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General Thoracic and Cardiovascular Surgery

Kazuma Okamoto
This review examines the historical and current status of minimally invasive cardiac surgery (MICS) in Japan, based on reports that have been published in English. Although enthusiasm for MICS in Japan increased during the 1990s, it waned during the early 2000s because of various limitations. However, the introduction of minimally invasive mitral valve surgery, aortic valve replacement, atrial septal defect closure, and coronary artery bypass has led to the resurgence of MICS in Japan during recent years. Academic societies and a national registry system will play an important role in ensuring that this new wave of MICS is implemented safely and effectively...
July 17, 2018: General Thoracic and Cardiovascular Surgery
Kazumasa Orihashi
Despite improved outcomes in acute aortic dissection in Japan, mesenteric ischemia remains a problem. This is largely due to difficulties in early diagnosis and treatment. To address this problem, this article will review several diagnostic modalities such as ultrasound and near-infrared spectroscopy, as well as surgical treatments. Ultrasound is useful for assessing mesenteric ischemia because it can be performed at bedside and it provides information on both morphology and perfusion in real time without exposure to radiation or contrast media...
July 17, 2018: General Thoracic and Cardiovascular Surgery
Zipeng Li, Hidetoshi Masumoto, Jun-Ichiro Jo, Kazuhiro Yamazaki, Tadashi Ikeda, Yasuhiko Tabata, Kenji Minatoya
OBJECTIVE: Chronic myocardial infarction (CMI) tends to be resistant to treatments possibly due to extensive solid fibrotic scar, hypoxia mediated by poorly vascularized environment, and/or inflammation and apoptosis. Here we aimed to testify the therapeutic effects of sustained release of basic fibroblast growth factor (bFGF) using gelatin hydrogel (GH) in a rat chronic MI model and to elucidate the therapeutic mechanism including the alteration of extracellular matrix component. METHODS: CMI model rats are prepared by the permanent ligation of proximal left anterior descending coronary artery...
July 7, 2018: General Thoracic and Cardiovascular Surgery
Tsuyoshi Ueno, Yuho Maki, Ryujiro Sugimoto, Motohiro Yamashita, Kentaro Nakata, Yoshifumi Sugawara, Rieko Nishimura, Norihiro Teramoto
INTRODUCTION: Bronchopulmonary carcinoids are low-grade tumors for which the standard treatment is surgical resection. We retrospectively evaluated the surgical outcomes. METHODS: Thirteen patients underwent surgical resection for them at our institution between January 2005 and December 2016. We collected their clinicopathologic data to evaluate surgical outcomes. RESULTS: The 13 patients comprised seven men and six women. Complete resection was performed in all cases...
July 3, 2018: General Thoracic and Cardiovascular Surgery
Hiroki Takaya, Shinya Masuda, Masaaki Naganuma, Ichiro Yoshioka, Goro Takahashi, Masatoshi Akiyama, Osamu Adachi, Kiichiro Kumagai, Shukei Sugita, Yoshikatsu Saiki
OBJECTIVES: Stentless bioprosthetic valves provide hemodynamic advantages over stented valves as well as excellent durability. However, some primary tissue failures in bioprostheses have been reported. This study was conducted to evaluate the morphometrical and biomechanical properties of the stentless Medtronic Freestyle™ aortic root bioprosthesis, to identify any arising problem areas, and to speculate on a potential solution. METHODS: The three-dimensional heterogeneity of the stentless bioprosthesis wall was investigated using computed tomography...
June 28, 2018: General Thoracic and Cardiovascular Surgery
Yo Kawaguchi, Jun Hanaoka, Yasuhiko Ohshio, Tomoyuki Igarashi, Yoko Kataoka, Keigo Okamoto, Ryosuke Kaku, Kazuki Hayashi
OBJECTIVE: In elderly patients with lung cancer, the presumed fear of postoperative complications has resulted in the delivery of limited resection. Surgical decision-making for such patients would become easier if clinicians could predict who is at high risk of postoperative complications. The purpose of this study is to propose a scoring system to predict the risk of postoperative complications for elderly patients with lung cancer. METHODS: We reviewed patients aged 75 years or older who underwent lobectomy for lung cancer at a single hospital (n = 199)...
June 28, 2018: General Thoracic and Cardiovascular Surgery
Yoshikazu Motohashi, Ryo Shimada, Tomoyasu Sasaki, Takahiro Katsumata, Kazunori Dan, Yasuhiro Tsutsui, Shintaro Nemoto
In the original publication of the article, the title was incorrectly published.
June 27, 2018: General Thoracic and Cardiovascular Surgery
Satoru Okada, Kazuhiro Ito, Junichi Shimada, Daishiro Kato, Masanori Shimomura, Hiroaki Tsunezuka, Naoko Miyata, Shunta Ishihara, Tatsuo Furuya, Masayoshi Inoue
OBJECTIVE: The purpose of this study was to clarify the clinical efficacy of postoperative non-invasive positive pressure ventilation (PONIV) after pulmonary lobectomy in patients with lung cancer. METHODS: From August 2010 and July 2015, 143 patients with lung cancer who underwent pulmonary lobectomy were retrospectively reviewed. PONIV was used immediately after surgery until the morning of postoperative day (POD) 1. Arterial blood gas was analyzed before and just after surgery (POD0) and on POD1...
June 27, 2018: General Thoracic and Cardiovascular Surgery
Toshiki Yajima, Kimihiro Shimizu, Akira Mogi, Takayuki Kosaka, Seshiru Nakazawa, Ken Shirabe
Reports of right middle lobe segmentectomy are rare. We report here that anatomical right middle lobe segmentectomy is a relatively simple surgical procedure and can achieve good expansion of the remnant lung for patients with a relatively large right middle lobe.
June 25, 2018: General Thoracic and Cardiovascular Surgery
Yasuhiro Arai, Toru Kimura, Yuki Takahashi, Takashi Hashimoto, Mamoru Arakawa, Homare Okamura
OBJECTIVE: Progression of cardiac rehabilitation after cardiovascular surgery can be affected by frailty. The nutritional status of the patient has been proposed as an indicator of frailty. In this study, we aimed to evaluate the influence of preoperative nutritional status on the progress of postoperative cardiac rehabilitation. METHODS: This study included 146 patients (82 males, 64 females, average age 71.9 ± 12.0 years) who underwent elective cardiovascular surgery...
June 23, 2018: General Thoracic and Cardiovascular Surgery
Naoko Imanishi, Masaru Takenaka, Yusuke Nabe, Yosuke Nishimura, Fumihiro Tanaka
Vascular rings are congenital anomalies of the aortic arch, which may cause compression of the trachea and esophagus. Compression symptoms usually present in infants and children. Adult presentations are quite rare, and compression symptoms may not be relieved by surgical correction due to tracheal remodeling and malacia caused by a long-standing compression. Here, we present an adult case of symptomatic vascular ring formed by the right aortic arch and persistent left ligamentum arteriosus. Respiratory symptoms were predominantly due to severe tracheal stenosis caused by tracheal wall thickening through remodeling during long-standing compression, and were relieved by surgery with transection of the persistent followed by resection and reconstruction of the trachea...
June 22, 2018: General Thoracic and Cardiovascular Surgery
Arminder S Jassar, Thoralf M Sundt
The outcome of surgery for acute aortic dissection is improving, but many debates remain as to the optimal treatment. These include the necessary extent of the operation proximally and distally, as well as the use of endovascular technologies.
June 20, 2018: General Thoracic and Cardiovascular Surgery
Takeshi Kamada, Ryoichi Tanaka, Hajime Kin, Akihiko Abiko, Tomoyuki Iwase
We present the case of a 77-year-old man with a saccular descending thoracic aortic aneurysm who underwent successful antegrade thoracic endovascular aortic repair (TEVAR) via the left axillary artery. The patient had a history of axillo-bifemoral bypass grafting due to aortoiliac occlusive disease (Leriche syndrome), which precluded normal retrograde TEVAR. Upon successful procedure completion, no endoleak was noted on postoperative computed tomography. The patient was discharged from the hospital without any complications...
June 19, 2018: General Thoracic and Cardiovascular Surgery
Isao Yada, Hiromi Wada, Masayuki Shinoda, Keishu Yasuda
The original publication of the articles cited above included incorrect values.
June 15, 2018: General Thoracic and Cardiovascular Surgery
Masatoshi Koga, Yasuyuki Iguchi, Tomoyuki Ohara, Yoshio Tahara, Tetsuya Fukuda, Teruo Noguchi, Hitoshi Matsuda, Kenji Minatoya, Kazuyuki Nagatsuka, Kazunori Toyoda
BACKGROUND: Stanford type A acute aortic dissection requires emergency surgery. Because patients with ischemic stroke as a complication of Stanford type A acute aortic dissection do not often complain of chest or back pain, probably due to consciousness disturbance, amnesia, or aphasia, a fatal course following inappropriate intravenous rt-PA therapy and delay of appropriate surgical treatment sometimes occur. REVIEW AND PROPOSED RECOMMENDATIONS: When treating any suspected stroke patients, emergency services and initial urgent care doctors should always suspect aortic dissection...
June 13, 2018: General Thoracic and Cardiovascular Surgery
Keiichi Fujiwara, Kousuke Yoshizawa, Nobuhisa Ohno, Hisanori Sakazaki
A 23-year-old female of Taussig-Bing heart with antero-posterior relation of the great arteries was underwent Patrick-McGoon's intraventricular rerouting at 6 years old of age. The left ventricular outflow obstruction (peak pressure gradient of 100 mmHg) developed, and severe aortic valve regurgitation following bacterial endocarditis was noted. The conversion to Rastelli's type operation and aortic valve replacement were performed successfully at 23 years old of age. She is doing well without any significant left or right ventricular outflow obstruction at 7 years postoperatively...
June 11, 2018: General Thoracic and Cardiovascular Surgery
Akira Furutachi, Kojiro Furukawa, Kouta Shimauchi, Junji Yunoki, Manabu Itoh, Masanori Takamatsu, Eijiro Nogami, Yosuke Mukae, Takahiro Nishida
We report a case of a 66-year-old man who was diagnosed with severe aortic regurgitation, moderate tricuspid regurgitation and chronic atrial fibrillation. Preoperative computed tomography showed left lung agenesis. We performed aortic valve replacement, tricuspid valve annuloplasty and right pulmonary vein isolation via a left thoracotomy. This approach provided an adequate field of view.
June 6, 2018: General Thoracic and Cardiovascular Surgery
Yuki Ikeno, Masamichi Matsumori, Koki Yokawa, Soichiro Henmi, Hidekazu Nakai, Takashi Matsueda, Katsuhiro Yamanaka, Takeshi Inoue, Hiroshi Tanaka, Yutaka Okita
We present a rare case of common carotid artery with acute type A aortic dissection. A 72-year-old woman underwent emergent aortic arch repair using Antegrade selective cerebral protection. Bottom-tapped cannulae were inserted into three orifices of arch vessels, however, regional cerebral oxygen saturation decreased after rewarming. We found that arch branches were in order from front to back, right subclavian artery, common carotid trunk, and left subcravian artery. The patient complicated stroke in the right middle cerebral artery...
June 4, 2018: General Thoracic and Cardiovascular Surgery
Giosuè Falcetta, Clemente Pascarella, Pietro Bertini, Stefano Pratali, Uberto Bortolotti
We describe a patient with mitral incompetence and aortic stenosis who underwent mitral valve repair and aortic valve replacement using a Perceval sutureless bioprosthesis. After weaning from cardiopulmonary bypass, repeated mitral valve repair was required due to residual mitral regurgitation. During this procedure, the aortic prosthesis was displaced, most likely by undue inadvertent traction on the atrial retractor, requiring its removal and reinsertion. When employing a sutureless valve gentle manipulation of the heart is mandatory to avoid possible adverse events as that herein described...
May 31, 2018: General Thoracic and Cardiovascular Surgery
Tomohito Saito, Yukihito Saito, Kento J Fukumoto, Hiroshi Matsui, Takahito Nakano, Yohei Taniguchi, Hiroyuki Kaneda, Toshifumi Konobu, Koji Tsuta, Tomohiro Murakawa
OBJECTIVES: Accumulating evidence suggests that spontaneous pneumothorax (SP) in women, while relatively rare, has higher rates of post-treatment recurrence than in men. Our aim was to further elucidate the clinical and pathological characteristics of SP in women. METHODS: We retrospectively reviewed 59 female patients with no known underlying lung disease undergoing surgery for their SP from January 1990 to December 2015. We divided the study population into those older than or equal to 50 years and those younger than 50 years, the latter of which was further subdivided into catamenial and non-catamenial pneumothorax...
May 30, 2018: General Thoracic and Cardiovascular Surgery
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