2015年, 日本胸部外科学会 優秀論文賞　　　　　　　　　　　　　　　
若狭哲

2013年12月, 第27回日本冠疾患学会学術集会, 最優秀演題　　　　　　　　　　　　　　　
若狭哲

A study protocol for an international registry observational study evaluating clinical outcomes of transcatheter versus standard surgical mitral valve operation for secondary mitral regurgitation: the TEERMISO study
Francesco Nappi, Sanjeet Singh Avtaar Singh, Antonio Salsano, Cristiano Spadaccio, Yasushige Shingu, Satoru Wakasa, Antonio Fiore
2024年11月02日

Distinct Roles of Omental and Latissimus Dorsi Flaps for Blocking Infection Pathways and Protecting A Left Ventricular Assist Device
Dongkyung Seo, Taku Maeda, Tomonori Ooka, Takahiro Miura, Kosuke Ishikawa, Emi Funayama, Satoru Wakasa, Yuhei Yamamoto
The Heart Surgery Forum, 27, 9, E998, E1002, Forum Multimedia Publishing LLC, 2024年09月10日
研究論文（学術雑誌）, Left ventricular assist devices (LVADs) are vital for managing severe heart failure in transplant-ineligible patients, but device exposure and infection pose significant challenges. This report details a 42-year-old man with dilated cardiomyopathy and bronchial asthma who presented with an externalized LVAD following a HeartMate II to HeartMate III exchange due to malfunction. Our tailored surgical strategy treated the LVAD driveline and main body as two distinct parts. This distinction is crucial, as major upstream infections typically originate from the driveline. We applied flaps to these parts for different purposes, maximizing their unique characteristics. The omental flap, chosen for its flexibility, blood supply, and immunological activation upon foreign body contact, covered the driveline. The latissimus dorsi flap provided vascularity and mechanical protection for the LVAD. Additionally, we review the omentum's basic physiological aspects, which are often unfamiliar to clinicians. Infection has not recurred in 6 months postoperatively, demonstrating the approach's effectiveness.

Orthotopic heart transplantation in patient with situs inversus and pectus excavatum: a case report.
Satoru Wakasa, Tomonori Ooka, Takuma Sato, Yasushige Shingu, Nobuyasu Kato, Toshiyuki Nagai, Toshihisa Anzai, Minoru Ono, Yoshiro Matsui
Surgical case reports, 10, 1, 202, 202, 2024年08月30日, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Heart transplantation in patients with situs inversus is challenging, especially in terms of reconstruction of the systemic venous return. Several rerouting techniques have been presented but are associated with vulnerability to external compression, which might cause hemodynamic instability, especially in the presence of chest deformity. In this study, we report a rare case of successful heart transplantation in the presence of situs inversus and pectus excavatum. CASE PRESENTATION: A 55-year-old man, with a history of surgeries for corrected transposition of the great arteries with ventricular septal defect, was registered for heart transplantation owing to progression of heart failure. Subsequently, he had undergone a left ventricular assist device implantation; 14 years after registration, he underwent transplantation of the heart with normal anatomy. The inferior vena cava was reconstructed by anastomosing the left atria with a counterclockwise rotation of the donor heart and by lengthening the recipient inferior vena cava with a conduit made of the residual right atrial tissue. The superior vena cava was reconstructed using a donor innominate vein harvested with sufficient length. After successful weaning from cardiopulmonary bypass, the chest could not be closed because the heart was compressed owing to chest deformity, resulting in hemodynamic instability. Therefore, to exclude the left lung, a left pericardial screen was created using a bovine pericardium, allowing the chest to be closed with acceptable hemodynamics. The patient suffered postoperatively from a higher venous pressure, suggesting an obstruction of venous return early after surgery. The obstruction gradually resolved, and the patient was transferred for rehabilitation. CONCLUSIONS: Heart transplantation in the presence of situs inversus is challenging; moreover, the presence of pectus excavatum further complicates the procedure. The paradoxically larger left lung and chest deformity compressed and impaired reconstructed systemic venous return. Although intrathoracic exclusion of the left lung was effective, an intraoperative or early postoperative thoracoplasty for pectus excavatum was also a viable option. Patient-specific management is mandatory, depending on the anatomy.

Incidence of atrial fibrillation after esophageal cancer surgery with L-carnitine use: a preliminary single-group interventional study.
Yasushige Shingu, Isao Yokota, Toshiaki Shichinohe, Soichi Murakami, Yuma Ebihara, Yo Kurashima, Satoshi Hirano, Satoru Wakasa
Surgery today, 54, 8, 892, 898, 2024年08月, ［国内誌］
英語, 研究論文（学術雑誌）, PURPOSE: We aimed to investigate the POAF rate and blood FABP4 levels after perioperative L-carnitine administration in patients with esophageal cancer. METHODS: L-carnitine (3 g in three divided doses) was administered to 15 patients 2 days before and 3 days after surgery. POAF during the study period and blood FABP4 levels (ELISA) before and after L-carnitine administration were evaluated. Accurate 95% confidence intervals (CI) for POAF incidence and changes in blood FABP4 levels were calculated. The preoperative predicted POAF rate was calculated using an application for esophageal cancer. The correlation between FABP4 levels and the predicted POAF rate was analyzed using Pearson's coefficient (r). RESULTS: Thirteen patients completed this study. The predicted POAF rate was 24% (17%, 34%) (median; interquartile range). The actual incidence of POAF was 7.7% (95% CI: 0.2-36%). Blood FABP4 levels changed from 10.3 to 7.0 ng/mL; the average change was - 3.3 (95% CI: - 6.6 to - 0.1). A positive correlation was found between preoperative FABP4 levels and the predicted POAF rates (r = 0.564). CONCLUSIONS: The POAF rate after esophageal surgery was 7.7% for L-carnitine. L-carnitine may reduce blood FABP4 levels. This preliminary study will contribute to the planning of sample sizes in future randomized trials.

Chronic Active Myocarditis After Transapical Transcatheter Aortic Valve Implantation.
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年05月24日, ［国内誌］
英語, 研究論文（学術雑誌）

Effects of Trehalose Preconditioning on H9C2 Cell Viability and Autophagy Activation in a Model of Donation after Circulatory Death for Heart Transplantation.
Jingwen Gao, Yasushige Shingu, Satoru Wakasa
Current issues in molecular biology, 46, 4, 3353, 3363, 2024年04月12日, ［国際誌］
英語, 研究論文（学術雑誌）, Donation after circulatory death (DCD) is a promising strategy for alleviating donor shortage in heart transplantation. Trehalose, an autophagy inducer, has been shown to be cardioprotective in an ischemia-reperfusion (IR) model; however, its role in IR injury in DCD remains unknown. In the present study, we evaluated the effects of trehalose on cardiomyocyte viability and autophagy activation in a DCD model. In the DCD model, cardiomyocytes (H9C2) were exposed to 1 h warm ischemia, 1 h cold ischemia, and 1 h reperfusion. Trehalose was administered before cold ischemia (preconditioning), during cold ischemia, or during reperfusion. Cell viability was measured using the Cell Counting Kit-8 after treatment with trehalose. Autophagy activation was evaluated by measuring autophagy flux using an autophagy inhibitor, chloroquine, and microtubule-associated protein 1A/1B light chain 3 B (LC3)-II by western blotting. Trehalose administered before the ischemic period (trehalose preconditioning) increased cell viability. The protective effects of trehalose preconditioning on cell viability were negated by chloroquine treatment. Furthermore, trehalose preconditioning increased autophagy flux. Trehalose preconditioning increased cardiomyocyte viability through the activation of autophagy in a DCD model, which could be a promising strategy for the prevention of cardiomyocyte damage in DCD transplantation.

Influence of epicardial adipose tissue inflammation and adipocyte size on postoperative atrial fibrillation in patients after cardiovascular surgery
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, Wiley, 2024年03月28日
研究論文（学術雑誌）, 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.

Interpapillary muscle distance independently predicts recurrent mitral regurgitation.
Ivancarmine Gambardella, Cristiano Spadaccio, Sanjeet S A Singh, Yasushige Shingu, Takashi Kunihara, Satoru Wakasa, Francesco Nappi
Journal of cardiothoracic surgery, 19, 1, 147, 147, 2024年03月20日, ［国際誌］
英語, 研究論文（学術雑誌）, OBJECTIVE: Ischaemic secondary mitral regurgitation (ISMR) after surgery is due to the displacement of papillary muscles resulting from progressive enlargement of the left ventricle end-diastolic diameter (LVEDD). Our aim was to prove that if the interpapillary muscle distance (IPMD) is surgically stabilized, an increase in LVEDD will not lead to a recurrence of ischaemic mitral regurgitation (MR). METHODS: Ninety-six patients with ISMR, who underwent surgical revascularisation and annuloplasty, were randomly assigned in a 1:1 ratio to undergo papillary muscle approximation (PMA). At the 5-year follow-up, we assessed the correlation between PMA and echocardiographic improvements, the effect size of PMA on echocardiographic improvements, and a prediction model for recurrent MR using inferential tree analysis. RESULTS: There was a significant correlation between PMA and enhancements in both the α and β angles (Spearman's rho > 0.7, p < 0.01). The α angle represents the angle between the annular plane and either the A2 annular-coaptation line or the P2 annular-coaptation line. The β angle indicates the angle between the annular plane and either the A2 annular-leaflet tip line or the P2 annular-leaflet tip line. PMA led to substantial improvements in LVEDD, tenting area, α and β angles, with a large effect size (Hedge's g ≥ 8, 95% CI ORs ≠ 1). The most reliable predictor of recurrent MR grade was the interpapillary distance, as only patients with an interpapillary distance greater than 40 mm developed ≥ 3 + grade MR. For patients with an IPMD of 40 mm or less, the best predictor of recurrent MR grade was LVEDD. Among the patients, only those with LVEDD greater than 62 mm showed moderate (2+) MR, while only those with LVEDD less than or equal to 62 mm had absent to mild (1+) MR. CONCLUSION: Prediction of recurrent ischaemic MR is not independent of progressive LVEDD increase. PMA-based surgical procedure stabilises IPMD.

Rough-zone suspension with mitral valve replacement for ventricular functional mitral regurgitation.
Satoru Wakasa, Yasushige Shingu
General thoracic and cardiovascular surgery, 2023年11月02日, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Impact of sarcopenia on early and mid-term outcomes of surgery for acute type A aortic dissection in octogenarians.
Takahiro Ishigaki, Satoru Wakasa, Yasushige Shingu, Yohei Ohkawa, Akira Yamada
General thoracic and cardiovascular surgery, 71, 11, 674, 680, 2023年11月, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Differences in blood flow dynamics between balloon- and self-expandable valves in patients with aortic stenosis undergoing transcatheter aortic valve replacement.
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年10月26日, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Blood flow characteristics of the bilateral internal thoracic artery: implications of optimal graft configuration for coronary artery bypass grafting to maximize blood supply.
Takashi Kunihara, Yasushige Shingu, Satoru Wakasa, Hiroshi Sugiki, Yasuhiro Kamikubo, Norihiko Shiiya, Yoshiro Matsui
General thoracic and cardiovascular surgery, 71, 10, 552, 560, 2023年10月, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Reconstruction of right ventricular outflow tract with severe calcification: lantern procedure.
Takahiro Ishigaki, Satoru Wakasa, Koji Sato, Nobuyasu Kato, Yasuhiro Kamikubo
General thoracic and cardiovascular surgery, 2023年08月24日, ［国内誌］
英語, 研究論文（学術雑誌）, 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, BioMed Central, 2023年08月
英語

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, 59回, [II, 03], (NPO)日本小児循環器学会, 2023年07月
日本語

Staged definitive repair for pulmonary atresia and ventricular septal defect 40 years after palliative surgery: a case report
Noriyoshi Ebuoka, Norihiro Ando, Hidetsugu Asai, Nobuyasu Kato, Tsuyoshi Tachibana, Satoru Wakasa
General Thoracic and Cardiovascular Surgery Cases, 2023年06月05日
研究論文（学術雑誌）

Impact of Steroid on Macrophage Migration Inhibitory Factor During and After Cardiopulmonary Bypass.
Takashi Kunihara, Yasushige Shingu, Satoru Wakasa, Norihiko Shiiya, Satoshi Gando
ASAIO journal (American Society for Artificial Internal Organs : 1992), 69, 4, 391, 395, 2023年04月01日, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Multimodal Imaging of Constrictive Pericarditis Induced by Long-term Pergolide Treatment for Parkinson's Disease.
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年03月31日, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Impact of right ventricular reserve on exercise capacity and quality of life in patients with left ventricular assist device.
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年03月01日, ［国際誌］
英語, 研究論文（学術雑誌）, 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, 12, 1, 200, 200, (一社)日本成人先天性心疾患学会, 2023年01月
日本語

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, 113, 4, 134, 138, (一社)日本泌尿器科学会, 2022年10月
日本語, 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, 113, 4, 134, 138, (一社)日本泌尿器科学会, 2022年10月, ［査読有り］
日本語

Iatrogenic Arteriovenous Fistula of Subclavian Artery to Vertebral Vein with Perimedullary Vein Reflux
Sato Koji, Shingu Yasushige, Fusegawa Masato, Ishigaki Takahiro, Wakasa Satoru
Annals of Vascular Diseases, 15, 3, 193, 196, The Editorial Committee of Annals of Vascular Diseases, 2022年09月25日, ［査読有り］, ［最終著者, 責任著者］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Changes in Cerebral Hemodynamics During Systemic Pulmonary Shunt and Pulmonary Artery Banding in Infants with Congenital Heart Disease.
Yoshifumi Takeda, Masataka Yamamoto, Koji Hoshino, Yoichi M Ito, Nobuyasu Kato, Satoru Wakasa, Yuji Morimoto
Pediatric cardiology, 44, 3, 695, 701, 2022年09月01日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

A preliminary prediction model using a deep learning software program for prolonged hospitalization after cardiovascular surgery.
Ryota Murase, Yasushige Shingu, Satoru Wakasa
Surgery today, 53, 3, 393, 395, 2022年08月05日, ［査読有り］, ［最終著者］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

A case report of video-assisted flap bronchoplasty for central type typical carcinoid
Yuya Wada, Hideki Ujiie, Ryohei Chiba, Shunsuke Nomura, Aki Fujiwara-Kuroda, Kichizo Kaga, Satoru Wakasa, Tatsuya Kato
VIDEO-ASSISTED THORACIC SURGERY, AME PUBLISHING COMPANY, 2022年08月
英語, 研究論文（学術雑誌）, 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.

A novel system for analyzing indocyanine green (ICG) fluorescence spectra enables deeper lung tumor localization during thoracoscopic surgery.
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年08月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Cardioprotective effects of chloroquine pretreatment on ischemic and reperfusion injury via activation of ERK1/2 in isolated rat hearts.
Ryota Murase, Yasushige Shingu, Satoru Wakasa
Molecular biology reports, 49, 10, 9429, 9436, 2022年07月27日, ［査読有り］, ［最終著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

心臓手術の凝固管理 心臓血管外科手術における止血の工夫
若狭 哲
日本臨床麻酔学会誌, 42, 4, 377, 384, 日本臨床麻酔学会, 2022年07月15日, ［招待有り］, ［筆頭著者, 責任著者］
日本語, 心臓血管外科手術中は薬剤や人工心肺の影響により出血傾向に陥りやすいため，出血原因を迅速かつ正確に判別し，的確な手段をもって確実に止血を行うことが手術成績の向上ならびに安定化において非常に重要である．またこれに際して，外科的出血は輸血や凝固因子の補充のみではコントロール困難であること，こうした補充療法の効果を発揮させるために術野における外科的出血点の速やかなコントロールが重要であることを外科医と麻酔科医が十分理解し，お互いに協力してそれぞれの役割を果たすことが重要である．本稿では，心臓血管外科手術中の止血に際しての考え方や手技の在り方について，外科医としての見解を述べることとする．

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, 58回, [III, 04], (NPO)日本小児循環器学会, 2022年07月
日本語

Effect of Diabetes Mellitus on Outcomes in Patients With Left Ventricular Assist Device - Analysis of Data From a Japanese National Database.
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年07月01日, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

特集 ファロー四徴症に対する外科治療 : 新生児期・幼少期から成人期まで—Surgery for tetralogy of Fallot from infancy to adulthood
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, 2022年06月, ［招待有り］, ［最終著者］
日本語

Long-term preservation of functional capacity and quality of life in advanced heart failure patients with bridge to transplant therapy: A report from Japanese nationwide multicenter registry.
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年06月01日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Protective effects of trehalose preconditioning on cardiac and coronary endothelial function through eNOS signaling pathway in a rat model of ischemia-reperfusion injury.
Kenichiro Suno, Yasushige Shingu, Satoru Wakasa
Molecular and cellular biochemistry, 477, 10, 2403, 2414, 2022年05月17日, ［査読有り］, ［最終著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Changes in AMPKα and Ubiquitin Ligases in Myocyte Reverse Remodeling after Surgical Ventricular Reconstruction in rats with ischemic cardiomyopathy.
Yasushige Shingu, Tetsuya Hieda, Satoshi Sugimoto, Hidetsugu Asai, Tomoji Yamakawa, Satoru Wakasa
Molecular biology reports, 49, 6, 4885, 4892, 2022年05月08日, ［査読有り］, ［最終著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Bronchial artery hypertrophy-associated perioperative pulmonary hemorrhage in cardiovascular surgery: a case report.
Shinji Abe, Yasuhiro Kamikubo, Nobuyasu Kato, Hiroki Kato, Tomonori Ooka, Yasushige Shingu, Satoru Wakasa
Surgical case reports, 8, 1, 80, 80, 2022年04月29日, ［査読有り］, ［最終著者, 責任著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

A simple closure method for a mechanical aortic valve in left ventricular assist device implantation.
Takahiro Ishigaki, Satoru Wakasa
General thoracic and cardiovascular surgery, 70, 7, 677, 679, 2022年04月07日, ［査読有り］, ［最終著者, 責任著者］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Presurgical assessment of flow variability in an azygos vein aneurysm using 4D-flow MRI.
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年04月06日, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Elective Uniportal Video-Assisted Thoracoscopic Lobectomy for Congenital Cystic Lung Disease in a 2-Year-Old Child Using One-Lung Ventilation
Haruhiko Shiiya, Hideki Ujiie, Tatsuya Kato, Shohei Honda, Satoru Wakasa, Kichizo Kaga
INDIAN JOURNAL OF SURGERY, SPRINGER INDIA, 2022年04月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

Chunnel debranching for hybrid repair of thoracoabdominal aortic aneurysm.
Satoru Wakasa, Koji Sato, Takahiro Ishigaki, Yoshinobu Watabe, Shinji Abe
General thoracic and cardiovascular surgery, 70, 6, 588, 590, 2022年03月21日, ［査読有り］, ［筆頭著者, 責任著者］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Effects of trehalose on recurrence of remodeling after ventricular reconstruction in rats with ischemic cardiomyopathy.
Tetsuya Hieda, Yasushige Shingu, Satoshi Sugimoto, Hidetsugu Asai, Tomoji Yamakawa, Satoru Wakasa
Heart and vessels, 37, 3, 528, 537, 2022年03月, ［査読有り］, ［最終著者］, ［国内誌］
英語, 研究論文（学術雑誌）, 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, 62, 1, 72, 73, (NPO)日本肺癌学会, 2022年02月, ［査読有り］
日本語

JCS 2018 Guideline on Revascularization of Stable Coronary Artery Disease.
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年01月31日, ［招待有り］, ［国内誌］
英語, 研究論文（学術雑誌）

肺血栓塞栓症を発症した膝窩静脈の静脈性血管瘤の1治験例
吉本 公洋, 若狭 哲
日本心臓血管外科学会雑誌, 51, 1, 53, 56, 特定非営利活動法人 日本心臓血管外科学会, 2022年01月15日, ［査読有り］, ［最終著者］
日本語, 静脈性血管瘤（Venous Aneurysm：VA）は限局性の静脈拡張性病変と定義される比較的稀な疾患であるが，深部静脈のVAでは瘤での血栓形成が肺血栓塞栓症（PTE）の原因となるため外科治療の適応となる．PTEの発症を契機に発見された膝窩静脈のVAが塞栓症の原因と考えられ手術を施行したので報告する．症例は79歳の女性．突然の呼吸困難の出現で当科を受診，心臓超音波検査で右心負荷と肺高血圧の所見があり，造影CTにて肺動脈塞栓と右膝窩静脈のVAを認めた．PTEの加療ののち内部に血栓を有するVAの外科治療を施行した．手術は腹臥位の後方アプローチで瘤切除と静脈形成術を行った．術後の造影CTでは静脈の瘤化や静脈内血栓像なく下腿浮腫などの静脈還流障害を疑う所見も認めていない．突然発症の呼吸苦ではPTEを念頭にすみやかに確定診断をなす必要があり，有症状の膝窩静脈のVAに対しては外科治療が推奨されると考える．

Simple Chordal Replacement with a Newly Designed "Mitral Plate" in Mitral Valvuloplasty.
Yoshiro Matsui, Suguru Kubota, Tatsuya Seki, Yasushige Shingu, Satoru Wakasa
The Annals of thoracic surgery, 114, 2, e141-e144, 2021年12月09日, ［査読有り］, ［最終著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

α-グルコシダーゼ阻害薬内服中に発症した肺移植後の腸管嚢胞様気腫症の一例—Pneumatosis Intestinalis After Living Donor Lung Transplantation Associated With Alpha-Glucosidase Inhibitor Treatment : A Case Report
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, 66, 2, 131, 133, 北海道外科学会, 2021年12月, ［査読有り］
日本語

Reduction of tethering distance by papillary muscle tugging approximation with mitral valve replacement for non-ischemic functional mitral regurgitation induces left ventricular reverse remodeling
Takahiro Ishigaki, Satoru Wakasa, Yasushige Shingu, Yohei Ohkawa, Akira Yamada, Toshihisa Anzai, Yoshiro Matsui
Journal of Cardiology, 79, 4, 530, 536, Elsevier BV, 2021年11月, ［査読有り］, ［責任著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Surgical treatment for tracheal stent prolapse in a patient with blunt tracheal trauma.
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年09月28日, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Elevated serum CYFRA 21-1 level as a diagnostic marker for thymic carcinoma.
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年09月27日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Intralobar pulmonary sequestration associated with left main coronary artery obstruction and mitral regurgitation.
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年09月21日, ［査読有り］, ［最終著者］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

虚血性僧帽弁閉鎖不全症に対する外科介入の是非
若狭 哲
日本心臓血管外科学会雑誌, 50, 5, 5, xxxviii, The Japanese Society for Cardiovascular Surgery, 2021年09月15日, ［招待有り］, ［筆頭著者］
日本語, 研究論文（学術雑誌）

A Novel Treatment of Widespread Empyema Necessitatis.
Shinya Otsuka, Hideki Ujiie, Kosuke Ishikawa, Takahiro Miura, Satoru Wakasa, Tatsuya Kato
The Annals of thoracic surgery, 112, 6, e471, 2021年09月04日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）

Repeated porphyrin lipoprotein-based photodynamic therapy controls distant disease in mouse mesothelioma via the abscopal effect
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, WALTER DE GRUYTER GMBH, 2021年09月
英語, 研究論文（学術雑誌）, 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.

三尖弁形成リングの選択と縫着のコツ
柴田利彦, 若狭哲
胸部外科, 74, 9, 652, 653, 2021年09月01日, ［招待有り］, ［筆頭著者］
日本語

Combined treatment of an aortosplenic bypass followed by coil embolization in the treatment of pancreaticoduodenal artery aneurysms caused by median arcuate ligament compression: a report of two cases.
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年08月04日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

A Nationwide Survey of Surgical Treatment for Severe Ischemic Mitral Regurgitation.
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年08月02日, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

心房内血流転換を併施し心内修復術を行った内臓錯位症候群・左側相同，鏡像型右胸心，完全型房室中隔欠損，単心房，下大静脈欠損，両側上大静脈の一例
加藤 伸康, 武田 充人, 新井 洋輔, 八田 英一郎, 八鍬 聡, 新宮 康栄, 大岡 智学, 若狭 哲
日本小児循環器学会雑誌, 37, 2, 126, 132, 特定非営利活動法人 日本小児循環器学会, 2021年08月01日, ［査読有り］, ［最終著者］
日本語, 内臓錯位症候群・左側相同に関連する心疾患では下大静脈欠損や両側上大静脈などの体静脈還流異常や単心房を合併することも多く，二心室修復の際には体静脈の再建も要する．今回我々は，内臓錯位症候群・左側相同，鏡像型右胸心，房室中隔欠損，単心房，両側上大静脈，下大静脈欠損，半奇静脈接続の4歳女児に対し，心房内血流転換を含めた心内修復術を行った．術前CTでは体静脈の心外再建には不向きな心大血管形態で，共通肺静脈腔の存在から心房内血流転換が適していると判断し，右上大静脈の血流を左側心房へ心房内血流転換しつつ，房室中隔欠損に対してmodified one patch法で共通房室弁の分割と心房中隔作成を行った．術後検査では体静脈や肺静脈の狭窄は認めず，経過良好で11日目に自宅退院となった．共通肺静脈腔を呈している場合は，心房内血流転換は体静脈還流異常に対して有用な術式となりうる．

Thymoma-Related Stiff-Person Syndrome with Successfully Treated by Surgery.
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年07月16日, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Rare Diagnosis of a Multilobular Pulmonary Mass.
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, ELSEVIER, 2021年07月, ［査読有り］, ［最終著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Blood flow dynamics with four-dimensional flow cardiovascular magnetic resonance in patients with aortic stenosis before and after transcatheter aortic valve replacement.
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年06月28日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

4-Dimensional Flow Cardiovascular Magnetic Resonance Imaging of Changes in Blood Flow Dynamics After Surgery for Discrete Subaortic Stenosis.
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年05月25日, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）

Diabetes Mellitus With Left Ventricular Dysfunction - Optimal Indication of Bilateral Internal Thoracic Artery Grafting?
Satoru Wakasa, Yoshiro Matsui
Circulation journal : official journal of the Japanese Circulation Society, 85, 11, 2002, 2003, 2021年05月14日, ［査読有り］, ［招待有り］, ［筆頭著者, 責任著者］, ［国内誌］
英語, 研究論文（学術雑誌）

Prediction of Pulmonary Embolism Following Resection of Pulmonary Infarction: A Case Series.
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, MEDICAL TRIBUNE INC, 2021年05月14日, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Pneumatosis Intestinalis After Living Donor Lung Transplantation Associated With Alpha-Glucosidase Inhibitor Treatment: A Case Report.
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年05月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Feasibility of limited resection for peripheral small-sized non-small cell lung cancer: a retrospective single-center-based study.
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年05月, ［査読有り］, ［最終著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Trehalose preconditioning for transient global myocardial ischemia in rats.
Norihiro Ando, Yasushige Shingu, Kenichiro Suno, Satoru Wakasa
Biochemical and biophysical research communications, 548, 14, 19, 2021年04月09日, ［査読有り］, ［最終著者, 責任著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Non-heart transplant surgical approaches with mitral valve operation and surgical ventricular reconstruction for non-ischaemic dilated cardiomyopathy: a Japanese multicenter study.
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年04月, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

L-Carnitine supplementation for the prevention of postoperative atrial fibrillation in aortic valve surgery.
Yasushige Shingu, Nobuyasu Katoh, Tomonori Ooka, Hiroki Katoh, Satoru Wakasa
General thoracic and cardiovascular surgery, 69, 11, 1460, 1466, 2021年03月10日, ［査読有り］, ［最終著者, 責任著者］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

A novel Tn antigen epitope-recognizing antibody for MUC1 predicts clinical outcome in patients with primary lung adenocarcinoma.
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年03月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Developing a virtual reality simulation system for preoperative planning of thoracoscopic thoracic surgery.
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年02月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Intraoperative real-time hemodynamics in intralobar pulmonary sequestration using indocyanine green and near-infrared thoracoscopy.
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年02月, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

大動脈弁に多発した Cardiac Papillary Fibloelastoma の1例
窪田 武浩, 新宮 康栄, 若狭 哲
日本心臓血管外科学会雑誌, 50, 4, 270, 273, 特定非営利活動法人 日本心臓血管外科学会, 2021年, ［査読有り］, ［最終著者］
日本語,

大動脈弁原発の多発乳頭状弾性線維腫（papillary fibroelastoma : PFE）の摘出手術を経験したので報告する．症例は60代女性で生来健康であったが，動悸を主訴に近医を受診し紹介され当院循環器内科にて精査目的に入院．体表心エコーにて腫瘍を発見され，可動性腫瘤であることから，本人の手術希望もあり当科紹介となり摘出手術を行った．当初1個の腫瘍と考えていたが，長さ7 mmの左冠尖中央大動脈側に付着する有茎性腫瘤を摘出し，大動脈を閉鎖，心拍再開したところ，術中経食道エコーにて腫瘤が残存していることが判明した．再度心停止ののち観察すると，大動脈弁右冠尖の右冠尖-無冠尖commissure部心臓側に長さ6 mmの疣贅様可動性腫瘤1個と無冠尖の弁腹心臓側に約1.5 mmの棘様の腫瘤があり，いずれも大動脈弁からそぎ取るように摘出し大動脈弁を温存した．無冠尖の腫瘤が腫瘍である確証はなかった．病理学的にはこのいずれもがPFEであることが判明した．あたかもPFEの発育段階を追うような3つの腫瘍であった．再発することは非常に稀であることから，有茎性の場合は腫瘍をそぎ取り弁を温存することが可能とされる．しかしこの症例のように弁の表裏を丁寧に観察しなければ見逃していたことになる．疑わしければ切除することで再発による，新たな脳梗塞，心筋梗塞のリスクを回避し，再手術を回避できたと考えた．

定型カルチノイドの治療 (特集 肺・胸腺神経内分泌腫瘍の治療)
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, 122, 1, 18, 25, 日本外科学会, 2021年
日本語, 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)

Persistent Fifth Aortic Arch With Left Ventricular Dysfunction and Left Bronchial Obstruction.
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年11月, ［査読有り］, ［最終著者］, ［国際誌］
英語, 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.

胸腹部大動脈瘤手術時の肋間動脈再建法の工夫と脊髄保護 internal cuff reimplantation法の有用性
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, 73回, CTA1, 5, (一社)日本胸部外科学会, 2020年10月
日本語

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, 73回, ECPA1, 2, (一社)日本胸部外科学会, 2020年10月
日本語

Preoperative identification of clinicopathological prognostic factors for relapse-free survival in clinical N1 non-small cell lung cancer: a retrospective single center-based study.
Masato Aragaki, Tatsuya Kato, Aki Fujiwara-Kuroda, Yasuhiro Hida, Kichizo Kaga, Satoru Wakasa
Journal of cardiothoracic surgery, 15, 1, 229, 229, 2020年08月28日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Phosphoglyceride crystal deposition disease as a rare tumour after cardiac surgery.
Tomoya Sato, Takao Konishi, Satoru Wakasa, Noriko Oyama-Manabe, Toshihisa Anzai
European heart journal, 41, 27, 2596, 2596, 2020年07月14日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）

特集 小児の先天性嚢胞性肺疾患に対する胸腔鏡手術
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, 65, 1, 2, 7, 北海道外科学会, 2020年06月, ［最終著者］
日本語, 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)

Autophagy during left ventricular redilation after ventriculoplasty: Insights from a rat model of ischemic cardiomyopathy.
Satoshi Sugimoto, Yasushige Shingu, Torsten Doenst, Tomoji Yamakawa, Hidetsugu Asai, Satoru Wakasa, Yoshiro Matsui
The Journal of thoracic and cardiovascular surgery, 2020年02月19日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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, (NPO)日本血管外科学会, 2020年
英語

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, (NPO)日本血管外科学会, 2020年
英語

Perioperative changes of the slope in the preload recruitable stroke work relationship by a single-beat technique after mitral valve surgery in functional mitral regurgitation with non-ischemic dilated cardiomyopathy.
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, 2020年01月, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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, 16, 1, 59, 62, KKR札幌医療センター, 2019年12月
日本語, 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)

The optimal treatment strategy for secondary mitral regurgitation: a subject of ongoing debate.
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年10月01日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）

Re-do mitral valve replacement for a bioprosthetic valve with central transvalvular leakage in a patient with ischemic cardiomyopathy: a case report.
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, 2019年06月, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Mechanical properties of a new thermally deformable mitral valve annuloplasty ring and its effects on the mitral valve.
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, 2019年06月, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Papillary Muscle Tugging Approximation for Functional Mitral Regurgitation.
Yoshiro Matsui, Yasushige Shingu, Satoru Wakasa, Tomonori Ooka, Suguru Kubota
The Annals of thoracic surgery, 107, 6, e427-e429, e429, 2019年06月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Impaired mitochondrial oxidative phosphorylation capacity in epicardial adipose tissue is associated with decreased concentration of adiponectin and severity of coronary atherosclerosis.
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年03月05日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Quantitative analysis of regional endocardial geometry dynamics from 4D cardiac CT images: endocardial tracking based on the iterative closest point with an integrated scale estimation.
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, 2019年02月25日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

心臓刺傷後遠隔期に広範脳梗塞を合併した左室瘤に対する左室形成術の1例
佐藤 公治, 須野 賢一郎, 若狭 哲
日本心臓血管外科学会雑誌, 48, 4, 254, 258, 特定非営利活動法人 日本心臓血管外科学会, 2019年, ［査読有り］, ［最終著者, 責任著者］
日本語,

症例は41歳男性．15歳時に自殺企図による心臓刺傷に対して外科的に救命された既往があるが，その後特に経過観察はされていなかった．突然の右半身麻痺を主訴に脳神経外科を受診，左中大脳動脈塞栓による脳梗塞と診断され血栓吸引療法が施行された．その後スクリーニングで施行したCTで左室瘤および左室内血栓を認め，さらなる塞栓症予防のため手術目的に当院搬送となった．左室内血栓は14 mm×23 mmと巨大で可動性があり，緊急手術が望ましいと考えられたが，脳梗塞が広範囲であり発症後急性期であることから，人工心肺を用いた開心術は脳出血の危険性が高いと判断し，4週間の慎重な経過観察の後に手術を行った．術中所見では，左室瘤内壁に器質化血栓と新鮮血栓が混在して付着しており，血栓を摘除し瘢痕化した左室壁を一部切除してオーバーラッピング型左室形成術を行った．術後経過は良好で神経学的所見の増悪を認めず，術後11日目にリハビリ目的に前医転院となった．心臓外傷は救命困難な病態であるが，救命症例でも遠隔期に左室瘤を形成し血栓塞栓症の原因となりうるため適切な経過観察が肝要である．

肉眼的に乳頭状線維弾性腫と鑑別が困難であった villous type 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, 松居 喜郎
日本心臓血管外科学会雑誌, 48, 6, 405, 410, 特定非営利活動法人 日本心臓血管外科学会, 2019年, ［査読有り］
日本語,

症例は60代女性．冠攣縮性狭心症で他院に通院加療中であった．経胸壁心エコー検査で左房内に心房中隔からバルサルバ洞後方の左房壁に至る広基性の可動性に富む腫瘍を指摘され，当院に紹介となった．CT検査やMRI検査の結果からは粘液腫が疑われた．手術は胸骨正中切開で行い，経心房中隔アプローチで左房腫瘍に到達した．左房内には同一の基部をもつ20×12×10 mm大と40×30×15 mm大の2つの腫瘍を認めた．粘液腫を念頭に約5 mmのマージンを確保して腫瘍を切除した．小さい腫瘍は充実性で粘液腫を疑った．大きい腫瘍は乳頭状で，生理食塩水に浸したところイソギンチャク様の特徴的な形態を示したことから乳頭状線維弾性腫を疑った．ウシ心膜パッチを用いて心房中隔欠損部を補填した．病理診断では，小さい腫瘍は索状，管腔様構造を形成する腫瘍細胞を認め典型的な粘液腫の像を認めた．大きい腫瘍の乳頭状構造部分にはcalretinin染色に陽性を示す腫瘍細胞を少数認め，villous typeの粘液腫と診断された．術前検査や肉眼所見で両者を鑑別することは困難であり，判断に迷う場合はマージンを設けて全層切除するべきである．

Estimating postoperative left ventricular volume: Identification of responders to surgical ventricular reconstruction.
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, 2018年12月, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Modified total cavopulmonary shunt as a staged Fontan operation.
Hidetsugu Asai, Tsuyoshi Tachibana, Yasushige Shingu, Hiroki Kato, Satoru Wakasa, Yoshiro Matsui
Asian cardiovascular & thoracic annals, 26, 9, 701, 703, 2018年11月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Anticoagulation management during cardiopulmonary bypass in patients with antiphospholipid syndrome.
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, 2018年09月, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

Surgery for Left Ventricular Outflow Tract Obstruction with a Relatively Thin Interventricular Septum.
Yasushige Shingu, Hiroshi Sugiki, Tomonori Ooka, Hiroki Kato, Satoru Wakasa, Tsuyoshi Tachibana, Yoshiro Matsui
The Thoracic and cardiovascular surgeon, 66, 4, 307, 312, 2018年06月, ［査読有り］, ［国際誌］
英語, 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, (一社)日本循環器学会, 2018年03月
英語

肺動脈閉鎖症兼心室中隔欠損症に対する Waterston 手術40年後の巨大肺動脈瘤に対する1治験例
安東 悟央, 松居 喜郎, 橘 剛, 加藤 伸康, 有村 聡士, 浅井 英嗣, 新宮 康栄, 若狭 哲, 加藤 裕貴, 大岡 智学
日本心臓血管外科学会雑誌, 47, 1, 13, 17, 特定非営利活動法人 日本心臓血管外科学会, 2018年
日本語,

非常に稀で，手術施行例の耐術例はほとんど報告がない，先天性心疾患姑息術後の肺動脈瘤の合併症例を経験した．症例は40代男性．肺動脈閉鎖症兼心室中隔欠損症に対して一歳時にWaterston手術を施行されたが，その後当時としては根治手術が困難と判断され，NYHA class I度のため数十年間近医で経過観察されていた．労作時の呼吸苦増悪を認め他院を受診，肺炎と心不全の疑いで入院加療されたが，胸部CT検査で95 mmの右肺動脈瘤を認め，切迫破裂も疑われたため外科的加療目的に当科紹介となった．入院時，右胸水と右肺の広範な無気肺を認めた．胸水ドレナージを施行（800 ml）した．胸水は漿液性で胸背部痛など認めず血行動態は安定していた．切迫破裂は否定的であったものの95 mmと巨大な瘤径であり，利尿薬および抗生剤治療を数日間先行し，準緊急的に右肺動脈瘤に対して瘤切除および人工血管置換を施行した．術前NYHA I度であったことから，もともとの吻合部径や末梢の肺動脈径にならい24×12 mm Y-graft人工血管を用いてcentral shuntとして肺動脈を再建した．PCPS装着のままICU入室，翌日離脱した．術後4日目に人工呼吸器離脱，術後38日目に退院となった．現在術後一年になるが，NYHA class I度で経過している．Waterston術後約40年後に発症した巨大肺動脈瘤に対し手術を施行し良好な結果を得たので報告する．

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
佐藤 公治, 松居 喜郎, 新宮 康栄, 若狭 哲, 加藤 伸康, 関 達也, 大岡 智学, 加藤 裕貴, 橘 剛, 久保田 卓
日本心臓血管外科学会雑誌, 47, 6, 257, 262, 特定非営利活動法人 日本心臓血管外科学会, 2018年
日本語,

［背景］腹部ステントグラフト内挿術後に持続するエンドリークは瘤径拡大や破裂の原因となる．特にType IIエンドリークに対する標準術式は存在しない．最近Type IIエンドリークによる瘤拡大に対し，開腹下に腰動脈を結紮しステントグラフトを温存しつつ瘤を縫縮する方法が報告されるようになってきた．［目的］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を施行した5例の術後成績と瘤径変化を検討する．［方法］持続するType IIエンドリークを有し初回腹部ステントグラフト内挿術時から10 mm以上瘤径が拡大するか，最大短径65 mm以上となった症例を手術適応とした．腹部正中切開し，腎動脈下の近位側のランディングゾーンで大動脈をバンディングした．大動脈を遮断することなく大動脈瘤前壁を切開し，血種を除去してType IIエンドリークの原因となっている腰動脈や正中仙骨動脈を大動脈瘤の内腔もしくは瘤壁の外側で結紮した．最後にステントグラフトを被覆するように瘤壁を縫縮した．［結果］初回手術から今回の腰動脈結紮・ステントグラフト温存瘤縫縮術までの期間は平均47±17カ月であった．手術時間は215±76分，4例に他家輸血を要した．術後平均在院日数は26±20日で在院死亡を認めなかった．術後合併症として誤嚥性肺炎を1例に，創感染を1例に認めた．瘤径は術前68±8 mmから術後47±5 mmに減少した．さらに677±322日の最終フォローアップ時における瘤径は36±7 mmであり早期の瘤縮小効果を認めた．［結語］持続する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は開腹の侵襲を考慮し，適応は慎重に検討すべきであり，長期成績については今後のフォローアップを要するが，比較的根治性と安全性が高く，標準術式となりうる．

国内多施設参加レジストリデータからみた虚血性心疾患に対する左室形成術の適応と限界
若狭 哲, 松居 喜郎, 重症心不全外科研究会
日本冠疾患学会雑誌, 23, 2, 125, 129, 特定非営利活動法人 日本冠疾患学会, 2017年, ［招待有り］, ［筆頭著者］
日本語

Left-Ventricular Plication Reduces Wall Stress and Cardiomyocyte Hypertrophy in a Rat Model of Ischemic Cardiomyopathy.
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, 2017年, ［査読有り］, ［国際誌］
英語, 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.

低侵襲手術時代の胸腹部大動脈瘤手術 : 脊髄虚血予防の観点からみた適切な手術法のあり方 (特集 心臓・大血管疾患に対する外科治療)
若狭 哲, 松居 喜郎
北海道外科雑誌 = The Hokkaido journal of surgery, 61, 1, 7, 12, 北海道外科学会, 2016年06月, ［招待有り］, ［筆頭著者］
日本語

症例 大動脈縮窄症を合併した大動脈一尖弁狭窄症の1例
窪田 武浩, 若狭 哲, 新宮 康栄, 松居 喜郎
胸部外科 = The Japanese journal of thoracic surgery, 69, 6, 467, 470, 南江堂, 2016年06月, ［査読有り］
日本語

The significance of the analysis on scalographic pattern for detecting malfunctioning bileaflet valve with the wavelet analysis.
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, 2016年03月, ［査読有り］, ［国内誌］
英語, 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.

機能的単心室における無機能右室に対する右室内腔縫縮術の応用
浅井 英嗣, 橘 剛, 新宮 康栄, 若狭 哲, 大岡 智学, 松居 喜郎
日本心臓血管外科学会雑誌, 45, 1, 26, 31, 特定非営利活動法人 日本心臓血管外科学会, 2016年, ［査読有り］
日本語, Fontan循環においては重症三尖弁逆流による右房・右室の拡大や，pulmonary atresia and intact ventricular septum（PA/IVS）などにおける著明な右室圧の上昇は右心系の機能障害だけでなく二次的な左心機能障害や肺低形成の一因となる．当科ではこのような無機能右室を内腔より縫縮（内腔縫縮術）することで血行動態より遮断する手術の工夫を行ってきたのでその有効性について検討した．対象は当施設で無機能右室に対し内腔縫縮術を施行した5例（6手術）．心胸郭比は71±10%から61±5%へ有意に減少（p＝0.017）し左室短縮率は27±17%から37±5%へ変化した（p＝0.071）．全例がFontan循環に到達し術後経過も良好である．新生児期に内腔縫縮術を施行した1例で経過中に右室の再拡大を認めたためFontan手術時に再度内腔縫縮を追加した．当科で施行した右室内腔縫縮術は無機能右室を有する機能的単心室において有効な手術方法であると考えられた．

3．感染性心内膜炎 編 1）感染性心内膜炎に対する外科手術
松居 喜郎, 若狭 哲, 大岡 智学, 新宮 康栄
日本内科学会雑誌, 105, 2, 238, 244, 一般社団法人 日本内科学会, 2016年, ［招待有り］
日本語,

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．

先天性左総頸動脈・気管支動脈-肺動脈瘻と左右両冠動脈-肺動脈瘻合併症例の手術経験
窪田 武浩, 若狭 哲, 新宮 康栄, 松居 喜郎
日本心臓血管外科学会雑誌, 45, 4, 170, 175, 特定非営利活動法人 日本心臓血管外科学会, 2016年, ［査読有り］
日本語,

先天性冠動脈-肺動脈瘻は珍しい疾患で，心筋虚血症状や瘤化などさまざまな病態を呈する．さらに体血管との連続性をも合併することは非常に稀である．症例は75歳男性で，生来健康であったが，自宅で数10秒の意識消失発作があり近医の神経外科を受診し，異常所見なく，心原性失神を疑われ当院循環器科を受診し精査が行われた．ホルター心電図で洞不全症候群と診断された．冠動脈造影で肺動脈-左右両冠動脈瘻と冠動脈狭窄との診断となった．瘻血管の存在により，冠動脈バイパス手術の適応決定においては苦慮し，通常の冠動脈造影に加え，冠血流予備量比，冠動脈内超音波検査，負荷心筋シンチを用い総合的に判断し，三枝バイパスが必要であると判断した．術前のCTアンギオで左総頸動脈・気管支動脈-肺動脈瘻が存在し左右両冠動脈-肺動脈瘻と交通していた．冠動脈バイパス術に加え，冠動脈-肺動脈瘻結紮，肺動脈開口部閉鎖，左総頸動脈-肺動脈瘻と気管支動脈-肺動脈瘻閉鎖，ペースメーカー埋め込み術をあわせて行うこととした．瘻孔開口部を決定するうえで術前のCTアンギオ，術中の心表面エコーは有用であった．あらかじめ，左総頸動脈，気管支動脈から流入する異常血管と瘻血管開口部に流入する異常血管を結紮処理した．心筋保護液注入時，さらに瘻孔開口部を直接圧迫することで，心筋保護液は十分に心筋に行き渡り十分な心停止が得られた．術後CTアンギオでは肺動脈-左右両冠動脈瘻，左総頸動脈・気管支動脈-肺動脈瘻は消失していた．左総頸動脈・気管支動脈-肺動脈瘻と左右両冠動脈-肺動脈瘻の合併症例の手術報告は探しうる限りなく，非常に稀な症例と考え文献的考察を含め報告する．

DCMはここまで治せる? (特集 内科医に必要な心臓外科手術の知識) -- (進歩する外科手術)
松居 喜郎, 若狭 哲, 新宮 康栄, 大岡 智学, 橘 剛
Heart view, 19, 10, 1146, 1152, メジカルビュー社, 2015年10月, ［招待有り］
日本語

胸部外科緊急手術のup to date II.弁膜症 1.感染性心内膜炎
若狭哲, 松居喜郎
胸部外科, 68, 8, 586, 590, 2015年07月20日, ［招待有り］, ［筆頭著者］
日本語

Slope in preload recruitable stroke work relationship predicts survival after left ventriculoplasty and mitral repair in patients with idiopathic cardiomyopathy.
Shingu Y, Kubota S, Wakasa S, Ooka T, Kato H, Tachibana T, Matsui Y
Journal of cardiology, 65, 2, 157, 63, 2015年02月, ［査読有り］, ［国際誌］
英語, 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, 42, 1, 84, 84, (公社)日本超音波医学会, 2015年01月
日本語

Characteristics of Inoperable Patients with Severe Aortic Valve Stenosis -In the Era of Transcatheter Aortic Valve Replacement.
Seki T, Sakakibara M, Shingu Y, Katoh H, Wakasa S, Tsutsui H, Matsui Y
Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia, 21, 2, 132, 8, 2015年, ［査読有り］, ［国内誌］
英語, 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.

Surgical strategy for ischemic mitral regurgitation adopting subvalvular and ventricular procedures.
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, 2015年, ［査読有り］, ［筆頭著者］, ［国内誌］
英語, 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.

Benefits of submitral procedures for ischemic mitral regurgitation.
Wakasa S, Matsui Y
General thoracic and cardiovascular surgery, 62, 9, 511, 5, 2014年09月, ［査読有り］, ［招待有り］, ［筆頭著者］, ［国内誌］
英語, 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.

The extent of papillary muscle approximation affects mortality and durability of mitral valve repair for ischemic mitral regurgitation
Satoru Wakasa, Suguru Kubota, Yasushige Shingu, Tomonori Ooka, Tsuyoshi Tachibana, Yoshiro Matsui
JOURNAL OF CARDIOTHORACIC SURGERY, 9, 98, BIOMED CENTRAL LTD, 2014年06月, ［査読有り］, ［筆頭著者］
英語, 研究論文（学術雑誌）, 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.

Risk scores for predicting mortality after surgical ventricular reconstruction for ischemic cardiomyopathy: Results of a Japanese multicenter study
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, MOSBY-ELSEVIER, 2014年06月, ［査読有り］, ［筆頭著者］
英語, 研究論文（学術雑誌）, 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.

胸部大動脈-食道瘻に対する治療法の推移とその成績
荒木 大, 若狭 哲, 久保田 卓
北海道外科雑誌, 59, 1, 37, 43, 北海道外科学会, 2014年06月, ［査読有り］, ［責任著者］
日本語

Internal Cuff Reimplantation Technique for Aortic Branch Reconstruction
Satoru Wakasa, Yuji Naito, Suguru Kubota, Makoto Iijima, Yasushige Shingu, Yoshiro Matsui
ANNALS OF THORACIC SURGERY, 97, 5, 1822, 1823, ELSEVIER SCIENCE INC, 2014年05月, ［査読有り］, ［筆頭著者］
英語, 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

Histological assessment of transmurality after repeated radiofrequency ablation of the left atrial wall
Satoru Wakasa, Suguru Kubota, Yasushige Shingu, Hiroki Kato, Tomonori Ooka, Tsuyoshi Tachibana, Yoshiro Matsui
General Thoracic and Cardiovascular Surgery, 62, 7, 428, 433, Springer-Verlag Tokyo, 2014年, ［査読有り］, ［筆頭著者］
英語, 研究論文（学術雑誌）, 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.

左室リモデリング進行度を考慮した虚血性僧帽弁閉鎖不全症に対する弁形成術の工夫ー乳頭筋接合術および左室形成術追加の意義ー
若狭 哲, 松居 喜郎
日本冠疾患学会雑誌, 20, 3, 255, 258, 特定非営利活動法人 日本冠疾患学会, 2014年, ［招待有り］, ［筆頭著者］
日本語

低左心機能例に対する外科的血行再建:僧帽弁手術併施の適応と成績
若狭 哲, 松居 喜郎
日本冠疾患学会雑誌, 20, 1, 84, 87, 特定非営利活動法人 日本冠疾患学会, 2014年, ［招待有り］, ［筆頭著者］
日本語

Preoperative Regional Left Ventricular Wall Thickening Determined by Quantitative Gated SPECT as a Predictor of Mid-Term Surgical Results for Ischemic and Nonischemic Cardiomyopathy
Suguru Kubota, Satoru Wakasa, Yasushige Shingu, Tomonori Ooka, Tsuyoshi Tachibana, Yoshiro Matsui
CIRCULATION JOURNAL, 77, 12, 2936, 2941, JAPANESE CIRCULATION SOC, 2013年12月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

One-stage radical operation of aortoesophageal fistula -combination of VATS esophagectomy and open aortic surgery : report of a case
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, 10, 4, 280, 284, The Japan Esophageal Society [編], 2013年12月
英語, 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.

Impact of left ventricular remodelling on outcomes after left ventriculoplasty for ischaemic cardiomyopathy: Japanese surgical ventricular reconstruction group experience(dagger)
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, OXFORD UNIV PRESS, 2013年06月, ［査読有り］, ［筆頭著者］
英語, 研究論文（学術雑誌）, 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.

Interrelation between myocardial oxidative metabolism and diastolic function in patients undergoing surgical ventricular reconstruction.
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, 2013年02月, ［査読有り］, ［国際誌］
英語, 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.

Surgical strategy for aortoesophageal fistula in the endovascular era
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, 10, 2013年, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

悪性リンパ腫の診断における心嚢液細胞診の有用性の検討
浅井 英嗣, 新宮 康栄, 内藤 佑嗣, 若狭 哲, 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, 42, 6, 494, 498, 特定非営利活動法人 日本心臓血管外科学会, 2013年
日本語, 心臓悪性腫瘍は一般に予後不良で稀な疾患である．多様な画像検査によりその診断率は上昇しているが確定診断が得られず治療方針の決定に難渋する症例が多い．今回，局所麻酔下・剣状突起下アプローチによる心膜生検と心嚢液細胞診の心臓腫瘍，特に悪性リンパ腫の確定診断における安全性と有用性について検討した．対象は心臓腫瘍の確定診断が得られないため治療が開始できなかった5例．無症状が2例，有症状が3例であった．男性3例，女性2例で平均年齢74歳（60～81歳）であった．局所麻酔下・剣状突起下アプローチ手術は全例で合併症なく短時間で安全に行えた．心嚢液細胞診の診断率は60%（5例中3例）であった．心膜生検は3例に施行したが陽性例はなかった．最終診断は4例で悪性リンパ腫，1例でリンパ腫であった．局所麻酔下・剣状突起下アプローチによる心嚢液細胞診は開胸を要さず安全かつ簡便に行え，診断に難渋する心臓悪性腫瘍，特に悪性リンパ腫において有効な一診断手段であると考えられた．また悪性リンパ腫の診断には心膜生検は必ずしも必要でないことが示唆された．

左室形成術の適応と限界 (特集 重症心不全に対する外科治療)
若狭 哲, 新宮 康栄, 久保田 卓, 南田太郎, 飯島誠, 内藤侑嗣, 大岡智学, 橘剛, 松居喜郎
胸部外科, 66, 1, 26, 30, 南江堂, 2013年01月, ［招待有り］, ［筆頭著者］
日本語

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, 57, 2, 130, 134, 北海道外科学会, 2012年12月, ［査読有り］
日本語, 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)

Postoperative atrial fibrillation: mechanism, prevention, and future perspective
Yasushige Shingu, Suguru Kubota, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Yoshiro Matsui
SURGERY TODAY, 42, 9, 819, 824, SPRINGER, 2012年09月, ［査読有り］
英語, 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.

虚血性心筋症の外科治療－左室形成術・補助人工心臓，そして心臓移植－
大岡 智学, 新宮 康栄, 若狭 哲, 橘 剛, 久保田 卓, 松居 喜郎
日本冠疾患学会雑誌, 18, 3, 265, 269, 特定非営利活動法人 日本冠疾患学会, 2012年, ［招待有り］
日本語

Surgical Ventricular Restoration Improves the Left Ventricle Basal Wall Function Using Quantitative Gated Spect
Suguru Kubota, Kinya Matsui, Satoru Wakasa, Yukio Suto, Shigeyuki Sasaki, Keiichiro Yoshinaga, Yoshiro Matsui
ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY, 17, 6, 552, 558, MEDICAL TRIBUNE INC, 2011年12月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

Analysis of the Risk Associated With Pregnancy in Women With Marfan Syndrome
Satoru Wakasa, Yoshiro Matsui
CIRCULATION JOURNAL, 75, 11, 2532, 2533, JAPANESE CIRCULATION SOC, 2011年11月, ［査読有り］, ［招待有り］, ［筆頭著者］
英語

虚血性心筋症に対する外科治療戦略 虚血性心筋症の外科治療成績
若狭哲, 新宮康栄, 大岡智学, 橘剛, 久保田卓, 松居喜郎
胸部外科, 64, 11, 985, 988, 2011年10月01日, ［招待有り］, ［筆頭著者］
日本語

Cytokine balance in hepatosplanchnic system during thoracoabdominal aortic aneurysm repair
Takashi Kunihara, Suguru Kubota, Norihiko Shiiya, Kenji Iizuka, Shigeyuki Sasaki, Satoru Wakasa, Kenji Matsuzaki, Yoshiro Matsui
JOURNAL OF ARTIFICIAL ORGANS, 14, 3, 192, 200, SPRINGER TOKYO, 2011年09月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

Measured Tube Technique for Ensuring the Correct Length of Slippery Artificial Chordae in Mitral Valvuloplasty
Yoshiro Matsui, Suguru Kubota, Hiroshi Sugiki, Satoshi Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Shigeyuki Sasaki
ANNALS OF THORACIC SURGERY, 92, 3, 1132, 1134, ELSEVIER SCIENCE INC, 2011年09月, ［査読有り］
英語, 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

Effects of surgical ventricular reconstruction and mitral complex reconstruction on cardiac oxidative metabolism and efficiency in nonischemic and ischemic dilated cardiomyopathy.
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, 7, 2011年07月, ［査読有り］, ［国際誌］
英語, 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.

Can we change the operative criteria for the MAZE procedure combined with valve surgery in the era of radiofrequency devices?
Suguru Kubota, Hiroshi Sugiki, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Shigeyuki Sasaki, Yoshiro Matsui
General Thoracic and Cardiovascular Surgery, 59, 6, 406, 412, 6, 2011年06月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

Successful excision of a saphenous vein graft aneurysm with different methods
Suguru Kubota, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Shigeyuki Sasaki, Yoshiro Matsui
General Thoracic and Cardiovascular Surgery, 59, 6, 426, 428, 6, 2011年06月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

Left-ventricular electromechanical delay is prolonged in patients with postoperative atrial fibrillation
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, OXFORD UNIV PRESS INC, 2011年05月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

感染性大動脈瘤の診断におけるFDG-PETの有用性
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, 341, 341, (NPO)日本血管外科学会, 2011年04月
日本語

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, 40, Suppl., 328, 328, (NPO)日本心臓血管外科学会, 2011年01月
日本語

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, 40, Suppl., 363, 363, (NPO)日本心臓血管外科学会, 2011年01月
日本語

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, 39, 2, S148, S148, (一社)日本人工臓器学会, 2010年11月
日本語

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, 55, 1, 67, 67, 北海道外科学会, 2010年06月
日本語

A case of Carpentier-Edwards pericardial bioprosthesis in mitral position explanted 22 years after implantation
Suguru Kubota, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Norihiko Shiiya, Yoshiro Matsui
JOURNAL OF ARTIFICIAL ORGANS, 13, 1, 48, 50, SPRINGER TOKYO, 2010年04月, ［査読有り］
英語, 研究論文（学術雑誌）, 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).

Anatomical Pattern of Feeding Artery and Mechanism of Intraoperative Spinal Cord Ischemia
Norihiko Shiiya, Satoru Wakasa, Kinya Matsui, Takashi Sugiki, Yasushige Shingu, Tomoshi Yamakawa, Yoshiro Matsui
ANNALS OF THORACIC SURGERY, 88, 3, 768, 772, ELSEVIER SCIENCE INC, 2009年09月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

成人重複大動脈弓の1例
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, 25, 4, 638, 639, (NPO)日本小児循環器学会, 2009年07月
日本語

Assessment of hepatosplanchnic pathophysiology during thoracoabdominal aortic aneurysm repair using visceral perfusion and shunt
Takashi Kunihara, Norihiko Shiiya, Satoru Wakasa, Kenji Matsuzaki, Yoshiro Matsui
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 35, 4, 677, 683, ELSEVIER SCIENCE BV, 2009年04月, ［査読有り］
英語, 研究論文（学術雑誌）, 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.

A semiquantitative analysis of reactive astrogliosis demonstrates its correlation with the number of intact motor neurons after transient spinal cord ischemia
Satoru Wakasa, Norihiko Shiiya, Tsuyoshi Tachibana, Tomonori Ooka, Yoshiro Matsui
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 137, 4, 983, 990, MOSBY-ELSEVIER, 2009年04月, ［査読有り］, ［筆頭著者, 責任著者］
英語, 研究論文（学術雑誌）, 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.

Sivelestat Sodium is Effective to Prevent Acute Lung Injury in Acute Aortic Dissection
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, SPRINGER-VERLAG TOKYO, 2009年, ［査読有り］
英語, 研究論文（国際会議プロシーディングス）

Aortic Valve Replacement Through Left Thoracotomy After Esophageal Operation
Satoru Wakasa, Tomonori Ooka, Suguru Kubota, Norihiko Shiiya, Toshifumi Murashita, Yoshiro Matsui
ANNALS OF THORACIC SURGERY, 86, 5, 1668, 1670, ELSEVIER SCIENCE INC, 2008年11月, ［査読有り］, ［筆頭著者］
英語, 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.

胸骨裏食道再建後の大動脈弁閉鎖不全症(AR)に対する左開胸での大動脈弁置換術の1例
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, 53, 1, 116, 116, 北海道外科学会, 2008年06月
日本語

Microembolization from an Abdominal Aortic Aneurysm after Thoracic Aortic Replacement
Yasushige Shingu, Norihiko Shiiya, Takashi Sugiki, Satoru Wakasa, Kenji Matsuzaki, Takashi Kunihara, Yoshiro Matsui
ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY, 14, 2, 126, 128, MEDICAL TRIBUNE INC, 2008年04月, ［査読有り］
英語, 研究論文（学術雑誌）, 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)

遠隔期に再手術を要した人工弁周囲逆流症(PVL)の2例
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, 52, 2, 209, 209, 北海道外科学会, 2007年12月
日本語

Porcelain aorta,冠動脈バイパス術後のsevere AS症例に対してapicoaortic bypassを施行した1例
杉木 孝司, 若狭 哲, 大岡 智学
北海道外科雑誌, 52, 2, 174, 177, 北海道外科学会, 2007年12月, ［査読有り］
日本語

ウサギ脊髄虚血再灌流モデルにおける Astrocyte 活性化と遅発性運動神経細胞死に関する検討
若狭 哲
北海道醫學雜誌 = Acta medica Hokkaidonensia, 82, 6, 401, 408, 2007年11月01日, ［筆頭著者, 責任著者］
日本語

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, 68, 9, 2420, 2420, 日本臨床外科学会, 2007年09月
日本語

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, 68, 9, 2421, 2421, 日本臨床外科学会, 2007年09月
日本語

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, 47, Suppl., S128, S128, (一社)日本脈管学会, 2007年09月
日本語

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, 32, 3, 495, 495, 日本外科系連合学会, 2007年06月
日本語

高度石灰化を伴う腹部大動脈瘤に対し、瘤穿刺による中枢balloon occlusionを用いて手術を施行した1症例
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, 52, 1, 77, 77, 北海道外科学会, 2007年06月
日本語

適応の破綻と修復 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 宏司, 杉木 孝司, 松井 欣哉, 椎谷 紀彦, 村下 十志文
適応医学, 11, 1, 21, 21, 日本適応医学会, 2007年05月
日本語

Off-pump aortic arch repair through a median sternotomy for type b interrupted aortic arch with single ventricle physiology
Satoru Wakasa, Toshifumi Murashita, Takehiro Kubota, Hiroshi Sugiki
JOURNAL OF CARDIAC SURGERY, 22, 3, 215, 217, BLACKWELL PUBLISHING, 2007年05月, ［査読有り］, ［筆頭著者］
英語, 研究論文（学術雑誌）, 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, 36, Suppl., 222, 222, (NPO)日本心臓血管外科学会, 2007年01月
日本語

"Distal end-to-side first"法を用いたCrawford II型胸腹部大動脈置換術
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, 54, Suppl., 491, 491, (一社)日本胸部外科学会, 2006年09月
日本語

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, 54, 5, 20, 20, (一社)日本胸部外科学会, 2006年05月
日本語

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, 54, 5, 25, 25, (一社)日本胸部外科学会, 2006年05月
日本語

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, 54, 5, 29, 29, (一社)日本胸部外科学会, 2006年05月
日本語

外傷性末梢動脈疾患に対する手術の経験
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, 50, 2, 177, 177, 北海道外科学会, 2005年12月
日本語

肺動脈弁輪はどこまで温存可能か ファロー4徴症根治手術における弁輪温存手術
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, 53, Suppl.II, 608, 608, (一社)日本胸部外科学会, 2005年09月
日本語

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, 34, Suppl., 470, 470, (NPO)日本心臓血管外科学会, 2005年01月
日本語

高安動脈炎に対する外科治療成績
國原 孝, 若狭 哲, 松崎 賢司, 椎谷 紀彦, 窪田 武浩, 村下 十志文, 安田 慶秀
脈管学, 44, 9, 363, 374, 2004年09月25日
日本語

Modified B-T shunt術後人工血管由来のseromaと難治性胸水の治療に苦慮した1例
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, 38, 38, 81, 83, 道南医学会, 2003年07月
日本語, 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

心不全で発症した Coronary-Subclavian Steal Syndrome の1症例
若狭哲
市立釧路医誌, 13, 94, 97, 2001年, ［筆頭著者］

重症金属アレルギーを有する僧帽弁位感染性心内膜炎に対する治療経験
松井双葉, 齊藤慈円, 加藤伸康, 阿部慎司, 加藤裕貴, 大岡智学, 新宮康栄, 若狭哲, 北海道外科雑誌, 69, 1, 2024年

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年06月
北海道外科学会, 日本語

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年04月
(一社)日本外科学会, 日本語

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年04月
(一社)日本外科学会, 日本語

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年04月
(一社)日本外科学会, 日本語

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年03月
日本臨床外科学会, 日本語

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年03月
(一社)日本循環器学会, 英語

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年02月
(NPO)日本肺癌学会, 日本語

化学放射線療法後の左主気管支腺様嚢胞癌の一手術例
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年

右主気管支狭窄に対し心膜吊り上げ法による縦隔授動とステント留置により救命し得た一例
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年

ロボット支援下後縦隔腫瘍切除術における,腹臥位アプローチの有用性の検討
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年

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(Web), 62, 1, 2022年

幼少期に留置した肺動脈ステント内狭窄に対する外科治療の経験　　　　　　　　　　　　　　　
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年01月
日本成人先天性心疾患学会, 日本語

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年12月
(一社)日本内視鏡外科学会, 日本語

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年12月
(一社)日本内視鏡外科学会, 日本語

有瘻性膿胸に対し気管支充填術と持続陰圧吸引療法を併用した2症例
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年11月
(NPO)日本呼吸器内視鏡学会, 日本語

低左心機能を伴う虚血性閉鎖不全症〜外科手術vs Mitraclip〜 虚血性僧帽弁閉鎖不全症に対する外科治療戦略　　　　　　　　　　　　　　　
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年10月
(一社)日本胸部外科学会, 日本語

混合型TAPVC術後の遺残病変修復に際して垂直静脈を遊離グラフトとして用いた1例　　　　　　　　　　　　　　　
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年10月
(一社)日本胸部外科学会, 日本語

クロロキンの心筋虚血再灌流障害抑制効果の実験的検討　　　　　　　　　　　　　　　
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年10月
(一社)日本胸部外科学会, 日本語

非虚血性機能性僧帽弁閉鎖不全症に対する僧帽弁置換術において僧帽弁下手技によるアンチテザリング効果の追加が術後左室リバースリモデリングを誘導する　　　　　　　　　　　　　　　
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年10月
(一社)日本胸部外科学会, 日本語

ECMO運用に関わる院内ガイドラインの作成　　　　　　　　　　　　　　　
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年10月
(一社)日本胸部外科学会, 日本語

ファロー四徴症に対するValve slicingを用いた肺動脈弁温存の検討　　　　　　　　　　　　　　　
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年10月
(一社)日本胸部外科学会, 日本語

未来のための今 胸部外科医育成のための新たなる挑戦 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, 日本胸部外科学会定期学術集会, 74回, SP5, 3, 2021年10月
(一社)日本胸部外科学会, 日本語

奇静脈瘤の伸展評価における4D-Flow MRIの有用性　　　　　　　　　　　　　　　
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年10月
(一社)日本胸部外科学会, 日本語

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年10月
(NPO)日本肺癌学会, 日本語

COVID-19に対する、北海道大学の取り組み　　　　　　　　　　　　　　　
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年05月
(NPO)日本呼吸器外科学会, 日本語

小児に対するReduced port VATS　　　　　　　　　　　　　　　
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年05月
(NPO)日本呼吸器外科学会, 日本語

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年05月
(NPO)日本呼吸器外科学会, 日本語

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年05月
(NPO)日本呼吸器外科学会, 日本語

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年04月
(一社)日本外科学会, 日本語

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年04月
(一社)日本外科学会, 日本語

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年02月
(NPO)日本心臓血管外科学会, 日本語

心室拡大による機能性僧帽弁閉鎖不全症の外科治療 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　　　　　　　　　　　　　　　
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年02月
(NPO)日本心臓血管外科学会, 日本語

ラット心筋虚血再灌流モデルにおけるトレハロース・プレコンディショニングの効果　　　　　　　　　　　　　　　
須野 賢一郎, 新宮 康栄, 安東 悟央, 若狭 哲, 日本心臓血管外科学会学術総会抄録集, 51回, OP13, 1, 2021年02月
(NPO)日本心臓血管外科学会, 日本語

小児房室弁(単心室共通房室弁を含む)形成術 右側房室弁にEbstein病様の異形成を合併した共通房室弁閉鎖不全に対する弁形成　　　　　　　　　　　　　　　
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年02月
(NPO)日本心臓血管外科学会, 日本語

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年02月
(NPO)日本心臓血管外科学会, 日本語

80歳以上高齢者の急性A型大動脈解離に対する外科手術のリスク因子解析　　　　　　　　　　　　　　　
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年02月
(NPO)日本心臓血管外科学会, 日本語

Arterial switch operation後の死亡・再介入関連因子の検討　　　　　　　　　　　　　　　
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年02月
(NPO)日本心臓血管外科学会, 日本語

Frozen elephant trunk術後早期SINE発生のリスク因子　　　　　　　　　　　　　　　
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年02月
(NPO)日本心臓血管外科学会, 日本語

血気胸を発症したPleuroparenchymal fibroelastosis(PPFE)合併肺癌の1切除例
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年02月
(NPO)日本肺癌学会, 日本語

血気胸を発症したPleuroparenchymal fibroelastosis(PPFE)合併肺癌の1切除例
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年02月
(NPO)日本肺癌学会, 日本語

神経線維腫症I型に肺腺癌、内頸動静脈瘻を合併した1例
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年02月
(NPO)日本肺癌学会, 日本語

肝移植後にPleuroparenchymal fibroelastosis(PPFE)合併肺癌を発症した一例
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年

胎児治療を施行したCongenital pulmonary airway malformation(CPAM)の患児に対し日齢9で完全胸腔鏡下右上葉切除術を施行した一例
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年

肺切除後難治性肺ろうの治療戦略
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総会(Web), 34th, 2021年

神経線維腫症I型に肺腺癌,内頚動静脈瘻を合併した1例
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(Web), 61, 1, 2021年

血気胸を発症したPleuroparenchymal fibroelastosis(PPFE)合併肺癌の1切除例
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年

バーチャル・リアリティー(VR)システムを用いた,呼吸器外科手術シミュレーション法の開発
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年

肺移植後に発症したα-グルコシダーゼ阻害薬内服中の腸管嚢胞様気腫症の一例
大塚慎也, 大塚慎也, 氏家秀樹, 加藤達哉, 千葉龍平, 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, 日本肺および心肺移植研究会プログラム・抄録集, 37th, 2021年

80歳以上高齢者の急性A型大動脈解離に対する外科手術のリスク因子解析　　　　　　　　　　　　　　　
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年
(NPO)日本血管外科学会, 日本語

Frozen elephant trunk術後dSINEリスクの検討　　　　　　　　　　　　　　　
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年
(NPO)日本血管外科学会, 日本語

止血デバイスを用いた経皮的腹部ステントグラフト内挿術の創合併症予防効果の検討　　　　　　　　　　　　　　　
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年
(NPO)日本血管外科学会, 日本語

二心室修復可能な心疾患に対する姑息的右室流出路再建術8例の検討　　　　　　　　　　　　　　　
加藤 伸康, 橘 剛, 新宮 康栄, 若狭 哲, 加藤 裕貴, 大岡 智学, 山澤 弘州, 武田 充人, 日本小児循環器学会雑誌, 36, Suppl.2, s2, 383, 2020年11月
(NPO)日本小児循環器学会, 日本語

透析患者における3年間のデノスマブ投与の効果　　　　　　　　　　　　　　　
伊藤 賀恵, 熊田 千晶, 飯塚 一秀, 永井 志保, 永井 哲士, 関口 孝, 中島 豊, 衣笠 えり子, 若狭 幹雄, 宍戸 寛治, 日本透析医学会雑誌, 53, Suppl.1, 553, 553, 2020年10月
(一社)日本透析医学会, 日本語

肺移植患者における超音波気管支鏡の安全性および有効性の検討
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, Keshavjee Shaf, Yasufuku Kazuhiro, 移植, 55, 総会臨時, 383, 383, 2020年10月
(一社)日本移植学会, 日本語

感染症対策を見据えたVAD治療の進歩と臨床展開 VAD関連感染症の治療戦略 大網と局所閉鎖陰圧療法の適用と有効性　　　　　　　　　　　　　　　
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年10月
(一社)日本人工臓器学会, 日本語

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年08月
日本気胸・嚢胞性肺疾患学会, 日本語

智と技の伝承(鏡視外科手術トレーニングの将来像) ドライラボ、カダバーを用いた単孔式胸腔鏡手術(Uniportal VATS)トレーニングの経験
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年06月
(NPO)小切開・鏡視外科学会, 日本語

先天性肺嚢胞性疾患に対する胸腔鏡手術の適応と成績
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年06月
(NPO)小切開・鏡視外科学会, 日本語

有茎肋間筋弁による胸腔鏡下気管支断端被覆の検討
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年06月
(NPO)小切開・鏡視外科学会, 日本語

【小児の先天性嚢胞性肺疾患に対する胸腔鏡手術】
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年06月
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), 北海道外科学会, 日本語

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年04月
(一社)日本インターベンショナルラジオロジー学会, 日本語

VISUALIZATION OF PERIPROCEDUAL BLOOD FLOW DYNAMICS WITH FOUR-DIMENSIONAL FLOW MAGNETIC RESONANCE IMAGING IN PATIENTS WITH SEVERE AORTIC STENOSIS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT
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年03月
ELSEVIER SCIENCE INC, 英語, 研究発表ペーパー・要旨（国際会議）

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年03月
(NPO)日本心臓血管外科学会, 日本語

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年03月
(NPO)日本心臓血管外科学会, 日本語

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年03月
(NPO)日本心臓血管外科学会, 日本語

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年03月
(NPO)日本心臓血管外科学会, 日本語

胸腹部大動脈瘤手術時の肋間動脈再建法の工夫と脊髄保護-internal cuff reimplantation法の有用性
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年

ステントグラフト保存動脈瘤形成術の中期結果
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年

肺移植患者における超音波気管支鏡の安全性および有効性の検討
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年
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。, 一般社団法人 日本移植学会, 日本語

ヘッドマウントディスプレイ(HMD)によるバーチャル・リアリティー(VR)システムを用いた,肺区域切除手術シミュレーション法の開発
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年

気管ステント留置後の逸脱に対し気管形成術を行い救命できた外傷性気管損傷の一例
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年

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年12月
北海道外科学会, 日本語

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年12月
北海道外科学会, 日本語

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年12月
(NPO)日本冠疾患学会, 日本語

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年12月
北海道外科学会, 日本語

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年12月
北海道外科学会, 日本語

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年10月
(一社)日本人工臓器学会, 日本語

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年10月
(一社)日本脈管学会, 日本語

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年10月
(一社)日本脈管学会, 日本語

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年10月
国家公務員共済組合連合会, 日本語

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年10月
(一社)日本人工臓器学会, 日本語

重症心不全に対する左室介入手術の功罪
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抄録集, 49回, [Ex, 3], 2019年02月
(NPO)日本心臓血管外科学会, 日本語

【心不全(第2版)中-最新の基礎・臨床研究の進歩-】補助循環・外科療法 左室形成術・僧帽弁関連手術
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年02月
(株)日本臨床社, 日本語

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年
(NPO)日本血管外科学会, 日本語

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年06月
(NPO)日本血管外科学会, 日本語

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する
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年

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(Web), 27, Supplement, ROMBUNNO.O21‐2(J‐STAGE), 2018年
日本語

ハイブリッドオペ後2年の吻合部狭窄にてPROPATENを使用した一例の転帰
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年
日本語

Blow‐out型左室破裂の1救命例
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年
日本語

TypeIIIbエンドリークによる瘤拡大に対する胸部ステントグラフト温存直達手術の経験
佐藤公治, 若狭哲, 北海道外科雑誌, 62, 2, 189, 2017年12月20日
日本語

高度粥状硬化病変を有する弓部大動脈瘤に対する胸部ステントグラフト内挿術時の脳梗塞予防の工夫
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年08月31日
日本語

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年07月
(NPO)日本小児循環器学会, 日本語

人工血管を用いたバイパス術により軽快したabdominal anginaの1例
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年06月20日
日本語

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年06月
(NPO)日本血管外科学会, 日本語

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年06月
(NPO)日本血管外科学会, 日本語

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年06月
(NPO)日本血管外科学会, 日本語

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年06月
(NPO)日本血管外科学会, 日本語

冠動脈肺動脈起始症(ACAPA)と冠動脈肺動脈瘻の治療経験
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年06月
北海道外科学会, 日本語

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年04月
(一社)日本移植学会, 日本語

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年04月
(一社)日本外科学会, 英語

Mitochondrial Dysfunction in Epicardial Adipose Tissue is Associated with Coronary Artery Stenosis(和訳中)
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年03月
(一社)日本循環器学会, 英語

高解像度CT画像に対する心臓内膜の3次元運動解析
木村 仁美, 金井 理, 伊達 宏昭, 松居 喜郎, 若狭 哲, 精密工学会学術講演会講演論文集, 2017, 231, 232, 2017年
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．, 公益社団法人 精密工学会, 日本語

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年10月
(一社)日本人工臓器学会, 日本語

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年06月
(NPO)日本血管外科学会, 日本語

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年06月
(NPO)日本血管外科学会, 日本語

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年06月
(NPO)日本血管外科学会, 日本語

Surgical Strategy for Ischemic Mitral Regurgitation Adopting Subvalvular and Ventricular Procedures (vol 21, pg 370, 2015)
Satoru Wakasa, Yasushige Shingu, Tomonori Ooka, Hiroki Katoh, Tsuyoshi Tachibana, Yoshiro Matsui, ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY, 22, 2, 125, 125, 2016年
MEDICAL TRIBUNE INC, 英語, その他

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年01月
(一社)日本集中治療医学会, 日本語

一期的に腹部大動脈瘤手術と脳死膵腎同時移植を実施した1例
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年12月20日
日本語

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年10月
日本Acute Care Surgery学会, 日本語

Stoke Work Index Predicts Left Ventricular Reverse Remodeling
Yasushige Shingu, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Yoshiro Matsui, JOURNAL OF CARDIAC FAILURE, 21, 10, S157, S157, 2015年10月
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS, 英語, 研究発表ペーパー・要旨（国際会議）

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年10月
(一社)日本人工臓器学会, 日本語

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年09月
(一社)日本移植学会, 日本語

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年04月
(一社)日本外科学会, 日本語

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年01月
(NPO)日本心臓血管外科学会, 日本語

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年01月
(NPO)日本心臓血管外科学会, 日本語

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年01月
(NPO)日本心臓血管外科学会, 日本語

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年01月
(NPO)日本心臓血管外科学会, 日本語

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年01月
(NPO)日本心臓血管外科学会, 日本語

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年01月
(NPO)日本心臓血管外科学会, 日本語

正中弓状靭帯症候群を合併した下膵十二指腸動脈瘤2例の治療経験
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年
(一社)日本外科学会, 日本語

下膵十二指腸動脈瘤に正中弓状靭帯症候群を合併した2例の治療経験
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年12月20日
北海道外科学会, 日本語

バイパス術後にIVRにて治療し得た未破裂膵十二指腸動脈瘤の1例
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年12月01日
(一社)日本インターベンショナルラジオロジー学会, 日本語

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年09月
(一社)日本人工臓器学会, 日本語

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年08月
(一社)日本移植学会, 日本語

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年05月
(一社)日本移植学会, 日本語

PD-2-4 心大血管再手術のPitfalls(PD-2 パネルディスカッション(2)心臓再手術のPitfalls,第114回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

VL-4 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(VL-4 映像による私の手術手技(4),第114回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

OP-098-6 大動脈瘤手術時の肋間動脈再建法の検討 : internal cuff reimplantation法の有用性(OP-098 大血管 胸部・その他,一般演題,第114回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-019-1 拡張型心筋症術後のreverse remodelingと術前心仕事量拡張末期容積関係の勾配との関連(PS-019 心臓 虚血性疾患・移植・その他,ポスターセッション,第114回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

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年03月
(一社)日本外科学会, 日本語

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年03月
(一社)日本外科学会, 日本語

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年01月
(NPO)日本心臓血管外科学会, 日本語

Complete Papillary Muscle Approximation is Associated with High Durability of Mitral Valve Repair for Ischemic Mitral Regurgitation
Satoru Wakasa, Yasushige Shingu, Tomonori Ooka, Tsuyoshi Tachibana, Yoshiro Matsui, JOURNAL OF CARDIAC FAILURE, 19, 10, S114, S114, 2013年10月
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS, 英語, 研究発表ペーパー・要旨（国際会議）

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年06月
北海道外科学会, 日本語

VF-048-3 機能的僧帽弁閉鎖不全症に対するpapillary muscle approximation with anterior suspension(VF ビデオフォーラム,第113回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-031-1 TOFに対する肺動脈弁温存/弁輪の工夫(PS ポスターセッション,第113回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-032-3 ブタ心大動脈基部を用いた大動脈弁逸脱症モデルの構築(PS ポスターセッション,第113回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-033-4 術後心房細動患者では術後心筋興奮-収縮連関時間が延長している(PS ポスターセッション,第113回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-034-1 機能性僧帽弁逆流への僧帽弁形成術後に発生する機能性僧帽弁狭窄の検討(PS ポスターセッション,第113回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-282-3 Marfan症候群における大血管病変に対する治療戦略(PS ポスターセッション,第113回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

VF-048-3 機能的僧帽弁閉鎖不全症に対するpapillary muscle approximation with anterior suspension(VF ビデオフォーラム,第113回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-031-1 TOFに対する肺動脈弁温存/弁輪の工夫(PS ポスターセッション,第113回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-032-3 ブタ心大動脈基部を用いた大動脈弁逸脱症モデルの構築(PS ポスターセッション,第113回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-033-4 術後心房細動患者では術後心筋興奮-収縮連関時間が延長している(PS ポスターセッション,第113回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-034-1 機能性僧帽弁逆流への僧帽弁形成術後に発生する機能性僧帽弁狭窄の検討(PS ポスターセッション,第113回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-282-3 Marfan症候群における大血管病変に対する治療戦略(PS ポスターセッション,第113回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

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年02月
(NPO)日本心臓血管外科学会, 日本語

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年02月
(NPO)日本心臓血管外科学会, 日本語

当科で施行したTOF術後成人期(16歳以上)での再手術症例の検討
加藤伸康, 浅井英嗣, 関達也, 南田大朗, 飯島誠, 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, 日本成人先天性心疾患学会雑誌, 2, 1, 83, 83, 2013年01月
日本成人先天性心疾患学会, 日本語

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年01月
日本成人先天性心疾患学会, 日本語

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年11月
(一社)日本人工臓器学会, 日本語

術後心房細動患者では術後心筋興奮-収縮連関時間が延長している
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年11月01日
日本語

Left Ventriculoplasty and Mitral Complex Reconstruction for Dilated Cardiomyopathy
Yoshiro Matsui, Yasushige Shingu, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Suguru Kubota, JOURNAL OF CARDIAC FAILURE, 18, 10, S134, S134, 2012年10月
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS, 英語, 研究発表ペーパー・要旨（国際会議）

重症左心不全に対する左室形成術後に左室拡張能改善と心筋酸素代謝軽減を認める
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年08月31日
日本語

重症左心不全患者に対する修正左室形成術(オーバーラッピング法)前後の左室拡張能と心筋酸素代謝の検討
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年08月06日
日本語

左室形成術は局所的な左室壁基部の収縮機能を改善する : QGSの左室壁 thickening による検討
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年08月01日
日本語

VWS-1-4 僧帽弁複合体形成術 : 僧帽弁輪縫縮・乳頭筋接合・乳頭筋つり上げ(VWS-1 ビデオワークショップ(1)機能的僧帽弁逆流に対する術式の工夫,第112回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

SF-080-2 傍腎動脈腹部大動脈瘤手術における常温腎動脈上遮断の安全性(SF-080 サージカルフォーラム(80)末梢血管 臨床,第112回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

SF-105-4 大動脈弁置換術非適応患者の手術危険率予測スコア評価 : 北海道における実情調査アンケート結果(SF-105 サージカルフォーラム(105)心臓,第112回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-153-2 先天性心疾患に対する右室流出路形成術後の再右室流出路再建例の検討(心臓小児・弁膜症,ポスターセッション,第112回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-153-5 溶血性貧血を伴う人工弁paravalvular leakに対する再置換術の早期手術成績に与える術前因子の検討(心臓小児・弁膜症,ポスターセッション,第112回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-153-7 SJM Tailor Ringを用いた二次性三尖弁閉鎖不全に対する弁輪形成術 : MC^3 ringとの比較(心臓小児・弁膜症,ポスターセッション,第112回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-154-4 高齢者の大動脈弁置換術の成績(心臓弁膜症,ポスターセッション,第112回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

PS-107-8 高周波焼灼デバイスを用いたメイズ手術 : 焼灼回数と貫壁性の検討(PS-107 心臓 虚血性疾患,ポスターセッション,第112回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

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年03月
(NPO)日本心臓血管外科学会, 日本語

静脈血リザーバ併用PCPS閉鎖回路による心筋負荷補助効果の実験的検討
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年12月20日
日本語

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年12月
北海道外科学会, 日本語

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年10月
(一社)日本人工臓器学会, 日本語

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年08月
(一社)日本心臓病学会, 日本語

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年08月
(一社)日本心臓病学会, 日本語

心不全治療の新展開―外科医との共働による新たな治療戦略《心不全に対する外科治療の新展開》左室形成術・僧帽弁手術
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年07月01日
日本語

左室形成術・僧帽弁手術 (特集 心不全治療の新展開--外科医との共働による新たな治療戦略) -- (心不全に対する外科治療の新展開)
松居 喜郎, 若狭 哲, 新宮 康栄, 内科, 108, 1, 81, 86, 2011年07月
南江堂, 日本語

感染性大動脈瘤の診断におけるFDG‐PETの有用性
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年06月20日
日本語

SF-067-1 PETを用いた心筋酸素代謝評価による重症僧帽弁閉鎖不全症手術指摘時期の検討(SF-067 サージカルフォーラム(67)心臓:基礎,第111回日本外科学会定期学術集会)
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年05月25日
一般社団法人日本外科学会, 日本語

感染性大動脈瘤の診断におけるFDG-PETの有用性
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年

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, 40, Supplement, 2011年

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, 40, Supplement, 2011年

過去10年間の医原性大腿動脈損傷の治療経験
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年

大動脈弁置換時に機能的2度僧帽弁逆流は放置しても良い?-MAP群との遠隔成績比較から-
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年

上行弓部大動脈人工血管置換術に伴う大伏在静脈を用いた冠動脈バイパス術の検討
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年

僧帽弁手術で二次性三尖弁閉鎖不全(TR)をどう扱う?-遺残TRの予測因子の検討-
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年

弁周囲逆流に対する手術の検討
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年

メインボディーによる両側腎動脈閉塞をきたしたがmainbody pull-down法で腎動脈rescueに成功した腹部大動脈ステントグラフトの一例
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年

体外設置型補助人工心臓(VAD)ABIOMED社MJ010の使用経験
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年

Mitral Complex Reconstruction and Left Ventriculoplasty for Functional Mitral Regurgitation With Dilated Cardiomyopathy
Yoshiro Matsui, Satoru Wakasa, Yasushige Shingu, Tomonori Ooka, Tsuyoshi Tachibana, Suguru Kubota, JOURNAL OF CARDIAC FAILURE, 16, 9, S137, S137, 2010年09月
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS, 英語, 研究発表ペーパー・要旨（国際会議）

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年08月
(一社)日本心臓病学会, 日本語

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年06月
北海道外科学会, 日本語

SV-2-2-3 虚血性/非虚血性拡張型心筋症に対する左室形成術(心臓・血管-2,特別ビデオセッション2,第110回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

OP-175-1 非虚血性拡張型心筋症に対する左室形成術の中期成績(心臓-3,一般口演,第110回日本外科学会定期学術集会)
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年03月05日
一般社団法人日本外科学会, 日本語

虚血性拡張型心筋症に対する左室形成術の中期成績~広範akinesis症例における術後左室容量の影響
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年

ウェーブ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(日本人工臓器学会), 39, 2, 2010年

二葉機械弁音のウェーブレット解析による新たな弁機能不全診断の試み
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年

心大血管手術における再手術症例(再胸骨正中切開)の検討
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年

当科における補助人工心臓装着症例の検討
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年

JACVSD risk解析モデルとEuroSCOREとの比較検討
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年

Wavelet解析による二葉機械弁機能不全の診断criteriaの再検討
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年

冠動脈手術領域におけるJapan scoreでの予測危険率の検討
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年

虚血性心筋症に対する左室形成術の成績
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年

SAPHO症候群に合併した繰り返す大動脈弁輪部膿瘍に対する大動脈基部再置換術
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年

結核性胸腹部大動脈瘤破裂緊急手術の2症例の検討
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年

TEVAR時代の弓部open surgeryの成績
若狭哲, 杉木宏司, 大岡智学, 橘剛, 久保田卓, 松居喜郎, 日本循環器学会北海道地方会(Web), 103rd, 2010年

鈍的外傷による大腿動静脈損傷に対し,緊急下肢血行再建を行った1症例
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年

胸部下行大動脈に対する自作ステントグラフト治療の遠隔期成績
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年

大動脈弁置換に併施した僧帽弁輪形成術の検討
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年

収縮期前方運動を伴った閉塞性肥大型心筋症の対する僧帽弁形成術-sliding leaflet technique-
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年

内科的コントロール中に大動脈基部拡大を来たし再手術を要した大動脈炎症候群の1例
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年

重症心不全に対する左室形成術~酢酸PETによる心筋酸素消費量評価に基づいたresponder判別の試み
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年

胸腹部大動脈瘤手術における脊髄モニターとしてのmotor evoked potential
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年

FDG-PET-CTを用いた縦隔炎の診断
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年

当科における感染性胸腹部大動脈瘤の外科治療
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年

大腿深部動脈内膜摘除後11年経過し,大腿動脈瘤を生じた1例
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年

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年01月
(NPO)日本心臓血管外科学会, 日本語

TA(Ib)に対するAPC後Af,PATに対してEC conversion,right side MAZEを行った一例
橘剛, 阿部慎司, 内藤祐嗣, 夷岡徳彦, 新宮康栄, 松井欣哉, 杉木孝司, 若狭哲, 大岡智学, 山川智士, 久保田卓, 椎谷紀彦, 村下十志文, 松居喜郎, Gen Thorac Cardiovasc Surg, 57, 8, 7, 2009年08月10日
日本語

拡張型心筋症と僧帽弁閉鎖不全症例における外科治療の心筋酸素代謝に対する効果
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年08月10日
日本語

外科治療のトピックス 先天性心疾患外科治療の進歩
橘剛, 夷岡徳彦, 松井欣哉, 若狭哲, 大岡智学, 久保田卓, 松居喜郎, 北海道外科雑誌, 54, 1, 2, 5, 2009年06月20日
日本語

¹¹C‐酢酸PETを用いた心筋代謝効率の左室形成術による変化についての検討
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年03月20日
日本語

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年03月
(NPO)日本心臓血管外科学会, 日本語

VS-008-4 二弁置換手術が必要な人工弁感染及び僧帽弁位人工弁周囲逆流症例におけるManouguian法の工夫 : double-layered patchによるintervalvular fibrous body reconstruction(心臓:後天性疾患,ビデオセッション,第109回日本外科学会定期学術集会)
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年02月25日
一般社団法人日本外科学会, 日本語

21) CTによる大動脈弁,僧帽弁石灰化の定量的評価(第99回日本循環器学会北海道地方会)
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年10月20日
社団法人日本循環器学会, 日本語

23) 高度左室拡大及び低左心機能を伴った重症大動脈弁狭窄症に対する手術経験(第99回日本循環器学会北海道地方会)
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年10月20日
社団法人日本循環器学会, 日本語

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年07月
(NPO)日本小児循環器学会, 日本語

PD-2-5 虚血性心筋症の外科治療戦略 : Overlapping法と僧帽弁複合体形成術(第108回日本外科学会定期学術集会)
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年04月25日
一般社団法人日本外科学会, 日本語

SF-018-1 ウサギ脊髄虚血再灌流モデルにおけるastrocyte活性化と遅発性運動神経細胞死に関する検討(第108回日本外科学会定期学術集会)
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年04月25日
一般社団法人日本外科学会, 日本語

肺動脈絞扼術後のccTGA(SLL),VSD,dextracardiaに対して経左房でconventional repair,TVPを行った1例
橘剛, 阿部慎司, 内藤祐嗣, 夷岡徳彦, 新宮康栄, 松井欣哉, 杉木孝司, 若狭哲, 杉木宏司, 山川智士, 久保田卓, 椎谷紀彦, 村下十志文, 松居喜郎, Gen Thorac Cardiovasc Surg, 56, 4, 16, 2008年04月10日
日本語

大動脈解離に対するETの長期予後
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年

左室流出路狭窄を伴う大動脈弁狭窄症に対し弁置換術と心室中隔筋切除を同時施行した2例
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年

QGSを用いた左室形成術前後壁運動解析
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年

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年01月
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。, 日本適応医学会, 日本語

Juxtarenal AAA手術症例の検討
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年12月
北海道外科学会, 日本語

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年11月
(NPO)日本冠疾患学会, 日本語

41)左室縮小率からみたオーバーラッピング型左室形成術後の心機能(第97回日本循環器学会北海道地方会)
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年10月20日
社団法人日本循環器学会, 日本語

10)Freestyle生体弁を使用してfull root replacementを施行した症例の検討(第96回日本循環器学会北海道地方会)
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年04月20日
社団法人日本循環器学会, 日本語

特発性/虚血性拡張型心筋症に伴う tethering による僧帽弁閉鎖不全症に対する乳頭筋接合術を中心とする僧帽弁複合体再建術
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年03月10日
一般社団法人日本外科学会, 日本語

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, 68, 9, 2007年

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, 68, 9, 2007年

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, 32, 3, 2007年

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, 47, Supplement, 2007年

特発性拡張型心筋症に対する左室形成術(オーバーラッピング,乳頭筋接合)施行症例のQGS(quantitative gated SPECT)による局所壁運動・血流量評価
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年

左室縮小率からみたオーバーラッピング型左室形成術後の心機能
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年

遠位弓部hybrid治療後のステントmigrationの1例
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年

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年01月
(公社)日本小児科学会, 日本語

両方向性グレン術後にTCPC非適応となった症例の検討
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年

乳児期に外科治療を要したASD+PH症例の検討
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年

Shaher 5A(intramural LCA)coronary patternのTGA(II)症例の治療経験
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年

先天性僧帽弁閉鎖不全症に対する弁形成術の1例
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年

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年07月
(NPO)日本小児循環器学会, 日本語

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年05月
(NPO)日本小児循環器学会, 日本語

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年05月
(NPO)日本小児循環器学会, 日本語

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, 34, Supplement, 2005年

ファロー型(TOFおよびDORV)根治手術における肺動脈弁輪温存症例の検討
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年

Fontan型手術非到達例の検討
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年

ファロー四徴症およびDORV根治手術における肺動脈弁輪温存症例の検討
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年

Total Cavopulmonary connectionの術後に関わる因子は何か,自験例22例の検討
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年

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年09月
(NPO)日本小児循環器学会, 日本語

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年05月
(NPO)日本小児循環器学会, 日本語

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年05月
(NPO)日本小児循環器学会, 日本語

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年05月
(NPO)日本小児循環器学会, 日本語

2. VSD根治術後に発症したfentanyl-induced muscle rigidityの1例(第69回日本小児外科学会北海道地方会)
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年
特定非営利活動法人 日本小児外科学会, 日本語

13) 大動脈解離におけるULP症例の外科的処置の検討
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年04月20日
社団法人日本循環器学会, 日本語

EBM循環器疾患の治療
三田村, 秀雄, 小室, 一成, 横井, 宏佳, 山下, 武志, 楽木, 宏実
中外医学社, 2001年10月, 4498034708, 冊, 日本語, ［分担執筆］

重症心不全に対する自己心温存外科治療戦略　　　　　　　　　　　　　　　
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年12月01日, その他
［招待講演］

僧帽弁形成術/後尖逸脱症例　　　　　　　　　　　　　　　
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年11月25日, その他
［招待講演］

心臓血管外科手術における止血の工夫　　　　　　　　　　　　　　　
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年11月05日, シンポジウム・ワークショップパネル（指名）
［招待講演］

虚血性僧帽弁閉鎖不全症に対する外科治療戦略　　　　　　　　　　　　　　　
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年11月03日, シンポジウム・ワークショップパネル（指名）
［招待講演］

Subvalvular surgical procedure for functional mitral regurgitation　　　　　　　　　　　　　　　
Satoru Wakasa
MITRAPLUS kick-off meeting, 2021年10月23日, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］

重症心不全外科治療とＮＯ吸入療法　　　　　　　　　　　　　　　
若狭哲
熊本県 iNO WEBフォーラム, 2021年10月08日, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］

重症心不全外科治療とＮＯ吸入療法　　　　　　　　　　　　　　　
若狭哲
神奈川県心臓周術期 iNO WEBセミナー, 2021年09月03日, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］

虚血性僧帽弁閉鎖不全症　　　　　　　　　　　　　　　
若狭哲
日本心臓血管外科学会U-40 online BLC, 2021年07月17日, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］

Small Aortic Root, session 3　　　　　　　　　　　　　　　
Satoru Wakasa
Abbott Japan/China Mentorship Program, 2021年06月24日, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］

Small Aortic Root, session 2　　　　　　　　　　　　　　　
Satoru Wakasa
Abbott Japan/China Mentorship Program, 2021年06月17日, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］

Small Aortic Root, session 1　　　　　　　　　　　　　　　
Satoru Wakasa
Abbott Japan/China Mentorship Program, 2021年06月03日, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］

Ischemic MR：touch or no touch？　　　　　　　　　　　　　　　
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年02月19日, 公開講演，セミナー，チュートリアル，講習，講義等
［招待講演］

心臓血管外科手術時の止血の工夫　　　　　　　　　　　　　　　
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年02月19日, 口頭発表（一般）
［招待講演］

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　　　　　　　　　　　　　　　
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年02月19日, シンポジウム・ワークショップパネル（指名）
［招待講演］

オープンステントグラフトを用いた胸部大動脈手術　　　　　　　　　　　　　　　
若狭哲
第24回九州心臓血管外科セミナー, 2021年01月09日
［招待講演］

Mitral valve replacement for FMR　　　　　　　　　　　　　　　
Satoru Wakasa
Think Mitral – EACTS Live Webinar -, 2020年10月10日, 英語, 口頭発表（一般）
［招待講演］

Functional mitral valve disease - Beyond annuloplasty: targeting the left ventricle　　　　　　　　　　　　　　　
若狭 哲
32nd Annual Meeting of the European Association for Cardio-Thoracic Surgery, Milan, 2018年10月18日, 英語, 口頭発表（招待・特別）
2018年10月18日 - 2018年10月20日, ［招待講演］

Who benefits from surgical ventricular restoration: consideration according to INTERMACS profiles　　　　　　　　　　　　　　　
若狭 哲
21st Annual Meeting of the Asian Society for Cardiovascular and Thoracic Surgery, Kobe, 2013年04月07日, 英語
2013年04月04日 - 2013年04月07日

Left ventriculoplasty for progressively deteriorated left ventricle with global akinesis due to ischaemic cardiomyopathy: Japanese surgical ventricular reconstruction group experience　　　　　　　　　　　　　　　
若狭 哲
26th Annual Meeting of the European Association for Cardio-Thoracic Surgery, Barcelona, 2012年10月29日, 英語, 口頭発表（一般）
2012年10月27日 - 2012年10月31日

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年09月13日
2010年09月11日 - 2010年09月15日

Integrated surgical approach with overlapping left ventriculoplasty and papillary muscle approximation for patients with severe heart failure due to ischemic dilated cardiomyopathy　　　　　　　　　　　　　　　
若狭 哲
Masters in Repair of Structural Heart Disease, Miami, 2010年

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年

胸部大血管手術～私の工夫　　　　　　　　　　　　　　　
若狭哲
第11回浜松心臓血管外科研究会, 口頭発表（招待・特別）
［招待講演］

重症虚血性僧帽弁閉鎖不全症に対する弁下組織介入形成術のNCD利用多施設共同研究
科学研究費助成事業 基盤研究(C)
2022年04月01日 - 2025年03月31日
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
日本学術振興会, 基盤研究(C), 東京慈恵会医科大学, 22K08964

熱可塑性樹脂と熱伝導部材を用いた術中変形可能な新しい人工弁輪の開発
科学研究費助成事業 基盤研究(C)
2017年04月01日 - 2020年03月31日
松居 喜郎, 橘 剛, 若狭 哲, 新宮 康栄, 久保田 卓, 大岡 智学
熱可塑性人工弁輪に使用したポリカプロラクトンは人工弁輪としての硬度は十分である考えられた。人工弁輪加熱において、弁輪被覆材は温度測定、サーモグラフィーにて40度以下であり、連続10回の熱変形時においてもブタ心臓組織への熱損傷所見を認めず、安全に使用可能と考えられた。人工弁輪の変形にて実際にブタ僧帽弁の接合様式を調整できた。弁尖接合距離の延長により僧帽弁形成術後の長期安定性を高められる。僧帽弁形成術後に修正が必要な場合に人工弁輪を変形させることで僧帽弁への追加手技や人工弁輪の変更を行わずに弁尖の接合を改善できる。症例ごとに術前評価によってオーダーメード人工弁輪を作成することもできる。
日本学術振興会, 基盤研究(C), 北海道大学, 17K10719

脊髄虚血障害におけるグリア細胞の役割の解明と治療への応用
科学研究費補助金(基盤研究(B))
2008年 - 2010年
椎谷 紀彦, 若狭 哲, 椎谷 紀彦
大動脈瘤手術における脊髄障害は非常に重篤かつ未解決の合併症である。我々は、障害予防の標的としてのグリア細胞の有用性を検討するため、脊髄虚血再潅流障害においてグリア細胞が果たす役割を分析した。ウサギ脊髄虚血再潅流モデルを用いた実験から、グリア細胞の活性化は遅発性神経細胞障害の程度に相関があることが示された。また、グリア細胞の活性化とアラキドン酸の動態が有意な相関を示すことが判明した。
文部科学省, 基盤研究(B), 北海道大学, 研究代表者, 競争的資金, 20390362