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Last Updated :2024/07/25

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Master

Affiliation (Master)

  • Faculty of Medicine　Surgery　Surgery

Affiliation (Master)

  • Faculty of Medicine　Surgery　Surgery

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Profile and Settings

Profile and Settings

  • Name (Japanese)

    Wakasa

  • Name (Kana)

    Satoru

  • Name

    201301015548335998

Alternate Names

Achievement

Research Interests

  • Mitral valve repair   Coronary artery bypass grafting   Aortic root surgery   Thoracoabdominal aortic aneurysm repair   Thoracic aortic aneurysm repair   Functional mitral regurgitation   Surgical ventricular reconstruction   heart failure   遅延性脊髄障害   脊髄虚血再灌流障害   活性化グリア細胞   

Research Areas

  • Life sciences / Cardiovascular surgery
  • Life sciences / Respiratory surgery

Research Experience

  • 2022/04 - Today Hokkaido University Graduate School of Medicine Department of Cardiovascular Surgery Professor and chairman
  • 2020/04 - 2022/03 Hokkaido University Graduate School of Medicine` Cardiovascular and Thoracic Surgery Professor and Chairman
  • 2019/04 - 2020/03 北海道大学大学院 循環器・呼吸器外科 診療准教授
  • 2017/04 - 2019/03 KKR Sapporo Medical Center Cardiovascular Surgery Chief
  • 2014/07 - 2017/03 Hokkaido University Graduate School of Medicine Cardiovascular and Thoracic Surgery
  • 2016/06 - 2016/11 Leiden University Medical Center Department of Cardiothoracic Surgery
  • 2014/04 - 2014/06 Hokkaido University Graduate School of Medicine
  • 2009/02 - 2014/03 Hokkaido University Hospital

Education

  • 2003/04 - 2007/03  北海道大学大学院
  • 1993/04 - 1999/03  Hokkaido University  School of Medicine

Awards

  • 2015 日本胸部外科学会 優秀論文賞
     
    受賞者: 若狭哲
  • 2013/12 第27回日本冠疾患学会学術集会 最優秀演題
     
    受賞者: 若狭哲

Published Papers

  • Yuta Kobayashi, Toshiyuki Nagai, Kiwamu Kamiya, Satonori Tsuneta, Yasushige Shingu, Kento Wakabayashi, Kohsuke Kudo, Yoshihiro Matsuno, Satoru Wakasa, Toshihisa Anzai
    Circulation journal : official journal of the Japanese Circulation Society 88 (6) 1008 - 1008 2024/05/24
  • Hiroyuki Natsui, Masaya Watanabe, Takashi Yokota, Satonori Tsuneta, Yoshizuki Fumoto, Haruka Handa, Matsushima Shouji, Jiro Koya, Kotaro Nishino, Daishiro Tatsuta, Takuya Koizumi, Takahide Kadosaka, Motoki Nakao, Taro Koya, Taro Temma, Yoichi M. Ito, Hatanaka C. Kanako, Yutaka Hatanaka, Shingu Yasushige, Satoru Wakasa, Shuhei Miura, Takahiko Masuda, Naritomo Nishioka, Shuichi Naraoka, Kayoko Ochi, Tomoko Kudo, Tsugumine Ishikawa, Toshihisa Anzai
    Physiological Reports 12 (6) 2051-817X 2024/03/28 
    Abstract Epicardial adipose tissue (EAT) is an active endocrine organ that is closely associated with occurrence of atrial fibrillation (AF). However, the role of EAT in the development of postoperative AF (POAF) remains unclear. We aimed to investigate the association between EAT profile and POAF occurrence in patients who underwent cardiovascular surgery. We obtained EAT samples from 53 patients to evaluate gene expression, histological changes, mitochondrial oxidative phosphorylation (OXPHOS) capacity in the EAT, and protein secretion in EAT‐conditioned medium. EAT volume was measured using computed tomography scan. Eighteen patients (34%) experienced POAF within 7 days after surgery. Although no significant difference was observed in EAT profile between patients with and without POAF, logistic regression analysis identified that the mRNA expression levels of tumor necrosis factor‐alpha (TNF‐α) were positively correlated and adipocyte size in the EAT was inversely correlated with onset of POAF, respectively. Mitochondrial OXPHOS capacity in the EAT was not associated with POAF occurrence; however, it showed an inverse correlation with adipocyte size and a positive correlation with adiponectin secretion. In conclusion, changes in the secretory profile and adipocyte morphology of the EAT, which represent qualitative aspects of the adipose tissue, were present before the onset of AF.
  • Satoru Wakasa, Yasushige Shingu
    General thoracic and cardiovascular surgery 2023/11/02 
    Chordal preservation is recommended in mitral valve replacement for functional mitral regurgitation to preserve left ventricular function. In contrast, papillary muscle suspension toward the anterior mitral annulus can induce left ventricular reverse remodeling after mitral valve replacement for functional mitral regurgitation. However, the extent of suspension depends on the surgeon's experience. Therefore, we developed a new concept of chordal preservation, called rough-zone suspension, which not only spares the subvalvular structure but also suspends the papillary muscles toward the annulus. This procedure is simple and reproducible for determining the extent of suspension, and can increase the probability of left ventricular reverse remodeling after mitral valve replacement for functional mitral regurgitation.
  • Takahiro Ishigaki, Satoru Wakasa, Yasushige Shingu, Yohei Ohkawa, Akira Yamada
    General thoracic and cardiovascular surgery 71 (11) 674 - 680 2023/11 
    OBJECTIVE: To determine the association between sarcopenia and surgical outcomes in octogenarians with acute type A aortic dissection. METHODS: We enrolled 72 octogenarians who had undergone type A aortic dissection surgery between April 2013 and March 2019. The psoas muscle index, an indexed area of the psoas muscle at the L3 level on preoperative computed tomography, was obtained as an indicator of sarcopenia. The study participants were divided into sarcopenia and non-sarcopenia groups based on the mean psoas muscle index. The postoperative outcomes were compared between the groups. RESULTS: The median age was 84 years (interquartile range 82-87 years), and 13 patients were male. The mean psoas muscle index was 3.53 ± 0.97 cm2/m2. Except for sex, no significant differences were observed in patients' baseline characteristics and operative data between the two groups. The 30-day mortality rates in the sarcopenia and non-sarcopenia groups were 14% and 8%, respectively (P = 0.71), and postoperative morbidity was similar in both groups. Postoperative all-cause mortality was significantly higher in the sarcopenia group (log-rank P = 0.038), especially in patients aged 85 years or older (log-rank P < 0.01). The sarcopenia group had a lower home discharge rate than the non-sarcopenia group (21% vs. 54%, P < 0.01), and home discharge was associated with longer survival (log-rank P = 0.015). CONCLUSIONS: All-cause mortality after emergency surgery for acute type A aortic dissection was significantly higher in octogenarians with sarcopenia than in those without, especially in patients aged 85 years or older.
  • Yuki Takahashi, Kiwamu Kamiya, Toshiyuki Nagai, Satonori Tsuneta, Noriko Oyama-Manabe, Takeshi Hamaya, Sho Kazui, Yutaro Yasui, Kohei Saiin, Seiichiro Naito, Yoshifumi Mizuguchi, Sakae Takenaka, Atsushi Tada, Suguru Ishizaka, Yuta Kobayashi, Kazunori Omote, Takuma Sato, Yasushige Shingu, Kohsuke Kudo, Satoru Wakasa, Toshihisa Anzai
    Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 25 (1) 60 - 60 2023/10/26 
    BACKGROUND: The differences in pre- and early post-procedural blood flow dynamics between the two major types of bioprosthetic valves, the balloon-expandable valve (BEV) and self-expandable valve (SEV), in patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR), have not been investigated. We aimed to investigate the differences in blood flow dynamics between the BEV and SEV using four-dimensional flow cardiovascular magnetic resonance (4D flow CMR). METHODS: We prospectively examined 98 consecutive patients with severe AS who underwent TAVR between May 2018 and November 2021 (58 BEV and 40 SEV) after excluding those without CMR because of a contraindication, inadequate imaging from the analyses, or patients' refusal. CMR was performed in all participants before (median interval, 22 [interquartile range (IQR) 4-39] days) and after (median interval, 6 [IQR 3-6] days) TAVR. We compared the changes in blood flow patterns, wall shear stress (WSS), and energy loss (EL) in the ascending aorta (AAo) between the BEV and SEV using 4D flow CMR. RESULTS: The absolute reductions in helical flow and flow eccentricity were significantly higher in the SEV group compared in the BEV group after TAVR (BEV: - 0.22 ± 0.86 vs. SEV: - 0.85 ± 0.80, P < 0.001 and BEV: - 0.11 ± 0.79 vs. SEV: - 0.50 ± 0.88, P = 0.037, respectively); there were no significant differences in vortical flow between the groups. The absolute reduction of average WSS was significantly higher in the SEV group compared to the BEV group after TAVR (BEV: - 0.6 [- 2.1 to 0.5] Pa vs. SEV: - 1.8 [- 3.5 to - 0.8] Pa, P = 0.006). The systolic EL in the AAo significantly decreased after TAVR in both the groups, while the absolute reduction was comparable between the groups. CONCLUSIONS: Helical flow, flow eccentricity, and average WSS in the AAo were significantly decreased after SEV implantation compared to BEV implantation, providing functional insights for valve selection in patients with AS undergoing TAVR. Our findings offer valuable insights into blood flow dynamics, aiding in the selection of valves for patients with AS undergoing TAVR. Further larger-scale studies are warranted to confirm the prognostic significance of hemodynamic changes in these patients.
  • Takashi Kunihara, Yasushige Shingu, Satoru Wakasa, Hiroshi Sugiki, Yasuhiro Kamikubo, Norihiko Shiiya, Yoshiro Matsui
    General thoracic and cardiovascular surgery 71 (10) 552 - 560 2023/10 
    PURPOSE: There is controversy regarding which internal thoracic artery (ITA) should be anastomosed to the left anterior descending artery (LAD). Here, we propose an optimal graft design based on measurement of blood flow in the ITA. METHODS: Sixty-one patients (53 men, median age 68 [62-75] years) undergoing first elective coronary artery bypass grafting were enrolled. Fifty-seven left ITAs (LITAs) and 28 right ITAs (RITAs) were harvested in either a semi-skeletonized manner using a harmonic scalpel covered with papaverine-soaked gauze (group-A, n = 45) or a fully skeletonized manner using electrocautery with intraluminal papaverine injection (group-B, n = 41). Free flow of 33 ITAs was measured after pharmacological dilatation and in situ ITA-LAD flow was measured in 59 patients by transit-time flowmetry. RESULTS: RITA and LITA free flow were 147.0 [87.8-213.0] mL/min and 108.0 [90.0-144.0] mL/min, respectively (P = 0.199). The group-B had significantly higher ITA free flow (135.0 [102.0-171.0] mL/min) than group-A (63.0 [36.0-96.0] mL/min, P = 0.009). In 13 patients with bilateral ITA harvesting, free flow of the RITA (138.0 [79.5-204.0] mL/min) was also significantly higher than the LITA (102.0 [81.0-138.0] mL/min, P = 0.046). There was no significant difference between RITA and LITA flow anastomosed to the LAD. The group-B had significantly higher ITA-LAD flow (56.5 [32.3-73.6] mL/min) than group-A (40.9 [20.1-53.7] mL/min, P = 0.023). CONCLUSION: RITA provides significantly higher free flow than LITA but similar blood flow to the LAD. Full skeletonization with intraluminal papaverine injection maximizes both free flow and ITA-LAD flow.
  • Takahiro Ishigaki, Satoru Wakasa, Koji Sato, Nobuyasu Kato, Yasuhiro Kamikubo
    General thoracic and cardiovascular surgery 2023/08/24 
    Right ventricular outflow tract reconstruction is repeatedly required after the Rastelli procedure. However, standard right ventricular outflow tract reconstruction using direct anastomosis on the posterior right ventricular outflow tract wall is unfeasible in cases with severe calcification. Herein, we present a novel technique called the "lantern procedure," which can fix the prosthetic pulmonary valve without anastomosis to the calcified right ventricular outflow tract wall.
  • Surgical repair of a residual lesion of mixed-type total anomalous pulmonary venous connection using a vertical vein as a free graft: a case report(タイトル和訳中)
    Watabe Yoshinobu, Kato Nobuyasu, Niwano Haruki, Shingu Yasushige, Ooka Tomonori, Kato Hiroki, Abe Shinji, Wakasa Satoru
    General Thoracic and Cardiovascular Surgery Cases 2 1 of 5 - 5 of 5 2023/08
  • 当科における冠動脈に対する外科介入
    加藤 伸康, 阿部 慎司, 新宮 康栄, 大岡 智学, 加藤 裕貴, 山澤 弘州, 武田 充人, 若狭 哲
    日本小児循環器学会総会・学術集会抄録集 (NPO)日本小児循環器学会 59回 [II - 03] 2023/07
  • Noriyoshi Ebuoka, Norihiro Ando, Hidetsugu Asai, Nobuyasu Kato, Tsuyoshi Tachibana, Satoru Wakasa
    General Thoracic and Cardiovascular Surgery Cases 2023/06/05
  • Takashi Kunihara, Yasushige Shingu, Satoru Wakasa, Norihiko Shiiya, Satoshi Gando
    ASAIO journal (American Society for Artificial Internal Organs : 1992) 69 (4) 391 - 395 2023/04/01 
    Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine released in response to glucocorticoids, which counter-regulates the effects of glucocorticoids. This study was performed to determine the impact of steroids on the expression of MIF and other pro- and anti-inflammatory cytokines during and after cardiopulmonary bypass (CPB). Twenty adult patients (10 men, 64 ± 8 years old) who underwent elective cardiac surgery by CPB were given either 2000 mg (group-H, n = 10) or 500 mg of methylprednisolone (group-L, n = 10) during CPB. The serum concentrations of MIF, interleukin (IL)-1β, IL-8, IL-10, and tumor necrosis factor-alpha (TNF-α) were measured at eight time points until 36 hours after skin closure. The early postoperative course was uneventful for all patients. There were no significant differences in duration of operation, CPB, or aortic cross-clamping (AXC) between the two groups. MIF and IL-10 levels peaked just after the conclusion of CPB and decreased gradually thereafter. IL-1β, IL-8, and TNF-α were undetectable throughout the study period. There were no significant differences in MIF or IL-10 levels between the two groups. Peak levels of MIF in all patients were significantly correlated with the duration of CPB and AXC, whereas no such correlation was observed for IL-10. MIF or IL-10 levels were significantly elevated during and after CPB, but there were no differences between the two doses of steroid administration. Both steroid doses sufficiently suppressed proinflammatory cytokines. MIF better reflected the invasiveness of the operation than IL-10.
  • Hiroyuki Aoyagi, Shingo Tsujinaga, Yuki Takahashi, Seiichiro Naito, Takuma Sato, Takuya Otsuka, Yoji Tamaki, Ko Motoi, Suguru Ishizaka, Yasuyuki Chiba, Kiwamu Kamiya, Hiroyuki Iwano, Toshiyuki Nagai, Satoru Wakasa, Toshihisa Anzai
    Internal medicine (Tokyo, Japan) 2023/03/31 
    We herein report the first case of constrictive pericarditis (CP) induced by long-term pergolide treatment for Parkinson's disease that was assessed using multimodal imaging in a 72-year-old patient with leg edema and dyspnea. The patient was correctly diagnosed with CP using multimodal imaging and successfully treated with pericardiectomy. The treatment history of Parkinson's disease and pathological findings of the removed pericardium suggested that long-term pergolide was the cause of CP. Properly recognizing pergolide as the cause of CP and accurately diagnosing CP using multimodal imaging may contribute to the early detection and treatment of pergolide-induced CP.
  • Sakae Takenaka, Takuma Sato, Toshiyuki Nagai, Kazunori Omote, Yuta Kobayashi, Kiwamu Kamiya, Takao Konishi, Atsushi Tada, Yoshifumi Mizuguchi, Yuki Takahashi, Seiichiro Naito, Kohei Saiin, Suguru Ishizaka, Satoru Wakasa, Toshihisa Anzai
    American journal of physiology. Heart and circulatory physiology 324 (3) H355-H363  2023/03/01 
    Although measuring right ventricular (RV) function during exercise is more informative than assessing it at rest, the relationship between RV reserve function, exercise capacity, and health-related quality of life (HRQoL) in patients with left ventricular assist devices (LVAD) remains unresolved. We aimed to investigate whether RV reserve assessed by the change in RV stroke work index (RVSWI) during exercise is correlated with exercise capacity and HRQoL in patients with LVAD. We prospectively assessed 24 consecutive patients with LVAD who underwent invasive right heart catheterization in the supine position. Exercise capacity and HRQoL were assessed using the 6-min walk distance (6 MWD) and peak oxygen consumption (V̇o2) in cardiopulmonary exercise testing, and the EuroQol visual analog scale (EQ-VAS), respectively. The patients were divided into two groups according to the median ΔRVSWI (change from rest to peak exercise). Patients with lower ΔRVSWI had significantly lower changes in cardiac index and absolute value of RV dP/dt than those with higher ΔRVSWI. The ΔRVSWI was positively correlated with 6 MWD (r = 0.59, P = 0.003) and peak V̇o2 (r = 0.56, P = 0.006). In addition, ΔRVSWI was positively correlated with the EQ-VAS (r = 0.44, P = 0.030). In contrast, there was no significant correlation between RVSWI at rest and 6 MWD (r = -0.34, P = 0.88), peak V̇o2 (r = 0.074, P = 0.74), or EQ-VAS (r = 0.127, P = 0.56). Our findings suggest that the assessment of RV reserve function is useful for risk stratification in patients with LVAD.NEW & NOTEWORTHY The change in right ventricular stroke work index (RVSWI) during exercise, not RVSWI at rest, was associated with exercise capacity and HRQoL. Our findings suggest that the assessment of change in RVSWI during exercise as a surrogate of RV reserve function may aid in risk stratification of patients with LVAD.
  • Closed VSDを合併した右室二腔症の手術症例
    齋藤 翔太, 石坂 傑, 下野 裕依, 甲谷 太郎, 神谷 究, 阿部 慎司, 加藤 伸康, 永井 利幸, 若狭 哲, 安斉 俊久
    日本成人先天性心疾患学会雑誌 (一社)日本成人先天性心疾患学会 12 (1) 200 - 200 2023/01
  • ステントグラフト内挿術後に外科的治療を要した尿管動脈瘻の1例
    杉戸 悠紀, 堀田 記世彦, 山田 修平, 千葉 博基, 松本 隆児, 大澤 崇宏, 安部 崇重, 阿保 大介, 佐藤 公治, 若狭 哲, 篠原 信雄
    日本泌尿器科学会雑誌 (一社)日本泌尿器科学会 113 (4) 134 - 138 0021-5287 2022/10 
    症例は36歳,女性.29歳時,子宮頸癌に対する広汎子宮全摘術の際に,両側尿管ステントが留置され,その後術後放射線療法として全骨盤照射,傍大動脈リンパ節照射が施行された.術後4年間は尿管ステント交換のために通院していたが,以後通院を自己中断した.術後7年目に肉眼的血尿を主訴に前医を受診した.右尿管ステント抜去直後に大量出血し,右尿管動脈瘻の疑いで当院に転院となった.血管造影検査および血管内超音波検査では右総腸骨動脈遠位端に仮性動脈瘤を認めたため,右総腸骨動脈内にステントグラフトを留置し,その後血尿の再燃なく退院となった.退院1ヵ月後に右水腎症と右腎盂腎炎を発症したため,右腎瘻が造設された.半年後発熱と腎瘻からの出血を来し,CTでは右総腸骨動脈に仮性瘤の形成とステントグラフト滑脱の所見を認めた.血管内治療は困難と判断し,手術にてステントグラフトの抜去と仮性動脈瘤の切除を行った.また大腿動脈-大腿動脈バイパス術を行い右下肢の血流を確保した.現在右腎瘻を定期交換しているが,感染や血尿の再燃なく,下肢の血流障害も認めず,安定して経過している.近年は尿管動脈瘻に対して低侵襲な血管内治療が第一選択となることが多いが,感染を合併した例では血管壁が脆弱化し,仮性瘤の形成やステントの滑脱が起こる場合がある.(著者抄録)
  • ステントグラフト内挿術後に外科的治療を要した尿管動脈瘻の1例
    杉戸 悠紀, 堀田 記世彦, 山田 修平, 千葉 博基, 松本 隆児, 大澤 崇宏, 安部 崇重, 阿保 大介, 佐藤 公治, 若狭 哲, 篠原 信雄
    日本泌尿器科学会雑誌 (一社)日本泌尿器科学会 113 (4) 134 - 138 0021-5287 2022/10 [Refereed]
  • Sato Koji, Shingu Yasushige, Fusegawa Masato, Ishigaki Takahiro, Wakasa Satoru
    Annals of Vascular Diseases 15 (3) 193 - 196 1881-641X 2022/09/25 [Refereed][Not invited]
     
    Iatrogenic arteriovenous fistula (AVF) rarely develops around the proximal subclavian artery, although open surgical repair of this etiology is known to be complicated as deep dissection is required around the fistula surrounded by dilated veins. In this study, we present the case of a 64-year-old man, who was referred to our hospital, with AVF between the right subclavian artery and the right vertebral vein. He had a history of accidental puncture of the right subclavian artery. An endovascular repair using a covered stent was successfully performed, and the AVF disappeared. Thus, covered stent placement should be considered as the first-line treatment for a deeply developed AVF, if anatomically feasible.
  • Yoshifumi Takeda, Masataka Yamamoto, Koji Hoshino, Yoichi M Ito, Nobuyasu Kato, Satoru Wakasa, Yuji Morimoto
    Pediatric cardiology 44 (3) 695 - 701 2022/09/01 [Refereed][Not invited]
     
    Palliative surgery is often performed in the treatment of congenital heart disease. Two representative palliative procedures are the systemic pulmonary shunt and pulmonary artery banding. Dramatic changes in cerebral hemodynamics may occur in these operations due to changes in the pulmonary-to-systemic blood flow ratio and systemic oxygenation. However, there seem to be almost no studies evaluating them. Accordingly, we evaluated cerebral perfusion by transcranial Doppler ultrasonography and cerebral oxygenation by near infrared spectroscopy during these procedures. In the post hoc analysis of a previous prospective observational study, cerebral blood flow velocities of the middle cerebral artery measured by transcranial Doppler were compared between the start and end of surgery as were the pulsatility index and resistance index. The cerebral oxygenation values were also compared between the start and end of surgery. Twenty-two infants with systemic pulmonary shunt and 20 infants with pulmonary artery banding were evaluated. There were no significant differences of the flow velocities between the start and end of surgery in either procedure. The pulsatility index significantly increased after pulmonary artery banding, which may compete with the increase in cerebral perfusion due to the increase in systemic blood flow. The cerebral oxygenation decreased in both procedures, possibly due to an increase in body temperature. Arterial oxygen saturation was almost the same before and after both procedures. Contrary to our expectation, the changes in cerebral hemodynamics in the palliative operations were small if the management of physiological indices such as arterial oxygen saturation was properly performed during the procedures.
  • Ryota Murase, Yasushige Shingu, Satoru Wakasa
    Surgery today 53 (3) 393 - 395 2022/08/05 [Refereed][Not invited]
     
    A prolonged length of hospital stay (LOS) has become an important issue among patients undergoing cardiovascular surgery in our aging society. However, there are no established prediction models for a prolonged LOS. We therefore created a prediction model of a prolonged LOS using a deep learning software program (Prediction One; Sony Network Communications Inc., Tokyo, Japan) using preoperative data. Subjects were 157 patients (121 for training data, 36 for validation data). A prolonged LOS was defined as a more than 30-day postoperative stay due to physical inactivity. The area under the receiver operating characteristic curve and the accuracy of the model in the validation data were 0.806 and 67%, respectively. In conclusion, the preliminary model demonstrated acceptable performance for the prediction of a prolonged LOS after cardiovascular surgery.
  • Yuya Wada, Hideki Ujiie, Ryohei Chiba, Shunsuke Nomura, Aki Fujiwara-Kuroda, Kichizo Kaga, Satoru Wakasa, Tatsuya Kato
    VIDEO-ASSISTED THORACIC SURGERY 2519-0792 2022/08 
    Background: The use of complete video-assisted thoracoscopic surgery (c-VATS) for primary bronchial tumors has increased due to its less invasive nature and cosmetic advantages. However, no studies have reported about flap bronchoplasty using c-VATS due to its technicality. Case Description: A woman in her 20s presented with dyspnea and chest tightness. Computed tomography (CT) showed a 15x18-mm-sized mass located from the left second carina to the lower lobe bronchus root. Flap bronchoplasty using c-VATS was performed. The tumor developed from the second carina near the anterior wall of the left main bronchial cartilage. The upper lobe bronchial root was resected while ensuring surgical margin. The B6 bronchial wall was trimmed to create a flap, and bronchoplasty was performed to fill the defect. After bronchoplasty, the fifth intercostal muscle valve was wrapped around the flap. Postoperative course was uneventful, and bronchoscopy revealed no stenosis. There has been no adverse events and recurrence for 2 years after surgery. Conclusions: Flap bronchoplasty from the resected area allowed preservation of the basal area, and was a useful technique in terms of function preservation. Since the patient in this case was a young female, a full thoracoscopic surgery was completed successfully in consideration of invasion and appearance.
  • Ryohei Chiba, Yuma Ebihara, Haruhiko Shiiya, Hideki Ujiie, Aki Fujiwara-Kuroda, Kichizo Kaga, Liming Li, Satoru Wakasa, Satoshi Hirano, Tatsuya Kato
    Journal of thoracic disease 14 (8) 2943 - 2952 2022/08 [Refereed][Not invited]
     
    Background: Palpation of tumors during thoracoscopic surgery remains difficult, and identification of deep-seated tumors may be impossible. This preclinical study investigated the usefulness of a novel indocyanine green (ICG) fluorescence spectroscopy system for tumor localization. Methods: ICG was diluted to 5.0×10-2 mg/mL in fetal bovine serum (FBS) and mixed with silicone resin to prepare pseudo-tumors. Sponges of different densities and a porcine lung were placed on top of the pseudo-tumors, which were examined using a novel fluorescence spectroscopy system and a near-infrared (NIR) camera. Spectra were measured for different sponge and lung thicknesses, and the lung spectra were measured during both inflation and deflation. Results: The fluorescence spectroscopy system was able to identify tumors at depths ≥15 mm, while the NIR system was not. The spectroscopy system also detected tumors at greater depths when the density of the intervening material was lower. Depending on the density and thickness of the intervening material, the system could detect spectra as deep as 40 mm for sponges and 30 mm for lungs. Conclusions: This new fluorescence spectroscopy system can be used to identify lung tumors up to a depth of 30 mm in experiments using pseudo-tumors and a porcine lung, which may aid in tumor identification during thoracoscopic surgery.
  • Ryota Murase, Yasushige Shingu, Satoru Wakasa
    Molecular biology reports 49 (10) 9429 - 9436 2022/07/27 [Refereed][Not invited]
     
    PURPOSE: Several therapeutic agents have been found to prevent myocardial ischemic and reperfusion (I/R) injury after cardiac surgery; however, no drug is routinely used to afford cardioprotective benefits in clinical settings. Herein, we aimed to determine whether chloroquine (CQ) pretreatment attenuates I/R injury after global ischemia in isolated rat hearts and elucidate mechanisms underlying the effects of CQ. METHODS: Isolated rat hearts were subjected to 30-min global ischemia, followed by 60-min reperfusion with Krebs-Henseleit buffer (KHB). Immediately before ischemia, 10 mL of pretreatment solutions (KHB, n = 4 or KHB + CQ [100 μM], n = 4) were injected through the aortic root. Cardiac function was examined based on the rate pressure product (RPP). Myocardial apoptosis was evaluated using TUNEL staining. To assess the reperfusion ischemia salvage kinase pathway, protein expression levels of AKT and extracellular signal-regulated kinase (ERK1/2) were determined using western blotting. To investigate the role of ERK1/2, an ERK1/2 selective inhibitor was used in eight additional rats. RESULTS: The recovery rate of the RPP was higher in the KHB + CQ group than in the KHB group 60 min after I/R (KHB, 44 ± 3% vs. KHB + CQ, 69 ± 7%; P = 0.019, d = 2.2). CQ pretreatment reduced apoptosis and enhanced the phosphorylation of ERK1/2; however, AKT phosphorylation was unaltered. In addition, the ERK1/2 inhibitor abolished CQ-mediated cardioprotective effects. CONCLUSIONS: CQ pretreatment showed protective effects on cardiac function after I/R by activating ERK1/2.
  • WAKASA Satoru
    THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA 日本臨床麻酔学会 42 (4) 377 - 384 0285-4945 2022/07/15 [Not refereed][Invited]
     
    Secure hemostasis is essential to achieve good outcomes after cardiovascular surgery because it is associated with less transfusion and shorter hospital stays. However, intraoperative use of anticoagulants and cardiopulmonary bypass can result in a tendency to bleeding and make it difficult to achieve secure hemostasis. The causes of intraoperative bleeding can be classified into surgical bleeding originating from a relatively large bleeding site, which develops during dissection and anastomosis, and consumption coagulopathy associated with a smaller bleeding site which is exaggerated by loss of coagulation factors and platelets due to surgical bleeding and hemodilution by use of cardiopulmonary bypass. Because transfusion alone is less effective in controlling surgical bleeding, the surgeon should control such bleeding in the operative field using surgical procedures to maximize the effect of supplemental treatment by anesthesiologists. To achieve effective and secure intraoperative hemostasis, surgeons and anesthesiologists should cooperate, sharing information about the cause of bleeding and the strategy of hemostasis.
  • 当院の体肺動脈短絡手術の治療成績
    加藤 伸康, 阿部 慎司, 新宮 康栄, 加藤 裕貴, 大岡 智学, 泉 岳, 山澤 弘州, 武田 充人, 若狭 哲
    日本小児循環器学会総会・学術集会抄録集 (NPO)日本小児循環器学会 58回 [III - 04] 2022/07
  • Daisuke Yoshioka, Koichi Toda, Minoru Ono, Norihide Fukushima, Akira Shiose, Yoshikatsu Saiki, Akihiko Usui, Satoru Wakasa, Hiroshi Niinami, Goro Matsumiya, Hirokuni Arai, Yoshiki Sawa, Shigeru Miyagawa
    Circulation journal : official journal of the Japanese Circulation Society 86 (12) 1950 - 1958 2022/07/01 [Refereed][Not invited]
     
    BACKGROUND: The objective of this study is to investigate the effect of preoperative diabetes on all-cause mortality and major postoperative complications among patients with continuous-flow left ventricular assist device (LVAD) by using data from a national database.Methods and Results: The 545 study patients who underwent primary HeartMateII implantation between 2013 and 2019 were divided into 2 groups according to their diabetes mellitus (DM) status; patients with DM (n=116) and patients without DM (n=429). First, the on-device survival and incidence of adverse events were evaluated. Second, after adjusting for patients' backgrounds, the change of laboratory data in the 2 groups were compared. Overall, on-device survival at 1, 2, and 3 years was almost equivalent between the 2 groups; it was 95%, 94%, and 91% in patients without DM, and 93%, 91%m and 91% in patients with DM (P=0.468) The incidence of adverse events was similar between 2 groups of patients, except for driveline exit site infection in the adjusted cohort. Cox proportional hazards regression analysis revealed younger age (HR: 0.98 (95% confidence interval (CI): 0.97-0.99, P=0.001) and presence of DM (HR: 1.83 (95% CI: 1.14-2.88), P=0.016) as significant predictors of driveline infection. Laboratory findings revealed no differences between groups throughout the periods. CONCLUSIONS: The clinical results after LVAD implantation in DM patients were comparable with those in non-DM patients, except for the driveline exit site infection.
  • 加藤 伸康, 阿部 慎司, 新宮 康栄, 加藤 裕貴, 大岡 智学, 若狭 哲
    北海道外科雑誌 = The Hokkaido journal of surgery / 北海道外科雑誌編集委員会 編 67 (1) 2 - 9 0288-7509 2022/06 [Not refereed][Invited]
  • Takuma Sato, Yuta Kobayashi, Toshiyuki Nagai, Takeshi Nakatani, Jon Kobashigawa, Yoshikatsu Saiki, Minoru Ono, Satoru Wakasa, Toshihisa Anzai
    International journal of cardiology 356 66 - 72 2022/06/01 [Refereed][Not invited]
     
    BACKGROUND: Under the revised heart allocation system in the United States, bridge to transplant (BTT) patients with left ventricular assist device (LVAD) have a longer waitlist period, as they are now lowly prioritized. However, little is known regarding the long-term trajectory of functional capacity (FC) and health-related quality of life (HR-QOL) among BTT-LVAD patients. METHODS: We retrospectively analyzed 442 consecutive patients with BTT-LVAD between April 2013 and May 2019 from a Japanese nationwide registry. FC (New York Heart Association [NYHA] functional class, peak oxygen uptake [VO2], and 6-min walk test [6MWT]) and HR-QOL (European Quality of Life [EQ-5D index] and Visual Analogue Scale [EQ-VAS]) were assessed at baseline and for up to 60 months after LVAD implantation. RESULTS: During the follow-up period of 30 months (IQR 18-42 months), 100 (22.6%) patients underwent transplantation, 37 (8.3%) died, and 14 (3.1%) underwent explantation for recovery. Mean peak VO2, 6MWT distance, EQ-5D index, and EQ-VAS significantly improved 3 months after LVAD implantation (p = 0.0012, p = 0.0037, p < 0.001, p < 0.001, respectively). Furthermore, these improvements were sustained for up to 60 months following LVAD implantation. Major adverse events including device failure, infection, stroke, and bleeding, which occurred within the first 3 months after LVAD implantation may have not affected FC or HR-QOL for up to 60 months (p = 0.15, p = 0.22, respectively). CONCLUSIONS: BTT patients showed long-term preservation of FC and HR-QOL, suggesting that BTT remains an option despite the long waiting time to HTx.
  • Kenichiro Suno, Yasushige Shingu, Satoru Wakasa
    Molecular and cellular biochemistry 477 (10) 2403 - 2414 2022/05/17 [Refereed][Not invited]
     
    Coronary endothelial dysfunction is a major cause of ischemia-reperfusion (I/R) injury. Trehalose, a natural disaccharide, has been reported to ameliorate endothelial dysfunction during aging by activating endothelial nitric oxide synthase (eNOS); however, its role in I/R injury is unknown. This study evaluated the effects of trehalose preconditioning on cardiac and coronary endothelial function after I/R. Langendorff-perfused rat hearts underwent 30 min of global ischemia followed by 80 min of reperfusion with or without trehalose preconditioning. Rate pressure product (RPP) and coronary flow (CF) were measured during reperfusion. Perivascular edema was assessed by hematoxylin and eosin staining. Myocardial oxidative stress and apoptosis were evaluated by immunohistochemistry and TUNEL staining, respectively. eNOS dimerization was determined by western blotting. An eNOS inhibitor was used to examine the role of eNOS. Trehalose preconditioning showed a higher recovery rate after I/R as indicated by high RPP (control vs. trehalose, 28 ± 6% vs. 46 ± 9%; P = 0.017, Cohen's d = 2.3) and CF values (35 ± 10% vs. 55 ± 9%; P = 0.025, d = 1.7). Furthermore, trehalose preconditioning reduced perivascular edema, myocardial oxidative stress, and apoptosis. The eNOS dimerization ratio was increased by trehalose (1.2 ± 0.2 vs. 1.6 ± 0.2; P = 0.023, d = 2.1), which was associated with the recovery of RPP and CF. These effects of trehalose were abolished by the eNOS inhibitor. Trehalose preconditioning showed protective effects on cardiac and coronary endothelial function after I/R through the eNOS signaling pathway.
  • Yasushige Shingu, Tetsuya Hieda, Satoshi Sugimoto, Hidetsugu Asai, Tomoji Yamakawa, Satoru Wakasa
    Molecular biology reports 49 (6) 4885 - 4892 2022/05/08 [Refereed][Not invited]
     
    BACKGROUND: The change in myocardial protein degradation systems after ventricular unloading has been unknown. We aimed to evaluate the anti-hypertrophic protein adenosine monophosphate-activated protein kinase (AMPK) and two major protein degradation systems (ubiquitin proteasome system and autophagy) in a model of surgical ventricular reconstruction (SVR) in rats with ischemic cardiomyopathy. METHODS AND RESULTS: Rats were randomized into the following groups: sham/sham (control group), myocardial infarction (MI)/sham (sham group) and MI/SVR (SVR group), with an interval of 4 weeks. Two (early, n = 5 for each) and 28 days (late, n = 5 for each) after SVR, ventricular size, and wall stress were assessed. Myocyte area, protein expression of AMPKα and autophagy markers, and gene expression of ubiquitin ligases (Atrogin-1 and Murf-1) were evaluated in the late phase. In the early phase, left ventricular dimensions and wall stress were smaller in the SVR group than in the sham group, whereas they were comparable in the late period. Myocyte area in the SVR group was reduced to the value in the control group, while it was larger in the sham group than in the control group. Total-AMPKα, p-AMPKα, and AMPKα phosphorylation rates were higher, and Atrogin-1 and Murf-1 were lower in the SVR group than in the sham group, while the autophagy markers were not different between the groups. p-AMPKα had strong negative correlations with myocyte area, Atrogin-1, and Murf-1. CONCLUSIONS: In myocyte reverse remodeling after SVR, AMPKα phosphorylation increased in association with reduced gene expression of ubiquitin ligases.
  • Shinji Abe, Yasuhiro Kamikubo, Nobuyasu Kato, Hiroki Kato, Tomonori Ooka, Yasushige Shingu, Satoru Wakasa
    Surgical case reports 8 (1) 80 - 80 2022/04/29 [Refereed][Not invited]
     
    BACKGROUND: Pulmonary hemorrhage is a life-threatening complication of cardiovascular surgery. Bronchial artery hypertrophy, a rare pathology associated with inflammatory and ischemic respiratory diseases, increases the risk of pulmonary hemorrhage; however, its involvement in cardiovascular surgery is not well known. We present two cardiovascular surgical cases in which embolization of the hypertrophied bronchial artery was effective in controlling perioperative pulmonary hemorrhage. CASE PRESENTATION: The first case was a 51-year-old man with chronic obstructive pulmonary disease who developed acute type A aortic dissection. After emergent surgery, his blood pressure suddenly dropped in the intensive care unit; computed tomography revealed a right hemothorax. Because a 4-mm dilated bronchial artery was identified on preoperative computed tomography, the hemothorax was suspected to be associated with bronchial artery hypertrophy. Selective bronchial arteriography was emergently performed and revealed a right pulmonary parenchymal blush. After subsequent coil embolization of the bronchial artery, the parenchymal blush disappeared, and his hemodynamic condition stabilized. The second case was a 66-year-old man with bronchiectasis who was referred for redo aortic valve replacement due to structural valve deterioration. A bioprosthesis was previously implanted to avoid permanent anticoagulation because the patient had repeated episodes of hemoptysis; however, he still had persistent hemosputum during admission for the redo aortic valve replacement. A dilated bronchial artery 3.7 mm in size was incidentally identified on preoperative computed tomography, and hence, the repeated hemosputum was suspected to be associated with bronchial artery hypertrophy. Bronchial arteriography revealed a right pulmonary parenchymal blush, and prophylactic embolization of the bronchial artery was performed. The hemosputum disappeared after the procedure, and redo aortic valve replacement was performed uneventfully 8 days later. CONCLUSION: In cardiovascular surgery, the risk of pulmonary hemorrhage associated with bronchial artery hypertrophy should be considered, especially in patients with inflammatory and ischemic respiratory diseases.
  • Takahiro Ishigaki, Satoru Wakasa
    General thoracic and cardiovascular surgery 70 (7) 677 - 679 2022/04/07 [Refereed][Not invited]
     
    Because a mechanical aortic valve is a contraindication for the implantation of left ventricular assist device, complicated additional procedures such as a replacement with a bioprosthesis and a closure of the left ventricular outflow tract are required to implant the device. Among such procedures, a sandwich plug technique using vascular clips is one of the simple and feasible procedures. However, this technique requires an off-label use of vascular clips within the aorta that could be associated with a risk of dislodgement and embolization. Thus, we developed a modified sandwich technique without using vascular clips, where the valve leaflets were fixed in the closed position using felt patches and sutures instead of vascular clips. This modified technique is a simple and secure method to close the mechanical aortic valve with the minimum use of artificial materials.
  • Takuya Ikushima, Hideki Ujiie, Satonori Tsuneta, Ryohei Chiba, Yukiko Tabata, Aki Fujiwara-Kuroda, Yasuhiro Hida, Kichizo Kaga, Satoru Wakasa, Tatsuya Kato
    General thoracic and cardiovascular surgery 70 (7) 673 - 676 2022/04/06 [Refereed][Not invited]
     
    Azygos vein aneurysm (AVA) is necessary to prevent pulmonary embolism due to the outflow of a thrombus or rupture of the aneurysm. However, there is no established modality to assess the properties of AVA. Time-resolved three-dimensional phase-contrast magnetic resonance imaging (4D-flow MRI) has been used to examine the hemodynamics in various fields. We report a case of AVA to evaluate the flow variability and adhesions of surrounding tissues using 4D-flow MRI. The findings of the study suggested aneurysm turbulence and the absence of thrombi. The cine image, which showed a sliding wall synchronized to the heartbeat, indicated no adhesion to the superior vena cava. Based on these results, the thoracoscopic approach was deemed possible preoperatively. Thoracoscopic AVA resection was performed, and the postoperative course was uneventful. This study documented the utility of 4D-flow MRI for a detailed evaluation of AVA.
  • Haruhiko Shiiya, Hideki Ujiie, Tatsuya Kato, Shohei Honda, Satoru Wakasa, Kichizo Kaga
    INDIAN JOURNAL OF SURGERY 0972-2068 2022/04 [Refereed][Not invited]
     
    To the best of our knowledge, no previous reports have described the indication criteria and details of uniportal video-assisted thoracoscopic lobectomy in younger children. We report the utility of uniportal video-assisted thoracoscopic right lower lobectomy via a 2-cm incision in a 2-year-old child with a prenatal diagnosis of congenital cystic lung disease. A male infant with a prenatal diagnosis of congenital cystic lung disease was delivered vaginally at 36 weeks of gestation. Computed tomography after birth showed that the disease was limited to the right lower lobe. The patient was asymptomatic and was initially treated conservatively. At the age of 2 years and 10 months, when compensatory lung growth can still be expected, the patient had become large enough to safely undergo one-lung ventilation and thoracoscopic surgery. Therefore, we decided to perform a curative lobectomy. A single 2-cm incision was made at the anterior axillary line on the 6th intercostal space. The vessels and bronchus were approached from the anterior side. We used a 3-mm thoracoscope and instruments with a small diameter. The patient was discharged without any complications or need for analgesic drugs. The crossing technique was utilized to minimize the interference between multiple instruments in a small incision with a narrow intercostal space.
  • Satoru Wakasa, Koji Sato, Takahiro Ishigaki, Yoshinobu Watabe, Shinji Abe
    General thoracic and cardiovascular surgery 70 (6) 588 - 590 2022/03/21 [Refereed][Not invited]
     
    Hybrid repair of a thoracoabdominal aortic aneurysm comprising thoracic endovascular aortic repair and total renovisceral debranching is a feasible alternative to open repair, especially for high-risk patients. However, transperitoneal debranching is a relatively complicated procedure that requires deep dissection around vital abdominal organs. Therefore, we developed a new debranching technique called Chunnel debranching, which was characterized by transaortic tunneling using a covered stent between the target artery and the prosthetic graft anastomosed on the aneurysmal wall using an inclusion technique. This procedure increases the feasibility of renovisceral debranching with fewer dissections than conventional transperitoneal debranching.
  • Tetsuya Hieda, Yasushige Shingu, Satoshi Sugimoto, Hidetsugu Asai, Tomoji Yamakawa, Satoru Wakasa
    Heart and vessels 37 (3) 528 - 537 2022/03 [Refereed][Not invited]
     
    Recurrence of left ventricular (LV) remodeling after surgical ventricular reconstruction (SVR) for ischemic cardiomyopathy has been reported to be partially attributed to autophagy. We aimed to examine the effects of trehalose, an autophagy inducer, on the recurrence of LV remodeling after SVR. After SVR in rats with ICM, trehalose was orally administered. The changes in LV end-diastolic dimension (LVEDD) and fractional shortening (FS) were evaluated. The activation of myocardial autophagy was also estimated by autophagy markers: microtubule-associated light chain 3 II (LC3-II) and p62; the former usually increases and the latter decreases if autophagy is activated. Significant LV reverse remodeling was observed early after SVR. On the other hand, the 28th postoperative day SVR + trehalose was associated with smaller LVEDD and better FS than SVR alone (LVEDD, P = 0.043; FS, P < 0.01). LC3-II increased comparably in both groups, while p62 was significantly lower in the SVR + trehalose group than in the SVR alone group (P < 0.01). In conclusion, trehalose attenuated the recurrence of LV remodeling and changed autophagy markers after SVR in rats with ICM. Trehalose may be a candidate for adjuvant therapy to retain the effects of SVR.
  • 切除を先行した巨大(>10cm)肺腫瘤の2症例
    千葉 龍平, 加賀 基知三, 幾島 拓也, 田畑 佑希子, 藤原 晶, 氏家 秀樹, 加藤 達哉, 樋田 泰浩, 若狭 哲, 岡崎 ななせ, 若林 健人, 松野 吉宏
    肺癌 (NPO)日本肺癌学会 62 (1) 72 - 73 0386-9628 2022/02 [Refereed][Not invited]
  • Masato Nakamura, Hitoshi Yaku, Junya Ako, Hirokuni Arai, Tohru Asai, Taishiro Chikamori, Hiroyuki Daida, Kiyoshi Doi, Toshihiro Fukui, Toshiaki Ito, Kazushige Kadota, Junjiro Kobayashi, Tatsuhiko Komiya, Ken Kozuma, Yoshihisa Nakagawa, Koichi Nakao, Hiroshi Niinami, Takayuki Ohno, Yukio Ozaki, Masataka Sata, Shuichiro Takanashi, Hirofumi Takemura, Takafumi Ueno, Satoshi Yasuda, Hitoshi Yokoyama, Tomoyuki Fujita, Tokuo Kasai, Shun Kohsaka, Takashi Kubo, Susumu Manabe, Naoya Matsumoto, Shigeru Miyagawa, Tomohiro Mizuno, Noboru Motomura, Satoshi Numata, Hiroyuki Nakajima, Hirotaka Oda, Hiromasa Otake, Fumiyuki Otsuka, Ken-Ichiro Sasaki, Kazunori Shimada, Tomoki Shimokawa, Toshiro Shinke, Tomoaki Suzuki, Masao Takahashi, Nobuhiro Tanaka, Hiroshi Tsuneyoshi, Taiki Tojo, Dai Une, Satoru Wakasa, Koji Yamaguchi, Takashi Akasaka, Atsushi Hirayama, Kazuo Kimura, Takeshi Kimura, Yoshiro Matsui, Shunichi Miyazaki, Yoshitaka Okamura, Minoru Ono, Hiroki Shiomi, Kazuo Tanemoto
    Circulation journal : official journal of the Japanese Circulation Society 86 (3) 477 - 588 2022/01/31 [Not refereed][Invited]
  • Yoshimoto Kimihiro, Wakasa Satoru
    Japanese Journal of Cardiovascular Surgery 特定非営利活動法人 日本心臓血管外科学会 51 (1) 53 - 56 0285-1474 2022/01/15 [Refereed][Not invited]
     
    Popliteal venous aneurysm (PVA) is recognized as source of fatal pulmonary embolism ; surgical treatment is indicated. A 79-year-old woman presented with acute shortness of breath. A cardiac ultrasound echography showed right heart overload and pulmonary hypertension. A contrast enhanced CT revealed multiple pulmonary artery emboli and right popliteal venous aneurysm. She was immediately started anticoagulation therapy with oral factor Xa inhibitor and her dyspnea improved. As thrombus in venous aneurysm was considered the cause of the pulmonary embolism, we recommended surgical treatment. Tangential aneurysmectomy with lateral venorrhaphy for the saccular venous aneurysm was performed. Postoperative contrast enhanced CT showed good morphology and she was discharged without complication. Surgical treatment of symptomatic popliteal venous aneurysm is considered useful strategy.
  • Yoshiro Matsui, Suguru Kubota, Tatsuya Seki, Yasushige Shingu, Satoru Wakasa
    The Annals of thoracic surgery 114 (2) e141-e144  2021/12/09 [Refereed][Not invited]
     
    Mitral valvuloplasty using Gore-Tex as the artificial chordae is often associated with difficulties in determining the length of the artificial chordae, achieving the correct artificial chordae length, and preventing knot slippage, especially for beginners. We describe a simple technique involving a novel device called the "Mitral Plate," which enables surgeons to automatically determine the correct length of the artificial chordae and tie slippery knots without performing excessive saline tests.
  • 大塚 慎也, 氏家 秀樹, 加藤 達哉, 椎谷 洋彦, 藤原 晶, 樋田 泰浩, 加賀 基知三, 若狭 哲, 井上 玲, 飯村 泰昭
    北海道外科雑誌 = The Hokkaido journal of surgery / 北海道外科雑誌編集委員会 編 北海道外科学会 66 (2) 131 - 133 0288-7509 2021/12 [Refereed][Not invited]
  • Takahiro Ishigaki, Satoru Wakasa, Yasushige Shingu, Yohei Ohkawa, Akira Yamada, Toshihisa Anzai, Yoshiro Matsui
    Journal of Cardiology 79 (4) 530 - 536 0914-5087 2021/11 [Refereed][Not invited]
     
    BACKGROUND: Functional mitral regurgitation (FMR) is caused by left ventricular (LV) remodeling and subsequent tethering of the mitral valve (MV). If LV remodeling is irreversibly advanced, it could not be attenuated by the MV procedure alone, although the additional subvalvular procedure could induce LV reverse remodeling by forcibly reducing MV tethering. This study aimed to assess the anti-tethering effect of papillary muscle tugging approximation (PMTA) on LV reverse remodeling after mitral valve replacement (MVR) for non-ischemic FMR. METHODS: The study subjects were 19 patients who underwent MVR with and without PMTA [MVR + PMTA (n = 11) and MVR alone (n = 8), respectively] for non-ischemic FMR. The tethering distance (TD) and LV end-systolic volume (ESV) at the preoperative, postoperative, and follow-up periods were assessed in terms of their correlation and time-dependent changes. The intra-LV energy efficiency was also evaluated through vector flow mapping analysis. RESULTS: TD and ESV were comparable between both procedures preoperatively and did not change after MVR alone. In MVR + PMTA, however, a significant decrease was identified in TD and ESV at the early postoperative and follow-up periods, respectively [TD = 48, 30, and 31 mm (p < 0.001) and ESV = 159, 133, and 82 mL (p < 0.001) at the preoperative, postoperative, and follow-up periods, respectively]. Finally, at follow-up, the extent of change from the preoperative value in ESV significantly correlated with that in TD (ρ = 0.81, p < 0.001 for overall; ρ = 0.93, p < 0.001 for MVR + PMTA; ρ = 0.86, p = 0.011 for MVR alone). The ratio of TD to ESV was also significantly correlated with systolic energy loss to LV stroke work after MVR + PMTA (ρ = 0.81, p = 0.015). CONCLUSIONS: PMTA for non-ischemic FMR could induce LV reverse remodeling depending on the extent of postoperative TD reduction. A smaller TD to ESV was associated with a higher intra-LV energy efficiency after PMTA + MVR.
  • Shinya Otsuka, Tatsuya Kato, Hideki Ujiie, Aki Fujiwara-Kuroda, Yasuhiro Hida, Kichizo Kaga, Satoru Wakasa, Yuta Takashima, Naofumi Shinagawa
    General thoracic and cardiovascular surgery 69 (12) 1589 - 1592 2021/09/28 [Refereed]
     
    Blunt tracheal injury is a rare but life-threatening condition. Several indications for treatment have been reported. Conservative treatment (i.e., stenting) can be performed when the patient is clinically stable or has medical contraindications to surgical treatment. Although some studies have reported the use of tracheal stents as treatment for iatrogenic injury and blunt trauma, the efficacy of these stents is unknown. Herein, we report a case of emergency tracheoplasty for the management of tracheal stent prolapse in a patient with blunt tracheobronchial trauma. This report highlights the necessity of being cautious about the migration and prolapse of tracheal stents, which can more frequently occur in blunt trauma than in malignant stenosis or iatrogenic injury. Due to the limitations of non-surgical treatments, early surgical intervention may be lifesaving.
  • Haruhiko Shiiya, Hideki Ujiie, Yasuhiro Hida, Tatsuya Kato, Kichizo Kaga, Satoru Wakasa, Eiki Kikuchi, Naofumi Shinagawa, Kazufumi Okada, Yoichi M Ito, Yoshihiro Matsuno
    Thoracic cancer 12 (21) 2933 - 2942 2021/09/27 [Refereed]
     
    BACKGROUND: No useful tumor markers have been identified for the diagnosis of thymic carcinomas. Serum cytokeratin 19 fragment, measured using the CYFRA 21-1 immunoassay, is used as a tumor marker for squamous cell carcinomas in various malignant tumors. Here, we evaluated the value of CYFRA 21-1 in diagnosing thymic carcinoma. METHODS: We retrospectively reviewed 94 patients with pathological diagnoses of thymic carcinoma or thymoma (32 and 62 patients, respectively) who were referred to our departments between January 2000 and March 2019. Primary outcomes included tumor marker levels and their diagnostic accuracy. RESULTS: Patients with thymic carcinoma were significantly more likely to be male (thymic carcinoma, 68.8%; thymoma, 40.3%; p = 0.02), have an advanced TNM stage (p < 0.01), and a significantly higher CYFRA 21-1 level than those with thymoma (thymic carcinoma: median = 4.2 ng/ml; interquartile range [IQR] = 2.1-6.1 ng/ml vs. thymoma: median = 1.2 ng/ml; IQR = 0.9-1.7 ng/ml; p < 0.01). Receiver operating characteristic curves demonstrated that the area under the curve for CYFRA 21-1 to distinguish thymic carcinoma from thymoma was 0.86 (95% confidence interval [CI]: 0.74-0.93; cutoff = 2.7 ng/ml; sensitivity = 68.8%; specificity = 95.2%). Multivariable analysis demonstrated that CYFRA 21-1 (odds ratio = 25.6; 95% CI: 4.6-141.6; p < 0.01) was an independent predictor for thymic carcinoma after adjusting for TNM stage. CONCLUSIONS: Serum CYFRA 21-1 level may help in diagnosing thymic carcinoma.
  • Yusuke Motohashi, Tatsuya Kato, Nobuyasu Kato, Masato Aragaki, Aki Fujiwara-Kuroda, Tsuyoshi Tachibana, Yasuhiro Hida, Kichizo Kaga, Satoru Wakasa
    General thoracic and cardiovascular surgery 69 (12) 1575 - 1579 2021/09/21 [Refereed]
     
    A 4-year-old boy with left intralobar pulmonary sequestration associated with left main coronary artery obstruction (LMCAO) and severe mitral regurgitation (MR) was admitted to our hospital. Since the patient presented with dyskinesia of the cardiac apex and increased left ventricular end-diastolic volume (LVEDV), left main coronary artery reconstruction and mitral annuloplasty were performed. The enlargement of the left ventricle was improved after sequential surgeries. There was a risk of deterioration of MR and regrowth of LVEDV due to shunt blood flow; therefore, left lower lobectomy and aberrant artery division were performed. This is a very rare case of a patient with pulmonary sequestration associated with LMCAO and severe MR.
  • Satoru Wakasa
    Japanese Journal of Cardiovascular Surgery 50 (5) 5 - xxxviii 0285-1474 2021/09/15 [Not refereed][Invited]
  • Shinya Otsuka, Hideki Ujiie, Kosuke Ishikawa, Takahiro Miura, Satoru Wakasa, Tatsuya Kato
    The Annals of thoracic surgery 112 (6) e471  2021/09/04 [Refereed]
  • Jenny Lou, Masato Aragaki, Nicholas Bernards, Tomonari Kinoshita, Jessica Mo, Yamoto Motooka, Tsukasa Ishiwata, Alexander Gregor, Tess Chee, Zhenchian Chen, Juan Chen, Kichizo Kaga, Satoru Wakasa, Gang Zheng, Kazuhiro Yasufuku
    NANOPHOTONICS 10 (12) 3279 - 3294 2192-8606 2021/09 
    While photodynamic therapy (PDT) can induce acute inflammation in the irradiated tumor site, a sustained systemic, adaptive immune response is desirable, as it may control the growth of nonirradiated distant disease. Previously, we developed porphyrin lipoprotein (PLP), a similar to 20 nm nanoparticle photosensitizer, and observed that it not only efficiently eradicated irradiated primary VX2 buccal carcinomas in rabbits, but also induced regression of nonirradiated metastases in a draining lymph node. We hypothesized that PLP-mediated PDT can induce an abscopal effect and we sought to investigate the immune mechanism underlying such a response in a highly aggressive, dual subcutaneous AE17-OVA+ mesothelioma model in C57BL/6 mice. Four cycles of PLP-mediated PDT was sufficient to delay the growth of a distal, nonirradiated tumor four-fold relative to controls. Serum cytokine analysis revealed high interleukin-6 levels, showing a 30-fold increase relative to phosphate-buffered solution (PBS) treated mice. Flow cytometry revealed an increase in CD4+ T cells and effector memory CD8+ T cells in non-irradiated tumors. Notably, PDT in combination with PD-1 antibody therapy prolonged survival compared to monotherapy and PBS. PLP-mediated PDT shows promise in generating a systemic immune response that can complement other treatments, improving prognoses for patients with metastatic cancers.
  • 柴田利彦, 若狭哲
    胸部外科 74 (9) 652 - 653 0021-5252 2021/09/01 [Not refereed][Invited]
  • Shuhei Kii, Hirofumi Kamachi, Daisuke Abo, Takuya Kato, Yousuke Tsuruga, Kenji Wakayama, Tatsuhiko Kakisaka, Takeshi Soyama, Toshiya Kamiyama, Tomonori Ooka, Satoru Wakasa, Akinobu Taketomi
    Surgical case reports 7 (1) 174 - 174 2021/08/04 [Refereed]
     
    BACKGROUND: Pancreaticoduodenal artery aneurysms (PDAAs) are rare visceral aneurysms, and prompt intervention/treatment of all PDAAs is recommended at the time of diagnosis to avoid rupture of aneurysms. Herein, we report two cases of PDAA caused by the median arcuate ligament syndrome, treated with surgical revascularization by aortosplenic bypass followed by coil embolization. CASE PRESENTATION: Case 1 A 54-year-old woman presented with a chief complaint of severe epigastralgia and was diagnosed with two large fusiform inferior PDAAs and celiac axis occlusion. To preserve the blood flow of the pancreatic head, duodenum, liver, and spleen, we performed elective surgery to release the MAL along with aortosplenic bypass. At 6 days postoperatively, transcatheter arterial embolization was performed. At the 8-year 6-month follow-up observation, no recurrent perfusion of the embolized PDAAs or rupture had occurred, including the non-embolized small PDAA, and the bypass graft had excellent patency. Case 2 A 39-year-old man who had been in good health was found to have a PDAA with celiac stenosis during a medical checkup. Computed tomography and superior mesenteric arteriography showed severe celiac axis stenosis and a markedly dilated pancreatic arcade with a large saccular PDAA. To preserve the blood flow of the pancreatic arcade, we performed elective surgery to release the MAL along with aortosplenic bypass. At 9 days postoperatively, transcatheter arterial embolization was performed. At the 6-year 7-month follow-up observation, no recurrent perfusion or rupture of the PDAA had occurred, and the bypass graft had excellent patency. CONCLUSION: Combined treatment with bypass surgery and coil embolization can be an effective option for the treatment of PDAAs associated with celiac axis occlusion or severe stenosis.
  • Akihiro Masuzawa, Tomomitsu Takagi, Hirokuni Arai, Goro Matsumiya, Shuichiro Takanashi, Hitoshi Yaku, Tatsuhiko Komiya, Yoshiro Matsui, Satoru Wakasa, Takashi Kunihara
    Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 28 (1) 56 - 62 2021/08/02 [Refereed]
     
    OBJECTIVE: Mitral subvalvular procedures in addition to restrictive annuloplasty are promising for ischemic mitral regurgitation (IMR). However, the prevalence and efficacy of specific subvalvular repair in severe IMR have not been elucidated. This is the first nationwide survey regarding surgeons' attitudes toward IMR in Japan. METHODS: A questionnaire was sent to 543 institutions. From 2015 to 2019, numbers of elective first-time mitral valve replacement (MVR) with/without complete chordal preservation (CCP)/papillary muscle approximation (PMA) and mitral valvuloplasty (MVP) with/without papillary muscle relocation (PMR)/PMA in patients with severe IMR were collected. Concomitant procedures for coronary artery, tricuspid valve, and arrhythmia could be included but left ventricular reconstruction was excluded. RESULTS: Completed questionnaires were received from 286 institutions (52.7%). The majority (90%) had less than 20 cases within 5 years. The number of MVP (1413, 61.5%) surpassed MVR (886, 38.5%). CCP was performed in half of MVR (50.0%), while PMA was included in only 1.9% of MVR. PMA and PMR were also performed infrequently, in only 7.7% and 10.9% of MVP, respectively. CONCLUSION: Japanese surgeons aggressively perform MVP for severe IMR. Subvalvular repair was also aggressively performed in addition to MVR, but not to MVP. A multicenter registry study is in progress.
  • Kato Nobuyasu, Takeda Atsuhito, Arai Yosuke, Hatta Eiichiro, Yakuwa Satoshi, Shingu Yasushige, Ooka Tomonori, Wakasa Satoru
    Pediatric Cardiology and Cardiac Surgery 特定非営利活動法人 日本小児循環器学会 37 (2) 126 - 132 0911-1794 2021/08/01 [Refereed][Not invited]
     
    Left isomerism is frequently associated with anomalous systemic venous connection and common atrium, requiring systemic venous abnormality correction and common-atrium septation in biventricular repair. Our case was a 4-year-old girl diagnosed with left isomerism, dextrocardia, complete atrioventricular septal defect, common atrium, bilateral superior vena cava, and interruption of the inferior vena cava with hemiazygos vein connection. She underwent intracardiac repair with intra-atrial rerouting. Preoperative computed tomography suggested that extracardiac reconstruction of the anomalous systemic vein was inappropriate, and showed that all the pulmonary veins drain to the common chamber in the common atrium. Thus, the blood flow from the right superior vena cava was diverted into the left side of the common atrium through an intra-atrial tunnel. Complete atrioventricular septal defect was repaired with modified one-patch method, and the patch divided the common atrium into the right and left atria. She was discharged on postoperative day 11 without obstruction in systemic and pulmonary venous return. Therefore, if all the pulmonary veins drain to the common chamber, intra-atrial rerouting may effectively correct anomalous systemic venous connection in the septation of the common atrium.
  • Akihiro Sasaki, Tatsuya Kato, Hideki Ujiie, Satoru Wakasa, Setsuyuki Otake, Keisuke Kikuchi, Koichi Ohno
    Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 28 (6) 448 - 452 2021/07/16 [Refereed]
     
    INTRODUCTION: Stiff-person syndrome (SPS) is a rare autoimmune neurological disorder. Paraneoplastic SPS associated with malignant tumors such as thymoma occurs in approximately 5% of all SPS cases. We present a rare case of thymoma accompanied by SPS successfully treated using surgery. PRESENTATION OF CASE: A 26-year-old woman presented with lower limbs convulsions and gait disturbance and complained of leg pain. Cerebrospinal fluid and blood test results showed a high level of anti-glutamic acid decarboxylase (GAD) antibodies. Computed tomography showed anterior mediastinal tumor suggestive of a thymoma. She underwent extended thymectomy, and her symptoms gradually improved after surgery. No evidence of recurrent thymoma and SPS has been observed over 44 months. CONCLUSION: Surgical treatment would be effective for patients with SPS and thymoma.
  • Yoshinobu Watabe, Hideki Ujiie, Yoshihiro Matsuno, Hideaki Fukui, Aki Fujiwara-Kuroda, Tatsuya Kato, Yasuhiro Hida, Kichizo Kaga, Satoru Wakasa
    Chest 160 (1) e63-e67 - E67 0012-3692 2021/07 [Refereed]
     
    CASE PRESENTATION: A 57-year-old woman was admitted to our hospital for an abnormal chest shadow found during routine chest radiography. She had no respiratory symptoms. Her medical history included dyslipidemia, and her surgical history included conization for cervical cancer at age 38 years. She was a social drinker and ex-smoker of approximately 10 cigarettes per day (from ages 20 to 30 years); she denied recreational drug use.
  • Hirokazu Komoriyama, Kiwamu Kamiya, Toshiyuki Nagai, Noriko Oyama-Manabe, Satonori Tsuneta, Yuta Kobayashi, Yoshiya Kato, Miwa Sarashina, Kazunori Omote, Takao Konishi, Takuma Sato, Shingo Tsujinaga, Hiroyuki Iwano, Yasushige Shingu, Satoru Wakasa, Toshihisa Anzai
    Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 23 (1) 81 - 81 2021/06/28 [Refereed]
     
    BACKGROUND: Pre- and post-procedural hemodynamic changes which could affect adverse outcomes in aortic stenosis (AS) patients who undergo transcatheter aortic valve replacement (TAVR) have not been well investigated. Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) enables accurate analysis of blood flow dynamics such as flow velocity, flow pattern, wall shear stress (WSS), and energy loss (EL). We sought to examine the changes in blood flow dynamics of patients with severe AS who underwent TAVR. METHODS: We examined 32 consecutive severe AS patients who underwent TAVR between May 2018 and June 2019 (17 men, 82 ± 5 years, median left ventricular ejection fraction 61%, 6 self-expanding valve), after excluding those without CMR because of a contraindication or inadequate imaging from the analyses. We analyzed blood flow patterns, WSS and EL in the ascending aorta (AAo), and those changes before and after TAVR using 4D flow CMR. RESULTS: After TAVR, semi-quantified helical flow in the AAo was significantly decreased (1.4 ± 0.6 vs. 1.9 ± 0.8, P = 0.002), whereas vortical flow and eccentricity showed no significant changes. WSS along the ascending aortic circumference was significantly decreased in the left (P = 0.038) and left anterior (P = 0.033) wall at the basal level, right posterior (P = 0.011) and left (P = 0.010) wall at the middle level, and right (P = 0.012), left posterior (P = 0.019) and left anterior (P = 0.028) wall at the upper level. EL in the AAo was significantly decreased (15.6 [10.8-25.1 vs. 25.8 [18.6-36.2]] mW, P = 0.012). Furthermore, a significant negative correlation was observed between EL and effective orifice area index after TAVR (r = - 0.38, P = 0.034). CONCLUSIONS: In severe AS patients undergoing TAVR, 4D flow CMR demonstrates that TAVR improves blood flow dynamics, especially when a larger effective orifice area index is obtained.
  • Hirokazu Komoriyama, Kiwamu Kamiya, Yuta Kobayashi, Satonori Tsuneta, Takao Konishi, Takuma Sato, Hiroyuki Iwano, Toshiyuki Nagai, Satoru Wakasa, Kohsuke Kudo, Toshihisa Anzai
    Circulation journal : official journal of the Japanese Circulation Society 85 (6) 954 - 954 2021/05/25 [Refereed]
  • Satoru Wakasa, Yoshiro Matsui
    Circulation journal : official journal of the Japanese Circulation Society 85 (11) 2002 - 2003 2021/05/14 [Refereed][Invited]
  • Hiroshi Yamasaki, Hideki Ujiie, Tatsuya Kato, Yasuhiro Hida, Kichizo Kaga, Satoru Wakasa, Yoshihiro Matsuno
    Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 27 (6) 371 - 379 1341-1098 2021/05/14 [Refereed]
     
    PURPOSE: Pulmonary nodules suspected to be cancerous are rarely diagnosed as pulmonary infarction (PI). This study examined the clinical, radiological, and laboratory data in cases diagnosed with PI to determine their potential utility as preoperative diagnostic markers. We also assessed factors affecting the postoperative course. METHODS: A total of 603 cases of peripheral pulmonary nodules undiagnosed preoperatively were resected at Hokkaido University Hospital from 2012 to 2019. Of these, we reviewed cases with a postoperative diagnosis of PI. We investigated clinical symptoms, preoperative laboratory data, radiological characteristics, and postoperative complications. RESULTS: Four patients (0.7%) were diagnosed with PI. All patients had a smoking history. One patient received systemic steroid administration, and none had predisposing factors for thrombosis. One case showed chronologically increased nodule size. Three cases showed weak uptake of 18F-fluorodeoxyglucose. One patient with preoperative high D-dimer levels developed a massive pulmonary embolism (PE) in the postoperative chronic phase and was treated with anticoagulants. CONCLUSIONS: Preoperative diagnosis of PI is difficult, and we could not exclude lung cancer. However, if a patient diagnosed with PI has a high D-dimer level, we recommend postoperative physical examination for deep venous thrombosis. Prophylactic anticoagulation therapy should be considered to avoid fatal PE.
  • Shinya Otsuka, Hideki Ujiie, Tatsuya Kato, Haruhiko Shiiya, Aki Fujiwara-Kuroda, Yasuhiro Hida, Kichizo Kaga, Satoru Wakasa, Rei Inoue, Yasuaki Iimura
    Transplantation proceedings 53 (4) 1379 - 1381 2021/05 [Refereed]
     
    INTRODUCTION: Pneumatosis intestinalis (PI) is a rare but critical condition in which gas is found in the bowel wall. Although organ transplant recipients have an increased PI risk because of long-term immunosuppression, alpha-glucosidase inhibitors (α-GI), a standard diabetes therapy, often contribute to PI. However, little is known about the postorgan transplantation relationship between PI and α-GI. To the best of our knowledge, this is the first reported case of PI in a lung transplant recipient treated with α-GI. CASE REPORT: A 59-year-old man underwent hybrid (living-donor and cadaveric) lung transplantation (LTx). The patient was treated with prednisolone and tacrolimus as immunosuppressive therapy and α-GI for diabetes for 4 years. He developed asymptomatic PI 1031 days after transplantation without any acute abdominal finding. After excluding other possible causes of PI, his PI was attributed to α-GI. The suspected α-GI was immediately withdrawn. The patient was managed conservatively with bowel rest and oxygen therapy. After 11 days of α-GI discontinuation, PI improved, and the patient completely recovered. CONCLUSION: Physicians should keep this rare adverse drug reaction in mind when prescribing α-GI, particularly in patients with diabetes after organ transplantation and including LTx. The management strategy for asymptomatic PI caused by α-GI is the immediate discontinuation of α-GI therapy, followed by conservative management initiation.
  • Masato Aragaki, Yasuhiro Hida, Tatsuya Kato, Aki Fujiwara-Kuroda, Kichizo Kaga, Satoru Wakasa
    Journal of cancer research and clinical oncology 147 (5) 1519 - 1527 2021/05 [Refereed]
     
    PURPOSE: This study aimed to establish new criteria for limited resection of non-small cell lung cancer (NSCLC) based on computed tomography findings and maximum standardized uptake value (SUVmax). METHODS: Between December 2007 and December 2015, 611 patients underwent lung cancer surgery; of these, 70 with cT1aN0M0 who underwent limited resection were enrolled. Criteria for undergoing intentional limited resection (ILR) were (1) tumor ground-glass opacity (GGO) ratio of ≥ 0.75 and (2) tumor SUVmax ≤ 1.5. Patients who met criteria (1) and (2) underwent partial resection, and those who only met criteria (2) underwent segmentectomy as ILR. The control group was subjected to limited surgery without meeting the criteria. RESULTS: Overall, 45 and 25 patients who met the criteria were included in the ILR and control groups, respectively. In the ILR group, 13 patients underwent partial resection, and 32 underwent segmentectomy; in the control group, 18 patients underwent partial resection and 7 underwent segmentectomy. According to our criteria, no relapsed cases occurred in the ILR group, although six patients showed recurrence of lung cancer in the control group. The 5-year overall survival (OS) rates in the ILR and control groups were 100% and 67.7%, respectively, and the relapse-free survival (RFS) rates were 100% and 61.6%, respectively. The log-rank test showed that this difference was statistically significant (OS: P < 0.0001, RFS: P < 0.0001). CONCLUSIONS: SUVmax may serve as a predictive marker of recurrence to determine the treatment strategy for patients with NSCLC. Patients with low GGO ratio and low SUVmax may be cured by limited resection.
  • Norihiro Ando, Yasushige Shingu, Kenichiro Suno, Satoru Wakasa
    Biochemical and biophysical research communications 548 14 - 19 2021/04/09 [Refereed]
     
    Autophagy is an intracellular pathway that degrades unnecessary proteins and organelles and provides energy substrates during cellular ischemic conditions. Although pharmacological myocardial preconditioning with an autophagy inducer has been reported to protect cells against ischemic reperfusion (I/R), the effects of preconditioning using naturally occurring substances are still unknown. We aimed to examine whether autophagic preconditioning with trehalose improves cardiac function after myocardial stunning by global ischemia in rats. Rat hearts were perfused by oxygenized Krebs Henseleit (KH) solution in Langendorff system. Ten rats were randomized into the following two groups according to the perfusates during the preconditioning: control (KH solution only, n = 5) and trehalose (KH + 2% trehalose, n = 5). After the 35-min preconditioning period and subsequent 20 min of global ischemia, the hearts were reperfused for 60 min. Cardiac function was assessed during the reperfusion. To evaluate autophagy, myocardial protein expression of microtubule-associated protein light chain 3 (LC3) II was evaluated by western blotting. During I/R, a systolic functional parameter, maximum dP/dt was significantly higher; meanwhile, coronary flow tended to be higher in the trehalose group than in the control group. Myocardial LC3-II expression after preconditioning was higher in the trehalose group than in the control group and decreased to the control level after I/R. In conclusion, in a rat model of global myocardial ischemia, trehalose preconditioning improved cardiac function during I/R. Further studies would be needed to identify the mechanism and effects of trehalose preconditioning.
  • Yasunori Cho, Satoru Wakasa, Akihiko Usui, Kenji Minatoya, Hirokuni Arai, Hitoshi Yaku, Atsushi Yamaguchi, Tatsuhiko Komiya, Goro Matsumiya, Kimikazu Hamano, Yoshikatsu Saiki, Yoshiro Matsui
    General thoracic and cardiovascular surgery 69 (4) 679 - 689 2021/04 [Refereed]
     
    OBJECTIVES: There is uncertainty over the efficacy of additional surgical ventricular reconstruction (SVR) associated with mitral valve operation for non-ischaemic dilated cardiomyopathy (DCM). This study aims to assess mid-term outcomes of these non-heart transplant surgical approaches for DCM. METHODS: We reviewed retrospectively 106 patients (median age 64, 44 females) who underwent isolated mitral annular plasty (MAP; n = 34), mitral valve replacement (MVR; n = 29), and SVR associated with MAP (SVR + MAP; n = 43) for DCM, in 11 Japanese hospitals. We analysed mid-term outcomes, specifically freedom from cardiac death and cardiac event. RESULTS: Hospital deaths occurred in 16 patients (15.1%) and cardiac deaths in 36 patients (34.0%) during the study period of 4.4 ± 3.5 years. Freedom from cardiac death at 7 years in patients undergoing MAP, MVR, and SVR + MAP were, respectively, 79.1%, 82.6%, and 29.5% (P < 0.0001). Freedom from cardiac event at 7 years in patients undergoing MAP, MVR, and SVR + MAP were, respectively, 42.8%, 59.9%, 22.6% (P = 0.0004). In the multivariable analyses, preoperative tricuspid regurgitation (TR) grade was the only risk factor for both cardiac death and event, whereas MVR for DCM emerged as a protective factor for cardiac event. CONCLUSIONS: This study could not show any benefit of additional SVR, by means of volume reduction, to MAP, because the baseline characteristics were different even after the stratification of DCM grade. MVR can be performed with favorable mid-term outcomes even in patients with advanced DCM, while patients undergoing MAP with/without SVR had more frequent MR recurrence or cardiac events. Interestingly, the right ventricular feature is a predictor of both cardiac death and events, with the TR grade being a predictor of poor mid-term outcomes.
  • Yasushige Shingu, Nobuyasu Katoh, Tomonori Ooka, Hiroki Katoh, Satoru Wakasa
    General thoracic and cardiovascular surgery 69 (11) 1460 - 1466 2021/03/10 [Refereed]
     
    OBJECTIVES: L-Carnitine, a quaternary amine, improves fatty acid metabolism in the heart and has anti-inflammatory effects. Several studies have reported the efficacy of L-carnitine for the prophylaxis of arrhythmia. We assessed the clinical effectiveness of L-carnitine in preventing postoperative atrial fibrillation (POAF) in aortic valve surgery. METHODS: Thirty patients who underwent aortic valve surgery were included. Fifteen patients had no prophylaxis other than conventional measures (control), while 15 patients received oral L-carnitine for 9 days (daily dose of 3 g). The incidence of POAF during 1 week after surgery was compared between the two groups. The multivariable logistic regression analysis for POAF was performed using the pre- and intraoperative parameters. RESULTS: Preoperative characteristics and operative data were comparable between the groups. The POAF rate was significantly lower in the L-carnitine group than in the control (20% and 60%, respectively; P = 0.025). L-Carnitine use was an independently negative predictor for POAF (odds ratio 0.067; 95% confidence interval 0.006-0.768). CONCLUSIONS: L-Carnitine administration may have potential for the prevention of POAF in aortic valve surgery.
  • Tatsuya Kato, Hideki Ujiie, Kanako C Hatanaka, Ayae Nange, Asami Okumura, Kaho Tsubame, Kentato Naruchi, Masaharu Sato, Kichizo Kaga, Yoshihiro Matsuno, Satoru Wakasa, Yutaka Hatanaka
    Oncology letters 21 (3) 202 - 202 2021/03 [Refereed]
     
    Mucin 1 (MUC1) expression is upregulated in multiple types of cancer, including lung cancer. However, the conventional anti-MUC1 antibody is not useful for the differentiation of malignant lung tumors and benign lesions due to its limited specificity. Our previous study screened a novel epitope-defined antibody against cancer-associated sugar chain structures that specifically recognizes the MUC1 Tn antigen (MUC1-Tn ED Ab). In the present study, its potential utility as a diagnostic marker and therapeutic tool for lung adenocarcinoma (ADC) was examined. Immunohistochemical analysis of a lung ADC tissue microarray was performed using the MUC1-Tn ED Ab (clone SN-102), and the results were compared with those of another clone and commercially available MUC1 antibodies. The association between positive immunoreactivity of SN-102 and clinicopathologic factors was analyzed. Furthermore, the association between MUC1-Tn expression and epithelial-mesenchymal transition markers and radiological characteristics was analyzed. Moderate or high MUC1-Tn expression (MUC1-Tn-H) was observed in 138 (78.9%) of the 175 lung ADC cases. MUC1-Tn-H was associated with male sex, cigarette smoking, tumor extension, pleural invasion, and higher preoperative serum carcinoembryonic antigen and cytokeratin 19 fragment levels. Tumors with MUC1-Tn-H had higher consolidation/tumor ratios according to computed tomography and greater uptakes of 18F-fluorodeoxyglucose. A total of 46 (26.9%) of the tumors had mesenchymal features, and MUC1-Tn positivity was higher in the mesenchymal group than in the epithelial and intermediate groups (P<0.01 and P<0.01, respectively). Patients with tumors exhibiting MUC1-Tn-H had significantly shorter 5-year overall and disease-free survival times (P=0.011 and P<0.001, respectively). Additionally, MUC1-Tn-H was identified as an independent prognostic factor in multivariate analysis (P=0.024). MUC1-Tn is specific for lung cancer cells and can improve diagnostic capabilities. Additionally, it may be a potential therapeutic target in lung ADC.
  • Hideki Ujiie, Aogu Yamaguchi, Alexander Gregor, Harley Chan, Tatsuya Kato, Yasuhiro Hida, Kichizo Kaga, Satoru Wakasa, Chad Eitel, Tod R Clapp, Kazuhiro Yasufuku
    Journal of thoracic disease 13 (2) 778 - 783 2021/02 [Refereed]
     
    Background: Video-assisted thoracoscopic surgery (VATS) has become a standard approach for the treatment of lung cancer. However, its minimally invasive nature limits the field of view and reduces tactile feedback. These limitations make it vital that surgeons thoroughly familiarize themselves with the patient's anatomy preoperatively. We have developed a virtual reality (VR) surgical navigation system using head-mounted displays (HMD). The aim of this study was to investigate the potential utility of this VR simulation system in both preoperative planning and intraoperative assistance, including support during thoracoscopic sublobar resection. Methods: Three-dimensional (3D) polygon data derived from preoperative computed tomography data was loaded into BananaVision software developed at Colorado State University and displayed on an HMD. An interactive 3D reconstruction image was created, in which all the pulmonary structures could be individually imaged. Preoperative resection simulations were performed with patient-individualized reconstructed 3D images. Results: The 3D anatomic structure of pulmonary vessels and a clear vision into the space between the lesion and adjacent tissues were successfully appreciated during preoperative simulation. Surgeons could easily evaluate the real patient's anatomy in preoperative simulations to improve the accuracy and safety of actual surgery. The VR software and HMD allowed surgeons to visualize and interact with real patient data in true 3D providing a unique perspective. Conclusions: This initial experience suggests that a VR simulation with HMD facilitated preoperative simulation. Routine imaging modalities combined with VR systems could substantially improve preoperative planning and contribute to the safety and accuracy of anatomic resection.
  • Yusuke Motohashi, Tatsuya Kato, Masato Aragaki, Aki Fujiwara-Kuroda, Yasuhiro Hida, Satoru Wakasa, Kichizo Kaga
    General thoracic and cardiovascular surgery 69 (2) 383 - 387 2021/02 [Refereed][Not invited]
     
    A 33-year-old man with left pulmonary sequestration was admitted to our hospital. We planned left basilar segmentectomy to preserve the lung function, using indocyanine green (ICG) and near-infrared thoracoscopy. The intravenous (IV) administration of ICG (0.1 mg/kg) showed the distribution of fluorescence from the aberrant arteries, blood flow blockage from the aberrant arteries after they were divided, and the superior-basal boundary after the pulmonary artery and vein were divided. In adult patients with intralobar pulmonary sequestration, ICG and near-infrared thoracoscopic techniques are useful to confirm abnormal hemodynamics and demonstrate a safe and successful basilar segmentectomy.
  • Kubota Takehiro, Shingu Yasushige, Wakasa Satoru
    Japanese Journal of Cardiovascular Surgery 特定非営利活動法人 日本心臓血管外科学会 50 (4) 270 - 273 0285-1474 2021 [Refereed]
     

    We report a case of multiple papillary fibroelastoma (PFE) on the aortic valve. A healthy woman in her 60 s was referred to a nearby doctor with the chief complaint of palpitation and was admitted to our hospital for detailed examination. A mobile tumor was found by transthoracic echo, and she was introduced to us. We undertook excision surgery for her. Initially, it was thought to be a single tumor, and a pedunculated tumor adhering to the central aortic side of the left coronary cusp with a length of 7 mm was removed. After closing the aorta, we recognized a remaining mobile tumor by transesophageal echo. We decided to perform cardiac arrest again, and we recognized one tumor with 6 mm long string-like mobile mass on the right and non-coronary commissure of cardiac side, and a thorn-like mass of about 1.5 mm on the non-coronary cusp of the cardiac side. We removed both tumors from the aortic valve using shaving resection and preserved the aortic valve. All of these were found to be PFE pathologically as if they were three tumors that followed the developmental stage of PFE. After surgery, PFE recurrence is extremely rare. In the case of a pedunculated tumor, it is possible to remove the tumor and preserve the valve. However, as in this case, if both sides of the valve were not carefully inspected, it can be overlooked. In addition, small tumor resection could avoid the risk of new cerebral infarction and myocardial infarction due to recurrence and could avoid reoperation.

  • 氏家 秀樹, 樋田 泰浩, 大塚 慎也, 佐々木 明洋, 山崎 洋, 藤原 晶, 加藤 達哉, 加賀 基知三, 若狭 哲, 松野 吉宏
    日本外科学会雑誌 = Journal of Japan Surgical Society 日本外科学会 122 (1) 18 - 25 0301-4894 2021 [Not refereed]
     
    定型カルチノイドは低悪性度(高分化型)な肺神経内分泌腫瘍(Neuroendocrine neoplasms、NEN)であり、比較的緩徐に増大し、胸部外の臓器に転移することはほとんどないとされている。本邦の2018年度肺癌診療ガイドライン、およびNational Comprehensive Cancer Network(NCCN)ガイドラインによると、カルチノイドの治療は、カルチノイドの種類(定型、異型)および腫瘍の進展度(切除可否)に大きく依存する。一般的に、切除可能な限局型のカルチノイド腫瘍は、非小細胞肺癌と同様に肺葉切除術および縦隔リンパ節郭清術で治癒し、他の治療を必要としない。定型カルチノイドでは、異型カルチノイドと比べてリンパ節転移の可能性も低く、十分な切除断端が確保できれば、気管支管状切除などの肺温存手術を試みることができる。稀に切除不能な定型カルチノイドが存在するが、緩徐に成長する傾向があり、化学療法と放射線治療の利点は不明であるため、経過観察になることも多い。ソマトスタチンレセプター陽性例に対しては、ソマトスタチンアナログによる治療を考慮する。以上より、カルチノイドの治療は、カルチノイドの種類、および腫瘍の進展度に大きく依存するため、適切な病期・病理診断が重要である。(著者抄録)
  • Nobuyasu Kato, Tsuyoshi Tachibana, Hidetsugu Asai, Noriyoshi Ebuoka, Yasushige Shingu, Tomonori Ooka, Hiroki Kato, Satoru Wakasa
    The Annals of thoracic surgery 110 (5) e361-e363  2020/11 [Refereed][Not invited]
     
    Persistent fifth aortic arch (AA) is a rare anomaly in congenital heart disease, which is often associated with aortic obstructive diseases. We report a 7-month-old infant diagnosed with persistent fifth AA with left ventricular dysfunction along with left bronchial malacia due to compression from their own heart. Surgical repair was performed, including AA reconstruction using the fifth AA as an in situ flap to enlarge the fourth AA with end-to-end anastomosis, and external stenting for the left bronchial malacia. Postoperative courses were uneventful. On computed tomography, a reconstructed AA without obstruction and an expanded left bronchus were seen.
  • 佐藤 公治, 杉本 聡, 加藤 伸康, 新宮 康栄, 杉木 宏司, 加藤 裕貴, 大岡 智学, 若狭 哲
    日本胸部外科学会定期学術集会 (一社)日本胸部外科学会 73回 CTA1 - 5 2020/10
  • 心嚢ドレナージ術と食道減圧ドレナージ術で保存的に軽快した食道心嚢瘻の一例
    植木 知音, 東嶋 宏泰, 楢崎 肇, 倉島 庸, 海老原 裕磨, 村上 壮一, 七戸 俊明, 若狭 哲, 平野 聡
    日本胸部外科学会定期学術集会 (一社)日本胸部外科学会 73回 ECPA1 - 2 2020/10
  • Masato Aragaki, Tatsuya Kato, Aki Fujiwara-Kuroda, Yasuhiro Hida, Kichizo Kaga, Satoru Wakasa
    Journal of cardiothoracic surgery 15 (1) 229 - 229 2020/08/28 [Refereed][Not invited]
     
    BACKGROUND: Given the difficulty in preoperatively diagnosing lymph node metastasis, patients with Stage I-III non-small cell lung cancer (NSCLC) are likely to be included in the clinical N1 (cN1) group. However, better treatment options might be selected through further stratification. This study aimed to identify preoperative clinicopathological prognostic and stratification factors for patients with cN1 NSCLC. METHODS: This retrospective study evaluated 60 patients who were diagnosed with NSCLC during 2004-2014. Clinical nodal status had been evaluated using routine chest computed tomography (CT) and/or positron emission tomography (PET). To avoid biasing the fluorodeoxyglucose uptake values based on inter-institution or inter-model differences, we used only two PET systems (one PET system and one PET/CT system). Relapse-free survival (RFS) and overall survival (OS) were the primary study outcomes. The maximum standardized uptake value (SUVmax) was calculated for each tumor and categorized as low or high based on the median value. Patient sex, age, histology, tumor size, and tumor markers were also assessed. RESULTS: Poor OS was associated with older age (P = 0.0159) and high SUVmax values (P = 0.0142). Poor RFS was associated with positive carcinoembryonic antigen (CEA) expression (P = 0.0035) and high SUVmax values (P = 0.015). Multivariate analyses confirmed that poor OS was independently predicted by older age (hazard ratio [HR] = 2.751, confidence interval [CI]: 1.300-5.822; P = 0.0081) and high SUVmax values (HR = 5.121, 95% CI: 1.759-14.910; P = 0.0027). Furthermore, poor RFS was independently predicted by positive CEA expression (HR = 2.376, 95% CI: 1.056-5.348; P = 0.0366) and high SUVmax values (HR = 2.789, 95% CI: 1.042-7.458; P = 0.0410). The primary tumor's SUVmax value was also an independent prognostic factor for both OS and RFS. CONCLUSIONS: For patients with cN1 NSCLC, preoperative prognosis and stratification might be performed based on CEA expression, age, and the primary tumor's SUVmax value. To enhance the prognostic value of the primary tumor's SUVmax value, minimizing bias between facilities and models could lead to a more accurate prognostication.
  • Tomoya Sato, Takao Konishi, Satoru Wakasa, Noriko Oyama-Manabe, Toshihisa Anzai
    European heart journal 41 (27) 2596 - 2596 2020/07/14 [Refereed][Not invited]
  • 加賀 基知三, 樋田 泰浩, 加藤 達哉, 藤原(黒田) 晶, 椎名 伸行, 氏家 秀樹, 佐々木 明洋, 山崎 洋, 若狭 哲
    北海道外科雑誌 = The Hokkaido journal of surgery 北海道外科学会 65 (1) 2 - 7 0288-7509 2020/06 [Not refereed][Not invited]
     
    先天性嚢胞性肺疾患で最も頻度の高い先天性肺気道奇形は、出生時の呼吸障害やその後の肺炎の併発のために外科的治療の対象となる。無症候性の先天性肺気道奇形の手術適応や適切な手術時期は明確ではない。一方、小児に対する胸腔鏡手術は低侵襲であると報告されているものの、成人と比較すると難易度は高い。小児に対する胸腔鏡手術が広く行われるようになると、適切な手術時期の決定はさらに複雑になるだろう。本疾患はまれな疾患であり、臨床的に小児外科と呼吸器外科の間(はざま)に存在するため、両領域の協力が必要である。本稿では現時点での論点を概説する。(著者抄録)
  • Satoshi Sugimoto, Yasushige Shingu, Torsten Doenst, Tomoji Yamakawa, Hidetsugu Asai, Satoru Wakasa, Yoshiro Matsui
    The Journal of thoracic and cardiovascular surgery 2020/02/19 [Refereed][Not invited]
     
    OBJECTIVES: Myocardial autophagy has been recognized as an important factor in heart failure. It is not known whether changes in ventricular geometry by left ventriculoplasty influence autophagy in ischemic cardiomyopathy. We hypothesized that myocardial autophagy plays an important role in left ventricular (LV) redilation after ventriculoplasty. METHODS: Four weeks after ligation of the left anterior descending artery, ventriculoplasty or sham operation was performed. The animals were euthanized at 2 days (early) or 28 days (late) after the second operation. Ventricular autophagy was evaluated by protein expression of microtubule-associated protein light chain 3 II, an autophagosome marker. Cardiomyocyte area was assessed by histologic examination. LV function was evaluated by echocardiography. To examine the implications of autophagy, an autophagy inhibitor (3-methyladenine) was injected intraperitoneally for 3 weeks before sacrifice. RESULTS: The LV was reduced in size early and redilated late after ventriculoplasty. LV systolic function was improved early and later worsened after ventriculoplasty. Light chain 3 II expression decreased early after ventriculoplasty and increased in the late period. Myocyte area increased from the early to late stage after ventriculoplasty. Autophagic inhibition exaggerated the increased myocyte hypertrophy and LV redilation. CONCLUSIONS: In a rat model of myocardial infarction, autophagy decreased early after ventriculoplasty and increased again during LV redilation. These results provide new insights into the mechanism underlying the late failure of ventriculoplasty.
  • ステントグラフト温存型動脈瘤切除術の中間成績(Midterm results of stent graft-conserving aneurysmorrhaphy)
    佐藤 公治, 若狭 哲, 新宮 康栄, 杉木 宏司, 加藤 裕貴, 大岡 智学
    日本血管外科学会雑誌 29 (Suppl.) SY11 - 5 0918-6778 2020
  • ステントグラフト温存型動脈瘤切除術の中間成績(Midterm results of stent graft-conserving aneurysmorrhaphy)
    佐藤 公治, 若狭 哲, 新宮 康栄, 杉木 宏司, 加藤 裕貴, 大岡 智学
    日本血管外科学会雑誌 29 (Suppl.) SY11 - 5 0918-6778 2020
  • Takahiro Ishigaki, Yasushige Shingu, Nobuyasu Katoh, Satoru Wakasa, Hiroki Katoh, Tomonori Ooka, Suguru Kubota, Yoshiro Matsui
    General thoracic and cardiovascular surgery 68 (1) 30 - 37 1863-6705 2020/01 [Refereed][Not invited]
     
    OBJECTIVES: The slope in the preload recruitable stroke work relationship is a highly linear, load-insensitive contractile parameter. However, the perioperative change of the slope has not been reported before. We examined the perioperative slope from a steady-state single beat in patients with functional mitral regurgitation and assessed the correlation with brain natriuretic peptide (BNP) levels. METHODS: The study included 16 patients with non-ischemic dilated cardiomyopathy and refractory heart failure: 10 patients underwent mitral valve plasty and left ventricular plasty (MVP + LVP group) and 6 patients who underwent mitral valve replacement and papillary muscle tugging approximation (MVR + PMTA group). The left ventricular ejection fraction was assessed by the modified Simpson method; the slope was assessed by the single-beat technique using transthoracic echocardiography. BNP levels were measured by chemiluminescent immunoassay. RESULTS: The left ventricular ejection fraction and slope did not significantly change from pre- to early post-surgery in the MVP + LVP group. Both the left ventricular ejection fraction and slope significantly increased 6 months after surgery in the MVR + PMTA group. Postoperative BNP level was low in the MVR + PMTA group. While the postoperative left ventricular ejection fraction did not correlate with BNP levels, the postoperative slope significantly correlated with BNP level after surgery in the MVP + LVP group and in the total functional mitral regurgitation group. CONCLUSIONS: The change of slope was dependent on surgical procedures. In functional mitral regurgitation, the slope may be a more sensitive parameter in reflecting the left ventricular contractile function than the left ventricular ejection fraction.
  • 卵円孔開存による慢性の右左シャントとplatypnea-orthodeoxia syndromeを合併した重症右心不全の1例
    佐藤 隆博, 伊東 直史, 魚住 健志, 児島 裕一, 須野 賢一郎, 佐藤 公治, 松名 伸記, 白井 真也, 若狭 哲, 神垣 光徳
    KKR札幌医療センター医学雑誌 KKR札幌医療センター 16 (1) 59 - 62 1881-6207 2019/12 [Not refereed][Not invited]
     
    症例は80歳代男性。外科で鼠経ヘルニア術後に呼吸状態の悪化を認めICUに入室。その際に卵円孔開存による右左シャントと三尖弁閉鎖不全症を伴った右心不全を認め循環器内科紹介となった。内科的治療により一般病棟に退出し、リハビリを開始した。臥位でも軽度の低酸素血症を認めていたが呼吸苦は認めなかった。しかし、立位で呼吸困難と低酸素血症の増悪を認めた。これはplatypnea-orthodeoxia syndromeという稀な病態であった。ADLの改善が進まなかったため、開心術にて卵円孔閉鎖と三尖弁形成術を行い、低酸素血症、呼吸困難の改善を認めリハビリも進み自宅退院をめざしリハビリ転院となった。(著者抄録)
  • Annelieke H J Petrus, Robert J M Klautz, Michele De Bonis, Frank Langer, Hans-Joachim Schäfers, Satoru Wakasa, Alec Vahanian, Jean-Francois Obadia, Roland Assi, Michael Acker, Matthias Siepe, Jerry Braun
    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 56 (4) 631 - 642 2019/10/01 [Refereed][Not invited]
  • Tatsuya Seki, Yasushige Shingu, Satoru Wakasa, Hiroki Katoh, Tomonori Ooka, Tsuyoshi Tachibana, Suguru Kubota, Yoshiro Matsui
    Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs 22 (2) 177 - 180 1434-7229 2019/06 [Refereed][Not invited]
     
    Transvalvular leakage (TVL) of a prosthetic heart valve is not negligible regurgitant flow in patients with critically low contractile function. Although the opening function of prosthetic valves has been reported, its closing function is not well understood. A man in his 70 s had a history of mitral valve replacement (MVR) with a Magna Mitral® valve for ischemic mitral valve regurgitation. He presented with dyspnea 2 years postoperatively. Echocardiography showed moderate TVL. The pulmonary capillary wedge pressure and cardiac index were 37 mmHg and 1.65 L/min/m2, respectively. Because we considered his TVL relevant, we performed re-do MVR with a mechanical valve and papillary muscle approximation and suspension ("papillary muscle tugging approximation"). His cardiac function improved postoperatively; he was discharged with New York Heart Association class I. For MVR in patients with critically low contractile function, prosthetic valves, such as mechanical valves, with small TVL are recommended.
  • Tatsuya Seki, Katsuyoshi Jimuro, Yasushige Shingu, Satoru Wakasa, Hiroki Katoh, Tomonori Ooka, Tsuyoshi Tachibana, Suguru Kubota, Toshiro Ohashi, Yoshiro Matsui
    Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs 22 (2) 126 - 133 1434-7229 2019/06 [Refereed][Not invited]
     
    Ideally, an annuloplasty ring's shape should be changed intraoperatively if mitral valve repair is unsuccessful because of a short coaptation length or systolic anterior motion. Several post-implantation adjustable rings have been developed, but they are not freely deformable and are unsuitable for asymmetric repair of the valvular annulus. We developed a novel thermally deformable mitral annuloplasty ring to address these problems and assessed the ring's mechanical properties and its effect on the mitral valve anatomy. This ring was made of polycaprolactone. Tensile and bending tests were performed to evaluate the ring's mechanical properties. The ratio of the transverse and septal-lateral length was determined as 4:3. Using 10 pig hearts, we measured the post-deformation coaptation length and minimum distance from the coaptation to the ventricular septum, which is a factor of abnormal systolic anterior motion of the mitral valve. In the mechanical tests, the ring's yield point was greater than the deformation force of the annulus in humans. In pigs with deformation from "4:3" to "4:2", the coaptation length was significantly increased in each mitral valve part. In pigs with deformation from "4:3" to "4:4", the minimum distance from the coaptation to the ventricular septum was significantly increased. Asymmetrical ring deformation increased the coaptation length only at the deformed area. In conclusion, this new thermally deformable mitral annuloplasty ring could be "order-made" to effectively change the coaptation length in all parts of the mitral valve and the distance from the coaptation to septum post-deformation via intraoperative heating.
  • Yoshiro Matsui, Yasushige Shingu, Satoru Wakasa, Tomonori Ooka, Suguru Kubota
    The Annals of thoracic surgery 107 (6) e427-e429 - e429 0003-4975 2019/06 [Refereed][Not invited]
     
    The surgical approach is challenging for patients with severe functional mitral regurgitation with nonischemic/ischemic dilated cardiomyopathy who are unsuitable for heart transplantation or ventricular assist device implantation. We developed a new surgical treatment named papillary muscle tugging approximation combined with mitral valve replacement. This technique is safe and feasible, with excellent midterm outcomes.
  • Takayuki Nakajima, Takashi Yokota, Yasushige Shingu, Akira Yamada, Yutaka Iba, Kosuke Ujihira, Satoru Wakasa, Tomonori Ooka, Shingo Takada, Ryosuke Shirakawa, Takashi Katayama, Takaaki Furihata, Arata Fukushima, Ryosuke Matsuoka, Hiroshi Nishihara, Flemming Dela, Katsuhiko Nakanishi, Yoshiro Matsui, Shintaro Kinugawa
    Scientific reports 9 (1) 3535 - 3535 2019/03/05 [Refereed][Not invited]
     
    Epicardial adipose tissue (EAT), a source of adipokines, is metabolically active, but the role of EAT mitochondria in coronary artery disease (CAD) has not been established. We investigated the association between EAT mitochondrial respiratory capacity, adiponectin concentration in the EAT, and coronary atherosclerosis. EAT samples were obtained from 25 patients who underwent elective cardiac surgery. Based on the coronary angiographycal findings, the patients were divided into two groups; coronary artery disease (CAD; n = 14) and non-CAD (n = 11) groups. The mitochondrial respiratory capacities including oxidative phosphorylation (OXPHOS) capacity with non-fatty acid (complex I and complex I + II-linked) substrates and fatty acids in the EAT were significantly lowered in CAD patients. The EAT mitochondrial OXPHOS capacities had a close and inverse correlation with the severity of coronary artery stenosis evaluated by the Gensini score. Intriguingly, the protein level of adiponectin, an anti-atherogenic adipokine, in the EAT was significantly reduced in CAD patients, and it was positively correlated with the mitochondrial OXPHOS capacities in the EAT and inversely correlated with the Gensini score. Our study showed that impaired mitochondrial OXPHOS capacity in the EAT was closely linked to decreased concentration of adiponectin in the EAT and severity of coronary atherosclerosis.
  • Kazuya Kobayashi, Satoru Wakasa, Koji Sato, Satoshi Kanai, Hiroaki Date, Satomi Kimura, Noriko Oyama-Manabe, Yoshiro Matsui
    Physics in medicine and biology 64 (5) 055009 - 055009 0031-9155 2019/02/25 [Refereed][Not invited]
     
    Regional cardiac function analysis is important for the diagnosis and treatment planning of ischemic heart disease, but has not been sufficiently developed in the field of computed tomography (CT). Therefore, we propose a 3D endocardial tracking framework for cardiac CT using local point cloud registration based on the iterative closest point with an integrated scale estimation algorithm. We also introduce regional function descriptors that express the curvature and stretching of the endocardium: Surface distortion (E) and Scaling rate (S). For a region-to-region comparison, we propose endocardial segmentation according to coronary perfusion territories defined by the Voronoi partition based on coronary distribution. Our study of 65 endocardial segments in ten subjects showed that global endocardial deformation has a positive relationship with the stroke volume index (r  =  0.896 and 0.829 in [Formula: see text] and [Formula: see text], respectively) and ejection fraction (r  =  0.804 and 0.835), and a positive relationship with the brain natriuretic peptide level (r  =  0.690 and 0.776). A positive relationship between segmental E and S (r  =  0.845), a higher value of E in ischemic segments (p   =  0.021) that are determined by fractional flow reserve estimated from coronary CT data, and a higher value of S in the left circumflex artery territory (p   <  0.05) were also observed. The required radiation dose was 5.0  ±  0.7 mSv and the computation time was 7.2  ±  1.1 min. The result suggests that proposed endocardial deformation analysis using CT can be conducted on site and in time for the acute setting, and may be useful for the diagnosis of cardiac dysfunction or myocardial ischemia.
  • Sato Koji, Suno Kenichiro, Wakasa Satoru
    Japanese Journal of Cardiovascular Surgery 特定非営利活動法人 日本心臓血管外科学会 48 (4) 254 - 258 0285-1474 2019 [Refereed][Not invited]
     

    A 41-year-old man who had a history of suicide attempt by self-stabbing of the chest at the age of 15 and surgical repair of the stab wound of the heart was transferred to a neurosurgical hospital suffering from right hemiparesis. Stroke was diagnosed and he successfully underwent endovascular thrombectomy but postoperative computed tomography revealed left ventricular aneurysm and intracavitary thrombus that could have caused the embolic stroke. He was transferred to our hospital for cardiac surgery to prevent another embolization. Although an emergency operation had been attempted for the large and mobile thrombus, the patient was carefully observed for 4 weeks prior to surgery because of acute and huge stroke with a high risk of perioperative intracranial hemorrhage. After a fortunately uneventful observation, thrombectomy with left ventriculoplasty was performed successfully and the postoperative course was uneventful without neurological impairment. To prevent a fatal embolic event, postoperative follow-up after successful repair of cardiac injury is mandatory.

  • Ishigaki Takahiro, Shingu Yasushige, Kato Nobuyasu, Wakasa Satoru, Ooka Tomonori, Katoh Hiroki, Matsui Yoshiro
    Japanese Journal of Cardiovascular Surgery 特定非営利活動法人 日本心臓血管外科学会 48 (6) 405 - 410 0285-1474 2019 [Refereed][Not invited]
     

    A female in her 60 s with a mobile cardiac tumor in the left atrium was referred to our hospital. The tumor was diagnosed as myxoma by echocardiography, CT scan, and MRI. Under cardiac arrest using cardiopulmonary bypass, we resected the tumor through the superior trans-septal approach. We resected two tumors (tumor 1 and 2) with adequate rims of the interatrial septum to avoid recurrence. Although the tumor had a broad base and extended to near the mitral annulus, mitral valve repair was not necessary. Tumor 1 was gelatinous and seemed to be a myxoma ; tumor 2 had a lot of papillary structures attached to the solid mass and presented with the figure of a sea anemone when it was put in saline, which is typical for papillary fibroelastomas. The defect of the interatrial septum was closed with the autologous pericardium. The postoperative course was uneventful. Unexpectedly, both tumor 1 and 2 were diagnosed as myxomas on pathological examination. Tumor 2 (papillary lesion) included a few tumor cells with positive staining of calretinin typical for myxoma and was diagnosed as a "villous-type myxoma". Because it is difficult to distinguish myxoma from papillary fibroelastoma by pre- and intraoperative findings, it would be recommended to resect tumors with an adequate margin to prevent recurrence.

  • Satoru Wakasa, Yoshiro Matsui, Junjiro Kobayashi, Yasunori Cho, Hitoshi Yaku, Goro Matsumiya, Tadashi Isomura, Shuichiro Takanashi, Akihiko Usui, Ryuzo Sakata, Tatsuhiko Komiya, Yoshiki Sawa, Yoshikatsu Saiki, Hideyuki Shimizu, Atsushi Yamaguchi, Kimikazu Hamano, Hirokuni Arai
    The Journal of thoracic and cardiovascular surgery 156 (6) 2088 - 2096 0022-5223 2018/12 [Refereed][Not invited]
     
    OBJECTIVES: The postoperative left ventricular end-systolic volume index and ejection fraction are benchmarks of surgical ventricular reconstruction but remain unpredictable. This study aimed to identify who could be associated with a higher long-term survival by adding surgical ventricular reconstruction to coronary artery bypass grafting than coronary artery bypass grafting alone (responders to surgical ventricular reconstruction). METHODS: The subjects were 293 patients (median age, 63 years; 255 men) who underwent coronary artery bypass grafting for ischemic heart disease with left ventricular dysfunction in 16 cardiovascular centers in Japan. The relationships among surgical ventricular reconstruction, postoperative end-systolic volume index, ejection fraction, and survival were analyzed to identify responders to surgical ventricular reconstruction. RESULTS: Surgical ventricular reconstruction was performed in 165 patients (56%). The end-systolic volume index and ejection fraction significantly improved (end-systolic volume index, 91 to 64 mL/m2; ejection fraction, 28% to 35%) for all patients. The postoperative end-systolic volume index and ejection fraction were estimated, and surgical ventricular reconstruction was found to be significantly associated with both end-systolic volume index (14.5 mL/m2 reduction, P < .001) and ejection fraction (3.1% increase, P = .003). During the median follow-up of 6.8 years, 69 patients (24%) died. Only the postoperative ejection fraction was significantly associated with survival (hazard ratio, 0.925; 95% confidence interval, 0.885-0.968), although this effect was limited to those with postoperative end-systolic volume index of 40 to 80 mL/m2 in the subgroup analysis (hazard ratio, 0.932; 95% confidence interval, 0.894-0.973). CONCLUSIONS: Adding surgical ventricular reconstruction to coronary artery bypass grafting could reduce the mortality risk by increasing ejection fraction for those with a postoperative end-systolic volume index within a specific range. The postoperative end-systolic volume index could demarcate responders to surgical ventricular reconstruction, and its estimation can help in surgical decision making.
  • Hidetsugu Asai, Tsuyoshi Tachibana, Yasushige Shingu, Hiroki Kato, Satoru Wakasa, Yoshiro Matsui
    Asian cardiovascular & thoracic annals 26 (9) 701 - 703 0218-4923 2018/11 [Refereed][Not invited]
     
    The left superior vena cava became occluded in an infant with hypoplastic left heart syndrome. After a bidirectional Glenn procedure, he presented with severe oxygen desaturation and right ventricular dysfunction; the left superior vena cava drained into the inferior vena cava through collateral veins. As salvage therapy, we created a modified total cavopulmonary shunt using only autologous tissue in which the right hepatic vein and inferior vena cava drained into the pulmonary artery via a lateral tunnel in the right atrium. Immediately after surgery, his oxygen saturation increased and right ventricular function improved.
  • Tatsuya Seki, Yasushige Shingu, Hiroshi Sugiki, Satoru Wakasa, Hiroki Katoh, Tomonori Ooka, Tsuyoshi Tachibana, Suguru Kubota, Yoshiro Matsui
    Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs 21 (3) 363 - 366 1434-7229 2018/09 [Refereed][Not invited]
     
    Antiphospholipid syndrome (APS) is a complex autoimmune disease often related to systemic lupus erythematosus. Although adequate anticoagulation is important for APS patients during cardiopulmonary bypass, clotting tests can be potentially misleading due to antiphospholipid antibodies. We performed cardiac surgery safely in two APS patients under anticoagulation monitoring determined using preoperative heparin titration. We performed heparin titration for activated clotting time to determine the appropriate heparin concentration during cardiac surgery. We changed the targeted heparin concentration considering each patient's thrombotic risks: 3 U/ml of heparin for a normal-risk APS patient and 5 U/ml for a high-risk APS patient with a history of antiphospholipid-antibody-associated thrombocytopenia. A higher targeted heparin concentration might be necessary for patients with high thrombotic risks.
  • Yasushige Shingu, Hiroshi Sugiki, Tomonori Ooka, Hiroki Kato, Satoru Wakasa, Tsuyoshi Tachibana, Yoshiro Matsui
    The Thoracic and cardiovascular surgeon 66 (4) 307 - 312 0171-6425 2018/06 [Refereed][Not invited]
     
    BACKGROUND: To examine the results of myectomy and mitral valve surgery for systolic anterior motion (SAM) of the mitral valve and left ventricular outflow tract obstruction (LVOTO) with a relatively thin interventricular septum. METHODS: The subjects were 12 patients with SAM and LVOTO. Eight had hypertrophic obstructive cardiomyopathy (HOCM) with a mean interventricular septal thickness of 16 mm. Three had sigmoid septum and one had an unknown etiology. For HOCM, isolated extended myectomy was performed when mitral regurgitation was mild (n = 1) and extended myectomy plus mitral valve surgery was performed when mitral regurgitation was more than mild (n = 4) or primary valve etiologies existed (n = 3). Myectomy was performed for the three cases with sigmoid septum. Myectomy plus height reduction of the posterior mitral leaflet was performed for the one case with the unknown etiology of SAM. RESULTS: In the patients with HOCM, the maximum LVOT pressure gradient significantly decreased from 140 ± 18 to 16 ± 6 and 3 ± 3 mm Hg, while mitral regurgitation significantly decreased from 2.3 ± 0.5 to 0.5 ± 0.3 and 0.4 ± 0.2 at pre-op, early post-op, and last follow-up (3 ± 1 years), respectively. In the other etiologies, the maximum LVOT pressure gradient changed from 56 ± 15 to 25 ± 15 and 5 ± 4 mm Hg; mitral regurgitation changed from 2.0 ± 0.6 to 1.3 ± 0.3 and 1.3 ± 0.8, at pre-op, early post-op, and the last follow-up (3 ± 2 years), respectively. CONCLUSION: Myectomy with mitral valve surgery is an option for SAM and LVOTO in patients with a relatively thin interventricular septum.
  • 心外膜脂肪組織におけるミトコンドリア機能障害は冠動脈狭窄と関連している(Mitochondrial Dysfunction in Epicardial Adipose Tissue is Associated with Coronary Artery Stenosis)
    Nakajima Takayuki, Yokota Takashi, Shingu Yasushige, Yamada Akira, Iba Yutaka, Ujihira Kosuke, Wakasa Satoru, Ooka Tomonori, Takada Shingo, Shirakawa Ryosuke, Furihata Takaaki, Tsuda Masaya, Matsumoto Junichi, Katayama Takashi, Fukushima Arata, Saito Akimichi, Matsuoka Ryosuke, Nishihara Hiroshi, Matsui Yoshiro, Kinugawa Shintaro
    日本循環器学会学術集会抄録集 82回 YIA - 1 2018/03
  • Ando Norihiro, Matsui Yoshiro, Tachibana Tsuyoshi, Kato Nobuyasu, Arimura Satoshi, Asai Hidetsugu, Shingu Yasushige, Wakasa Satoru, Kato Hiroki, Ooka Tomonori
    Japanese Journal of Cardiovascular Surgery 特定非営利活動法人 日本心臓血管外科学会 47 (1) 13 - 17 0285-1474 2018 [Not refereed][Not invited]
     

    Surgical cases for pulmonary artery aneurysm after palliative operation for congenital heart disease are rare. A man in his 40s underwent Waterston operation (side-side anastomosis of the ascending aorta and right pulmonary artery) for pulmonary atresia and ventricular septal defect at the age of one. Medical follow-up was continued at a local clinic without definitive repair. He had complained of exertional dyspnea and cough for one month. CT scan on admission showed a large right pulmonary artery aneurysm and atelectasis of the right lung. An urgent operation was planned for the huge pulmonary artery aneurysm. Under cardiac arrest, the proximal end-to-side anastomosis to the aorta was conducted using a Y-shaped vascular prosthesis at the previous Waterston anastomosis. The peripheral pulmonary arteries were reconstructed by inclusion technique. Percutaneous cardiopulmonary support was necessary for one day after operation due to unstable hemodynamics. He was extubated on postoperative day (POD) 4 and transferred to our general ward on POD 5. He was discharged home on POD 38. He is now free from heart failure symptoms and recurrence of aneurysm one year after surgery. Careful follow-up is necessary for the dilatation of the pulmonary artery and aortic root. A definitive operation—Rastelli and closure of the ventricular septal defect—may be considered in the future if the pulmonary artery resistance is suitable for the repair.

  • Sato Koji, Matsui Yoshiro, Shingu Yasushige, Wakasa Satoru, Kato Nobuyasu, Seki Tatsuya, Ooka Tomonori, Kato Hiroki, Tachibana Tsuyoshi, Kubota Suguru
    Japanese Journal of Cardiovascular Surgery 特定非営利活動法人 日本心臓血管外科学会 47 (6) 257 - 262 0285-1474 2018 [Not refereed][Not invited]
     

    Background : Persistent endoleak is a major cause of aneurysmal enlargement or rupture after endovascular aneurysm repair (EVAR). Although several reports have described ligation of lumbar arteries and stent graft-conserving aneurysmorrhaphy as useful strategies, treatment for type II endoleak after EVAR is controversial. Objectives : We investigated the early results in 5 patients who underwent ligation of lumbar arteries and stent graft-conserving aneurysmorrhaphy for type II endoleak. Methods : A>10 mm increase in aneurysm diameter after primary EVAR or a maximum diameter>65 mm serve as indications for intervention for type II endoleak. Under general anesthesia, following transperitoneal exposure of the abdominal aorta, the infrarenal aorta was banded using a tape at the proximal landing zone. After the aorta was opened without clamping, the lumbar arteries were ligated, and a stent graft-conserving aneurysmorrhaphy was performed. Results : The mean interval from the primary EVAR was 47±17 months. The mean operation time was 215±76 min. Blood transfusion was necessary in 4 patients (estimated blood loss 1,260±710 ml). No in-hospital deaths were observed, and the mean postoperative hospital stay was 26±20 days. One patient developed aspiration pneumonia and 1 developed surgical site infection post-surgery. The diameter of the aneurysm changed from 68±8 to 47±5 mm during hospitalization and decreased further to 36±7 mm at the last follow-up. Conclusions : The early results of ligation of lumbar arteries and stent graft-conserving aneurysmorrhaphy were favorable. Although this strategy could be useful for aneurysmal dilatation secondary to persistent type II endoleak after EVAR, the indications for this approach should be determined following careful evaluation of the patient's status considering the invasiveness of the procedure.

  • Wakasa Satoru, Matsui Yoshiro, SURVIVE registry
    Journal of the Japanese Coronary Association 特定非営利活動法人 日本冠疾患学会 23 (2) 125 - 129 1341-7703 2017 [Not refereed][Invited]
  • Hidetsugu Asai, Yasushige Shingu, Tomoji Yamakawa, Haruki Niwano, Satoru Wakasa, Tomonori Ooka, Hiroki Kato, Tsuyoshi Tachibana, Yoshiro Matsui
    European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes 58 (1-2) 69 - 80 0014-312X 2017 [Refereed][Not invited]
     
    BACKGROUND: The indications of left-ventricular plication (LVP) are controversial, although several studies have reported favorable outcomes in heart failure patients. The aim of this study was to assess left-ventricular (LV) wall stress and myocardial remodeling after LVP in a rat model of myocardial infarction (MI). METHODS: Sixteen rats underwent LVP by excluding the LV anterior wall scar 4 weeks after ligation of the left anterior descending artery. After 4 weeks, LV wall stress was assessed using transthoracic echocardiography and an LV catheter. Gene expression of the wall stress markers, atrial natriuretic factor (ANF) and brain natriuretic peptide (BNP), were evaluated via reverse transcription polymerase chain reaction. Cardiomyocyte area and myocardial fibrosis were also examined through histological examinations. These parameters were compared to those in 16 rats that underwent coronary artery ligation but not LVP. RESULTS: We noted that the LV end-diastolic dimension was smaller (9.9 ± 0.3 vs. 11.2 ± 0.2 mm, p < 0.05) and fractional shortening was greater (25 ± 2 vs. 15 ± 1%, p < 0.05) in LVP rats than in sham rats. Moreover, systolic wall stress was lower in LVP rats (71 ± 7 vs. 111 ± 9 × 103 dyn/cm2, p < 0.05). Myocardial ANF and BNP expression levels were lower in LVP rats (2.6 ± 0.3 vs. 4.4 ± 0.5 and 1.0 ± 0.1 vs. 1.5 ± 0.2 arbitrary units, respectively; p < 0.05). Cardiomyocyte area was significantly decreased in LVP rats (556 ± 15 vs. 670 ± 28 μm2, p = 0.003) and was correlated with LV wall stress (r = 0.669, p = 0.002). The reduction in myocardial fibrosis after LVP was not significant. CONCLUSION: LVP reduced LV wall stress and cardiomyocyte hypertrophy in a rat model of MI.
  • 若狭 哲, 松居 喜郎
    北海道外科雑誌 = The Hokkaido journal of surgery 北海道外科学会 61 (1) 7 - 12 0288-7509 2016/06 [Not refereed][Invited]
  • 窪田武浩, 若狭哲, 新宮康栄, 松居喜郎
    胸部外科 南江堂 69 (6) 467 - 470 0021-5252 2016/06 [Refereed][Not invited]
  • Hiroshi Sugiki, Kenji Sugiki, Tomonori Ooka, Satoru Wakasa, Yasushige Shingu, Tsuyoshi Tachibana, Yoshiro Matsui
    Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs 19 (1) 62 - 9 1434-7229 2016/03 [Refereed][Not invited]
     
    The authors developed the wavelet analysis system which can detect the splitting of bileaflet mechanical heart valve (BLV) into two spikes on the scalogram, and reported that either consecutive single spike or the split behavior can detect malfunctioning BLV (MBV). The latest study on 12 BLVs suggested that the comparison between two spike areas showed higher potential to detect MBV than the split behavior. The aim of the current study is to review 226 files of BLV sound and to select the suitable scalographic property to differentiate the function of BLV with the split. Eight of 30 MBV files showed consecutive single spike, and the rest of 22 MBV files showed two spikes. Two spike areas can be compared by the following three ratios; the anterior spike area/posterior spike area (Aa/La), its reverse ratio (Pa/Aa) and the smaller spike area/the larger spike ratio (Sa/La). Therefore, the current study compared those three ratios to pursue the suitable ratio to compare two spike areas and its sensitivity to differentiate valve function by the ROC analysis. As a result, the Sa/La was suitable for comparing two spike areas, and only this ratio showed high accuracy to differentiate the function of BVL with the split, and its cutoff value was <0.665. Conclusively, the key for detecting MBV was either consecutive single spike or the mean of Sa/La < 0.665. However, this cutoff point is still tentative due to small number of malfunctioning valves, and other key might be available in future.
  • Asai Hidetsugu, Tachibana Tsuyoshi, Shingu Yasushige, Wakasa Satoru, Oooka Tomonori, Matsui Yoshiro
    Japanese Journal of Cardiovascular Surgery 特定非営利活動法人 日本心臓血管外科学会 45 (1) 26 - 31 0285-1474 2016 [Refereed][Not invited]
     
    Introduction : Right atrial (RA) and right ventricular (RV) dilatation that are associated with severe tricuspid regurgitation, and severe high RV pressure that is associated with pulmonary atresia and intact ventricular septum cause left ventricular (LV) dysfunction and hypoplastic lung. We have applied a modified RV obliteration technique that excludes non-functional enlarged RV for these diseases. Objectives : To evaluate the efficacy of our procedure. Methods and Results : Five patients (six operations) underwent the procedure without complications. Cardiothoracic ratio significantly decreased from 71±10% to 61±5% (p=0.017), and fractional shortening ended to increase from 27±17% to 37±5% (p=0.071). All of them achieved Fontan completion finally. One patient who underwent this procedure as a neonate experienced RV re-dilation 19 months later. He additionally received the same procedure in a Fontan operation, and then RV reduced again and good LV function was maintained. Conclusion : The application of modified RV obliteration technique is effective for Fontan candidates with nonfunctional RV.
  • Matsui Yoshiro, Wakasa Satoru, Ooka Tomonori, Shingu Yasushige
    Nihon Naika Gakkai Zasshi 一般社団法人 日本内科学会 105 (2) 238 - 244 0021-5384 2016 [Not refereed][Invited]
     

    活動期感染性心内膜炎（infective endocarditis：IE）に対する外科治療は，心不全や感染の制御，塞栓症の予防の観点から，適応，手術時期を判断し，感染組織の可及的切除により再感染を予防する．また，脳合併症を呈する場合には，梗塞後出血や新規発症のリスクを考慮に入れたうえで適切な手術時期を決定すべきである．大動脈弁位では弁周囲膿瘍が起こりやすく，周囲組織との解剖学的関係を十分理解し，郭清，再建を行う．僧帽弁位では弁形成の可能性を常に考慮すべきである．

  • Kubota Takehiro, Wakasa Satoru, Shingu Yasushige, Matsui Yoshiro
    Japanese Journal of Cardiovascular Surgery 特定非営利活動法人 日本心臓血管外科学会 45 (4) 170 - 175 0285-1474 2016 [Refereed][Not invited]
     

    Congenital coronary artery-pulmonary artery fistula is rare and occurs concomitantly with various disease conditions, including myocardial ischemia symptoms and aneurisms. Such a fistula complicated by continuity to a systemic blood vessel is even rarer. The patient was a healthy 75-year-old man who had lost consciousness for several tens of seconds at home. An examination performed at a nearby neurosurgical clinic showed no abnormalities, and he was referred to our cardiovascular department for detailed examination for suspected cardiogenic syncope. Sick sinus syndrome was diagnosed based on Holter monitoring. Pulmonary artery-bilateral coronary artery fistula with coronary artery stenosis was diagnosed on coronary arteriography. It was difficult to determine whether coronary bypass surgery was indicated because of the presence of a fistula. Based on the overall evaluation of coronary fractional flow reserve, coronary artery ultrasound, and stress myocardial scintigraphy in addition to usual coronary arteriography, triple-vessel bypass surgery was indicated. Preoperative CT angiography showed a left common carotid artery/bronchial artery-pulmonary artery fistula, with a communication at a bilateral coronary artery-pulmonary artery fistula. Coronary artery bypass surgery was performed in addition to coronary artery-pulmonary artery fistula ligation, left common carotid artery-pulmonary artery fistula closure, bronchial artery-pulmonary artery fistula closure, and pacemaker implantation. Preoperative CT angiography and perioperative surface echocardiography were useful for locating fistula openings. The abnormal blood vessels that allowed blood flow from the left common carotid and bronchial arteries, and into the fistula vessel opening were ligated previously. When cardioplegic solution was injected, the fistula opening was directly pressed, which facilitated the solution to spread over the cardiac muscle, contributing to full cardiac arrest. Postoperative CT angiography showed disappearance of the pulmonary artery-bilateral coronary artery fistula and left common carotid artery/bronchial artery-pulmonary artery fistula. To our knowledge, there are no reports describing the surgical treatment of left common carotid artery/bronchial artery-pulmonary artery fistula and bilateral coronary artery-pulmonary artery fistula. Here we report this rare case with a review of the relevant literature.

  • 松居喜郎, 若狭哲, 新宮康栄, 大岡智学, 橘剛
    Heart view メジカルビュー社 19 (10) 1146 - 1152 1342-6591 2015/10 [Not refereed][Invited]
  • 若狭哲, 松居喜郎
    胸部外科 68 (8) 586 - 590 0021-5252 2015/07/20 [Not refereed][Invited]
  • Yasushige Shingu, Suguru Kubota, Satoru Wakasa, Tomonori Ooka, Hiroki Kato, Tsuyoshi Tachibana, Yoshiro Matsui
    Journal of cardiology 65 (2) 157 - 63 0914-5087 2015/02 [Refereed][Not invited]
     
    BACKGROUND: Left ventriculoplasty (LVP) and mitral valve plasty (MVP) are sometimes effective for patients with idiopathic dilated cardiomyopathy (DCM) who are not eligible for heart transplantation. Strict patient selection is warranted for these controversial procedures. METHODS AND RESULTS: The subjects were 18 patients with idiopathic DCM and mitral regurgitation who had not been indicated for heart transplantation due to either older age or patient refusal, and who underwent LVP and MVP. Their mean age was 57±14 years and 50% were dependent on catecholamine infusion. The preload recruitable stroke work (PRSW) relationship and its slope (Mw) were estimated by a single-beat technique using transthoracic echocardiography. There were one 30-day mortality and six (33%) hospital deaths due to heart failure. The one-year survival rate was 50%. Left ventricular end-diastolic dimension (LVDd) decreased from 77±11 to 68±11mm (p=0.001) whereas the ejection fraction did not change. Preoperative Mw was significantly higher in one-year survivors than that in non-survivors (54±17ergcm(-3)10(3) vs. 31±10ergcm(-3)10(3), p=0.005). Preoperative LVDd was not different between the groups. The cut-off value of 42ergcm(-3)10(3) for Mw predicted one-year survival with high sensitivity (100%) and specificity (77%). CONCLUSIONS: Mw, the slope in the PRSW relationship, may predict survival after LVP and MVP in patients with idiopathic DCM.
  • S字状心室中隔に伴う流出路狭窄による僧帽弁逆流と弁穿孔が溶血性貧血の原因となった僧帽弁形成術後の1例
    横山 しのぶ, 山田 聡, 新宮 康栄, 中鉢 雅大, 岩野 弘幸, 若狭 哲, 西田 睦, 渋谷 斉, 清水 力, 松居 喜郎
    超音波医学 (公社)日本超音波医学会 42 (1) 84 - 84 1346-1176 2015/01
  • Tatsuya Seki, Mamoru Sakakibara, Yasushige Shingu, Hiroki Katoh, Satoru Wakasa, Hiroyuki Tsutsui, Yoshiro Matsui
    Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 21 (2) 132 - 8 1341-1098 2015 [Refereed][Not invited]
     
    PURPOSE: Transcatheter aortic valve replacement (TAVR) has emerged as a therapeutic option for severe aortic valvular stenosis (AS). To determine the indication for TAVR, it is mandatory to clarify the characteristics of the patients who were judged as inoperable for conventional aortic valve replacement (cAVR). METHODS: Of 185 patients newly diagnosed as severe AS from March 2010 to April 2011, we studied the characteristics of 61 (33%) patients (mean age, 86 ± 8 years) who were judged as inoperable. RESULTS: Younger patients (<85 years old, n = 22) had more major comorbidities and lower left ventricular ejection fraction than older patients (≥85 years old, n = 39). Mean estimated mortality for cAVR by Japan score was 7.0% ± 7.4%. Japan score did not correlate to age and was calculated relatively low in the older age group (6.2% ± 7.0%) than the younger age group (8.3% ± 8.1%). CONCLUSION: One thirds of severe AS patients were judged as inoperable. In advanced age patients, age itself and other factors, which are not included in the conventional scoring systems, might have contributed to the decision making not to perform cAVR by cardiologists. Further study is necessary to define risk factors except for age.
  • Satoru Wakasa, Yasushige Shingu, Tomonori Ooka, Hiroki Katoh, Tsuyoshi Tachibana, Yoshiro Matsui
    Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 21 (4) 370 - 7 1341-1098 2015 [Refereed][Not invited]
     
    PURPOSE: The progression of left ventricular (LV) remodeling and subsequent mitral valve tethering impair the results of reduction annuloplasty for ischemic mitral regurgitation (MR). METHODS: We studied 90 patients who underwent surgical repair of ischemic MR between 1999 and 2013 according to our surgical strategy adding submitral and ventricular procedures to annuloplasty as follows: annuloplasty alone (stage 1, n = 30), additional papillary muscle approximation (PMA) for progression of tethering (stage 2, n = 26), and additional left ventriculoplasty with PMA for progression of LV remodeling and tethering (stage 3, n = 34). RESULTS: The preoperative New York Heart Association (NYHA) functional classes (2.5 ± 0.7, 3.1 ± 0.7 and 3.3 ± 0.7 for stages 1, 2 and 3, respectively, P <0.001), LV end-diastolic diameters (56 ± 7 mm, 66 ± 5 mm and 70 ± 7 mm, P <0.001), and LV ejection fractions (45 ± 12%, 32 ± 9% and 27 ± 9%, P <0.001) significantly differed among the stages. In contrast, the MR grades did not significantly differ (2.9 ± 0.8, 3.0 ± 1.0, and 2.9 ± 1.1, respectively; P = 0.93). Both the rates of cardiac-related survival and freedom from reoperation were comparable among the 3 groups (log-rank P = 0.92 and 0.58, respectively). CONCLUSION: Additional submitral and ventricular procedures can compensate for the possible impairment of the outcomes after annuloplasty alone for ischemic MR in patients with severe LV remodeling and tethering.
  • Satoru Wakasa, Yoshiro Matsui
    General thoracic and cardiovascular surgery 62 (9) 511 - 5 1863-6705 2014/09 [Refereed][Invited]
     
    The surgical strategy for ischemic mitral regurgitation (MR) remains controversial. Ischemic MR is a secondary valve disease caused by left ventricular (LV) remodeling and subsequent papillary muscle displacement, usually without structural valve lesions. Reduction annuloplasty is the standard surgical procedure for this condition, though it cannot clearly provide a survival benefit for those with LV dysfunction and is associated with a high prevalence of late recurrence of MR. The valvular procedure alone could be insufficient to treat ischemic MR in terms of long-term survival and the prevention of recurrence because ischemic MR is primarily a ventricular disorder. Thus, recent studies have focused on alternative procedures that target the primary cause of ischemic MR, the papillary muscles and left ventricle. We believe that the appropriate selection of surgical procedures among valvular, subvalvular, and even ventricular ones, considering the severity of LV remodeling for each patient would be more beneficial. Here we review recent studies featuring various surgical approaches to ischemic MR, especially with submitral procedures.
  • Satoru Wakasa, Suguru Kubota, Yasushige Shingu, Tomonori Ooka, Tsuyoshi Tachibana, Yoshiro Matsui
    JOURNAL OF CARDIOTHORACIC SURGERY 9 98  1749-8090 2014/06 [Refereed][Not invited]
     
    Background: Since reduction annuloplasty alone for ischemic mitral regurgitation (MR) cannot prevent late recurrence of MR or improve survival for those with left ventricular (LV) dysfunction, and the surgical approach to this etiology is still controversial, we conducted a study to assess the efficacy of the additional papillary muscle approximation (PMA) procedure for ischemic MR by comparing the different subtypes of PMA. Methods: We studied 45 patients who underwent mitral annuloplasty and papillary muscle approximation (PMA) for ischemic MR between 2003 and 2012. Papillary muscles were approximated entirely (cPMA: complete PMA, n = 32) through an LV incision or partially from the tips to mid-parts (iPMA: incomplete PMA, n = 13) through the mitral and aortic valves. Twenty-three patients with cPMA also underwent LV plasty (LVP). We assessed the outcomes after PMA by comparing cPMA and iPMA. Results: The baseline MR grade, NYHA class, LV end-diastolic diameter, and LV ejection fraction (LVEF) were 2.8 +/- 1.0, 3.2 +/- 0.6, 67 +/- 6 mm, and 30 +/- 10%, respectively. There were no significant differences in these parameters among those with iPMA, cPMA/LVP-, and cPMA/LVP+, though iPMA patients had better LVEF than others. Three patients died before discharge and 12 died during the follow-up. Recurrence of grade 2+ and 3+ MR occurred in 8 and 2 patients, respectively. Reoperation for recurrent MR was performed only for the 2 patients with recurrence of grade 3+ MR. The cPMA was associated with lower mortality (log-rank P = 0.020) and a lower rate of recurrence of MR >= 2+ (log-rank P = 0.005) than iPMA. In contrast, there were no significant differences in the mortality (log-rank P = 0.45) and rate of recurrence (log-rank P = 0.98) between those with cPMA/LVP- and cPMA/LVP+. The 4-year survival rate and rate of freedom from recurrence of MR >= 2+ were 83% and 85% for those with cPMA, repectively. In contrast, the rates were 48% and 48% for those with iPMA, respectively. Conclusions: Complete PMA could be associated with lower postoperative mortality and higher durability of mitral valve repair for ischemic MR.
  • Satoru Wakasa, Yoshiro Matsui, Tadashi Isomura, Shuichiro Takanashi, Atsushi Yamaguchi, Tatsuhiko Komiya, Yasunori Cho, Junjiro Kobayashi, Hitoshi Yaku, Kiyokazu Kokaji, Hirokuni Arai, Yoshiki Sawa
    JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 147 (6) 1868 - U215 0022-5223 2014/06 [Refereed][Not invited]
     
    Objectives: Surgical ventricular reconstruction has been believed to be beneficial for those with ischemic cardiomyopathy. However, the effectiveness of surgical ventricular reconstruction was not proved by a large-scale trial, and no report has clearly demonstrated the exact indications and limitations of surgical ventricular reconstruction. The purpose of this study was to elucidate predictive factors of mortality after surgical ventricular reconstruction and to develop a prognostic model by calculating risk scores. Methods: The study subjects were 596 patients who underwent surgical ventricular reconstruction for chronic ischemic heart failure in 11 Japanese cardiovascular hospitals between 2000 and 2010. Potential predictors of postoperative mortality were assessed using the Cox proportional hazards model, and a risk score was calculated. Results: Forty-one patients died before discharge, and 81 patients died during a mean follow-up time of 2.9 years. Four independent predictors of mortality were identified: age, Interagency Registry for Mechanically Assisted Circulatory Support profile, left ventricular ejection fraction, and severity of mitral regurgitation. Each variable was assigned a number of points proportional to its regression coefficient. A risk score was calculated using the point scores for each patient, and 3 risk groups were developed: a low-risk group (0-4 points), an intermediate-risk group (5-6 points), and a high-risk group (7-12 points). Their 3-year survivals were 93%, 81%, and 44%, respectively (log-rank P < .001). Harrell's C-index of the predictive model was 0.69. Conclusions: A simple prognostic model was developed to predict mortality after surgical ventricular reconstruction. It can be useful in clinical practice to select treatment options for ischemic heart failure.
  • 荒木大, 若狭哲, 久保田卓, 新宮康栄, 大岡智学, 橘剛, 松居喜郎
    北海道外科雑誌 北海道外科学会 59 (1) 37 - 43 0288-7509 2014/06 [Refereed][Not invited]
  • Satoru Wakasa, Yuji Naito, Suguru Kubota, Makoto Iijima, Yasushige Shingu, Yoshiro Matsui
    ANNALS OF THORACIC SURGERY 97 (5) 1822 - 1823 0003-4975 2014/05 [Refereed][Not invited]
     
    Massive blood loss during thoracoabdominal aortic aneurysm repair may impair postoperative outcomes but can be reduced by a secure suture line. Our internal cuff reimplantation is a novel technique for the reconstruction of branch arteries with a cuff of the native aortic wall, which is anastomosed inside the prosthesis through a hole created in it. This technique can ensure hemostasis at the anastomosis by decompression of the suture line, improve patency of the reconstructed branches by leaving the diseased orifices untouched, and prevent future enlargement of the remnant native aortic wall by covering it with the prosthesis. (C) 2014 by The Society of Thoracic Surgeons
  • Satoru Wakasa, Suguru Kubota, Yasushige Shingu, Hiroki Kato, Tomonori Ooka, Tsuyoshi Tachibana, Yoshiro Matsui
    General Thoracic and Cardiovascular Surgery 62 (7) 428 - 433 1863-6713 2014 [Refereed][Not invited]
     
    Objective: Radiofrequency ablation (RFA) makes the Cox-Maze procedure less complicated but cannot always achieve transmural lesions. In this study, we assessed whether repeated application of RFA could improve histological transmurality even in thick lesions. Methods: Left atrial appendages (LAA) amputated from 20 consecutive patients (age 68 ± 9 years, 9 males) who underwent the Cox-Maze procedure using bipolar RFA devices were studied. Three different segments in the amputated LAA were ablated once, twice, or three times. Thereafter, cross sections made along each of the ablation lines were histologically assessed. Transmurality, which was defined as completion of transmural fibrotic changes, and wall thickness were investigated at an average of 3 different sites in each section. Results: A total of 177 sites were investigated and divided into groups with single, double, and triple RFA treatments for 56, 61, and 60 lesions, respectively. Transmural lesions were observed in 25 (45 %), 27 (44 %), and 41 (68 %) lesions, respectively (P = 0.011). The transmurality was 100 % for all lesions with a thickness of 1.0 mm or less. In the thicker lesions (> 1.0 mm), however, wall thickness impaired transmurality, though triple RFA was associated with significantly higher transmurality than single and double RFA (P = 0.005). Conclusions: Triple repetition of RFA was associated with higher transmurality of lesions than double RFA, especially for thicker lesions. Increasing the number of repetitions could improve the success rate of the Cox-Maze procedure using RFA devices. © 2014 The Japanese Association for Thoracic Surgery.
  • Wakasa Satoru, Matsui Yoshiro
    Journal of the Japanese Coronary Association 特定非営利活動法人 日本冠疾患学会 20 (3) 255 - 258 1341-7703 2014 [Not refereed][Invited]
  • Wakasa Satoru, Matsui Yoshiro
    Journal of the Japanese Coronary Association 特定非営利活動法人 日本冠疾患学会 20 (1) 84 - 87 1341-7703 2014 [Not refereed][Invited]
  • Suguru Kubota, Satoru Wakasa, Yasushige Shingu, Tomonori Ooka, Tsuyoshi Tachibana, Yoshiro Matsui
    CIRCULATION JOURNAL 77 (12) 2936 - 2941 1346-9843 2013/12 [Refereed][Not invited]
     
    Background: This study aimed to elucidate whether regional left ventricular wall thickening (LVWT) determined by quantitative gated SPECT (QGS) is useful in predicting surgical outcomes for ischemic (ICM) and nonischemic cardiomyopathy (NICM). Methods and Results; The study group comprised 53 patients with either ICM (n=30, left ventricular ejection fraction (LVEF)=24.7 +/- 7.1%) or NICM (n=23, LVEF=24.0 +/- 6.3%) scheduled for surgical repair underwent preoperative QGS to evaluate regional LV function. LVWT of 20 segments derived from QGS was normalized by being divided by the normal value of each LV level. Normalized values of the segments were summed to be representative of each area. For 16 of the 30 patients with ICM and 17 of the 23 patients with NICM, surgical ventricular restoration and papillary muscle approximation (PMA) were performed for surgical repair and, for the rest, PMA alone was done for both ICM and NICM patients. Adjunctive coronary artery bypass grafting for ICM patients was added when necessary. Mean follow-up periods were 2.5 +/- 1.8 years for ICM and 2.2 +/- 2.4 years for NICM. Posterior regional LVWT in NICM (normalized sum value <0.61 n=7, ROC: AUC=0.80) predicted cardiac events (chronic heart failure and cardiac-caused death). The one-year cardiac event-free rates were 22.2% and 85.1% and the 2 years rates were 11.1% and 48.6% for the lower posterior WT group and higher posterior WT group respectively (P=0.003). Conclusions: Posterior LVWT can be a predictor for postoperative cardiac events in patients with NICM.
  • Shichinohe Toshiaki, Wakasa Satoru, Kubota Suguru, Kato Kentaro, Ebihara Yuma, Kurashima Yo, Tsuchikawa Takahiro, Tanaka Eiichi, Matsui Yoshiro, Hirano Satoshi
    Esophagus : official journal of the Japan Esophageal Society The Japan Esophageal Society [編] 10 (4) 280 - 284 1612-9059 2013/12 
    Aortoesophageal fistula is a rare but fatal disease of thoracic surgery. We present a case of a 74-year-old male with aortoesophageal fistula. The patient underwent successful one-stage surgical treatment by video-assisted esophagectomy with esophageal reconstruction by gastric conduit and open aortic graft replacement subsequent to a temporary thoracic endovascular aortic repair.
  • Satoru Wakasa, Yoshiro Matsui, Tadashi Isomura, Shuichiro Takanashi, Atsushi Yamaguchi, Tatsuhiko Komiya, Yasunori Cho, Junjiro Kobayashi, Hitoshi Yaku, Kiyokazu Kokaji, Hirokuni Arai, Yoshiki Sawa
    INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY 16 (6) 785 - 791 1569-9293 2013/06 [Refereed][Not invited]
     
    Surgical ventricular reconstruction (SVR) for patients with severe left ventricular (LV) remodelling due to ischaemic cardiomyopathy is still controversial, because the Surgical Treatment for Ischaemic Heart Failure (STICH) trial demonstrated that SVR not only has no beneficial effect on survival compared with coronary artery bypass grafting (CABG) alone, but also is worse for those with a larger LV. Therefore, we assessed the impact of LV remodelling on the outcomes after SVR for ischaemic cardiomyopathy in Japan, using Di Donato's LV shape classification. From 2000 to 2010, 627 patients underwent SVR for ischaemic heart failure in 11 Japanese hospitals. To assess the patients with an LV ejection fraction (LVEF) of < 35% like the STICH trial, considering the severity of LV remodelling, the patients with a preoperative LVEF of > 35%, no preoperative LV volume assessment and no preoperative LV shape classification were excluded. Finally, 323 patients were selected as the study subjects. The LV shape was divided into three types according to Di Donato's classification. Types 1 and 3 indicate the aneurysmal and globally akinetic LV, respectively. Type 2 is the intermediate shape. Type 1, 2 and 3 LV shapes were observed in 85 (26%), 104 (32%) and 134 (42%) of the patients, respectively. The preoperative LV volume and diameter increased if the LV became more akinetic (Type 3 > 2 > 1, P < 0.001). LVEF was lower in those with more akinetic LV (P = 0.002). The preoperative LV end-diastolic volume index and LVEF in Type 3 patients were 133 +/- 47 ml/m(2) and 22 +/- 7%, respectively. Mitral valve repair was more frequently performed for patients with the Type 3 LV shape (65%) than for the others (P < 0.001). The hospital mortality rates were 2.4, 2.9 and 7.4% for Type 1, 2 and 3 patients, respectively (P = 0.16). Kaplan-Meier analysis demonstrated no significant difference in mortality among the three groups (log-rank P = 0.37). The 5-year survival rates were 81, 70 and 73% for Type 1, 2 and 3 patients, respectively. The severity of LV remodelling did not affect survival after SVR plus CABG. The results of SVR were acceptable even for those with globally akinetic LV due to ischaemic cardiomyopathy.
  • Satoru Chiba, Masanao Naya, Hiroyuki Iwano, Keiichiro Yoshinaga, Chietsugu Katoh, Osamu Manabe, Satoshi Yamada, Satoru Wakasa, Suguru Kubota, Yoshiro Matsui, Nagara Tamaki, Hiroyuki Tsutsui
    European journal of nuclear medicine and molecular imaging 40 (3) 349 - 55 1619-7070 2013/02 [Refereed][Not invited]
     
    PURPOSE: Diastolic function is impaired in patients with end-stage heart failure. Favorable structural changes by surgical ventricular reconstruction (SVR) are thought to improve diastolic function, however, previous studies reported the contradictory results. We hypothesized that cardiac oxidative metabolism and diastolic dysfunction might improve in parallel to the reduction of left ventricular chamber size after SVR. METHODS: We studied 11 patients underwent SVR associated with mitral valve repair for end-stage heart failure due to dilated cardiomyopathy. Diastolic function was assessed by echocardiography and myocardial oxidative metabolism was measured by the monoexponential clearance (k-mono) of (11)C-acetate positron emission tomography at baseline and 1 month after SVR. RESULTS: All patients had preoperative severe diastolic dysfunction [E/A 4.11 ± 1.18, deceleration time (DT) 134 ± 26 ms]. The study patients were divided into 2 groups according to the changes in diastolic function after SVR; unchanged or worsened diastolic function in 6 patients (55 %, Non-responder) and improved diastolic function in 5 (45 %, Responder). K-mono and wall stress decreased only in responder. The changes in k-mono before and after SVR correlated with those in deceleration time (r =  -0.63; p < 0.05) and wall stress (r = 0.75; p < 0.01). CONCLUSIONS: Improvement of diastolic dysfunction in patients with end-stage heart failure by SVR was in parallel to that in oxidative metabolism. It suggests that SVR reduced excessive metabolism during the diastolic phase, in part, via the improvement in diastolic function and the reduction in LV wall stress.
  • Suguru Kubota, Norihiko Shiiya, Yasushige Shingu, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Hidetoshi Yamauchi, Yoshimitu Ishibashi, Jun-Ichi Oba, Yoshiro Matsui
    General Thoracic and Cardiovascular Surgery 61 (10) 560 - 564 1863-6705 2013 [Refereed][Not invited]
     
    Objective: Aortoesophageal fistula (AEF) is relatively rare and usually life-threatening. Lots of strategies have so far been discussed for this entity including the role of endovascular repair. The aim of this study is to review our experiences and reconsider the surgical strategy for aortoesophageal fistula in the endovascular era. Methods: This is a retrospective multicenter study. From 1995 to 2011, 10 aortoesophageal fistula cases were identified in four institutions. For all of these cases surgical procedures and results were retrieved from medical records. Results: Six patients underwent open aortic repair and four patients underwent thoracic endovascular aortic repair (TEVAR) as a primary intervention. Three patients who underwent open aortic repair with esophagectomy and omental coverage in early phase, either as a primary intervention or performed after bridging TEVAR, showed 100 % 1-year survival. On the other hand, three patients with TEVAR alone did not survive more than 1 year without recurrence. One patient with bridging TEVAR underwent concomitant esophageal resection and conventional aortic graft replacement 2 days later, and simultaneous gastric tube reconstruction was performed with intact whole omentum covering the aortic prosthesis. This patient is doing well with no sign of infection at 1-year follow-up. Conclusion: For AEF, TEVAR as a primary approach is quite useful to stabilize the patients' condition. However, definitive aortic repair with omental coverage should be performed as early as possible as a next step. It may be one of the strategies for the treatment of AEF that concomitant esophageal resection and aortic graft replacement is performed with simultaneous gastric tube reconstruction with intact whole omentum after removing the stent graft, so far as the patient's physical condition permits. © 2013 The Japanese Association for Thoracic Surgery.
  • Asai Hidetsugu, Shingu Yasushige, Naito Yuji, Wakasa Satoru, Ōoka Tomonori, Tachibana Tsuyoshi, Kubota Suguru, Matsui Yoshiro
    Japanese Journal of Cardiovascular Surgery 特定非営利活動法人 日本心臓血管外科学会 42 (6) 494 - 498 0285-1474 2013 [Not refereed][Not invited]
     
    Introduction : Although there are various diagnostic tools like computed tomography, magnetic resonance imaging, and positron emission tomography, it is sometimes difficult to precisely diagnose cardiac tumors. Early pathological diagnosis is crucial for possible chemotherapy and/or radiation therapy in cardiac malignant lymphoma. Objectives : To assess the diagnostic value of pericardial excisional biopsy and cytology of pericardial effusion for the pathological diagnosis of cardiac lymphoma. Methods : Five patients had a clinical diagnosis of cardiac tumor with no pathological diagnosis. The pericardial biopsy and pericardial effusion were obtained without sternotomy through the subxyphoid by a small incision under local anesthesia. Results : All procedures were completed without complications. In 3 cases, the cytology of pericardial effusion yielded a diagnosis of malignant lymphoma. One patient who had a negative cytology result in whom surgical resection was performed for definitive diagnosis and tumor volume reduction was found to have malignant lymphoma. The remaining patient underwent tumor biopsy via a cardiac catheter and benign lymphoma was diagnosed. There were no specific findings in the pericardial excisional biopsy in 3 cases. Conclusion : The analysis of cytology of pericardial effusion obtained through the subxyphoid may be useful for the diagnosis of cardiac malignant lymphoma. Pericardial excisional biopsy may not be necessary for the diagnosis of cardiac malignant lymphoma.
  • WAKASA SATORU, SHINGU YASUSHIGE, KUBOTA SUGURU, MINAMIDA TARO, IIJIMA MAKOTO, NAITO YUJI, OOKA TOMONORI, TACHIBANA TSUYOSHI, MATSUI YOSHIRO
    胸部外科 南江堂 66 (1) 26 - 30 0021-5252 2013/01 [Not refereed][Invited]
  • 機能的僧帽弁逆流に対する前方への乳頭筋つり上げ術は左室流入血流障害を軽減する
    新宮 康栄, 若狭 哲, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎
    北海道外科雑誌 北海道外科学会 57 (2) 130 - 134 0288-7509 2012/12 [Refereed][Not invited]
     
    機能的僧帽弁逆流に対する単独の僧帽弁輪縫縮(MAP)では高頻度で逆流が再発するのみならず、拡張期に僧帽弁前尖が乳頭筋に牽引され左室流入血流障害を惹起するとも報告されている。我々は乳頭筋の前方へのつり上げが左室流入血流に及ぼす影響を検討した。対象は機能的僧帽弁逆流に対する手術症例38例。虚血性21例、非虚血性17例。全例に乳頭筋接合術とMAPを施行した。乳頭筋つり上げなしが6例、後方つり上げ8例、前方つり上げ24例。前方つり上げ群では他群に比較して左室流入血流角度が大きく(75±8度vs.63±17度vs.60±6度;p<0.001)、左房/左室の最大圧較差が小さかった(5.9±2.0vs.7.2±3.3vs.10±2.6mmHg;p<0.001)。機能的僧帽弁逆流に対する前方への乳頭筋つり上げは左室流入血流障害を軽減できる可能性がある点で有用な方法であると考えられる。(著者抄録)
  • Yasushige Shingu, Suguru Kubota, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Yoshiro Matsui
    SURGERY TODAY 42 (9) 819 - 824 0941-1291 2012/09 [Refereed][Not invited]
     
    Postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery, despite improvements in anesthesia, surgical techniques, and medical therapies. Although beta-blockers have been proven to be effective, the incidence of POAF is around 20 % even with these agents. The mechanism of POAF is not fully elucidated and no optimal strategy has been established for POAF. There are two important elements of "structural" and "electrical" remodelling of the atrium in the mechanism of POAF. A patient's age and preoperative left atrial fibrosis can predict POAF associated with structural remodelling. Although inflammation and oxidative stress during cardiac surgery may be the underlying mechanisms for electrical remodelling causing POAF, there are no reliable clinical parameters for their detection. Nonetheless, postoperative P-wave dispersion and electromechanical delay, which reflects excitation-contraction coupling abnormalities, could be new parameters for POAF. In conclusion, despite the importance of prevention of POAF, there are only a few parameters for predicting POAF. It is therefore necessary to consider both disease-mediated structural remodeling before surgery and electrical remodeling caused by cardiac surgery.
  • 大岡 智学, 新宮 康栄, 若狭 哲, 橘 剛, 久保田 卓, 松居 喜郎
    Journal of the Japanese Coronary Association 特定非営利活動法人 日本冠疾患学会 18 (3) 265 - 269 1341-7703 2012 [Not refereed][Invited]
  • Suguru Kubota, Kinya Matsui, Satoru Wakasa, Yukio Suto, Shigeyuki Sasaki, Keiichiro Yoshinaga, Yoshiro Matsui
    ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY 17 (6) 552 - 558 1341-1098 2011/12 [Refereed][Not invited]
     
    Objective: It is not clear whether surgical ventricular restoration (SVR) or procedures approaching mitral complex for controlling functional mitral regurgitation (MR) affect the regional left ventricular wall function. The purpose of the present study was to evaluate the regional LV function after SVR using overlapping left ventriculoplasty (OLVP) using quantitative gated myocardial perfusion SPECT (QGS). Patients and Method: Forty-one heart failure patients, including those with ischemic cardiomyopathy (ICM) (n = 25) and non-ICM (NICM) (n = 16), underwent SVR and/or papillary muscle approximation (PMA). The rest myocardial perfusion SPECT were performed before and early after operation (mean 25.8 +/- 10.6 days). These patients were divided into 4 groups based on the surgical procedures (SVR and/or PMA) and etiology of patients (ICM or NICM) as follows: SVR (with or without PMA) of ICM, SVR of NICM, PMA of ICM and PMA of NICM groups. The regional wall thickening was compared before and after the operation between the four groups. Results: NYHA functional classes were improved after the operation in all four groups. MR grade was also improved in three groups other than SVR of the ICM group. The left ventricular basal wall thickening was improved postoperatively in following three groups (SVR of ICM: 12.7 +/- 3.8% to 16.5 +/- 4.6% p <0.05, PMA of ICM: 11.1 +/- 4.3% to 14.9 +/- 4.8% p <0.05, SVR of NICM: 5.8 +/- 6.6% to 12.3 +/- 6.4% p <0.05), whereas PMA of the NICM group did not show an improvement. Wall thickening in the middle and distal levels was not improved in all groups. Conclusion: OLVP improved NYHA functional classes, and also improved the regional wall function at the basal level of the left ventricle. In contrast, lone PMA did not improve or impair the regional wall function at any of the levels.
  • Satoru Wakasa, Yoshiro Matsui
    CIRCULATION JOURNAL 75 (11) 2532 - 2533 1346-9843 2011/11 [Refereed][Invited]
  • WAKASA SATORU, SHINGU SUYASHIGE, OOKA TOMONORI, TACHIBANA TSUYOSHI, KUBOTA SUGURU, MATSUI YOSHIRO
    胸部外科 64 (11) 985 - 988 0021-5252 2011/10/01 [Not refereed][Invited]
  • Takashi Kunihara, Suguru Kubota, Norihiko Shiiya, Kenji Iizuka, Shigeyuki Sasaki, Satoru Wakasa, Kenji Matsuzaki, Yoshiro Matsui
    JOURNAL OF ARTIFICIAL ORGANS 14 (3) 192 - 200 1434-7229 2011/09 [Refereed][Not invited]
     
    While prolonged visceral ischemia seems to be a potential source of elevated proinflammatory cytokines during thoracoabdominal aortic aneurysm (TAAA) repair, the underlying mechanisms are unclear. We have investigated the production of cytokines and fatty acid binding proteins (FABPs) in the hepatosplanchnic system during TAAA repair. Arterial and hepatic venous levels of tumor necrosis factor-alpha (TNF-alpha), interleukin (IL) -6, -8, and -10, and liver- and intestinal-type FABPs (L-FABP, I-FABP) were measured at four time points in ten patients undergoing TAAA repair. Visceral arteries were perfused through either a side-arm of distal aortic perfusion or an individual circuit using an independent pump, or both, without measuring perfusion pressure or blood flow. The postoperative courses of all patients were uneventful. During visceral perfusion, the levels of arterial IL-6, -8, and -10, and L-FABP elevated significantly (P = 0.0077, 0.0051, 0.0077, 0.0077, respectively), and these elevated levels persisted up to skin closure, with the exception of L-FABP (P = 0.0051 each). In contrast, there were only subtle increases in TNF-alpha and I-FABP levels. The production ratio through the hepatosplanchnic system of TNF-alpha, L-FABP, and I-FABP showed a pronounced peak during visceral perfusion, but only the peak of L-FABP was significant compared with baseline (P = 0.0077). All production ratios returned to baseline level at skin closure. The production ratio of IL-6 was negative throughout the operation and that of IL-8 and IL-10 remained at baseline during visceral perfusion. In conclusion, a portion of the TNF-alpha, L-FABP, and I-FABP might be produced temporarily in the hepatosplanchnic system during TAAA repair. Systemic elevation of IL-6, IL-8, and IL-10 might be modulated by inflammatory response to extracorporeal circulation or surgical stress. Thus, our simple visceral perfusion techniques may indeed be justified.
  • Yoshiro Matsui, Suguru Kubota, Hiroshi Sugiki, Satoshi Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Shigeyuki Sasaki
    ANNALS OF THORACIC SURGERY 92 (3) 1132 - 1134 0003-4975 2011/09 [Refereed][Not invited]
     
    Mitral valvuloplasty using Gore-Tex (W.L. Gore & Associates, Inc, Flagstaff, AZ) as artificial chordae is often associated with difficulties in determining the length of the artificial chordae, as well as preventing knot slippage, especially for patients with broad anterior leaflet prolapse. We describe a simple technique that enables surgeons to easily determine the correct length of the artificial chordae and tie slippery knots without using a specific device. (Ann Thorac Surg 2011; 92: 1132-4) (C) 2011 by The Society of Thoracic Surgeons
  • Takashi Sugiki, Masanao Naya, Osamu Manabe, Satoru Wakasa, Suguru Kubota, Satoru Chiba, Hiroyuki Iwano, Satoshi Yamada, Keiichiro Yoshinaga, Nagara Tamaki, Hiroyuki Tsutsui, Yoshiro Matsui
    JACC. Cardiovascular imaging 4 (7) 762 - 70 1936-878X 2011/07 [Refereed][Not invited]
     
    OBJECTIVES: The aim of this study was to investigate the effects of surgical ventricular reconstruction (SVR) on cardiac efficiency as a surrogate marker for cardiac function and oxidative metabolism in patients with severe heart failure. BACKGROUND: Our new integrated overlapping left ventriculoplasty, modified SVR, combined with mitral complex reconstruction, reduce left ventricular (LV) volume associated with improvement of symptoms of heart failure. METHODS: Twelve consecutive patients with end-stage heart failure due to nonischemic dilated cardiomyopathy (DCM) (n = 6) and ischemic dilated cardiomyopathy (ICM) (n = 6) who underwent SVR were studied. Myocardial oxidative metabolism per gram of tissue was estimated by monoexponential clearance of (11)C-acetate positron emission tomography (K(mono)). Forward stroke volume at the LV outflow tract was measured by echocardiography. Cardiac efficiency was estimated by the ratio of external work (stroke volume at the LV outflow tract index × systolic blood pressure × heart rate) to K(mono) before and 1 month after SVR. RESULTS: After SVR, medians of New York Heart Association functional class significantly improved from 3 to 1.5 (p < 0.01) in both DCM and ICM patients. End-systolic and end-diastolic volume and LV mass significantly decreased in both groups. Stroke volume at the LV outflow tract increased from 43 ± 8 ml to 52 ± 11 ml (p = 0.028) in DCM patients, but not in ICM patients (49 ± 21 ml to 59 ± 26 ml, p = 0.12). K(mono) × LV mass, as an index of global LV oxidative metabolism, decreased in DCM patients (13.6 ± 1.9 g/min vs. 8.6 ± 1.5 g/min, p = 0.03) and ICM patients (12.0 ± 3.4 g/min vs. 9.2 ± 1.0 g/min, p = 0.06). As a result, cardiac efficiency increased in all patients with DCM (3.34 ± 0.46 × 10E6 vs. 4.74 ± 0.88 × 10E6 mm Hg·ml·min/m(2), p = 0.03) and in 5 of 6 patients with ICM (4.54 ± 1.66 × 10E6 vs. 5.99 ± 2.11 × 10E6 mm Hg·ml·min/m(2), p = 0.12). CONCLUSIONS: Combined surgery with SVR and mitral complex reconstruction reduced LV volume in association with improvement of cardiac efficiency in patients with severe heart failure.
  • Suguru Kubota, Hiroshi Sugiki, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Shigeyuki Sasaki, Yoshiro Matsui
    General Thoracic and Cardiovascular Surgery 59 (6) 406 - 412 1863-6705 2011/06 [Refereed][Not invited]
     
    Purpose: After radiofrequency (RF) ablation became available, the indication of MAZE procedure conducted with bipolar RF was expanded. We examined the efficacy and feasibility of the RF MAZE procedure in valve surgery and identified the predictors of atrial fibrillation (AF) recurrence. Methods: Forty-four patients had permanent AF at the time of operation and underwent a biatrial RF MAZE procedure. Univariate and multivariate analysis for the predictor of permanent AF recurrence and follow-up studies were performed. Results: Of the patients, 37 (84.1%) were in non-AF rhythm at discharge and 25 (80.6%) were at the latest follow-up (mean, 2.1 ± 1.2 years). In stepwise multivariate analysis, left atrial dimension (LAD) > 61.5 mm was an independent predictor of early-term recurrence of AF (P = 0.006) and late-term recurrence (P = 0.038) as well. F-wave voltage < 0.1 mV was significant in univariate analysis but was not significant in multivariate analysis for predictor of late-term AF recurrence. Avoidance of AF in the late term was 56% for LAD > 60 mm whereas it was 91% for LAD ≤ 60 mm (P = 0.043), 67% for F-wave < 0.1 mV compared to 100% for F-wave ≥ 0.1 mV (P = 0.031), and 43% for LAD > 60 mm and F-wave < 0.1 mV compared to 91% for LAD ≤ 60 mm and/or F-wave ≥ 0.1 mV (P = 0.016), respectively. Although avoidance of AF in the late term was lower in patients with LAD > 60 mm or F-wave < 0.1 mV, more than half of these patients were free from AF in the late term. Conclusion: LA size was assumed to be a simple and strong predictor of recurrent AF in this procedure. Predictive criteria that had been widely employed for the "cut-and-sew" MAZE procedure accompanied with valve surgery can be expanded in the MAZE procedure with RF devices. © 2011 The Japanese Association for Thoracic Surgery.
  • Suguru Kubota, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Shigeyuki Sasaki, Yoshiro Matsui
    General Thoracic and Cardiovascular Surgery 59 (6) 426 - 428 1863-6705 2011/06 [Refereed][Not invited]
     
    Aneurysm of an aortocoronary saphenous vein graft (SVG) is a rare but potentially fatal complication after coronary artery bypass grafting (CABG). Prevention of cerebral infarction or myocardial infarction due to the intraluminal debris from the SVG aneurysm is an important issue during surgical procedures. We report two patients with SVG aneurysms located in the proximal and distal portions of the SVG body, respectively. The surgical strategy for each case was determined according to the location of the aneurysm. We used low-flow cardiopulmonary bypass without aortic clamping in one patient and cardiac arrest with aortic clamping in the other. Both patients were discharged without sequelae. © 2011 The Japanese Association for Thoracic Surgery.
  • Yasushige Shingu, Suguru Kubota, Satoru Wakasa, Noriyoshi Ebuoka, Daisuke Mori, Tomonori Ooka, Tsuyoshi Tachibana, Yoshiro Matsui
    EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY 39 (5) 684 - 688 1010-7940 2011/05 [Refereed][Not invited]
     
    Objective: Although several risk factors for postoperative atrial fibrillation (AF) have been proposed, it remains the most common complication after cardiac surgery, even in low-risk patients. There is still no single reliable and reproducible parameter for predicting AF, and no standardized recommendation exists for this issue. Electromechanical delay (excitation-contraction coupling delay) is the time delay from the electrical activation to the actual systolic motion, and it reflects abnormality in calcium-handling proteins, which is considered one mechanism of postoperative AF. We hypothesized that left-ventricular electromechanical delay (LVEMD) is correlated to postoperative AF and serially examined it by echocardiography. Methods: We prospectively included 16 patients with relatively low risk for AF, who underwent cardiac surgery. The inclusion criteria were younger than 80 years, an ejection fraction greater than 45%, a left-atrial dimension less than 50 mm, and a brain natriuretic peptide (BNP) value less than 250 pg ml(-1). Postoperative AF for 10 postoperative days was monitored by 24-h electrocardiogram. The LVEMD was assessed by pulse-wave tissue Doppler echocardiography before and 1, 3, and 7 days after the operation. Serum BNP, adrenalin, and noradrenalin levels were also examined at the same time. Results: Postoperative AF was detected in six (37.5%) patients. There was no significant difference in heart rate, QRS duration, and serum hormones between the non-AF (n = 10) and AF (n = 6) groups. Although the preoperative LVEMD was comparable, that on postoperative day 1 of the AF group was significantly longer than that of the non-AF group (in the septal wall, 174 +/- 50 vs 101 +/- 36 ms, p = 0.020; in the lateral wall, 195 +/- 71 and 111 +/- 37 ms, p = 0.029). A LVEMD on postoperative day 1 greater than 150 ms well predicted postoperative AF (sensitivity, 75% and 75%; specificity, 100% and 86%, in septal and lateral LVEMDs, respectively). Conclusions: LVEMD is prolonged in patients with postoperative AF. This could be a new predicting parameter for AF in low-risk patients. (C) 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B. V. All rights reserved.
  • 飯島 誠, 浅井 英嗣, 澁谷 千英子, 加藤 伸康, 南田 太朗, 小林 一哉, 内藤 祐嗣, 夷岡 徳彦, 松井 欣哉, 若狭 哲, 杉木 宏司, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎
    日本血管外科学会雑誌 (NPO)日本血管外科学会 20 (2) 341 - 341 0918-6778 2011/04
  • 心大血管再手術80例の検討
    内藤 祐嗣, 夷岡 徳彦, 松井 欣哉, 若狭 哲, 杉木 宏司, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎
    日本心臓血管外科学会雑誌 (NPO)日本心臓血管外科学会 40 (Suppl.) 328 - 328 0285-1474 2011/01
  • 虚血性僧帽弁閉鎖不全症に対する乳頭筋接合術の成績
    若狭 哲, 杉木 宏司, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎
    日本心臓血管外科学会雑誌 (NPO)日本心臓血管外科学会 40 (Suppl.) 363 - 363 0285-1474 2011/01
  • ウェーヴレット解析による新しい二葉弁機能不全診断基準の検討
    杉木 宏司, 久保田 卓, 大岡 智学, 橘 剛, 若狭 哲, 夷岡 徳彦, 松井 欣哉, 杉木 健司, 松居 喜郎
    人工臓器 (一社)日本人工臓器学会 39 (2) S148 - S148 0300-0818 2010/11
  • 心房内腫瘍栓を伴う肝細胞癌の4切除例
    大野 陽介, 神山 俊哉, 中西 一彰, 横尾 英樹, 蒲池 浩文, 田原 宗徳, 福森 大介, 松下 通明, 藤堂 省, 若狭 哲, 久保田 卓
    北海道外科雑誌 北海道外科学会 55 (1) 67 - 67 0288-7509 2010/06
  • Suguru Kubota, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Norihiko Shiiya, Yoshiro Matsui
    JOURNAL OF ARTIFICIAL ORGANS 13 (1) 48 - 50 1434-7229 2010/04 [Refereed][Not invited]
     
    A case of Carpentier-Edwards PERIMOUNT (CEP) mitral pericardial bioprosthesis explanted 22 years after the valve replacement is reported. This patient underwent the previous replacement at the age of 50. The extracted bioprosthesis showed three rigid leaflets, one of which had a tear causing severe mitral regurgitation. The X-ray demonstrated calcification of varied extent among these leaflets, ranging from none to severe. When leaflet calcification is suppressed, perhaps the lifespan of a CEP valve can be prolonged more than previously expected. When a literature search was conducted, this case was found to represent the longest reported interval from the implantation of a CEP valve in the mitral position to the explantation as a result of severe mitral regurgitation caused by structural valve deterioration (SVD).
  • Norihiko Shiiya, Satoru Wakasa, Kinya Matsui, Takashi Sugiki, Yasushige Shingu, Tomoshi Yamakawa, Yoshiro Matsui
    ANNALS OF THORACIC SURGERY 88 (3) 768 - 772 0003-4975 2009/09 [Refereed][Not invited]
     
    Background. We evaluated correlation between anatomical pattern of the spinal cord feeding artery, detected by preoperative multidetector row computed tomography, and the mechanism of spinal cord ischemia during aortic surgery. Methods. One hundred sixteen patients underwent multidetector row computed tomography before descending or thoracoabdominal replacement. Segmental arteries feeding the spinal cord were detected in 92 patients (79%), and were classified into "critical" (isolated hairpin shaped) or "supplemental" (confluence-shaped or multiple). Spinal cord ischemia was monitored together with distal aortic perfusion in 53 of them by motor-evoked potentials, evoked spinal cord potentials, or both. The relationship between monitoring results and operative management to the detected feeding arteries was analyzed. Results. When no feeding segmental artery was involved in the extent of replacement (n = 18), spinal cord ischemia was detected in 1 (6%), which was due to cross-clamping the subclavian artery. When a supplemental feeding artery was involved (n = 15), ischemia was detected in 7 patients (47%), and was reversed by stopping back-bleeding. When a critical feeding artery was involved (n = 20), ischemia was detected in 6 (30%). In 3 of them, ischemia was reversed by stopping back-bleeding, whereas it was reversed only after reconstruction of the critical feeder in the remaining 3. Paraparesis occurred in 1 of the latter 3, and the incidence of spinal cord injury was 2% (1 of 53). Conclusions. When the involved feeding artery is a supplemental one, the steal phenomenon is the predominant mechanism of ischemia. Conversely, blood flow interruption to the critical feeding artery may cause spinal cord ischemia without steal phenomenon.
  • 阿部 慎司, 夷岡 徳彦, 新宮 康栄, 杉木 孝司, 若狭 哲, 大岡 智学, 橘 剛, 久保田 卓, 山川 智士, 椎谷 紀彦, 村下 十志文, 松居 喜郎
    日本小児循環器学会雑誌 (NPO)日本小児循環器学会 25 (4) 638 - 639 0911-1794 2009/07
  • Takashi Kunihara, Norihiko Shiiya, Satoru Wakasa, Kenji Matsuzaki, Yoshiro Matsui
    EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY 35 (4) 677 - 683 1010-7940 2009/04 [Refereed][Not invited]
     
    Objective: Despite the recognition of importance to avoid visceral ischemia during thoracoabdominal aortic aneurysm (TAAA) repair, the methodology of visceral perfusion seems still controversial and its pathophysiology has not been clearly understood. We investigated hepatosplanchnic metabolism during visceral perfusion/shunt in TAAA repair. Methods: Seventeen patients (10 male, 64 +/- 15 years old) who underwent elective TAAA repair using visceral perfusion/shunt under mild hypothermic distal aortic perfusion were retrospectively enrolled. Their aneurysm extension was type I and II in eight patients. In seven patients, four visceral arteries were perfused through a side-arm of distal aortic perfusion, white they were perfused by an independent pump in another five patients. In four of these 12 (two in each technique), visceral perfusion was converted into selective shunt after completion of aortic anastomosis. In the remaining five patients, four branches were initially perfused through a side-arm of distal aortic perfusion, and aortic perfusion was subsequently stopped after completion of aortic anastomosis. Hepatic venous oxygen saturation (ShO(2)), oxygen and lactate extraction ratio (OER, LER), and arterial ketone body ratio (AKBR) were measured at six time points. Results: There was no mortality, liver/renal dysfunction, or spinal cord injury. Two patients required re-exploration for bleeding. Fourteen patients were extubated within 24 h postoperatively. Mean intensive care unit stay was 2.3 +/- 1.7 days. During visceral perfusion, OER raised (31 +/- 13% to 68 +/- 21%, p = 0.0012) and ShO(2) decreased (67 +/- 12% to 34 +/- 24%, p = 0.0026) significantly. They recovered to baseline at skin closure. During the same period, LER (41 +/- 22% to -1 +/- 34%, p = 0.0035) and AKBR (0.47 +/- 0.13 to 0.20 +/- 0.08, p = 0.0012) significantly decreased. AKBR recovered to baseline at skin closure, but LER did not. ShO(2) (R(2) = 0.483, p = 0.0257) and LER (R(2) = 0.774, p = 0.0018) at skin closure and LER after initiation of partial cardiopulmonary bypass (R(2) = 0.427, p = 0.0211) had significant correlation with postoperative peak serum bilirubin level. AKBR after initiation of partial cardiopulmonary bypass had significant correlation with postoperative peak serum alanine aminotransferase level (R(2) = 0.289, p = 0.0476). Conclusions: Visceral perfusion/shunt in TAAA repair may avoid critical irreversible hepatosplanchnic ischemia but provide unphysiological blood flow to the liver and thus should be shortened. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
  • Satoru Wakasa, Norihiko Shiiya, Tsuyoshi Tachibana, Tomonori Ooka, Yoshiro Matsui
    JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 137 (4) 983 - 990 0022-5223 2009/04 [Refereed][Not invited]
     
    Objective: We evaluated the relationship between reactive astrogliosis and delayed motor neuron death after transient spinal cord ischemia in rabbits using a semiquantitative analysis of glial fibrillary acidic protein expression. Methods: Spinal cord ischemia was induced by means of balloon occlusion of the infrarenal aorta for 15 minutes at 39 degrees C in 18 New Zealand white rabbits. At 1, 3, and 7 days after reperfusion, 6 animals at each time point were killed, and the spinal cord was removed for histologic and immunohistochemical study. The variables analyzed were (1) neurologic function (Johnson score) at every 24 hours after reperfusion, (2) the number of intact motor neurons and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick-end labeling-positive positive neurons, and (3) expression of glial fibrillary acidic protein in the gray and white matter, which was expressed as the percentage of stained area. Results: All animals presented delayed motor neuron death. The number of intact neurons decreased correlatively with neurologic function. No obvious terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphatebiotin nick-end labeling-positive cells were observed. Glial fibrillary acidic protein expression increased with time in both the gray and white matter, representing the development of reactive astrogliosis. Significant correlation was found between glial fibrillary acidic protein expression and the number of intact motor neurons on the third day in both the gray (r(2) = 0.726, P = .031) and white (r(2) = 0.927, P = .002) matter. Conclusions: Reactive astrogliosis 3 days after transient spinal cord ischemia correlates with the number of intact motor neurons. Our method for semiquantitative analysis of reactive astrogliosis is simple and reproducible and seems useful for such experimental studies.
  • Yasushige Shingu, Norihiko Shiiya, Suguru Kubota, Yuji Naito, Kinya Matsui, Satoru Wakasa, Hiroshi Sugiki, Tsuyoshi Tachibana, Tomoji Yamakawa, Toshifumi Murashita, Yoshiro Matsui
    ADVANCES IN UNDERSTANDING AORTIC DISEASES 187 - 187 2009 [Refereed][Not invited]
  • Satoru Wakasa, Tomonori Ooka, Suguru Kubota, Norihiko Shiiya, Toshifumi Murashita, Yoshiro Matsui
    ANNALS OF THORACIC SURGERY 86 (5) 1668 - 1670 0003-4975 2008/11 [Refereed][Not invited]
     
    A 67-year-old man was referred for aortic valve surgery due to aortic valve regurgitation. He underwent an aortic valve replacement through a left thoracotomy, since he had a history of esophageal surgery with substernal gastric tube reconstruction and lymph node dissection through a right thoracotomy 14 years ago. The aortic valve was successfully replaced with excellent visualization using vacuum-assisted venous drainage on a cardiopulmonary bypass. Although exposing the aortic valve through a left thoracotomy is difficult, the application of vacuum-assisted venous drainage helps visualize the aortic valve in this approach.
  • 若狭 哲, 阿部 慎司, 夷岡 徳彦, 内藤 祐嗣, 新宮 康栄, 松井 欣哉, 杉木 孝司, 大岡 智学, 橘 剛, 久保田 卓, 山川 智士, 椎谷 紀彦, 村下 十志文, 松居 喜郎
    北海道外科雑誌 北海道外科学会 53 (1) 116 - 116 0288-7509 2008/06
  • Yasushige Shingu, Norihiko Shiiya, Takashi Sugiki, Satoru Wakasa, Kenji Matsuzaki, Takashi Kunihara, Yoshiro Matsui
    ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY 14 (2) 126 - 128 1341-1098 2008/04 [Refereed][Not invited]
     
    A 66-year-old man with thoracic and abdominal aortic aneurysm suffered from microembolism in the lower extremities after total arch replacement. He presented with livedo reticularis with palpable peripheral pulses, and the serum creatinine kinase level elevated up to 7,695. The abdominal aortic aneurysm, but not the thoracic aorta, was the origin of this complication. The morphological change of thrombus in the abdominal aorta detected by ultrasonography was the key to the diagnosis. Graft replacement of the abdominal aorta finally resolved his problem. (Ann Thorac Cardiovasc Surg 2008; 14: 126-128)
  • 夷岡 徳彦, 阿部 慎司, 内藤 祐嗣, 新宮 康栄, 松井 欣哉, 杉木 孝司, 若狭 哲, 杉木 宏司, 橘 剛, 久保田 卓, 山川 智士, 椎谷 紀彦, 村下 十志文, 松居 喜郎
    北海道外科雑誌 北海道外科学会 52 (2) 209 - 209 0288-7509 2007/12
  • 杉木 孝司, 若狭 哲, 大岡 智学
    北海道外科雑誌 北海道外科学会 52 (2) 174 - 177 0288-7509 2007/12 [Refereed][Not invited]
  • 若狭 哲
    北海道醫學雜誌 = Acta medica Hokkaidonensia 82 (6) 401 - 408 0367-6102 2007/11/01 [Not refereed][Not invited]
  • 開心術後のCEDV/RVEFモニタリングによる右室容量と中心静脈圧の変化
    新宮 康栄, 松井 欣哉, 杉木 孝司, 若狭 哲, 杉木 宏司, 橘 剛, 山川 智士, 久保田 卓, 椎谷 紀彦, 村下 十志文, 松居 喜郎
    日本臨床外科学会雑誌 日本臨床外科学会 68 (9) 2420 - 2420 1345-2843 2007/09
  • シャント閉鎖術後、自家静脈再建術後、再々発上腕動脈瘤の一例
    松井 欣哉, 椎谷 紀彦, 新宮 康栄, 杉木 孝, 若狭 哲, 杉木 宏司, 橘 剛, 山川 智士, 久保田 卓, 村下 十志文, 松居 喜郎
    日本臨床外科学会雑誌 日本臨床外科学会 68 (9) 2421 - 2421 1345-2843 2007/09
  • 上行弓部大動脈置換術後における急性期心機能と脳性ナトリウム利尿ペプチド(BNP)
    新宮 康栄, 椎谷 紀彦, 阿部 慎司, 内藤 祐嗣, 松井 欣哉, 若狭 哲, 杉木 宏司, 橘 剛, 山川 智士, 久保田 卓, 村下 十志文, 松居 喜郎
    脈管学 (一社)日本脈管学会 47 (Suppl.) S128 - S128 0387-1126 2007/09
  • 心不全、不整脈に対する外科治療 重症心不全に対する左室形成術のpitfalls
    松居 喜郎, 杉木 宏司, 若狭 哲, 新宮 康栄, 久保田 卓, 椎谷 紀彦, 村下 十志文
    日本外科系連合学会誌 日本外科系連合学会 32 (3) 495 - 495 0385-7883 2007/06
  • 松井 欣哉, 椎谷 紀彦, 松崎 賢司, 長谷川 公生, 杉木 孝司, 若狭 哲, 山下 知剛, 杉木 宏司, 国原 孝, 村下 十志文, 松居 喜郎
    北海道外科雑誌 北海道外科学会 52 (1) 77 - 77 0288-7509 2007/06
  • 松居 喜郎, 新宮 康栄, 若狭 哲, 杉木 宏司, 杉木 孝司, 松井 欣哉, 椎谷 紀彦, 村下 十志文
    適応医学 日本適応医学会 11 (1) 21 - 21 1342-9787 2007/05
  • Satoru Wakasa, Toshifumi Murashita, Takehiro Kubota, Hiroshi Sugiki
    JOURNAL OF CARDIAC SURGERY 22 (3) 215 - 217 0886-0440 2007/05 [Refereed][Not invited]
     
    Background: The aortic arch repair for interrupted aortic arch (IAA) with the hypoplastic ascending aorta through a median sternotomy requires cardiopulmonary bypass (CPB), which is very invasive in neonates and complicates pulmonary artery banding (PAB) is staged repair. Methods: A 22-day-old neonate with a type B IAA having a functional single ventricle underwent arch repair and PAB through a median sternotomy without CPB. A partial occlusion clamp could be placed on the ascending aorta without cerebral malperfusion and the descending aorta could be directly anastomosed to the ascending aorta in an end-to-side fashion under stable circulatory condition. Thereafter, the tight PAB was performed with a circumference of 23mm without any difficulty. Results: The postoperative echocardiogram revealed no stenosis on the anastomotic site and the patient was discharged uneventfully. Conclusion: This approach is effective in neonates with IAA who require staged repair, and least invasive for them.
  • 拡張心に伴う機能的僧帽弁逆流に対する我々のmitral complex reconstruction法の効果
    松居 喜郎, 志村 信一郎, 須藤 幸雄, 深山 雅寿, 若狭 哲, 杉木 宏司, 国原 孝, 椎谷 紀彦, 村下 十志文
    日本心臓血管外科学会雑誌 (NPO)日本心臓血管外科学会 36 (Suppl.) 222 - 222 0285-1474 2007/01
  • 椎谷 紀彦, 國原 孝, 松崎 賢司, 若狭 哲, 杉木 宏司, 松居 喜郎
    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY (一社)日本胸部外科学会 54 (Suppl.) 491 - 491 1344-4964 2006/09
  • 右側下行大動脈を伴った重複大動脈弓の1例
    杉木 宏司, 村下 十志文, 窪田 武浩, 若狭 哲, 椎谷 紀彦, 国原 孝, 松崎 賢司
    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY (一社)日本胸部外科学会 54 (5) 20 - 20 1344-4964 2006/05
  • 僧帽弁形成術後の外科治療成績 中期遠隔期成績
    村下 十志文, 国原 孝, 杉木 宏司, 山下 知剛, 若狭 哲, 松崎 賢司, 窪田 武浩, 椎谷 紀彦
    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY (一社)日本胸部外科学会 54 (5) 25 - 25 1344-4964 2006/05
  • DICを併発したIEに対して両弁置換(ステントレス生体弁)を施行した一症例
    松井 欣哉, 村下 十志文, 国原 孝, 杉木 宏司, 若狭 哲, 松崎 賢司, 窪田 武浩, 椎谷 紀彦
    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY (一社)日本胸部外科学会 54 (5) 29 - 29 1344-4964 2006/05
  • 若狭 哲, 新宮 康栄, 杉木 宏司, 菅 敏郎, 松崎 賢司, 國原 孝, 上久保 康弘, 椎谷 紀彦
    北海道外科雑誌 北海道外科学会 50 (2) 177 - 177 0288-7509 2005/12
  • 窪田 武浩, 若狭 哲, 杉木 宏司, 橘 剛, 村下 十志文, 安田 慶秀
    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY (一社)日本胸部外科学会 53 (Suppl.II) 608 - 608 1344-4964 2005/09
  • ファロー四徴症、両大血管右室起始症に対する根治術後に発生した肺動脈再狭窄の検討
    八田 英一郎, 若狭 哲, 杉木 宏司, 橘 剛, 窪田 武浩, 椎谷 紀彦, 村下 十志文, 安田 慶秀
    日本心臓血管外科学会雑誌 (NPO)日本心臓血管外科学会 34 (Suppl.) 470 - 470 0285-1474 2005/01
  • KUNIHARA Takashi, WAKASA Satoshi, MATSUZAKI Kenji, SHIIYA Norihiko, KUBOTA Takehiro, MURASHITA Toshifumi, YASUDA Keishu
    脈管学 44 (9) 363 - 374 0387-1126 2004/09/25 [Not refereed][Not invited]
  • 坂野 康人, 佐藤 一義, 若狭 哲, 衣川 佳数, 武田 充人, 山崎 弘州
    道南医学会誌 道南医学会 38 (38) 81 - 83 0288-1829 2003/07 [Not refereed][Not invited]
     
    日齢6,女児.生直後よりチアノーゼを認め,NICUに搬送入院した.心エコー検査でエプスタイン奇形が認められた.機能的肺動脈弁閉鎖,肺血流量の減少,肺血流動脈管依存が認められた.挿管,人工呼吸管理を行ったが,状態の改善を認めず肺循環維持目的にB-Tシャント術を施行した.術後2日目,夜間に急激にLOSに陥った.レントゲン,超音波検査上,心嚢液貯留,心タンポナーデの所見で,緊急ドレナージ術を施行した.保存的治療では改善が見込めないため,再開胸止血術を施行した.手術後経過は良好で,術後の胸水殆ど認めず,術後5日目にドレーン抜去し,以後再貯留を認めなかった.現在,フォンタン型手術への待機中である
  • 若狭哲
    市立釧路医誌 13 94 - 97 2001 [Not refereed][Not invited]

MISC

  • 植込型補助人工心臓治療におけるunmet medical needsの考察
    渡部 克将, 大岡 智学, 松本 嶺, 東 亮太, 須野 賢一郎, 稗田 哲也, 石垣 隆弘, 村瀬 亮太, 阿部 慎司, 加藤 伸康, 加藤 裕貴, 新宮 康栄, 若狭 哲  北海道外科雑誌  67-  (1)  92  -92  2022/06
  • 大動脈気管支瘻腸管瘻に対する治療 大動脈食道瘻に対する治療戦略 内視鏡手術を行う食道外科医の立場から
    七戸 俊明, 海老原 裕磨, 村上 壮一, 倉島 庸, 若狭 哲, 平野 聡  日本外科学会定期学術集会抄録集  122回-  WS  -1  2022/04
  • 3D-バーチャル・リアリティー(VR)システムを用いた、呼吸器外科ロボット手術トレーニング法の開発
    氏家 秀樹, 幾島 拓也, 大塚 慎也, 千葉 龍平, 野村 俊介, 椎谷 洋彦, 田畑 佑希子, 藤原 晶, 加藤 達哉, 樋田 泰浩, 加賀 基知三, 若狭 哲  日本外科学会定期学術集会抄録集  122回-  SF  -3  2022/04
  • 3D-バーチャル・リアリティー(VR)システムを用いた、呼吸器外科ロボット手術トレーニング法の開発
    氏家 秀樹, 幾島 拓也, 大塚 慎也, 千葉 龍平, 野村 俊介, 椎谷 洋彦, 田畑 佑希子, 藤原 晶, 加藤 達哉, 樋田 泰浩, 加賀 基知三, 若狭 哲  日本外科学会定期学術集会抄録集  122回-  SF  -3  2022/04
  • 人工知能を用いた心大血管手術後長期リハビリ症例予測モデルの構築と検証
    村瀬 亮太, 新宮 康栄, 加藤 伸康, 加藤 裕貴, 大岡 智学, 若狭 哲  日本臨床外科学会雑誌  83-  (3)  600  -600  2022/03
  • 低左心機能に合併した機能性僧帽弁閉鎖不全症に対する治療-カテーテル治療(MitraClip、TMVR)と僧帽弁形成術、僧帽弁置換術 カテーテルインターベンション時代における機能性僧帽弁閉鎖不全症に対する治療選択肢の適切な準備(Proper Arrangement of Treatment Options for Functional Mitral Regurgitation in the Era of Catheter Mitral Intervention)
    若狭 哲  日本循環器学会学術集会抄録集  86回-  SY13  -5  2022/03
  • 切除を先行した巨大(>10cm)肺腫瘤の2症例
    千葉 龍平, 加賀 基知三, 幾島 拓也, 田畑 佑希子, 藤原 晶, 氏家 秀樹, 加藤 達哉, 樋田 泰浩, 若狭 哲, 岡崎 ななせ, 若林 健人, 松野 吉宏  肺癌  62-  (1)  72  -73  2022/02
  • 幾島拓也, 氏家秀樹, 千葉龍平, 野村俊介, 田畑佑希子, 藤原晶, 樋田泰浩, 加賀基知三, 品川尚文, 高島雄太, 若狭哲, 松野吉宏, 加藤達哉  日本胸部外科学会定期学術集会(Web)  75th-  2022
  • 長島諒太, 藤原晶, 千葉龍平, 田畑佑希子, 氏家秀樹, 加藤達哉, 樋田泰浩, 加賀基知三, 若狭哲, 品川尚文  日本呼吸器外科学会総会(Web)  39th-  2022
  • 氏家秀樹, 海老原裕麿, 長島諒太, 千葉龍平, 野村俊介, 田畑祐希子, 藤原晶, 加藤達哉, 樋田泰浩, 加賀基知三, 若狭哲  日本ロボット外科学会学術集会プログラム・抄録集  14th-  2022
  • 千葉龍平, 加賀基知三, 幾島拓也, 田畑佑希子, 藤原晶, 氏家秀樹, 加藤達哉, 樋田泰浩, 若狭哲, 岡崎ななせ, 若林健人, 松野吉宏  肺癌(Web)  62-  (1)  2022
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    加藤 伸康, 新宮 康栄, 加藤 裕貴, 大岡 智学, 若狭 哲  日本成人先天性心疾患学会雑誌  11-  (1)  195  -195  2022/01
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    加賀 基知三, 樋田 泰浩, 加藤 達哉, 藤原 晶, 氏家 秀樹, 田畑 佑希子, 野村 俊介, 千葉 龍平, 幾島 拓也, 若狭 哲  日本内視鏡外科学会雑誌  26-  (7)  WS32  -3  2021/12
  • 難治性肺瘻をどう取り扱うか 肺切除後難治性肺瘻の治療戦略
    加賀 基知三, 樋田 泰浩, 加藤 達哉, 藤原 晶, 氏家 秀樹, 田畑 佑希子, 野村 俊介, 千葉 龍平, 幾島 拓也, 若狭 哲  日本内視鏡外科学会雑誌  26-  (7)  WS32  -3  2021/12
  • 田畑 佑希子, 加藤 達哉, 大塚 慎也, 幾島 拓也, 千葉 龍平, 藤原 晶, 氏家 秀樹, 樋田 泰浩, 品川 尚文, 有里 仁希, 高島 雄太, 加賀 基知三, 若狭 哲  気管支学  43-  (6)  689  -689  2021/11
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    若狭 哲, 新宮 康栄, 加藤 伸康, 阿部 慎司, 大岡 智学, 松居 喜郎  日本胸部外科学会定期学術集会  74回-  CWS2  -3  2021/10
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    渡部 克将, 加藤 伸康, 庭野 陽樹, 松本 嶺, 東 亮太, 須野 賢一郎, 石垣 隆弘, 稗田 哲也, 村瀬 亮太, 阿部 慎司, 新宮 康栄, 大岡 智学, 若狭 哲  日本胸部外科学会定期学術集会  74回-  CCPA3  -8  2021/10
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    村瀬 亮太, 新宮 康栄, 加藤 伸康, 加藤 裕貴, 大岡 智学, 若狭 哲  日本胸部外科学会定期学術集会  74回-  COP35  -4  2021/10
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    石垣 隆弘, 若狭 哲, 新宮 康栄, 大川 洋平, 山田 陽, 松居 喜郎  日本胸部外科学会定期学術集会  74回-  COP41  -4  2021/10
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    藤原 晶, 若狭 哲, 大岡 智学, 斉藤 仁志, 新宮 康栄, 加賀 基知三, 太田 稔, 南須原 康行  日本胸部外科学会定期学術集会  74回-  OD1  -1  2021/10
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    稗田 哲也, 加藤 伸康, 新宮 康栄, 加藤 裕貴, 大岡 智学, 若狭 哲  日本胸部外科学会定期学術集会  74回-  COD38  -3  2021/10
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    氏家 秀樹, 幾島 拓也, 大塚 慎也, 千葉 龍平, 野村 俊介, 椎谷 洋彦, 田畑 佑希子, 藤原 晶, 加藤 達哉, 樋田 泰浩, 加賀 基知三, 若狭 哲  日本胸部外科学会定期学術集会  74回-  SP5  -3  2021/10
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    幾島 拓也, 氏家 秀樹, 加藤 達哉, 大塚 慎也, 千葉 龍平, 野村 俊介, 椎谷 洋彦, 田畑 佑希子, 藤原 晶, 樋田 泰浩, 加賀 基知三, 若狭 哲  日本胸部外科学会定期学術集会  74回-  LOD19  -5  2021/10
  • バーチャル・リアリティー(VR)システムを用いた,ロボット外科手術シミュレーション法の開発
    氏家 秀樹, 幾島 拓也, 千葉 龍平, 野村 俊介, 田畑 佑希子, 藤原 晶, 加藤 達哉, 樋田 泰浩, 加賀 基知三, 若狭 哲  肺癌  61-  (6)  613  -613  2021/10
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    氏家 秀樹, 大塚 慎也, 千葉 龍平, 椎谷 洋彦, 藤原 晶, 加藤 達哉, 樋田 泰浩, 加賀 基知三, 若狭 哲, 石黒 信久, 豊嶋 崇徳  日本呼吸器外科学会雑誌  35-  (3)  SP2  -3  2021/05
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    加賀 基知三, 大塚 慎也, 千葉 龍平, 椎谷 洋彦, 氏家 秀樹, 藤原 晶, 加藤 達哉, 樋田 泰浩, 若狭 哲  日本呼吸器外科学会雑誌  35-  (3)  SP4  -6  2021/05
  • 呼吸器外科におけるトランスレーショナルリサーチの最前線 ctDNAを用いた肺癌術後のMinimal residual diseaseモニタリングの有用性
    加藤 達哉, Low Siew-Kee, 清谷 一馬, 林 理絵, 氏家 秀樹, 藤原 晶, 樋田 泰浩, 加賀 基知三, 若狭 哲, 中村 祐輔  日本呼吸器外科学会雑誌  35-  (3)  PD1  -5  2021/05
  • 気管支充填術と分離陰圧閉鎖療法を併用した治療戦略
    大塚 慎也, 加藤 達哉, 千葉 龍平, 椎谷 洋彦, 氏家 秀樹, 藤原 晶, 樋田 泰浩, 加賀 基知三, 若狭 哲, 三浦 隆洋, 石川 耕資  日本呼吸器外科学会雑誌  35-  (3)  O14  -3  2021/05
  • 通常採血管を用いたctDNA測定による肺癌術後モニタリングは術後早期再発検出に有用である
    加藤 達哉, Low Siew-Kee, 清谷 一馬, 氏家 秀樹, 藤原 晶, 樋田 泰浩, 加賀 基知三, 若狭 哲, 中村 祐輔  日本外科学会定期学術集会抄録集  121回-  SF  -2  2021/04
  • 通常採血管を用いたctDNA測定による肺癌術後モニタリングは術後早期再発検出に有用である
    加藤 達哉, Low Siew-Kee, 清谷 一馬, 氏家 秀樹, 藤原 晶, 樋田 泰浩, 加賀 基知三, 若狭 哲, 中村 祐輔  日本外科学会定期学術集会抄録集  121回-  SF  -2  2021/04
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    益澤 明広, 齊藤 翔吾, 有村 聡士, 高木 智充, 星野 理, 中尾 充貴, 松村 洋高, 儀武 路雄, 長堀 隆一, 坂東 興, 森田 紀代造, 荒井 裕国, 松宮 護郎, 高梨 秀一郎, 夜久 均, 小宮 達彦, 佐田 文宏, 松居 喜郎, 若狭 哲, 國原 孝  日本心臓血管外科学会学術総会抄録集  51回-  OP15  -3  2021/02
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    若狭 哲, 新宮 康栄, 石垣 隆弘, 加藤 伸康, 加藤 裕貴, 大岡 智学  日本心臓血管外科学会学術総会抄録集  51回-  SY3  -4  2021/02
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    加藤 伸康, 新宮 康栄, 加藤 裕貴, 大岡 智学, 若狭 哲  日本心臓血管外科学会学術総会抄録集  51回-  VS2  -4  2021/02
  • 重症虚血性僧帽弁閉鎖不全症に対する手術術式、乳頭筋介入に関する全国アンケート調査
    益澤 明広, 齊藤 翔吾, 有村 聡士, 高木 智充, 星野 理, 中尾 充貴, 松村 洋高, 儀武 路雄, 長堀 隆一, 坂東 興, 森田 紀代造, 荒井 裕国, 松宮 護郎, 高梨 秀一郎, 夜久 均, 小宮 達彦, 佐田 文宏, 松居 喜郎, 若狭 哲, 國原 孝  日本心臓血管外科学会学術総会抄録集  51回-  OP15  -3  2021/02
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    石垣 隆弘, 新宮 康栄, 若狭 哲  日本心臓血管外科学会学術総会抄録集  51回-  OP19  -4  2021/02
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    稗田 哲也, 加藤 伸康, 新宮 康栄, 加藤 裕貴, 大岡 智学, 若狭 哲  日本心臓血管外科学会学術総会抄録集  51回-  OP28  -1  2021/02
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    佐藤 公治, 加藤 伸康, 新宮 康栄, 加藤 裕貴, 大岡 智学, 若狭 哲  日本心臓血管外科学会学術総会抄録集  51回-  OP32  -4  2021/02
  • 大塚 慎也, 加藤 達哉, 佐々木 明洋, 山崎 洋, 氏家 秀樹, 藤原 晶, 樋田 泰浩, 加賀 基知三, 若狭 哲, 中村 順一, 篠崎 鮎香, 中久保 祥, 木村 孔一, 渡辺 正明, 岡崎 ななせ, 松野 吉宏  肺癌  61-  (1)  67  -67  2021/02
  • 大塚 慎也, 加藤 達哉, 佐々木 明洋, 山崎 洋, 氏家 秀樹, 藤原 晶, 樋田 泰浩, 加賀 基知三, 若狭 哲, 中村 順一, 篠崎 鮎香, 中久保 祥, 木村 孔一, 渡辺 正明, 岡崎 ななせ, 松野 吉宏  肺癌  61-  (1)  67  -67  2021/02
  • 横山 誓也, 氏家 秀樹, 加藤 達哉, 大塚 慎也, 佐々木 明洋, 山崎 洋, 藤原 晶, 樋田 泰浩, 加賀 基知三, 若狭 哲, 松野 吉宏, 今井 陽子  肺癌  61-  (1)  67  -68  2021/02
  • 大塚慎也, 加藤達哉, 氏家秀樹, 椎谷洋彦, 加賀基知三, 若狭哲, 中村順一, 中久保祥, 木村孔一, 渡辺正明, 嶋村剛, 岡崎ななせ, 松野吉宏, 田中敏  日本移植学会総会プログラム抄録集  57th (Web)-  2021
  • 幾島拓也, 氏家秀樹, 加藤達哉, 大塚慎也, 千葉龍平, 野村俊介, 椎谷洋彦, 田畑佑希子, 藤原晶, 樋田泰浩, 加賀基知三, 若狭哲, 本多昌平  日本気胸・嚢胞性肺疾患学会雑誌  21-  (2)  2021
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  • 大塚慎也, 加藤達哉, 佐々木明洋, 山崎洋, 氏家秀樹, 藤原晶, 樋田泰浩, 加賀基知三, 若狭哲, 中村順一, 篠崎鮎香, 中久保祥, 木村孔一, 渡辺正明, 岡崎ななせ, 松野吉宏  肺癌(Web)  61-  (1)  2021
  • 氏家秀樹, 大塚慎也, 千葉龍平, 椎谷洋彦, 藤原晶, 加藤達哉, 樋田泰浩, 加賀基知三, 若狭哲  気管支学  43-  2021
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    石垣 隆弘, 新宮 康栄, 若狭 哲, HOCARD members  日本血管外科学会雑誌  30-  (Suppl.)  O11  -1  2021
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    佐藤 公治, 加藤 伸康, 新宮 康栄, 加藤 裕貴, 大岡 智学, 若狭 哲  日本血管外科学会雑誌  30-  (Suppl.)  O24  -1  2021
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    鍋島 龍一, 石垣 隆弘, 加藤 伸康, 加藤 裕貴, 新宮 康栄, 大岡 智学, 若狭 哲  日本血管外科学会雑誌  30-  (Suppl.)  O37  -1  2021
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    大岡 智学, 布施川 真哲, 鍋島 龍二, 小市 裕太, 稗田 哲也, 石垣 隆弘, 佐藤 公治, 加藤 伸康, 新宮 康栄, 若狭 哲  人工臓器  49-  (2)  S  -53  2020/10
  • 非典型的な先天性嚢胞性肺疾患
    加賀 基知三, 大塚 慎也, 佐々木 明洋, 山崎 洋, 氏家 秀樹, 藤原 晶[黒田], 加藤 達哉, 樋田 泰浩, 若狭 哲  日本気胸・嚢胞性肺疾患学会雑誌  20-  (1)  69  -69  2020/08
  • 藤原 晶, 大塚 慎也, 山崎 洋, 佐々木 明洋, 氏家 秀樹, 加藤 達哉, 樋田 泰浩, 加賀 基知三, 若狭 哲  小切開・鏡視外科学会雑誌  11-  (1)  38  -38  2020/06
  • 加賀 基知三, 大塚 慎也, 佐々木 明洋, 山崎 洋, 氏家 秀樹, 藤原 晶[黒田], 加藤 達哉, 樋田 泰浩, 若狭 哲  小切開・鏡視外科学会雑誌  11-  (1)  50  -50  2020/06
  • 山崎 洋, 加賀 基知三, 大塚 慎也, 佐々木 明洋, 氏家 秀樹, 藤原 晶, 加藤 達也, 樋田 泰浩, 若狭 哲  小切開・鏡視外科学会雑誌  11-  (1)  57  -57  2020/06
  • 加賀 基知三, 樋田 泰浩, 加藤 達哉, 藤原 晶[黒田], 椎名 伸行, 氏家 秀樹, 佐々木 明洋, 山崎 洋, 若狭 哲  北海道外科雑誌  65-  (1)  2  -7  2020/06  
    先天性嚢胞性肺疾患で最も頻度の高い先天性肺気道奇形は、出生時の呼吸障害やその後の肺炎の併発のために外科的治療の対象となる。無症候性の先天性肺気道奇形の手術適応や適切な手術時期は明確ではない。一方、小児に対する胸腔鏡手術は低侵襲であると報告されているものの、成人と比較すると難易度は高い。小児に対する胸腔鏡手術が広く行われるようになると、適切な手術時期の決定はさらに複雑になるだろう。本疾患はまれな疾患であり、臨床的に小児外科と呼吸器外科の間(はざま)に存在するため、両領域の協力が必要である。本稿では現時点での論点を概説する。(著者抄録)
  • Type IIエンドリークに対する腰動脈結紮・ステントグラフト温存瘤縫縮術
    小市 裕太, 新宮 康栄, 新井 洋輔, 石垣 隆弘, 安東 悟央, 稗田 哲也, 佐藤 公治, 加藤 伸康, 関 達也, 加藤 裕貴, 若狭 哲, 大岡 智学  日本インターベンショナルラジオロジー学会雑誌  34-  (4)  298  -298  2020/04  [Not refereed][Not invited]
  • Hirokazu Komoriyama, Kiwamu Kamiya, Toshiyuki Nagai, Noriko Oyama-Manabe, Satonori Tsuneta, Yuta Kobayashi, Yoshiya Kato, Kazunori Omote, Takao Konishi, Takuma Sato, Shingo Tsujinaga, Hiroyuki Iwano, Yasushige Shingu, Satoru Wakasa, Toshihisa Anzai  JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY  75-  (11)  1639  -1639  2020/03
  • 心筋症に対する外科的左室負荷軽減と「アジュバント治療」の可能性
    新宮 康栄, 稗田 哲也, 加藤 伸康, 若狭 哲, 大岡 智学  日本心臓血管外科学会学術総会抄録集  50回-  PR20  -1  2020/03
  • 機能性僧帽弁逆流に対する置換術式による左室内エネルギー損失の違い VFMによる検討
    石垣 隆弘, 新宮 康栄, 加藤 伸康, 若狭 哲, 大岡 智学, 大川 洋平, 山田 陽, 高橋 順一郎, 松居 喜郎  日本心臓血管外科学会学術総会抄録集  50回-  O9  -1  2020/03
  • 肺動脈血栓内膜摘除は慢性血栓塞栓性肺高血圧症に対する標準治療であり続けられるか?
    大岡 智学, 小市 裕太, 稗田 哲也, 荒木 大, 石垣 隆弘, 安東 悟央, 佐藤 公治, 加藤 伸康, 新宮 康栄, 若狭 哲, 加藤 裕貴  日本心臓血管外科学会学術総会抄録集  50回-  O11  -4  2020/03
  • 当院における完全型房室中隔欠損症に対する二心室修復の成績
    稗田 哲也, 加藤 伸康, 小市 裕太, 安東 悟央, 荒木 大, 石垣 隆弘, 佐藤 公治, 新宮 康栄, 若狭 哲, 加藤 裕貴, 大岡 智学, 橘 剛  日本心臓血管外科学会学術総会抄録集  50回-  P2  -3  2020/03
  • 佐藤公治, 杉本聡, 加藤伸康, 新宮康栄, 杉木宏司, 加藤裕貴, 大岡智学, 若狭哲  日本胸部外科学会定期学術集会(Web)  73rd-  2020
  • 佐藤公治, 若狭哲, 新宮康栄, 杉木宏司, 加藤裕貴, 大岡智学  日本血管外科学会雑誌(Web)  29-  (Supplement)  2020
  • 氏家 秀樹, 加藤 達哉, 稲毛 輝長, 石綿 司, 新垣 雅人, 樋田 泰浩, 加賀 基知三, 若狭 哲  移植  55-  (Supplement)  383_2  -383_2  2020  
    目的 気管支腔内超音波検査法（EBUS）は低侵襲かつ高い診断能を有する検査手技である。本研究では、肺移植待機患者および移植後患者の経過中に、悪性腫瘍が疑われた肺・リンパ節病変に対するEBUSの有用性を検討した。方法 2008年～2018年までの間にEBUSガイド下経気道的肺生検 (EBUS-GS-TBB, EBUS-TBNA)が施行された肺移植後患者及び待機患者に対し後方視的検討を行った。結果 全28例に対してEBUS-TBNA：20例、EBUS-GS-TBB：8例 が施行された。肺移植術後患者19例の内訳は、移植後に肺腫瘤を認め悪性腫瘍が疑われた11例、肺門及び縦隔リンパ節腫大を認め移植後リンパ増殖性疾患(PTLD)が疑われた8例であった。全症例において確定診断が可能であり、重篤な合併症を認めなかった。診断の内訳は、原発性肺癌6例、PTLD 4例、感染性疾患3例、良性疾患6例であった。PTLDが疑われた8例中、4例（50%）がPTLDと診断され、肺悪性腫瘍が疑われた11例中、6例(55%)で肺悪性腫瘍の確定診断が可能であった。また、肺移植待機9例のうち、5例（56%）にて肺悪性腫瘍の確定診断に至り、治療方針が変更された。結論 移植待機中の末期慢性肺疾患症例及び肺移植術前後症例におけるEBUSは、肺病変及び縦隔肺門リンパ節に対する安全かつ高精度な質的診断が可能な検査法と考えられた。
  • 氏家秀樹, 大塚慎也, 佐々木明洋, 山崎洋, 藤原晶, 加藤達哉, 樋田泰浩, 加賀基知三, 若狭哲  日本胸部外科学会定期学術集会(Web)  73rd-  2020
  • 大塚慎也, 加藤達哉, 氏家秀樹, 山崎洋, 佐々木明洋, 藤原晶, 樋田泰浩, 加賀基知三, 若狭哲, 高島雄太, 品川尚文  日本胸部外科学会定期学術集会(Web)  73rd-  2020
  • 石垣 隆弘, 新宮 康栄, 加藤 伸康, 若狭 哲, 大岡 智学, 加藤 裕貴, 若林 健人, 三橋 智子, 松居 喜郎  北海道外科雑誌  64-  (2)  207  -207  2019/12  [Not refereed][Not invited]
  • 新宮 康栄, 小市 裕太, 稗田 哲也, 新井 洋輔, 安東 悟央, 石垣 隆弘, 佐藤 公治, 加藤 伸康, 若狭 哲, 大岡 智学  北海道外科雑誌  64-  (2)  209  -209  2019/12  [Not refereed][Not invited]
  • 川崎病冠動脈障害に対する冠動脈バイパス術
    安東 悟央, 若狭 哲, 加藤 伸康, 新宮 康栄, 加藤 裕貴, 大岡 智学  日本冠疾患学会誌  (Suppl.2019)  179  -179  2019/12  [Not refereed][Not invited]
  • 肉眼的に乳頭状線維弾性腫と鑑別が困難であったvilloustype左房粘液腫の1例
    石垣 隆弘, 新宮 康栄, 加藤 伸康, 若狭 哲, 大岡 智学, 加藤 裕貴, 若林 健人, 三橋 智子, 松居 喜郎  北海道外科雑誌  64-  (2)  207  -207  2019/12  [Not refereed][Not invited]
  • カルニチンによる心臓弁膜症手術後の心房細動の予防(単群介入試験)
    新宮 康栄, 小市 裕太, 稗田 哲也, 新井 洋輔, 安東 悟央, 石垣 隆弘, 佐藤 公治, 加藤 伸康, 若狭 哲, 大岡 智学  北海道外科雑誌  64-  (2)  209  -209  2019/12  [Not refereed][Not invited]
  • 長期(3年以上)VAD治療の課題と対策 長期植込型補助人工心臓治療の現状、課題、そして対策
    大岡 智学, 加藤 伸康, 新宮 康栄, 若狭 哲, 加藤 裕貴, 松居 喜朗, 寒河江 磨, 矢萩 亮児, 櫛引 勝年, 加藤 美香  人工臓器  48-  (2)  S  -75  2019/10  [Not refereed][Not invited]
  • 感染性大動脈瘤に対するウシ心膜ロールを用いた人工血管置換症例の検討
    関 達也, 松居 喜郎, 新宮 康栄, 大岡 智学, 若狭 哲  脈管学  59-  (Suppl.)  S231  -S231  2019/10  [Not refereed][Not invited]
  • 原発性肺動脈腫瘍に対する治療経験
    安東 悟央, 大岡 智学, 小市 裕太, 新井 洋輔, 稗田 哲也, 石垣 隆弘, 佐藤 公治, 関 達也, 新宮 康栄, 若狭 哲, 加藤 裕貴  脈管学  59-  (Suppl.)  S288  -S288  2019/10  [Not refereed][Not invited]
  • 卵円孔開存の判断に苦慮した心房内血栓症の一症例
    佐藤 文昭, 加賀谷 希望, 土田 幸弘, 若狭 哲, 柳内 充  共済医報  68-  (Suppl.)  111  -111  2019/10  [Not refereed][Not invited]
  • 長期(3年以上)VAD治療の課題と対策 長期植込型補助人工心臓治療の現状、課題、そして対策
    大岡 智学, 加藤 伸康, 新宮 康栄, 若狭 哲, 加藤 裕貴, 松居 喜朗, 寒河江 磨, 矢萩 亮児, 櫛引 勝年, 加藤 美香  人工臓器  48-  (2)  S  -75  2019/10  [Not refereed][Not invited]
  • 松居喜郎, 新宮康栄, 若狭哲, 久保田卓, 大岡智学, 加藤信康, 加藤裕貴  日本心臓血管外科学会学術総会(Web)  49回-  [Ex  -3]  2019/02  [Not refereed][Not invited]
  • 松居喜郎, 新宮康栄, 若狭哲, 大岡智学, 久保田卓  日本臨床  77-  (増刊1 心不全(中))  446  -451  2019/02  [Not refereed][Not invited]
  • EVAR後type II ELの治療戦略 EVAR術後エンドリークに対するステントグラフト温存瘤縫縮術
    佐藤 公治, 須野 賢一郎, 若狭 哲  日本血管外科学会雑誌  28-  (Suppl.)  PR6  -1  2019  [Not refereed][Not invited]
  • 急性及び慢性B型大動脈解離に対する胸部ステントグラフトが凝固線溶系に与える影響
    佐藤 公治, 久保田 卓, 上田 秀樹, 若狭 哲  日本血管外科学会雑誌  27-  (Suppl.)  O21  -2  2018/06
  • NAKAJIMA Takayuki, YOKOTA Takashi, SHINGU Yasushige, YAMADA Akira, IBA Yutaka, UJIHIRA Kosuke, WAKASA Satoru, OOKA Tomonori, TAKADA Shingo, SHIRAKAWA Ryosuke, FURIHATA Takaaki, TSUDA Masaya, MATSUMOTO Junichi, KATAYAMA Takashi, FUKUSHIMA Arata, SAITO Akimichi, MATSUOKA Ryosuke, NISHIHARA Hiroshi, MATSUI Yoshiro, KINUGAWA Shintaro  日本循環器学会学術集会(Web)  82nd-  2018
  • 佐藤公治, 久保田卓, 上田秀樹, 若狭哲  日本血管外科学会雑誌(Web)  27-  (Supplement)  ROMBUNNO.O21‐2(J‐STAGE)  2018  [Not refereed][Not invited]
  • 松井欣哉, 長谷川幸生, 川崎浩一, 齋藤克憲, 若狭哲  日本血管外科学会雑誌(Web)  27-  (Supplement)  ROMBUNNO.P32‐7(J‐STAGE)  2018  [Not refereed][Not invited]
  • 須野賢一郎, 佐藤公治, 若狭哲  日本循環器学会北海道地方会(Web)  119th-  HOKKAIDO119,1 (WEB ONLY)  2018  [Not refereed][Not invited]
  • 佐藤公治, 若狭哲  北海道外科雑誌  62-  (2)  189  2017/12/20  [Not refereed][Not invited]
  • 小倉直浩, 小倉直浩, 小倉直浩, 阿部文靖, 鍋島豊, 佐藤崇太, 棚田智之, 大宮裕樹, 山内孝, 若狭哲  人工臓器(日本人工臓器学会)  46-  (2)  S.127  2017/08/31  [Not refereed][Not invited]
  • 大血管転位症3型に対する当院の治療戦略 体肺動脈短絡術+短周径肺動脈絞扼術(BT-shunt with tight PAB)の有効性
    加藤 伸康, 橘 剛, 佐々木 理, 泉 岳, 山澤 弘州, 武田 充人, 新宮 康栄, 若狭 哲, 加藤 裕貴, 大岡 智学, 松居 喜郎  日本小児循環器学会雑誌  33-  (Suppl.1)  s1  -224  2017/07  [Not refereed][Not invited]
  • 古川夕里香, 安東悟央, 村瀬亮太, 杉本聡, 佐藤公治, 加藤伸康, 新宮康栄, 加藤裕貴, 若狭哲, 大岡智学, 橘剛, 松居喜郎  北海道外科雑誌  62-  (1)  80  2017/06/20  [Not refereed][Not invited]
  • TypeIIエンドリークに対するステントグラフト温存直達手術
    佐藤 公治, 新宮 康栄, 太安 孝允, 加藤 伸康, 若狭 哲, 大岡 智学, 加藤 裕貴, 橘 剛, 松居 喜郎  日本血管外科学会雑誌  26-  (Suppl.)  V4  -10  2017/06  [Not refereed][Not invited]
  • Frailtyからみた腹部大動脈瘤開腹手術の成績
    村瀬 亮太, 新宮 康栄, 大岡 智学, 若狭 哲, 橘 剛, 松居 喜郎  日本血管外科学会雑誌  26-  (Suppl.)  O18  -3  2017/06  [Not refereed][Not invited]
  • 胸腹部動脈瘤術後脊髄障害予防を目的とした分節動脈再建法の工夫 再建動脈開存性の意義
    若狭 哲, 佐藤 公治, 新宮 康栄, 大岡 智学, 加藤 裕貴, 橘 剛, 松居 喜郎  日本血管外科学会雑誌  26-  (Suppl.)  P19  -8  2017/06  [Not refereed][Not invited]
  • 右冠動脈肺動脈起始症に対しreimplantation法、肺動脈欠損壁自己心膜パッチ形成術を施行した1例
    安東 悟央, 大岡 智学, 古川 夕里香, 村瀬 亮太, 杉本 聡, 佐藤 公治, 加藤 伸康, 浅井 英嗣, 太安 孝允, 新宮 康栄, 若狭 哲, 加藤 裕貴, 橘 剛, 松居 喜郎  日本血管外科学会雑誌  26-  (Suppl.)  P37  -8  2017/06  [Not refereed][Not invited]
  • 安東 悟央, 大岡 智学, 古川 夕里香, 有村 聡士, 村瀬 亮太, 杉本 聡, 佐藤 公治, 加藤 伸康, 新宮 康栄, 若狭 哲, 橘 剛, 松居 喜郎, 太安 孝允, 加藤 裕貴  北海道外科雑誌  62-  (1)  80  -80  2017/06  [Not refereed][Not invited]
  • 急性期にタクロリムスが原因とされる横紋筋融解症・多臓器不全を呈した心移植の1例
    大岡 智学, 大安 孝允, 新宮 康栄, 若狭 哲, 加藤 裕貴, 橘 剛, 松居 喜郎, 小林 真梨子, 櫛引 勝年  移植  52-  (1)  90  -91  2017/04  [Not refereed][Not invited]
  • 我が国の人工心臓治療の現況と展望 Destination Therapy導入に向け、5年間の植込型補助人工心臓によるBridge to Transplantationから何を学んだか?
    大岡 智学, 佐藤 公治, 新宮 康栄, 加藤 裕貴, 若狭 哲, 橘 剛, 松居 喜郎  日本外科学会定期学術集会抄録集  117回-  SY  -5  2017/04  [Not refereed][Not invited]
  • 中島 孝之, 横田 卓, 新宮 康栄, 山田 陽, 伊庭 裕, 若狭 哲, 大岡 智学, 高田 真吾, 白川 亮介, 降旗 高明, 津田 正哉, 松本 純一, 片山 貴史, 福島 新, 松居 喜郎, 絹川 真太郎  日本循環器学会学術集会抄録集  81回-  PJ  -075  2017/03  [Not refereed][Not invited]
  • Kimura Satomi, Kanai Satoshi, Date Hiroaki, Matsui Yoshirou, Wakasa Satoru  Proceedings of JSPE Semestrial Meeting  2017-  231  -232  2017  [Not refereed][Not invited]
     
    現在，心機能の評価では，心臓全体の運動を指標化する方法が一般的である．しかし，心不全の場合心臓の壁運動は局所的に不均一となり，拡張収縮運動が正常に行われている領域とその運動が殆ど見られない領域に分かれる為，診断・治療ではそれらの局所的な違いを解析する事が重要となる．そこで本研究では，時系列CT画像より3次元心内膜メッシュモデルを作成し，これらを利用した3次元運動解析を行った為，報告を行う．
  • 植込み型補助人工心臓装着患者の在宅管理 北海道大学病院における植込型補助人工心臓装着患者に対する在宅管理の現状と課題
    大岡 智学, 新宮 康栄, 若狭 哲, 橘 剛, 櫛引 勝年, 加藤 美香, 鴇田 智久, 矢萩 亮児, 寒河江 磨, 松居 喜郎  人工臓器  45-  (2)  S  -57  2016/10  [Not refereed][Not invited]
  • TEVAR後のtypeIIエンドリークによる瘤拡大に対して動脈瘤直接切開による肋間動脈結紮および瘤縫縮を施行した1例
    村瀬 亮太, 若狭 哲, 杉本 聡, 佐藤 公治, 浅井 英嗣, 太安 孝允, 小林 一哉, 新宮 康栄, 大岡 智学, 加藤 裕貴, 橘 剛, 松居 喜郎  日本血管外科学会雑誌  25-  (Suppl.)  228  -228  2016/06  [Not refereed][Not invited]
  • 感染性大動脈瘤手術における遠隔期再感染予防
    飯島 誠, 若狭 哲, 新宮 康栄, 加藤 裕貴, 大岡 智学, 橘 剛, 松居 喜郎  日本血管外科学会雑誌  25-  (Suppl.)  251  -251  2016/06  [Not refereed][Not invited]
  • 鼠径部の人工血管感染に対して閉鎖孔バイパス術を施行した3例の経験
    須野 賢一郎, 新宮 康栄, 杉本 聡, 村瀬 亮太, 浅井 英嗣, 大安 孝允, 佐藤 公治, 飯島 誠, 小林 一哉, 若狭 哲, 大岡 智学, 加藤 裕貴, 橘 剛, 松居 喜郎  日本血管外科学会雑誌  25-  (Suppl.)  362  -362  2016/06  [Not refereed][Not invited]
  • Satoru Wakasa, Yasushige Shingu, Tomonori Ooka, Hiroki Katoh, Tsuyoshi Tachibana, Yoshiro Matsui  ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY  22-  (2)  125  -125  2016  [Not refereed][Not invited]
  • 小児先天性心疾患術後管理におけるトルバプタンの使用経験
    太安 孝允, 浅井 英嗣, 佐藤 公治, 新宮 康栄, 加藤 裕貴, 大岡 智学, 若狭 哲, 橘 剛, 松居 喜郎, 丸藤 哲  日本集中治療医学会雑誌  23-  (Suppl.)  514  -514  2016/01  [Not refereed][Not invited]
  • 藤居勇貴, 腰塚靖之, 財津雅昭, 川村典生, 後藤了一, 山下健一郎, 杉谷篤, 若狭哲, 松居喜郎, 嶋村剛  北海道外科雑誌  60-  (2)  214  2015/12/20  [Not refereed][Not invited]
  • 上行大動脈弓部置換術後の大動脈食道瘻に対し、TEVAR内挿後、胸腔鏡下食道切除術を施行した一例
    上村 志臣, 七戸 俊明, 村上 壮一, 海老原 裕磨, 倉島 庸, 鯉沼 潤吉, 田中 公貴, サシーム・パウデル, 若狭 哲, 平野 聡  Japanese Journal of Acute Care Surgery  5-  (2)  211  -211  2015/10  [Not refereed][Not invited]
  • Yasushige Shingu, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Yoshiro Matsui  JOURNAL OF CARDIAC FAILURE  21-  (10)  S157  -S157  2015/10  [Not refereed][Not invited]
  • Bridge to recoverとなったHeartmate II装着例に対する治療経験
    大岡 智学, 浅井 英嗣, 佐藤 公治, 小林 一哉, 新宮 康栄, 加藤 裕貴, 若狭 哲, 橘 剛, 松居 喜郎  人工臓器  44-  (2)  S  -156  2015/10  [Not refereed][Not invited]
  • 心移植直後に発症した、タクロリムスによると思われる横紋筋融解を呈した1例
    大岡 智学, 大安 孝允, 佐藤 公治, 小林 一哉, 新宮 康栄, 加藤 裕貴, 若狭 哲, 櫛引 勝年, 小林 真梨子, 松居 喜郎  移植  50-  (総会臨時)  383  -383  2015/09  [Not refereed][Not invited]
  • 心臓血管 small volume centerにおける慢性血栓性肺高血圧症に対する肺動脈血栓内膜摘除の成績
    大岡 智学, 関 達也, 内藤 祐嗣, 新宮 康栄, 若狭 哲, 橘 剛, 松居 喜郎  日本外科学会定期学術集会抄録集  115回-  OP  -184  2015/04  [Not refereed][Not invited]
  • 北大関連病院データベース(HOCARD)を用いた腹部大動脈瘤破裂の検討
    佐藤 公治, 若狭 哲, 浅井 英嗣, 太安 孝允, 関 達也, 内藤 祐嗣, 新宮 康栄, 大岡 智学, 加藤 裕貴, 橘 剛, 松居 喜郎  日本心臓血管外科学会雑誌  44-  (Suppl.)  283  -283  2015/01  [Not refereed][Not invited]
  • 左室形態からみた虚血性心筋症に対する左室形成と乳頭筋接合術の意義
    若狭 哲, 新宮 康栄, 大岡 智学, 加藤 裕貴, 橘 剛, 松居 喜郎  日本心臓血管外科学会雑誌  44-  (Suppl.)  343  -343  2015/01  [Not refereed][Not invited]
  • 心大血管再手術138例の検討
    内藤 祐嗣, 新宮 康栄, 若狭 哲, 大岡 智学, 加藤 裕貴, 橘 剛, 松居 喜郎  日本心臓血管外科学会雑誌  44-  (Suppl.)  376  -376  2015/01  [Not refereed][Not invited]
  • 僧帽弁収縮期前方運動と左室流出路狭窄に対する心室中隔切除術の検討
    新宮 康栄, 若狭 哲, 大岡 智学, 橘 剛, 杉木 宏司, 松居 喜郎  日本心臓血管外科学会雑誌  44-  (Suppl.)  392  -392  2015/01  [Not refereed][Not invited]
  • 末梢吻合部位の深さからみた遠位弓部大動脈瘤に対するstaged repair選択基準の検討
    佐藤 公治, 若狭 哲, 浅井 英嗣, 太安 孝允, 関 達也, 内藤 祐嗣, 新宮 康栄, 大岡 智学, 加藤 裕貴, 橘 剛, 松居 喜郎  日本心臓血管外科学会雑誌  44-  (Suppl.)  438  -438  2015/01  [Not refereed][Not invited]
  • 遠隔成績を鑑みて、機能性三尖弁閉鎖不全に対する弁輪形成術単独は十分か?
    大岡 智学, 関 達也, 内藤 祐嗣, 新宮 康栄, 若狭 哲, 橘 剛, 松居 喜郎  日本心臓血管外科学会雑誌  44-  (Suppl.)  236  -236  2015/01  [Not refereed][Not invited]
  • 加藤拓也, 蒲池浩文, 敦賀陽介, 若山顕治, 折茂達也, 柿坂達彦, 横尾英樹, 神山俊哉, 若狭哲, 大岡智学, 阿保大介, 作原祐介, 松居喜郎, 武冨紹信  日本外科学会定期学術集会(Web)  115th-  RS-19-7 (WEB ONLY)  -7  2015  [Not refereed][Not invited]
  • 加藤拓也, 蒲池浩文, 敦賀陽介, 若山顕治, 折茂達也, 柿坂達彦, 横尾英樹, 神山俊哉, 武冨紹信, 若狭哲, 大岡智学, 阿保大介, 作原祐介  北海道外科雑誌  59-  (2)  190  -190  2014/12/20  [Not refereed][Not invited]
  • 木井修平, 蒲池浩文, 敦賀陽介, 若山顕治, 柿坂達彦, 横尾英樹, 神山俊哉, 武冨紹信, 阿保大介, 若狭哲  IVR  29-  (4)  426  -426  2014/12/01  [Not refereed][Not invited]
  • EVAHEART装着後のMRSA縦隔炎及びポンプポケット感染例に対するJarvik2000換装(左開胸)の経験
    大岡 智学, 内藤 祐嗣, 新宮 康栄, 若狭 哲, 橘 剛, 松居 喜郎  人工臓器  43-  (2)  S  -149  2014/09  [Not refereed][Not invited]
  • 北海道における心臓移植報告
    大岡 智学, 新宮 康栄, 若狭 哲, 松居 喜郎, 榊原 守, 絹川 真太郎, 筒井 裕之, 小林 真梨子, 久保田 卓, 杉木 宏司  日本移植学会総会プログラム抄録集  50回-  431  -431  2014/08  [Not refereed][Not invited]
  • 北海道大学における植込型補助人工心臓治療及び心臓移植実施体制の現状
    大岡 智学, 新宮 康栄, 若狭 哲, 橘 剛, 久保田 卓, 松居 喜郎, 絹川 真太郎, 榊原 守, 筒井 裕之, 小林 真梨子, 浅野 恵子, 寒河江 磨, 法邑 まなみ, 矢萩 亮児, 加藤 伸彦  移植  49-  (1)  192  -193  2014/05  [Not refereed][Not invited]
  • 松居 喜郎, 内藤 祐嗣, 新宮 康栄, 若狭 哲, 大岡 智学, 加藤 裕貴, 橘 剛, 久保田 卓  日本外科学会雑誌  115-  (2)  171  -171  2014/03/05  [Not refereed][Not invited]
  • 松居 喜郎, 新宮 康栄, 若狭 哲, 大岡 智学, 加藤 裕貴, 裕貴 剛, 久保田 卓  日本外科学会雑誌  115-  (2)  241  -241  2014/03/05  [Not refereed][Not invited]
  • 若狭 哲, 内藤 祐嗣, 久保田 卓, 関 達也, 小林 一哉, 新宮 康栄, 大岡 智学, 橘 剛, 松居 喜郎  日本外科学会雑誌  115-  (2)  489  -489  2014/03/05  [Not refereed][Not invited]
  • 新宮 康栄, 若狭 哲, 大岡 智学, 加藤 裕貴, 橘 剛, 久保田 卓, 松居 喜郎  日本外科学会雑誌  115-  (2)  612  -612  2014/03/05  [Not refereed][Not invited]
  • 心臓再手術のPitfalls 心大血管再手術のPitfalls
    松居 喜郎, 内藤 祐嗣, 新宮 康栄, 若狭 哲, 大岡 智学, 加藤 裕貴, 橘 剛, 久保田 卓  日本外科学会雑誌  115-  (臨増2)  171  -171  2014/03  [Not refereed][Not invited]
  • 大動脈弁形成術を伴うRemodeling法による弁温存大動脈塞部再建術
    松居 喜郎, 新宮 康栄, 若狭 哲, 大岡 智学, 加藤 裕貴, 橘 剛, 久保田 卓  日本外科学会雑誌  115-  (臨増2)  241  -241  2014/03  [Not refereed][Not invited]
  • 当科におけるTOFの肺動脈二尖弁に対する自己弁温存の術式と変遷
    加藤 伸康, 橘 鹿, 浅井 英嗣, 安東 悟央, 関 達也, 小林 一哉, 内藤 裕嗣, 新宮 康栄, 若狭 哲, 加藤 裕貴, 大岡 智学, 久保田 卓, 武田 充人, 松居 喜郎  日本心臓血管外科学会雑誌  43-  (Suppl.)  443  -443  2014/01  [Not refereed][Not invited]
  • Satoru Wakasa, Yasushige Shingu, Tomonori Ooka, Tsuyoshi Tachibana, Yoshiro Matsui  JOURNAL OF CARDIAC FAILURE  19-  (10)  S114  -S114  2013/10  [Not refereed][Not invited]
  • 植込型補助人工心臓装着後の課題
    大岡 智学, 新宮 康栄, 若狭 哲, 橘 剛, 久保田 卓, 松居 喜郎  北海道外科雑誌  58-  (1)  70  -70  2013/06  [Not refereed][Not invited]
  • 若狭 哲, 新宮 康栄, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎  日本外科学会雑誌  114-  (2)  2013/03/05  [Not refereed][Not invited]
  • 加藤 伸康, 橘 剛, 浅井 英嗣, 関 達也, 南田 太朗, 飯島 誠, 内藤 祐嗣, 新宮 康栄, 若狭 哲, 大岡 智学, 久保田 卓, 松居 喜郎  日本外科学会雑誌  114-  (2)  2013/03/05  [Not refereed][Not invited]
  • 関 達也, 新宮 康栄, 若狭 哲, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎  日本外科学会雑誌  114-  (2)  2013/03/05  [Not refereed][Not invited]
  • 新宮 康栄, 若狭 哲, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎  日本外科学会雑誌  114-  (2)  2013/03/05  [Not refereed][Not invited]
  • 南田 大朗, 若狭 哲, 加藤 伸康, 関 達也, 浅井 英嗣, 飯島 誠, 内藤 祐嗣, 新宮 康栄, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎  日本外科学会雑誌  114-  (2)  2013/03/05  [Not refereed][Not invited]
  • 内藤 祐嗣, 新宮 康栄, 若狭 哲, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎  日本外科学会雑誌  114-  (2)  2013/03/05  [Not refereed][Not invited]
  • 若狭 哲, 新宮 康栄, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎  日本外科学会雑誌  114-  (2)  465  -465  2013/03/05  [Not refereed][Not invited]
  • 加藤 伸康, 橘 剛, 浅井 英嗣, 関 達也, 南田 太朗, 飯島 誠, 内藤 祐嗣, 新宮 康栄, 若狭 哲, 大岡 智学, 久保田 卓, 松居 喜郎  日本外科学会雑誌  114-  (2)  560  -560  2013/03/05  [Not refereed][Not invited]
  • 関 達也, 新宮 康栄, 若狭 哲, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎  日本外科学会雑誌  114-  (2)  562  -562  2013/03/05  [Not refereed][Not invited]
  • 新宮 康栄, 若狭 哲, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎  日本外科学会雑誌  114-  (2)  563  -563  2013/03/05  [Not refereed][Not invited]
  • 南田 大朗, 若狭 哲, 加藤 伸康, 関 達也, 浅井 英嗣, 飯島 誠, 内藤 祐嗣, 新宮 康栄, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎  日本外科学会雑誌  114-  (2)  564  -564  2013/03/05  [Not refereed][Not invited]
  • 内藤 祐嗣, 新宮 康栄, 若狭 哲, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎  日本外科学会雑誌  114-  (2)  914  -914  2013/03/05  [Not refereed][Not invited]
  • 心臓・大血管手術における止血法の工夫 TFF(TachoSil-Fibrin-Felt)StripとTF Sheet
    松居 喜郎, 若狭 哲, 新宮 康栄, 大岡 智学, 橘 剛, 久保田 卓  日本心臓血管外科学会雑誌  42-  (Suppl.)  193  -193  2013/02  [Not refereed][Not invited]
  • 機能性三尖弁閉鎖不全に対する弁輪形成術後中等度以上の遺残閉鎖不全は予測可能か?
    大岡 智学, 新宮 康栄, 若狭 哲, 橘 剛, 久保田 卓, 松居 喜郎  日本心臓血管外科学会雑誌  42-  (Suppl.)  363  -363  2013/02  [Not refereed][Not invited]
  • KATO NOBUYASU, ASAI HIDETSUGU, SEKI TATSUYA, MINAMIDA TARO, IIJIMA MAKOTO, NAITO YUJI, SHINGU YASUSHIGE, WAKASA SATORU, OOKA TOMONORI, TACHIBANA TSUYOSHI, KUBOTA SUGURU, MATSUI YOSHIRO  日本成人先天性心疾患学会雑誌  2-  (1)  83  -83  2013/01  [Not refereed][Not invited]
  • TCPC conversion時にextra cardiac routeにおける工夫と右室縫縮を施行した一例
    浅井 英嗣, 加藤 伸康, 若狭 哲, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎, 古川 卓朗, 武井 黄太, 山澤 弘州, 武田 充人, 上野 倫彦  日本成人先天性心疾患学会雑誌  2-  (1)  109  -109  2013/01  [Not refereed][Not invited]
  • 植込型補助人工心臓承認によって重症心不全治療はどう変わったか? 重症心不全患者に対する左室形成術の成績から見た植込型補助人工心臓装着を含む外科的重症心不全治療戦略
    大岡 智学, 新宮 康栄, 若狭 哲, 橘 剛, 久保田 卓, 松居 喜郎  人工臓器  41-  (2)  S  -33  2012/11  [Not refereed][Not invited]
  • 新宮 康栄, 久保田 卓, 若狭 哲, 夷岡 徳彦, 森 大輔, 大岡 智学, 橘 剛, 松居 喜郎  北海道醫學雜誌 = Acta medica Hokkaidonensia  87-  (6)  268  -268  2012/11/01  [Not refereed][Not invited]
  • Yoshiro Matsui, Yasushige Shingu, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Suguru Kubota  JOURNAL OF CARDIAC FAILURE  18-  (10)  S134  -S134  2012/10  [Not refereed][Not invited]
  • 千葉知, 納谷昌直, 吉永恵一郎, 岩野弘幸, 山田聡, 若狭哲, 新宮康栄, 久保田卓, 松居喜郎, 筒井裕之, 玉木長良  核医学  49-  (3)  261  2012/08/31  [Not refereed][Not invited]
  • 千葉知, 納谷昌直, 岩野弘幸, 吉永恵一郎, 山田聡, 若狭哲, 松居喜郎, 玉木長良, 筒井裕之  日本心臓病学会誌  7-  (Supplement 1)  339  2012/08/06  [Not refereed][Not invited]
  • 久保田 卓, 松井 欣哉, 若狭 哲, 須藤 行雄, 佐々木 重幸, 吉永 恵一郎, 松居 喜郎  北海道醫學雜誌 = Acta medica Hokkaidonensia  87-  (4)  191  -191  2012/08/01  [Not refereed][Not invited]
  • 松居 喜郎, 新宮 康栄, 内藤 祐嗣, 夷岡 徳彦, 若狭 哲, 大岡 智学, 橘 剛, 久保田 卓  日本外科学会雑誌  113-  (2)  261  -261  2012/03/05  [Not refereed][Not invited]
  • 内藤 祐嗣, 夷国 徳彦, 新宮 康栄, 若狭 哲, 大岡 智学, 加藤 裕貴, 橘 剛, 久保田 卓, 松居 喜郎  日本外科学会雑誌  113-  (2)  392  -392  2012/03/05  [Not refereed][Not invited]
  • 関 達也, 新宮 康栄, 榊原 守, 若狭 哲, 大岡 智学, 橘 剛, 久保田 卓, 筒井 裕之, 松居 喜郎  日本外科学会雑誌  113-  (2)  428  -428  2012/03/05  [Not refereed][Not invited]
  • 浅井 英嗣, 松居 喜朗, 久保田 卓, 橘 剛, 大岡 智学, 若狭 哲, 夷岡 徳彦, 内藤 裕嗣, 新宮 康栄, 南田 太朗, 関 達也  日本外科学会雑誌  113-  (2)  797  -797  2012/03/05  [Not refereed][Not invited]
  • 久保田 卓, 関 達也, 浅井 英嗣, 新宮 康栄, 内藤 祐嗣, 夷岡 徳彦, 若狭 哲, 大岡 智学, 橘 剛, 松居 喜郎  日本外科学会雑誌  113-  (2)  798  -798  2012/03/05  [Not refereed][Not invited]
  • 大岡 智学, 新宮 康栄, 若狭 哲, 橘 剛, 久保田 卓, 松居 喜郎  日本外科学会雑誌  113-  (2)  798  -798  2012/03/05  [Not refereed][Not invited]
  • 新宮 康栄, 関 達也, 久保田 卓, 若狭 哲, 大岡 智学, 橘 剛, 松居 喜郎  日本外科学会雑誌  113-  (2)  799  -799  2012/03/05  [Not refereed][Not invited]
  • 若狭 哲, 久保田 卓, 新宮 康栄, 大岡 智学, 橘 剛, 松居 喜郎  日本外科学会雑誌  113-  (2)  706  -706  2012/03/05  [Not refereed][Not invited]
  • 新しい僧帽弁形成術 Measured Tube Techniqueによる人工腱策再建
    松居 喜郎, 新宮 康栄, 夷岡 徳彦, 若狭 哲, 杉木 宏司, 大岡 智学, 橘 剛, 久保田 卓  日本心臓血管外科学会雑誌  41-  (Suppl.)  345  -345  2012/03  [Not refereed][Not invited]
  • 飯島誠, 関達也, 浅井英嗣, 加藤伸康, 南田大朗, 夷岡徳彦, 内藤祐嗣, 新宮康栄, 若狭哲, 大岡智学, 橘剛, 久保田卓, 松居喜郎  北海道外科雑誌  56-  (2)  160  -161  2011/12/20  [Not refereed][Not invited]
  • 北海道初の植込型補助人工心臓を用いた重症心不全治療の経験 院内治療体制構築からHub-Satellite Hospital systemへ
    大岡 智学, 新宮 康栄, 若狭 哲, 橘 剛, 久保田 卓, 松居 喜郎  北海道外科雑誌  56-  (2)  156  -156  2011/12  [Not refereed][Not invited]
  • 北海道初の植込型補助人工心臓を用いた重症心不全治療の経験 院内治療体制構築からHub-Satellite Hospital systemへ
    大岡 智学, 新宮 康栄, 若狭 哲, 橘 剛, 久保田 卓, 松居 喜郎  人工臓器  40-  (2)  S134  -S134  2011/10  [Not refereed][Not invited]
  • 最新の弁膜症治療 外科治療からカテーテル治療まで 虚血性僧帽弁逆流の外科治療
    松居 喜郎, 久保田 卓, 橘 剛, 大岡 智学, 若狭 哲, 新宮 康栄  日本心臓病学会誌  6-  (Suppl.I)  160  -160  2011/08  [Not refereed][Not invited]
  • 心不全に対する外科治療 左室形成術と心臓移植、植込型補助人工心臓はどのようにすみ分けるか?
    松居 喜郎, 久保田 卓, 橘 剛, 大岡 智学, 若狭 哲, 新宮 康栄  日本心臓病学会誌  6-  (Suppl.I)  172  -172  2011/08  [Not refereed][Not invited]
  • 松居喜郎, 若狭哲, 新宮康栄, 杉木宏司, 大岡智学, 久保田卓  内科  108-  (1)  81  -86  2011/07/01  [Not refereed][Not invited]
  • 松居 喜郎, 若狭 哲, 新宮 康栄  内科  108-  (1)  81  -86  2011/07  [Not refereed][Not invited]
  • 飯島誠, 澁谷千英子, 南田大朗, 小林一哉, 松井欣哉, 杉木宏司, 橘剛, 松居喜郎, 浅井英嗣, 加藤伸康, 夷岡徳彦, 内藤祐嗣, 若狭哲, 大岡智学, 久保田卓  北海道外科雑誌  56-  (1)  69  -70  2011/06/20  [Not refereed][Not invited]
  • 若狭 哲, 久保田 卓, 杉木 宏司, 大岡 智学, 橘 剛, 千葉 知, 吉永 恵一郎, 筒井 裕之, 玉木 長良, 松居 喜郎  日本外科学会雑誌  112-  (1)  418  -418  2011/05/25  [Not refereed][Not invited]
  • 飯島誠, 浅井英嗣, 澁谷千英子, 加藤伸康, 南田太朗, 小林一哉, 内藤祐嗣, 夷岡徳彦, 松井欣哉, 若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  日本血管外科学会雑誌  20-  (2)  2011
  • 内藤祐嗣, 夷岡徳彦, 松井欣哉, 若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  日本心臓血管外科学会雑誌  40-  (Supplement)  2011
  • 若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  日本心臓血管外科学会雑誌  40-  (Supplement)  2011
  • 松井欣哉, 飯島誠, 小林一哉, 夷岡徳彦, 若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  日本血管外科学会雑誌  20-  (2)  2011
  • 久保田卓, 澁谷千英子, 夷岡徳彦, 松井欣哉, 若狭哲, 杉木宏司, 大岡智学, 橘剛, 松居喜郎  日本心臓血管外科学会雑誌  40-  (Supplement)  2011
  • 若狭哲, 国原孝, 久保田卓, 杉木宏司, 大岡智学, 橘剛, 椎谷紀彦, 松居喜郎  日本血管外科学会雑誌  20-  (2)  2011
  • 大岡智学, 松居喜郎, 松井欣哉, 杉木宏司, 若狭哲, 橘剛, 久保田卓  日本心臓血管外科学会雑誌  40-  (Supplement)  2011
  • 内藤祐嗣, 夷岡徳彦, 若狭哲, 杉木宏司, 大岡智学, 加藤裕貴, 橘剛, 久保田卓, 松居喜郎  北海道外科雑誌  56-  (1)  2011
  • 澁谷千英子, 久保田卓, 若狭哲, 杉木宏司, 大岡智学, 橘剛, 松居喜郎  北海道外科雑誌  56-  (1)  2011
  • 大岡智学, 若狭哲, 久保田卓, 杉木宏司, 橘剛, 松居喜郎  北海道外科雑誌  56-  (1)  2011
  • Yoshiro Matsui, Satoru Wakasa, Yasushige Shingu, Tomonori Ooka, Tsuyoshi Tachibana, Suguru Kubota  JOURNAL OF CARDIAC FAILURE  16-  (9)  S137  -S137  2010/09  [Not refereed][Not invited]
  • 僧帽弁逆流の手術時期 虚血性・拡張型心筋症における僧帽弁逆流
    松居 喜郎, 若狭 哲, 杉木 宏司, 大岡 智学, 橘 剛, 久保田 卓  日本心臓病学会誌  5-  (Suppl.I)  171  -171  2010/08  [Not refereed][Not invited]
  • 三尖弁閉鎖不全に対するSJMT Tailor Ringを用いた三尖弁形成術の術後早期成績の検討
    大岡 智学, 松居 喜郎, 久保田 卓, 橘 剛, 若狭 哲  北海道外科雑誌  55-  (1)  76  -76  2010/06  [Not refereed][Not invited]
  • 松居 喜郎, 松井 欣哉, 夷岡 徳彦, 加藤 裕貴, 若狭 哲, 大岡 智学, 橘 剛, 久保田 卓  日本外科学会雑誌  111-  (2)  50  -50  2010/03/05  [Not refereed][Not invited]
  • 若狭 哲, 新宮 康栄, 松井 欣哉, 大岡 智学, 橘 剛, 久保田 卓, 松居 喜郎  日本外科学会雑誌  111-  (2)  557  -557  2010/03/05  [Not refereed][Not invited]
  • 若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  日本冠動脈外科学会学術大会講演抄録集  15th-  2010
  • 杉木宏司, 久保田卓, 大岡智学, 橘剛, 若狭哲, 夷岡徳彦, 松井欣哉, 杉木健司, 松居喜郎  人工臓器(日本人工臓器学会)  39-  (2)  2010
  • 杉木宏司, 久保田卓, 大岡智学, 橘剛, 若狭哲, 松井欣哉, 内藤祐嗣, 夷岡徳彦, 杉木健司, 松居喜郎  日本循環器学会北海道地方会(Web)  104th-  2010
  • 内藤祐嗣, 南田大朗, 飯島誠, 夷岡徳彦, 松井欣哉, 若狭哲, 杉木宏司, 大岡智学, 加藤裕貴, 橘剛, 久保田卓, 松居喜郎  日本循環器学会北海道地方会(Web)  103rd-  2010
  • 大岡智学, 夷岡徳彦, 内藤祐嗣, 松井欣哉, 杉木宏司, 若狭哲, 橘剛, 久保田卓, 松居喜郎  日本循環器学会北海道地方会(Web)  103rd-  2010
  • 南田大朗, 夷岡徳彦, 松井欣哉, 若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  日本循環器学会北海道地方会(Web)  103rd-  2010
  • 杉木宏司, 久保田卓, 大岡智学, 若狭哲, 橘剛, 杉木健司, 松居喜郎  日本循環器学会北海道地方会(Web)  103rd-  2010
  • 杉木宏司, 南田大朗, 大岡智学, 久保田卓, 若狭哲, 橘剛, 夷岡徳彦, 松居喜郎  日本冠動脈外科学会学術大会講演抄録集  15th-  2010
  • 若狭哲, 久保田卓, 杉木宏司, 大岡智学, 橘剛, 松居喜郎  日本冠疾患学会雑誌  16-  (4)  2010
  • 若狭哲, 松井欣哉, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  日本血管外科学会雑誌  19-  (2)  2010
  • 松井欣哉, 夷岡徳彦, 若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  日本血管外科学会雑誌  19-  (2)  2010
  • 若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  日本循環器学会北海道地方会(Web)  103rd-  2010
  • 松井欣哉, 渋谷千鶴子, 夷岡徳彦, 若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  日本循環器学会北海道地方会(Web)  103rd-  2010
  • 飯島誠, 松居喜郎, 久保田卓, 橘剛, 大岡智学, 杉木宏司, 若狭哲, 松井欣哉, 夷岡徳彦, 内藤祐嗣, 河合昭浩, 澁谷千英子  日本循環器学会北海道地方会(Web)  103rd-  2010
  • 久保田卓, 澁谷千英子, 内藤祐嗣, 夷岡徳彦, 松井欣哉, 杉木宏司, 若狭哲, 大岡智学, 橘剛, 松居喜郎  日本循環器学会北海道地方会(Web)  103rd-  2010
  • 久保田卓, 河合昭浩, 内藤祐嗣, 夷岡徳彦, 松井欣哉, 杉木宏司, 若狭哲, 大岡智学, 橘剛, 松居喜郎  日本循環器学会北海道地方会(Web)  104th-  2010
  • 澁谷千英子, 加藤伸康, 内藤祐司, 夷岡徳彦, 松井欣哉, 若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  日本循環器学会北海道地方会(Web)  103rd-  2010
  • 若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  General Thoracic and Cardiovascular Surgery  58-  (Supplement)  2010
  • 若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  北海道外科雑誌  55-  (1)  2010
  • 南田大朗, 杉木宏司, 内藤祐嗣, 夷岡徳彦, 松井欣哉, 若狭哲, 大岡智学, 橘剛, 久保田卓, 松居喜郎  北海道外科雑誌  55-  (2)  2010
  • 飯島誠, 澁谷千英子, 河合昭浩, 加藤伸康, 南田大朗, 内藤祐嗣, 夷岡徳彦, 松井欣哉, 若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  北海道外科雑誌  55-  (2)  2010
  • 松井欣哉, 内藤祐嗣, 夷岡徳彦, 若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎  北海道外科雑誌  55-  (2)  2010
  • 三尖弁閉鎖不全に対する人工弁輪を用いた三尖弁形成術の術後早期成績の検討
    大岡 智学, 夷岡 徳彦, 松井 欣哉, 若狭 哲, 橘 剛, 久保田 卓, 松居 喜郎  日本心臓血管外科学会雑誌  39-  (Suppl.)  272  -272  2010/01  [Not refereed][Not invited]
  • TACHIBANA TSUYOSHI, ABE SHINJI, NAITO YUJI, EBUOKA NORIYOSHI, SHINGU YASUSHIGE, MATSUI KIN'YA, SUGIKI TAKASHI, WAKASA SATOSHI, OOKA TOMONORI, YAMAKAWA SATOSHI, KUBOTA SUGURU, SHIIYA NORIHIKO, MURASHITA TOSHIFUMI, MATSUI YOSHIRO  Gen Thorac Cardiovasc Surg  57-  (8)  7  2009/08/10  [Not refereed][Not invited]
  • 杉木孝司, 納谷昌直, 新宮康栄, 松井欣也, 若狭哲, 久保田卓, 椎谷紀彦, 筒井裕之, 玉木長良, 松居喜郎  Gen Thorac Cardiovasc Surg  57-  (8)  15  2009/08/10  [Not refereed][Not invited]
  • TACHIBANA TSUYOSHI, EBUOKA NORIYOSHI, MATSUI KIN'YA, WAKASA SATORU, OOKA TOMONORI, KUBOTA SUGURU, MATSUI YOSHIRO  北海道外科雑誌  54-  (1)  2  -5  2009/06/20  [Not refereed][Not invited]
  • 杉木孝司, 納谷昌直, 新宮康栄, 松井欣也, 若狭哲, 大岡智学, 久保田卓, 椎谷紀彦, 玉木長良, 筒井裕之, 松居喜郎  日本心臓血管外科学会雑誌  38-  (Supplement)  351  2009/03/20  [Not refereed][Not invited]
  • 当科における慢性血栓塞栓性肺高血圧症に対する肺動脈血栓内膜摘除症例の検討
    大岡 智学, 夷岡 徳彦, 新宮 康栄, 杉木 孝司, 松井 欣哉, 若狭 哲, 橘 剛, 久保田 卓, 山川 智士, 椎谷 紀彦, 松居 喜郎, 安藤 太三  日本心臓血管外科学会雑誌  38-  (Suppl.)  324  -324  2009/03  [Not refereed][Not invited]
  • 大岡 智学, 夷岡 徳彦, 新宮 康栄, 杉木 孝司, 松井 欣哉, 若狭 哲, 橘 剛, 久保田 卓, 椎谷 紀彦, 松居 喜郎  日本外科学会雑誌  110-  (2)  378  -378  2009/02/25  [Not refereed][Not invited]
  • 新宮 康栄, 大山 徳子, 加藤 伸康, 夷岡 徳彦, 杉木 孝司, 若狭 哲, 大岡 智学, 橘 剛, 山川 智士, 久保田 卓, 椎谷 紀彦, 村下 十志文, 松居 喜郎  Circulation journal : official journal of the Japanese Circulation Society  72-  (0)  1073  -1073  2008/10/20  [Not refereed][Not invited]
  • 久保田 卓, 夷岡 徳彦, 新宮 康栄, 松井 欣哉, 杉木 孝司, 若狭 哲, 大岡 智学, 橘 剛, 山川 智士, 椎谷 紀彦, 村下 十志文, 松居 喜郎  Circulation journal : official journal of the Japanese Circulation Society  72-  (0)  1073  -1073  2008/10/20  [Not refereed][Not invited]
  • 片側肺血管床の発育不良、側副血行路の発達を認め、intrapulmonary septation(IPS)を施行した1例
    武井 黄太, 八鍬 聡, 武田 充人, 上野 倫彦, 村上 智明, 村下 十志文, 若狭 哲, 杉木 宏司  日本小児循環器学会雑誌  24-  (4)  563  -563  2008/07  [Not refereed][Not invited]
  • 新宮 康栄, 夷岡 徳彦, 松井 欣哉, 杉木 孝司, 若狭 哲, 橘 剛, 山川 智士, 久保田 卓, 椎谷 紀彦, 村下 十志文, 松居 喜郎  日本外科学会雑誌  109-  (2)  123  -123  2008/04/25  [Not refereed][Not invited]
  • 若狭 哲, 椎谷 紀彦, 橘 剛, 久保田 卓, 村下 十志文, 松居 喜郎  日本外科学会雑誌  109-  (2)  208  -208  2008/04/25  [Not refereed][Not invited]
  • TACHIBANA TAKESHI, ABE SHINJI, NAITO HIROSHI, EBISUOKA NORIHIKO, SHINGU YASUEI, MATSUI KIN'YA, SUGIKI KOJI, WAKASA SATOSHI, SUGIKI KOJI, YAMAKAWA SATOSHI, KUBOTA TAKASHI, SHIIYA NORIHIKO, MURASHITA TOSHIFUMI, MATSUI YOSHIRO  Gen Thorac Cardiovasc Surg  56-  (4)  16  2008/04/10  [Not refereed][Not invited]
  • 新宮康栄, 阿部慎司, 内藤祐嗣, 松井欣哉, 若狭哲, 杉木宏司, 橘剛, 山川智士, 久保田卓, 椎谷紀彦, 村下十志文, 松居喜郎  General Thoracic and Cardiovascular Surgery  56-  (4)  2008
  • 阿部慎司, 内藤祐嗣, 新宮康栄, 松井欣哉, 若狭哲, 杉木宏司, 橘剛, 久保田卓, 山川智士, 椎谷紀彦, 村下十志文, 松居喜郎  General Thoracic and Cardiovascular Surgery  56-  (4)  2008
  • 松井欣哉, 阿部慎司, 夷岡徳彦, 内藤祐嗣, 新宮康栄, 杉木孝司, 若狭哲, 杉木宏司, 橘剛, 久保田卓, 山川智士, 椎谷紀彦, 村下十志文, 松居喜郎  General Thoracic and Cardiovascular Surgery  56-  (4)  2008
  • 重症心不全に対する左室形成術による外科治療
    松居 喜郎, 新宮 康栄, 若狭 哲, 杉木 孝司, 松井 欣哉, 久保田 卓, 椎谷 紀彦, 村下 十志文, 志村 信一郎, 須藤 幸雄  適応医学  11-  (2)  50  -56  2008/01  [Not refereed][Not invited]
     
    拡張心に伴う重症心不全に対して、症例に応じOverlapping法あるいは乳頭筋接合術を加えた変法、さらに乳頭筋接合術単独施行を行った。今回これらの術式による中期遠隔成績を報告した。非虚血性拡張型心筋症(DCM)36例、虚血性拡張型心筋症(ICM)34例を対象とした。周術期は心臓関連死亡はなく、緊急手術の1例が脳障害、2例が肺炎で死亡した。中期成績では4例が心不全、1例が不整脈、5例が感染、2例が脳梗塞、1例が腎不全で死亡した。1年、3年生存率は順にDCM 59±5、59±5%、ICM 92±6、87±6%、total 75±6、72±6%であった。Overlapping法、乳頭筋接合術を組み合わせた左室形成術は短期的には比較的安全で、特に虚血性心筋症に対し心機能改善の意味で有効な術式であるが、中期成績では非心臓死が多く、術前状態の悪化する前の手術が重要であることが示唆された。
  • 内藤 祐嗣, 阿部 慎司, 夷岡 徳彦, 新宮 康栄, 杉木 孝司, 松井 欣哉, 若狭 哲, 杉木 宏司, 橘 剛, 山川 智士, 久保田 卓, 椎谷 紀彦, 村下 十志文, 松居 喜郎  北海道外科雑誌  52-  (2)  212  -212  2007/12
  • 虚血性MRの病態と治療戦略 拡大心によるfunctional MRに対して僧帽弁輪形成にPapillary muscle approximationを加えた治療戦略
    久保田 卓, 松居 喜郎, 阿部 慎司, 夷岡 徳彦, 新宮 康栄, 杉木 孝司, 若狭 哲, 橘 剛, 山川 智士, 椎谷 紀彦, 村下 十志文  日本冠疾患学会雑誌  13-  (4)  296  -296  2007/11
  • 新宮 康栄, 松居 喜郎, 内藤 祐嗣, 松井 欣哉, 若狭 哲, 杉木 宏司, 橘 剛, 山川 智士, 久保田 卓, 椎谷 紀彦, 村下 十志文  Circulation journal : official journal of the Japanese Circulation Society  71-  (0)  1010  -1010  2007/10/20  [Not refereed][Not invited]
  • 杉木 孝司, 国原 孝, 若狭 哲, 杉木 宏司, 椎谷 紀彦, 村下 十志文, 松屑 喜郎  Circulation journal : official journal of the Japanese Circulation Society  71-  (0)  824  -824  2007/04/20  [Not refereed][Not invited]
  • 松居 喜郎, 須藤 幸雄, 志村 信一郎, 若狭 哲, 杉木 宏司, 国原 孝, 椎谷 紀彦, 村下 十志文  日本外科学会雑誌  108-  (2)  322  -322  2007/03/10  [Not refereed][Not invited]
  • 松井欣哉, 椎谷紀彦, 新宮康栄, 杉木孝, 若狭哲, 杉木宏司, 橘剛, 山川智士, 久保田卓, 村下十志文, 松居喜郎  日本臨床外科学会雑誌  68-  (9)  2007
  • 新宮康栄, 松井欣哉, 杉木孝司, 若狭哲, 杉木宏司, 橘剛, 山川智士, 久保田卓, 椎谷紀彦, 村下十志文, 松居喜郎  日本臨床外科学会雑誌  68-  (9)  2007
  • 松居喜郎, 杉木宏司, 若狭哲, 新宮康栄, 久保田卓, 椎谷紀彦, 村下十志文  日本外科系連合学会誌  32-  (3)  2007
  • 新宮康栄, 椎谷紀彦, 阿部慎司, 内藤祐嗣, 松井欣哉, 若狭哲, 杉木宏司, 橘剛, 山川智士, 久保田卓, 村下十志文, 松居喜郎  脈管学  47-  (Supplement)  2007
  • 松井欣哉, 新宮康栄, 杉木孝司, 若狭哲, 杉木宏司, 橘剛, 久保田卓, 山川智士, 椎谷紀彦, 村下十志文, 松居喜郎, 吉永恵一郎, 玉木長良, 志村信一郎, 須藤幸雄  General Thoracic and Cardiovascular Surgery  55-  (Supplement)  2007
  • 新宮康栄, 内藤祐嗣, 松井欣哉, 若狭哲, 杉木宏司, 橘剛, 山川智士, 久保田卓, 椎谷紀彦, 村下十志文, 松居喜郎  General Thoracic and Cardiovascular Surgery  55-  (Supplement)  2007
  • 松井欣哉, 椎谷紀彦, 内藤祐嗣, 新宮康栄, 杉木孝司, 若狭哲, 杉木宏司, 橘剛, 松崎賢司, 山川智, 久保田卓, 村下十志文, 松居喜郎  北海道外科雑誌  52-  (2)  2007
  • 新生児期より心室中隔欠損孔の狭小化を来したファロー四徴症の1例
    上野 倫彦, 武井 黄太, 八鍬 聡, 武田 充人, 村上 智明, 若狭 哲, 杉木 宏司, 村下 十志文  日本小児科学会雑誌  111-  (1)  76  -77  2007/01  [Not refereed][Not invited]
  • 若狭哲, 杉木宏司, 橘剛, 八田英一郎, 窪田武浩, 村下十志文, 安田慶秀  Japanese Journal of Thoracic and Cardiovascular Surgery  54-  (5)  2006
  • 杉木宏司, 窪田武浩, 八田英一郎, 橘剛, 若狭哲, 村下十志文, 安田慶秀  Japanese Journal of Thoracic and Cardiovascular Surgery  54-  (5)  2006
  • 橘剛, 杉木孝司, 若狭哲, 杉木宏司, 山下知剛, 加藤裕貴, 松崎賢司, 八田英一郎, 国原孝, 窪田武浩, 椎谷紀彦, 村下十志文, 安田慶秀  Japanese Journal of Thoracic and Cardiovascular Surgery  54-  (5)  2006
  • 若狭哲, 杉木孝司, 杉木宏司, 橘剛, 窪田武浩, 村下十志文  Japanese Journal of Thoracic and Cardiovascular Surgery  54-  (5)  2006
  • 肺血流量を増加させないように管理しFontan循環に到達した心房錯位症候群の2例
    八鍬 聡, 村上 智明, 盛一 享徳, 武田 充人, 上野 倫彦, 若狭 哲, 杉木 宏司, 八田 英一郎, 窪田 武浩, 村下 十志文, 佐川 浩一, 石川 司郎, 角 秀秋  日本小児循環器学会雑誌  21-  (4)  508  -508  2005/07  [Not refereed][Not invited]
  • 新生児・乳児期混合型総肺静脈還流異常症(TAPVC)の治療方針とその妥当性
    窪田 武浩, 若狭 哲, 杉木 宏司, 橘 剛, 今村 道明, 村下 十志文, 安田 慶秀, 村上 智明, 上野 倫彦, 武田 充人  日本小児循環器学会雑誌  21-  (3)  345  -345  2005/05  [Not refereed][Not invited]
  • 心嚢カテーテル留置によるlate tamponadeの予防効果について
    橘 剛, 若狭 哲, 杉木 宏司, 窪田 武浩, 村下 十志文, 安田 慶秀, 武田 充人, 上野 倫彦, 村上 智明  日本小児循環器学会雑誌  21-  (3)  427  -427  2005/05  [Not refereed][Not invited]
  • 八田英一郎, 若狭哲, 杉木宏司, 橘剛, 窪田武浩, 椎谷紀彦, 村下十志文, 安田慶秀  日本心臓血管外科学会雑誌  34-  (Supplement)  2005
  • 杉木宏司, 窪田武浩, 八田英一郎, 橘剛, 若狭哲, 村下十志文, 今村道明, 村上智明, 上野倫彦  日本小児循環器学会雑誌  21-  (3)  2005
  • 若狭哲, 杉木宏司, 橘剛, 今村道明, 窪田武浩, 村下十志文, 安田慶秀, 村上智明  日本小児循環器学会雑誌  21-  (3)  2005
  • 杉木宏司, 窪田武浩, 八田英一郎, 橘剛, 若狭哲, 村下十志文, 椎谷紀彦, 安田慶秀  日本小児循環器学会雑誌  21-  (4)  2005
  • 窪田武浩, 村下十志文, 今村道明, 八田英一郎, 橘剛, 若狭哲, 杉木宏司, 安田慶秀  日本心臓血管外科学会雑誌  34-  (Supplement)  2005
  • Cantrell症候群に合併したDORV,subaortic VSDの1例
    橘 剛, 若狭 哲, 八田 英一郎, 窪田 武浩, 村下 十志文, 安田 慶秀, 石川 友一, 武田 充人, 斎田 吉伯, 上野 倫彦, 村上 智明  日本小児循環器学会雑誌  20-  (5)  560  -560  2004/09  [Not refereed][Not invited]
  • 先天性心疾患開心術に対するminimal accessは患者に美容上の恩恵をもたらしたのか? 術後遠隔期での検証
    八田 英一郎, 窪田 武浩, 若狭 哲, 橘 剛, 村下 十志文, 安田 慶秀, 齋田 吉伯, 武田 充人, 上野 倫彦, 村上 智明  日本小児循環器学会雑誌  20-  (3)  307  -307  2004/05  [Not refereed][Not invited]
  • 新生児大動脈縮窄症及び大動脈弓離断症に対する治療の検討
    八田 英一郎, 窪田 武浩, 若狭 哲, 橘 剛, 村下 十志文, 安田 慶秀, 齋田 吉伯, 武田 充人, 上野 倫彦, 村上 智明  日本小児循環器学会雑誌  20-  (3)  354  -354  2004/05  [Not refereed][Not invited]
  • 心内膜床欠損症に対するmodified one patch法を行った3症例
    窪田 武浩, 若狭 哲, 橘 剛, 八田 英一郎, 村下 十志文, 安田 慶秀, 村上 智明, 上野 倫彦, 武田 充人, 齋田 吉伯  日本小児循環器学会雑誌  20-  (3)  354  -354  2004/05  [Not refereed][Not invited]
  • 若狭 哲, 加藤 裕貴, 橘 剛, 八田 英一郎, 窪田 武浩, 村下 十志文, 安田 慶秀  日本小児外科学会雑誌  40-  (1)  101  -101  2004  [Not refereed][Not invited]
  • 加藤 裕貴, 明神 一宏, 石橋 義光, 石井 浩二, 宮嵜 直樹, 若狭 哲  Japanese circulation journal  64-  (0)  734  -734  2000/04/20  [Not refereed][Not invited]

Books etc

  • 三田村, 秀雄, 小室, 一成, 横井, 宏佳, 山下, 武志, 楽木, 宏実 (Contributor)
    中外医学社 2001/10 (ISBN: 4498034708) 冊

Presentations

  • 重症心不全に対する自己心温存外科治療戦略  [Invited]
    若狭哲
    重症心不全に対する非薬物治療を考える/アボットメディカル Web講演会  2021/12
  • 僧帽弁形成術/後尖逸脱症例  [Invited]
    若狭哲
    僧帽弁形成術におけるマイテクニック/エドワーズ・オンライン座談会  2021/11
  • 心臓血管外科手術における止血の工夫  [Invited]
    若狭哲
    第41回日本臨床麻酔学会学術集会 シンポジウム１「心臓手術の凝固管理」  2021/11
  • 虚血性僧帽弁閉鎖不全症に対する外科治療戦略  [Invited]
    若狭哲
    第74回日本胸部外科学会定期学術集会 ワークショップ 低左心機能を伴う虚血性閉鎖不全症 ～外科手術 vs Mitraclip～  2021/11
  • Subvalvular surgical procedure for functional mitral regurgitation  [Invited]
    Satoru Wakasa
    MITRAPLUS kick-off meeting  2021/10
  • 重症心不全外科治療とＮＯ吸入療法  [Invited]
    若狭哲
    熊本県 iNO WEBフォーラム  2021/10
  • 重症心不全外科治療とＮＯ吸入療法  [Invited]
    若狭哲
    神奈川県心臓周術期 iNO WEBセミナー  2021/09
  • 虚血性僧帽弁閉鎖不全症  [Invited]
    若狭哲
    日本心臓血管外科学会U-40 online BLC  2021/07
  • Small Aortic Root, session 3  [Invited]
    Satoru Wakasa
    Abbott Japan/China Mentorship Program  2021/06
  • Small Aortic Root, session 2  [Invited]
    Satoru Wakasa
    Abbott Japan/China Mentorship Program  2021/06
  • Small Aortic Root, session 1  [Invited]
    Satoru Wakasa
    Abbott Japan/China Mentorship Program  2021/06
  • Ischemic MR：touch or no touch？  [Invited]
    若狭哲
    第51回日本心臓血管外科学会学術総会 卒後教育セミナー＜冠動脈＞  2021/02
  • 心臓血管外科手術時の止血の工夫  [Invited]
    若狭哲
    第51回日本心臓血管外科学会学術総会 ランチョンセミナー  2021/02
  • 左室リモデリングを中心に考える機能性僧帽弁閉鎖不全症に対する外科治療  [Invited]
    若狭哲
    第51回日本心臓血管外科学会学術総会 シンポジウム2「心室拡大による機能性僧帽弁閉鎖不全症の外科治療」  2021/02
  • オープンステントグラフトを用いた胸部大動脈手術  [Invited]
    若狭哲
    第24回九州心臓血管外科セミナー  2021/01
  • Mitral valve replacement for FMR  [Invited]
    Satoru Wakasa
    Think Mitral – EACTS Live Webinar -  2020/10
  • Functional mitral valve disease - Beyond annuloplasty: targeting the left ventricle  [Invited]
    Satoru Wakasa
    32nd Annual Meeting of the European Association for Cardio-Thoracic Surgery, Milan  2018/10
  • Who benefits from surgical ventricular restoration: consideration according to INTERMACS profiles
    Satoru Wakasa
    21st Annual Meeting of the Asian Society for Cardiovascular and Thoracic Surgery, Kobe  2013/04
  • Left ventriculoplasty for progressively deteriorated left ventricle with global akinesis due to ischaemic cardiomyopathy: Japanese surgical ventricular reconstruction group experience  [Not invited]
    Satoru Wakasa
    26th Annual Meeting of the European Association for Cardio-Thoracic Surgery, Barcelona  2012/10
  • Complete papillary muscle approximation could prevent the recurrence of functional mitral regurgitaion effectively in patients with severe heart failure
    若狭 哲
    24th Annual Meeting of the European Association for Cardio-Thoracic Surgery, Geneva  2010/09
  • Integrated surgical approach with overlapping left ventriculoplasty and papillary muscle approximation for patients with severe heart failure due to ischemic dilated cardiomyopathy
    Satoru Wakasa
    Masters in Repair of Structural Heart Disease, Miami  2010
  • Influence of right ventricular-coronary artery fistula and right ventricular morphology on surgery of pulmonary atresia and intact ventricular septum
    若狭 哲
    14th Annual Meeting of the Asian Society for Cardiovascular Surgery, Osaka  2006
  • 胸部大血管手術～私の工夫  [Invited]
    若狭哲
    第11回浜松心臓血管外科研究会

Research Projects

  • 日本学術振興会：科学研究費助成事業 基盤研究(C)
    Date (from‐to) : 2022/04 -2025/03 
    Author : 中村 賢, 國原 孝, 尾辻 豊, 上嶋 徳久, 荒井 裕国, 松宮 護郎, 高梨 秀一郎, 夜久 均, 松居 喜郎, 若狭 哲, 小宮 達彦, 本村 昇
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C)
    Date (from‐to) : 2017/04 -2020/03 
    Author : Matsui Yoshiro
     
    We developed a novel thermally deformable mitral annuloplasty ring to address the problems in mitral valve surgery. We assessed the ring's mechanical properties and its effect on the mitral valve anatomy. This ring was made of polycaprolactone. In the mechanical tests, the ring's yield point was greater than the deformation force of the annulus in humans. In pigs with deformation from "4:3" to "4:2", the coaptation length was significantly increased in each mitral valve part. Asymmetrical ring deformation increased the coaptation length only at the deformed area. In conclusion, this new thermally deformable mitral annuloplasty ring could be "order-made" to effectively change the coaptation length in all parts of the mitral valve post-deformation via intraoperative heating.
  • Ministry of Education, Culture, Sports, Science and Technology：Grants-in-Aid for Scientific Research(基盤研究(B))
    Date (from‐to) : 2008 -2010 
    Author : 椎谷 紀彦, Satoru WAKASA, Norihiko SHIIYA
     
    Spinal cord injury is one of the disastrous complications after surgical repair of thoracoabdominal aortic aneurysm and remains to be eliminated. We investigated the role of astrocytes in the spinal cord injury after transient spinal cord ischemia to elucidate whether the astrocyte would be a target for prevention of spinal cord injury. In the rabbit model, we demonstrated the significant inverse correlation between the activity of astrocytes and number of intact motor neurons. Furthermore, a concentration of arachidonic adid significantly correlated with the activity of astrocytes.

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