Faculty Profiles - MUTSUGA Masato

Electrical gaps in recurrence of atrial tachyarrhythmias after Maze surgery: regional patterns and clinical significance

Yano, D; Tokuda, Y; Yasuda, N; Tsurumi, N; Mashiko, Y; Kuwabara, F; Hirate, Y; Tajima, K; Mutsuga, M

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 87 ( 1 ) page： 122 - 132 2025.2

Publisher：Nagoya Journal of Medical Science

The Maze procedure is a well-established technique for treating atrial fibrillation; however, atrial tachyarrhythmias can recur postoperatively. This study analyzed the mechanisms of recurrence in patients who underwent electrophysiological studies and catheter ablation following the Maze procedure. Among 88 patients who underwent treatment with a modified Maze procedure, 42 developed recurrent atrial tachyarrhythmias. Among these, 18 underwent electrophysiological studies and simultaneous transcatheter radiofrequency ablation. The median period between the Maze procedure and catheter ablation was 29 months. Macro-reentrant circuits were identified in 12 patients (67%) with or without atrial fibrillation. Most patients (n = 15, 83%) had more than one conduction gap. The most frequently identified gap was around the left inferior pulmonary vein (n = 10, 56%), followed by the peri-coronary sinus area (n = 8, 44%), and the mitral isthmus area (n = 5, 28%). Catheter ablation targeting these gaps successfully eliminated tachyarrhythmias in 15 (83%) patients. At a follow-up examination 49 months after catheter ablation, 14 patients (78%) had no recurrence of tachyarrhythmia. An electrophysiological study revealed conduction gaps in patients with recurrent atrial tachyarrhythmia after the Maze procedure. Modifications to the Maze procedure should include meticulous ablation around the left inferior pulmonary vein orifice, mitral isthmus, and coronary sinus where conduction gaps frequently occur. In cases of recurrence, catheter ablation targeting the lesion effectively controlled the tachyarrhythmia.

DOI： 10.18999/nagjms.87.1.122

Intervening to Preserve Function in Ischemic Cardiomyopathy with a Porous Hydrogel and Extracellular Matrix Composite in a Rat Myocardial Infarction Model Open Access

Merits and Demerits of FET

Mutsuga Masato

Japanese Journal of Cardiovascular Surgery Vol. 54 ( 1 ) page： i - vi 2025.1

Hayashi, Y; Fujii, T; Kim, S; Ozeki, T; Badylak, SF; D'Amore, A; Mutsuga, M; Wagner, WR

ADVANCED HEALTHCARE MATERIALS Vol. 14 ( 2 ) page： e2402757 2025.1

Language：English Publisher：Advanced Healthcare Materials

Multiple hydrogels are developed for injection therapy after myocardial infarction, with some incorporating substances promoting tissue regeneration and others emphasizing mechanical effects. In this study, porosity and extracellular matrix-derived digest (ECM) are incorporated, into a mechanically optimized, thermoresponsive, degradable hydrogel (poly(N-isopropylacrylamide-co-N-vinylpyrrolidone-co-MAPLA)) and evaluate whether this biomaterial injectate can abrogate adverse remodeling in rat ischemic cardiomyopathy. After myocardial infarction, rats are divided into four groups: NP (non-porous hydrogel) without either ECM or porosity, PM (porous hydrogel) from the same synthetic copolymer with mannitol beads as porogens, and PME with porosity and ECM digest added to the synthetic copolymer. PBS injection alone is a control group. Intramyocardial injections occurred 3 days after myocardial infarction followed by serial echocardiography and histological assessments 8 weeks after infarction. Echocardiographic function and neovascularization improved in the PME group compared to the other hydrogels and PBS injection. The PME group also demonstrated improved LV geometry and macrophage polarization (toward M2) compared to PBS, whereas differences are not observed in the NP or PM groups versus control. These results demonstrate further functional improvement may be achieved in hydrogel injection therapy for ischemic cardiomyopathy by incorporating porosity and ECM digest, representing combined mechanical and biological effects.

DOI： 10.1002/adhm.202402757

Impact of direct mesenteric perfusion on malperfusion in acute type A aortic dissection repair

Yamamoto, R; Kato, W; Tokuda, Y; Yamaki, K; Morita, K; Uemura, T; Yamamoto, T; Ito, H; Yoshizumi, T; Terazawa, S; Narita, Y; Mutsuga, M

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY Vol. 67 ( 1 ) 2024.12

Language：English Publisher：European Journal of Cardio-thoracic Surgery

OBJECTIVES: Mesenteric malperfusion in acute aortic dissection remains a life-threatening complication with no standardized treatment strategy. This study aimed to describe and evaluate the outcomes of our integrated approach combining exploratory laparotomy, immediate mesenteric reperfusion, and central aortic repair. METHODS: We retrospectively reviewed patients with acute aortic dissection with a preoperative diagnosis of mesenteric malperfusion who were treated between August 2011 and November 2022. Our surgical approach was to establish cardiopulmonary bypass, followed by exploratory laparotomy with mesenteric artery flow assessment using Doppler ultrasound and direct perfusion if needed, central aortic repair, and subsequent mesenteric artery reconstruction. The primary end-point was the 30-day operative mortality. RESULTS: Among 217 patients with acute aortic dissection, 12 (5.5%) had mesenteric malperfusion on preoperative computed tomography. Ten patients underwent exploratory laparotomy, where Doppler ultrasonography revealed reduced mesenteric blood flow in five patients (2.3% of the total 217 patients). These patients underwent direct perfusion of the mesenteric artery via a side branch of the cardiopulmonary bypass circuit. Doppler ultrasound confirmed the restoration of mesenteric blood flow in all perfused patients. No bowel resections were required. The operative mortality in patients with mesenteric malperfusion was 20%. The causes of death were stroke (n = 1) and acute myocardial infarction (n = 1). CONCLUSIONS: Our integrated surgical strategy combining central aortic repair with concurrent exploratory laparotomy and immediate mesenteric perfusion demonstrated technical feasibility in managing mesenteric malperfusion during aortic repair. Further prospective studies with larger cohorts are warranted to validate these findings.

DOI： 10.1093/ejcts/ezae452

Modification of Antibacterial Copolymers on the Surface of PVA-Based Microfibers via Thermal Cross-Linking and Their Antibacterial Properties Open Access

Saito, S; Matsuno, S; Saito, A; Mutsuga, M; Yamawaki-Ogata, A; Narita, Y; Kotsuchibashi, Y

ACS OMEGA Vol. 9 ( 46 ) page： 45961 - 45969 2024.11

Language：English Publisher：ACS Omega

Bacterial infections on material surfaces are a serious public health concern worldwide. Although poly(vinyl alcohol) (PVA)-based materials have great potential as medical devices, they lack antibacterial properties on their surfaces and pose bacterial infection risks during implantation surgery. Copolymers containing antibacterial [2-(methacryloyloxy)ethyl]trimethylammonium chloride (METAC) units were used to modify the surfaces of chemically cross-linked water-insoluble PVA-based microfibers. The copolymers also had carboxy units that were used to react with the hydroxy group of the PVA-based microfibers via a simple thermal treatment at 135 °C. PVA-based materials containing METAC units exhibit significant swelling due to electrostatic repulsions. Because the copolymers were modified on the extreme surface of the microfibers, no difference in the diameters between unmodified microfibers (PM-fiber) and copolymers with METAC unit-modified microfibers (PM-METAC-fiber), in both the dry and swollen states, was observed. The viable bacterial cell numbers, which were evaluated by colony counting, decreased by exposure to the poly(METAC-co-methacrylic acid (MAAc)) aqueous solution or PM-METAC-fibers. The value of CFU/mL decreased to 0.1% (against B. subtilis) and 3.9% (against E. coli) after contact with the PM-METAC-fibers compared to the PM-fibers. The percentage of hemolysis against rabbit red blood cells was equivalent to that of the negative control, suggesting that PM-METAC-fibers can selectively exhibit antibacterial properties. This modification method can be applied to various PVA-based materials if hydroxy groups are present on their surface. This study provides a facile, cost-effective, and promising strategy to impart antibacterial properties to the surface of PVA-based materials without significantly affecting their physicochemical properties.

DOI： 10.1021/acsomega.4c05637

Risk factors for proximal and distal aortic events after type A acute aortic dissection

Akita, S; Tokuda, Y; Kato, W; Tanaka, K; Mutsuga, M

GENERAL THORACIC AND CARDIOVASCULAR SURGERY 2024.9

Language：English Publisher：General Thoracic and Cardiovascular Surgery

Objectives: Type A acute aortic dissection (TAAAD) is a life-threatening condition often requiring emergency surgery, with approximately 30% of patients needing reoperation. This study aimed to identify predictors of long-term aortic events from early postoperative computed tomography (CT) examinations. Methods: A total of 336 cases underwent TAAAD surgery at two institutions between 2002 and 2018. Of these, 302 patients received CT examinations immediately after initial TAAAD surgery. Predictors of aortic events were evaluated from these early postoperative CT exams. Aortic events were defined as any events involving aortic-related death, open surgery, reoperation, endovascular stenting, or thoracic aorta diameter enlargement to ≥ 55 mm. Results: Excluding 34 in-hospital deaths (10.1%; 34/336), the 1-, 5-, and 10-year actuarial survival rates after primary TAAAD surgery were 98.2%, 88.6%, and 81.7%, respectively. Over a mean follow-up period of 7.4 ± 5.1 years, 67 aortic events (proximal: 19, distal: 45, both: 3) were observed. Freedom from proximal aortic events was 98.6%, 93.9%, and 85.2% at 1, 5, and 10 years, respectively. Proximal anastomosis new entry was identified as a significant risk factor for aortic events, with a 92% vs. 42% incidence at 10 years (p < 0.001). Freedom from distal aortic events was 99.6%, 84.5%, and 67.2% at 1, 5, and 10 years, respectively. A false/true area ratio greater than 1 and distal anastomosis new entry were significant risk factors for aortic events (low-risk group: 83.3% vs. high-risk group: 42.3% at 10 years, p < 0.001). Conclusions: Detailed analysis of early postoperative CT scans following primary TAAAD surgery may help identify predictors of subsequent aortic events, potentially improving long-term patient management and outcomes.

DOI： 10.1007/s11748-024-02077-z

HeartMate 3 driveline damage by gradual corrosion due to liquid infiltration: a case report

[How to Insert the Cannula for Central or Peripheral Venous-arterial Extracorporeal Membrane Oxygenation(VA-ECMO)?].

Mutsuga M

Kyobu geka. The Japanese journal of thoracic surgery Vol. 77 ( 10 ) page： 729 - 733 2024.9

Yoshizumi, T; Ito, H; Terazawa, S; Tokuda, Y; Sakurai, H; Narita, Y; Mutsuga, M

JOURNAL OF ARTIFICIAL ORGANS 2024.8

Language：English Publisher：Journal of Artificial Organs

A 31-year-old man with a HeartMate 3 was admitted with a “Driveline Communication Fault” alarm due to liquid infiltration. Eleven months earlier, the connector between the modular and pump cables had gotten wet when he was taking a shower. The cable connector was dried immediately, and no alarm had been observed during follow-up. Subsequently, the modular cable and system controller were replaced, with corrosion found on the modular cable connector. The “Communication Fault” alarm recurred, and complete damage to the communication cables was discovered. The pump was replaced, and the removed pump cable connector showed corrosion as well. If the driveline connector gets wet, the multidisciplinary team should discuss if it should be immediately disconnected and dried, averting the need for future pump replacements due to corrosion.

DOI： 10.1007/s10047-024-01464-w

Administration of an antibody against apoptosis inhibitor of macrophage prevents aortic aneurysm progression in mice Open Access

Fujii, T; Yamawaki-Ogata, A; Terazawa, S; Narita, Y; Mutsuga, M

SCIENTIFIC REPORTS Vol. 14 ( 1 ) page： 15878 2024.7

Language：English Publisher：Scientific Reports

Apoptosis inhibitor of macrophage (AIM) is known to induce apoptosis resistance in macrophages and to exacerbate chronic inflammation, leading to arteriosclerosis. The role of AIM in aortic aneurysm (AA) remains unknown. This study examined the effects of an anti-AIM antibody in preventing AA formation and progression. In apolipoprotein E-deficient mice, AA was induced by subcutaneous angiotensin II infusion. Mice were randomly divided into two groups: (i) AIM group; weekly anti-murine AIM monoclonal antibody injection (n = 10), and (ii) IgG group; anti-murine IgG antibody injection as control (n = 14). The AIM group, compared with the IgG group, exhibited reduced AA enlargement (aortic diameter at 4 weeks: 2.1 vs. 2.7 mm, respectively, p = 0.012); decreased loss of elastic lamellae construction; reduced expression levels of IL-6, TNF-α, and MCP-1; decreased numbers of AIM-positive cells and inflammatory M1 macrophages (AIM: 1.4 vs. 8.0%, respectively, p = 0.004; M1 macrophages: 24.5 vs. 55.7%, respectively, p = 0.017); and higher expression of caspase-3 in the aortic wall (22.8 vs. 10.5%, respectively, p = 0.019). Our results suggest that administration of an anti-AIM antibody mitigated AA progression by alleviating inflammation and promoting M1 macrophage apoptosis.

DOI： 10.1038/s41598-024-66791-7

Patient management important for long-term support beyond 5 years in the BTT: republication of the article published in the Japanese Journal of Artificial Organs.

Mutsuga M

Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs 2024.3

Thromboelastographic evaluation after cardiac surgery optimizes transfusion requirements in the intensive care unit: a single-center retrospective cohort study using an inverse probability weighting method

Tamura, T; Suzuki, S; Fujii, T; Hirai, T; Imaizumi, T; Kubo, Y; Shibata, Y; Narita, Y; Mutsuga, M; Nishiwaki, K

GENERAL THORACIC AND CARDIOVASCULAR SURGERY Vol. 72 ( 1 ) page： 15 - 23 2024.1

Contemporary Surgical Treatment for Functional Mitral Regurgitation

Hosoba Soh, Kato Riku, Morita Koji, Mutsuga Masato

Journal of Transcatheter Valve Therapies Vol. 6 ( 1 ) page： 51 - 62 2024

Language：English Publisher：Japan Transcatheter Valve Therapies

The treatment of functional mitral regurgitation (FMR) has evolved dramatically in recent years and remains dynamic. Generally, the treatment of FMR involves a combination of medication optimization and surgical or transcatheter interventions. The use of transcatheter edge-to-edge repair has been increasing for FMR. This less invasive approach allows for transcatheter mitral valve repair, avoiding open heart surgery. On the other hand, surgical mitral valve repair techniques, such as annuloplasty, still play a crucial role in managing FMR. Simultaneous surgical ablation for atrial fibrillation or left atrial appendage closure can be performed. Surgical interventions also encompass concomitant operations, including addressing commonly coexisting secondary tricuspid valve pathology or performing coronary artery bypass grafting, which is relevant, especially in the case of ischemic mitral regurgitation. The management of FMR involves a multidisciplinary heart team consisting of cardiologists, cardiac surgeons, and other specialists. This collaborative approach aims to tailor treatment strategies to individual patients, considering survival and the quality of life.

DOI： 10.33290/jtvt.ra.24-0008

A Case of Aortic Valve Replacement With Bioprosthetic Valve and Mitral Valve Commissurotomy in a Patient With Desire for Childbearing

Kimata Ryutaro, Fujita Takashi, Ihara Tsutomu, Mutsuga Masato, Yagami Kei

Shinzo Vol. 55 ( 12 ) page： 1195 - 1200 2023.12

Impact of aortopulmonary collaterals on adverse events after total cavopulmonary connection

Osawa, T; Schaeffer, T; Borgmann, K; Schmiel, M; Staehler, H; Di Padua, C; Heinisch, PP; Piber, N; Mutsuga, M; Hager, A; Ewert, P; Hörer, J; Ono, M

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY Vol. 64 ( 6 ) 2023.12

Development of novel waxy bone haemostatic agents composed of biodegradable polymers with osteogenic-enhancing peptides in rabbit models

Ohno, T; Suenaga, H; Yamawaki-Ogata, A; Kanie, K; Kato, R; Uto, K; Ebara, M; Ito, H; Narita, Y; Usui, A; Mutsuga, M

INTERDISCIPLINARY CARDIOVASCULAR AND THORACIC SURGERY Vol. 37 ( 5 ) 2023.11

Surgical reconstruction after resection of cardiac metastasis from oropharyngeal carcinoma: a case report

Nishi, T; Fujimoto, KL; Hiramatsu, M; Okada, T; Suzuki, Y; Shimoyama, Y; Terazawa, S; Tokuda, Y; Mutsuga, M; Usui, A

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 85 ( 4 ) page： 875 - 879 2023.11

Hypopharyngeal Injury by Transesophageal Echocardiography During Cardiac Surgery

Aoki, Y; Tamura, T; Uchida, W; Morioka, H; Yamamoto, M; Yuhara, S; Nishio, N; Mutsuga, M; Furune, S; Suzuki, S; Nishiwaki, K

JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA Vol. 37 ( 10 ) page： 2027 - 2031 2023.10

Cadaver surgical training for brain-dead donor lung procurement: Educational note

Nakamura, S; Ueno, H; Mutsuga, M; Chen-Yoshikawa, TF

JTCVS TECHNIQUES Vol. 21 page： 261 - 264 2023.10

Fabrication of pH-responsive poly(vinyl alcohol)-based microfibers crosslinked with copolymers containing benzoxaborole and carboxy groups

Momose, T; Takeuchi, K; Uchida, H; Saito, S; Nakada, K; Mutsuga, M; Yamawaki-Ogata, A; Narita, Y; Kotsuchibashi, Y

POLYMER Vol. 283 2023.9

特集胸部外科領域における周術期管理の重要ポイント I. 心臓血管領域 14.人工心肺離脱時の凝固機能評価

六鹿雅登

胸部外科 Vol. 76 ( 10 ) page： 824 - 828 2023.9

[Perioperative Management of Coagulation After the Weaning of Cardiopulmonary Bypass in Cardiac Surgery].

Mutsuga M

Kyobu geka. The Japanese journal of thoracic surgery Vol. 76 ( 10 ) page： 824 - 828 2023.9

A review of current status of cell-based therapies for aortic aneurysms

Yamawaki-Ogata, A; Mutsuga, M; Narita, Y

INFLAMMATION AND REGENERATION Vol. 43 ( 1 ) page： 40 2023.8

Transcatheter Aortic Valve Replacement for Bicuspid Aortic Stenosis With a Severely Calcified Raphe Using An Under-Sized SAPIEN 3 Valve: Sizing by the Circle Method and Deployment by the Pressure-Regulated Method

Tobe, A; Tanaka, A; Tokuda, Y; Shirai, Y; Miyazaki, T; Yuhara, S; Akita, S; Furusawa, K; Ishii, H; Mutsuga, M; Murohara, T

CARDIOVASCULAR REVASCULARIZATION MEDICINE Vol. 53 page： S149 - S152 2023.8

Cardiac rehabilitation in a heart-failure patient using customized "cardiac support net" treatment: a case report

Kobayashi, K; Akita, T; Akita, S; Ito, H; Terazawa, S; Mutsuga, M; Usui, A

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 85 ( 3 ) page： 626 - 634 2023.8

Hybrid Repair of Extensive Aortic Arch Aneurysms: Outcomes of Isolated Frozen Elephant Trunk Repair and of Elephant Trunk with Second Stage Thoracic Endovascular Aortic Repair

Tokuda, Y; Terazawa, S; Yoshizumi, T; Ito, H; Banno, H; Mutsuga, M

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY Vol. 66 ( 2 ) page： 284 - 285 2023.8

致死的不整脈に対する導電性繊維電極付き心臓ネットによる意識下除細動治療の試み

秋田利明, 六鹿雅登, 鷲尾巧, 杉浦清了, 久田俊明, 杉山純男, 佐々木敏哉, 佐々木哲哉

日本心臓血管外科学会雑誌 Vol. 52 ( 4 ) page： i - iii 2023.7

BTTにおける5年を超える長期補助のために重要となる患者管理

六鹿雅登

人工臓器 Vol. 52 ( 1 ) page： 62 - 66 2023.6

Incidence and clinical impact of silent pancreatitis after aortic arch surgery

Ohno, T; Mutsuga, M; Saito, S; Tokuda, Y; Nagai, K; Umemoto, N; Abe, T; Usui, A

ASIAN CARDIOVASCULAR & THORACIC ANNALS Vol. 31 ( 4 ) page： 303 - 311 2023.5

Clinical implications of the cardio-ankle vascular index before and after transcatheter aortic valve implantation

Miki, Y; Tanaka, A; Tokuda, Y; Tobe, A; Shirai, Y; Yuhara, S; Akita, S; Furusawa, K; Ishii, H; Mutsuga, M; Murohara, T

JOURNAL OF CARDIOVASCULAR MEDICINE Vol. 24 ( 5 ) page： 302 - 307 2023.5

Contractile pericarditis-like hemodynamics in dilated-phase hypertrophic cardiomyopathy with giant atrium.

Morimoto R, Ito R, Araki T, Mizutani T, Kimura Y, Kazama S, Oishi H, Kuwayama T, Sugiura Y, Hiraiwa H, Kondo T, Okumura T, Kobayashi K, Mutsuga M, Murohara T

Journal of cardiology cases Vol. 27 ( 5 ) page： 199 - 202 2023.5

Increased risk of purge system malfunction after Impella 5.0 replacement: a case series

Oishi, H; Morimoto, R; Ito, R; Kazama, S; Kimura, Y; Araki, T; Mizutani, T; Kuwayama, T; Hiraiwa, H; Kondo, T; Okumura, T; Mutsuga, M; Usui, A; Murohara, T

JOURNAL OF ARTIFICIAL ORGANS Vol. 26 ( 1 ) page： 79 - 83 2023.3

Administration of anti-inflammatory M2 macrophages suppresses progression of angiotensin II-induced aortic aneurysm in mice

Ashida, S; Yamawaki-Ogata, A; Tokoro, M; Mutsuga, M; Usui, A; Narita, Y

SCIENTIFIC REPORTS Vol. 13 ( 1 ) page： 1380 2023.1

Impact of Albuminuria on the Prognosis After Transcatheter Aortic Valve Implantation

Tobe, A; Tanaka, A; Tokuda, Y; Shirai, Y; Miyazaki, T; Yuhara, S; Akita, S; Furusawa, K; Ishii, H; Mutsuga, M; Murohara, T

AMERICAN JOURNAL OF CARDIOLOGY Vol. 186 page： 156 - 162 2023.1

心臓移植待機中の現状とheart allocation system改定への課題

奥村貴裕, 六鹿雅登, 風間信吾, 平岩宏章, 森本竜太, 吉住朋, 室原豊明

移植 Vol. 58 ( Supplement ) page： s154_1 - s154_1 2023

Language：Japanese Publisher：一般社団法人日本移植学会

近年の心臓移植レシピエント候補の増加とわが国の深刻なドナー不足により、心臓移植待機期間は1,700日を超えるに至った。移植前状態のほぼ100%は非拍動型植込型VAD装着状態にある。J-MACSデータによれば、術後1年のVAD関連合併症として、感染(36％)、神経機能障害(24％)、大量出血(21％)、右心不全(7％)、除細動を要する不整脈(8%)があり、3年生存は85％とされる。現在当院では、心臓移植適応承認84名中12名(14%)に心臓移植を施行しえたが、待機中に16名(19%)が死亡しており、原因として多臓器不全、脳血管障害、感染が多い。また、緊急入院では、心室頻拍や心室細動等の不整脈、右室不全、ドライブライン断線、感染が多い。待機中のこれらの状態を考慮した、わが国独自のスコアリングシステムの開発、allocation systemが望まれる。不整脈や右心不全にて繰り返し入退院を余儀なくされる症例、BiVADサポート症例、後遺症のない待機中脳血管障害症例、繰り返す溶血・血栓等の症例は、待機中予後の改善の観点から、優先度を再考してもよいかもしれない。しかしながら現在、これらの合併症の程度やそれに伴うStatusの変更においては客観的な検証はされておらず、各要素を組み込む際には客観的な評価システムの構築が必要となろう。当院における心臓移植待機の現状を報告し、allocation systemの現状の課題と将来的なあり方、改定への進め方を議論したい。

DOI： 10.11386/jst.58.supplement_s154_1

Higher F-wave frequency associates with poor procedural success rate after Maze procedure

Usui, R; Mutsuga, M; Narita, Y; Tokuda, Y; Terazawa, S; Ito, H; Uchida, W; Inden, Y; Murohara, T; Usui, A

GENERAL THORACIC AND CARDIOVASCULAR SURGERY Vol. 70 ( 12 ) page： 997 - 1004 2022.12

Effectiveness of the scheduled transfusion strategy for factor V deficiency with platelet dysfunction during coronary artery surgery

Morita, K; Mutsuga, M; Uchida, W; Usui, A

JOURNAL OF CARDIAC SURGERY Vol. 37 ( 12 ) page： 5493 - 5495 2022.12

特集胸部外科の緊急手術up to date I. 大動脈疾患 4.外傷性胸部大動脈破裂

六鹿雅登

胸部外科 Vol. 75 ( 10 ) page： 759 - 762 2022.9

Methods for confirming the safety of radiation therapy in patients with left ventricular assist device: a case of extranodal NK/T-cell lymphoma, nasal type

Oishi, H; Kondo, T; Kawamura, M; Shimada, K; Mutsuga, M; Kurokawa, T; Kuwayama, T; Hiraiwa, H; Morimoto, R; Okumura, T; Nishida, T; Kiyoi, H; Naganawa, S; Usui, A; Murohara, T

JOURNAL OF ARTIFICIAL ORGANS Vol. 25 ( 3 ) page： 274 - 278 2022.9

[Traumatic Thoracic Aortic Injury].

Mutsuga M

Kyobu geka. The Japanese journal of thoracic surgery Vol. 75 ( 10 ) page： 759 - 762 2022.9

Multiple giant coronary artery aneurysms with extended coronary ectasia emerging 12years after previous coronary artery bypass grafting

Fujii, T; Mutsuga, M; Narita, Y; Tokuda, Y; Terazawa, S; Ito, H; Uchida, W; Yuhara, S; Usui, A

SAGE OPEN MEDICAL CASE REPORTS Vol. 10 page： 2050313X221116681 2022.8

Lateralized Purplish Skin Discoloration Due to Aortic Dissection.

Ishida S, Mutsuga M, Fujita T, Yagami K

Circulation reports Vol. 4 ( 7 ) page： 332 2022.7

Surgical techniques for infectious endocarditis of the mitral valve with hypertrophic cardiomyopathy in Costello syndrome.

Ishida S, Mutsuga M, Fujita T, Yagami K

Journal of cardiology cases Vol. 25 ( 6 ) page： 367 - 369 2022.6

Flexion limitation of the Impella 5.0 when implanted using the femoral approach in patients with small stature

Hiraiwa, H; Kimura, Y; Morimoto, R; Ito, R; Araki, T; Mizutani, T; Kazama, S; Oishi, H; Kuwayama, T; Kondo, T; Furusawa, K; Okumura, T; Mutsuga, M; Usui, A; Murohara, T

JOURNAL OF ARTIFICIAL ORGANS Vol. 25 ( 2 ) page： 182 - 183 2022.6

Plaster technique for filling up a future entry at the suture hole in type A aortic dissection

Ishida, S; Mutsuga, M; Fujita, T; Yagami, K

INDIAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY Vol. 38 ( 3 ) page： 339 - 341 2022.5

Impella5.0 "ILIPELLA" Approach for a Fulminant Myocarditis Patient With a Small Peripheral Artery

Mutsuga, M; Banno, H; Okumura, T; Morimoto, R; Kondo, T; Kimura, Y; Hiraiwa, H; Murohara, T; Usui, A

HEART LUNG AND CIRCULATION Vol. 31 ( 5 ) page： E72 - E74 2022.5

Impact of an Improved Standardized Strategy and Individually Tailored Protocol for Heartmate II and Heartmate 3 Left Ventricular Assist Devices on the Incidence of Driveline Infections

Mutsuga, M; Okumura, T; Morimoto, R; Kondo, T; Ito, H; Uchida, W; Terazawa, S; Tokuda, Y; Narita, Y; Murohara, T; Usui, A

JOURNAL OF HEART AND LUNG TRANSPLANTATION Vol. 41 ( 4 ) page： S489 - S489 2022.4

Relationship between spleen size and exercise tolerance in advanced heart failure patients with a left ventricular assist device

Hiraiwa, H; Okumura, T; Sawamura, A; Araki, T; Mizutani, T; Kazama, S; Kimura, Y; Shibata, N; Oishi, H; Kuwayama, T; Kondo, T; Furusawa, K; Morimoto, R; Adachi, T; Yamada, S; Mutsuga, M; Usui, A; Murohara, T

BMC RESEARCH NOTES Vol. 15 ( 1 ) page： 40 2022.2

Late detection of communication between juxtaposed atrial appendages

Ishida, S; Mutsuga, M; Fujita, T; Yagami, K

GENERAL THORACIC AND CARDIOVASCULAR SURGERY Vol. 70 ( 2 ) page： 190 - 192 2022.2

Alternative therapeutic strategy for existing aortic aneurysms using mesenchymal stem cell-derived exosomes

Kozakai, M; Narita, Y; Yamawaki-Ogata, A; Fujimoto, KL; Mutsuga, M; Tokuda, Y; Usui, A

EXPERT OPINION ON BIOLOGICAL THERAPY Vol. 22 ( 1 ) page： 95 - 104 2022.1

Late-phase left ventricular pseudoaneurysm after three-time mitral valve surgery

Ishida, S; Mutsuga, M; Fujita, T; Yagami, K

JOURNAL OF SURGICAL CASE REPORTS Vol. 2022 ( 1 ) 2022.1

Surgical Management for Systolic Anterior Motion (SAM) of the Mitral Valve in Obstructive Hypertrophic Myopathy

Usui, A; Mutsuga, M

ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY Vol. 28 ( 4 ) page： 239 - 248 2022

植込み型補助人工心臓入れ替え術後に偽性高クレアチニン血症を来した一例

安田宜成, 金恒秀, 石川裕介, 斎藤尚二, 加藤規利, 小杉智規, 六鹿雅登, 丸山彰一

移植 Vol. 57 ( Supplement ) page： s335_3 - s335_3 2022

Language：Japanese Publisher：一般社団法人日本移植学会

症例は50歳代男性。Xー12年に心不全のためA病院入院。心筋生検にて拡張型心筋症と診断。その後入退院を繰り返し、心臓移植申請を目的にX－5年7月に名大病院紹介となった。心臓移植適応判定を得て、同年10月に植込み型補助人工心臓（HM-II)植え込み術施行。X年3月24日にドライブラインの断線疑いでHM-IIIへ入れ替え術施行。術後に尿路感染合併し4月2日より抗菌薬治療開始したところ、sCr（mg/dL）0.79-0.96から2.49へと悪化し、その後も改善しないため、4月4日腎臓内科紹介された。CTでは左胸水少量認め、IVC虚脱や水腎症を認めず、腎機能障害の原因は不明であった。ARB中止して経過観察したが4月8日sCr3.02と腎機能は改善せず，別の腎機能検査であるsCysC(mg/L)は0.91と著しい乖離を認めた。4月18日イヌリンクリアランス検査を行い実測GFR84.2（ｍL/分/1.73m2）、sCr.2.59，sCysC0.85、eGFRcreat21.3，eGFRcys88.8であり、偽性高Cr血症が疑われた。そこで酵素法（シグナスオートCRE）とHPLC法でsCrを比較したところ2.4と0.8であった。酵素法のR-Ⅱ試薬添加後に副波長の吸光度が上昇し続けており、血清に含めれる蛋白成分による混濁が疑われた。その後はsCrは希釈無し、2倍、4倍希釈で評価しており、各々3.23～4.69，0.76～1.14、0.76～0.96であった。心臓移植待機者において偽性高Cr血症を経験したため文献的考察を含め報告する。

DOI： 10.11386/jst.57.supplement_s335_3

Comparison of Impella 5.0 and extracorporeal left ventricular assist device in patients with cardiogenic shock

Kondo, T; Morimoto, R; Mutsuga, M; Fujimoto, K; Okumura, T; Shibata, N; Kazama, S; Kimira, Y; Oishi, H; Kuwayama, T; Hiraiwa, H; Usui, A; Murohara, T

INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS Vol. 44 ( 11 ) page： 846 - 853 2021.11

Sudden circulatory collapse caused by mechanical obstruction of the left main coronary trunk with infective endocarditis vegetation: a case report

Usui, R; Mutsuga, M; Narita, Y; Tokuda, Y; Terazawa, S; Ito, H; Uchida, W; Usui, A

SURGICAL CASE REPORTS Vol. 7 ( 1 ) page： 223 2021.10

"Double Cuff" Technique for Modified Bentall Procedure.

Mutsuga M, Usui A

Heart, lung & circulation 2021.5

Predictors of failure of mitral valve repair using artificial chordae.

Mutsuga M, Narita Y, Tokuda Y, Uchida W, Ito H, Terazawa S, Nakaguro M, Usui A

The Annals of thoracic surgery 2021.5

Pericardioperitoneal and pericardiopleural windows: A drainage technique for the treatment of recurrent cardiac tamponade. A case report.

Ishida S, Yagami K, Fujita T, Mutsuga M

International journal of surgery case reports Vol. 83 page： 105962 2021.5

"Millefeuille Technique" by Using Excised Intimal Layers in Repair of Type A Aortic Dissection.

Mutsuga M, Yagami K, Fujita T, Ishida S, Usui A

Heart, lung & circulation 2021.4

A surgical case for pregnancy-related spontaneous coronary artery dissection.

Usui R, Mutsuga M, Yoshizumi T, Oshima H, Usui A

The Annals of thoracic surgery 2021.4

Midterm Outcomes of Zone 0 Antegrade Endograft Implantation During Type I Hybrid Aortic Arch Repair.

Banno H, Mutsuga M, Sugimoto M, Tokuda Y, Kodama A, Usui A, Komori K

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery 2021.3

Coronary artery aneurysm complicated by pneumothorax with a history of Kawasaki disease

Ishida Shinichi, Mutsuga Masato, Fujita Takashi, Ito Masao, Okamoto Sawako, Yagami Kei

JOURNAL OF SURGICAL CASE REPORTS Vol. 2021 ( 3 ) page： rjab053 2021.3

多職種チームで行う「献体を用いた臓器摘出トレーニング」in Clinical Anatomy Laboratory Nagoya (CALNA)

中村彰太, 六鹿雅登, 後藤和大, 仲西慶太, 杉山燈人, 門松由佳, 上野陽史, 後藤真輝, 尾関直樹, 福本紘一, 伊藤英樹, 小山富生, 碓氷章彦, 芳川豊史

移植 Vol. 56 ( Supplement ) page： s105 - s105 2021

Language：Japanese Publisher：一般社団法人日本移植学会

【背景】脳死ドナー臓器摘出では、外科医だけでなく臨床工学技士（ME）・看護師・コーディネーター等多職種が関わる医療で、実際の手技を知っていればよりよい連携が可能かもしれない。献体されたご遺体の固定方法は進化しており、特殊な保存液で固定された状態は生体と類似しているため、手術トレーニングに用いることが可能となった。肺移植実施施設でない当院での実施施設へのとり組みの一貫として、心臓外科医・ME・医学生と合同で臓器摘出トレーニングを実行したので報告する。【トレーニング概要】開胸・心嚢切開し臓器評価方法を全員で確認した後、心灌流液注入用と肺灌流液ドレナージ用のカテーテルを各留置し、大血管を遮断し心臓摘出、続いて肺摘出を行った。続いてバックテーブルにて肺の植え込みができる状態にまで処理を行いトレーニング終了とした。心肺摘出に際して重要となる左房の処理については、操作を止め指導医にポイントを解説してもらいつつ、心臓外科・呼吸器外科の双方の考えを伝え、解剖を確認しながら行った。また、MEと肺灌流液ドレナージ経路の方法や肺灌流のタイミングなど細やかな部分まで共有できた。【結語】本トレーニングは多職種での手技と順序の確認に有用で、臓器摘出の際互いに心がけているポイントや考えも共有・理解できた。今後はプログラムを定型化し、実践に対応できるレベルに質を高めつつ、看護師やコーディネーターも含めて行う予定である。

DOI： 10.11386/jst.56.supplement_s105

心臓移植において悪性腫瘍は一律に適応除外とされるべきか？

奥村貴裕, 木村祐樹, 近藤徹, 六鹿雅登, 碓氷章彦, 室原豊明

移植 Vol. 56 ( Supplement ) page： s504 - s504 2021

Language：Japanese Publisher：一般社団法人日本移植学会

44歳女性、Duchenne型筋ジストロフィーの保因者。頻回の入退院を繰り返し、NYHA III～IV度で推移した。最高酸素摂取量は7.7mL/min/kgまで低下し、10回の心不全増悪による入院に至った。左室駆出率は14%、左室拡張末期径は84mmであった。心臓移植適応検討に向けた精査にて、甲状腺右葉に結節影を認めた。甲状腺乳頭癌と診断され、心臓移植の適応外と判断された。年齢およびT3N1aM0からStage 1と診断され、甲状腺全摘出術および気管周囲リンパ節郭清が行われた。当時はDestination Therapy/Bridge to Decision目的の植込型補助人工心臓は装着できず、カテコラミン持続投与あるいは体外式補助人工心臓装着下に、心臓移植適応となる寛解治癒後5年を待つ方針も検討されたが、長期にわたる入院下での移植待機生活には耐えられない旨の申し出があり、その後4回の心不全増悪入院を繰り返し、翌年永眠された。現行の適応基準では、悪性腫瘍は絶対的除外条件のひとつであるが、本症例の適応外要因となった甲状腺乳頭癌Stage 1の5年生存率は99%以上であり、5年の再発・死亡回避率も90％程度に至る。実際、2016年のISHLTのlisting criteriaにおいても、癌のタイプ、治療への反応性、転移などにより、再発リスクが低い場合には心臓移植も考慮されるべきと記されている。再発リスクが低く生命予後が担保されうる悪性腫瘍合併例では、心臓移植適応に再考の余地があるのではないかと考える。

DOI： 10.11386/jst.56.supplement_s504

症例三度目の感染性心内膜炎に対しウシ心膜で縫着部を被覆した僧帽弁置換術の1例

石田真一, 藤田山, 八神啓, 六鹿雅登

胸部外科 Vol. 73 ( 11 ) page： 950 - 953 2020.10

Dementia and Cognitive Impairment on Coronary Artery Bypass Grafting Patients in Aging Society

Terazawa Sachie, Narita Yuji, Fujimoto Kazuro, Mutsuga Masato, Tokuda Yoshiyuki, Ito Hideki, Uchida Wataru, Usui Akihiko

Journal of Coronary Artery Disease Vol. 25 ( 3 ) page： 66 - 71 2019

Language：English Publisher：The Japanese Coronary Association

Coronary artery bypass grafting (CABG) is strategy for complex coronary artery disease (CAD) practiced worldwide that has become to be performed in relatively elderly patients in recent years, regarding to the development of off-pump CABG. As the population of elderly patients with cognitive disorders increases, a certain proportion of CABG candidates are likely to have some degree of cognitive impairment, especially dementia. The discussions about the CABG candidates with dementia are still insufficient, although several reports have suggested that 9.6%&ndash20% of CABG candidates may have preoperative dementia. An analysis indicated higher rate of hospital mortality and delirium in dementia patients, but ideal strategies for managing such patients remain controversial. An estimated 20%&ndash35% of CABG patients may have preoperative mild cognitive impairment (MCI), which is associated with an increased risk of morbidity and poor physical recovery after CABG. This preoperative cognitive decline was identified as a predictive factor for post-operative cognitive decline (POCD). Several randomized control trial have compared the cognitive outcomes between elderly high-risk patients after CABG with or without cardiopulmonary bypass, finding no significant cognitive differences between on- and off-pump treatments at 3 to 12 months after CABG. In addition, any late cognitive decline is likely associated with the progression of underlying cerebrovascular disease rather than surgical procedure itself or cardiopulmonary bypass. Preoperative evaluations of the cognitive function may contribute to appropriate postoperative management, reduce the incidence of delirium and improve the overall surgical outcome.

DOI： 10.7793/jcad.25.010

特集進化した大動脈基部置換術 Bio-Bentall手術の展望

六鹿雅登, 碓氷章彦

胸部外科 Vol. 71 ( 1 ) page： 37 - 42 2018.1

Future Aspects of Bio-Bentall Procedure

Mutsuga M., Usui A.

Kyobu geka. The Japanese journal of thoracic surgery Vol. 71 ( 1 ) page： 37 - 42 2018.1

Publisher：Kyobu geka. The Japanese journal of thoracic surgery

The Bentall procedures using biological valved conduit is expanding owing to the increasing incidence of aortic valve disease in the aging population and usage for young generation. The long-term durability of the biological valve including the risks of structural valve deterioration(SVD) is the major concern of the bio-Bentall procedure. Bio-Bentall in our hospital are reviewed and literature review are added. Our surgical results of long-term survival in bio-Bentall patients is acceptable compare to other study and freedom from SVD and reoperation is better than other results. There was no experience of SVD complication so far. Modification using double sewing ring technique is useful to put larger valve, keep better hemostasis, easy to do reoperation for further SVD and expect for future valve in valve situation.

胸部大動脈に対するステントグラフト治療up-to-date Stanford A型大動脈解離術後の慢性解離性大動脈瘤に対する企業製frozen elephant trunkを用いた弓部置換術の手術成績

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

胸部外科 Vol. 70 ( 4 ) page： 281 - 285 2017.4

Total Arch Replacement Using Manufactured Frozen Elephant Trunk after Acute Type-A Dissection Repair

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

Kyobu geka. The Japanese journal of thoracic surgery Vol. 70 ( 4 ) page： 281 - 285 2017.4

Publisher：Kyobu geka. The Japanese journal of thoracic surgery

The purpose of this study is to assess the result of total arch replacement(TAR) using manufactured frozen elephant trunk(FET) for chronic aortic dissection after initial repair including the effect of aortic remodeling by the FET. Between 2003 and 2015, we performed 11 TAR using manufactured FET. Initial repairs before were 9 ascending aortic replacements and 2 Bentall operations. The entry of residual dissection was located at arch in 7 and at distal anastomosis site in 4. There was no hospital death. The operative complication included 2 surgical site infection, 1 interstitial pneumonia and 1 paraplegia with almost full recovery. Postoperative computed tomography 2.1 months after operation showed distal end of the FET was located at aortic valve level in 7 and at pulmonary bifurcation level in 4. There was no entry in thoracic aorta. Thrombosis of descending aorta was achieved in 7 patients. Significant midterm aortic remodeling (increased diameter of true lumen and decreased diameter of false lumen) was achieved, although the total diameter of aorta was increased. TAR using manufactured FET after type-A dissection repair promoted entry closure and thrombosis of false lumen. It requires long-term observation to judge the effect for aortic remodeling.

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 - 324 2016.4

Publisher：Kyobu geka. The Japanese journal of thoracic surgery

Congenital quadricuspid aortic valve is a very rare malformation. In most cases it has been found incidentally at aortic valve surgery or at autopsy. It frequently causes aortic regurgitation, which may become manifest in adulthood and require surgical treatment. We reported 4 cases of aortic regurgitation with quadricuspid aortic valve. In all cases, aortic valve replacement was preformed with prosthetic valve, and their postoperative courses were uneventful. Two were Hurwitz's classification type b, one was type a and the last patient was type c. Although quadricuspid aortic valve is a rare anomaly, its potential for severe valve failure in adulthood should be kept in mind.

弓部大動脈瘤-こだわりの術式と遠隔期成績広範囲弓部大動脈瘤に対する外科治療の変遷

荒木善盛, 六鹿雅登, 徳田順之, 岡田正穂, 阿部知伸, 大島英揮, 碓氷章彦

胸部外科 Vol. 66 ( 11 ) page： 960 - 964 2013.10

28年経過して再発した多発性左房粘液腫の1例

高野橋暁, 碓氷章彦, 六鹿雅登, 徳田順之, 荒木善盛, 成田裕司, 大島英揮, 上田裕一

胸部外科 Vol. 65 ( 12 ) page： 1089 - 1092 2012.11

An unexpected example of protein-templated click chemistry

Suzuki T., Ota Y., Kasuya Y., Mutsuga M., Kawamura Y., Tsumoto H., Nakagawa H., Finn M., Miyata N.

Angewandte Chemie - International Edition Vol. 49 ( 38 ) page： 6817 - 6820 2010.9

Publisher：Angewandte Chemie - International Edition

(Figure Presented) It all happened with a click: In a search for histone deacetylase (HDAC) inhibitors using in situ click chemistry, the first example of protein-Cu acceleration of the azide-alkyne cycloaddition reaction was uncovered. The copper center in the protein target HDAC8 catalyzed triazole formation between one azide-alkyne pair among 30 possibilities. These results provide a new route to HDAC inhibitors and a precedent for new types of proteinbased catalysts for click chemistry. © 2010 Wiley-VCH Verlag GmbH &. Co. KGaA, Weinheim.

DOI： 10.1002/anie.201002205

Usefulness of bicarbonate-based Impella purge solution in a patient with heparin-induced thrombocytopenia: the first case report of long-term management in Japan. Open Access

[Surgical treatment for aortic root dilatation and aortic regurgitation after arterial switch operation].

Mutsuga M, Tamaki S, Yokoyama Y, Ishikawa H, Ishimoto N, Usui A, Ueda Y

Kyobu geka. The Japanese journal of thoracic surgery Vol. 61 ( 12 ) page： 1043 - 7 2008.11

Shin Nagai, Hiroaki Hiraiwa, Ryota Ito, Yuichiro Koyama, Kiyota Kondo, Shingo Kazama, Toru Kondo, Ryota Morimoto, Takahiro Okumura, Hideki Ito, Tomo Yoshizumi, Masato Mutsuga, Toyoaki Murohara

Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs Vol. 28 ( 1 ) page： 83 - 89 2025.3

Language：English Publishing type：Research paper (scientific journal)

Percutaneous mechanical circulatory support utilizing micro-axial flow pumps, such as the Impella group of devices, has become a life-saving technique in the treatment of refractory cardiogenic shock, with ever-increasing success rates. A 30-year-old man presented with acute decompensated heart failure and a severely reduced left ventricular ejection fraction (17%). Despite initial treatment with inotropic drugs and intra-aortic balloon pump support, his hemodynamic status remained unstable. Transition to Impella CP mechanical circulatory support was made on day 6 owing to persistently low systolic blood pressure. A significant decline in platelet count prompted suspicion of heparin-induced thrombocytopenia (HIT), later confirmed by positive platelet-activated anti-platelet factor 4/heparin antibody and a 4Ts score of 6 points. Argatroban was initially used as the purge solution, but owing to complications, a switch to Impella 5.0 and a bicarbonate-based purge solution (BBPS) was performed. Despite additional veno-arterial extracorporeal membrane oxygenation support on day 24, the patient, aiming for ventricular assist device treatment and heart transplantation, died from infection and multiple organ failure. Remarkably, the Impella CP continued functioning normally until the patient's demise, indicating stable Impella pump performance using BBPS. This case highlights the usefulness of BBPS as an alternative to conventional Impella heparin purge solution when HIT occurs.

DOI： 10.1007/s10047-024-01452-0

Predicting survival after Impella implantation in patients with cardiogenic shock: The J-PVAD risk score. International journal Open Access

Toru Kondo, Tomo Yoshizumi, Ryota Morimoto, Takahiro Imaizumi, Shingo Kazama, Hiroaki Hiraiwa, Takahiro Okumura, Toyoaki Murohara, Masato Mutsuga

European journal of heart failure Vol. 27 ( 1 ) page： 51 - 59 2025.1

Language：English Publishing type：Research paper (scientific journal)

AIMS: Impella has become a new option for mechanical circulatory support in patients with cardiogenic shock (CS); however, prognostic models for patients after Impella are lacking. We aimed to identify the factors that predict in-hospital mortality in patients with CS requiring Impella and develop a new risk prediction model. METHODS AND RESULTS: We utilized the J-PVAD registry, which includes all cases where Impella was implanted in Japan. Two-thirds of the patients in the J-PVAD registry were randomly assigned to the derivation cohort (n = 1701), and the other third was assigned to the validation cohort (n = 850). A backward stepwise logistic regression model was developed to identify factors associated with in-hospital mortality. In the derivation cohort, 956 patients were discharged alive, and 745 patients (43.8%) died during hospitalization. Among 29 candidate variables, 12 were independently associated with in-hospital mortality and were applied as components of the risk model, including age, sex, body mass index, fulminant myocarditis aetiology, cardiac arrest in hospital, baseline veno-arterial extracorporeal membrane oxygenation use, mean arterial pressure, lactate, lactate dehydrogenase, total bilirubin, creatinine, and albumin levels. The comparison of predicted and observed in-hospital mortality according to the 7th quantiles using the J-PVAD risk score showed good calibration. The area under the curve for the J-PVAD risk score was 0.76 (95% confidence interval 0.73-0.78). In the validation cohort, the J-PVAD risk score showed good calibration and discrimination ability. CONCLUSIONS: The J-PVAD risk score can be calculated using variables easily obtained in routine clinical practice. It helps the accurate stratification of mortality risk and facilitates clinical decision-making.

DOI： 10.1002/ejhf.3471

The incidence and influencing factors of in-hospital frailty progression following transcatheter aortic valve implantation. Open Access

Tatsuya Miyazaki, Akihito Tanaka, Yoshiyuki Tokuda, Yoshinori Shirai, Koji Mizutani, Kenji Furusawa, Sho Akita, Takahiro Ozeki, Kiyonori Kobayashi, Hideki Ishii, Masato Mutsuga, Toyoaki Murohara

Internal medicine (Tokyo, Japan) Vol. 63 ( 24 ) page： 3283 - 3289 2024.12

Language：English Publishing type：Research paper (scientific journal) Publisher：The Japanese Society of Internal Medicine

Objective Patients undergoing transcatheter aortic valve implantation (TAVI) are generally older and frailty is therefore an important clinical issue. The baseline degree of frailty is associated with the prognosis in patients undergoing TAVI; however, the incidence of in-hospital frailty progression and its influencing factors have not yet been elucidated. Methods This observational, single-center study retrospectively evaluated 281 patients who underwent TAVI. The degree of frailty at baseline and discharge was evaluated using the Clinical Frailty Scale (CFS). In-hospital frailty progression was defined as an increase of at least one level in the CFS score at discharge from baseline, and predictors of frailty progression were assessed. Results The median baseline CFS score was 4.0 (interquartile range: 3.0-4.0). In-hospital frailty progression was observed in 49 patients (17.4%). No significant differences were observed in age, sex, comorbidities, or surgical risk scores between patients with and without frailty progression. Patients with frailty progression experienced stroke more frequently during hospitalization than those without (12.2% vs. 1.3%, p = 0.001). A multivariable logistic analysis showed that in-hospital stroke was a significant predictor of frailty progression (odds ratio, 10.7; 95% confidence interval: 2.34-49.2, p = 0.002). Patients with frailty progression had a longer hospital stay than those without frailty progression [7.0 (4.0-17.0) vs. 4.0 (4.0-8.0) days, p = 0.001]. Conclusions In-hospital frailty progression was not uncommon in patients undergoing TAVI. Stroke incidence was a significant influencing factor in frailty progression, whereas baseline comorbidities and surgical risks were not.

DOI： 10.2169/internalmedicine.3146-23

Clinical Features and Postoperative Mobilization following Total Aortic Arch Replacement.

Yuya Shirai, Yoshiyuki Tokuda, Yohei Tsuchikawa, Kiyonori Kobayashi, Shinya Tanaka, Natsumi Yoshito, Yuto Hori, Daichi Takagi, Yoshihiro Nishida, Masato Mutsuga

International heart journal Vol. 65 ( 6 ) page： 1075 - 1078 2024.11

Language：English Publishing type：Research paper (scientific journal) Publisher：International Heart Journal Association

Open thoracic aortic surgery is believed to necessitate more intensive rehabilitation. This study aimed to compare the progress of postoperative rehabilitation between standard and delayed mobilization. A retrospective review was conducted on 199 patients who underwent isolated total aortic arch replacement via median sternotomy. Cases of in-hospital mortality and postoperative stroke were excluded. Based on the current guidelines for cardiovascular rehabilitation of the Japanese Circulation Society, patients were categorized into standard mobilization (could sit on the edge of bed within 2 days) and delayed mobilization (could not do so) groups. Rehabilitation progress was compared among both groups. Initial mobilization was delayed in 100 patients (delayed mobilization group), primarily because of respiratory failure (46.0%). Preoperative risk characteristics, including EuroSCORE II (median, 2.9 versus 3.5), were similar between the standard and delayed mobilization groups. The delayed mobilization group had longer operation (median, 6.1 versus 8.0 hours, P < 0.001) and cardiopulmonary bypass (median, 3.2 versus 4.1 hours, P < 0.001) times. Independent ambulation occurred earlier in the standard mobilization group (median, 6.0 versus 8.0 days, P < 0.001).In conclusion, early initiation of sitting on the edge of the bed within 2 days was associated with earlier independent ambulation during postoperative rehabilitation, which supports the current guidelines. Longer operation and cardiopulmonary bypass times were associated with delayed mobilization initiation, suggesting the need for more tailored approaches in such cases.

DOI： 10.1536/ihj.24-261

DT LVADの現状と今後-DT治療の拡大による諸問題への取り組み(患者の看取りを含めて) DT-LVAD実施施設新規参入後1年間に施行した4例の検討

吉住朋, 植村友稔, 山本暁邦, 平岩宏章, 風間信吾, 近藤徹, 森本竜太, 奥村貴裕, 六鹿雅登

人工臓器 Vol. 53 ( 2 ) page： S - 56 2024.10

最新のLVAD治療における合併症抑止への取り組みドライブライン感染撲滅を目指した当院の取り組み

吉住朋, 林泰成, 風間信吾, 平岩宏章, 近藤徹, 森本竜太, 奥村貴裕, 六鹿雅登

人工臓器 Vol. 53 ( 2 ) page： S - 71 2024.10

現代の日本に適した臓器アロケーションシステムの確立に向けて心臓移植におけるアロケーションシステムの課題と改善への提案

奥村貴裕, 風間信吾, 平岩宏章, 近藤徹, 森本竜太, 吉住朋, 六鹿雅登, 室原豊明

移植 Vol. 59 ( 総会臨時 ) page： 191 - 191 2024.9

拡張相肥大型心筋症に対して心臓移植4年経過後、肺高血圧症の合併を診断された一例

平岩宏章, 長井伸, 伊藤亮太, 小山雄一郎, 近藤喜代太, 風間信吾, 近藤徹, 森本竜太, 奥村貴裕, 伊藤英樹, 吉住朋, 六鹿雅登, 室原豊明

移植 Vol. 58 ( 4 ) page： 407 - 408 2024.3

Factors associated with postsurgical muscle weakness in patients who undergo thoracic aortic surgery: a retrospective cohort study. International journal

Miho Shimizu, Takuji Adachi, Kiyonori Kobayashi, Masato Mutsuga, Hideki Oshima, Akihiko Usui, Sumio Yamada

Physiotherapy theory and practice Vol. 39 ( 10 ) page： 2180 - 2188 2023.10

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: Aortic surgery is often performed in elderly patients, and these patients have a high risk of postsurgical muscle weakness. To reinforce purposeful postsurgical rehabilitation, we aimed to investigate the factors associated with postsurgical muscle weakness in patients who underwent thoracic aortic surgery. METHODS: This retrospective cohort study analyzed data of consecutive patients who underwent elective thoracic aortic surgery with cardiopulmonary bypass, and whose knee extensor isometric muscle strength (KEIS) were measured pre- and postoperatively at University Hospital between January 2012 and December 2018. The primary outcome was percent change in KEIS (% change in KEIS). Multivariate linear regression analysis was used to identify independent risk factors for % change in KEIS. RESULTS: Overall, 218 patients were included. Multivariate linear regression analysis showed that mechanical ventilation time, days from initial sitting to 100 m walking, and the number of exercises in the rehabilitation room were associated with % change in KEIS. CONCLUSIONS: This study may serve as a reference to stratify patients at risk of postsurgical muscle weakness. The preventive or alternative interventions in patients undergoing thoracic aortic surgery will be assessed in future studies.

DOI： 10.1080/09593985.2022.2068168

心臓移植Allocation Systemは具体的にどのように変更すべきか心臓移植待機中の現状とHeart Allocation System改定への課題

当院のMCS使用下で発症した頭蓋内出血症例の検討

長井伸, 森本竜太, 伊藤亮太, 近藤喜代太, 小山雄一郎, 風間信吾, 平岩宏章, 奥村貴裕, 六鹿雅登, 室原豊明

人工臓器 Vol. 52 ( 2 ) page： S - 103 2023.10

奥村貴裕, 六鹿雅登, 風間信吾, 平岩宏章, 森本竜太, 吉住朋, 室原豊明

移植 Vol. 58 ( 総会臨時 ) page： 154 - 154 2023.9

Cardiac rehabilitation in a heart failure patient using customized “cardiac support net” treatment: A case report Reviewed

Kiyonori Kobayashi, Toshiaki Akita, Sho Akita, Hideki Ito, Sachie Terazawa, Masato Mutsuga, Akihiko Usui

Nagoya J Med Sci Vol. 85 ( 3 ) page： 626 - 634 2023.8

Cardiac Rehabilitation in Severe Heart Failure Patients with Impella 5.0 Support via the Subclavian Artery Approach Prior to Left Ventricular Assist Device Implantation

Miho Shimizu, Hiroaki Hiraiwa, Shinya Tanaka, Yohei Tsuchikawa, Ryota Ito, Shingo Kazama, Yuki Kimura, Takashi Araki, Takashi Mizutani, Hideo Oishi, Tasuku Kuwayama, Toru Kondo, Ryota Morimoto, Takahiro Okumura, Hideki Ito, Tomo Yoshizumi, Masato Mutsuga, Akihiko Usui, Toyoaki Murohara

Journal of Personalized Medicine Vol. 13 ( 4 ) page： 630 - 630 2023.4

Language：English Publishing type：Research paper (scientific journal) Publisher：MDPI AG

Impella 5.0 circulatory support via subclavian artery (SA) access may be a safe approach for patients undergoing cardiac rehabilitation (CR). In this case series, we retrospectively analyzed the demographic characteristics, physical function, and CR data of six patients who underwent Impella 5.0 implantation via the SA prior to left ventricular assist device (LVAD) implantation between October 2013 and June 2021. The median age was 48 years, and one patient was female. Grip strength was maintained or increased in all patients before LVAD implantation (pre-LVAD) compared to after Impella 5.0 implantation. The pre-LVAD knee extension isometric strength (KEIS) was less than 0.46 kgf/kg in two patients and more than 0.46 kgf/kg in three patients (unavailable KEIS data, n = 1). With Impella 5.0 implantation, two patients could ambulate, one could stand, two could sit on the edge of the bed, and one remained in bed. One patient lost consciousness during CR due to decreased Impella flow. There were no other serious adverse events. Impella 5.0 implantation via the SA allows mobilization, including ambulation, prior to LVAD implantation, and CR can be performed relatively safely.

DOI： 10.3390/jpm13040630

移植前後における心筋生検のキーポイント

奥村貴裕, 木村祐樹, 平岩宏章, 坂本岳, 小山雄一郎, 伊藤亮太, 風間信吾, 森本竜太, 伊藤英樹, 吉住朋, 六鹿雅登, 室原豊明

移植 Vol. 57 ( 4 ) page： 391 - 391 2023.4

植込み型左室補助人工心臓装着患者における運動能力の軌跡(Trajectory of Exercise Capacity in Patients with Durable Left Ventricular Assist Device)

風間信吾, 坂本岳, 伊藤亮太, 木村祐樹, 小山雄一郎, 平岩宏章, 近藤徹, 森本竜太, 奥村貴裕, 吉住朋, 六鹿雅登, 室原豊明

日本循環器学会学術集会抄録集 Vol. 87回 page： OJ05 - 6 2023.3

Impact of an improved driveline management for HeartMate II and HeartMate 3 left ventricular assist devices. International journal

Masato Mutsuga, Takahiro Okumura, Ryota Morimoto, Toru Kondo, Hideki Ito, Sachie Terazawa, Yoshiyuki Tokuda, Yuji Narita, Kazuki Nishida, Toyoaki Murohara, Akihiko Usui

Artificial organs Vol. 47 ( 2 ) page： 387 - 395 2023.2

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: We evaluated the impact of a standardized driveline care strategy, including a subfascial-tunneling method and dressing protocol, on the incidence of driveline infection (DLI). METHODS: DLI data from all HeartMate II (HMII) and HeartMate 3 (HM3) patients (including exchange devices) were retrospectively collected between 2013 and 2021. The driveline subfascial-tunneling method was altered in three steps (A: right direct; B: left triple, C: right triple), and the shower protocol was changed in two steps (A: with/without cover, B: with cover). Disinfection was individually tailored after changing the shower protocol. Complications associated with morbidity and mortality were evaluated for each modification. RESULTS: During the study period, 80 devices were implanted (HMII, n = 54; HM3, n = 26). The 8-year incidence of DLI was 15% (n = 8) in HMII patients and 0% in HM3 patients (p = 0.039). DLI was not associated with hospital mortality. The modified dressing protocol and tunneling method was associated with a significantly better DLI incidence rate in comparison to the previous one: Protocol-A (n = 17), Protocol-B (n = 63), 35% vs 3% (p = 0.0009), Method-A (n = 13), Method-B (n = 42), Method-C (n = 25), 46% vs 5% vs 0% (p = 0.0001). The rete of freedom form DLI at 1, 2, and 3 years had also significant difference between groups: Protocol-A and Protocol-B, 80%, 54%, 54% vs 96%, 96%, 96%, respectively (p < 0.0001), Method-A, Method-B and Method-C, 76%, 44%, 44%, vs 94%, 94%, 94% vs 100%, 100%, respectively (p < 0.0001). CONCLUSIONS: A standardized triple driveline tunneling strategy and waterproof dressing protocol reduced driveline infection in HM3 patients to 0%.

DOI： 10.1111/aor.14426

Impact of Early Ambulation on the Prognosis of Coronary Artery Bypass Grafting Patients.

Yohei Tsuchikawa, Yoshiyuki Tokuda, Hideki Ito, Miho Shimizu, Shinya Tanaka, Kazuki Nishida, Daichi Takagi, Akimasa Fukuta, Natsuki Takeda, Hiromasa Yamamoto, Masaya Hori, Yoshihiro Nishida, Masato Mutsuga

Circulation journal : official journal of the Japanese Circulation Society Vol. 87 ( 2 ) page： 306 - + 2023.1

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The effect of delayed ambulation on the outcome of coronary artery bypass grafting (CABG) remains to be clarified.Methods and Results: The long-term and in-hospital outcomes of 887 patients who underwent isolated CABG (455 off-pump cases, 135 urgent cases) were evaluated, with a focus on the timing of first ambulation. In-hospital mortality cases were excluded. Early ambulation (first ambulation within 3 days after operation) was achieved in 339 (38%) patients. In the multivariable logistic regression analysis, longer operation time and urgent case, EuroSCORE II, re-thoracotomy, and respiratory time were associated with delayed (≥4 days) ambulation. Delayed ambulation was associated with a high incidence of postoperative complications, such as pneumonia, and stroke (P<0.01). Following discharge, 22.2% of patients experienced major cardiac events and 13.8% died during the follow-up period (median follow-up 60 months). Cox hazards analysis revealed that delayed ambulation was associated with long-term adverse events (hazard ratio 1.04 per day, P<0.001). With adjustment for preoperative factors, the estimated future risk of adverse events was found to be increased day-by-day during the delay until initial ambulation. CONCLUSIONS: In isolated CABG patients, delayed ambulation was associated with poor outcomes, even in the long-term period. The results support the current guideline recommending early ambulation protocol after cardiac surgery.

DOI： 10.1253/circj.CJ-22-0416

植込型補助人工心臓治療管理施設からの提言心臓移植実施施設、DT非実施施設における重症心不全管理

奥村貴裕, 六鹿雅登, 木村祐樹, 風間信吾, 平岩宏章, 森本竜太, 伊藤英樹, 吉住朋, 室原豊明

人工臓器 Vol. 51 ( 2 ) page： S - 47 2022.10

Relationship between muscle strength and rehospitalization in ventricular assist device patients. International journal

Kiyonori Kobayashi, Masato Mutsuga, Akihiko Usui

Scientific reports Vol. 12 ( 1 ) page： 50 - 50 2022.1

Language：English Publishing type：Research paper (scientific journal)

We examined the relationship between leg extensor muscle strength (LEMS) at discharge and rehospitalization within 1 year in patients with a newly implanted ventricular assist device (VAD). This study included 28 patients who had received a VAD at our institution between October 2013 and February 2019, all of whom had been discharged for 1 year. The patients were divided into two groups according to their LEMS at discharge (higher strength [group H] and lower strength [group L]), based on the median value of the 55.2 kg-force (kgf)/body weight (BW) equation. Exercise performance parameters (e.g., grip strength, 6-min walk distance, and peak VO2) and laboratory data concerning nutritional status were also collected. Nine patients (64.3%) in group L were rehospitalized within 1 year after discharge. The rehospitalization rate was significantly higher in group L than group H (p = 0.020). Compared with discharge, patients exhibited higher grip strength (56.3 vs. 48.6 kg/BW, respectively; p = 0.011), 6-min walk distances (588 vs. 470 m, respectively; p = 0.002), and peak VO2 (15.4 vs. 11.9 mL/min/kg, respectively; p < 0.001) at 1 year after discharge. However, the LEMS (57.4 vs. 58.0 kgf/BW, respectively; p = 0.798) did not increase after discharge in VAD patients who avoided rehospitalization. LEMS at discharge was associated with rehospitalization after VAD surgery; a high LEMS improves the likelihood of avoiding rehospitalization.

DOI： 10.1038/s41598-021-04002-3

大動脈手術後後の急性腎機能障害の危険因子に対する検討

胸部大動脈手術患者における術後筋力低下の関連因子

清水美帆, 足立拓史, 小林聖典, 六鹿雅登, 大島英揮, 碓氷章彦, 山田純生

日本臨床生理学会雑誌 Vol. 51 ( 4 ) page： 60 - 60 2021.10

左室補助人工心臓患者における6分間歩行距離の遠隔期成績に関する検討

小林聖典, 六鹿雅登, 高木大地, 堀将也, 服部慶子, 伊藤英樹, 碓氷章彦

日本臨床生理学会雑誌 Vol. 51 ( 4 ) page： 60 - 60 2021.10

Left brachiocephalic vein aneurysm: a case report

Ueno Harushi, Yazawa Mari, Tsubouchi Hideki, Nakanishi Keita, Sugiyama Tomoshi, Kadomatsu Yuka, Goto Masaki, Ozeki Naoki, Nakamura Shota, Fukui Takayuki, Mutsuga Masato, Yoshikawa Toyofumi Fengshi Chen

SURGICAL CASE REPORTS Vol. 7 ( 1 ) page： 66 2021.3

Associations between hemodynamic parameters at rest and exercise capacity in patients with implantable left ventricular assist devices

Kondo Toru, Okumura Takahiro, Oishi Hideo, Arao Yoshihito, Kato Hiroo, Yamaguchi Shogo, Kuwayama Tasuku, Haga Tomoaki, Yokoi Tsuyoshi, Hiraiwa Hiroaki, Fukaya Kenji, Sawamura Akinori, Morimoto Ryota, Mutsuga Masato, Fujimoto Kazuro, Usui Akihiko, Murohara Toyoaki

INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS Vol. 44 ( 3 ) page： 174 - 180 2021.3

Beating-heart total arch replacement for an octogenarian patient with severe heart failure

Mutsuga Masato, Banno Hiroshi, Tokuda Yoshiyuki, Usui Akihiko

JOURNAL OF CARDIAC SURGERY Vol. 36 ( 3 ) page： 1126 - 1129 2021.3

Beating heart left ventricle thrombectomy through mini-left-anterior thoracotomy for a patient with cardiogenic shock

Mutsuga Masato, Usui Akihiko

GENERAL THORACIC AND CARDIOVASCULAR SURGERY Vol. 69 ( 3 ) page： 614 - 617 2021.3

Sutures on the Anterior Mitral Leaflet to Prevent Systolic Anterior Motion.

Tokuda Y, Fujimoto K, Narita Y, Mutsuga M, Usui A

The Annals of thoracic surgery Vol. 111 ( 3 ) page： e213 - e215 2021.3

Predictors of residual mitral regurgitation after left ventricular assist device implantation

Kimura Yuki, Okumura Takahiro, Kazama Shingo, Shibata Naoki, Oishi Hideo, Arao Yoshihito, Kuwayama Tasuku, Kato Hiroo, Yamaguchi Shogo, Hiraiwa Hiroaki, Kondo Toru, Morimoto Ryota, Mutsuga Masato, Fujimoto Kazuro, Usui Akihiko, Murohara Toyoaki

INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS Vol. 44 ( 2 ) page： 101 - 109 2021.2

Hypofibrinogenemia can be estimated by the predictive formula in aortic surgery

Nishi Toshihiko, Mutsuga Masato, Akita Toshiaki, Narita Yuji, Fujimoto Kazuro, Tokuda Yoshiyuki, Nishida Kazuki, Matsui Shigeyuki, Nishiwaki Kimitoshi, Usui Akihiko

GENERAL THORACIC AND CARDIOVASCULAR SURGERY 2021.1

Cor triatriatum in adulthood with mitral valve regurgitation and atrial fibrillation

Ishida Shinichi, Yagami Kei, Fujita Takashi, Mutsuga Masato

JOURNAL OF CARDIAC SURGERY Vol. 36 ( 1 ) page： 309 - 311 2021.1

Long-term outcome 10 years after free gastroepiploic artery graft for coronary artery bypass surgery.

Yamamoto T, Mutsuga M, Matsuura A, Miyahara K, Takemura H, Saito S, Otsuka R, Usui A

The Annals of thoracic surgery 2020.12

Aortic insufficiency associated with Impella that required surgical intervention upon implantation of the durable left ventricular assist device

Oishi Hideo, Kondo Toru, Fujimoto Kazuro, Mutsuga Masato, Morimoto Ryota, Hirano Ken-ichi, Sawamura Akinori, Kazama Shingo, Kimura Yuki, Shibata Naoki, Kato Hiroo, Arao Yoshihito, Kuwayama Tasuku, Yamaguchi Shogo, Hiraiwa Hiroaki, Okumura Takahiro, Usui Akihiko, Murohara Toyoaki

JOURNAL OF ARTIFICIAL ORGANS Vol. 23 ( 4 ) page： 378 - 382 2020.12

Upper thoracoabdominal aortic repair through partial posterior incision of the diaphragm via left thoracotomy

Ito Hideki, Mutsuga Masato, Tokuda Yoshiyuki, Usui Akihiko

GENERAL THORACIC AND CARDIOVASCULAR SURGERY Vol. 68 ( 12 ) page： 1594 - 1595 2020.12

Exclusion Technique for Entire Shaggy Aorta Followed by One-Stage Repair of the Aortic Arch and Descending Aorta

Mutsuga Masato, Ito Hideki, Usui Akihiko

HEART LUNG AND CIRCULATION Vol. 29 ( 11 ) page： E269 - E272 2020.11

Which is superior, the frozen elephant trunk technique alone or the classical elephant trunk technique followed by second-stage thoracic endovascular aortic repair for extensive aortic arch repair?

Mutsuga Masato, Banno Hiroshi, Narita Yuji, Komori Kimihiro, Usui Akihiko

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 82 ( 4 ) page： 657 - 666 2020.11

Mid-term results of Biological Bentall using a larger valve implantation technique

Mutsuga Masato, Narita Yuji, Usui Akihiko

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 82 ( 4 ) page： 645 - 655 2020.11

Is Hybrid Repair for an Entire Shaggy Aorta Feasible?

Mutsuga M, Tokuda Y, Narita Y, Terazawa S, Ito H, Usui A

Heart, lung & circulation 2020.10

Do meteorological factors influence the occurrence of acute aortic dissection? A 10-year retrospective institutional study

Usui Rena, Mutsuga Masato, Yoshizumi Tomo, Oshima Hideki, Eda Tadahito, Usui Akihiko

GENERAL THORACIC AND CARDIOVASCULAR SURGERY 2020.10

Commentary: Continuous steady development is made by taking 2 steps forward, 1 step back.

Mutsuga M, Chen-Yoshikawa TF

The Journal of thoracic and cardiovascular surgery 2020.10

[Covering Suture Line Using Bovine Pericardium during Mitral Valve Replacement for Third Time Infectious Endocarditis;Report of a Case].

Ishida S, Fujita T, Yagami K, Mutsuga M

Kyobu geka. The Japanese journal of thoracic surgery Vol. 73 ( 11 ) page： 950 - 953 2020.10

Impella 5.0 for Cardiogenic Shock After Thrombectomy in a Patient With Intraventricular Thrombosis

Kimura Yuki, Kondo Toru, Mutsuga Masato, Morimoto Ryota, Kazama Shingo, Shibata Naoki, Oishi Hideo, Arao Yoshihito, Kuwayama Tasuku, Kato Hiroo, Yamaguchi Shogo, Hiraiwa Hiroaki, Okumura Takahiro, Fujimoto Kazuro, Usui Akihiko, Murohara Toyoaki

CANADIAN JOURNAL OF CARDIOLOGY Vol. 36 ( 10 ) 2020.10

高齢植込み型補助人工心臓装着患者の運動機能に関する検討

小林聖典, 六鹿雅登, 奥村貴裕, 平岩宏章, 近藤徹, 室原豊明, 碓氷章彦

人工臓器 Vol. 49 ( 2 ) page： S - 111 2020.10

大野司, 秋田利明, 成田裕司, 六鹿雅登, 藤本和朗, 徳田順之, 寺澤幸枝, 伊藤英樹, 内田亘, 松村泰基, 宗像寿祥, 芦田真一, 西俊彦, 秋田翔, 矢野大介, 阿部知伸, 碓氷章彦

日本胸部外科学会定期学術集会 Vol. 73回 page： CLO7 - 7 2020.10

Surgery for anomalous papillary muscle directly into the anterior mitral leaflet. Reviewed International journal

Masato Mutsuga, Yoshiyuki Tokuda, Kazuro Fujimoto, Sachie Terazawa, Hideki Ito, Yuji Narita, Akihiko Usui

The Annals of thoracic surgery 2020.9

Publishing type：Research paper (scientific journal)

BACKGROUND: The anomalous insertion of papillary muscle directly into the anterior mitral leaflet is a rare congenital anomaly concomitant with hypertrophic cardiomyopathy. We herein report our surgical technique, which is designed to relieve left ventricular obstruction and preserve the mitral valve and sub-valvular apparatus. METHODS: Among 38 patients who underwent septal myectomy from 2007 to 2020, 4 had an anomalous mitral sub-valvular apparatus with papillary muscle with direct insertion into the anterior mitral leaflets. In all cases, mitral valve repair was accomplished with excision and reconstruction of all anomalous PMs, concomitant with septal myectomy. In other 34 patients, 20 cases needed mitral valve repair with regards to systolic anterior motion by hypertrophic cardiomyopathy. The comparison study was conducted between anomalous papillary muscle group (group A) and the others (group B). RESULTS: There was no early or late death in group A, three early death and two late death in group B. The mean peak gradient in the left ventricle was significantly decreased in both groups. Mitral valve regurgitation grade was also significantly decreased from 3 to 0.5 without valve replacement in group A, from 2 to 0.6 in group B. Six patients needed mitral valve replacement due to the thickness of anterior mitral leaflet in group B. CONCLUSIONS: Hypertrophic obstructive cardiomyopathy associated with the anomalous insertion of papillary muscle can be successfully treated without mitral valve replacement. Excision and reconstruction with the anomalous papillary muscle seems to be a feasible operation to reduce mitral regurgitation and relieve outflow tract obstruction.

DOI： 10.1016/j.athoracsur.2020.07.031

Association between splenic volume and pulsatility index in patients with left ventricular assist devices

Hiraiwa Hiroaki, Okumura Takahiro, Sawamura Akinori, Kondo Toru, Kazama Shingo, Kimura Yuki, Shibata Naoki, Arao Yoshihito, Oishi Hideo, Kato Hiroo, Kuwayama Tasuku, Yamaguchi Shogo, Furusawa Kenji, Morimoto Ryota, Fujimoto Kazuro, Mutsuga Masato, Usui Akihiko, Murohara Toyoaki

INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS 2020.9

Efficacy of Plasma free Hemoglobin for detecting centrifugal pump thrombosis

Kuroda Taiyo, Mutsuga Masato, Yamada Masao, Yamakawa Masato, Yuhara Satoshi, Hasegawa Hiroki, Yokote Jun, Yokoyama Yukifusa, Yamada Tetsuya, Koyama Tomio, Usui Akihiko

PERFUSION-UK 2020.9

IMPELLAとVA-ECMOの併用により管理をし得た重症心不全の一症例

平岩宏章, 山本尚範, 尾崎将之, 沼口敦, 後藤縁, 奥村貴裕, 室原豊明, 六鹿雅登, 碓氷章彦, 松田直之

日本集中治療医学会雑誌 Vol. 27 ( Suppl. ) page： 720 - 720 2020.9

Bilateral versus single internal thoracic artery grafting in hemodialysis patients

Munakata Hisaaki, Tajima Kazuyoshi, Kato Wataru, Tanaka Keisuke, Tokuda Yoshiyuki, Mutsuga Masato, Usui Akihiko

GENERAL THORACIC AND CARDIOVASCULAR SURGERY Vol. 68 ( 8 ) page： 768 - 773 2020.8

Modified sutureless repair using left atrial appendage flap for acquired left-sided pulmonary vein stenosis

Ito Hideki, Mutsuga Masato, Tokuda Yoshiyuki, Usui Akihiko

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY Vol. 58 ( 2 ) page： 395 - 397 2020.8

The incidence and risk factors of hypofibrinogenemia in cardiovascular surgery

Nishi Toshihiko, Mutsuga Masato, Akita Toshiaki, Narita Yuji, Fujimoto Kazuro, Tokuda Yoshiyuki, Terazawa Sachie, Ito Hideki, Nishiwaki Kimitoshi, Usui Akihiko

GENERAL THORACIC AND CARDIOVASCULAR SURGERY Vol. 68 ( 4 ) page： 335 - 341 2020.4

肺高血圧治療部門新規開設施設におけるCTEPHに対するPEA/BPA中期成績の検討

寺澤幸枝, 安藤太三, 足立史郎, 近藤隆久, 石田真一, 矢野大介, 秋田翔, 西俊彦, 芦田真一, 宗像寿祥, 内田亘, 松村泰基, 伊藤英樹, 徳田順之, 六鹿雅登, 藤本和朗, 成田裕司, 碓氷章彦

日本心臓血管外科学会学術総会抄録集 Vol. 50回 page： O11 - 3 2020.3

Pathological changes of the myocardium in reworsening of anthracycline-induced cardiomyopathy after explant of a left ventricular assist device

Hiraiwa Hiroaki, Okumura Takahiro, Shimizu Shinya, Arao Yoshihito, Oishi Hideo, Kato Hiroo, Kuwayama Tasuku, Yamaguchi Shogo, Haga Tomoaki, Yokoi Tsuyoshi, Kondo Toru, Sugiura Yuki, Kano Naoaki, Watanabe Naoki, Fukaya Kenji, Furusawa Kenji, Sawamura Akinori, Morimoto Ryota, Fujimoto Kazuro, Mutsuga Masato, Usui Akihiko, Murohara Toyoaki

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 82 ( 1 ) page： 129 - 134 2020.2

Spinal cord injury following aortic arch replacement

Tokuda Yoshiyuki, Fujimoto Kazuro, Narita Yuji, Mutsuga Masato, Terazawa Sachie, Ito Hideki, Matsumura Yasumoto, Uchida Wataru, Munakata Hisaaki, Ashida Shinichi, Ono Tsukasa, Nishi Toshihiko, Yano Daisuke, Ishida Shinichi, Kuwabara Fumiaki, Akita Toshiaki, Usui Akihiko

SURGERY TODAY Vol. 50 ( 2 ) page： 106 - 113 2020.2

A Floating Stitch on the Anterior Mitral Leaflet Can Eliminate Systolic Anterior Motion in Hypertrophic Obstructive Cardiomyopathy

Mutsuga Masato, Narita Yuji, Usui Akihiko

SEMINARS IN THORACIC AND CARDIOVASCULAR SURGERY Vol. 32 ( 2 ) page： 266 - 268 2020

Total resection of an infected aortic arch aneurysm caused by Mycobacterium avium: a case report

Yagami Kei, Fujita Takashi, Ishida Shinichi, Mutsuga Masato

JOURNAL OF CARDIOTHORACIC SURGERY Vol. 14 ( 1 ) 2019.8

A functional evaluation of cerebral perfusion for coronary artery bypass grafting patients

Teramoto Chikao, Mutsuga Masato, Kawaguchi Osamu, Araki Yoshimori, Matsuda Joe, Usui Akihiko

HEART AND VESSELS Vol. 34 ( 7 ) page： 1122 - 1131 2019.7

Neurologic Deficit After Aortic Arch Replacement: The Influence of the Aortic Atherosclerosis

Tokuda Yoshiyuki, Narita Yuji, Fujimoto Kazuro, Mutsuga Masato, Terazawa Sachie, Ito Hideki, Uchida Wataru, Usui Akihiko

ANNALS OF THORACIC SURGERY Vol. 108 ( 1 ) page： 107 - 114 2019.7

The efficacy of immediate bridging thoracic endovascular aortic repair for ruptured infected thoracic aortic aneurysms

Ito Hideki, Mutsuga Masato, Oshima Hideki, Usui Akihiko

JOURNAL OF VASCULAR SURGERY CASES AND INNOVATIVE TECHNIQUES Vol. 5 ( 2 ) page： 152 - 155 2019.6

術前の神経筋電気刺激療法を併用した理学療法が有効であった植込型補助人工心臓装着術症例

服部慶子, 小林聖典, 羽賀智明, 六鹿雅登, 寺井千晶, 高木大地, 奥村貴裕, 碓氷章彦, 室原豊明

日本循環器学会学術集会抄録集 Vol. 83回 page： CP31 - 6 2019.3

Hemodynamics of cardiac tamponade during extracorporeal membrane oxygenation support in a patient with fulminant myocarditis Reviewed

Toru Kondo, Ryota Morimoto, Tsuyoshi Yokoi, Shogo Yamaguchi, Tasuku Kuwayama, Tomoaki Haga, Hiroaki Hiraiwa, Yuki Sugiura, Naoki Watanabe, Naoaki Kano, Takeo Ichii, Kenji Fukaya, Akinori Sawamura, Takahiro Okumura, Tomo Yoshizumi, Masato Mutsuga, Kazuro Fujimoto, Naoyuki Matsuda, Akihiko Usui, Toyoaki Murohara

Journal of Cardiology Cases Vol. 19 ( 1 ) page： 22 - 24 2019.1

Usefulness of lymphography and computed tomography for detecting the site of chyle leakage

Ito Hideki, Usui Akihiko, Uchida Wataru, Mutsuga Masato

INDIAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY Vol. 35 ( 1 ) page： 104 - 107 2019.1

Stem Cell Therapy for Aortic Aneurysm: Does the Administered Cell Type Influence the Therapeutic Effects? Reviewed

Yamawaki-Ogaka A, Fujimoto KL, Mutsuga M, Tokuda Y, Usui A, Narita Y

J Regen Med. Vol. 8 ( 1 ) 2019

Strategy of Cardiovascular Surgery for Patients With Dementia as Evaluated by Mini-Mental State Examination

Terazawa Sachie, Oshima Hideki, Narita Yuji, Fujimoto Kazuro, Mutsuga Masato, Tokuda Yoshiyuki, Yoshizumi Tomo, Ito Hideki, Uchida Wataru, Usui Akihiko

CIRCULATION JOURNAL Vol. 82 ( 12 ) page： 2998 - 3004 2018.12

The oral administration of clarithromycin prevents the progression and rupture of aortic aneurysm

Uchida Wataru, Narita Yuji, Yamawaki-Ogata Aika, Tokuda Yoshiyuki, Mutsuga Masato, Fujimoto Kazuro Lee, Abe Tomonobu, Oshima Hideki, Usui Akihiko

JOURNAL OF VASCULAR SURGERY Vol. 68 ( 6 ) page： 82S - + 2018.12

The Possibility of Clarithromycin for the Treatment of Type B Aortic Dissection.

Uchida Wataru, Yamawaki-Ogata Aika, Hideki Ito, Sachie Tarazawa, Tokuda Yoshiyuki, Mutsuga Masato, Fujimoto Kazuro L., Yuji Narita, Usui Akihiko

CIRCULATION Vol. 138 2018.11

Aortic sarcoidosis complicated by a pulmonary artery aneurysm

Uchida Wataru, Tokuda Yoshiyuki, Mutsuga Masato, Usui Akihiko

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY Vol. 54 ( 4 ) page： 786 - 788 2018.10

Usefulness of lymphography and computed tomography for detecting the site of chyle leakage. Reviewed

Hideki Ito, Akihiko Usui, Wataru Uchida, Masato Mutsuga

Indian Journal of Thoracic and Cardiovascular Surgery volume Vol. 35 page： 104 - 107 2018.9

Promising method for management of venoarterial extracorporeal membrane oxygenation: A case of severe heart failure successfully stabilized by “high-flow/vasodilation method” Reviewed

Toru Kondo, Akinori Sawamura, Takahiro Okumura, Naoaki Kano, Ryota Morimoto, Naoki Watanabe, Hiroaki Hiraiwa, Tasuku Kuwayama, Yuki Sugiura, Tomoaki Haga, Shogo Yamaguchi, Kenji Fukaya, Tsuyoshi Yokoi, Kazuro Fujimoto, Masato Mutsuga, Tomo Yoshizumi, Naoyuki Matsuda, Akihiko Usui, Toyoaki Murohara

Journal of Cardiology Cases Vol. 18 ( 2 ) page： 81 - 84 2018.8

Publishing type：Research paper (scientific journal) Publisher：Elsevier Ltd

We report the case of a 58-year-old man with dilated cardiomyopathy who was hospitalized because of worsening heart failure. As his symptoms were refractory even with the administration of inotropes, he was given peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) upon transfer to our hospital. On admission, serum creatinine was 2.62 mg/dL and total bilirubin 10.8 mg/dL. The cannulas inserted were 16-Fr for infusion and 21-Fr for drainage. When the blood flow was increased to 2.14 L/min/m2 to improve organ dysfunction, the aortic valve became continuously close with the mean arterial pressure of 85 mmHg. Therefore, we administrated vasodilators to decrease mean arterial pressure, or left ventricular afterload, which achieved opening aortic valve continuously. After the cannula sizes were scaled up to 18Fr for infusion and 24Fr for drainage to gain further blood flow, the aortic valve opened continuously and mean pulmonary pressure decreased. Our strategy to maintain adequate flow rate of VA-ECMO using vasodilator, “high-flow/vasodilation method”, achieved hemodynamic stability. Additionally, the concentration of serum creatinine and total bilirubin gradually decreased to within the normal range, although the patient succumbed 58 days after transfer to our hospital. &lt
Learning objective: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is often used as a first-line mechanical circulatory support in patients with severe heart failure. However, its management is difficult and not established. We discuss the efficacy and potency of our “high-flow/vasodilation method” in the management of VA-ECMO.&gt

DOI： 10.1016/j.jccase.2018.05.002

東海地区心臓移植実施施設の検討名古屋大学の補助人工心臓治療の現状を踏まえて

破裂性感染性胸部大動脈瘤に対するBridging TEVARの有効性

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, 吉住朋

日本血管外科学会雑誌 Vol. 27 ( Suppl. ) page： PR10 - 1 2018.6

急性A型解離での脳保護頸動脈Static Obstructionに対するAorto Carotid Bypassの試み

阿部知伸, 伊藤英樹, 吉住朋, 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

日本血管外科学会雑誌 Vol. 27 ( Suppl. ) page： SS(M)3 - 5 2018.6

大血管浸潤癌に対する血管外科的治療戦略上大静脈再建を要する上大静脈浸潤腫瘍に対する治療成績

寺本慎男, 秋田利明, 大島英揮, 成田裕司, 阿部知伸, 六鹿雅登, 藤本和朗, 徳田順之, 寺澤幸枝, 伊藤英樹, 吉住朋, 川口晃司, 福井高幸, 横井香平, 碓氷章彦

日本血管外科学会雑誌 Vol. 27 ( Suppl. ) page： PD3 - 2 2018.6

Non-Bacterial Thrombotic Endocarditis Associated With Crohn's Disease.

Uchida W, Mutsuga M, Ito H, Oshima H, Usui A

The Annals of thoracic surgery Vol. 105 ( 5 ) page： E199 - E201 2018.5

術中凝固障害の危険因子の検討術中最低フィブリノーゲン値からの考察

西俊彦, 秋田利明, 大島英揮, 成田裕司, 阿部知伸, 六鹿雅登, 藤本和朗, 徳田順之, 寺澤幸枝, 吉住朋

日本集中治療医学会雑誌 Vol. 25 ( Suppl. ) page： [P32 - 8] 2018.2

植込み型LVAD術後および心臓移植後の社会復帰への集学的チームアプローチ

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

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 829 - 829 2018.2

機械弁による弁置換後のAnticoagulation Related Hemorrhageの発生と年齢との関係

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

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 786 - 786 2018.2

自己弁温存手術時代のBio-Bentallの意義

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

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 672 - 672 2018.2

急性大動脈解離術後、吻合部仮性瘤破裂に対する治療戦略

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

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 987 - 987 2018.2

人工弁周囲逆流に対する治療

西俊彦, 秋田利明, 大島英揮, 成田裕司, 阿部知伸, 六鹿雅登, 藤本和朗, 徳田順之, 寺澤幸枝, 吉住朋, 伊藤英樹, 寺本慎男, 増子雄二, 内田亘, 宗像寿祥, 大河秀行, 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. 48回 page： 886 - 886 2018.2

大伏在静脈Sequential AnastomosisでのParallel Anastomosisの応用

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

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 821 - 821 2018.2

大動脈性状が弓部置換の成績に与える影響

徳田順之, 伊藤英樹, 吉住朋, 寺澤幸枝, 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. 48回 page： 110 - 110 2018.2

大動脈手術後のSecondary graft-esophageal fistula7例の経験

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, 吉住朋

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 400 - 400 2018.2

大動脈術後人工血管感染19例における検討

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, 吉住朋, 碓氷章彦

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 921 - 921 2018.2

大動脈解離術後に認めた膵虚血性変化

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

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 104 - 104 2018.2

弓部大動脈手術における脊髄障害に関する検討

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

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 414 - 414 2018.2

当院におけるRITA-LAD開存症例に対する再開心術の検討

増子雄二, 大島英揮, 成田裕司, 阿部知伸, 六鹿雅登, 藤本和朗, 徳田順之, 寺澤幸枝, 吉住朋, 伊藤英樹, 寺本慎男, 内田亘, 宗像寿祥, 大河秀行, 大野司, 西俊彦, 碓氷章彦

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 185 - 185 2018.2

当院における僧帽弁形成術後僧帽弁再手術の検討

内田亘, 西俊彦, 大野司, 大河秀行, 宗像寿祥, 増子雄二, 寺本慎男, 伊藤英樹, 吉住朋, 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, 秋田利明, 碓氷章彦

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 811 - 811 2018.2

心大血管手術におけるフレイル評価と周術期成績の検討

寺澤幸枝, 伊藤英樹, 吉住朋, 徳田順之, 六鹿雅登, 藤本和朗, 阿部知伸, 成田裕司, 小林聖典, 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. 48回 page： 289 - 289 2018.2

Stent graft治療後に胸部大動脈open surgeryを要した17症例の検討

吉住朋, 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, 秋田利明, 碓氷章彦

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 673 - 673 2018.2

LVOTO、SAMを有するMRに対するcine-CT/MRIを用いた正確な僧帽弁形成術

大島英揮, 成田裕司, 阿部知伸, 藤本和朗, 六鹿雅登, 徳田順之, 寺澤幸枝, 吉住朋, 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. 48回 page： 67 - 67 2018.2

Sapien XTにて術中にopen stuckをきたした1例

宗像寿祥, 秋田利明, 大島英揮, 成田裕司, 阿部知伸, 六鹿雅登, 藤本和朗, 徳田順之, 寺澤幸枝, 碓氷章彦

日本集中治療医学会雑誌 Vol. 25 ( Suppl. ) page： [P42 - 7] 2018.2

CABG手術時に合併する中等度MRに対する治療成績冠動脈バイパス手術施行時に中等度機能性MRに対する介入を行うべきか

宗像寿祥, 大島英揮, 成田裕司, 阿部知伸, 六鹿雅登, 藤本和朗, 徳田順之, 寺澤幸枝, 吉住朋, 伊藤英樹, 寺本慎男, 増子雄二, 内田亘, 大河秀行, 碓氷章彦

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 430 - 430 2018.2

A型急性大動脈解離でのCentral RepairとAorto-Carotid Bypassの同時施行

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

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 727 - 727 2018.2

高齢者弓部大動脈瘤に対するTotal debranching TEVARの遠隔期成績

寺本慎男, 秋田利明, 大島英揮, 成田裕司, 阿部知伸, 六鹿雅登, 藤本和朗, 徳田順之, 寺澤幸枝, 伊藤英樹, 吉住朋, 古森公浩, 坂野比呂志, 児玉章朗, 碓氷章彦

日本心臓血管外科学会学術総会抄録集 Vol. 48回 page： 854 - 854 2018.2

集中治療管理で周術期合併症を予防する弓部大動脈手術における脊髄障害に関する検討

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

日本集中治療医学会雑誌 Vol. 25 ( Suppl. ) page： [PD8 - 3] 2018.2

[Future Aspects of Bio-Bentall Procedure].

Mutsuga M, Usui A

Kyobu geka. The Japanese journal of thoracic surgery Vol. 71 ( 1 ) page： 37 - 42 2018.1

Hemorrhagic Pericardial Cyst Complicated with Constrictive Pericarditis

Oguri Mitsutoshi, Ohguchi Shiou, Takahara Kunihiko, Kawamura Yoshihiro, Yokoi Yuki, Izumi Kazuhiro, Fujita Takashi, Yagami Kei, Mutsuga Masato

INTERNAL MEDICINE Vol. 57 ( 24 ) page： 3565 - 3568 2018

Virtual angioscopy with multidetector computed tomography for the diagnosis of pannus formation in mechanical aortic valves

Mutsuga Masato, Narita Yuji, Oshima Hideki, Usui Akihiko

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY Vol. 52 ( 6 ) page： 1233 - 1233 2017.12

Clinical outcomes and quality of life after surgery for dilated ascending aorta at the time of aortic valve replacement; wrapping versus graft replacement

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

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 79 ( 4 ) page： 443 - 451 2017.11

ここまできた日本の補助人工心臓 DT時代に向けてのVAD治療の現状

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

日本臨床外科学会雑誌 Vol. 78 ( 増刊 ) page： 384 - 384 2017.10

植込み型LVAD患者の社会復帰への課題植込み型LVAD患者の社会復帰の重要性

藤本和朗, 碓氷章彦, 大島英揮, 成田裕司, 阿部知伸, 六鹿雅登, 徳田順之

人工臓器 Vol. 46 ( 2 ) page： S - 32 2017.8

心原性ショックに対するVAD治療体外式拍動流型と遠心ポンプの使い分け当院におけるINTERMACS profile 1-2に対する体外式VADの治療戦略

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

人工臓器 Vol. 46 ( 2 ) page： S - 35 2017.8

当院におけるリズムコントロールデバイスの経静脈的リード抜去症例の検討合併症ゼロを目指して

成田裕司, 西俊彦, 大野司, 大河秀行, 宗像寿祥, 内田亘, 増子雄二, 寺本慎男, 伊藤英樹, 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

人工臓器 Vol. 46 ( 2 ) page： S - 105 2017.8

Entire Circumferential Reconstruction of the Right Atrium Surrounded by Angiosarcoma

Hibino Makoto, Abe Tomonobu, Oshima Hideki, Narita Yuji, Mutsuga Masato, Fujimoto Kazuro L., Tokuda Yoshiyuki, Yamana Koji, Kuroda Taiyo, Usui Akihiko

ANNALS OF THORACIC SURGERY Vol. 103 ( 6 ) page： E483 - E485 2017.6

慢性B型大動脈解離に対する治療戦略

六鹿雅登, 伊藤英樹, 山名幸治, 寺澤幸枝, 徳田順之, 藤本和郎, 阿部知伸, 成田裕司, 大島英輝, 碓氷章彦

日本血管外科学会雑誌 Vol. 26 ( Suppl. ) page： O5 - 2 2017.6

[Total Arch Replacement Using Manufactured Frozen Elephant Trunk after Acute Type-A Dissection Repair].

Hibino M, Mutsuga M, Oshima H, Narita Y, Abe T, Fujimoto K, Tokuda Y, Usui A

Kyobu geka. The Japanese journal of thoracic surgery Vol. 70 ( 4 ) page： 281-285 2017.4

The efficacy and risk of cerebrospinal fluid drainage for thoracoabdominal aortic aneurysm repair: a retrospective observational comparison between drainage and non-drainage

Sugiura Junya, Oshima Hideki, Abe Tomonobu, Narita Yuji, Araki Yoshimori, Fujimoto Kazuro, Mutsuga Masato, Usui Akihiko

INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY Vol. 24 ( 4 ) page： 609 - 614 2017.4

胸腹部大動脈瘤に対する二期的TEVARを目的としたHybrid手術

六鹿雅登, 伊藤英樹, 山名幸治, 寺澤幸枝, 徳田順之, 藤本和郎, 阿部知伸, 成田裕司, 大島英輝, 碓氷章彦

日本外科学会定期学術集会抄録集 Vol. 117回 page： PS - 8 2017.4

藤本和朗, 六鹿雅登, 成田裕司, 阿部知伸, 大島英揮, 碓氷章彦

移植 Vol. 52 ( 1 ) page： 88 - 88 2017.4

我が国の人工心臓治療の現況と展望日本における重症心不全に対してVAD治療が主流となる時代の予測(Prediction of dominant VAD therapy era for severe heart failure in Japan)

藤本和朗, 碓氷章彦, 大島英揮, 成田裕司, 阿部知伸, 六鹿雅登, 徳田順之

日本外科学会定期学術集会抄録集 Vol. 117回 page： SY - 2 2017.4

ビッグデータ時代の外科医療 JACVSD/NCDビッグデータの臨床応用への課題

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

日本外科学会定期学術集会抄録集 Vol. 117回 page： SY - 1 2017.4

【胸部大動脈に対するステントグラフト治療up-to-date】Stanford A型大動脈解離術後の慢性解離性大動脈瘤に対する企業製frozen elephant trunkを用いた弓部置換術の手術成績

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

胸部外科 Vol. 70 ( 4 ) page： 281 - 285 2017.4

Language：Japanese Publisher：(株)南江堂

Stanford A型大動脈解離術後の慢性解離性大動脈瘤に対してJ Graft Open Stent Graft(JOSG)を使用して弓部置換術を施行した11例(男性6名、女性5名、平均66.2±8.0歳)を対象とした。全例独歩退院した。合併症は軽度感覚障害のみ遺残した不全対麻痺を1例に認めた。ほかの合併症としては創感染2例、間質性肺炎1例を認めた。術後平均2.1±1.9ヵ月時にCTで大動脈を評価し、JOSG末梢端は7例で大動脈弁、4例で肺門部に位置した。全例で術前に認めた弓部のエントリーは、術後には末梢側吻合部を含む胸部には認めず、残存する主要エントリーは全例で、術前のリエントリーである腹部大動脈以下に限局した。腹部分枝閉塞は認めなかった。中期遠隔(平均観察9.2ヵ月、最長14ヵ月)に死亡例は認めなかったが大動脈関連合併症は4例に認めた。下行大動脈の切迫破裂2例、下行大動脈の偽腔拡大1例、下行大動脈の再解離1例で、全3例に再手術を要した。早期、中期とも死亡例は認めなかった。

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認知機能障害を伴う症例に対する心臓大血管手術における治療戦略の検討

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

日本外科学会定期学術集会抄録集 Vol. 117回 page： CSS - 3 2017.4

LVAD装着周術期の上腕周囲径変化は骨格筋蛋白分解を反映する可能性がある

小林聖典, 六鹿雅登, 奥村貴裕, 清水美帆, 山田純生, 碓氷章彦

日本循環器学会学術集会抄録集 Vol. 81回 page： CA - 09 2017.3

術前の握力低下は胸部大血管手術患者における長期人工呼吸器管理のリスク因子である

清水美帆, 山田純生, 大島英揮, 六鹿雅登, 藤本和朗, 成田裕司, 阿部知伸, 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： 686 - 686 2017.2

胸部大動脈手術において脳保護法が高次脳機能に及ぼす影響の検討

寺澤幸枝, 林和寛, 大野司, 内田亘, 増子雄二, 寺本慎男, 伊藤英樹, 山名孝治, 徳田順之, 六鹿雅登, 藤本和朗, 成田裕司, 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： 270 - 270 2017.2

虚血性僧帽弁閉鎖不全に対する僧帽弁輪形成と両尖温存弁置換術の長期成績の比較

阿部知伸, 伊藤英樹, 山名孝治, 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

日本心臓血管外科学会学術総会抄録集 Vol. 47回 page： 144 - 144 2017.2

慢性B型解離の治療戦略

六鹿雅登, 伊藤英樹, 山名幸治, 寺澤幸枝, 徳田順之, 藤本和郎, 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. 47回 page： 234 - 234 2017.2

上行置換術後の再手術弓部全置換術におけるtrifurcate graft使用の有用性

山名孝治, 大島英揮, 大野司, 内田亘, 増子雄二, 伊藤英樹, 寺本慎男, 寺澤幸枝, 徳田順之, 藤本和朗, 六鹿雅登, 阿部知伸, 成田裕司, 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： 58 - 58 2017.2

人工心肺離脱困難症例に対する補助循環導入症例の検討

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： 789 - 789 2017.2

僧帽弁手術における、左房内腔からの僧帽弁輪直接エコーによる冠状動脈回旋枝の描出

阿部知伸, 内田亘, 伊藤英樹, 山名孝治, 寺澤幸枝, 徳田順之, 藤本和郎, 六鹿雅登, 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. 47回 page： 568 - 568 2017.2

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

広範囲弓部大動脈瘤に対するType III hybrid arch repairの遠隔成績

徳田順之, 六鹿雅登, 藤本和朗, 阿部知伸, 成田裕司, 大島英揮, 古森公浩, 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： 237 - 237 2017.2

心臓血管肉腫に対する、広範両心房・上大静脈切除と、右房左房別個再建

阿部知伸, 成田裕司, 日尾野誠, 大野司, 内田亘, 増子雄二, 寺本慎男, 伊藤英樹, 山名孝治, 寺澤幸枝, 徳田順之, 藤本和朗, 六鹿雅登, 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： 493 - 493 2017.2

unprotected LMTに対するPCI及びCABGによる血行再建の治療成績

寺本慎男, 碓氷章彦, 大島英輝, 成田祐司, 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, 増子雄二, 内田亘, 大野司

日本心臓血管外科学会学術総会抄録集 Vol. 47回 page： 175 - 175 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

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

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

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

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

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。

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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

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

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

低左心機能、慢性大動脈弁閉鎖不全症に対する大動脈弁置換術の長期成績

末永啓人, 碓氷章彦, 大島英揮, 成田裕司, 阿部知伸, 六鹿雅登, 藤本和朗, 寺澤幸枝, 伊藤英樹, 小坂井基史, 内田亘, 日尾野誠, 大野司, 小西康信, 黒田太陽

日本心臓血管外科学会学術総会抄録集 Vol. 46回 page： OP20 - 2 2016.2

大動脈弁位機械弁生体弁の長期予後単施設540例20余年のフォローアップ

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, 黒田太陽, 藤田山, 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： OP3 - 4 2016.2

大動脈瘤に対する幹細胞療法効果のメカニズムに関して

成田裕司, 緒方藍歌, 小坂井基史, 藤本和朗, 六鹿雅登, 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. 46回 page： OP10 - 2 2016.2

弓部大動脈瘤の治療戦略 A型解離術後の慢性解離性大動脈瘤に対するJOSGを用いた弓部置換術

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

日本心臓血管外科学会学術総会抄録集 Vol. 46回 page： PR7 - 2 2016.2

当院における弁膜症再手術の初期および遠隔成績

伊藤英樹, 大島英揮, 成田裕司, 阿部知伸, 六鹿雅登, 藤本和朗, 寺澤幸枝, 杉浦純也, 内田亘, 小坂井基司, 日尾野誠, 小西康信, 大野司, 末永啓人, 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： PP - 192 2016.2

ハイリスク・高齢者の大動脈弁狭窄症に対する弁置換術費用対効果からの検討

大島英揮, 成田裕司, 阿部知伸, 六鹿雅登, 藤本和朗, 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： PP - 041 2016.2

HD患者の弁種選択機械弁か生体弁か? 一般患者の人工弁選択基準を血液透析患者にあてはめることは妥当か? モデル解析

阿部知伸, 岡田典隆, 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, 田嶋一喜, 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： PD4 - 7 2016.2

Type III hybrid arch repairによる広範大動脈瘤の治療 L字切開広範弓部置換との比較

徳田順之, 伊藤英樹, 寺澤幸枝, 藤本和朗, 六鹿雅登, 阿部知伸, 成田裕司, 大島英揮, 古森公浩, 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： PP - 245 2016.2

CABG術後再手術におけるliving graftと心筋保護 to cramp or not to cramp

黒田太陽, 大島英揮, 成田裕司, 阿部知伸, 六鹿雅登, 藤本和朗, 寺澤幸枝, 杉浦純也, 伊藤英樹, 小坂井基史, 日尾野誠, 内田亘, 小西康信, 大野司, 末永啓人, 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： PR2 - 3 2016.2

65歳以上の患者に対する大動脈弁温存時代のBio-Bentallの意義

六鹿雅登, 伊藤英樹, 杉浦純也, 寺澤幸枝, 藤本和朗, 阿部知伸, 成田裕司, 大島英輝, 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： PP - 172 2016.2

80歳以上の高齢者の大動脈弁狭窄症に対する大動脈弁置換術の手術成績

藤田山, 伊藤英樹, 杉浦純也, 寺澤幸枝, 藤本和朗, 六鹿雅登, 成田裕司, 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. 46回 page： OP3 - 2 2016.2

高安血管炎に合併した広範囲弓部瘤にL字開胸での人工血管置換が奏功した一例

日本心臓血管外科学会学術総会抄録集 Vol. 46回 page： VP4 - 4 2016.2

非弁膜症に合併するAfの外科治療非弁膜症心疾患に合併した心房細動に対する外科的治療の検討

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

日本心臓血管外科学会学術総会抄録集 Vol. 46回 page： PR1 - 6 2016.2

Hybrid versus open repair of aortic arch aneurysms: comparison of postoperative and mid-term outcomes with a propensity score-matching analysis Reviewed

Yoshiyuki Tokuda, Hideki Oshima, Yuji Narita, Tomonobu Abe, Yoshimori Araki, Masato Mutsuga, Kazuro Fujimoto, Sachie Terazawa, Kei Yagami, Hideki Ito, Kiyoto Yamamoto, Kimihiro Komori, Akihiko Usui

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY Vol. 49 ( 1 ) page： 149 - 156 2016.1

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

OBJECTIVES: Operative strategies for repairing aortic arch aneurysms should be re-evaluated following recent technical advances.
METHODS: Of 364 patients who underwent aortic arch repair between 2002 and 2014, 58 were high-risk subjects who received isolated hybrid arch repair (HAR) via median sternotomy (type I n = 32, type II n = 1 and type III n = 25). During this period, excluding patients with type A dissection or extensive aneurysms, 124 patients received isolated open arch repair via median sternotomy. The patients in the HAR and open arch repair groups were compared. A propensity score-matching analysis was applied to adjust for baseline risk factors.
RESULTS: The patients in the HAR group were older (77 years +/- 6 vs 69 +/- 9, P < 0.0001), exhibited a greater rate of malignancy (21 vs 4.8%, P = 0.0022) and had higher logistic EuroSCORE values (31 +/- 18 vs 20 +/- 15, P < 0.0001) than those in the open arch repair group. Following propensity score matching creating 38 matched pairs, the differences in preoperative risk diminished. Operative complications, including the mortality rate (2.6 vs 0%), were similar between the groups. Apart from the lower rates of cardiopulmonary bypass (CPB) and circulatory arrest, there was no apparent superiority of HAR with respect to patient recovery. The mean follow-up duration was 52.5 months, during which the rate of freedom from aortic events in the HAR and open arch repair groups was 79 and 99% at 24 months, respectively (P < 0.0001).
CONCLUSIONS: HAR achieves equivalent short-term results to standard open arch repair, with a decreased need for CPB. However, considering the inferior mid-term outcomes of this procedure, its indications should be limited to high-risk patients.

DOI： 10.1093/ejcts/ezv063

慢性解離性大動脈瘤の術後トラネキサム酸投与の有用性

日尾野誠, 碓氷章彦, 伊藤英樹, 寺澤幸枝, 藤本和郎, 六鹿雅登, 成田祐司, 阿部知伸, 大島英揮

日本集中治療医学会雑誌 Vol. 23 ( Suppl. ) page： 792 - 792 2016.1

An Epicardial Mesothelial Cyst Attached to the Ascending Aorta Reviewed

Yoshihito Suenaga, Tomonobu Abe, Masato Mutsuga, Yoshimori Araki, Akihiko Usui

HEART SURGERY FORUM Vol. 18 ( 5 ) page： E194 - E195 2015.10

Publishing type：Research paper (scientific journal) Publisher：FORUM MULTIMEDIA PUBLISHING, LLC

An epicardial mesothelial cyst, which can be defined as a mesothelial cyst attached to the epicardium surrounding the heart and the great vessels inside the pericardial sac, is a rare condition. We herein report a case of epicardial cyst, which was attached to the ascending aorta. The patient was a 76-year-old male who underwent coronary artery bypass surgery, and the cyst was found incidentally. It was approximately 5 cm in diameter, and histological examination confirmed mesothelial cell origin. The ascending aorta has not previously been reported as the origin of an epicardial mesothelial cyst. This case gives new insight into the embryology of these cysts.

DOI： 10.1532/hsf.1293

人工弁の遠隔成績からみた選択メタアナリシスから見た本邦の機械弁置換術後長期成績の特徴とそれが人工弁選択に与える影響

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

人工臓器 Vol. 44 ( 2 ) page： S - 59 2015.10

Destination Therapyに向けての植込み型補助人工心臓の展望と問題点

六鹿雅登, 藤本和朗, 伊藤英樹, 杉浦純也, 阿部知伸, 成田裕司, 大島英揮, 碓氷章彦

人工臓器 Vol. 44 ( 2 ) page： S - 153 2015.10

長期管理を要したTemporal LVADの一例感染防御のためのcannula管理

黒田タイヨウ, 六鹿雅登, 藤本和朗, 大島英揮, 成田裕司, 阿部知伸, 荒木善盛, 寺澤幸枝, 杉浦純也, 伊藤英樹, 小坂井基史, 日尾野誠, 小西康信, 末永啓人, 藤田山, 碓氷章彦

人工臓器 Vol. 44 ( 2 ) page： S - 144 2015.10

透析患者に対する心血管手術の遠隔成績透析患者に対する胸部大動脈手術の遠隔成績

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

人工臓器 Vol. 44 ( 2 ) page： S - 28 2015.10

The number of cardiovascular surgeries in Japan may decrease after 2020

Usui Akihiko, Abe Tomonobu, Araki Yoshimori, Narita Yuji, Mutsuga Masato, Oshima Hideki

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 77 ( 3 ) page： 389 - 398 2015.8

Impact of Surgical Stroke on the Early and Late Outcomes After Thoracic Aortic Operations Reviewed

Noritaka Okada, Hideki Oshima, Yuji Narita, Tomonobu Abe, Yoshimori Araki, Masato Mutsuga, Kazuro L. Fujimoto, Yoshiyuki Tokuda, Akihiko Usui

ANNALS OF THORACIC SURGERY Vol. 99 ( 6 ) page： 2017 - 2023 2015.6

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

Background. Thoracic aortic operations still remain associated with substantial risks of death and neurologic injury. This study investigated the impact of surgical stroke on the early and late outcomes, focusing on the physical status and quality of life (QOL).
Methods. From 1986 to 2008, 500 patients (aged 63 +/- 13 years) underwent open thoracic aortic repair for root and ascending (31%), arch (39%), extended arch (10%), and descending and thoracoabdominal (19%) aneurysms. Brain protection consisted of retrograde cerebral perfusion (52%), antegrade cerebral perfusion (29%), and simple deep hypothermic circulatory arrest (19%). Surgical stroke was defined as a neurologic deficit persisting more than 72 hours after the operation. QOL was assessed with the Short-Form 36 Health Survey Questionnaire 5.9 +/- 4.2 years after the operation.
Results. Stroke occurred in 10.3% of patients. Hospital mortality was 21% in the stroke group and 2.7% in the nonstroke group (p < 0.001). At hospital discharge, 76% of survivors in the stroke group had permanent neurologic deficits (PNDs), with sustained tracheostomy in 39%, tube feeding in 46%, and gastrostomy in 14%, and 89% required transfer to other facilities. PND was an independent risk factor for late death (hazard ratio, 2.29; 95% confidence interval, 1.04 to 4.62; p = 0.041) in a multivariate analysis. The physical component of the QOL score was worse in the PND group (51% vs 100%; p = 0.039), whereas the mental component was similar in both groups (14% vs 14%).
Conclusions. Surgical stroke is associated with high hospital mortality and PNDs that decrease late survival and the physical component score of the QOL survey. (C) 2015 by The Society of Thoracic Surgeons

DOI： 10.1016/j.athoracsur.2015.01.033

Influence of the characteristics of Japanese patients on the long-term outcomes after aortic valve replacement: results of a microsimulation Reviewed

Tomonobu Abe, Hideki Oshima, Yuji Narita, Yoshimori Araki, Masato Mutsuga, Kazuro Fujimoto, Yoshiyuki Tokuda, Sachie Terazawa, Kei Yagami, Akihiko Usui

General Thoracic and Cardiovascular Surgery Vol. 63 ( 5 ) page： 260 - 266 2015.5

Open stentの適応と問題点広範囲弓部瘤に対するFrozen Elephant Trunk;FET法の適応と問題点

六鹿雅登, 伊藤英樹, 阿部知伸, 大島英輝, 碓氷章彦

日本血管外科学会雑誌 Vol. 24 ( 3 ) page： 302 - 302 2015.5

An L-Shaped Incision for an Extensive Thoracic Aortic Aneurysm and Coronary Artery Bypass Using the Left Internal Thoracic Artery. Reviewed

Abe T, Suenaga H, Oshima H, Araki Y, Mutsuga M, Fujimoto K, Usui A

Aorta (Stamford, Conn.) Vol. 3 ( 2 ) page： 86 - 9 2015.4

心臓血管 B型解離性大動脈瘤の治療戦略

荒木善盛, 碓永章彦, 大島英揮, 阿部知伸, 成田裕司, 六鹿雅登, 藤本和朗, 寺澤幸枝, 八神啓, 伊藤英樹, 藤井恵

日本外科学会定期学術集会抄録集 Vol. 115回 page： OP - 5 2015.4

大動脈弁狭窄ハイリスク症例に対する治療その適応と成績心臓血管ハイリスク高齢者大動脈弁狭窄症に対するTAVRの適応 risk-SCOREと医療費からの検討

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, 八神啓, 伊藤英樹, 碓氷章彦

日本外科学会定期学術集会抄録集 Vol. 115回 page： PD - 1 2015.4

IMPACT OF THE INTRAOPERATIVE USE OF FIBRINOGEN CONCENTRATE FOR HYPOFIBRINOGENEMIA DURING THORACIC AORTIC SURGERY Reviewed

Yoshimori Araki, Akihiko Usui, Hideki Oshima, Tomonobu Abe, Kazuro Fujimoto, Masato Mutsuga, Yoshiyuki Tokuda, Sachie Terazawa, Kei Yagami, Hideki Ito

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 77 ( 1-2 ) page： 265 - 273 2015.2

Language：English Publishing type：Research paper (scientific journal) Publisher：NAGOYA UNIV, SCH MED

Thoracic aortic surgery often causes massive bleeding due to coagulopathy. Hypofibrinogenemia is one of the major causative factors, but the utility of the intraoperative administration of fibrinogen concentrate has not yet been proven. The aim of this study was to estimate incidence of hypofibrinogenemia and to evaluate efficacy of using fibrinogen concentrate intraoperatively. The perioperative serum fibrinogen levels (SFL) had routinely been measured in consecutive 216 thoracic aortic surgeries performed from 2010 to 2012. Fibrinogen concentrate was principally used for hypofibrinogenemia (< 150 mg/dl of SFL) at cardiopulmonary bypass (CPB) termination. The patients who received fibrinogen concentrate (FIB group) were compared with the patients who did not received (non Fib group). There were 147 patients (68%) in FIB group at a dose of 5.5 +/- 3.5 g. The SFL were dramatically decreased with values of 164 +/- 71 mg/dl at CPB termination, compared to the preoperative SFL of 352 +/- 131 mg/dl. In the FIB group, the intraoperative and postoperative SFLs were 139 +/- 53 and 262 +/- 75 (mg/dl), respectively. Thus the SFL was recovered quickly by the administration. 110 cases (51%) showed hypofibrinogenemia at the termination of CPB. The predictors of hypofibrinogenemia were preoperative SFL < 250 mg/dl, emergency surgery and thracoabdominal aortic surgery. Hypofibrinogenemia frequently was observed at the termination of CPB during thoracic aortic surgery. Administering intraoperative fibrinogen concentrate appears to be a useful option to treat coagulopathy.

心臓血管外科領域の難治感染症に対するFDG-PET/CTの応用

胸部大血管手術におけるフィブリノゲン製剤使用の実際

荒木善盛, 伊藤英樹, 八神啓, 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雑誌 Vol. 44 ( Suppl. ) page： 342 - 342 2015.1

胸部大動脈再手術症例の現況とその手術戦略

六鹿雅登, 伊藤英樹, 八神啓, 寺澤幸枝, 徳田順行, 藤本和朗, 荒木善盛, 阿部知伸, 成田裕司, 大島英輝, 碓氷章彦

日本心臓血管外科学会雑誌 Vol. 44 ( Suppl. ) page： 436 - 436 2015.1

心臓移植実施施設の必要性の検討拡大か縮小か?地域の重症心不全治療からの考察

藤本和朗, 碓氷章彦, 大島英輝, 成田裕司, 阿部知伸, 荒木善盛, 六鹿雅登, 徳田順之, 寺澤幸枝

日本心臓血管外科学会雑誌 Vol. 44 ( Suppl. ) page： 508 - 508 2015.1

冠動脈疾患を合併する胸部大動脈手術症例の検討

伊藤英樹, 大島英揮, 成田裕司, 阿部知伸, 荒木善盛, 六鹿雅登, 藤本和朗, 徳田順之, 寺澤幸枝, 八神啓, 蒔苗永, 藤井恵, 大野司, 末永啓人

日本心臓血管外科学会雑誌 Vol. 44 ( Suppl. ) page： 437 - 437 2015.1

多発瘤形成を伴うCervical Aortic Archに対する外科的治療例

伊藤英樹, 大島英揮, 成田裕司, 阿部知伸, 荒木善盛, 六鹿雅登, 藤本和朗, 徳田順之, 寺澤幸枝, 八神啓, 蒔苗永, 藤井恵, 大野司, 末永啓人

日本心臓血管外科学会雑誌 Vol. 44 ( Suppl. ) page： 497 - 497 2015.1

大動脈弁治療の現在と未来術式と人工弁の選択本邦の大動脈置換術後の弁関連合併症の特徴と、それが人工弁選択に与える影響

阿部知伸, 大島英揮, 成田裕司, 荒木善盛, 六鹿雅登, 藤本和郎, 徳田順之, 寺澤幸枝, 八神啓, 伊藤英樹, 碓氷章彦

日本心臓血管外科学会雑誌 Vol. 44 ( Suppl. ) page： 149 - 149 2015.1

当院における胸部人工血管感染に対する再血行再建術の術後成績

大野司, 大島英揮, 成田裕司, 阿部知伸, 荒木善盛, 六鹿雅登, 藤本和朗, 徳田順之, 寺澤幸枝, 八神啓, 伊藤英樹, 蒔苗永, 藤井恵, 末永啓人, 碓氷章彦

日本心臓血管外科学会雑誌 Vol. 44 ( Suppl. ) page： 497 - 497 2015.1

三尖弁輪形成術遠隔期にmoderate以上の逆流が残存する危険因子の検討

伊藤英樹, 大島英揮, 成田裕司, 阿部知伸, 荒木善盛, 六鹿雅登, 藤本和朗, 徳田順之, 寺澤幸枝, 八神啓, 蒔苗永, 藤井恵, 大野司, 末永啓人

日本心臓血管外科学会雑誌 Vol. 44 ( Suppl. ) page： 234 - 234 2015.1

Debranching TEVARの合併症対策と手技上の工夫

徳田順之, 末永啓人, 藤井恵, 伊藤英樹, 八神啓, 寺澤幸枝, 藤本和朗, 六鹿雅登, 荒木善盛, 成田裕司, 阿部知伸, 大島英揮, 山本清人, 古森公浩, 碓氷章彦

日本心臓血管外科学会雑誌 Vol. 44 ( Suppl. ) page： 326 - 326 2015.1

Entire shaggy aortaの治療方針

八神啓, 碓氷章彦, 大島英揮, 成田裕司, 阿部知伸, 荒木善盛, 藤本和朗, 六鹿雅登, 徳田順之, 寺澤幸枝, 蒔苗永, 伊藤英樹, 大野司, 末永啓人

日本心臓血管外科学会雑誌 Vol. 44 ( Suppl. ) page： 322 - 322 2015.1

TEVAR後ステントグラフト抜去を伴う開胸大動脈手術を要した症例の検討

寺澤幸枝, 大島英揮, 末永啓人, 大野司, 藤井恵, 蒔苗永, 伊藤英樹, 八神啓, 徳田順之, 藤本和朗, 六鹿雅登, 荒木善盛, 成田裕司, 阿部知伸, 碓氷章彦

日本心臓血管外科学会雑誌 Vol. 44 ( Suppl. ) page： 324 - 324 2015.1

ガイドライン施行後の冠血行再建術 2011年ガイドライン施行後にみられる外科的冠血行再建術における変化

大島英揮, 成田裕司, 阿部知伸, 荒木善盛, 六鹿雅登, 藤本和朗, 徳田順之, 碓氷章彦

日本心臓血管外科学会雑誌 Vol. 44 ( Suppl. ) page： 173 - 173 2015.1

超高齢者社会を迎え心臓外科手術数は2020年をピークに減少する

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

日本心臓血管外科学会雑誌 Vol. 44 ( Suppl. ) page： 308 - 308 2015.1

植え込み型人工心臓(HeartMate II)患者管理の集学的向上への試み

藤本和朗, 六鹿雅登, 大島英輝, 成田裕司, 阿部知伸, 荒木善盛, 徳田順之, 碓氷章彦

人工臓器 Vol. 43 ( 2 ) page： S - 214 2014.9

人工臓器感染に対する治療戦略ペースメーカー等(Cardiovascular Implantable Electrical Devices)感染に対する治療戦略

成田裕司, 末永啓人, 大野司, 松村泰基, 藤井恵, 蒔苗永, 伊藤英樹, 八神啓, 寺澤幸枝, 徳田順之, 六鹿雅登, 藤本和朗, 荒木善盛, 阿部知伸, 大島英揮, 碓氷章彦

人工臓器 Vol. 43 ( 2 ) page： S - 64 2014.9

徳田順之, 大島英揮, 阿部知伸, 成田裕司, 荒木善盛, 藤本和朗, 六鹿雅登, 岡田正穂, 寺澤幸枝, 蒔苗永, 八神啓, 大野司, 末永啓人, 碓氷章彦

日本外科学会雑誌 Vol. 115 ( 臨増2 ) page： 486 - 486 2014.3

心臓再手術のPitfalls 胸部大動脈再手術症例の検討

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

日本外科学会雑誌 Vol. 115 ( 臨増2 ) page： 172 - 172 2014.3

胸腹部慢性解離性大動脈瘤に対する計画的二期的手術例の検討

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, 徳田順之, 岡田正穂, 寺澤幸枝, 蒔苗永, 森脇博夫, 大野司, 末永啓人

日本心臓血管外科学会雑誌 Vol. 43 ( Suppl. ) page： 352 - 352 2014.1

本邦の大動脈弁位生体弁の至適年齢は? micro simulationと再手術死亡率による感度分析

阿部知伸, 大島英揮, 荒木善盛, 成田裕司, 藤本和郎, 六鹿雅登, 徳田順之, 岡田正穂, 寺澤幸枝, 碓氷章彦

日本心臓血管外科学会雑誌 Vol. 43 ( Suppl. ) page： 278 - 278 2014.1

機械弁の植込み時年齢が高いと出血性合併症の発生率も高いメタ回帰による解析

阿部知伸, 大島英揮, 荒木善盛, 成田裕司, 藤本和朗, 六鹿雅登, 徳田順之, 岡田正穂, 寺澤幸枝, 碓氷章彦

日本心臓血管外科学会雑誌 Vol. 43 ( Suppl. ) page： 277 - 277 2014.1

感染性弓部大動脈瘤破裂に対するbridging TEVAR

大島英揮, 成田裕司, 阿部知伸, 荒木善盛, 藤本和朗, 六鹿雅登, 岡田正穂, 徳田順之, 末永啓人, 碓氷章彦

日本心臓血管外科学会雑誌 Vol. 43 ( Suppl. ) page： 305 - 305 2014.1

同一アプローチによる胸部大動脈再手術症例の検討

末永啓人, 碓氷章彦, 大島英揮, 成田裕司, 阿部知伸, 荒木善盛, 藤本和朗, 六鹿雅登, 岡田正穂, 徳田順之, 寺澤幸枝, 蒔苗永, 八神啓, 大野司

日本心臓血管外科学会雑誌 Vol. 43 ( Suppl. ) page： 465 - 465 2014.1

当院における大動脈基部再建術の長期予後および遠隔期QOL

六鹿雅登, 寺澤幸枝, 岡田正穂, 徳田順行, 藤本和朗, 成田裕司, 荒木善盛, 阿部知伸, 大島英輝, 碓氷章彦

日本心臓血管外科学会雑誌 Vol. 43 ( Suppl. ) page： 287 - 287 2014.1

Maze術後カテーテルアブレーションを要した症例の検討

成田裕司, 末永啓人, 大野司, 八神啓, 蒔苗永, 寺澤幸枝, 徳田順之, 岡田正穂, 六鹿雅登, 藤本和朗, 荒木善盛, 阿部知伸, 大島英揮, 碓氷章彦

日本心臓血管外科学会雑誌 Vol. 43 ( Suppl. ) page： 366 - 366 2014.1

Double sewing ring法を用いた改変型生物学的Bentall手術(Modified Biological-Bentall procedure with the double sewing ring technique)

六鹿雅登, 寺澤幸枝, 岡田正穂, 徳田順行, 藤本和朗, 荒木善盛, 成田裕司, 阿部知伸, 大島英輝, 碓氷章彦

日本心臓血管外科学会雑誌 Vol. 43 ( Suppl. ) page： 559 - 559 2014.1

重症大動脈弁狭窄症の治療選択 Risk-SCOREと医療費からみた高齢者大動脈弁狭窄症に対するTAVR適応基準の検討

大島英揮, 成田裕司, 阿部知伸, 荒木善盛, 藤本和朗, 六鹿雅登, 徳田順之, 岡田正穂, 碓氷章彦

日本心臓血管外科学会雑誌 Vol. 43 ( Suppl. ) page： 160 - 160 2014.1

超高齢者(80歳以上)に対する胸部大血管手術のリスク評価

寺澤幸枝, 大島英輝, 阿部知伸, 成田裕司, 荒木善盛, 藤本和朗, 六鹿雅登, 岡田正穂, 徳田順之, 蒔苗永, 八神啓, 大野司, 末永啓人, 碓永章彦

日本心臓血管外科学会雑誌 Vol. 43 ( Suppl. ) page： 314 - 314 2014.1

A comparative study of two types of sternal pins used for sternal closure: poly-L-lactide sternal pins versus uncalcined hydroxyapatite poly-L-lactide sternal pins Reviewed

Xian-ming Fu, Hideki Oshima, Yoshimori Araki, Yuji Narita, Masato Mutsuga, Noritaka Okada, Tomohiro Tsunekawa, Akihiko Usui

JOURNAL OF ARTIFICIAL ORGANS Vol. 16 ( 4 ) page： 458 - 463 2013.12

Publishing type：Research paper (scientific journal) Publisher：SPRINGER JAPAN KK

Bioabsorbable poly-l-lactide (PLLA) sternal pins are applied to reinforce sternal closure during cardiac surgery. However, these pins lack osteoconductivity. A new bioabsorbable sternal pin with osteoconductivity, made of uncalcined hydroxyapatite and poly-l-lactide (u-HA-PLLA) has been developed. This study was conducted to compare the two types of sternal pins in terms of sternal stability and healing after median sternotomy. Between October 2006 and January 2012, 105 patients underwent aortic surgery for aortic aneurysms or dissection via median sternotomy and sternal closure with sternal pins. Among these patients, 75 were followed for 12 months using serial computed tomography (CT). PLLA sternal pins were used in 30 patients (group A) and u-HA-PLLA sternal pins were used in 45 patients (group B). The incidence rates of transverse sternal dehiscence, anteroposterior displacement and complete sternal fusion were evaluated using CT. The cross-sectional cortical bone density area (CBDA) of the sternum around the sternal pins was examined to evaluate the osteoconductivity of the sternal pins. There were no significant differences between groups A and B in the sternal dehiscence rate (6.7 vs 4.4 %), sternal displacement rate (6.7 vs 2.2 %) or 12-month sternal fusion rate (63.3 vs 73.3 %). The CBDA around the sternal pins significantly increased between discharge and 12 months after surgery in group B (P < 0.001) but not in group A. These results show that u-HA-PLLA sternal pins exhibit certain osteoconductivity; however, both PLLA and u-HA-PLLA sternal pins provide comparable clinical outcomes regarding sternal stability and healing.

DOI： 10.1007/s10047-013-0727-z

【弓部大動脈瘤-こだわりの術式と遠隔期成績】広範囲弓部大動脈瘤に対する外科治療の変遷

[Surgical strategy for extended aortic arch aneurysm].

Araki Y, Mutsuga M, Tokuda Y, Okada M, Abe T, Oshima H, Usui A

Kyobu geka. The Japanese journal of thoracic surgery Vol. 66 ( 11 ) page： 960 - 4 2013.10

荒木善盛, 六鹿雅登, 徳田順之, 岡田正穂, 阿部知伸, 大島英揮, 碓氷章彦

胸部外科 Vol. 66 ( 11 ) page： 960 - 964 2013.10

Language：Japanese Publisher：(株)南江堂

広範囲弓部瘤に対するL字開胸法(L群)、frozen elephant trunk法(F群)、long elephant trunk法(E群)、debranched TEVAR法(D群)を比較検討した。非解離性大動脈で待機手術を行った241例を対象とした。L群28例、F群30例、E群21例、D群10例であった。胸骨正中切開で行った弓部置換術152例(K群)を対照とした。術後合併症としては、L群では脳梗塞合併率が25.0%と高く、F群では脊髄障害の発生率が23.3%と高かった。E群は脊髄障害の発生はなかったが脳梗塞は19%で、D群では脳梗塞を40%と高率に認めた。呼吸不全はL群、E群で高率であった。入院死亡率はL群0%、F群6.7%、E群4.8%、D群20%、K群0.7%であった。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J00349&link_issn=&doc_id=20130926210006&doc_link_id=40019809964&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F40019809964&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

当院における生体弁機能不全手術症例の検討

岡田正穂, 末永啓人, 大野司, 岡田典隆, 蒔苗永, 寺澤幸枝, 徳田順之, 六鹿雅登, 藤本和朗, 荒木善盛, 成田裕司, 阿部知伸, 大島英揮, 碓氷章彦

人工臓器 Vol. 42 ( 2 ) page： S - 226 2013.9

劇症型心筋炎に対するBIVAD治療 Cannulation techniqueによる簡易BIVAD

六鹿雅登, 寺澤幸枝, 岡田正穂, 徳田順行, 藤本和朗, 荒木善盛, 阿部知伸, 成田裕司, 大島英輝, 碓氷章彦

人工臓器 Vol. 42 ( 2 ) page： S - 211 2013.9

弁膜症手術症例のQOLとペースメーカ

蒔苗永, 荒木善盛, 大島英揮, 成田裕司, 阿部知伸, 六鹿雅登, 碓氷章彦

人工臓器 Vol. 42 ( 2 ) page： S - 225 2013.9

当院におけるデバイス感染に伴うリード抜去症例の検討

成田裕司, 末永啓人, 大野司, 岡田典隆, 蒔苗永, 寺澤幸枝, 徳田順之, 岡田正穂, 六鹿雅登, 藤本和朗, 荒木善盛, 阿部知伸, 大島英揮, 碓氷章彦

人工臓器 Vol. 42 ( 2 ) page： S - 225 2013.9

Detection of thoracic aortic prosthetic graft infection with 18F-fluorodeoxyglucose positron emission tomography/computed tomography Reviewed

Yoshiyuki Tokuda, Hideki Oshima, Yoshimori Araki, Yuji Narita, Masato Mutsuga, Katsuhiko Kato, Akihiko Usui

European Journal of Cardio-thoracic Surgery Vol. 43 ( 6 ) page： 1183 - 1187 2013.6

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVES: To investigate the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in detecting thoracic aortic prosthetic graft infection. METHODS: Nine patients with clinically suspected thoracic aortic graft infection underwent FDG-PET/CT scanning. In these patients, the diagnoses could not be confirmed using conventional modalities. The patients' clinical courses were retrospectively reviewed. RESULTS: On the basis of surgical, microbiological and clinical follow-up findings, the aortic grafts were considered infected in 4 patients and not infected in 5. All 4 patients with graft infection (root: 2 cases, arch: 1 case and descending: 1 case) eventually underwent in situ re-replacement. Two of the 4 patients also had abdominal grafts
however, only the thoracic grafts were replaced because uptake was low around the abdominal grafts. The maximal standardized uptake value (SUVmax) in the perigraft area was higher in the infected group than in the non-infected group (11.4 ± 4.5 vs 6.9 ± 6.4), although the difference was not statistically significant. According to the receiver operating characteristic analysis, SUVmax &gt
8 appeared to be the cut-off value in distinguishing the two groups (sensitivity: 1.0 and specificity: 0.8). CONCLUSIONS: FDG-PET/CT is useful for confirming the presence of graft infection by detecting high uptake around grafts and excluding other causes of inflammation. An SUVmax value greater than 8 around a graft suggests the presence of graft infection. In addition, FDG-PET/CT can be used to clarify the precise extent of infection. This is especially useful if multiple separated prosthetic grafts have been implanted. © The Author 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

DOI： 10.1093/ejcts/ezs693

金型使用による自己心膜のglutaraldehyde処理を行った弓部パッチによるNorwood手術

櫻井一, 阿部知伸, 櫻井寛久, 杉浦純也, 寺田貴史, 種市哲吉, 六鹿雅登

日本心臓血管外科学会雑誌 Vol. 42 ( Suppl. ) page： 215 - 215 2013.2

[Recurrence of cardiac myxoma in the left atrial after 28 years; report of a case].

Takanohashi A, Usui A, Mutsuga M, Tokuda Y, Araki Y, Narita Y, Oshima H, Ueda Y

Kyobu geka. The Japanese journal of thoracic surgery Vol. 65 ( 12 ) page： 1089 - 92 2012.11

Fast-track extubation after modified Fontan procedure Reviewed

Masato Mutsuga, Luis G. Quinonez, Andrew S. Mackie, Colleen M. Norris, B. Elaine Marchak, Jennifer M. Rutledge, Ivan M. Rebeyka, David B. Ross

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY Vol. 144 ( 3 ) page： 547 - 52 2012.9

Publishing type：Research paper (scientific journal) Publisher：MOSBY-ELSEVIER

Objective: In 2007, we introduced a policy to plan to extubate all patients after a modified Fontan procedure in the operating room. Our objective was to review the feasibility, safety, and clinical outcomes of this approach.
Methods: Patients who underwent a modified Fontan operation between May 2004 and May 2010 were reviewed.
Results: Ninety-seven patients underwent a modified Fontan operation (mean age, 3.9 +/- 2.2 years; mean weight, 15.1 +/- 5.0 kg); 46 patients (47%) were extubated in the operating room (group A). Nineteen patients were extubated in the intensive care unit within 24 hours (group B), and 32 patients had delayed extubation (group C). The 3 groups were not significantly different with respect to preoperative characteristics. Twenty-four hours postoperatively, group A had a lower mean central venous pressure compared with patients in group B or C (13 vs 14 vs 17 mm Hg, respectively, P <. 001); a higher base excess (0.4 vs -1.3 vs -3.4, P <. 001); a lower fluid balance (234 vs 514 vs 730 mL, P <. 001); and a lower inotrope score (4.6 vs 6.7 vs 10.8, P <. 001). Group C had a longer median intensive care unit length of stay (2 vs 3 vs 6 nights, P = .01), kept their chest tubes longer (8 vs 9 vs 15 days, P = .001), and had a longer median hospital length of stay (9 vs 11 vs 21 days, P = .001).
Conclusions: Extubation in the operating room after a modified Fontan procedure seems feasible. This approach is associated with improved early postoperative hemodynamics, earlier time to chest tube removal, and shorter intensive care unit and hospital lengths of stay. (J Thorac Cardiovasc Surg 2012; 144:547-52)

DOI： 10.1016/j.jtcvs.2012.05.047

Biodegradable nanofibers in cardiovascular medicine: Drug delivery application

The Clinical Outcomes of Prolonged Donor Ischemic Time in Adult Patients Undergoing Heart Transplantation. A Single Center Experiences in Canada

Mutsuga M., Wang S., MacArthur R., Mullen J., Modry D., Ross D., Meyer S.

JOURNAL OF HEART AND LUNG TRANSPLANTATION Vol. 31 ( 4 ) page： S93 - S94 2012.4

Masato Mutsuga, Aika Yamawaki-Ogata, Makoto Satake, Hiroaki Kaneko, Yuichi Ueda, Yuji Narita

Nanomedicine and the Cardiovascular System page： 345 - 369 2011.1

Language：English Publishing type：Part of collection (book) Publisher：CRC Press

Nanotechnology will play a great role in the field of cardiovascular disease in the near future. It will be a very useful tool in drug delivery approaches to treat cardiovascular disease. Nanomedicine (medical treatment using nanotechnology) can be considered a refinement of molecular medicine and integrates advances in genomics and proteomics to facilitate the development of personalized medicine. Nanomedicine for cardiovascular disease has focused on materials at super-molecular levels to deliver increased therapeutic efficacy and diminish adverse effects, which have ultimately resulted in their clinical application. All the aforementioned developments have revolutionized the application of nanotechnologies and have led to improved understanding of the possibilities for drug delivery to diseased tissues and organs. In this chapter we introduce a novel drug delivery system (DDS) using biodegradable nano-scaled fiber for use in cardiovascular medicine. Occasionally, systemic administration of the drug for cardiovascular diseases not only fails to work sufficiently, but also causes adverse side effects due to the limited effective threshold of the drug. Therefore, these medicines may need to be released locally and gradually. Our newly developed DDS applied biodegradable polymer mixed with a drug used for surgical treatment of cardiovascular diseases, to achieve sustained release. The mechanisms of sustained release of a drug are quite simple
the drug is released with diffusion, hydrolysis of the biodegradable polymer and/or degradation of polymer by enzymatic or phagocytotic effects in vivo. An electrospinning procedure is used to fabricate the nanofiber configurations for these materials. In this chapter, we review the DDS scaffold using electrospinning nanofiber technology, and also highlight our recent results using our new DDS with biodegradable nano-scaled fiber for cardiovascular diseases to prevent anastomotic stricture and treat aortic aneurysm.

Spinal cord protection during a thoracoabdominal aortic repair for a chronic type B aortic dissection using the aortic tailoring strategy Reviewed

Masato Mutsuga, Yuji Narita, Yoshimori Araki, Atsuo Maekawa, Hideki Oshima, Akihiko Usui, Yuichi Ueda

INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY Vol. 11 ( 1 ) page： 15 - 18 2010.7

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

This study evaluated the clinical advantage of a novel technique to reconstruct a true lumen with aortic wall tailoring for aortic repair (aortic tailoring) or the reimplantation of intercostal arteries (vascular tube) in a chronic type B aortic dissection. Thirty-three consecutive extended thoracoabdominal aortic repairs have been performed for chronic type B dissection since 2000. The novel strategy was applied in 17 cases since 2004 including eight cases of aortic repair (group A) and nine cases of a vascular tube (group B). The other 16 cases were graft interposition in five and no reimplantation in 11 for group C. There were no surgical deaths in either group A or B, and only one late death in group C. No patients sustained transient or permanent paraplegia in group A and B, while three cases of paraplegia occurred in group C (18.8%). All of the intercostal arteries were well preserved in group A and an average of 9.8 intercostal arteries for nine patients were reimplantated in group B. The present technique can optimally preserve the intercostal arteries maximally and showed an excellent surgical mortality and morbidity, especially with regard to the protection of the spinal cord. (C) 2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

DOI： 10.1510/icvts.2009.223099

Effects of Extracellular Matrix on Differentiation of Human Bone Marrow-Derived Mesenchymal Stem Cells into Smooth Muscle Cell Lineage: Utility for Cardiovascular Tissue Engineering Reviewed

Shuichi Suzuki, Yuji Narita, Aika Yamawaki, Yosuke Murase, Makoto Satake, Masato Mutsuga, Hideki Okamoto, Hideaki Kagami, Minoru Ueda, Yuichi Ueda

CELLS TISSUES ORGANS Vol. 191 ( 4 ) page： 269 - 280 2010

Publishing type：Research paper (scientific journal) Publisher：KARGER

Background: Bone marrow-derived mesenchymal stem cells (MSCs) can differentiate into various types of cell, and the extracellular matrix (ECM) is acknowledged to be important for the regulation of cell functions. In this study, we demonstrated the effects of ECMs on the differentiation of human bone marrow-derived MSCs into a smooth muscle cell (SMC) lineage. Methods: Human MSCs (hMSCs) were cultured on dishes coated with 3 types of ECM including laminin (LM), collagen type IV (Col-IV) and fibronectin for 7 days, and simultaneously cultured on a noncoated dish as a control. Cell numbers of these cultured hMSCs were counted, and their expression of SMC-specific genes and proteins was evaluated. hMSCs were then seeded on LM-coated biodegradable sheets and implanted into rat subcutaneous space. After 2 weeks of implantation, these tissues were evaluated. Results: The number of hMSCs was significantly increased by culture on Col-IV-coated dishes. The expression of SMC-specific genes and proteins (alpha-smooth muscle actin, ASMA; h1-calponin, CALP) in hMSC was significantly upregulated from culture on LM-coated dishes. LM-coated sheets showed
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a significantly increased expression of ASMA and CALP protein in vivo. Moreover, a fully differentiated marker (SM2) was expressed in the in vivo implanted hMSCs in the course of 2 weeks on the LM-coated sheet. Conclusion: These results suggest that the signal transduction of the cell-matrix interaction for the differentiation of hMSCs into SMCs was activated when cultured with LM. LM-coated materials may thus be useful for cardiovascular tissue engineering. Copyright (C) 2009 S. Karger AG, Basel

DOI： 10.1159/000260061

Institutional report - Congenital development of novel drug-eluting biodegradable nano-fiber for prevention of postoperative pulmonary venous obstruction Reviewed

Masato Mutsuga, Yuji Narita, Aika Yamawaki, Makoto Satake, Hiroaki Kaneko, Akihiko Usui, Yuichi Ueda

Interactive Cardiovascular and Thoracic Surgery Vol. 8 ( 4 ) page： 402 - 6; discussion 406 2009.4

Publishing type：Research paper (international conference proceedings)

Pulmonary venous obstruction (PVO) after correction of total anomalous pulmonary venous connection (TAPVC) frequently occurs due to intimal-hyperplasia and the required re-operation. We have developed a novel sustained-release drug delivery system, using Tacrolimuseluting biodegradable nano-fiber (TEBN). It consists of nano-scale fiber composed of biodegradable polymer and Tacrolimus. This study evaluated the effects of TEBN for prevention of venous anastomotic stricture in a rat model to apply to PVO operation. Tacrolimus was incorporated into poly (L-lactide-co-glycolide). The venous stricture model was made by rat inferior vena cava anastomosis. The IVC anastomosis was covered with TEBN with 1.0 wt% Tacrolimus (n=12) or without TEBN as a control (n=12), and evaluated histologically at 1, 2, and 4 weeks after operation. The ratio of intimal area was significantly reduced in the TEBN group compared with the control group (ratio
1 week: 0.43 ± 0.26 vs. 0.07 ± 0.04, P=0.04, 2 weeks: 0.39 ± 0.19 vs. 0.05 ± 0.02, P=0.01, 4 weeks: 0.31±0.15 vs. 0.09 ± 0.04, P=0.03, control vs. TEBN, respectively). Histological findings showed endothelialization along the inner surface of the vein even in TEBN. The TEBN reduced intimal hyperplasia and preserved endothelialization even in a venous stricture. These results suggested that this strategy might be useful for prevention of recurrent PVO after TAPVC correction. © 2009 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

DOI： 10.1510/icvts.2008.192831

A new strategy for prevention of anastomotic stricture using tacrolimus-eluting biodegradable nanofiber Reviewed

Masato Mutsuga, Yuji Narita, Aika Yamawaki, Makoto Satake, Hiroaki Kaneko, Yoshihiro Suematsu, Akihiko Usui, Yuichi Ueda

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY Vol. 137 ( 3 ) page： 703 - 709 2009.3

Publishing type：Research paper (scientific journal) Publisher：MOSBY-ELSEVIER

Objective: We developed a novel sustained drug-eluting device using tacrolimus-eluting biodegradable nanofiber to prevent anastomotic stricture and evaluated the effects in a rat abdominal aortic anastomosis model.
Methods: In vitro and in vivo tacrolimus release tests for tacrolimus-eluting biodegradable nanofiber were performed to confirm its sustained release. To verify the prevention of anastomotic stricture, tacrolimus-eluting biodegradable nanofiber was placed around the end-to-end anastomosis of abdominal aorta in rats. Five rats were allocated to the following 5 groups: ( 1) control without tacrolimus-eluting biodegradable nanofiber, ( 2) 5 mg of nanofiber only ( 0 wt% of tacrolimus), ( 3) 5 mg of tacrolimus-eluting biodegradable nanofiber containing 0.04 wt% of tacrolimus, ( 4) 5 mg of tacrolimus-eluting biodegradable nanofiber containing 0.1 wt% of tacrolimus, and ( 5) 5 mg of tacrolimus-eluting biodegradable nanofiber containing 1.0 wt% of tacrolimus. Morphometric and histologic analyses including immunohistochemistry were performed in each of the groups 2 weeks after the operation.
Results: The tacrolimus-eluting biodegradable nanofiber gradually released tacrolimus for at least 1 month in vitro and in vivo. The ratio of intimal area was significantly reduced in the 1.0 wt% tacrolimus-eluting biodegradable nanofiber group compared with the other groups (0.26, 0.24, 0.25, 0.21, and 0.08 in control, 0 wt%, 0.04 wt%, 0.1 wt%, and 1.0 wt%, respectively, P <. 05). The cells, which constitute intimal hyperplasia, were positive for smooth muscle actin and SMemb, and factor VIII revealed that endothelial cells covered the surface of the aortic lumen even in the 1.0 wt% tacrolimus-eluting biodegradable nanofiber group in immunohistochemistry.
Conclusion: Tacrolimus-eluting biodegradable nanofiber reduced neointimal hyperplasia and preserved endothelialization. This device may be useful in the prevention of anastomotic stricture.

DOI： 10.1016/j.jtcvs.2008.11.017

補助循環・人工肺・体外循環

阿部裕輔, 奥村高広, 岩田英理子, 六鹿雅登, 磯山隆

人工臓器 Vol. 35 ( 2 ) page： S171 - S173 2006

Acute occlusion of left coronary ostium associated with congenital quadricuspid aortic valve Reviewed

M Mutsuga, S Tamaki, Y Yokoyama, N Kato, J Yokote, N Ohata

ANNALS OF THORACIC SURGERY Vol. 79 ( 5 ) page： 1760 - 1 2005.5

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

A 10-year-old girl suffered from chest discomfort during exercise. She experienced an acute myocardial infarction accompanied by an obstruction in an orifice to the left coronary artery. An emergency operation revealed that the aortic valve was quadricuspid, and a left-sided small cusp had adhered to the aortic wall resulting in an unusual sac with a tiny slit. Resection of the sac disclosed the ostium to left coronary artery. Blood toward the left coronary artery passed through the tiny slit. The mechanisms of obstruction in the coronary artery were uncertain. She recovered well after the aortic valve replacement with resection of the aortic cusps. (c) 2005 by The Society of Thoracic Surgeons.

DOI： 10.1016/j.athoracsur.2003.11.052

Pseudoaneurysm from the Mitral-Aortic Intervalvular Fibrosa Following Endocarditis Reviewed

Yukifusa Yokoyama, Shuji Tamaki, Noriyuki Kato, Jun Yokote, Masato Mutsuga

Japanese Journal of Thoracic and Cardiovascular Surgery Vol. 51 ( 8 ) page： 374 - 7 2003.8

Publishing type：Research paper (international conference proceedings) Publisher：Japanese Association for Thoracic Surgery

A rare case of a pseudoaneurysm from the mitral-aortic intervalvular fibrosa following bacterial endocarditis in a 17-year-old male is presented. Destructive infection secondarily involved the mitral-aortic intervalvular fibrosa. Perforation of this portion resulted in the formation of the pseudoaneurysm situated at the base of the left ventricle between the aorta and the left atrium. With echocardiography, computed topography, angiography, and magnetic resonance imaging (MRI), a pseudoaneurysm was diagnosed. MRI especially revealed detailed information and the extension of pseudoaneurysm. Our patient underwent resection of the pseudoaneurysm, reconstruction of left ventricular outflow with glutaraldehyde-preserved bovine pericardium, and replacement of the aortic valve. His postoperative course was uneventful. No recurrence of endocarditis was detected in the following year.

DOI： 10.1007/BF02719470

新生児・乳児の人工心肺に対する血液浄化法の工夫充填血液に対するSingle Pass HDF及び持続的HDFの効果

小山富生, 玉木修治, 横山幸房, 加藤紀之, 横手淳, 六鹿雅登

The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY Vol. 50 ( Suppl. ) page： 283 - 283 2002.9

PCPS長期補助例における血液浄化の有用性

横山幸房, 玉木修治, 伊藤正夫, 加藤紀之, 横手淳, 六鹿雅登, 岡田正穂, 小山富生, 山田哲也, 片山浩司

ICUとCCU Vol. 25 ( 12 ) page： 974 - 975 2001.12

Right atrial myxoma associated with atrial septal defect: a case report and review of the literature Reviewed

H Murayama, S Tamaki, N Kato, N Yuji, J Yokote, M Mutsuga, M Okada

Ann Thorac Cardiovasc Surg Vol. 7 ( 3 ) page： 166 - 169 2001.6

Repair of intercostal arteries in thoracoabdominal aneurysm Reviewed

Y. Yokoyama, S. Tamaki, M. Ito, N. Kato, J. Yokote, M. Mutsuga, M. Okada

Asian Cardiovascular and Thoracic Annals Vol. 9 ( 3 ) page： 221 - 222 2001

Language：English Publishing type：Research paper (scientific journal) Publisher：Asia Publishing Exchange Pte Ltd

A parallel aortic graft composed of a 20-mm graft with two 10-mm accessory grafts was used in the repair of a large thoracoabdominal aneurysm in a 50-year-old man. The graft was attached to 6 intercostal arteries and used immediately for spinal cord perfusion before repairing the aneurysm. The patient recovered quickly without paraplegia.

DOI： 10.1177/021849230100900315