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

Minimally invasive mitral valve surgery (MIMVS) is widespread and has become a standard procedure in cardiac surgery [Chitwood 1997; Carpentier 1996]. Therefore, MIMVS is a common procedure for patients with degenerative disease [Raanani 2010; Iribarne 2010] as well. However, the safety of MIMVS in patients with rheumatic heart disease (RHD) has not thoroughly been investigated, due to the low prevalence of RHD in developed countries, where MIMVS is standardized [Miceli 2015]. Here, we investigated the safety of MIMVS for patients with RHD at Lampang Hospital in Thailand.

DOI： 10.1532/hsf.5391

PubMed

researchmap

Language：English  

With an incidence of 3 in 100 million, giant coronary artery aneurysm (CAA) with coronary artery fistula (CAF) is a very rare condition. To prevent rupture, giant CAA with CAF should be swiftly treated. We present a Jehovah's Witness patient with giant CAA and coronary-pulmonary artery fistula. We resected the giant CAA in one piece, while ligating the CAF, without allogeneic blood transfusion. Due to rarity of these conditions, many thoracic surgeons lack direct experience in its surgical procedures. Herein, we share footage of this surgery as an example of how to safely resect CAA with minimal bleeding.

DOI： 10.1055/s-0042-1757877

PubMed

researchmap

Language：Japanese   Publisher：北海道外科学会  

researchmap

Language：Japanese   Publisher：(一社)日本胸部外科学会  

researchmap

Language：English  

The best treatment for ventricular functional mitral regurgitation still remains unclear. Papillary muscle tugging approximation (PMTA) is a technique known to preserve function of the sub-valvular apparatus, keeping it functionally in synch with the left ventricle systolic and diastolic dynamics. Herein, we present a case of mitral valve replacement with PMTA in a patient with severely impaired left ventricular function 14 years post initial mitral valve repair, which significantly improved during a course of 4 years after the reoperation without any complications.

DOI： 10.1093/jscr/rjac339

PubMed

researchmap

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

DOI： 10.1093/eurheartj/ehab539

PubMed

researchmap

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

BACKGROUND: The aim of the present study was to validate safety of total arch replacement (TAR) using a novel frozen elephant trunk device, operated by trainees as surgical education. METHODS: Sixty-four patients including 19 patients (29.6%) with acute aortic dissection type A (AADA) underwent TAR in our institute between April 2014 and March 2019 were retrospectively analyzed. Twenty-nine patients were operated by trainees (group T) and 35 patients were operated by attending surgeons (group A). RESULTS: Patient characteristics did not differ between groups. Operative time (409.4 ± 87.8 vs. 468.6 ± 129.6 minutes, p = 0.034), cardiopulmonary bypass time (177.7 ± 50.4 vs. 222.9 ± 596.7 minutes, p = 0.019), and hypothermic circulatory arrest time (39.5 ± 13.4 vs. 54.5 ± 18.5 minutes, p = 0.001) were significantly shorter in group A than in group T, but aortic clamping time did not differ between groups (115.3 ± 55.7 vs. 114.2 ± 35.0 minutes, p = 0.924) because the rate of concomitant surgery was higher in group A (37.1 vs. 10.3%, p = 0.014). Thirty-day mortality was 3.1% in the entire cohort. Although operation time was longer in group T, there were no significant difference in postoperative results between the groups, and the experience levels of the main operator were not independent predictors for in-hospital mortality + major postoperative complications. There was no difference in late death and aortic events between groups. CONCLUSIONS: The present study demonstrated that TAR can be safely performed by trainees, and suggests TAR as a possible and safe educational operation.

DOI： 10.1055/s-0040-1713354

PubMed

researchmap

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

Coronary artery fistula (CAF) is a relatively rare congenital abnormality of the coronary arteries; typically, patients who undergo surgery for CAFs are relatively young because it is a congenital disease. Here we present a case of an aneurysmal coronary-to-pulmonary artery fistula rupture in a 96-year-old female. Considering her extreme high age and missing preoperative diagnostics, only local hemostasis without anatomical repair was performed but the patient is still doing well 1 year after the operation.

DOI： 10.1007/s11748-020-01488-y

PubMed

researchmap

Language：English  

Transcatheter aortic valve replacement has become a popular choice for cases with severe aortic stenosis. However, when severe mitral regurgitation is comorbid in high-risk patients with severe aortic stenosis, therapeutic options must be weighed for each case. Here we present a very frail 88-year-old patient with severe aortic stenosis and severe mitral valve regurgitation who underwent a successful awake minimally invasive mitral valve repair after transcatheter aortic valve replacement.

DOI： 10.1055/s-0040-1718774

PubMed

researchmap

Language：Japanese   Publisher：北海道外科学会  

症例は70歳代女性、胸腹部大動脈瘤破裂で前医より緊急搬送された。クラウド型遠隔医療システムを用いて、前医にて撮像されたCTを転送し、患者到着前から治療戦略を決定することで迅速に手術を行うことができた。CTでは並列に起始する腹腔動脈(CA)、上腸間膜動脈(SMA)を巻き込み、腎動脈直上に及ぶ最大径78mmの大動脈瘤とその周囲への造影剤の漏出を認めた。大動脈造影にてCAより中枢側に破裂孔を認め、ステントグラフト(SG)をCA・SMA直上の瘤内に留置した。退院直前のCTにて瘤径の拡大を認めたため術後67日に胸腹部人工血管置換術を行った。術後肺炎を契機に敗血症を発症しSG挿入術から265日後に死亡した。手術前・周術期死亡率の高い本疾患において、クラウド型遠隔医療システムを用いることで迅速にSG挿入術を行い、破裂孔閉鎖を行うことができた。次の治療につなぐことが出来た点において胸腹部大動脈瘤破裂治療の選択肢になりうると考えられる。(著者抄録)

researchmap

Other Link： https://search.jamas.or.jp/default/link?pub_year=2020&ichushi_jid=J01375&link_issn=&doc_id=20210115020012&doc_link_id=%2Fdc7hksrg%2F2020%2F006502%2F013%2F0164-0168%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdc7hksrg%2F2020%2F006502%2F013%2F0164-0168%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：English  

Unloading of the left ventricle (LV) is essential for the treatment of LV free-wall rupture (LVFWR), and it is well-known that the LV can be optimally unloaded with the Impella system. However, there has been no report on applying the Impella system for the treatment of LVFWR. Here, we report a patient with FWR after massive myocardial infarction who was successfully treated with non-suture repair via median sternotomy and implantation of Impella CP (Abiomed, Danvers, MA).

DOI： 10.1093/jscr/rjaa263

PubMed

researchmap

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

BACKGROUND: Pulmonary vein stenosis or occlusion is a rare but one of the most devastating complications after catheter ablation for cardiac arrhythmias, and surgical repair is an option in severe cases. The sutureless technique, which avoids direct suture of vessel walls, was initially described for congenital pulmonary vein stenosis and has been widely performed due to its good restenosis-free rate. CASE PRESENTATION: A 52-year-old male developed left pulmonary vein occlusion after catheter ablation for atrial fibrillation. The surgical repair with sutureless technique using the left atrial appendage was performed without any complications. Postoperative computed tomography demonstrated the revascularization of the pulmonary vein. CONCLUSIONS: The sutureless technique using the left atrial appendage is significantly reasonable particularly in case of left pulmonary vein stenosis or occlusion after catheter ablation for atrial fibrillation since it reduces the risks of restenosis and thromboembolism.

DOI： 10.1186/s40792-020-00930-w

PubMed

researchmap

Language：English  

We experienced two cases of postoperative iatrogenic aorto-right atrial fistula (ARAF) after tricuspid valve repair (TVR) using minimally invasive cardiac surgery (MICS) technique. In both the cases, the flow of ARAF passed through the sinus of Valsalva near the noncoronary cusp (NCC)/right coronary cusp (RCC) commissure or NCC to right atrium. The quality of the fine needle used in the MICS technique may be inferior to that used in conventional surgery; ARAF after TVR could be a unique pitfall with the MICS technique.

DOI： 10.1055/s-0040-1718552

PubMed

researchmap

Language：English  

Hemoptysis after thoracic endovascular/open aortic repair is relatively rare but a well-known complication, and normally diagnosed with aortobronchial fistula (ABF). Here, we present a patient who suffered from recurrent massive hemoptyses even after multiple thoracic endovascular aortic repairs (TEVARs), where hemoptysis was ultimately controlled by pneumonectomy. In this case, the bleeding source was not the aorta but the lung parenchyma itself, indicating the importance of raising awareness that the cause of massive hemoptysis after TEVAR may not always be an ABF.

DOI： 10.1177/1179547620939078

PubMed

researchmap

Language：English   Publisher：(NPO)日本血管外科学会  

researchmap

Language：English  

An emergency thoracic endovascular aortic repair (TEVAR) with zone 2 landing without revascularization of the left subclavian artery was performed due to the impending rupture of a distal arch aneurysm in an old patient presenting hemoptysis. Two months later, the patient had recurrent massive hemoptyses and continued after additional zone 0 TEVAR. The lung parenchyma was considered to be the bleeding source and transcatheter pulmonary artery embolization was performed, and the episodes of massive hemoptysis appeared to have ceased. However, the patient died of sudden recurrent massive hemoptysis 40 days later. Inflammation and/or infection of the lung parenchyma adjunct to the aortic aneurysm could be cause of fatal hemoptysis, and aggressive therapy such as lung resection should be considered in such patients.

DOI： 10.1177/1179547619896577

PubMed

researchmap

Event date： 2022.9

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Event date： 2022.9

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Event date： 2022.9

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Event date： 2022.9

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Event date： 2021.9

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Event date： 2021.6

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap