Publications by authors named "Nagahori R"

Aortic valvuloplasty for bicuspid aortic valve carries a risk of postoperative stenosis. We evaluated the haemodynamic differences between aortic valvuloplasty for bicuspid aortic valve, tricuspid aortic valve, and aortic valve replacement by echocardiography. We also assessed whether a higher postoperative pressure gradient affects the outcomes of aortic valvuloplasty for bicuspid aortic valve.

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Article Synopsis
  • Selective sinus replacement can be a good choice for patients needing one or two sinuses of Valsalva replaced due to conditions like acute aortic dissection, especially when there's a high bleeding risk.
  • Six patients (mostly older males) had successful selective replacements of the right sinus of Valsalva, with all surviving the surgeries and no need for re-exploration due to bleeding.
  • Long-term follow-up showed that most patients remained asymptomatic, though some experienced varying degrees of aortic regurgitation, indicating the need for further studies with more patients to validate these findings.
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A 52-year-old man underwent surgery due to shortness of breath caused by severe aortic regurgitation with right coronary cusp prolapse. Operative findings revealed 3 symmetric cusps with small raphe between the right and noncoronary cusps situated lower than the others, indicating a forme fruste bicuspid aortic valve (BAV). The BAV was successfully repaired by tricuspidization, including raphe suspension, right coronary cusp plication, and double annuloplasty.

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Ultrasound cardiography showed severe aortic regurgitation (AR) due to bicuspid aortic valve with dilatation of the aortic annulus and sinotubular junction in a 27-year-old man hospitalized with loss of consciousness. He underwent aortic valvuloplasty combined with external suture annuloplasty using an expanded polytetrafluoroethylene (ePTFE) suture. Intraoperative findings revealed thickening and adhesion of the aortic root despite the first surgery.

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The present study aimed to understand the biofilm formation mechanism of by analyzing the components and structure of the biofilms. strains were isolated from the surface of explanted cardiac pacemaker devices that exhibited no clinical signs of infection. Culture tests using a simple stamp culture method (pressing pacemakers against the surface of agar plates) revealed frequent colonization on the surface of cardiac pacemaker devices.

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Left ventricular pseudoaneurysm is a rare, but potentially fatal, condition that generally occurs as a complication of myocardial infarction, infective endocarditis, or cardiac surgery. Surgical repair is the treatment of first choice because of the marked risk of rupture, but deteriorated hemodynamics and complicated procedures to treat the pseudoaneurysm may lead to a high mortality rate. We report a 62-year-old woman with a large left ventricular pseudoaneurysm after mitral valve replacement for rheumatic mitral valve stenosis.

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A patient with multiple leaks caused by active mitral prosthetic valve endocarditis with an annular abscess underwent repeat mitral valve replacement. To secure the new mitral prosthesis, sutures were placed through the healthy interatrial septal wall from right to left at the posteromedial region and then to the new prosthetic valve sewing cuff. In the anterolateral region, sutures were placed through the reconstructed annulus after debridement of the abscess and then reinforced with a pericardial xenograft patch.

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Purpose: The benefit of terminal blood cardioplegia (TWBCP) is insufficient after prolonged ischemia associated with inevitable oxidant-mediated injury by this modality alone. We tested the effects of TWBCP supplemented with high-dose olprinone, which is a phosphodiesterase III inhibitor, a clinically available compound with the potential to reduce oxidant stress and calcium overload. We evaluated the effects with respect to avoiding oxidant-mediated myocardial reperfusion injury and prompt functional recovery after prolonged single-dose crystalloid cardioplegic arrest in a infantile piglet cardiopulmonary bypass (CPB) model.

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Objective: An in vivo study of piglets on cardiopulmonary bypass was performed to determine whether postconditioning has a cardioprotective effect after cardioplegic arrest in large animals.

Methods: Eighteen piglets were subjected to 90 minutes of cardioplegic arrest followed by 30 minutes of reperfusion. In 6 animals (control), there was no intervention at reperfusion.

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Objective: Pulmonary ischemia and reperfusion during routine open heart surgery with cardiopulmonary bypass can lead to pulmonary dysfunction and vasoconstriction, resulting in a high morbidity and mortality. We investigated whether ischemia/reperfusion-induced pulmonary dysfunction after full-flow cardiopulmonary bypass could be prevented by the infusion of leukocyte-depleted hypoxemic blood during the early phase of reperfusion (terminal leukocyte-depleted lung reperfusion) and whether the benefits of this method were nullified by using hyperoxemic blood for reperfusion.

Methods: Twenty-one neonatal piglets underwent 180 minutes of full-flow cardiopulmonary bypass with pulmonary artery occlusion, followed by reperfusion.

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Purpose: Phosphodiesterase (PDE) III inhibitors have been reported in various cellular protective activities via the cyclic adenosine monophosphate (cAMP) pathway. We investigated the effects of amrinone on ischemia/reperfusion injury and intracellular calcium (Ca2+) handling if utilized as a component of terminal warm blood cardioplegia (TWBCP).

Methods: Anesthetized pig hearts were subjected to 90-min global ischemia with single-dose crystalloid cardioplegia, followed by 30-min reperfusion under cardiopulmonary bypass.

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A 63-year-old man was diagnosed as having grade IV mitral regurgitation (MR). Intraoperative examination revealed perforation (13x7 mm) of the anterior mitral leaflet (AML) and prolapse of the posterior mitral leaflet (PML). The prolapsing part of the PML was resected as a rectangle and the AML perforation was covered with this resected PML patch.

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The infarct exclusion technique with a xeno-pericardial patch which Komeda and associates firstly reported in 1990 is one of the best procedure to close ventricular septal perforation. A large patch can protect the perforation and the surrounding weak tissue from the internal left ventricular pressure. However, suturing this large patch to the left ventricular wall through the small incision is not technically easy because of the patch design in the ventricle.

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Background: A heparin/protamine titration system for measurement of heparin levels (Hepcon) is promising for efficient anticoagulation during cardiopulmonary bypass (CPB).

Methods: Fifty-seven patients subjected to CPB were divided into two groups, control (n = 24) and Hepcon groups (n = 33). The Hepcon group was further divided into three subgroups according to perfusion temperature.

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The minimal effective dose of aprotinin on hemostasis under normothermic perfusion, the influence of anticoagulant therapy on graft patency, and the thromboembolic and hemorrhagic events were investigated after aortocoronary bypass graft operation (CABG). One hundred CABG patients under normothermic perfusion were randomly divided into the following groups: (1) coumadin plus acetylsalicylic acid (ASA) (n=32); no aprotinin used during cardiopulmonary bypass (CPB); (2) minimal-dose, 10(6) KIU during CPB, aprotinin used, followed by ASA and coumadin (n=36); and (3) very low-dose, total of 2x10(6) KIU before CPB and during CPB; aprotinin used; anticoagulation therapy with heparin early after surgery and followed by replacement with ASA and coumadin (n=32). The patency of arterial grafts was 100% in all groups.

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Only three cases of the combination of bicuspid aortic valve and ruptured aneurysm of the sinus of Valsalva, associated with previously repaired coarctation of aorta, have been reported. A twenty-year-old man with a sudden onset of CHF due to ruptured aneurysm of the sinus of Valsalva underwent intracardiac repair by direct closure of the sinus Valsalva in combination with patch closure of a subarterial VSD. Although, no AR was detected preoperatively, massive regurgitation occurred after the repair due to subsequent failure of aortic valve coaptation in the present of the bicuspid aortic valve, which was not diagnosed preoperatively.

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14 living flaps in 8 children were used to repair for the congenital heart disease, because artificial material and xeno grafts were shrunk in growing children but living flaps were going to glow with children. It were possible to use the living flaps to reconstruct of pulmonary outflow in truncus arteriosus, for septoplasty in partial anomarous of pulmonary venous return and reconstruction of unloofed coronary sinus in endocardial defect with triatriatum and intraatrial tunnel in TCPC or Fontan type operation.

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Degenerative mitral valve disease is a major cause of mitral regurgitation and mitral valve repair has acquired greater importance as a surgical treatment of mitral regurgitation. Since 1991 we have used mitral valve repair to remodel the mitral valve leaflet, chordae tendineae and annulus. The final aim of our mitral valve remodeling technique is to correct the coaptation line of both leaflets.

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A left ventricular pressure volume loop (PV loop) is useful not only in evaluating cardiac function, but also in predicting the postoperative hemodynamic state. There are two methods available for the intraoperative measurement of a PV loop: a conductance catheter and two-dimensional echocardiography. Although the accuracy of conductance catheter is well established for the measurement of ventricular volume, however, the accuracy of echocardiography remains controversy.

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Anomalous origin of the left coronary artery (ALCA) arising from the pulmonary artery is a rare anomary, and causes myocardial infarction and death in children. Direct implantation of ALCA to the aorta was performed in the 6-year-old female patient. A large button of pulmonary arterial wall resected with ALCA could spare the shortage of the distance between the aorta and the ALCA.

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To evaluate the mitral reconstructive technique from the pathological and surgical points of view, 33 consecutive cases were analyzed. Eighteen patients (54.5%) were men, and the mean age was 40.

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Total cavopulmonary connection with use of an autogenous intraatrial tunnel to create a straight tube between the inferior vena cava and the pulmonary artery was attempted in several types of cardiac anomaly in eight consecutive candidates for the Fontan operation. A small right atrium with an extraordinary location of the inferior vena cava and a short superior vena cava prevented the use of this procedure in two cases. By preserving the crista terminalis and the sinus node and its arteries we prevented the development of postoperative atrial arrhythmias in the short follow-up period, and the P trigger-signal averaged P waves were not different from those of other cardiac anomalies.

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Unlabelled: The purpose of this experimental study is to evaluate the efficacy of linear-type right ventricular (RV) dynamic cardiomyoplasty in a setting of patch enlargement model for hypoplastic RV. In 6 puppies (6-8 kg), under a cardiopulmonary bypass (CPB), RV free wall and septal traveculation were resected and replaced with large pericardial patch, simulating RV patch enlargement of hypoplastic RV. A pedicled left LD, anchored to 3rd rib, wrapped onto the RV patch in parallel to RV long axis, while LD fixed to only RV diaphragma surface without wrapping LV surface.

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Thirty-six patients who underwent mitral valve repair were analyzed to evaluate the effect of mitral valve reconstructive technique. The final aim of this technique is to true up the coaptation line of both leaflets. Resection and reconstruction of the leaflet was performed on anterior leaflet in 11, on posterior leaflet in 12, and on both leaflets in 5.

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One and one half ventricle repair consisting of the Glenn operation and the right ventricular outflow tract reconstruction was performed in a 4-year-old boy. The diagnosis of this patient was pure pulmonary atresia. He had undergone Brock's operation, Blalock-Taussig shunt and a central shunt at neonatal period.

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