著者

Jun Yasuhara Toshiki Kuno Moe Taki Koichi Toda Takashi Kumamoto Takuro Kojima Hiroyuki Shimizu Shigeki Yoshiba Toshiki Kobayashi Naokata Sumitomo

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

pp.19-099, (Released:2019-11-15)

参考文献数

25

被引用文献数

1

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Postoperative arrhythmias are a frequent and fatal complication after the Fontan operation. However, clinical evidence demonstrating early postoperative arrhythmias in children undergoing the Fontan operation is limited. This study aimed to evaluate the prevalence of arrhythmias and identify the predictors of early postoperative supraventricular tachyarrhythmias (SVTs) after the Fontan procedure.Data were analyzed from 80 pediatric patients who underwent Fontan procedures between April 2000 and December 2017 in a single-center retrospective study. Early postoperative SVTs were defined as arrhythmias within 30 days after the Fontan procedure. We divided the patients into two groups, with or without early postoperative arrhythmias, and the predictors of early postoperative arrhythmias were analyzed. A multivariate logistic regression analysis was performed to determine independent predictors of early postoperative SVTs after the Fontan procedure.Early postoperative SVTs were observed in 21 patients (26.3%). The most common arrhythmia was junctional ectopic tachycardia. After an adjustment, an atrioventricular valve regurgitation (AVVR) grade of ≥2 (odds ratio 10.54, 95% confidence interval 2.52 to 44.17, P = 0.001) and preoperative arrhythmias (odds ratio 26.49, 95% confidence interval 1.64 to 428.62, P = 0.021) were significant predictors of early postoperative SVTs after the Fontan operation.An AVVR grade ≥2 and preoperative arrhythmia were significant predictors associated with early postoperative SVTs. Intervention for AVVR may provide clinical benefit for preventing early postoperative arrhythmias after the Fontan operation.

著者

Toshiki Kuno Akimichi Shibata Masaki Kodaira Yohei Numasawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-18-0143, (Released:2018-06-12)

被引用文献数

3

著者

Masaki Kodaira Hiroyuki Yamazaki Ryota Tabei Toshiki Kuno Kazuhiko Shimizu Yohei Numasawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-18-0094, (Released:2018-05-16)

参考文献数

2

被引用文献数

2

著者

Reiichiro Obata Tetsuro Maeda Dahlia Rizk DO Toshiki Kuno

出版者

National Institute of Infectious Diseases, Japanese Journal of Infectious Diseases Editorial Committee

雑誌

Japanese Journal of Infectious Diseases (ISSN:13446304)

巻号頁・発行日

pp.JJID.2020.884, (Released:2020-12-25)

参考文献数

27

被引用文献数

37

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Since cytokine release syndrome is considered to be associated with severe cases of COVID-19, steroids are expected to be effective for its treatment. We aimed to investigate the use of steroids and its impact. We conducted a retrospective chart review and analysis of 226 consecutive hospitalized patients with confirmed COVID-19. Patients were divided into those who received steroids (steroid group) and those who did not (no steroid group). Inverse weighted probability weighted analysis was performed to assess the effect of steroids for in-hospital mortality. The steroid group had higher rates of preexisting hypertension and peripheral vascular disease than no steroid group and also had higher lactate dehydrogenase, d-dimer, and inflammatory makers compared to no steroid group (all P<0.05). The steroid group had significantly higher rates of multifocal pneumonia than no steroid group at admission (75.4% versus 50.3%, P=0.001). Notably, steroid group had higher rates of bacterial infection (25% versus 13.1%, P=0.041) and fungal infection (12.7% versus 0.7%, P<0.001) during hospital course. After adjustment, steroid did not decrease or increase in-hospital mortality (OR [95% CI]: 1.02 [0.60-1.73, P=0.94]). Steroid did not decrease the in-hospital mortality rate. There were increased bacterial and fungal infections with steroid use.

著者

Jun Yasuhara Toshiki Kuno Moe Taki Koichi Toda Takashi Kumamoto Takuro Kojima Hiroyuki Shimizu Shigeki Yoshiba Toshiki Kobayashi Naokata Sumitomo

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.60, no.6, pp.1358-1365, 2019-11-30 (Released:2019-11-30)

参考文献数

25

被引用文献数

1

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Postoperative arrhythmias are a frequent and fatal complication after the Fontan operation. However, clinical evidence demonstrating early postoperative arrhythmias in children undergoing the Fontan operation is limited. This study aimed to evaluate the prevalence of arrhythmias and identify the predictors of early postoperative supraventricular tachyarrhythmias (SVTs) after the Fontan procedure.Data were analyzed from 80 pediatric patients who underwent Fontan procedures between April 2000 and December 2017 in a single-center retrospective study. Early postoperative SVTs were defined as arrhythmias within 30 days after the Fontan procedure. We divided the patients into two groups, with or without early postoperative arrhythmias, and the predictors of early postoperative arrhythmias were analyzed. A multivariate logistic regression analysis was performed to determine independent predictors of early postoperative SVTs after the Fontan procedure.Early postoperative SVTs were observed in 21 patients (26.3%). The most common arrhythmia was junctional ectopic tachycardia. After an adjustment, an atrioventricular valve regurgitation (AVVR) grade of ≥2 (odds ratio 10.54, 95% confidence interval 2.52 to 44.17, P = 0.001) and preoperative arrhythmias (odds ratio 26.49, 95% confidence interval 1.64 to 428.62, P = 0.021) were significant predictors of early postoperative SVTs after the Fontan operation.An AVVR grade ≥2 and preoperative arrhythmia were significant predictors associated with early postoperative SVTs. Intervention for AVVR may provide clinical benefit for preventing early postoperative arrhythmias after the Fontan operation.