Publications by authors named "Nobushige Tamura"

A 53-year-old male, diagnosed with Stanford A acute aortic dissection, underwent a total arch replacement with a conventional elephant trunk. During the extubation phase, paraplegia and sensory disturbance were identified, prompting suspicion of spinal cord injury (SCI) attributed to thrombosis of the false lumen and subsequent obstruction of the segmental arteries. Apixaban was administered in addition to spinal drainage, meticulous blood pressure management, and administration of mannitol, edaravone, naloxone, and prednisolone.

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We examined the influence of left ventricular diameter on surgical outcomes after isolated coronary artery bypass grafting (CABG) in patients with left ventricular ejection fraction (LVEF) <35%. The subjects were patients who underwent isolated CABG with and without cardiopulmonary bypass from January 2015 to the end of August 2023. Twenty-four patients were categorized into the LVEF ≥55% group( group N) and 14 patients into the LVEF ≤35% group( group L).

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is a gram-negative bacillus that is typically found in freshwater environments and the feces of reptiles. A 48-year-old woman with Marfan's syndrome presented to our hospital with fever, nausea, and general fatigue. She had previously undergone a mechanical Bentall procedure and total aortic arch replacement for acute type A aortic dissection.

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There are insufficient reports on the use of andexanet alfa in cardiac surgery. A 67-year-old man was diagnosed with type A aortic dissection and performed emergent surgery. His medical history included atrial fibrillation treated with Edoxaban.

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Article Synopsis
  • The study examined the impact of very low levels of low-density lipoprotein cholesterol (LDL-C) on patients with coronary artery disease, using data from over 39,000 patients who underwent coronary revascularization.
  • It was found that patients with very low LDL-C levels (<85 mg/dL) had more health issues and a higher risk of all-cause mortality compared to those with higher levels, revealing significant risks for various types of death and heart failure.
  • Overall, the research suggests that lower LDL-C levels correlate with more serious health problems and increased mortality risk, highlighting the need for careful management of cholesterol levels in at-risk patients.
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We investigated impact of persistent malperfusion syndrome (MPS) following central repair of acute type A aortic dissection (ATAAD) on outcomes. Thirty patients who underwent central repair for ATAAD with MPS were included. Patients were divided into two groups:23 patients without MPS following central repair (No-MPS group) and 7 with MPS (Persistent-MPS group).

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Article Synopsis
  • GRAND FIX mesh-type plates and pins are thin, bioabsorbable devices made from poly-L-lactide (PLLA) intended for rib fixation in clinical settings.
  • The article outlines a method for using these devices during rib fixation after thoracotomy in aortic surgery.
  • The procedure is noted to be straightforward, though it requires careful handling to ensure the ribs are fixed correctly.
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Cardiac perforation by a transvenous pacemaker lead is an uncommon, but serious complication. Management strategies in pacemaker lead cardiac perforation depend on the symptoms, the presence of pericardial effusion, hemodynamic status, and injured neighboring organs. A 70-year-old man was admitted due to suspicious right atrial perforation with pneumothorax secondary to a transvenous pacemaker lead.

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Objectives: This study investigated early and late outcomes between ascending aorta/partial arch replacement and total arch replacement with entry resection in DeBakey type I acute aortic dissection (DIAAD) repair.

Methods And Results: This study included 98 patients who underwent DIAAD repair from January 2005 to December 2020. Seventy-four patients underwent ascending aorta and partial arch replacement with entry resection (Non-TAR group), and 24 underwent total arch replacement with entry resection (TAR group).

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Background: Cytomegalovirus (CMV) colitis with colonic perforation is an exceedingly rare but life-threatening condition. The most comorbid diagnosis in patients with perforated CMV colitis is human immunodeficiency virus in the setting of advanced immunosuppression associated with CD4 < 50 cells/μL.

Case Presentation: A 75-year-old female with a ≥ 30-year history of hemodialysis presented with progressive dyspnea on exertion.

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A 64-year-old man was transferred to our hospital due to a diagnosis of Stanford type A acute aortic dissection complicated by cardiac tamponade. He was in shock status as well. Careful inspection of contrast- enhanced computed tomography revealed Kommerell's diverticulum with the aberrant right subclavian artery running behind the esophagus.

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Background: The surgical strategy for aortoesophageal fistula (AEF) depends on the experience of each surgeon, and there is no consensus on the strategy to be adopted. We propose our two-stage operation compromising esophagectomy and reconstruction as the first step and in situ aortic graft replacement as the second step after 7 days for treating AEF secondary to thoracic aortic stent graft infection.

Case Presentation: A diagnosis of AEF was made in a 70-year-old man with a history of multiple aortic interventions.

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The St. Jude Medical Epic Supra valve is a porcine bioprosthesis designed for complete supraannular implantation. No report has shown the hemodynamic performance and clinical outcomes of aortic valve replacement with the Epic Supra valve for severe aortic stenosis in a Japanese cohort.

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Ascending aorta thrombosis unaccompanied by an aneurysm or a primary hypercoagulable state is rare. We report a surgical case of ascending aorta thrombosis with multiple emboli. A 44-year-old woman visited the hospital for evaluation of dysarthria and was diagnosed with multiple cerebral infarcts.

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Whereas cerebral aneurysm is a well-known consequence of autosomal dominant polycystic kidney disease (ADPKD), acute aortic dissection has been rarely reported. A patient was a 44-year-old male with a diagnosis of ADPKD, who had previously undergone transcatheter arterial embolization for a renal cyst hemorrhage. He presented with sudden onset of back pain, which got worse at emergency service.

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Article Synopsis
  • The study investigates life expectancy after aortic valve replacement (AVR) in patients with severe aortic stenosis (AS), highlighting a lack of existing data on this topic.
  • Data from 3815 patients in the CURRENT AS registry revealed that those who underwent AVR had better survival rates than those using a conservative treatment strategy, especially among younger patients.
  • The findings suggest that assessing surgical risk based on age and STS score can help estimate life expectancy post-AVR, which is crucial for deciding between surgical and transcatheter approaches.
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Mycotic aneurysm of the aortic arch is a rare, but critical entity. We reviewed our surgical experience of mycotic aneurysm of the aortic arch. Between January 2007 and December 2015, we operated on six patients who had mycotic aneurysm of the aortic arch.

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Unlabelled: An 81-year-old female with a history of type I diabetes mellitus underwent mitral valve repair and tricuspid annuloplasty for severe mitral and tricuspid regurgitation. A nasogastric tube was inserted on postoperative day 2, and enteral feeding was initiated. She complained about severe abdominal pain on postoperative day 7.

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Background: Diabetes is a well-known risk factor for adverse outcomes after coronary revascularization.

Objectives: This study sought to determine high-risk subgroups in whom the excess risks of diabetes relative to nondiabetes are particularly prominent and thus may benefit from more aggressive interventions.

Methods: The study population consisted of 39,427 patients (diabetes: n = 15,561; nondiabetes: n = 23,866) who underwent first percutaneous coronary intervention (n = 33,144) or coronary artery bypass graft (n = 6,283) in the pooled CREDO-Kyoto PCI/CABG (Coronary Revascularization Demonstrating Outcome Study in Kyoto Percutaneous Coronary Intervention/Coronary Artery Bypass Graft) registry.

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Background: Mitral valve repair is preferred for pediatric mitral valve disease. However, it is technically difficult because of complex lesions, poor surgical exposure, and tissue fragility, especially in infants. We investigated the midterm outcomes of mitral valve surgery for mitral regurgitation in infancy.

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Article Synopsis
  • - The study compares the long-term outcomes of percutaneous coronary intervention (PCI) using new-generation drug-eluting stents (DES) and coronary artery bypass grafting (CABG) in 2,464 patients with multi-vessel coronary artery disease.
  • - Although the 5-year risk of combined events like death, heart attack, or stroke was not significantly different between the two groups, adjusted analysis showed that PCI had a higher risk of myocardial infarction and the need for additional revascularization compared to CABG.
  • - The findings suggest that while both procedures have similar outcomes regarding death and stroke, PCI with new-generation DES may carry a greater long-term risk for major cardiovascular issues in patients requiring complex multi-vessel treatments
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