performed in 71 limbs. The 1-year primary patency, primary-assisted patency, limb salvage, and survival rates were 76%, 88%, 96%, and 92%, respectively. Multivariate Cox analysis of primary patency showed that critical limb ischemia (CLI; hazard ratio [HR], 2.53; 95% confidence interval [CI], 1.08-5.33; P < .01) and TASC II C/D disease (HR, 2.70; 95% CI, 1.14-6.39; P < .05) were independent predictors of decreased primary patency. In conclusion, patients with CLI or extensive lesions have reduced patency after EVT for femoropopliteal artery disease.
    No preview · Article · Nov 2015 · Vascular and Endovascular Surgery
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    ABSTRACT: Sternal instability or dehiscence results in serious sternal wound infection. We sought to assess the early outcomes with such a plating system for sternal closure in comparison to the conventional wiring technique in off-pump coronary artery bypass grafting (CABG). Patients who underwent off-pump CABG were enrolled. Thirty-one patients received plate sternal fixation. A total of 64 patients who underwent off-pump CABG by a single surgeon at our hospital from July 2013 to December 2014 were enrolled. Thirty-one patients received plate sternal fixation (Plate group), while 33 received conventional wire closure (Wire group). The early outcomes, including the pain score and analgesic usage count were compared. Dietary intake was also recorded to assess the duration of appetite loss. At discharge, the largest sternal displacement was measured on computed tomography. In the Plate group, the pain scores were significantly lower on post-operative day 5-8 and POD 9-12 from those in the Wire group. The analgesic usage count on POD 9-12 was significantly lower in the Plate group. The duration of appetite loss and hospital stay was significantly shorter in the Plate group. The displacement in both the anterior-posterior and lateral directions was significantly smaller in the Plate group. Sternal closure by rigid plate fixation contributes to a more rapid post-operative recovery through reduced pain.
    No preview · Article · Oct 2015 · Journal of Artificial Organs
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    ABSTRACT: Purpose: The purpose of this study was to analyze the risk factors for an adverse outcome after endovascular therapy (EVT) for critical limb ischemia (CLI) with tissue loss due to infrainguinal artery disease. Materials and methods: We retrospectively reviewed the charts of patients with tissue loss (Rutherford class 5 and 6) due to infrainguinal artery disease who were managed with endovascular therapy (EVT) between January 2006 and December 2013. The primary end point was amputation-free survival (AFS), while the secondary endpoints were freedom from a major adverse limb event (MALE) plus perioperative (30 days) death (POD), limb salvage, and survival rates at one year. Multivariable perioperative predictors of AFS were identified using the stepwise Cox proportional hazards regression model. Results: A total of 65 patients underwent EVT for infrainguinal artery disease on 72 limbs. The technical success rate was 94% (68/72), while the clinical success was attained in 54 of 72 limbs (72%). The AFS, MALE + POD, limb salvage, and survival rates at one year were 76%, 86%, 91%, and 81%, respectively. The multivariate analysis demonstrated that major tissue loss classified as Rutherford class 6 (HR, 5.68; 95% CI, 2.29-14.13; P < .05) was negatively associated with decreased AFS, while clinical success (HR, 0.25; 95% CI, 0.11-0.60; P < .05) was positively associated with increased AFS. Conclusions: EVT resulted in an acceptable rate of AFS, MALE+POD, limb salvage, and survival. However, we must keep in mind that there are significant limitations to be considered for EVT in patients with major tissue loss, and that, even if revascularization could be successfully performed, a significant number of the treated limbs are still in a critical situation, such as major amputation or death.
    No preview · Article · Sep 2015 · International angiology: a journal of the International Union of Angiology
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    ABSTRACT: Objective: To investigate the impact of preoperative identification of the Adamkiewicz artery (AKA) on prevention of spinal cord injury (SCI) through the multicenter Japanese Study of Spinal Cord Protection in Descending and Thoracoabdominal Aortic Repair (JASPAR) registry. Methods: Between January 2000 and October 2011, 2435 descending/thoracoabdominal aortic repairs were performed, including 1998 elective repairs and 437 urgent repairs, in 14 major centers in Japan. The mean patient age was 67 ± 13 years, and 74.2% were males. There were 1471 open repairs (ORs), including 748 descending and 137 thoracoabdominal extent [Ex] I, 136 Ex II, 194 Ex III, 115 Ex IV, and 138 Ex V, and 964 endovascular repairs (EVRs). Of the 2435 patients, 1252 (51%) underwent preoperative magnetic resonance or computed tomography angiography to identify the AKA. Results: The AKA was identified in 1096 of the 1252 patients who underwent preoperative imaging (87.6%). Hospital mortality was 9.2% (n = 136) in those who underwent OR and 6.4% (n = 62) in those who underwent EVR. The incidence of SCI was 7.3% in the OR group (descending, 4.2%; Ex I, 9.4%; Ex II, 14.0%; Ex III, 14.4%; Ex IV, 4.2 %; Ex V, 7.2%) and 2.9% in the EVR group. The risk factors for SCI in ORs were advanced age, extended repair, emergency, and occluded bilateral hypogastric arteries. In ORs of the aortic segment involving the AKA, having no AKA reconstruction was a significant risk factor for SCI (odds ratio, 2.79, 95% confidence interval, 1.14-6.79; P = .024). Conclusions: In descending/thoracoabdominal aortic repairs, preoperative AKA identification with its adequate reconstruction or preservation, especially, in ORs of aortic pathologies involving the AKA, would be a useful adjunct for more secure spinal cord protection.
    No preview · Article · Sep 2015 · The Journal of thoracic and cardiovascular surgery
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    ABSTRACT: The purpose of this study was to review our experiences treating peripheral artery disease by common femoral artery endarterectomy (CFE) with and without endovascular therapy (EVT), and to describe the role of CFE in the endovascular era. We retrospectively reviewed a contemporary series of 38 limbs from January 2010 to September 2014. Clinical outcomes of primary patency, assisted primary patency, limb salvage, and survival were analyzed with the Kaplan-Meier method. Multivariable perioperative predictors of primary patency were identified using the stepwise Cox proportional hazards regression model. Hemodynamic success was achieved in 36/38 limbs (95%). The mean ABI improved significantly, rising from 0.56±0.04 preoperatively to 0.89±0.04 postoperatively (P=0.0001). Overall primary and assisted primary patency rates, respectively, were 90% and 85% at 12 months and 100% and 94% at 24 months. There was no significant difference in primary patency rate between isolated CFE and hybrid CFE plus EVT. Both limb salvage and survival rates were 97% at 12 months and 97% at 24 months. Multivariate Cox regression analysis revealed that no clinical or perioperative risk factors were predictive of decreased primary patency. CFE is a safe, effective, and durable procedure for common femoral artery disease, and hybrid CFE plus EVT can be a valid alternative to open surgical bypass for multilevel occlusive artery disease. These observations stress that CFE plays a vital role in the management of PAD even in the endovascular era. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · Jul 2015 · Annals of Vascular Surgery
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    ABSTRACT: We report a rare case of massive type IIIb endoleaks from an abdominal endograft, which were difficult to diagnose and required hybrid repair (including open surgery). The patient had previously undergone three catheter interventions for type Ia and II endoleaks after abdominal endografting. However, the abdominal aortic aneurysm gradually enlarged and required hybrid treatment (including an open repair), to successfully perform aneurysmorrhaphy and additional endograft insertions for the massive type IIIb endoleaks. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    Preview · Article · Apr 2015 · Interactive Cardiovascular and Thoracic Surgery
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    ABSTRACT: A 54-year-old man underwent aortic repair for the infected thoracoabdominal aneurysm with a woven Dacron graft (Vascutek, Renfrewshire, Scotland) treated with gentian violet. Four months later, he complained of sudden back pain, resulting in preshock status. Computed tomographic scans showed massive hematoma around the Dacron graft, suggesting graft rupture. Initially, emergency thoracic endovascular aortic repair was performed, which was subsequently followed by open repair. The Dacron graft had a small hole, which was completely compatible with the site contacting with the rib. The graft rupture was considered due to its friction against the rib. We report on a rare event of mechanical Dacron graft rupture after the thoracoabdominal aortic replacement.
    No preview · Article · Dec 2014
  • Tomohiro Saito · Hiroaki Sasaki · Hitoshi Ogino

    No preview · Article · Oct 2014 · Artificial Organs
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    ABSTRACT: Objectives: A retrospective analysis was performed to determine the impact of cystic medial necrosis (CMN) of the aortic wall on the early and late outcome of patients requiring surgical repairs for aortic dissection. Methods: Between 2003 and 2013, 321 patients underwent initial surgical treatments for aortic dissection for type A in 183 or type B in 138. Surgical specimens of the aortic walls from 298 patients (56% male, 64.0 ± 15.7 years) including 31 patients with Marfan syndrome or other connective tissue disorders, were examined histopathologically. The presence of CMN and its impact on the early and late outcome were determined. The follow-up period was 45.6 ± 37.4 months. Results: CMN was present in 141/298 patients (47%). As shown in Fig. 1, the incidences of CMN were higher in the younger patients: 78.4% in 51 patients aged under 50 years, 52.4% in 42 (51–60 years), 40.9% in 88 (61–70 years), 37.2% in 86 (71–80 years) and 35.5% in 31(> 80 years). The early mortality including 30-day and in-hospital deaths was 5.0% in all, which was lower in the younger patients: 0%, 2.3%, 3.2%, 8.3%, and 12.1%, respectively. On the other hand, late deaths occurred in 4.6%. The late-mortality/reoperation rates were rather higher in the younger patients: 7.5/69.8%, 4.6/ 20.5%, 2.1/28.6%, 3.4/14.9%, and 6.4/16.7%. Conclusion: Younger patients aged under 50 years had significantly higher rates of evidence of CMN, which might be related to the earlier onset of aortic dissection and the worse late prognoses.
    Preview · Article · Oct 2014 · Interactive Cardiovascular and Thoracic Surgery
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    ABSTRACT: Prosthetic graft infection in the ascending aorta or aortic arch is a life-threatening complication. Redo graft replacement is also associated with high mortality and morbidity rates. Conservative treatments without graft removal recently developed as alternatives to conventional surgical approach have been reported with successful outcomes. We report a case of successful treatment of prosthetic graft infection in the aortic arch, for which percutaneous catheter drainage was initially performed prior to open surgery, followed by graft coverage with an omental flap. <Learning objective: Redo graft replacement for the prosthetic graft infection in the ascending aorta or aortic arch is associated with high mortality and morbidity rates. Conservative treatments without graft removal have recently been developed as alternatives to surgical approaches. Less invasive percutaneous drainage and irrigation would be a useful alternative second-line treatment before radical open repairs for the treatment of aortic graft infection.
    No preview · Article · Sep 2014 · Journal of Cardiology Cases
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    ABSTRACT: We present a 52-year-old male with a syphilitic aortic arch aneurysm accompanied by relevant extensive cerebral infarction. He was admitted to a local hospital for sudden loss of consciousness, where he was diagnosed with serious cerebral infarction. During his treatment, a multilocular aortic arch aneurysm involving the arch vessels was found incidentally. He was transferred to our hospital for surgical treatment. A preoperative routine laboratory test for syphilis was highly positive, which suggested that the aneurysm was likely caused by syphilis and the cerebral infarction was also induced by the involvement of syphilitic aortitis or arteritis. After 2 weeks of antibiotic therapy for syphilis, total arch replacement was performed successfully using meticulous brain protection with antegrade selective cerebral perfusion and deep hypothermia. He recovered without any further cerebral deficits. The pathological examination of the surgical specimen showed some characteristic changes of syphilitic aortitis.
    No preview · Article · Feb 2014
  • Hitoshi Ogino
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    ABSTRACT: Pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH) remains challenging with some difficulties, although it has been a well-established procedure. Its current situation including indications, surgical techniques with perioperative management, early and late outcome, and risk factors for mortality and poor hemodynamic improvement are reviewed. With the recent advancement of PEA including perioperative management and the accumulation of experiences, early outcome has been improved with low mortality rates, which are 5-10 % in most or <5 % in experienced centers. The risk factors for mortality were high pulmonary vascular resistance before and immediately after surgery, poor preoperative exercise capacity (NYHA-class IV), and advanced age. Reperfusion lung injury and residual pulmonary hypertension remain problematic as the most serious complications. The latter occurs in cases with surgically inaccessible distal lesions. For them, more careful perioperative management using pharmacological agents in conjunction with skillful PEA is required, occasionally with prompt use of percutaneous cardiopulmonary support. Although there have been a few reports on the long-term outcome, it is also favorable with good survival and event-free rates, which are affected by residual pulmonary hypertension. The recurrence of CTEPH after PEA is extremely rare. Consequently, as the first-line treatment for CTEPH, PEA can be performed safely with hemodynamic improvement and favorable early and long-term outcomes, except for potentially high-risk patients with distal lesions, elevated pulmonary vascular resistance, poor exercise capacity, and advanced age. Recently advanced balloon pulmonary angioplasty might be a promising alternative for such difficult patients.
    No preview · Article · Sep 2013 · General Thoracic and Cardiovascular Surgery
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    ABSTRACT: Stent-grafts for endovascular repair of thoracic aortic aneurysms have been commercially available for more than ten years in the West, whereas, in Japan, a manufactured stent-graft was not approved for the use until March 2008. Nevertheless, endovascular thoracic intervention began to be performed in Japan in the early 1990s, with homemade devices used in most cases. Many researchers have continued to develop their homemade devices. We have participated in joint design and assessment efforts with a stent-graft manufacturer, focusing primarily on fenestrated stent-grafts used in repairs at the distal arch, a site especially prone to aneurysm. In March 2008, TAG (W.L. Gore & Associates, Inc., Flagstaff, Arizona, USA) was approved as a stent graft for the thoracic area first in Japan, which was major turning point in treatment for thoracic aortic aneurysms. Subsequently, TALENT (Medtronic, Inc., Minneapolis, Minnesota, USA) was approved in May 2009, and TX2 (COOK MEDICAL Inc., Bloomington, Indiana, USA) in March 2011. Valiant as an improved version of TALENT was approved in November 2011, and TX2 Proform as an improved version of TX2 began to be supplied in October 2012. These stent grafts are excellent devices that showed good results in Western countries, and marked effectiveness can be expected by making the most of the characteristics of each device. A clinical trial in Japan on Najuta (tentative name) (Kawasumi Labo., Inc., Tokyo, Japan) as a line-up of fenestrated stent grafts that can be applied to distal arch aneurysms showing a high incidence, and allow maintenance of blood flow to the arch vessel was initiated. This trial was completed, and Najuta has just been approved in January of 2013 in Japan, and further development is expected. In the U.S., great efforts have recently been made to develop and manufacture excellent stent grafts for thoracic aneurysms, and rapid progress has been achieved. In particular, in the area of the aortic arch, in which we often experience aneurysmal change, but there are no commercially available devices which are urgently needed. Companies are competing keenly to develop devices. To our knowledge, more than 4 manufacturers are involved in the development of functionally new stent grafts in this area. The introduction of branched stent grafts may not be faraway.
    No preview · Article · Jul 2013 · Annals of Vascular Diseases
  • Yasunori Iida · Toru Saguchi · Norihiko Ikeda · Hitoshi Ogino

    No preview · Article · Jul 2013 · Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
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    ABSTRACT: Heparin-induced thrombocytopenia (HIT) can often result in devastating thromboembolic outcomes. Argatroban is frequently administered as an alternative anticoagulant to heparin. We present a complicated case of HIT in which off-pump coronary artery bypass grafting was performed using anticoagulation with argatroban. Although the active clotting time was maintained between 220 and 270 s using argatroban, intraoperative thrombotic complications and postoperative prolonged coagulopathy were encountered.<Learning objective: The use of argatroban involves a potential risk of inadequate anticoagulation or life-threatening postoperative bleeding depending on the dose. We recommend that the target ACT during off-pump coronary artery bypass grafting with argatroban should be strictly maintained over 250 s, although an ACT exceeding 300 s may cause prolonged coagulopathy>.
    Full-text · Article · Jul 2013 · Journal of Cardiology Cases
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    ABSTRACT: Bleeding from the distal anastomosis suture line in total arch replacement is a serious and major concern for surgeons. We present a simple, flanged elephant trunk technique to reduce or eliminate bleeding from the distal anastomosis suture line in total arch replacement using a multibranched arch graft. This method allows not only a secure and reinforced distal anastomosis, but also simultaneous elephant trunk insertion.
    No preview · Article · Mar 2013 · Annals of Vascular Surgery
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    ABSTRACT: An 86-year-old woman was admitted for emergency treatment of increasing dyspnea. Transthoracic echocardiography revealed decreased left ventricular systolic function with dyskinesis at the apex, and severe aortic stenosis. The apex of the left ventricle showed a huge mobile thrombus. Coronary angiography revealed total occlusion at the middle portion of the left anterior descending coronary artery. Emergency operation was successful, and a partially calcified thrombus was observed at the site of the old myocardial infarction area. In this case, myocardial infarction and elevated intraventricular pressure due to aortic stenosis likely contributed to the wall motion abnormality and thrombus formation.
    No preview · Article · Mar 2013 · Journal of Echocardiography
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    ABSTRACT: Since the first report by Cooley and colleagues in 1975 [Cooley DA, Norman JC, Mullins CE, Grace R. Left ventricle to abdominal aorta conduit for relief of aortic stenosis. Cardiovasc Dis 1975;2:376-83], an apicoaortic valved conduit bypass has been usually administrated to selected patients presenting with certain clinical conditions or complications such as aortic stenosis associated with porcelain aorta, unclampable atherosclerotic aorta, resternotomy, or previous coronary bypass surgery. On the other hand, thoracic endovascular aortic repair for various aortic lesions has become a promising and less invasive therapy. We encountered a critical case of a patient suffering from aortic graft stenosis due to malformation of a previous thoracic endovascular aortic repair procedure originally performed for acute type A aortic dissection. Because of a deep sternal wound infection, apicoaortic valved conduit bypass from the left ventricular apex to the abdominal aorta was successfully performed.
    No preview · Article · Jan 2013 · The Annals of thoracic surgery
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    ABSTRACT: Objective: With the recent advance of endovascular aortic repair, conventional open repair for aortic arch lesions should be reassessed. We reviewed our contemporary open arch repair with selective antegrade cerebral perfusion by way of the axillary artery with deep or moderate hypothermia. Methods: From 2001 to 2011, 1007 patients (median age, 72 years) underwent open arch repair with selective cerebral perfusion through the right axillary artery and hypothermic circulatory arrest: deep (<25 °C) in 48% and moderate (25 °-28 °C) in 52%. Of the 1007 patients, 73% underwent total arch replacement and 26% emergent surgery for aneurysm rupture or acute aortic dissection. Results: The early mortality was 4.7% for all patients. Permanent and temporary neurologic dysfunction occurred in 3.5% and 6.7%, respectively. No spinal cord injury occurred, even with moderate hypothermia. The independent predictors of in-hospital mortality included chronic obstructive pulmonary disease, liver dysfunction, chronic kidney disease, and concomitant coronary artery bypass. The independent predictors of permanent neurologic dysfunction included cerebrovascular disease, emergency surgery, and concomitant coronary artery bypass. The cumulative survival rate was 80.4% and 71.2% at 5 and 8 years, respectively. Freedom from reoperation related to the initial arch repair was 98.0% and 96.9% at 5 and 8 years, respectively. Conclusions: Conventional open arch repair yielded satisfactory outcomes and should remain the standard therapy, with good long-term durability in all but high-risk patients.
    No preview · Article · Dec 2012 · The Journal of thoracic and cardiovascular surgery

Publication Stats

2k Citations
425.09 Total Impact Points


  • 2011-2015
    • Tokyo Medical University
      • • Division of Cardiovascular Surgery
      • • Department of Surgery V
      Edo, Tōkyō, Japan
  • 2001-2012
    • National Cerebral and Cardiovascular Center
      • Department of Cardiovascular Medicine
      Ōsaka, Ōsaka, Japan
  • 2009
    • University of Dallas
      Irving, Texas, United States
  • 2007
    • Fujita Health University
      • Department of Cardiovascular Surgery
      Nagoya, Aichi, Japan
  • 2006
    • National Cancer Center, Japan
      Edo, Tōkyō, Japan
  • 1997-2001
    • Tenri Yorozu Hospital
      Тэнри, Nara, Japan
  • 1998
    • University Hospital of Lausanne
      Lausanne, Vaud, Switzerland
  • 1985
    • UHN: Toronto General Hospital
      Toronto, Ontario, Canada