Publications by authors named "Yutaka Iba"

Purpose: Previous clinical studies have reported on the short- and mid-term prognoses of thoracic endovascular aortic repair (TEVAR) using the GORE thoracic aortic graft (TAG) or conformable GORE TAG. We evaluated the long-term prognoses of patients who underwent TEVAR using the GORE TAG or conformable GORE TAG in a real-world setting.

Materials And Methods: This retrospective observational study analyzed the data of all consecutive patients aged 20 years or older who underwent TEVAR using either the GORE TAG or the conformable GORE TAG at a single center.

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A 63-year-old man was diagnosed with myelodysplastic syndrome (MDS) at the age of 62 by the hematology department. The patient underwent four cycles of azacitidine (AZA) therapy, followed by successful bone marrow transplantation (BMT). Subsequently, he was hospitalized twice for graft-versus-host disease (GVHD).

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Purpose: The Clinical Frailty Scale (CFS), used to define frail patients, is significantly associated with clinical outcomes. The CFS can predict postoperative prognosis after cardiovascular procedures. However, no reports exist on the relationship between frailty defined by the CFS and thoracic endovascular aortic repair (TEVAR) outcomes.

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Objectives: In this multicentre retrospective observational study, we present the early outcomes of physician-modified fenestrated/inner-branched endovascular repair for pararenal and thoracoabdominal aortic aneurysms in patients at high risk for open surgical repair.

Methods: We comprehensively reviewed the clinical data and outcomes of consecutive patients treated with physician-modified fenestrated/inner-branched endovascular repair for pararenal or thoracoabdominal aortic aneurysms at 6 centres between December 2020 and December 2021. Primary end-points included technical success, in-hospital mortality rates, major adverse events.

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Background: Pulmonary artery banding (PAB) is performed as a palliative surgery for congenital heart diseases. Although pulmonary stenosis is one of the complications of PAB, symptomatic supravalvular pulmonary stenosis (SVPS) in adulthood after PAB is an extremely rare condition. Further, very few studies have focused on surgical cases of SVPS in adult.

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Objectives: This study was performed to assess postoperative aortic remodelling (AR) after total arch replacement for acute type A aortic dissection (AAD) with a frozen elephant trunk (FET) or conventional elephant trunk (cET). Furthermore, the shape of the residual true lumen was analysed based on elliptical Fourier analysis and evaluated as a predictor of AR.

Methods: This study involved patients who underwent total arch replacement with a cET or FET for AAD from December 2006 to January 2023 at five institutions.

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Objective: This study aimed to evaluate the long-term outcomes of surgical strategies for communicating DeBakey IIIb chronic dissecting aortic aneurysm, considering the optimal primary surgical repair to prevent aortic events.

Methods: From 2002 to 2021, 101 patients with communicating DeBakey IIIb chronic dissecting aortic aneurysm who underwent surgical repair were categorized based on the primary surgical repair: 1-stage repair of thoracoabdominal aortic aneurysm (TAAAR) (n = 22) or staged repair, such as descending thoracic aneurysm repair (DTAR) (n = 43) or total arch replacement with elephant trunk implantation (TARET) (n = 25), and thoracic endovascular aortic repair (TEVAR) (n = 11). Early and late postoperative outcomes were compared among the groups.

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Background: Aortic dissection with malperfusion necessitates emergency surgery and is associated with poor outcomes. Therefore, in this study, we analyzed patients' treatment courses from the initial management to hospital discharge in cases of acute aortic dissection (AAD) with malperfusion and investigated the risk factors associated with mortality.

Methods: We evaluated cases of AAD with malperfusion treated at our institution over a 16-year period from 2007 to 2022.

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Article Synopsis
  • The study examines the impact of cooling status during aortic surgery on the risk of transient neurologic dysfunction in patients undergoing total arch replacement.
  • It analyzes data from surgeries conducted between December 2011 and January 2021, focusing on various parameters such as cooling speed and the cooling area.
  • Findings suggest that both a larger cooling area and a faster cooling speed are linked to a higher incidence of transient neurologic dysfunction, indicating that excessive or rapid cooling could lead to brain injury.
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  • Essential thrombocythemia (ET) is a blood disorder that results in abnormally high platelet counts due to increased production of megakaryocytes, leading to risks of thrombosis and bleeding, which require personalized treatment.
  • A 76-year-old male patient with a history of leukemia was diagnosed with ET after experiencing symptoms like leukocytosis and anemia, confirmed by genetic testing for a JAK2 mutation.
  • He underwent successful heart surgery, including aortic valve replacement and bypass grafting, with continuous monitoring of his coagulation function using an automated hemostasis analyzer system, and had an uneventful recovery with no complications related to his blood condition.
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A 79-year-old man underwent bioprosthetic valve replacement for aortic regurgitation 10 years previously (Carpentier-Edwards PERIMOUNT Magna Ease, 21 mm; Edwards Lifesciences, Irvine, CA, USA). The indexed effective orifice area decreased to 0.422 cm/m, and heart failure symptoms appeared.

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Article Synopsis
  • * During surgery, the insertion of the acetabular cup caused a sharp drop in blood pressure, raising concerns about a possible pelvic vascular injury.
  • * The surgical team cautiously advanced with the orthopedic procedure after conducting thorough tests, ultimately avoiding vascular damage without needing additional vascular interventions.
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  • Perforation by pacemaker leads is a rare but serious complication of pacemaker therapy, with recent occurrence rates between 1-2% instead of the previously reported 5%.
  • A 54-year-old man with a history of heart failure experienced a series of cardiac problems, including cardiac arrest, leading to advanced treatments like VA-ECMO and CRT-D implantation.
  • After three months, he developed cardiac tamponade due to a pericardial effusion, and further investigation revealed that a pacemaker lead had eroded into the aorta, requiring surgery to repair the aorta and address the perforation.
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A 66-year-old man with a history of type 2 diabetes mellitus who was undergoing hemodialysis presented with angina. Coronary angiography revealed triple-vessel coronary artery disease. He underwent multiple percutaneous coronary interventions due to recurrent restenosis and was referred for coronary artery bypass grafting (CABG).

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Objectives: Our goal was to evaluate early and mid-term outcomes of physician-modified endografting for pararenal and thoraco-abdominal aortic aneurysms from 10 Japanese aortic centres.

Methods: From January 2012 to March 2022, a total of 121 consecutive adult patients who underwent physician-modified endografting for pararenal and thoraco-abdominal aortic aneurysms were enrolled. We analysed early and mid-term postoperative outcomes, including postoperative complications and mortality.

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Background: In patients with retrosternal neo-esophageal conduit after right thoracotomy, the approach to cardiac surgery could be challenging. Particularly, in patients with infective endocarditis, there is a risk of injury to the conduit through standard median sternotomy. Moreover, right lung adhesions could be predicted.

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Background We focused on coronary artery bypass grafting using the great saphenous vein and compared the no-touch great saphenous vein and conventional great saphenous vein. Methods Coronary artery bypass grafting using the great saphenous vein was performed at our hospital over a 15-year period from 2007/04 to 2022/08. The primary endpoint was the patency of the great saphenous vein at discharge, and secondary endpoints were delayed healing of the great saphenous vein harvest wound, delayed healing of the mid-thoracic wound, and factors related to coronary artery bypass surgery.

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Objective: The purpose of this study was to statistically analyze the factors that influence cardiovascular surgery recruitment.

Methods: Fifth- and sixth-year medical students and first-year residents who participated in cardiovascular surgery-related events at our university over a 10-year period from April 2013 to August 2022 were included. The primary endpoint was admission to the department of cardiovascular surgery.

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A 46-year-old male developed a Stanford type B aortic dissection. At age 48, he underwent left open thoracic descending aorta replacement because of the enlargement of the descending thoracic aorta. At 51 years old, he underwent abdominal aorta replacement because of ischemia in the right lower extremity and the enlargement of an abdominal aortic aneurysm.

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