Faculty Profiles - MUTSUGA Masato

Papers - MUTSUGA Masato

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僧帽弁手術時に三尖弁に介入しなかった症例の予後

伊藤英樹, 大島英揮, 成田裕司, 阿部知伸, 藤本和朗, 六鹿雅登, 徳田順之, 寺澤幸枝, 山名孝治, 寺本慎男, 増子雄二, 内田亘, 大野司, 碓氷章彦

日本心臓血管外科学会学術総会抄録集 Vol. 47回 page： 524 - 524 2017.2

冠動脈バイパス術のグラフト選択、術式選択(on-or off-pump) 透析、糖尿病、肥満、高齢患者での選択と理由 70歳以上高齢者におけるONCABとOPCABの比較早期および遠隔成績

大島英揮, 成田裕司, 阿部知伸, 藤本和朗, 六鹿雅登, 徳田順之, 寺澤幸枝, 山名孝治, 伊藤英樹, 碓氷章彦

日本心臓血管外科学会学術総会抄録集 Vol. 47回 page： 730 - 730 2017.2

冠動脈瘤を合併した冠動脈瘻に対する外科手術

増子雄二, 大島英揮, 成田裕司, 阿部知伸, 藤本和朗, 六鹿雅登, 徳田順之, 寺澤幸枝, 山名孝治, 伊藤英樹, 寺本慎男, 内田亘, 大野司, 碓氷章彦

日本心臓血管外科学会学術総会抄録集 Vol. 47回 page： 334 - 334 2017.2

Modified double patch法によるpost-infarction VSP修復術

大島英揮, 成田裕司, 阿部知伸, 藤本和朗, 六鹿雅登, 徳田順之

日本心臓血管外科学会学術総会抄録集 Vol. 47回 page： 45 - 45 2017.2

Clarithromycinの大動脈瘤発生抑制効果の作用機序の解明

内田亘, 成田裕司, 緒方藍歌, 伊藤英樹, 山名孝治, 寺澤幸枝, 徳田順之, 六鹿雅登, 藤本和朗, 阿部知伸, 大島英揮, 碓氷章彦

日本心臓血管外科学会学術総会抄録集 Vol. 47回 page： 850 - 850 2017.2

Early and Late Outcomes of Thoracic Aortic Surgery in Hemodialysis Patients (vol 102, pg 1282, 2016)

M. Hibino, H. Oshima, Y. Narita, T. Abe, M. Mutsuga, K. L. Fujimoto, Y. Tokuda, S. Terazawa, H. Ito, A. Usui

ANNALS OF THORACIC SURGERY Vol. 103 ( 1 ) page： 366 - 366 2017.1

The changes of aortic diameter after aortic repair with aortic tailoring technique for chronic type B aortic dissection Reviewed

Hiroto Suenaga, Akihiko Usui, Masato Mutsuga, Hideki Oshima, Tomonobu Abe, Yuji Narita, Kazuro Fujimoto, Yoshiyuki Tokuda

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY Vol. 50 ( 6 ) page： 1118 - 1123 2016.12

Publishing type：Research paper (scientific journal) Publisher：OXFORD UNIV PRESS INC

OBJECTIVES: Aortic repair with aortic tailoring of the false lumen can preserve the true lumen and intercostal arteries naturally. It is a useful surgical strategy to prevent paraplegia. However, aortic remodelling of tailored segments in a late phase after surgery is another concern. This study investigates the destiny of aortic remodelling of tailored aorta.
METHODS: From June 2004 to April 2013, 21 consecutive patients underwent aortic tailoring operation for chronic type B aortic dissecting aneurysm. The mean age at operation was 60 +/- 10 years (range, 43-77). The tailored aortic segments were followed by serial CT scanning with the mean follow-up period of 46 +/- 32 months (range, 2-103).
RESULTS: There were no operative deaths but paraplegia in 1, stroke in 1 and reversible renal failure in 2 patients. There were two late deaths: one due to pneumonia and the other due to aneurysmal rupture of the abdominal aorta. Eighteen patients revealed a completely thrombosed false lumen and no expansion of the tailored aorta, with it remaining less than 40 mm in diameter during follow-up. However, 3 cases were associated with a patent false lumen and 2 cases revealed aortic events. The aortic event-free rate at 5 years was 95 +/- 5.1% in all patients and 66 +/- 27% in patients in the patent false lumen group.
CONCLUSIONS: Aortic tailoring is a useful surgical technique for chronic type B aortic dissection. Paraplegia and ischaemia of other visceral organs could less likely occur. Patients with a completely thrombosed false lumen revealed no aortic events; however, a patent false lumen was associated with a high risk of aortic events.

DOI： 10.1093/ejcts/ezw240

Web of Science

PubMed

The long-term results and changing patterns of biological valves at the mitral position in contemporary practice in Japan

Abe Tomonobu, Ito Hideki, Mutsuga Masato, Fujimoto Kazuro, Terazawa Sachie, Narita Yuji, Oshima Hideki, Usui Akihiko

Nagoya Journal of Medical Science Vol. 78 ( 4 ) page： 369 - 376 2016.11

Early and Late Outcomes of Thoracic Aortic Surgery in Hemodialysis Patients Reviewed

Makoto Hibino, Hideki Oshima, Yuji Narita, Tomonobu Abe, Masato Mutsuga, Kazuro L. Fujimoto, Yoshiyuki Tokuda, Sachie Terazawa, Hideki Ito, Akihiko Usui

ANNALS OF THORACIC SURGERY Vol. 102 ( 4 ) page： 1282 - 1288 2016.10

Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

Background. The number of cardiovascular surgeries among hemodialysis patients is increasing according to the growing population of hemodialysis patients; however, the clinical outcome has not yet been clarified, especially in thoracic aortic surgery. The purpose of this study was to assess the early and late outcomes of thoracic aortic surgery in hemodialysis patients.
Methods. We retrospectively analyzed the outcomes of 700 consecutive open thoracic aortic surgeries from 2002 to 2014. We identified 21 patients receiving preoperative hemodialysis (group HD) and 679 patients not receiving preoperative hemodialysis (group N). The patients were predominantly male, had diabetes mellitus and cardiogenic shock, and had less hyperlipidemia and elective surgery in group HD. The early and late outcomes were compared between 21 patients in each group using a propensity-score matched analysis.
Results. The hospital stay and intensive care unit stay were significantly longer in group HD even after matching. The 30-day mortality and inhospital mortality showed no significant differences, whereas the rate of postoperative pneumonia was significantly higher in group HD compared with the matched group N (p=0.0067). The 1-year, 3-year, and 7-year survival rates in group HD were 73.4%, 45.7%, and 30.5%, respectively, which were significantly poorer than that of group N both in the prematched (p < 0.001) and matched analyses (p=0.0027).
Conclusions. Considering the various operative risks associated with hemodialysis patients, the early mortality rate is acceptable, even after the association with many respiratory complications. Although hemodialysis patients have a compromised prognosis after surgery, excessive hesitation to perform thoracic aortic surgery may be avoided. (C) 2016 by The Society of Thoracic Surgeons

DOI： 10.1016/j.athoracsur.2016.03.073

Web of Science

PubMed

植込み型補助人工心臓装着患者の在宅管理長期植心移植待機時代の植え込み型補助人工心臓装着患者の在宅管理

藤本和朗, 碓氷章彦, 大島英揮, 成田裕司, 阿部知伸, 六鹿雅登

人工臓器 Vol. 45 ( 2 ) page： S - 58 2016.10

中・長期成績からみた透析患者に対する人工弁選択機械弁・生体弁による透析患者の弁置換後の長期予後マイクロシミュレーション

阿部知伸, 岡田典隆, 田嶋一喜, 寺澤幸枝, 徳田順之, 藤本和朗, 六鹿雅登, 成田裕司, 大島英揮, 碓氷章彦

人工臓器 Vol. 45 ( 2 ) page： S - 71 2016.10

重症心不全治療への挑戦重症両心不全に対するPCPS+LVADの有用性

六鹿雅登, 藤本和朗, 山名孝治, 阿部知伸, 成田裕司, 大島英揮, 碓氷章彦

人工臓器 Vol. 45 ( 2 ) page： S - 30 2016.10

Extended total arch replacement via the L-incision approach: single-stage repair for extensive aneurysms of the aortic arch Reviewed

Yoshiyuki Tokuda, Hideki Oshima, Yuji Narita, Tomonobu Abe, Masato Mutsuga, Kazuro Fujimoto, Sachie Terazawa, Hideki Ito, Makoto Hibino, Wataru Uchida, Kimihiro Komori, Akihiko Usui

INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY Vol. 22 ( 6 ) page： 750 - 755 2016.6

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：OXFORD UNIV PRESS

OBJECTIVES: Total arch replacement via the L-incision approach (a combination of left anterior thoracotomy and upper median sternotomy) can be used to achieve more extensive replacement.
METHODS: In the period between 2002 and 2014, 279 total arch replacement procedures were performed. After excluding cases of acute aortic dissection and cases involving concomitant, hybrid or frozen elephant trunk procedures, patients who underwent isolated total arch replacement via an L-incision (n = 29) and via median sternotomy (n = 143) were identified and the data pertaining to their cases were analysed.
RESULTS: Operative mortality was higher in the L-incision group than in the median sternotomy group (6.9 vs 2.1%); however, the difference was not statistically significant. The L-incision group displayed a higher rate of respiratory complications, including pneumonia (28 vs 7.0%, P = 0.0034), the need for tracheostomy (17 vs 2.1%, P = 0.0038) and pulmonary haemorrhage (6.9 vs 0%, P = 0.028). The rate of paraplegia was similar between the groups (0 vs 1.4%, P = 1.00), despite the wider range replaced via the L-incision approach (7.3 +/- 1.5 vs 4.7 +/- 0.8 anatomical zones, P < 0.001). The rates of other complications and functional recovery were similar. The long-term survival (73 vs 84% at 5 years) and aortic event-free rates (94 vs 96% at 5 years) were similar in both groups.
CONCLUSIONS: A combination of left anterior thoracotomy and upper median sternotomy can be applied to the single-stage repair of extended aneurysms with acceptable results in appropriately selected patients.

DOI： 10.1093/icvts/ivw034

Web of Science

PubMed

A型解離術後の慢性解離性大動脈瘤に対する弓部大動脈置換術

日尾野誠, 碓氷章彦, 伊藤英樹, 寺澤幸枝, 徳田順之, 藤本和朗, 六鹿雅登, 阿部知伸, 成田裕司, 大島英揮

日本血管外科学会雑誌 Vol. 25 ( Suppl. ) page： 322 - 322 2016.6

[Aortic Valve Replacement of Quadricuspid Valve with Regurgitation].

Yagami K, Oshima H, Narita Y, Abe T, Araki Y, Fujimoto K, Mutsuga M, Terazawa S, Ito H, Kuwabara F, Usui A

Kyobu geka. The Japanese journal of thoracic surgery Vol. 69 ( 4 ) page： 321 - 4 2016.4

臨床経験閉鎖不全を呈した大動脈四尖弁に対する弁置換術

八神啓, 大島英揮, 成田裕司, 阿部知伸, 荒木善盛, 藤本和朗, 六鹿雅登, 寺澤幸枝, 伊藤英樹, 桑原史明, 碓氷章彦

胸部外科 Vol. 69 ( 4 ) page： 321 - 324 2016.4

Language：Japanese Publisher：(株)南江堂

症例は60〜72歳の男性3例、女性1例であった。いずれも呼吸苦を主訴とした大動脈弁閉鎖不全症による心不全症状で、前医から著者らの施設へ紹介となった。術前の冠状動脈造影では全例、異常はみられなかった。1例は術前経胸壁エコーによる術前診断が可能であったが、3例は術中にはじめて大動脈四尖弁と診断された。Hurwitz分類ではtype aが1例、type bが2例、type cが1例であった。4症例とも人工弁による大動脈弁置換術が施行された。その結果、病理所見では全例で切除弁尖に粘液腫様の変性を認めた。術後経過も合併症なく経過良好で、独歩退院となった。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J00349&link_issn=&doc_id=20160405010019&doc_link_id=40020777450&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F40020777450&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

脳合併症を伴う活動期感染性心内膜炎に対する治療戦略

寺澤幸枝, 伊藤英樹, 六鹿雅登, 藤本和朗, 阿部知伸, 成田裕司, 大島英揮, 碓氷章彦

日本心臓血管外科学会学術総会抄録集 Vol. 46回 page： OP5 - 4 2016.2

心臓外科医が母になること如何にbalanceを保ちゆくか

寺澤幸枝, 伊藤英樹, 徳田順之, 藤本和朗, 六鹿雅登, 阿部知伸, 成田裕司, 大島英揮, 碓氷章彦

日本心臓血管外科学会学術総会抄録集 Vol. 46回 page： SP6 - 1 2016.2

活動性感染性心内膜炎に対する外科的介入の治療戦略

藤本和朗, 碓氷章彦, 大島英揮, 阿部知伸, 成田裕司, 六鹿雅登, 寺澤幸枝, 伊藤英樹

日本心臓血管外科学会学術総会抄録集 Vol. 46回 page： PP - 057 2016.2

胸腹部大動脈瘤Open Surgeryにおける左腎動脈の先行再建

阿部知伸, 大島英揮, 成田裕司, 六鹿雅登, 藤本和朗, 寺澤幸枝, 杉浦純也, 伊藤英樹, 日比野誠, 小坂井基史, 小西康信, 内田亘, 末永啓人, 大野司, 碓永章彦

日本心臓血管外科学会学術総会抄録集 Vol. 46回 page： VP10 - 2 2016.2

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Papers - MUTSUGA Masato