Publications by authors named "Ikuta A"

Background: Transcatheter aortic valve replacement (TAVR) is a well-established treatment option for patients with severe aortic valve stenosis; however, clinical valve thrombosis is a major challenge.

Case Summary: A 92-year-old woman underwent TAVR for severe aortic stenosis. One month later, the patient developed acute heart failure.

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Background: With the rapid expansion of transcatheter aortic valve replacement (TAVR), TAVR valve explantation is also increasing. Nevertheless, previous reports on Lotus Edge valve explantation are limited to only two reports, none of which include intraoperative videos. Therefore, we report the case of an older adult who underwent a 2-year-old Lotus Edge valve explantation, after developing prosthetic valve endocarditis (PVE) and aortic annular abscess, with a strong indication for a TAVR explantation and surgical aortic valve replacement (AVR).

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Porphyromonas gingivalis (Pg) is a keystone bacterium associated with systemic diseases, such as diabetes mellitus and Alzheimer's disease. Outer membrane vesicles (OMVs) released from Pg have been implicated in systemic diseases by delivering Pg virulence factors to host cells in distant organs and inducing cellular dysfunction. Pg OMVs also have the potential to enter distant organs via the bloodstream.

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Background: Reversing heparin when managing coronary artery perforation (CAP) during percutaneous coronary intervention (PCI) can provide hemostasis but may cause coronary thrombosis if a device is still present in a coronary artery.

Aims: To assess the impact of heparin reversal while an intracoronary artery device is in place for CAP.

Methods: This study analyzed CAP cases during PCI from January 2006 to October 2023.

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Chronic total occlusion (CTO) lesions of the femoropopliteal artery have been shown to benefit from drug-coated balloon (DCB) angioplasty. However, because bailout stenting is often performed, the outcome of DCB angioplasty alone remains unknown, particularly the differences in outcomes between low-dose DCB (LD-DCB) and high-dose DCB (HD-DCB). To address these issues, we conducted a single-center, retrospective cohort study and enrolled 66 consecutive patients undergoing initial endovascular therapy with DCBs for femoropopliteal CTO lesions from June 2018 to February 2023.

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Aims: Safety of aspirin-free strategy immediately after percutaneous coronary intervention (PCI) for cardiovascular events in patients with diabetes was unknown.

Methods And Results: We conducted the prespecified subgroup analysis on diabetes in the STOPDAPT-3 trial, which randomly compared prasugrel (3.75 mg/day) monotherapy (2984 patients) to dual antiplatelet therapy (DAPT) with prasugrel and aspirin (2982 patients) in patients with acute coronary syndrome or high bleeding risk.

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Article Synopsis
  • Early use of EcMELLA has shown better outcomes, but guidelines for its use are still unclear, especially concerning risks related to access routes and contraindications like left ventricular thrombosis.
  • In a case study, a 74-year-old patient with heart failure and left ventricular thrombosis successfully received a single-access EcMELLA treatment after surgery, leading to significant recovery and discharge after 31 days.
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Background: Concomitant tricuspid valve (TV) repair is a safe and effective procedure to protect against late moderate or greater tricuspid regurgitation (TR) after left-sided valve surgery, but studies regarding its late outcomes and recurrent TR are limited. This study aimed to reveal the late outcomes and explore the predictors of mortality and recurrent TR among patients who underwent concomitant TV repair with left-sided valve surgery.

Methods And Results: This study included 645 patients (mean age, 69.

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Article Synopsis
  • The Academic Research Consortium (ARC) has established criteria for identifying patients at high bleeding risk (HBR) undergoing percutaneous coronary intervention, but the impact of these criteria on endovascular therapy (EVT) for femoropopliteal lesions is not well understood.
  • A study involving 165 patients undergoing EVT found that 75.8% were classified as HBR, and these patients had significantly higher rates of adverse outcomes, including all-cause death, major bleeding, and target lesion revascularization within two years.
  • The findings indicate that most patients with peripheral artery disease are considered HBR, and being classified as HBR increases the risk of serious complications compared to non-HBR patients.
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Background: Transcatheter aortic valve replacement (TAVR) has become widely used in recent years, However, there is also an increasing need for removal of TAVR valves due to prosthetic valve dysfunction (PVD) and the development of infective endocarditis. Surgical aortic valve replacement (AVR) for these patients is risky due to the original patient background and anatomic conditions. Intuity rapid deployment aortic valve (Edwards Lifesciences, Irvine, CA) replacement would be useful for such high risk patients to prevent longer cardiac arrest time and obtain good hemodynamic results.

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Background: Clinical outcomes after percutaneous coronary intervention have improved with the use of drug-eluting stents, but data beyond 10 years are limited. The purpose of this study was to evaluate the clinical outcomes of patients undergoing sirolimus-eluting stent implantation with follow-up beyond 10 years and to determine the impact of clinical and angiographic characteristics on long-term prognosis.

Methods and results: The clinical outcomes of 885 patients who had undergone sirolimus-eluting stent implantation at a single institution were retrospectively reviewed.

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Objective: The association between a combined anaemia and renal failure index and 1-year prognosis of patients undergoing transcatheter aortic valve implantation (TAVI) is unexplored. We aimed to investigate a simple risk score in patients undergoing TAVI.

Methods: A total of 469 consecutive patients undergoing TAVI between 2015 and 2021 were enrolled.

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Article Synopsis
  • - The study reviews the impact of computed tomography-derived fractional flow reserve (FFR) on the treatment of coronary artery disease in Japan, where it is reimbursed by insurance, assessing its clinical effectiveness and economic benefits.
  • - In a multicenter registry involving 410 patients, results showed that FFR usage significantly reduced the need for invasive coronary angiography (ICA) in 39.5% of cases and avoided unnecessary additional tests in patients with FFR values above 0.80.
  • - Overall, the introduction of FFR not only minimized unnecessary procedures but also led to an estimated 35% reduction in medical costs, highlighting its potential value in everyday clinical practice.
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Objectives: Developments in both technique and technology have enabled surgeons to perform the maze procedure via right minithoracotomy (RMT) to treat atrial fibrillation (AF). This study aimed to clarify the outcomes of the modified cryomaze procedure via the RMT approach compared with the sternotomy approach.

Methods: The study cohort comprised 803 consecutive patients who underwent a modified cryomaze procedure (130 via RMT and 673 via sternotomy) for paroxysmal AF and persistent AF from January 2001 to March 2022.

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Background: Despite the growing popularity of robotically assisted mitral repair, robotically assisted tricuspid repair has not been widely adopted. We assessed the safety and feasibility of robotic tricuspid annuloplasty with continuous sutures for tricuspid regurgitation (TR).

Methods And Results: We studied consecutive 68 patients (median age, 74 years) with secondary TR who underwent tricuspid annuloplasty using continuous sutures with (n = 61) and without mitral valve repair (n = 7) from 2018 to 2021.

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Background This study assessed risk factors for mitral regurgitation (MR) recurrence or functional mitral stenosis during long-term follow-up in patients undergoing mitral valve repair for isolated posterior mitral leaflet prolapse. Methods and Results We assessed a consecutive series of 511 patients who underwent primary mitral valve repair for isolated posterior leaflet prolapse between 2001 and 2021. Annuloplasty using a partial band was selected in 86.

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A 62-year-old man presented with ST-elevation myocardial infarction. Thrombectomy using an aspiration catheter was performed, but the wire lumen of the catheter had been torn during the catheter was removed. The aspiration catheter could not be retrieved into the guide catheter, and the entire system along with the guide catheter was removed.

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Objective: Postprocedural ischaemic and bleeding risks after transcatheter aortic valve replacement (TAVR) remain a major concern. Nevertheless, no reliable risk models incorporating both possibilities are currently available. We aimed to assess the accuracy of percutaneous coronary intervention (PCI)-derived models and the performance of a recalibrated model that included variables more applicable to TAVR.

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Background: Data on long-term outcomes of transcatheter aortic valve replacement (TAVR) in Japanese patients beyond 5 years are limited.

Methods: Between June 2010 and December 2014, 55 consecutive inoperable or high surgical risk patients underwent TAVR with SAPIEN XT valves (Edwards Lifesciences, Irvine, CA, USA) for severe aortic stenosis at our institution. Among them, 2 patients were excluded from the analysis because one was converted to open surgery during the TAVR procedure and the other could not undergo TAVR due to device delivery failure.

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The surgical indication for aneurysmal coronary-pulmonary artery fistula (CPAF) has not yet been established. We present 2 cases of aneurysmal CPAFs successfully treated with bilateral minithoracotomy. Case 1 involved a 40-year-old woman who presented with asymptomatic CPAFs and aneurysms measuring 25 mm in diameter.

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The distal radial approach (DRA) has been proposed as an alternative approach for coronary angiography (CAG) and percutaneous coronary intervention (PCI); however, the predictors of DRA failure and puncture site complications are unclear. Among 7153 consecutive patients undergoing CAG or PCI between November 2018 and January 2021, 3610 patients undergoing CAG or PCI with DRA were analyzed. The primary endpoint of this study was the procedural success, and the secondary endpoint of this study was puncture site complications during procedure.

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Article Synopsis
  • * Researchers analyzed data from 3,410 PCI patients between 2010 and 2013, tracking incidences of significant bleeding events (Types 3 or 5) through various bleeding risk scores, including ARC-HBR, PRECISE-DAPT, PARIS, and CREDO-Kyoto.
  • * Results showed that as bleeding risk scores increased, the incidence of bleeding events rose, with ARC-HBR demonstrating greater sensitivity in identifying patients at risk for long-term bleeding compared to the other scores.
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