著者

Hitoshi Ogino Osamu Iida Koichi Akutsu Yoshiro Chiba Hiromitsu Hayashi Hatsue Ishibashi-Ueda Shuichiro Kaji Masaaki Kato Kimihiro Komori Hitoshi Matsuda Kenji Minatoya Hiroko Morisaki Takao Ohki Yoshikatsu Saiki Kunihiro Shigematsu Norihiko Shiiya Hideyuki Shimizu Nobuyoshi Azuma Hirooki Higami Shigeo Ichihashi Toru Iwahashi Kentaro Kamiya Takahiro Katsumata Nobuyoshi Kawaharada Yoshihisa Kinoshita Takuya Matsumoto Shinji Miyamoto Takayuki Morisaki Tetsuro Morota Kiyonori Nanto Toshiya Nishibe Kenji Okada Kazumasa Orihashi Junichi Tazaki Masanao Toma Takuro Tsukube Keiji Uchida Tatsuo Ueda Akihiko Usui Kazuo Yamanaka Haruo Yamauchi Kunihiro Yoshioka Takeshi Kimura Tetsuro Miyata Yutaka Okita Minoru Ono Yuichi Ueda on behalf of the Japanese Circulation Society the Japanese Society for Cardiovascular Surgery the Japanese Association for Thoracic Surgery and the Japanese Society for Vascular Surgery Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0794, (Released:2023-09-01)

参考文献数

1943

被引用文献数

13

著者

Akihiko Nogami Takashi Kurita Haruhiko Abe Kenji Ando Toshiyuki Ishikawa Katsuhiko Imai Akihiko Usui Kaoru Okishige Kengo Kusano Koichiro Kumagai Masahiko Goya Yoshinori Kobayashi Akihiko Shimizu Wataru Shimizu Morio Shoda Naokata Sumitomo Yoshihiro Seo Atsushi Takahashi Hiroshi Tada Shigeto Naito Yuji Nakazato Takashi Nishimura Takashi Nitta Shinichi Niwano Nobuhisa Hagiwara Yuji Murakawa Teiichi Yamane Takeshi Aiba Koichi Inoue Yuki Iwasaki Yasuya Inden Kikuya Uno Michio Ogano Masaomi Kimura Shun-ichiro Sakamoto Shingo Sasaki Kazuhiro Satomi Tsuyoshi Shiga Tsugutoshi Suzuki Yukio Sekiguchi Kyoko Soejima Masahiko Takagi Masaomi Chinushi Nobuhiro Nishi Takashi Noda Hitoshi Hachiya Masataka Mitsuno Takeshi Mitsuhashi Yasushi Miyauchi Aya Miyazaki Tomoshige Morimoto Hiro Yamasaki Yoshifusa Aizawa Tohru Ohe Takeshi Kimura Kazuo Tanemoto Hiroyuki Tsutsui Hideo Mitamura on behalf of the JCS/JHRS Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0637, (Released:2021-06-01)

参考文献数

1350

被引用文献数

75

著者

Akihiko Usui Masato Mutsuga

出版者

The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery

雑誌

Annals of Thoracic and Cardiovascular Surgery (ISSN:13411098)

巻号頁・発行日

pp.ra.22-00103, (Released:2022-07-15)

参考文献数

49

被引用文献数

3

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In patients with obstructive hypertrophic cardiomyopathy, left ventricular outflow tract (LVOT) obstruction can be created by the hypertrophic interventricular septum (IVS) as well as systolic anterior motion (SAM) of the anterior mitral leaflet (AML). Sufficient septal myectomy is a fundamental surgical technique to treat LVOT obstruction, however, direct surgical management for SAM is another key aspect. Besides the hypertrophic IVS, mitral valve, subvalvular apparatus, and papillary muscle may play important role for SAM and several surgical techniques have been proposed to treat SAM in literature. In this review, each surgical technique is classified by the anatomical structure on which the surgical procedure is applied. The AML is the main surgical site and is applied with plication (vertical plication, resection–plication–release strategy), extension (the AML extension, transverse incision of the AML), sutured (edge-to-edge repair, anterior leaflet retention plasty), or traction (floating stitch, papillary muscle-to-anterior annulus stitches, paradoxical stitches, transposition of a directed chorda tendinea to the AML). Height reduction of the posterior mitral valve leaflet and papillary muscle reorientation are other techniques. We should understand theoretical aspects of each technique on correction of anatomical and functional abnormalities of the structure and should apply them under proper indication.

著者

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

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.82, no.12, pp.2998-3004, 2018-11-24 (Released:2018-11-24)

参考文献数

28

被引用文献数

9

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Background: The strategy for cardiovascular surgery in dementia patients is controversial, so we aimed to investigate whether preoperative dementia and its severity might affect the outcomes of cardiovascular surgery by evaluating with the Mini-Mental State Examination (MMSE). Methods and Results: The study group comprised 490 patients undergoing cardiovascular surgery. Their preoperative cognitive status was evaluated using the MMSE, and analysis was performed to compare the patients with MMSE score <24 (dementia group, n=51) or MMSE score 24–30 (non-dementia group, n=439). Furthermore, the effect of the severity of dementia was analyzed with a cut-off MMSE score of 19/20. Risk factors for surgical outcomes were explored using multivariate logistic regression analysis. Hospital mortality was 11.8% in the dementia group and 2.1% in the non-dementia group (P=0.002). Regarding the postoperative morbidities, the incidence of cerebrovascular disorder (P=0.001), pneumonia (P=0.039), delirium (P=0.004), and infection (P=0.006) was more frequent in dementia group. Among the patients with MMSE <20, hospital mortality was as high as 25%, and the rate of delirium was 58%. Multivariate logistic regression analysis revealed that MMSE score <24 (P=0.003), lower serum albumin (P=0.023) and aortic surgery (P=0.036) were independent risk factors for hospital death. Conclusions: Preoperative dementia affects the outcomes of cardiovascular surgery with regard to hospital death and delirium. The surgical indication for patients with MMSE <20 might be difficult, but surgery with an appropriate strategy should be considered for patients with MMSE <24.

著者

Akihiko Usui Masato Mutsuga

出版者

The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery

雑誌

Annals of Thoracic and Cardiovascular Surgery (ISSN:13411098)

巻号頁・発行日

vol.28, no.4, pp.239-248, 2022 (Released:2022-08-20)

参考文献数

49

被引用文献数

3

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In patients with obstructive hypertrophic cardiomyopathy, left ventricular outflow tract (LVOT) obstruction can be created by the hypertrophic interventricular septum (IVS) as well as systolic anterior motion (SAM) of the anterior mitral leaflet (AML). Sufficient septal myectomy is a fundamental surgical technique to treat LVOT obstruction, however, direct surgical management for SAM is another key aspect. Besides the hypertrophic IVS, mitral valve, subvalvular apparatus, and papillary muscle may play important role for SAM and several surgical techniques have been proposed to treat SAM in literature. In this review, each surgical technique is classified by the anatomical structure on which the surgical procedure is applied. The AML is the main surgical site and is applied with plication (vertical plication, resection–plication–release strategy), extension (the AML extension, transverse incision of the AML), sutured (edge-to-edge repair, anterior leaflet retention plasty), or traction (floating stitch, papillary muscle-to-anterior annulus stitches, paradoxical stitches, transposition of a directed chorda tendinea to the AML). Height reduction of the posterior mitral valve leaflet and papillary muscle reorientation are other techniques. We should understand theoretical aspects of each technique on correction of anatomical and functional abnormalities of the structure and should apply them under proper indication.

著者

Toshihiko Nishi Yoshiyuki Tokuda Akihito Tanaka Kenji Furusawa Yusuke Miki Akihiro Tobe Toyoaki Murohara Akihiko Usui

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.2, no.11, pp.701-702, 2020-11-10 (Released:2020-11-10)

参考文献数

1

著者

Teruhiko Imamura Koichiro Kinugawa Minoru Ono Osamu Kinoshita Norihide Fukushima Akira Shiose Yoshiro Matsui Kenji Yamazaki Yoshikatsu Saiki Akihiko Usui Hiroshi Niinami Goro Matsumiya Hirokuni Arai Yoshiki Sawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-18-1215, (Released:2019-04-24)

参考文献数

35

被引用文献数

7

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Background:Hemocompatibility-related adverse events (HRAEs) are substantial issues in patients with left ventricular assist devices (LVADs). Atrial fibrillation (AF) is associated with worse prognosis in patients with heart failure (HF), but its effect on HRAEs following LVAD implantation remain uncertain.Methods and Results:Data from the Japanese Mechanically Assisted Circulatory Support registry of consecutive patients who received HeartMate II LVADs and were followed for 1 year were retrospectively reviewed. Among 190 patients, 23 had AF and 167 had sinus rhythm. The AF group had comparable baseline characteristics with the non-AF group except for their higher age (53 vs. 42 years, P<0.001). Following LVAD implantation, most cases of AF (73%) persisted. Antiplatelet therapy, anticoagulation therapy, and LVAD speed following LVAD implantation were comparable between groups (P>0.05 for all). The 1-year survival free from HRAEs was comparable between groups (83% vs. 76%, P=0.52). Event rates of the breakdown of HRAEs were comparable between groups except for a relatively higher rate of surgically managed pump thrombosis in the AF group (0.16 vs. 0.04, incidence rate ratio 3.75, 95% confidence interval 0.87–16.1, P=0.075). These trends still remained with propensity score-matched comparison.Conclusions:Existence of AF had no effect on the development of HRAEs following LVAD implantation. The need to aggressively treat AF before or after LVAD implantation needs further investigation.