Publications by authors named "Motoki Fukutomi"
Article Synopsis
- The treatment of high-risk patients with multivessel coronary artery disease (CAD) and functional mitral regurgitation (MR) is debated, but a two-stage hybrid approach may offer a solution.
- Two successful cases are presented where patients underwent transcatheter mitral valve repair followed by off-pump coronary artery bypass grafting, showing stability without worsening MR.
- This two-stage treatment strategy could be an ideal option for those patients due to its effectiveness in maintaining hemodynamic stability.
Article Synopsis
- A history of hospitalization for heart failure (HHF) before transcatheter aortic valve implantation (TAVI) is linked to poorer clinical outcomes in patients with severe aortic stenosis (AS).
- In a study of 2,752 patients, those with prior HHF had significantly higher 30-day mortality and overall risk of negative outcomes compared to those without such a history.
- The findings highlight that prior HHF affects patients regardless of their heart function, emphasizing the need for careful evaluation and management in these cases post-TAVI.
Background: Transcatheter aortic valve implantation (TAVI) requires several bail-out techniques for safe valve delivery and deployment. Particularly in cases of challenging aortic anatomy, the snare technique from the contralateral side of the surgical site can facilitate delivery of the transcatheter heart valve (THV) system. However, there are no previous reports of the snare technique from the ipsilateral side of the surgical site in TAVI cases.
View Article and Find Full Text PDFThe impact of procedural volume on transcatheter aortic valve replacement (TAVR) outcomes in Japan remains uncertain. Japan has carefully introduced TAVR after the establishment of techniques in Western countries and therefore may not exhibit volume-outcome relations after TAVR. Data on transfemoral TAVR was collected from the Japan Transcatheter Valve Therapy (J-TVT) registry between 2018 and 2020.
View Article and Find Full Text PDFArticle Synopsis
- This study evaluated the use of two different access sites, transaxillary/trans-subclavian (TX/TS) and transfemoral (TF), for Impella-assisted patients experiencing cardiogenic shock, using data from the Japanese Percutaneous Ventricular Assist Device registry.
- Among 2,564 cases, 6.5% utilized the TX/TS approach, which was more common in younger patients and those with specific conditions, like acute coronary syndrome and the use of inotropic medications.
- The analysis found no significant difference in 30-day mortality rates between the TX/TS (29.3%) and TF (29.6%) approaches, suggesting that TX/TS could be a viable alternative for selected patients needing
Background: Previous reports have shown a mitral annuloplasty-like effect after MitraClip, i.e. a shortening of the anterior-posterior diameter of mitral valve annulus.
View Article and Find Full Text PDFIn-hospital mortality following percutaneous coronary intervention (PCI) varies across institutions with different annual PCI volumes. The failure to rescue (FTR) rate, defined as the mortality rate following PCI-related complications, may account for the volume-outcome relationship. The Japanese Nationwide PCI Registry, a consecutive, nationally mandated registry between 2019 and 2020, was queried.
View Article and Find Full Text PDFArticle Synopsis
- Recent studies show that transcatheter aortic valve implantation (TAVI) is both safe and effective for treating severe aortic stenosis, even in patients aged 90 and older.
- In a study involving nearly 2,300 patients, those who experienced any periprocedural bleeding had higher 30-day mortality rates compared to those who did not experience bleeding.
- Specifically, severe bleeding in patients under 90 was linked to higher overall mortality, while in nonagenarians, any bleeding was associated with increased cardiovascular mortality.
Background: In transcatheter aortic valve implantation, high implantation on the aortic annulus may prevent conduction pathway injury, leading to a decrease in the rate of permanent pacemaker implantation.
Aim: To assess the impact of high implantation of SAPIEN 3 on the prevention of permanent pacemaker implantation.
Methods: Since August 2020, we have performed high implantation by fluoroscopically positioning the lower part of the lucent line at the virtual basal ring line on a coplanar view before valve implantation.
A novel "proximal first" Inoue balloon catheter for retrograde aortic valvuloplasty: Initial case report.
Catheter Cardiovasc Interv
June 2022
The Inoue balloon, invented for percutaneous transseptal mitral commissurotomy for mitral stenosis, is initially dilated in the distal portion and then the proximal portion, forming an hourglass shape that stabilizes the balloon at the mitral valve orifice with a pulling action. The device has been successfully applied to antegrade aortic valvuloplasty; the hourglass shape stabilizes the balloon across the aortic valve without rapid ventricular pacing. Subsequently, an Inoue balloon was developed for retrograde aortic valvuloplasty using the same design as the antegrade balloon.
View Article and Find Full Text PDFArticle Synopsis
- A study in Japan evaluated the outcomes of zero-fluoroscopy ablation for cardiac arrhythmias to enhance safety for patients and healthcare staff, as radiation exposure is a risk during traditional procedures.
- The analysis involved 221 patients, primarily with atrial fibrillation, using advanced imaging techniques; the 24-month follow-up revealed varying recurrence rates for different types of arrhythmias and low complication rates.
- Results suggest that zero-fluoroscopy ablation can be safely and effectively performed, reducing radiation exposure for everyone involved in the procedure.
Background: An inferoposterior transseptal puncture (TSP) is generally recommended for percutaneous left atrial appendage (LAA) closure. However, the LAA is a highly variable anatomical structure. This may have an impact on the preferred TSP site.
View Article and Find Full Text PDFObjectives: To report on the experience with a selective prophylactic permanent pacemaker (PPx-PPM) implantation strategy in patients with pre-existing right bundle branch block (RBBB) undergoing transcatheter aortic valve replacement (TAVR).
Background: Pre-existing RBBB is an independent predictor for PPM after TAVR and has been linked to increased mortality.
Methods: Hospital patient flow and longer-term clinical endpoints were compared for TAVR patients with pre-existing RBBB treated in a period with and without selective PPx-PPM strategy (2013-2020).
Objectives: We evaluated the in-hospital outcomes of percutaneous coronary intervention (PCI) for bypass graft vessels (GV-PCI) compared with those of PCI for native vessels (NV-PCI) using data from the Japanese nationwide coronary intervention registry.
Methods: We included PCI patients (N = 748,229) registered between January 2016 and December 2018 from 1,123 centers. We divided patients into three groups: GV-PCI (n = 2,745); NV-PCI with a prior coronary artery bypass graft (pCABG) (n = 23,932); and NV-PCI without pCABG (n = 721,552).
Hemodialysis (HD) patients tend to have sarcopenia and malnutrition, and both conditions are related to poor prognosis in the cardiovascular disease that often accompanies HD. However, the impact of sarcopenia or malnutrition on the long-term prognosis of HD patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) remains unclear. We analyzed 1,605 consecutive patients with ACS who had undergone PCI at a single center between January 2009 and December 2014.
View Article and Find Full Text PDFBackground: The high mortality of acute myocardial infarction (AMI) with cardiogenic shock (i.e., Killip class IV AMI) remains a challenge in emergency cardiovascular care.
View Article and Find Full Text PDFFeasibility and safety of a fully percutaneous transcatheter aortic valve replacement program.
Catheter Cardiovasc Interv
February 2021
Objectives: This study aimed to assess the feasibility and safety of conducting an entire transcatheter aortic valve replacement (TAVR) program by using percutaneous techniques only.
Background: Surgically assisted transthoracic TAVR has been reported to be associated with more complications and longer hospital stays.
Methods: During 2019, all TAVR at a single center were performed by standard transfemoral (TF), intravascular lithotripsy-assisted TF, transaxillary (TAx), or transcaval approach using percutaneous techniques only.
Background: ST-segment elevation myocardial infarction is known to be associated with worse short-term outcome than non-ST-segment elevation myocardial infarction. However, whether or not this trend holds true in patients with a high Killip class has been unclear.
Methods: We analyzed 3704 acute myocardial infarction patients with Killip II-IV class from the Japan Acute Myocardial Infarction Registry and compared the short-term outcomes between ST-segment elevation myocardial infarction ( = 2943) and non-ST-segment elevation myocardial infarction ( = 761).
Left atrial appendage closure (LAAC) is noninferior to oral vitamin K antagonist therapy for the reduction of nonvalvular atrial fibrillation-related stroke risk. Currently, the procedure is most widely accepted in patients who cannot tolerate oral anticoagulants. This patient population is generally comorbid, making any reduction in procedural complications paramount.
View Article and Find Full Text PDFPurpose: To analyze the difference in morphological patterns between in-stent restenosis (ISR) lesions of overlapping segments and ISR lesions of non-overlapping segments with second- and third-generation drug-eluting stents (DESs) using optical frequency domain imaging (OFDI).
Methods: We analyzed 23 consecutive ISR lesions after second- or third-generation DES implantation using OFDI.
Results: A total of 18 men and 5 women (median age, 68.