Perfusionist education in Japan: A survey of challenges and current status.

Introduction: This study aimed to examine the educational challenges faced by perfusionists in Japan. Although Japan has over 400 cardiovascular surgery centers, it performs fewer surgeries than by countries such as Germany and the United States. We focused on challenges related to varying caseloads and working conditions.

Depth reconstruction with coaxial multi-wavelength aperture telecentric optical system.

An optical system to measure depth information is proposed here. The proposed optical system has double coaxial multi-wavelength apertures, which makes it possible to simultaneously take an orthogonal projection image and a perspective projection image with these two images separated by wavelengths. The three-dimensional physical position of an object can be derived with the ratio of the radial distances of these separated images with the centers located on the optical axis.

Transition of intestinal fatty acid-binding protein on hypothermic circulatory arrest with cardiopulmonary bypass.

Introduction: Intestinal fatty acid-binding protein (I-FABP) is increasingly employed as a highly specific marker of intestinal necrosis. However, the value of this marker associated with cardiovascular surgery with hypothermic circulatory arrest is unclear. The aim of this study was to measure serum I-FABP levels and provide the transition of I-FABP levels with hypothermic circulatory arrest to help in the management of intestinal perfusion.

An Evaluation Trial of The National Perfusion Registry.

The International Consortium for Evidence-Based Perfusion (ICEBP) is a collaborative group whose mission is to improve, continuously, the delivery of care and outcomes for patients undergoing cardiac surgery. To achieve this end, the ICEBP supports the development of perfusion registries to evaluate clinical practices and has established evidence-based guidelines for perfusion. The Japanese Society of Extra-Corporeal Technology in Medicine (JaSECT) developed a perfusion registry to examine variation in perfusion practice in Japan.

Direct reperfusion of the right common carotid artery prior to cardiopulmonary bypass in patients with brain malperfusion complicated with acute aortic dissection.

The cases of 3 patients with brain malperfusion secondary to acute aortic dissection who underwent preoperative perfusion of the right common carotid artery are presented. The patients were 64, 65 and 72 years old and 2 were female. All were in a comatose or semi-comatose state with left hemiplegia.

Efficacy of nafamostat mesilate as anticoagulation during cardiopulmonary bypass for early surgery in patients with active infective endocarditis complicated by stroke.

Background And Aim Of The Study: Recent brain complications (e.g., bleeding or infarction) in patients with active infective endocarditis (AIE) are recognized as a contraindication for early surgery.

Clinical outcomes of combined aortic root reimplantation technique and total arch replacement.

Objectives: The goal of this study was to evaluate early and late outcomes of combined valve-sparing aortic root replacement and total arch replacement (TAR).

Methods: From October 1999 to May 2014, 195 patients underwent valve-sparing operations using the David reimplantation technique. Thirty-one patients underwent combined TAR for aortic regurgitation (AR) with extended aortic aneurysm from the aortic root to the aortic arch.

Effects of cyclodextrins on intramolecular photoinduced electron transfer in a boronic acid fluorophore.

An inclusion complex consisting of a boronic acid fluorophore (C1-APB) and β-cyclodextrin (β-CyD) acts as a supramolecular sugar sensor whose response mechanism is based on photoinduced electron transfer (PET) from the excited pyrene to the boronic acid. We have investigated the PET process in C1-APB/CyD complexes by using time-resolved photoluminescence (TRPL) measurements at room temperature, and have succeeded in estimating the electron-transfer time to be about 1 ns. We have also studied the effects of CyDs on the PET process by comparing two kinds of CyDs (α-CyD, β-CyD) under different water-dimethyisulfoxide (DMSO) concentration conditions.

New indicator of postoperative delayed awakening after total aortic arch replacement.

Objective: Impact of the decrease of regional cerebral oxygen saturation (rSO2) on postoperative delayed awakening after total aortic arch replacement (TAR) was validated.

Methods: From 2008 to 2013, 143 consecutive patients underwent TAR using selective antegrade cerebral perfusion. rSO2 was monitored using near-infrared spectroscopy.

Strategies for the treatment of aorto-oesophageal fistula.

Objectives: Presenting a surgical strategy for aorto-oesophageal fistula (AEF).

Methods: From October 1999 to August 2013, 16 patients with AEF were treated at Kobe University Hospital. The mean age was 65.

Mitral valve repair in active infective endocarditis with cerebral infarction.

A 19-year-old woman, who had a recent extensive cerebral infarction caused by a septic embolization in the left-sided territory of the middle cerebral artery, successfully underwent mitral valve repair for severe mitral regurgitation caused by active infective endocarditis, 24 h after the onset of stroke. Anticoagulation during cardiopulmonary bypass was maintained with low-dose heparin and additional nafamostat mesilate. She had no further aggravation of the brain complication and recovered well with midterm mitral valve durability.

[Total aortic arch replacement;our current surgical management and outcomes].

Objective: We report our current surgical management and early and late outcomes of total arch replacement.

Method: From October 1999 to December 2012, 372 consecutive patients (mean age 71.8±12.

Total arch replacement using selective antegrade cerebral perfusion as the neuroprotection strategy.

Background: Optimal neuro-protection strategy in aortic arch surgery is a controversial issue. The present study reported surgical outcomes of total arch replacement using selective antegrade cerebral perfusion (SACP).

Methods: From January 2002 to December 2012, 438 consecutive patients (mean age 69.

Open reconstruction of thoracoabdominal aortic aneurysms.

Technical details of our strategy for reconstructing the thoracoabdominal aorta are presented. Between October 1999 and June 2012, 152 patients underwent surgery for thoracoabdominal aortic aneurysms (Crawford classification type I =21, type II =43, type III =73, type IV =15). Mean age was 64.

Outcome of elective total aortic arch replacement in patients with non-dialysis-dependent renal insufficiency stratified by estimated glomerular filtration rate.

Objective: Little is known about the impact of preoperative renal function stratified by estimated glomerular filtration rate (eGFR) on outcomes of total aortic arch replacement (TAR). The current study addressed this issue and identified a cutoff value of eGFR for the requirement of postoperative renal replacement therapy.

Methods: From January 2000 to May 2011, 229 consecutive patients who did not require preoperative hemodialysis were retrospectively studied after elective TAR.

Total arch replacement using antegrade cerebral perfusion.

Objective: The technical details of total arch replacement using antegrade cerebral perfusion are presented.

Methods: From January 2002 to May 2012, 423 consecutive patients (mean age, 69.2 ± 13.

Extended replacement of the thoracic aorta.

Objectives: We present our experience of total aortic arch replacement.

Methods: Twenty-nine patients (21 males and 8 females; mean age 63.3 ± 13.

Aggressive surgical treatment of acute pulmonary embolism with circulatory collapse.

Background: Acute high-risk pulmonary embolism is a life-threatening condition with high early mortality rates resulting from acute right ventricular failure and cardiogenic shock. We retrospectively analyzed the outcomes of surgical embolectomy among patients with circulatory collapse.

Methods: Between July 2000 and September 2011, 24 consecutive patients (17 women and 7 men; mean age, 59.

Short and midterm outcomes of elective total aortic arch replacement combined with coronary artery bypass grafting.

Background: This study was performed to investigate the early and late outcomes of total aortic arch replacement (TAR) with or without coronary artery bypass grafting (CABG).

Methods: From October 1999 to December 2010, 200 consecutive patients underwent elective TAR for nondissecting aneurysm through a median sternotomy. Of this number, 131 (65.

Effect of atherothrombotic aorta on outcomes of total aortic arch replacement.

Objective: The effect of an atherothrombotic aorta on the short- and long-term outcomes of total aortic arch replacement, including postoperative neurologic deficits, remains unknown. We evaluated this relationship and also elucidated the synergistic effect of multiple other risk factors, in addition to an atherothrombotic aorta, on the neurologic outcome.

Methods: A group of 179 consecutive patients undergoing total aortic arch replacement were studied.

Recent advancements of total aortic arch replacement.

Objective: Recent advancements in total aortic arch replacement achieved by our approach were presented.

Methods: From January 2002 to December 2010, 321 consecutive patients (mean age 69.8 ± 13.

Controlled low-flow reperfusion after warm brain ischemia reduces reperfusion injury in canine model.

Background: Acute occlusion of the carotid artery caused by acute type A aortic dissection (AAD) induces on-going warm brain ischemia. The purpose of this study was to elucidate the hypothesis that low-flow reperfusion could mitigate reperfusion injury after warm ischemic damage to the brain.

Methods: Experiments were performed using a canine global brain ischemia model, with 15 minutes of ischemia followed by 3 hours reperfusion, which was established by a simple brain reperfusion circuit with a roller pump.