Publications by authors named "Itoda Y"

A 68-year-old woman were admitted with chief complaints of persistent hoarseness, dysphagia and dyspnea on effort. She was found to have a left atrial myxoma with obstruction of mitral inflow on echo-cardiogram. The tumor was extensively attached to the atrial septum and left atrium.

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Background: Aspiration of fish bones is common, but perforation of the gastrointestinal tract is very rare. Once perforation occurs, fatal complications such as mediastinitis and cardiac tamponade can occur. Here, we present a case of acute pericarditis due to perforation of a fish bone.

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Background: Tocilizumab is effective in treating severe coronavirus disease 2019 (COVID-19). However, the specific time point it acts as a valid indicator of treatment efficacy remains unclear. This study aimed to determine the optimal day for assessing the prognostic value of the oxygen saturation/fraction of inspired oxygen (SpO/FiO) and ratio of respiratory rate-oxygenation (ROX) index in patients receiving tocilizumab for COVID-19.

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Persistent sciatic artery( PSA) is a rare congenital anomaly and often results in aneurismal or occlusive changes. A 82-year-old woman was reffered with diagnosis of Stanford type A acute aortic dissection complicated cardiac tamponade. Emergent aortic arch replacement was performed.

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Although the anticoagulant complications of Impella are well known, the timing of heparin administration when using Impella immediately after open heart surgery has not been established. We report a case of a 59-year-old man with Impella-assisted repair of a ventricular septal perforation after acute myocardial infarction who developed thromboembolism of the lower extremity arteries after removal of Impella.

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Article Synopsis
  • * A study analyzed 97 OSAS patients and categorized them into clusters based on their clinical features and leptin levels, observing that some had normal levels while others had high levels despite similar obesity.
  • * After 6 months of CPAP treatment, excessive daytime sleepiness improved across all clusters, and leptin levels decreased significantly in one group; however, the role of leptin as a biomarker for CPAP efficacy remains inconclusive.
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Objectives: Although off-pump coronary artery bypass (OPCAB) has been reported to have better short-term results than on-pump coronary artery bypass (ONCAB) in terms of bleeding and stroke even in patients with cardiac dysfunction, details are unknown. The purpose of this study was to evaluate the outcomes of CABG (coronary artery bypass graft) in patients with low cardiac function based on our treatment policy.

Methods: Retrospectively, we reviewed patients with low ejection fraction (< 35%), who underwent isolated OPCAB or ONCAB between 2013 and 2020 in our institute.

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Traumatic accidents sometimes cause primary traumatic tricuspid regurgitation (TR), and the diagnosis is occasionally delayed due to the load adaptability of the right ventricle, which may lead to fatal outcomes. Here, we report a case of a 28-year-old man with traumatic TR, which presented with late-onset exertional dyspnea 5 years after a blunt chest injury from a bicycle accident. The chordae tendineae of anterior tricuspid leaflet was ruptured with right heart dilatation, and he underwent surgical tricuspid valvuloplasty.

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Background: Quadricuspid aortic valve is a rare congenital heart disease that may be associated with a different anatomical relationship between the coronary artery ostium and the commissure.

Case Presentation: Herein, we report a case of a 59-year-old woman who underwent aortic valve replacement for a quadricuspid aortic valve with severe aortic regurgitation. Intraoperatively, the aortic valve had four cusps of almost equal size and the right coronary artery arose adjacent to the commissure between the right coronary cusp and one of the two non-coronary cusps.

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Article Synopsis
  • This study investigates the effects of prone positioning during ex vivo lung perfusion (EVLP) on human donor lungs previously deemed unsuitable for transplant, building on earlier research with porcine lungs.
  • Results show that lungs in the prone position had better oxygenation (higher P/F ratio) and lower weight compared to those in the supine position, with a higher transplant suitability rate (3 out of 5 vs. 0 out of 5).
  • The findings suggest that prone positioning may enhance the function of lower lung lobes during EVLP, indicating a potential improvement in the viability of human donor lungs for transplantation.
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Objectives: Aortic surgeries performed under moderate hypothermia require antegrade cerebral perfusion. The influence of retrograde cerebral perfusion under moderate hypothermic circulatory arrest remains unknown. To clarify this effect, this study aimed to compare the early outcomes of retrograde versus antegrade cerebral perfusion under moderate hypothermia for hemiarch replacement.

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Root infection or dissection involving coronary artery frequently necessitates an emergent Bentall procedure, with low left ventricular ejection fraction (LVEF). In contrast, concerning an elective Bentall for aneurysm, surgeons should balance the risk and benefit of surgery, especially in low LVEF cases. We investigated the association between preoperative LVEF and outcomes after Bentall.

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Blunt traumatic aortic injury is a rare but life-threatening condition, usually following high-energy trauma. We present the case of a 79-year-old man who was transferred to a hospital complaining of nausea after being struck on the chest. Computed tomography led to diagnosis of ascending aortic dissection with cardiac tamponade.

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Background: Currently, pulmonary edema is evaluated via surgical inspection and palpation in donor lungs, and there is no quantitative standard diagnostic tool for evaluating pulmonary edema in donor procurement and ex vivo lung perfusion (EVLP). The purpose of this study was to investigate the significance of lung weight at the donor hospital and lung weight during EVLP as a complementary parameter of transplant suitability in EVLP.

Materials And Methods: Twenty-one of rejected human lungs were perfused in cellular EVLP.

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Few reports have discussed appropriate strategies for patient referrals to advanced heart failure (HF) centers with available left ventricular assist devices (LVADs). We examined the association between the characteristics and prognoses of referred patients with advanced HF and the bed volume of the referring hospitals. This retrospective analysis evaluated 186 patients with advanced HF referred to our center for consultation about the indication of LVAD between January 1, 2015, and August 31, 2018.

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Purpose: To evaluate the threshold of serum memantine for prevention of spinal cord injury (SCI) in a rabbit paraplegic model.

Methods: Forty-two New Zealand white rabbits were divided into 7 groups. Preoperatively, oral memantine was given starting from 60 mg OD for 7 days in the initial group, then reducing the dose and/or duration to 60 mg OD for 5 days, 30 mg OD for 5 days, 30 mg OD for 3 days, 15 mg OD for 3 days, 30 mg single dose, and 60 mg single dose, in subsequent 6 groups.

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Objectives: Survival is poor following an orthotopic heart transplant with gender-mismatched donors and recipients. Patients bridged to an orthotopic heart transplant with a ventricular assist device (VAD) frequently become sensitized. We hypothesized that the combination of VAD bridging and gender-mismatch may result in greater rejection and poorer survival.

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Background: Donor lungs with smoking history are perfused in ex vivo lung perfusion (EVLP) to expand donor lung pool. However, the impact of hyperinflation of perfused lungs in EVLP remains unknown. The aim of this study was to investigate the significance of hyperinflation, using an ex vivo measurement delta V, during EVLP in smoker's lungs.

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Article Synopsis
  • Ex vivo lung perfusion (EVLP) allows for the extended assessment of donor lungs for transplants, but the ideal duration for the Lund protocol remains uncertain.
  • A study using 25 pairs of human lungs previously deemed unsuitable for transplant explored the effects of 1-hour versus 2-hour EVLP, measuring factors like blood gas levels and lung compliance.
  • The findings revealed that lung transplant suitability varied between the two time points in about 32% of cases, suggesting that extending the evaluation period beyond 1 hour may enhance the determination of donor organ viability.
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Background: Large atelectatic areas in donor lungs are frequently resistant to standard recruitment maneuvers, producing a tenaciously low PO/FiO ratio. The aim of this study is to investigate the optimal protocol for the recruitment of large atelectatic areas in the context of ex vivo lung perfusion (EVLP).

Methods: Seventeen rejected lungs with large lower lobe atelectasis (≥40%) were divided into 2 groups: manual resuscitation (n = 5) and selective recruitment (n = 12).

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Background: Extravascular lung water (EVLW) could change in donor lungs in a time-dependent fashion during procurement or ex-vivo lung perfusion (EVLP) and may vary across different zones. Current techniques for EVLW assessment are either subjective, general estimation, or not feasible in the clinical setting. An accurate and non-invasive diagnostic tool for EVLW would be desirable for donor lung assessment and management.

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For more accurate lung evaluation in ex vivo lung perfusion (EVLP), we have devised a new parameter, PaO /FiO ratio difference (PFD); PFD  = P/F ratio at FiO 1.0 - P/F ratio at FiO 0.4.

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Objectives: Typically, single-lung ex vivo lung perfusion (SL-EVLP) is preferred when there is concern of contamination from the opposite lung. However, a comprehensive assessment of the SL-EVLP has not been completed. The purpose of this study is to compare the physiological parameters of SL-EVLP and double-lung EVLP (DL-EVLP) in the assessment of transplant suitability.

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Objective: Prone positioning has been shown to improve oxygenation in patients with lung injury. We hypothesized that prone positioning of lungs during ex vivo lung perfusion (EVLP) can not only improve oxygenation but also diminish ischemia-reperfusion injury (IRI). The aim of our study was to evaluate the potential benefits of prone positioning of lungs during EVLP compared with the standard supine position.

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