1
|
Morishita A, Tomioka H, Katahira S, Hoshino T, Hanzawa K. Mitral valve replacement using a collar-reinforced mitral prosthesis for severe mitral annular calcification, which secures implantation in both the supra-annular and intra-atrial positions: a case report. J Cardiothorac Surg 2023; 18:319. [PMID: 37951918 PMCID: PMC10638697 DOI: 10.1186/s13019-023-02429-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 11/03/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Appropriate management of mitral annular calcification associated with mitral valve surgery must be determined on a case-by-case basis. However, an established procedure remains uncertain. CASE PRESENTATION This report describes a surgical case of severe mitral and aortic valve stenosis associated with severe mitral annular calcification in a 71-year-old woman who underwent mitral valve replacement with a collar-reinforced mitral prosthesis. The patient underwent surgical repair after the treatment for heart failure. As the present patient was deemed to be at high risk for conventional mitral valve replacement, we applied a composite prosthetic valve that was enlarged circumferentially on the ventricular side of the prosthesis with a bovine pericardial patch. First, the solid calcium bar was left untouched and only the friable calcified mass that was easily scattered was removed. Subsequently, the prosthesis was secured by two mattress sutures placed in the intra-atrial position at the region of the extended calcified myocardium. Additionally, ten mattress sutures were placed in the supra-annular position at the other regions capable of passing stitches from the ventricular side to the atrial side. Finally, a 1.5 cm wide trimmed bovine pericardial collar was sutured circumferentially from the annulus to the atrial wall using running 4-0 polypropylene for reinforcement. Although temporary hemodialysis was performed for acute renal failure, the patient remained asymptomatic. CONCLUSIONS The present case suggests that mitral valve replacement using a collar-reinforced mitral prosthesis may be an effective technique for severe mitral annular calcification. To avoid catastrophic complications associated with treatment for severely calcified annulus, it is crucial to make a prudent preoperative decision regarding the surgical strategy under circumstances where conventional mitral valve replacement is impossible.
Collapse
|
2
|
Kamada K, Uchida D, Okuda H, Koya A, Ohira S, Ikura M, Kikuchi S, Hanzawa K, Azuma N. Venous Screening Activities at the Site of Hokkaido East Iburi Earthquake: Report from the Result of Venous Screening in Preventive Awareness Activities. Ann Vasc Dis 2023; 16:163-168. [PMID: 37779645 PMCID: PMC10539123 DOI: 10.3400/avd.oa.23-00046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/24/2023] [Indexed: 10/03/2023] Open
Abstract
After previous earthquakes, high prevalence of cardiovascular diseases including venous thromboembolism (VTE) has been reported. We performed venous screening at the site of Hokkaido East Iburi Earthquake which happened at 6th September 2018. VTE screening using ultrasound sonography was performed for total 7 days at Atsuma town, Mukawa town and Abira town (total 9 shelters). Deep vein thrombosis (DVT) was found in 19 of 195 evacuees (9.7%), including 8 fresh thrombus cases (4.1%). On multivariable analysis of evacuees and shelter environment factors, systolic blood pressure, use of cardboard bed and toilet environment were significant predictor of DVT. Introduction and setting-up of cardboard beds were found as an important shelter environment factor. (This is secondary publication from Jpn J Phlebol 2021; 32(1): 5-10.).
Collapse
|
3
|
Sakai R, Fujiki S, Kashimura T, Tsuchiya H, Takahashi K, Ozaki K, Okura Y, Hanzawa K, Inomata T. Long-Term Outcomes in Patients with Not-Retrieval Inferior Vena Cava Filter Under Anticoagulation. Int Heart J 2022; 63:306-311. [PMID: 35354751 DOI: 10.1536/ihj.21-814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Since permanent inferior vena cava (IVC) filters increase deep vein thrombosis (DVT), filter retrieval should be performed as possible. Despite the guideline recommendation, IVC filters are not always retrieved in clinical practice. To date, many patients with not-retrieval IVC filters have been prescribed anticoagulant therapy, but the long-term prognosis, including venous thromboembolism (VTE) and bleeding events, remains unknown. In this study, 195 patients who underwent IVC filter implantation between 2006 and 2017 at 3 institutions in Niigata City have been investigated about their deaths, VTE recurrence, and bleeding events. After peaking 2009, the number of IVC filter implantation gradually decreased. During observational period, there were 158 patients with not-retrieval IVC filters (the overall retrieval rate of 19.0%). The not-retrieval group included significantly older and more patients with cancer compared to the retrieval group. Anticoagulation therapy was continued in 88% of the not-retrieval group. During a mean follow-up of 5.0 years, 6 symptomatic DVT events associated with inadequate control of anticoagulation and 13 bleeding events were observed. A total of 52 patients died and only the presence of cancer was prognostic risk factor. Although long-term anticoagulation therapy may be associated with bleeding events, there were few recurrent VTE under optimal anticoagulation. It is anticipated that even if the IVC filter cannot be retrieved, appropriate anticoagulation is useful for prevention of DVT recurrence despite the risk of bleeding.
Collapse
|
4
|
Onishi H, Yamamura O, Ueda S, Shibata M, Enomoto S, Maeda F, Tsubouchi H, Hirobe T, Shimizu S, Kishimoto T, Chiba H, Sasaki K, Hanzawa K, Hamano T, Nakamoto Y, Kaku B, Terasawa H. Deep-vein thrombosis detection rates and consideration of the living environment in a tsunami disaster area during the disaster reconstruction phase: A cross-sectional study. ACTA ANGIOLOGICA 2021. [DOI: 10.5603/aa.2020.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
5
|
Soga K, Shimizu T, Hagiwara Y, Ogura H, Akiyama H, Yamauchi J, Sato T, Hanzawa K, Hasegawa Y, Yamano Y. Soleal vein dilatation in the early phase of hospitalization is associated with subsequent development of deep vein thrombosis in patients with acute stroke. J Med Ultrason (2001) 2021; 48:97-104. [PMID: 33512678 DOI: 10.1007/s10396-020-01075-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/14/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the usefulness of soleal vein (SOV) diameter as a predictor of new onset of deep vein thrombosis (DVT) in acute stroke patients. METHODS A total of 121 acute stroke patients who were admitted within 48 h of onset underwent a calf vein ultrasonography (CVUS) examination within 7 days after hospitalization. They were evaluated for the presence of DVT and risk factors including maximum SOV diameter. Next, the patients in whom DVT was not detected at the first CVUS examination underwent a second CVUS examination on the 21st hospital day, and were evaluated for the presence of new DVT. RESULTS DVT was detected in 27 of 121 patients at the first CVUS examination. A significant association was noted between the presence of DVT and higher levels of soluble fibrin monomer, D-dimer, and C-reactive protein, and a higher rate of having cancer concomitantly. Furthermore, 50 of 94 patients without DVT at the first CVUS examination underwent a second CVUS examination. Of the 94 patients, 44 were excluded, because they were discharged by the 21st day. Note that DVT was newly developed in 12 of the 50 patients who underwent the second CVUS. A significant association was found between the presence of new DVT and the rate of history of stroke, hematocrit level, and maximum SOV diameter at the first examination. CONCLUSION In our acute stroke patients, SOV dilation, history of stroke, and elevated hematocrit level were found to be associated with risk of developing a new DVT.
Collapse
|
6
|
Morishita A, Hagino I, Tomioka H, Katahira S, Hoshino T, Hanzawa K. Novel technique of repairing right partial anomalous pulmonary venous connection with intact atrial septum using in situ interatrial septum as a flap in a 68-year-old-woman: a case report. J Cardiothorac Surg 2020; 15:269. [PMID: 32977845 PMCID: PMC7519534 DOI: 10.1186/s13019-020-01313-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partial anomalous pulmonary venous connection draining into the right atrium with an intact atrial septum is a very rare clinical entity in the adult population. Partial anomalous pulmonary venous connection must be suspected as a differential diagnosis when the cause of right heart enlargement and pulmonary artery hypertension is unknown. CASE PRESENTATION This study describes the surgical case of an isolated right partial anomalous pulmonary venous connection to the right atrium in a 68-year-old woman, who underwent tricuspid ring annuloplasty and right-sided maze procedure simultaneously. She had complaints of gradually progressing dyspnea on exertion. However, a diagnosis could not be established despite consultations at multiple hospitals for over a year. Right heart catheterization revealed severe pulmonary artery hypertension with a mean pulmonary artery pressure of 46 mmHg, step-up phenomenon of oxygen saturation at the mid-level of the right atrium with a pulmonary-to-systemic blood flow ratio of 2.4, and a pulmonary vascular resistance of 3.1 Wood Units. As medical treatment with pulmonary artery vasodilator therapy did not improve her symptoms, she underwent surgical repair. An atrial septal defect was created surgically with a curvilinear tongue-shaped cut. The right anomalous pulmonary veins were rerouted through the surgically created atrial septal defect into the left atrium with a baffle comprised of the interatrial septum flap, kept in continuity with the anterior margin and sutured while mobilizing the enlarged right atrium. The patient had an uneventful postoperative course and remains asymptomatic. CONCLUSIONS The described surgical technique could be considered an effective alternative for patients undergoing surgical repair for a partial anomalous pulmonary venous connection isolated to the right atrium. The indication for surgery must be judged on a case-by-case basis in these patients with prevalent systemic-to-pulmonary shunting.
Collapse
|
7
|
Shiraishi Y, Yambe T, Narracott AJ, Yamada A, Morita R, Qian Y, Hanzawa K. Modeling Approach for An Aortic Dissection with Endovascular Stenting. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:5008-5011. [PMID: 33019111 DOI: 10.1109/embc44109.2020.9176423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Repair of dissected aorta requires remodeling the structure of the media. Modeling approaches specific to endovascular stenting for aortic dissection have been reported. We created a goat model of descending thoracic aortic dissection and reproduced its morphological characteristics in a mock circulatory system. The purpose of this study was to examine a newly developed aortic stent which was capable of installing to the aortic dissected lesion for biomedical hemodynamics point of view. In this study, we examined the changes in hemodynamics of dissected lesions and the amelioration by endovascular stent intervention. Firstly, we performed animal experiments with the dissected aorta and examined the effects of stenting on volumetric changes in the false lumen. Secondly, we made several types of 3-D stereolithographic dissected aortic models with silicone rubber membrane between the false and the true lumens. Then, the hemodynamic characteristics in each model were evaluated in the pulsatile flow conditions in a mock circulatory system. These modelling approaches enabled the quantitative examination of post-therapeutic effects of stenting followed by elucidating of hemodynamic changes in the vicinity of stents, which may follow the management of clinical amelioration of interventional treatment with aortic stenting.Clinical Relevance- This study represents a modelling approach of the dissected aorta for endovascular intervention using stenting followed by the examination of false lumen volumetric changes resulting in the deterioration of pressure increase in diseased lesions.
Collapse
|
8
|
Morishita A, Katahira S, Hoshino T, Hanzawa K, Tomioka H. Rapidly vanishing left atrial dissection following mitral valve replacement: a case report. J Cardiothorac Surg 2020; 15:73. [PMID: 32375864 PMCID: PMC7203858 DOI: 10.1186/s13019-020-01112-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 04/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Left atrial dissection is an extremely rare complication of mitral valve replacement. Because of its severity, its prompt diagnosis and treatment is mandatory. The most effective treatment (i.e. surgical vs. non-surgical) for left atrial dissection has not been fully established yet. CASE PRESENTATION Herein, we have reported left atrial dissection after mitral valve replacement in a 68-year-old obese woman. After closing the thorax, transesophageal echocardiography (TEE) revealed an atrial mass of 3 cm × 2 cm, visualized as an oval hypoechoic appearance extending from the posterior annulus of the mitral valve to the posterior wall of the left atrium. Because hemodynamic conditions were stable, surgery was ruled out and conservative treatment with close observation was selected. On postoperative day 2, TEE revealed that the atrial mass had vanished and the broken piece of the endocardium merely remained fluttering in the atrium. On postoperative day 6, the appearance of the left atrium was normalized completely, leaving no traces of left atrial dissection. The patient recovered uneventfully. Serial TEE was a very effective imaging modality during the non-surgical treatment of left atrial dissection. CONCLUSIONS It is crucial to accurately define diagnosis and optimally consider therapeutic strategies for left atrial dissection based on the hemodynamic conditions of the patient and serial TEE follow-up examinations. In our case study, left atrial dissection was successfully treated with conservative treatment; therefore, we believe that TEE could be a feasible modality for the early diagnosis of this condition.
Collapse
|
9
|
Komorita T, Fujisue K, Sueta D, Sakamoto K, Yamamoto E, Hashimoto Y, Sakamoto T, Tsunoda R, Uesugi H, Suzuki R, Naito H, Hanzawa K, Araki E, Nakayama H, Kasaoka S, Hokimoto S, Fukui T, Tsujita K. Clinical Features of Patients With Acute Aortic Dissection After an Earthquake: Experience from the Kumamoto Earthquake 2016. Am J Hypertens 2020; 33:261-268. [PMID: 31738384 DOI: 10.1093/ajh/hpz183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/15/2019] [Accepted: 11/15/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND While there is a concern about the increase in the occurrence of acute aortic dissection (AAD) caused by the worsening of hypertension, mental stress, etc., there is a lack of data regarding the influence of disasters on this event. The aim of this study was to address this issue in the acute-subacute phase after the Kumamoto Earthquake occurred on 14 April 2016. METHODS We retrospectively investigated the impacts of the Kumamoto Earthquake on various cardiovascular diseases, including AAD, utilizing the medical records of patients in 16 hospitals in Kumamoto Prefecture during the period from 14 April to 30 June (78 days) in 2014, 2015, 2016, and 2017. RESULTS The occurrence of heart failure and venous thromboembolism increased significantly in the acute-subacute phase after the earthquake. When comparing the earthquake year (2016) to the non-earthquake years (2014, 2015, and 2017), the difference in the occurrences and mortalities of AADs were not significant. When other characteristics of the patients were compared between the earthquake year and the non-earthquake years, there were no differences. CONCLUSIONS It might be possible that the Kumamoto Earthquake did not affect the incidence of AAD or deaths from AAD, possibly because the climate was mild and the preventive efforts based on previous experience were successful. REGISTRATION University Hospital Medical Information Network (UMIN)-CTR (http://www.umin.ac.jp/ctr/). IDENTIFIER UMIN000023864. PUBLIC ACCESS INFORMATION Opt-out materials were available at the following website: http://www.kumadai-junnai.com/home/wp-content/uploads/shinsai.pdf.
Collapse
|
10
|
Satoh J, Yokono K, Ando R, Asakura T, Hanzawa K, Ishigaki Y, Kadowaki T, Kasuga M, Katagiri H, Kato Y, Kurosawa K, Miura M, Nakamura J, Nishitsuka K, Ogawa S, Okamoto T, Sakuma S, Sakurai S, Satoh H, Shimauchi H, Shimokawa H, Shoji W, Sugiyama T, Suwabe A, Tachi M, Takahashi K, Takahashi S, Terayama Y, Tomita H, Tsuchiya Y, Waki H, Watanabe T, Yahata K, Yamashita H. Diabetes Care Providers' Manual for Disaster Diabetes Care. J Diabetes Investig 2019; 10:1118-1142. [PMID: 31197978 PMCID: PMC6626940 DOI: 10.1111/jdi.13053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 04/01/2019] [Indexed: 11/26/2022] Open
Abstract
To ensure that experiences and lessons learned from the unprecedented 2011 Great East Japan Earthquake are used to improve future disaster planning, the Japan Diabetes Society (JDS) launched the "Research and Survey Committee for Establishing Disaster Diabetes Care Systems Based on Relevant Findings from the Great East Japan Earthquake" under the supervision of the Chairman of the JDS. The Committee conducted a questionnaire survey among patients with diabetes, physicians, disaster medical assistance teams (DMATs), nurses, pharmacists, and nutritionists in disaster areas about the events they saw happening, the situations they found difficult to handle, and the needs that they felt required to be met during the 2011 Great East Japan Earthquake. A total of 3,481 completed questionnaires were received. Based on these and other experiences and lessons reported following the 2011 Great East Japan Earthquake and the 2004 Niigata-Chuetsu Earthquakes, the current "Manual for Disaster Diabetes Care" has been developed by the members of the Committee and other invited authors from relevant specialties. To our knowledge, the current Manual is the world's first to focus on emergency diabetes care, with this digest English version translated from the Japanese original. It is sincerely hoped that patients with diabetes and healthcare providers around the world will find this manual helpful in promoting disaster preparedness and implementing disaster relief.
Collapse
|
11
|
Morishita A, Tomioka H, Katahira S, Hoshino T, Hanzawa K. Surgical Treatment for Kommerell's Diverticulum Associated with a Right-Sided Aortic Arch and an Aberrant Left Subclavian Artery: Endovascular or Hybrid. Ann Vasc Dis 2019; 12:228-232. [PMID: 31275480 PMCID: PMC6600113 DOI: 10.3400/avd.cr.18-00170] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A right-sided aortic arch, associated with an aberrant left subclavian artery and a Kommerell's diverticulum, is a rare congenital anomaly. Case 1: A 53-year-old man, complaining of dysphasia, underwent a two-stage hybrid operation. Total arch replacement with the reconstruction of supra-aortic vessels was performed via a median sternotomy. Thoracic endovascular aortic repair was subsequently completed with the femoral approach. Case 2: A 81-year-old man, complaining of syncope and dizziness, underwent thoracic endovascular aortic repair after endovascular aneurysm repair for a common iliac artery aneurysm. Treatment strategies for Kommerell's diverticulum should be individually determined depending on the clinical situation and anatomical features.
Collapse
|
12
|
Sato K, Sakamoto K, Hashimoto Y, Hanzawa K, Sueta D, Kojima S, Fukuda M, Usuku H, Kihara F, Hosokawa H, Nagai Y, Nakajima M, Saito Y, Sakai K, Masunaga S, Tanaka S, Fujimoto K, Morihisa K, Noda K, Nishigami K, Nagata K, Fujisue K, Tabata N, Ando Y, Tsujita K, Ogawa H, Hokimoto S. Risk Factors and Prevalence of Deep Vein Thrombosis After the 2016 Kumamoto Earthquakes. Circ J 2019; 83:1342-1348. [DOI: 10.1253/circj.cj-18-1369] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
13
|
Onishi H, Yamamura O, Ueda S, Shibata M, Enomoto S, Maeda F, Tsubouchi H, Hirobe T, Shimizu S, Hanzawa K, Hamano T, Nakamoto Y, Hayashi H, Terasawa H. Ultrasound cardiography examinations detect victims' long-term realized and potential consequences after major disasters: a case-control study. Environ Health Prev Med 2018; 23:37. [PMID: 30103685 PMCID: PMC6090717 DOI: 10.1186/s12199-018-0721-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 06/15/2018] [Indexed: 12/05/2022] Open
Abstract
Background An increase in cardiovascular diseases has been reported following major disasters. Previous work has shown that ultrasonographic findings from ultrasound cardiography examination (UCG) increased until the 44th month after the tsunami caused by the Great East Japan Earthquake. The present study conducted UCG among victims in the tsunami disaster area and investigated the frequency of disaster-related cardiovascular diseases and changes over time until the 55th month after the disaster. Methods The subjects were residents of temporary housing complexes and neighboring housing in Watari-gun, Miyagi Prefecture, Japan. There were 207 subjects in the 18th month, 125 in the 30th month, 121 in the 44th month, and 106 in the 55th month after the disaster. Data were collected through UCG and self-report questionnaire. Results Significant changes were observed among subjects with clinical findings from the UCG, which increased over the study period—from 42.0 to 60.8, 72.7, and 73.6% beginning in the 18th month after the disaster (p < 0.0001). Conclusions It is possible that the UCG can become a useful examination to visualize the potential impact of a major disaster on the cardiac function of victims. Victims with clinical findings continued increasing not only during the acute phase after a disaster but also in the long term. We therefore need to keep this in mind, and note that it is important to establish a support system to control cardiovascular diseases from the early stage of disaster. Trial registration UMIN; ID000029802. R000034050. 2 November 2017.
Collapse
|
14
|
Sueta D, Hokimoto S, Hashimoto Y, Sakamoto K, Hosokawa H, Nishigami K, Sato K, Fujisue K, Kojima S, Takahashi T, Hanzawa K, Ogawa H, Tsujita K. Venous Thromboembolism Caused by Spending a Night in a Vehicle After an Earthquake (Night in a Vehicle After the 2016 Kumamoto Earthquake). Can J Cardiol 2018; 34:813.e9-813.e10. [PMID: 29729882 DOI: 10.1016/j.cjca.2018.01.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 01/14/2018] [Indexed: 11/28/2022] Open
|
15
|
Sato K, Namura O, Hanzawa K, Kikuchi C, Takekubo M, Asami F, Wakabayashi T, Saito T, Homma T, Baba H, Hayashi JI. Major Factors of Homologous Blood Transfusion in Valvular Heart Operation with Intraoperative Autologous Blood Predonation in Cases with Difficulty in Preoperative Predonation. Int J Artif Organs 2018. [DOI: 10.1177/039139881003300202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Intraoperative autologous blood predonation is reported to be useful for the prevention of homologous blood transfusion in cardiac operations, especially in on-pump coronary artery bypass grafting (CABG). However, CABG is now performed more often off-pump than on-pump. We analyzed the major factors of homologous blood transfusion in 25 consecutive cases of valvular heart operation with intraoperative autologous blood predonation except those with preoperative autologous blood donation. Homologous blood was not transfused in 18 cases, but was in 7 cases only after cardiopulmonary bypass (CPB). The homologous transfusion was not correlated with body weight, CPB dilution or duration, or preoperative hematocrit level, but was found to correlate with age (R2=0.289, p=0.0413), bleeding output (R2=0.197, p=0.0485), and predonation blood volume (R2=0.436, p=0.0152). In conclusion, suitable intraoperative predonation may reduce the necessity for homologous blood transfusion in valvular heart operations.
Collapse
|
16
|
Natsumeda M, Uzuka T, Watanabe J, Fukuda M, Akaiwa Y, Hanzawa K, Okada M, Oishi M, Fujii Y. High Incidence of Deep Vein Thrombosis in the Perioperative Period of Neurosurgical Patients. World Neurosurg 2018; 112:e103-e112. [DOI: 10.1016/j.wneu.2017.12.139] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 10/18/2022]
|
17
|
Okamoto T, Yokoi Y, Aoki K, Namura O, Hanzawa K, Tsuchida M. A Case of Branched Thoracic Endovascular Aneurysm Repair for Distal Arch Aneurysm. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.04.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
18
|
Onishi R, Okamoto T, Nakamura N, Aoki K, Hanzawa K, Namura O, Tsuchida M. Endovascular Aortic Repair with Recanalisation of a Chronically Occluded Common Iliac Artery. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.04.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
19
|
Shibata M, Chiba H, Sasaki K, Ueda S, Yamamura O, Hanzawa K. The utility of on-site ultrasound screening in population at high risk for deep venous thrombosis in temporary housing after the great East Japan Earthquake. JOURNAL OF CLINICAL ULTRASOUND : JCU 2017; 45:566-574. [PMID: 28556184 DOI: 10.1002/jcu.22505] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 05/02/2017] [Accepted: 05/04/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND To evaluate the diagnostic performance of ultrasonography for screening of a population at risk for deep vein thrombosis (DVT) in a post-disaster setting. METHODS Ultrasonography was applied as a screening technique to the residents of a temporary housing facility who were displaced following the Great East Japan Earthquake. Thirty DVT screening sessions were held from April 2013 to June 2015. Individuals were invited to participate if they were identified as "high risk" for DVT, defined as those with low activity levels, a history of lower limb trauma, baseline lower limb pain or swelling, a cancer-bearing status, or a history of venous thromboembolic event. Ultrasonographic examinations were performed from the calf to the popliteal veins using portable devices. RESULTS Of the 3,316 subjects screened (682 men and 2,634 women) with a mean age of 71 ± 9.7 years, DVT was diagnosed in 382 (11.5%). DVT was more likely in older, symptomatic, or female patients with a history of venous thromboembolism and attempting to perform daily exercise. The rate of DVT diagnosis increased from 9.9% in 2013 to 13.5% in 2015. CONCLUSIONS Ultrasonography is efficient for screening at-risk populations in challenging settings. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:566-574, 2017.
Collapse
|
20
|
Sato K, Hanzawa K, Okamoto T, Nagasawa A, Aoki K, Namura O, Tsuchida M. Abstract 131: Could One Define "FARD Score (Female, Aging, Respiratory & D-Dimer)" in Regard to Deep Vein Thrombosis in Cases With Immobilization? Arterioscler Thromb Vasc Biol 2017. [DOI: 10.1161/atvb.37.suppl_1.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives:
With 17 sub-analyses, this prospective study aimed at evaluating the prevalence and indicators of deep vein thrombosis (DVT) associated with pulmonary embolism (PE) in patients immobilized on admission to internal medical wards.
Methods:
In sub-groups (with more than 20 cases) of the 189 consecutive patients immobilized for more than 48 hours after admission (screening), we studied the significance of the major clinical factors in relation to whether DVT was identified with ultrasonography. If D-dimer level was positive (≥ 1.0 μg/ ml) in each case, chest enhanced CT was performed.
Results:
With regard to 16 PE cases (8.5%) of the 189 cases, incidence of PE was higher in the groups of
elderly
patients (14%, 9 of 63 cases), of
women
(12%, 13 of 111 cases) and of patients with
respiratory
disease (9%, 3 of 33 cases) than in the other sub-groups. Among 77 DVT cases (40%) of the 189 cases, the groups of patients with
respiratory
disease (13 DVT cases), with gastro-intestinal disease (13 DVT cases) and with renal disease (13 DVT cases) included respectively more than those with the other diseases, in addition to the group of patients with malignant disease (15 DVT cases). In the groups of patients with abdominal disease (52%, 14 of 27 cases), central venous catheter (50%, 12 of 24 cases) and
advanced age
(49%, 31 of 63 cases), ratios of DVT cases were higher than in the other sub-groups. In patients with renal disease (P=0.01) and in
women
(P=0.02),
D-dimer
level was higher in DVT cases than in non-DVT cases whereas, in the groups with abdominal disease (P=0.72) and with respiratory disease (P=0.49),
D-dimer
level was essentially comparable between in DVT cases and in non-DVT cases. Only in the group of
elderly
patients, the prevalence of DVT was higher above-knee than below-knee. Multiple presence of DVT (20 of 77 DVT cases) was associated with presence of pulmonary embolism (P=0.09) in DVT cases.
Conclusions:
In DVT cases with immobilization, practical risk factors of pulmonary embolism could be Female, Aging (older than 70 years, classified possibly), Respiratory disease and, in women, high D-dimer level.
Collapse
|
21
|
Morishita A, Hanzawa K, Katahira S, Hoshino T, Tomioka H. Antegrade thoracic endovascular aortic repair using an ascending aortofemoral through-and-through wire technique for a severely tortuous aorta associated with rickets. Surg Case Rep 2017; 3:48. [PMID: 28341978 PMCID: PMC5366989 DOI: 10.1186/s40792-017-0324-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 03/21/2017] [Indexed: 11/10/2022] Open
Abstract
Background Severe aortic tortuosity of the access route often prevents successful complete exclusion of an aneurysm in thoracic endovascular aortic repair (TEVAR). Case presentation We performed antegrade TEVAR on a 79-year-old man with right hemiparesis. We deployed the stent graft from the ascending aorta with a tube graft conduit to treat a descending thoracic aortic aneurysm associated with rickets and multiple comorbidities. Although the application of a ministernotomy diminished the potential advantages of endovascular treatment in view of less invasive surgery, antegrade TEVAR using an ascending aortofemoral through-and-through wire technique was a good option in this patient because a conventional retrograde approach was not feasible due to his severely tortuous aorta. Conclusions To avoid device-related complications, it is crucial to make a prudent preoperative decision on a patient-by-patient basis, taking into account the appropriate access site, adjuvant guidewire technique, and adjunctive surgical interventions.
Collapse
|
22
|
Asaji S, Suzuki S, Ishige T, Hosomichi K, Shiina T, Hara H, Hirano T, Hanzawa K. P4020 Diversity analysis of transcribed MHC class IIβ loci in Japanese quail. J Anim Sci 2016. [DOI: 10.2527/jas2016.94supplement488b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
23
|
Hirano T, Okazaki A, Sasaki S, Suzuki Y, Hara H, Sugimoto Y, Hanzawa K. P6014 Mapping and exome sequencing of a weak calf syndrome with premature birth. J Anim Sci 2016. [DOI: 10.2527/jas2016.94supplement4155x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
24
|
Aoki K, Okamoto T, Sato H, Namura O, Onishi R, Hanzawa K, Tsuchida M. [Endovascular Repair for Acute Phase of Retrograde Type A Aortic Dissection with an Entry in the Descending Aorta]. KYOBU GEKA. THE JAPANESE JOURNAL OF THORACIC SURGERY 2016; 69:276-281. [PMID: 27210254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Endovascular repair for retrograde type A aortic dissection with an entry in the descending aorta (RAAD) is challenging. We present early and mid- term results of endovascular repair for acute phase of RAAD by using commercially-available device. METHODS From April 2012 to June 2014, 10 consecutive patients with acute phase of RAAD underwent endovascular repair in our hospital. Of them, 9 patients had emergency surgery within 24 hours after the onset. The other one patient had urgent surgery 3 days after the onset. In all patients, the entry tear was covered with TAG or conformable TAG. RESULTS Technical success was achieved in all patients. No in-hospital mortality was experienced. In all patients, follow-up computed tomography images showed significant remodeling in the ascending aorta 3 months after surgery. During a median follow-up period of 19.5 months, no patients died and no re-intervention occurred. CONCLUSIONS In patients with acute phase of RAAD, endovascular repair with commercially-available device can be safely performed and it provides sufficient remodeling in the ascending aorta early after surgery. This technique is an alternative to open repair in these patients.
Collapse
|
25
|
Morishita A, Tomioka H, Katahira S, Hoshino T, Hanzawa K. Open Surgery for Giant Bilateral Internal Iliac Artery Aneurysms with Compression of Neighboring Abdominal Structures: A Case Report. Ann Vasc Dis 2015; 8:265-7. [PMID: 26421081 DOI: 10.3400/avd.cr.15-00065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 07/16/2015] [Indexed: 11/13/2022] Open
Abstract
We describe a patient with successfully treated giant bilateral internal iliac artery aneurysms that were associated with acute renal failure secondary to bilateral hydronephrosis, lumbosacral plexopathy, and ileus. After hemodialysis for 1 month, the patient underwent graft replacement of the abdominal aorta and iliac arteries, including complete obliteration of the internal iliac artery branches, reconstruction of the inferior mesenteric artery, and ureterolysis. Weaning from hemodialysis was achieved and postoperative renal function improved. Although the patient had serious preoperative co-morbidities, emergency traditional open surgery should be the gold standard for securely releasing compression of the neighboring organs instead of endovascular treatment.
Collapse
|
26
|
Yamada N, Hanzawa K, Ota S, Nakamura M, Sato K, Ikura M, Suzuki T, Kaise T, Nakajima H, Ito M. Occurrence of Deep Vein Thrombosis among Hospitalized Non-Surgical Japanese Patients. Ann Vasc Dis 2015; 8:203-9. [PMID: 26421068 DOI: 10.3400/avd.oa.14-00132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 05/21/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To estimate the frequency of deep vein thrombosis (DVT) among non-surgical inpatients, and to evaluate the D-dimer assay as a screening tool for DVT. METHODS Subjects were non-surgical inpatients aged 20 years or older who had been bedridden for at least 24 hours and had moderate-to-high risk factors for DVT. We assessed the presence of DVT by venous ultrasonography. Patients who received a diagnosis of venous thromboembolism (VTE) before admission, who had symptoms or findings of VTE at admission, or who had surgery or trauma within the past 3 months before admission were excluded. RESULTS DVT was confirmed in 96 of 525 patients (18.3%). In a logistic regression analysis, longer duration of hospitalization, higher D-dimer value, and history of cancer surgery were significantly associated with the occurrence of DVT. The D-dimer assay showed high sensitivity (96.1%) and high negative predictive value (97.6%). CONCLUSION Non-surgical inpatients with a long-term hospitalization or history of cancer surgery have a risk for DVT, and need to be considered for added DVT preventive measures as recommended in the prevention guidelines. In addition, the D-dimer assay is beneficial for the screening of DVT in medical practice.
Collapse
|
27
|
Koike T, Sato H, Sato S, Okamoto T, Hashimoto T, Hanzawa K, Tsuchida M. [Simultaneous pulmonary resection and endovascular repair for patients with coexisting primary lung cancer and aneurysm]. KYOBU GEKA. THE JAPANESE JOURNAL OF THORACIC SURGERY 2015; 68:293-297. [PMID: 25837003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The surgical strategy for coexisting lung cancer and aneurysm is controversial owing to the risk of aneurysm rupture during the perioperative period of pulmonary resection. We performed simultaneous pulmonary resection and endovascular repair in 2 patients with coexisting lung cancer and aneurysm. Case 1:A 74-year-old man presented at our hospital with cT2aN0M0 lung cancer and a 5.0 cm abdominal aortic aneurysm. Because computed tomography indicated the possibility of advanced lung cancer, we decided to perform simultaneous surgery for lung cancer and the aneurysm. Under general anesthesia, endovascular aneurysm repair was performed before right lower lobectomy with lymphadenectomy. The postoperative course was uneventful, and the patient was discharged on postoperative day 12. Case 2:A 72-year-old man presented at our hospital with cT2aN1M0 lung cancer, a 5.0 cm left internal iliac artery aneurysm, and right renal cell carcinoma( RCC). Because the lung cancer was advanced and the patients needed following surgical treatment for RCC, we decided to perform simultaneous surgery for lung cancer and the aneurysm. Under general anesthesia, endovascular aneurysm repair was performed before right upper lobectomy with lymphadenectomy. The postoperative course was uneventful, and the patient was discharged on postoperative day 11.
Collapse
|
28
|
Ueda S, Hanzawa K, Shibata M. One-year overview of deep vein thrombosis prevalence in the ishinomaki area since the great East Japan earthquake. Ann Vasc Dis 2014; 7:365-8. [PMID: 25593620 DOI: 10.3400/avd.oa.14-00106] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 09/12/2014] [Indexed: 11/13/2022] Open
Abstract
After the Great East-Japan Earthquake, the prevalence of deep vein thrombosis (DVT) in disaster shelters in Ishinomaki (Pacific coast, Miyagi, Japan) was found much higher than that ever reported in Japan. In Ishinomaki, twelve patients were found to have pulmonary thromboembolism for one month since the earthquake and DVT was found in 10 of those patients. The calf DVT was examined using ultrasonography in the shelters (from March to July 2011) and in temporary emergency housings (from August to December 2011). Calf DVT was found in 190 of 701 evacuees. DVT prevalence was higher in the tsunami-flooded shelters (34.2%) than in that in the non-flooded shelters (19.1%). This indicated that deteriorated and crowded condition in the tsunami-flooded shelters might induce thrombogenesis in calf veins. Therefore, evacuees were recommended to leave tsunami-flooded areas. DVT prevalence in the shelters was gradually reduced, however, that was still higher in the temporary emergency housings (8.9%) than in the non-disaster area in Japan (2.2% in Yokohama city). The risk of calf DVT in the temporary emergency housings was increased because of reduced blood flow in the calf veins caused by immobility. The residents of the housings were required to be physically active to avoid calf DVT. (English translation of Jpn J Phlebol 2013; 24: 380-384).
Collapse
|
29
|
Morishita A, Tomioka H, Katahira S, Hoshino T, Hanzawa K. Delayed visceral and spinal cord malperfusion after axillo-bifemoral bypass for complicated acute type B aortic dissection. Ann Vasc Dis 2014; 7:331-4. [PMID: 25298840 DOI: 10.3400/avd.cr.14-00059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 06/11/2014] [Indexed: 11/13/2022] Open
Abstract
We describe a successfully treated case of acute type B aortic dissection complicated with lower extremity, visceral, and spinal cord malperfusion. To restore perfusion to both lower extremities, we performed an emergency right axillo-bifemoral bypass. Furthermore, we performed total arch replacement, including primary entry closure, because of delayed visceral organ ischemia. Unexpectedly, delayed paraplegia occurred after hospital discharge; however, the patient recovered without any neurologic sequelae after early introduction of hyperbaric oxygen therapy. Because another episode of organ malperfusion in the long term cannot be anticipated, and even though the previous organ malperfusion episode was treated successfully, close observation is mandatory for detecting clinical manifestations in combination with the availability of imaging modalities.
Collapse
|
30
|
Okubo Y, Aoki K, Namura O, Okamoto T, Hanzawa K, Moro H, Tsuchida M. [Adult endocardial blood cyst; report of a case]. KYOBU GEKA. THE JAPANESE JOURNAL OF THORACIC SURGERY 2014; 67:571-574. [PMID: 25137331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We report herein a rare case of endocardial blood cyst (EBC) in an adult patient. A 63-year-old asymptomatic woman underwent echocardiography, which incidentally detected a cardiac tumor in the right atrium. On echocardiography, the tumor was revealed to be a 30-mm round mass with thin, hyperechogenic walls and heterogeneously hypoechogenic contents. The lesion was attached to the septum. On computed tomography, the tumor appeared partly calcified and showed poor contrast-enhancement. On magnetic resonance imaging, the lesion appeared isointense or slightly hyperintense in T1 and T2-weighted sequences. Myxoma was strongly suspected based on these preoperative imaging findings. The tumor was successfully excised under cardiopulmonary bypass. Gross examination confirmed that the cyst was filled with blood. The cystic walls comprised thin-layered fibrous tissue lined with endocardial cells. No tumor cells were found. The diagnosis of EBC was confirmed based on histopathological examination, and the postoperative course was uneventful.
Collapse
|
31
|
Morishita A, Tomioka H, Katahira S, Hoshino T, Hanzawa K. Simultaneous surgery for patent ductus arteriosus associated with papillary fibroelastoma. Ann Thorac Cardiovasc Surg 2013; 20 Suppl:797-800. [PMID: 23801176 DOI: 10.5761/atcs.cr.12.02114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We describe a case of patent ductus arteriosus (PDA) in a 76-year-old woman with a history of stroke, atrial fibrillation, and chronic obstructive pulmonary disease. Cranial diffusion-weighted imaging (DWI) performed for preoperative assessment showed a hyperintense lesion in the left cerebellum. Preoperative transesophageal echocardiography (TEE) demonstrated two highly mobile masses approximately 5 mm in diameter adherent to the left and non-coronary cusps of the aortic valve. We performed transpulmonary patch closure of PDA under hypothermic circulatory arrest. Subsequently, two frond-like masses were completely shaved off the cusps, preserving the native aortic leaflets. Pathological examination confirmed the diagnosis of papillary fibroelastoma (PFE). To our knowledge, this is the first report of PDA associated with PFE. Perioperative use of TEE is an effective tool for management of cardiovascular patients with suspected cardiogenic embolism.
Collapse
|
32
|
Shibata M, Hanzawa K, Ueda S, Yambe T. Deep venous thrombosis among disaster shelter inhabitants following the March 2011 earthquake and tsunami in Japan: a descriptive study. Phlebology 2013; 29:257-66. [DOI: 10.1177/0268355512474252] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives A retrospective analysis of data collected during subject screening following Japan's March 2011 earthquake and tsunami was performed. We aimed to determine the incidence of deep venous thrombosis (DVT) among screened subjects and to identify risk factors associated with the development of DVT as independent variables. Methods Calf ultrasonography was undertaken in 269 subjects living in 21 shelters in Miyagi prefecture during the one-month period immediately following the March 2011 disaster. Information regarding the health and risk factors of subjects was collected by questionnaire and assessment of physical signs. Results Of the 269 evacuees screened, 65 (24%) met the criteria for calf DVT. We found lower limb trauma, reduced frequency of urination and sleeping in a vehicle to be independent positive predictors of DVT. Conclusions Evacuees had an increased risk of developing DVT, associated with tsunami-related lower limb injury, immobility and dehydration.
Collapse
|
33
|
Shimizu T, Takada T, Shimode A, Fujita Y, Usuki N, Kato B, Takaishi S, Hirayama T, Hanzawa K, Hasegawa Y. Association between paroxysmal atrial fibrillation and the left atrial appendage ejection fraction during sinus rhythm in the acute stage of stroke: a transesophageal echocardiographic study. J Stroke Cerebrovasc Dis 2013; 22:1370-6. [PMID: 23608370 DOI: 10.1016/j.jstrokecerebrovasdis.2013.03.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 03/14/2013] [Accepted: 03/19/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This study aimed to investigate whether left atrial appendage (LAA) dysfunction evaluated by transesophageal echocardiography (TEE) during sinus rhythm is predictable of paroxysmal atrial fibrillation (PAF) as an embolic source in the acute stage of stroke. METHODS AND RESULTS We measured and analyzed LAA flow velocity (LAA-FV) and LAA ejection fraction (LAA-EF) in 300 acute ischemic stroke patients by TEE. We divided the acute ischemic stroke patients into 3 groups. The atrial fibrillation (AF) group (n=58) comprised patients whose TEE was performed during AF rhythm. The PAF group (n=42) comprised patients with a history of AF but with normal sinus rhythm when TEE was performed. The normal sinus (sinus) group (n=200) did not have any history of AF. We found that mean LAA-FV and LAA-EF values in the PAF group were significantly lower than those in the sinus group (P<.001). The diagnostic accuracy of LAA-FV for the diagnosis of PAF calculated as the area under receiver operating characteristic curves was low (.582, 95% confidence interval [CI]=.498-.665) but that of LAA-EF was modest (.721, 95% CI=.653-.789), with an optimal cutoff point of 49.1%. CONCLUSIONS LAA dysfunction as determined by TEE (LAA-EF<49.1%) in the acute stage of stroke is predictive of PAF with moderate accuracy. Long-term electrocardiographic monitoring is recommended for cryptogenic stroke patients with LAA dysfunction.
Collapse
|
34
|
Kikuchi C, Asami F, Hanzawa K, Tsuchida M. Successful surgical removal of an intravenous leiomyoma extending to the right atrium 4 years after hysterectomy. Eur J Cardiothorac Surg 2013; 43:1262. [PMID: 23299239 DOI: 10.1093/ejcts/ezs610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
35
|
Ueda S, Hanzawa K, Shibata M. One-year Overview of Deep Vein Thrombosis Prevalence in the Ishinomaki Area Since the Great East Japan Earthquake. ACTA ACUST UNITED AC 2013. [DOI: 10.7134/phlebol.409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
36
|
Hanzawa K. [Environment of evacuation facility and deep vein thrombosis in the Great East Japan Earthquake]. [RINSHO KETSUEKI] THE JAPANESE JOURNAL OF CLINICAL HEMATOLOGY 2012; 53:1730-1736. [PMID: 23037745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
37
|
Hanzawa K, Okamoto T, Sato K, Hayashi JI, Ikura M, Nakajima T, Shinada K. DVT in Residents in Mid Niigata Prefecture Earthquake after 6 Years: Relationship between DVT and Hypertention. ACTA ACUST UNITED AC 2012. [DOI: 10.7134/phlebol.23.315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
38
|
Ueda S, Hanzawa K, Shibata M, Suzuki S. High Prevalence of Deep Vein Thrombosis in Tsunami-Flooded Shelters Established after the Great East-Japan Earthquake. TOHOKU J EXP MED 2012; 227:199-202. [DOI: 10.1620/tjem.227.199] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
39
|
Satoh H, Yamamoto K, Takahashi S, Wakabayashi T, Takizawa K, Sugimoto T, Yoshii S, Hanzawa K. [Single-stage procedure for multiple dissected aortic aneurysms with coagulopathy in an elderly patient]. KYOBU GEKA. THE JAPANESE JOURNAL OF THORACIC SURGERY 2012; 65:81-85. [PMID: 22314160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
An 86-year-old man was admitted for abdominal pain. Dissected descending thoracic aortic aneurysm and infrarenal abdominal aortic aneurysm were observed under computed tomographic (CT) scan. Hematologic studies revealed low platelet count and an increase in fibrin degradation products (FDP), and disseminated intravascular coagulation( DIC) associated with dissecting aortic aneurysm was highly suspected. Platelet transfusion was performed and gabexate mesilate was administered, however, no improvement of DIC could be obtained. An increase in aortic diameter was observed under CT scan and surgery was performed. The infrarenal aneurysm was replaced with a bifurcated prosthetic graft under open repair. Simultaneously, an endovascular stent-graft was delivered from the left limb of the abdominal graft and implanted into the descending thoracic aorta. The postoperative recovery was uneventful but platelet count did not improve in this case.
Collapse
|
40
|
Okamoto T, Hanzawa K, Namura O, Takekubo M, Hayashi JI. Silent Pulmonary Embolism After TEVAR. Chest 2011. [DOI: 10.1378/chest.1118493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
41
|
Namura O, Sogawa M, Asami F, Okamoto T, Hanzawa K, Hayashi JI. Floating thrombus originating from an almost normal thoracic aorta. Gen Thorac Cardiovasc Surg 2011; 59:612-5. [DOI: 10.1007/s11748-010-0752-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Accepted: 11/28/2010] [Indexed: 11/29/2022]
|
42
|
Nakamura M, Okano Y, Minamiguchi H, Munemasa M, Sonoda M, Yamada N, Hanzawa K, Aoyagi N, Tsujimoto H, Sarai N, Nakajima H, Kunieda T. Multidetector-Row Computed Tomography-Based Clinical Assessment of Fondaparinux for Treatment of Acute Pulmonary Embolism and Acute Deep Vein Thrombosis in Japanese Patients. Circ J 2011; 75:1424-32. [DOI: 10.1253/circj.cj-10-1036] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
43
|
Sato K, Namura O, Hanzawa K, Kikuchi C, Takekubo M, Asami F, Wakabayashi T, Saito T, Homma T, Baba H, Hayashi JI. Major factors of homologous blood transfusion in valvular heart operation with intraoperative autologous blood predonation in cases with difficulty in preoperative predonation. Int J Artif Organs 2010; 33:72-75. [PMID: 20306433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Intraoperative autologous blood predonation is reported to be useful for the prevention of homologous blood transfusion in cardiac operations, especially in on-pump coronary artery bypass grafting (CABG). However, CABG is now performed more often off-pump than on-pump. We analyzed the major factors of homologous blood transfusion in 25 consecutive cases of valvular heart operation with intraoperative autologous blood predonation except those with preoperative autologous blood donation. Homologous blood was not transfused in 18 cases, but was in 7 cases only after cardiopulmonary bypass (CPB). The homologous transfusion was not correlated with body weight, CPB dilution or duration, or preoperative hematocrit level, but was found to correlate with age (r2=0.289, p=0.0413), bleeding output (r2=0.197, p=0.0485), and predonation blood volume (r2=0.436, p=0.0152). In conclusion, suitable intraoperative predonation may reduce the necessity for homologous blood transfusion in valvular heart operations.
Collapse
|
44
|
Kumagai M, Osada S, Hanzawa K. Artifacts from dental implants in magnetic resonance imaging in the head and neck region. Int J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.ijom.2009.03.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
45
|
Sato K, Hanzawa K, Okamoto T, Kyo S, Hayashi JI. Frequency analysis of high-intensity transient signals of transcranial Doppler ultrasound in patients supported with a left ventricular assist device. J Artif Organs 2008; 11:201-3. [PMID: 19184284 DOI: 10.1007/s10047-008-0430-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2008] [Accepted: 08/13/2008] [Indexed: 10/21/2022]
Abstract
Left ventricular assist devices (LVADs) have become more important than ever for patients with terminal heart disease. The chronic shortage of donors for heart transplantation may enhance the importance of LVADs as destination therapy. To prevent cerebral complications, the evaluation of high-intensity transient signals (HITS) of transcranial Doppler (TCD) ultrasound is important. In the present study, HITS were measured on seven occasions in patients supported with LVADs. The high-frequency counts in HITS were greater than the low-frequency counts (47 +/- 42 vs. 9 +/- 9 in 3 min, P = 0.025), and declined further with oxygen delivery to the patient. The high frequency of signals may imply air microemboli, and the counts may increase with time.
Collapse
|
46
|
Hanzawa K, Okamoto T, Sato K, Hayashi J. PLASMA D-DIMER CORRELATES WITH AGE, CAROTID ARTERIAL OR THORACIC AORTIC ATHEROSCLEROSIS. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb00554.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
47
|
Suzuki K, Tanaka J, Ogaw Y, Kasai A, Ohno Y, Sakail K, Nakayama H, Tsukada H, Gejyo F, Hanzawa K, Suzuki E. [Pulmonary thromboembolism during the Niigata Chuetsu earthquake in 2004]. NIHON KOKYUKI GAKKAI ZASSHI = THE JOURNAL OF THE JAPANESE RESPIRATORY SOCIETY 2007; 45:324-8. [PMID: 17491310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
We encountered 2 cases of pulmonary thromboembolism developed during refuge for Niigata Chuetsu earthquake in 2004. Case 1 was a 76-year-old woman who moved to the back seat of a car for refuge since the earthquake struck on October 23rd, 2004. When she emerged from the car on the morning of October 25th, she felt sudden dyspnea and lost consciousness. On arrival at the hospital, she had low blood pressure and hypoxemia, hypocapnia, and metabolic acidosis. Based on her clinical history and her symptoms, pulmonary thromboembolism was suspected and heparinization was begun immediately. In our hospital, the chest CT angiography proved the diagnosis. She was transferred to a university hospital for further treatment. Case 2 was a 79-year-old woman. She spent only one night in a car. Fifteen days after the earthquake, chest tightness and dyspnea occurred. Although her symptoms were improved and disappeared, she came to our hospital. Chest CT images confirmed pulmonary thromboembolism, and treatment with heparin was begun. We think this pulmonary thromboembolism was related to the knee-bending position she had assumed in the car and decreased activity during refuge. This is a clinical condition which could happen during disasters in the future. We should recognize the likelihood of pulmonary thromboembolisms in the disasters in the future.
Collapse
|
48
|
Sakuma M, Nakamura M, Hanzawa K, Kobayashi T, Kuroiwa M, Nakanishi N, Miyahara Y, Tanabe N, Yamada N, Kuriyama T, Kunieda T, Sugimoto T, Nakano T, Shirato K. Acute Pulmonary Embolism after an Earthquake in Japan. Semin Thromb Hemost 2006; 32:856-60. [PMID: 17171600 DOI: 10.1055/s-2006-955468] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
There have been no reports on acute pulmonary embolism (APE) after earthquakes. Our aim was to clarify the actual the occurrence of APE following the 2004 Mid Niigata Prefecture earthquake in Japan, and to assess the risk factors for APE after the event. We sent questionnaires to 122 hospitals in the Niigata Prefecture after the earthquake. Cities, towns, and villages in the prefecture were classified into two areas (high evacuee rate area, and low evacuee rate area) due to the mean ratio of evacuees to the overall population during 1 week immediately after the earthquake. A rate of 5% and higher was encountered for the high evacuee rate area and a rate of < 5% was encountered for the low evacuee rate area. Ten out-of-hospital cases of APE (seven in the high evacuee rate area and three in the low evacuee rate area) were diagnosed within the first month after the earthquake. The relative risk of APE was high in the high evacuee rate area (13.09; P = 0.0002) and also higher in women (8.55; P = 0.04). All patients in the high evacuee rate area had stayed in their automobiles for long periods of time, but none had done so in the low evacuee rate area ( P = 0.008).
Collapse
|
49
|
Kitamura M, Hanzawa K, Takekubo M, Aoki K, Hayashi JI. Preclinical Assessment of a Transaortic Venting Catheter for Percutaneous Cardiopulmonary Support. Artif Organs 2004; 28:298-302. [PMID: 15046629 DOI: 10.1111/j.1525-1594.2004.47036.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Left ventricular unloading and energy charge as effects of transaortic catheter venting (TACV) during venoarterial bypass (VAB) in normal and failing hearts has been reported previously. The aim of this study was to assess the effectiveness and safety of a special multipurpose catheter for TACV during percutaneous cardiopulmonary support (PCPS) in a preclinical setting. Six adult pigs underwent PCPS with or without the TACV. With standard hemodynamic monitoring, LV volume and function were assessed by direct ultrasonic cardiography (UCG) in each condition. PCPS was smoothly established and the TACV catheter was safely introduced in all cases. As compared with isolated PCPS, the TACV combined with PCPS maintained significant blood flow with LV venting and systemic perfusion: the heart rate of the native heart, systemic arterial pressure, and central venous pressure were stable. Also the additional TACV led to a significant reduction of LV preload during PCPS, and the reduction was 25-30% of LVDd and 20-35% of LVAd. The results of this investigation suggest that clinical application of the TACV technique with a clinical PCPS circuit would be feasible and additional TACV might be use-ful for LV recovery during PCPS in patients with severe heart failure.
Collapse
|
50
|
Hanzawa K, Lear TL, Piumi F, Bailey E. Mapping of equine potassium chloride co-transporter (SLC12A4) and amino acid transporter (SLC7A10) and preliminary studies on associations between SNPs from SLC12A4, SLC7A10 and SLC7A9 and osmotic fragility of erythrocytes. Anim Genet 2002; 33:455-9. [PMID: 12464022 DOI: 10.1046/j.1365-2052.2002.00907.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Consensus DNA sequences from human, mouse and/or rat were used to design oligonucleotide primers for equine homologues of exons 16, 17 and 20-23 of potassium chloride co-transporter (SLC12A4) and exons 10, 11 and 3, 4, respectively, for two amino acid transporters (SLC7A10 and SLC7A9). DNA sequences of the PCR products showed high sequence identity to these regions. Equine BAC clones were obtained for SLC12A4 and SLC7A10 and mapped to equine chromosomes ECA3p13 and ECA10p15, respectively, by fluorescence in situ hybridization (FISH). Several single nucleotide polymorphisms (SNP) were found. Substitutions of A/G were found within exon 17 of SLC12A4, within intron 11 of SLC7A10 and within intron 3 of SLC7A9. The SNP associated with SLC7A10 and SLC7A9 were sufficiently polymorphic to investigate associations with erythrocyte fragility among a group of 20 thoroughbred horses. A non-parametric rank-sum test showed a weak association between erythrocyte fragility and the SNP associated with SLC7A10 (P < 0.05).
Collapse
|