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Nakata K, Moriyama S, Takaki J, Takeo M, Doi H, Matsumura T, Fukui T. Pseudoaneurysm of mitral-aortic intervalvular fibrosa with rupture: a case report. Surg Case Rep 2023; 9:210. [PMID: 38044395 PMCID: PMC10694109 DOI: 10.1186/s40792-023-01789-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/26/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Mitral-aortic intervalvular fibrosa (MAIVF) is a fibrous region connecting the anterior mitral leaflet (AML) and aortic valve. Pseudoaneurysm of the MAIVF is a rare condition that has been reported as a sequela of infective endocarditis (IE) and surgical trauma. Here, we report a case of a ruptured pseudoaneurysm of the MAIVF, along with some literature reviews. CASE PRESENTATION A 65-year-old man diagnosed with moderate aortic regurgitation five years previously had a fever of unknown origin. He suddenly developed headache and apraxia and was transported to our hospital. He was diagnosed with intracranial hemorrhage and admitted. One week after admission, echocardiography revealed aorto-mitral discontinuity and protrusion with severe regurgitant flow from left ventricular outflow tract to the left atrium. The AML was suspected to have ruptured. However, intraoperatively, the AML structure was preserved. A ruptured pseudoaneurysm of the MAIVF was also observed. Therefore, we successfully performed pseudoaneurysm repair using a bovine pericardial patch, aortic valve replacement, and mitral annuloplasty. CONCLUSIONS P-MAIVF is a rare but potentially life-threatening complication of IE, for which timely diagnosis and prompt appropriate therapeutic intervention are required. In the present case, although neither obvious active IE nor history of previous IE could be identified, healed IE was considered based on the clinical course. The patient had intracranial hemorrhage (ICH) with well-controlled heart failure and underwent elective surgical repair more than one month after the onset of ICH, while the clinical course after the surgical procedure was uneventful.
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Affiliation(s)
- Kosuke Nakata
- Department of Cardiovascular Surgery, Kumamoto Rosai Hospital, 1670 Takehara-Machi, Yatsushiro, Kumamoto, 866-8533, Japan.
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan.
| | - Shuji Moriyama
- Department of Cardiovascular Surgery, Kumamoto Rosai Hospital, 1670 Takehara-Machi, Yatsushiro, Kumamoto, 866-8533, Japan
| | - Jun Takaki
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Masahiro Takeo
- Department of Cardiology, Kumamoto Rosai Hospital, Yatsushiro, Kumamoto, Japan
| | - Hideki Doi
- Department of Cardiology, Kumamoto Rosai Hospital, Yatsushiro, Kumamoto, Japan
| | - Toshiyuki Matsumura
- Department of Cardiology, Kumamoto Rosai Hospital, Yatsushiro, Kumamoto, Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
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Takaki J, Morinaga J, Sadanaga T, Hirota T, Hidaka H, Horibe T, Nishigawa K, Yoshinaga T, Fukui T. Renal Biomarkers in the Early Detection of Acute Kidney Injury After Off-Pump Coronary Artery Bypass Grafting. Circ J 2023:CJ-23-0570. [PMID: 38008427 DOI: 10.1253/circj.cj-23-0570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
BACKGROUND Cardiac surgery-associated (CSA) acute kidney injury (AKI) is a severe postoperative complication in patients undergoing off-pump coronary artery bypass grafting (OPCAB). Early detection of postoperative CSA-AKI may be key to improving patient outcomes. This study explored the use of renal biomarkers measured immediately after surgery for the early detection of CSA-AKI in patients undergoing OPCAB.Methods and Results: In all, 111 patients who underwent OPCAB at Kumamoto University Hospital between June 2020 and October 2022 were included in this study. Urinary neutrophil gelatinase-associated lipocalin, liver-type fatty acid-binding protein, and N-acetyl-β-D-glucosaminidase (NAG) were measured upon arrival in the intensive care unit (ICU) after surgery. AKI was diagnosed using KDIGO criteria. Of the 111 patients, 32 (28.8%) developed postoperative AKI. Regarding AKI staging, 19 (59.4%), 11 (34.4%), and 2 (6.3%) patients had Stage 1, 2, and 3 AKI, respectively. There were significant differences in chronic kidney disease, preoperative estimated glomerular filtration rate (eGFR), and NAG between the AKI and non-AKI groups. Multivariate analysis showed that preoperative eGFR (odds ratio [OR] for 5-mL/min/1.73 m2increase in eGFR 0.75; 95% confidence interval [CI] 0.63-0.89) and increasing urinary NAG concentrations at ICU admission (OR 2.44; 95% CI 1.30-4.60) were significant risk factors for CSA-AKI in OPCAB patients. CONCLUSIONS NAG and eGFR may be valuable biomarkers for the early detection of CSA-AKI in patients undergoing OPCAB.
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Affiliation(s)
- Jun Takaki
- Department of Cardiovascular Surgery, Kumamoto University Hospital
| | - Jun Morinaga
- Center for Clinical Research, Graduate School of Medical Sciences, Kumamoto University Hospital
| | | | - Takahumi Hirota
- Department of Cardiovascular Surgery, Kumamoto University Hospital
| | - Hideaki Hidaka
- Department of Cardiovascular Surgery, Kumamoto University Hospital
| | - Tatsuya Horibe
- Department of Cardiovascular Surgery, Kumamoto University Hospital
| | - Kosaku Nishigawa
- Department of Cardiovascular Surgery, Kumamoto University Hospital
| | | | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University Hospital
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Hidaka H, Horibe T, Numaguchi R, Takaki J, Nishigawa K, Yoshinaga T, Fukui T. [A Combination Therapy with Antibiotic and Surgical Treatment in a Patient with Patent Ductus Arteriosus with Pulmonary Vegetation:Report of a Case]. Kyobu Geka 2023; 76:1016-1019. [PMID: 38057979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
We present a case of a 24-year-old female who presented with a history of fever and back pain. She had no particular medical history and was not taking any medication. Transthoracic echocardiology and computed tomography showed a patent ductus arteriosus with vegetation in the pulmonary artery. She was treated with penicillin G;however, the vegetation embolized into the left pulmonary artery. After the antibiotics was changed to clindamycin and ceftriaxone, the resolution of the lung abscess was shown by computed tomography( CT). Two months later, a surgical repair of the patent ductus arteriosus was successfully performed. Patent ductus arteriosus-associated infectious endocarditis is relatively rare in adulthood.
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Affiliation(s)
- Hideaki Hidaka
- Department of Cardiovascular Surgery, Kumamoto University, Kumamoto, Japan
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Numaguchi R, Takaki J, Nishigawa K, Yoshinaga T, Fukui T. Outcomes of mitral valve replacement with complete annular decalcification. Asian Cardiovasc Thorac Ann 2023; 31:775-780. [PMID: 37844584 DOI: 10.1177/02184923231206237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
BACKGROUND This study aimed to examine the clinical outcomes of mitral valve replacement (MVR) in patients with severe mitral annular calcification (MAC) who required extensive decalcification and mitral annular reconstruction. METHODS We reviewed 15 patients with severe MAC who underwent MVR between January 2016 and May 2022. In all cases, the calcified mitral annulus was resected completely using a Cavitron Ultrasound Surgical Aspirator, and a new annulus was created using bovine pericardium. In the acute postoperative phase, strict afterload reduction therapy using an intra-aortic balloon pump (IABP) was administered. RESULTS The mean age of patients was 73 ± 8 years, and 13 (86.7%) were women. Concomitant aortic valve replacement was performed in 11 (73.3%) patients, tricuspid annuloplasty in 9 (60.0%), coronary artery bypass grafting in 1 (6.7%), and arrhythmia surgery in 7 (46.7%). The mean aortic cross-clamp and cardiopulmonary bypass times were 143 ± 32 min and 175 ± 34 min, respectively. In 13 patients, an IABP was used for 2 or 3 days postoperatively. There were no in-hospital deaths, left ventricular ruptures, or other MAC-related complications. Postoperative echocardiography revealed no paravalvular leakages. CONCLUSION Our strategy for managing severe MAC is safe and reproducible even in relatively high-risk patients. Afterload reduction using an IABP in the acute postoperative phase may reduce the risk of fatal complications after extensive decalcification and mitral annular reconstruction.
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Affiliation(s)
- Ryosuke Numaguchi
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Jun Takaki
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Kosaku Nishigawa
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Takashi Yoshinaga
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
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Nishigawa K, Horibe T, Hidaka H, Numaguchi R, Takaki J, Yoshinaga T, Fukui T. Do chronic total occlusive lesions affect patency of coronary bypass grafts to the right coronary artery? Asian Cardiovasc Thorac Ann 2023; 31:768-774. [PMID: 37801488 DOI: 10.1177/02184923231205967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
OBJECTIVES To evaluate the impact of chronic total occlusion (CTO) lesions on the patency of bypass grafts to the right coronary artery territory. METHODS Two hundred patients undergoing primary isolated coronary artery bypass grafting with revascularization to the right coronary artery territory between April 2015 and July 2022 were retrospectively analyzed. Study patients were divided into two groups according to their right coronary artery lesion: patients with CTO lesions (n = 76) and those without CTO lesions (n = 124). Graft flow of the right coronary artery territory was evaluated by intraoperative transit time flow measurement and patency of the bypass graft was evaluated by multidetector row computed tomography. RESULTS A total of 200 patients (76 patients with CTO and 124 patients without CTO) were included in this study. Intraoperative transit time flow measurement demonstrated that there was no significant difference in the median mean graft flow (30 ml/min vs. 25 ml/min; p = 0.114), pulsatility index (2.1 vs. 2.4; p = 0.079), and diastolic filling rate (65% vs. 64%; p = 0.844) between patients with CTO and those without CTO. Postoperative multidetector row computed tomography demonstrated that the patency of bypass grafts to the right coronary artery territory was similar between the groups (94.7% in patients with CTO vs. 96.0% in those without CTO; p = 0.733). In patients with CTO, the patency of bypass graft tended to be worse in subgroup with rich collateral blood flow (Rentrop grade 3). CONCLUSIONS Chronic total occlusion lesions do not affect the patency of bypass grafts to the right coronary artery territory.
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Affiliation(s)
- Kosaku Nishigawa
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Tatsuya Horibe
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Hideaki Hidaka
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Ryosuke Numaguchi
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Jun Takaki
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Takashi Yoshinaga
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
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Araki N, Hirota T, Hidaka H, Horibe T, Numaguchi R, Takaki J, Nishigawa K, Yoshinaga T, Fukui T. Factors Affecting Recovery of 6-Minute Walk Distance After Coronary Artery Bypass Grafting. Circ Rep 2023; 5:317-322. [PMID: 37564878 PMCID: PMC10411994 DOI: 10.1253/circrep.cr-23-0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 08/12/2023] Open
Abstract
Background: This single-center retrospective analysis investigated the number of days required for postoperative 6-minute walk distance (6MWD) to recover to preoperative values after coronary artery bypass grafting (CABG) and the factors influencing this recovery. Methods and Results: The 6MWD was measured in 101 patients (median age 69 years; 18 women) before and every day after CABG. Univariate and multivariate analyses were performed to identify factors affecting 6MWD recovery to preoperative values after CABG. The median number of days required for recovery of 6MWD after CABG was 9 (interquartile range 7-11 days). Patients were divided into 2 groups based on the median number of days required for recovery of 6MWD; there were 60 patients in the early recovery group (<9 days) and 41 in the "non-early" recovery group (38 who recovered after the median 9 days, and 3 who did not recover during hospitalization). Using univariate logistic regression analysis, diabetes (P=0.01), stroke (P=0.26), left ventricular ejection fraction (P=0.27), and grip strength (P=0.13) were selected for multivariate analysis. Multivariate logistic regression analysis revealed that diabetes (odds ratio 2.955; 95% confidence interval 1.208-7.229; P=0.02) was the only independent predictor of 6MWD recovery. Conclusions: Diabetes was the single factor influencing the recovery of postoperative 6MWD in patients undergoing CABG.
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Affiliation(s)
- Naoya Araki
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Takafumi Hirota
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Hideaki Hidaka
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Tatsuya Horibe
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Ryosuke Numaguchi
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Jun Takaki
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Kosaku Nishigawa
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Takashi Yoshinaga
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
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Horibe T, Hidaka H, Numaguchi R, Takaki J, Nishigawa K, Yoshinaga T, Fukui T. Mitral valve replacement with annuloplasty in a patient with infected mitral annular calcification. Clin Case Rep 2023; 11:e7802. [PMID: 37593342 PMCID: PMC10427749 DOI: 10.1002/ccr3.7802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 07/11/2023] [Accepted: 07/28/2023] [Indexed: 08/19/2023] Open
Abstract
Key Clinical Message Extensive resection of the infected calcified annulus and the reconstruction with a pericardial patch for the debrided annulus is an effective surgical option for the treatment of infectious endocarditis in patients with mitral annular calcification. Abstract A 78-year-old woman was referred to our hospital because of left-sided hemiparesis. During the treatment for cerebral infarction, the patient became feverish and lost consciousness. Transthoracic echocardiography revealed mitral annular calcification and a tumor-like mass on the posterior leaflet despite no findings of mitral regurgitation. She underwent successful mitral valve replacement with debridement of the infected mitral annulus and reconstruction of the posterior annulus (annuloplasty) with bovine pericardium after removal of the mitral annular calcification.
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Affiliation(s)
- Tatsuya Horibe
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
| | - Hideaki Hidaka
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
| | - Ryosuke Numaguchi
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
| | - Jun Takaki
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
| | - Kosaku Nishigawa
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
| | - Takashi Yoshinaga
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
| | - Toshihiro Fukui
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
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Yoshinaga T, Okamoto K, Takaki J, Nishigawa K, Horibe T, Hidaka H, Fukui T. Free Jejunal Graft Interposition with Vascular Reconstruction in Patients Undergoing Pharyngo Laryngo Esophagectomy. Ann Vasc Surg 2023; 91:155-160. [PMID: 36521762 DOI: 10.1016/j.avsg.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/28/2022] [Accepted: 11/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pharyngo-esophageal reconstruction using free jejunal grafts has been widely used for the treatment of locally advanced carcinomas of the hypopharynx and cervical esophagus. However, the procedure is technically demanding and requires complex recontractions. The aim of this study was to evaluate our institutional outcomes of reconstruction using a free jejunal graft with vascular reconstruction in patients undergoing pharyngo laryngo esophagectomy with a multidisciplinary surgical team. METHODS There were 90 consecutive patients between October 2006 and February 2021. The mean age was 64.6 ± 10.3 years, and there were 76 male patients. Of 90 patients, 49 underwent preoperative chemotherapy and/or radiotherapy. Jejunal vessels were commonly anastomosed to the common carotid artery and the internal jugular vein (77.8% and 92.2%, respectively). Continuous intravenous infusion of heparin was used postoperatively. RESULTS Necrosis of the graft was observed in 5 patients. An isolated revision of vein was necessary in 1 patient. In all cases of graft failure, heparin was not used postoperatively. On the other hand, among the patients without graft failure, heparin was used for about two-thirds of the patients and was significantly different (0% vs. 66%, P = 0.01). CONCLUSIONS Free jejunal graft with vessel reconstruction is a safe and effective method for patients undergoing pharyngo laryngo esophagectomy. The position for the prevention of kinking as well anastomosis maneuver of vein is especially important. Moreover, early postoperative anticoagulation is essential.
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Affiliation(s)
- Takashi Yoshinaga
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Ken Okamoto
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan.
| | - Jun Takaki
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Kosaku Nishigawa
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Tatsuya Horibe
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Hideaki Hidaka
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
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Nakata K, Takaki J, Nishigawa K, Yoshinaga T, Okamoto K, Fukui T. [Coronary Artery Bypass Grafting via Partial Sternotomy Late after Partial Chest Wall Resection:Report of a Case]. Kyobu Geka 2022; 75:643-647. [PMID: 35892306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A 74-year-old man was referred to our department to receive coronary artery bypass grafting (CABG) because of severe triple vessel disease. He had undergone a chest wall resection including the right clavicle and the first and second ribs for the fibrosarcoma 40 years ago. The right internal thoracic artery was resected at the operation. Twenty-nine years after the operation, the plate used for the reconstruction of the chest wall was removed because of its infection. Off-pump CABG using left internal thoracic artery and vein grafts with lower partial sternotomy was successfully performed for the complete revascularization. This patient had a high possibility of sternum dehiscence and postoperative mediastinitis due to poor blood flow in the right upper sternum.
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Affiliation(s)
- Kosuke Nakata
- Department of Cardiovascular Surgery, Kumamoto University, Kumamoto, Japan
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Takaki J, Nakata K, Nishigawa K, Yoshinaga T, Okamoto K, Fukui T. [Concurrent Surgical Venous Repair during Laser-assisted Pacemaker Lead Extraction]. Kyobu Geka 2022; 75:163-168. [PMID: 35249946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Pacemakers are widely used to treat arrhythmia, however, one of problems after implantation of pacemaker is device infection. Total removal of leads and generator is recommended for radical cure. Recently, transvenous laser-assisted extraction of pacemaker leads has been developed and has achieved good results. However, catastrophic complications during pacemaker and implantable cardioverter-defibrillator leads extraction have been reported, and cases requiring surgical reconstruction have been also reported. Most of the repair technique include a direct suturing or a partial repair with patch. We herein report two cases of superior vena cava and innominate vein reconstruction with bovine pericardium during transvenous laser-assisted extraction. A hybrid approach using transvenous laser-assisted extraction and surgical repair through median sternotomy should be considered to perform complete lead extraction in complex cases with pacemaker lead infection.
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Affiliation(s)
- Jun Takaki
- Department of Cardiovascular Surgery, Kumamoto University, Kumamoto, Japan
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Shimbori R, Takaki J, Hosoda Y, Okamoto K, Fukae K, Fukui T. Incidentally detected atrioventricular septal defect in an adult. Clin Case Rep 2021; 9:e05110. [PMID: 34987807 PMCID: PMC8693825 DOI: 10.1002/ccr3.5110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/17/2021] [Accepted: 10/26/2021] [Indexed: 11/06/2022] Open
Abstract
A 34-year-old woman, a liver transplantation donor for her son, was referred to our hospital for preoperative evaluation. She was diagnosed with an incomplete atrioventricular septal defect (AVSD). She underwent double valve repair and patch closure of the defect. Incidental discovery of an asymptomatic AVSD in an adult is rare.
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Affiliation(s)
- Risa Shimbori
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
| | - Jun Takaki
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
| | - Yasuhito Hosoda
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
| | - Ken Okamoto
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
| | - Koji Fukae
- Department of Pediatric Cardiac SurgeryKumamoto City HospitalKumamotoJapan
| | - Toshihiro Fukui
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
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Nishigawa K, Fukui T, Takaki J, Takanashi S. Coronary endarterectomy for diffusely diseased coronary artery: An ace in the hole in coronary artery surgery. JTCVS Tech 2021; 10:133-137. [PMID: 34977715 PMCID: PMC8689673 DOI: 10.1016/j.xjtc.2021.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 11/05/2022] Open
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Takaki J, Yoshinaga T, Nishigawa K, Okamoto K, Fukui T. Left atrial intramural hematoma after percutaneous coronary intervention. Clin Case Rep 2021; 9:e04654. [PMID: 34430017 PMCID: PMC8364996 DOI: 10.1002/ccr3.4654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/06/2021] [Indexed: 11/10/2022] Open
Abstract
Left atrial intramural hematoma is a rare complication of percutaneous coronary intervention. The combination treatment with surgery and interventional therapy is one of therapeutic options.
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Affiliation(s)
- Jun Takaki
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
| | - Takashi Yoshinaga
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
| | - Kosaku Nishigawa
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
| | - Ken Okamoto
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
| | - Toshihiro Fukui
- Department of Cardiovascular SurgeryKumamoto University HospitalKumamotoJapan
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Abstract
A 68-year-old man who had undergone descending thoracic aortic replacement was referred to our hospital with a thoracoabdominal aortic aneurysm. During the original surgery, the Adamkiewicz artery was directly reconstructed. However, multidetector row computed tomography showed occlusion of the reconstructed artery at its orifice, with supply by a collateral vessel from the left lateral thoracic artery. With careful incision to avoid damage to the collateral vessel, no postoperative neurological deficit was observed.
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Affiliation(s)
- Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Jun Takaki
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Ken Okamoto
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
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Takaki J, Hosoda Y, Okamoto K, Fukui T. Radiotherapy-related skin ulcer communicating with a left ventricular aneurysm. Interact Cardiovasc Thorac Surg 2020; 30:783-784. [PMID: 32048710 DOI: 10.1093/icvts/ivaa014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/15/2019] [Accepted: 01/06/2020] [Indexed: 11/13/2022] Open
Abstract
Although radiation therapy is widely used to treat breast cancer, high doses of radiation may cause various complications. We report a case of a left ventricular aneurysm complicated with an intractable skin ulcer caused by radiation therapy for breast cancer. The communication between the aneurysm and skin ulcer caused severe bleeding. An urgent left ventricular repair and chest wall reconstruction with a rectus abdominis flap were performed successfully.
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Affiliation(s)
- Jun Takaki
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Yasuhito Hosoda
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Ken Okamoto
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
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Abstract
A 58-year-old woman was referred to our hospital with progressively increasing breathlessness. She reported a history of bioprosthetic valve implantation for tricuspid valve replacement and direct closure of an atrial septal defect for Ebstein's anomaly, 31 years before presentation. Transthoracic echocardiography revealed prosthetic valve failure, an enlarged coronary sinus, and severe mitral regurgitation. Computed tomography revealed a giant coronary sinus with thrombosis and persistent left superior vena cava. She underwent successful mitral and tricuspid valve replacement; however, severe hemodynamic deterioration necessitated mechanical ventilatory support with extracorporeal membrane oxygenation.
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Affiliation(s)
- Risa Shimbori
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Jun Takaki
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Yasuhito Hosoda
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Hideaki Hidaka
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Ken Okamoto
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
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Kamohara K, Koga S, Takaki J, Yoshida N, Furukawa K, Morita S. Long-term durability of preserved aortic root after repair of acute type A aortic dissection. Gen Thorac Cardiovasc Surg 2017; 65:441-448. [DOI: 10.1007/s11748-017-0783-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/11/2017] [Indexed: 12/01/2022]
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