Updated on 2025/11/10

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写真a

 
Keiji Uchida
 
Organization
YCU Medical Center Associate Professor
Title
Associate Professor
Homepage
http://www.ycu-cardiac.jp/
Profile
2015年日本血管外科学会雑誌 最優秀論文受賞
External link

Degree

  • 博士（医学） ( 横浜市立大学 )

Research Interests

  • 大動脈瘤発生

  • 大血管外科学

  • 大動脈解離

  • 大動脈瘤

  • 虚血性心疾患

Research Areas

  • Life Science / Respiratory surgery

  • Life Science / Cardiovascular surgery

Research History

  • Yokohama City University   Associate Professor

    2010

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Professional Memberships

Papers

  • Impact of New-Onset Right Bundle-Branch Block After Transcatheter Aortic Valve Replacement on Permanent Pacemaker Implantation. International journal

    Shinnosuke Kikuchi, Yugo Minamimoto, Kensuke Matsushita, Tomoki Cho, Kengo Terasaka, Yohei Hanajima, Hidefumi Nakahashi, Masaomi Gohbara, Yuichiro Kimura, Shota Yasuda, Kozo Okada, Yasushi Matsuzawa, Noriaki Iwahashi, Masami Kosuge, Toshiaki Ebina, Olivier Morel, Patrick Ohlmann, Keiji Uchida, Kiyoshi Hibi

    Journal of the American Heart Association   13 ( 9 )   e032777   2024.5

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    Language：English   Publishing type：Research paper (scientific journal)  

    BACKGROUND: A delayed and recurrent complete atrioventricular block (CAVB) is a life-threatening complication of transcatheter aortic valve replacement (TAVR). Post-TAVR evaluation may be important in predicting delayed and recurrent CAVB requiring permanent pacemaker implantation (PPI). The impact of new-onset right bundle-branch block (RBBB) after TAVR on PPI remains unknown. METHODS AND RESULTS: In total, 407 patients with aortic stenosis who underwent TAVR were included in this analysis. Intraprocedural CAVB was defined as CAVB that occurred during TAVR. A 12-lead ECG was evaluated at baseline, immediately after TAVR, on postoperative days 1 and 5, and according to the need to identify new-onset bundle-branch block (BBB) and CAVB after TAVR. Forty patients (9.8%) required PPI, 17 patients (4.2%) had persistent intraprocedural CAVB, and 23 (5.7%) had delayed or recurrent CAVB after TAVR. The rates of no new-onset BBB, new-onset left BBB, and new-onset RBBB were 65.1%, 26.8%, and 4.7%, respectively. Compared with patients without new-onset BBB and those with new-onset left BBB, the rate of PPI was higher in patients with new-onset RBBB (3.4% versus 5.6% versus 44.4%, P<0.0001). On post-TAVR evaluation in patients without persistent intraprocedural CAVB, the multivariate logistic regression analysis showed that new-onset RBBB was a statistically significant predictor of PPI compared with no new-onset BBB (odds ratio [OR], 18.0 [95% CI, 5.94-54.4]) in addition to the use of a self-expanding valve (OR, 2.97 [95% CI, 1.09-8.10]). CONCLUSIONS: Patients with new-onset RBBB after TAVR are at high risk for PPI.

    DOI： 10.1161/JAHA.123.032777

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  • Ratio of left ventricular outflow tract area to aortic annulus area and complete atrioventricular block after transcatheter aortic valve replacement for aortic stenosis. International journal

    Shinnosuke Kikuchi, Yugo Minamimoto, Kensuke Matsushita, Tomoki Cho, Kengo Terasaka, Yohei Hanajima, Hidefumi Nakahashi, Masaomi Gohbara, Yuichiro Kimura, Shota Yasuda, Kozo Okada, Yasushi Matsuzawa, Noriaki Iwahashi, Masami Kosuge, Toshiaki Ebina, Olivier Morel, Patrick Ohlmann, Keiji Uchida, Kiyoshi Hibi

    International journal of cardiology   397   131608 - 131608   2024.2

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    Language：English   Publishing type：Research paper (scientific journal)  

    BACKGROUND: Mechanical compression of cardiac conduction system by transcatheter heart valves leads to complete atrioventricular block (CAVB) after transcatheter aortic valve replacement (TAVR). Bulging of ventricular septum in the left ventricular outflow tract (LVOT) may be associated with greater compression of conduction system, leading to irreversible CAVB. OBJECTIVE: This study aimed to investigate the association of ventricular septal bulging with TAVR-related CAVB and permanent pacemaker implantation (PPI). METHODS: Among 294 consecutive patients with severe aortic stenosis who underwent TAVR between July 2017 and February 2023, 271 were included in the analysis. As a quantitative evaluation of bulging of the ventricular septum, the ratio of LVOT area to aortic annulus area (L/A ratio) was measured at the systolic phase of computed tomography images. RESULTS: TAVR-related CAVB occurred in 64 patients (23.6%). Twenty-eight patients (10.3%) required PPI. The optimal thresholds of L/A ratio for predicting TAVR-related CAVB and PPI were 1.0181 and 0.985, respectively. Patients with less than the cut-off values had higher rate of TAVR-related CAVB and PPI than those above (28.3% vs 13.1%, p = 0.0063; 14.7% vs 4.4%, p = 0.0077, respectively). A multivariate analysis showed that L/A ratio < 1.0181 was an independent predictor of TAVR-related CAVB (odds ratio [OR] 2.65, p = 0.011), in addition to prior right bundle branch block (OR 3.76, p = 0.0005), use of a self-expanding valve (OR 1.99, p = 0.030), and short membranous septum length (OR 0.96, p = 0.037). Only L/A ratio < 0.985 was independently associated with PPI (OR 3.70, p = 0.011). CONCLUSION: Low L/A ratio is a predictor of TAVR-related CAVB and PPI.

    DOI： 10.1016/j.ijcard.2023.131608

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  • Coronary protection using a pressure wire during transcatheter aortic valve implantation.

    Shinnosuke Kikuchi, Kengo Terasaka, Yugo Minamimoto, Tomoki Cho, Kozo Okada, Yasushi Matsuzawa, Noriaki Iwahashi, Keiji Uchida, Kiyoshi Hibi

    Journal of cardiology cases   29 ( 2 )   73 - 77   2024.2

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    Language：English  

    UNLABELLED: Coronary obstruction is a rare but life-threatening complication of transcatheter aortic valve implantation (TAVI). This article describes the case of a patient with severe aortic valve stenosis treated with TAVI, during which preventive coronary wiring using a pressure wire was performed for coronary protection. After the deployment of the transcatheter heart valve (THV), the values of the fractional flow reserve (FFR) and resting full-cycle ratio (RFR) remarkably decreased, although the findings of transesophageal echocardiography and coronary angiography did not suggest coronary obstruction. Intravascular ultrasound revealed severe stenosis in the left main trunk due to the displacement of the calcified native leaflets. The decrease in the FFR and RFR values after THV deployment led to a diagnosis of partial coronary obstruction, and percutaneous coronary intervention was successfully performed. In patients at a high risk for coronary obstruction, coronary protection with a pressure wire is useful for the diagnosis and prevention of coronary flow deterioration during TAVI. Functional assessment using a pressure wire before and after TAVI may contribute to the accurate diagnosis of coronary obstruction. LEARNING OBJECTIVE: Accurate diagnosis of coronary obstruction during transcatheter aortic valve implantation (TAVI) is important for successful management. In patients at a high risk for coronary obstruction, coronary protection with a pressure wire is useful for the diagnosis and prevention of coronary flow deterioration during TAVI. The remarkable decrease in the fractional flow reserve and resting full-cycle ratio values after the deployment of the transcatheter heart valve may suggest coronary obstruction.

    DOI： 10.1016/j.jccase.2023.10.008

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  • Clinical Usefulness of Echocardiographic Measurement of Proximal Aortic Diameter in Early Differentiation Between Type A Acute Aortic Dissection and ST-Segment-Elevation Myocardial Infarction. International journal

    Jin Kirigaya, Noriaki Iwahashi, Takeru Abe, Masaomi Gohbara, Yohei Hanajima, Mutsuo Horii, Kozo Okada, Yasushi Matsuzawa, Shota Yasuda, Masami Kosuge, Toshiaki Ebina, Ichiro Takeuchi, Keiji Uchida, Kouichi Tamura, Kiyoshi Hibi

    Journal of the American Heart Association   e029506   2023.10

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    Language：English   Publishing type：Research paper (scientific journal)  

    Background Contradictions between management modalities of type A acute aortic dissection (TAAAD) and ST-elevation-myocardial infarction (STEMI) may result in clinical catastrophe. Therefore, we aimed to explore which 2-dimensional echocardiography (2DE) findings are optimal for differentiating TAAAD from STEMI. Methods and Results This study included 340 patients with STEMI and 340 patients with TAAAD who underwent 2DE in the emergency department between 2012 and 2021. The proximal ascending aorta (PAA) diameter and other echocardiographic parameters were analyzed. PAA diameters were measured at 4 levels in the parasternal view: Valsalva, the sinotubular junction (STJ), the PAA at 1 cm above the STJ, and the PAA at 2 cm above the STJ. Receiver-operating characteristic curve analysis showed that Valsalva, STJ, PAA at 1 cm above the STJ, and PAA at 2 cm above the STJ were significant predictors of TAAAD (areas under the curve: 0.777, 0.924, 0.965, and 0.975, respectively; P<0.001) with the respective cutoff values of 39.4, 38.5, 39.8, and 41.2 mm. Multivariable analysis suggested that all 2DE parameters were significant predictors of TAAAD. Among the 2DE parameters examined, the incorporation of PAA at 2 cm above the STJ to clinical indicators exhibited the most significant diagnostic capability (C-statistics, 0.97; net reclassification improvement, 1.81; integrated discrimination improvement, 0.61). When only TAAAD with coronary malperfusion and STEMI were analyzed, the diagnostic utility of PAA at 1 cm above the STJ was evident (C-statistics, 0.99; net reclassification improvement, 1.79; integrated discrimination improvement, 0.67), with PAA at 2 cm above the STJ ranking second in diagnostic significance (C-statistics, 0.99; net reclassification improvement, 1.12; integrated discrimination improvement, 0.66). Conclusions PAA measurements were the most beneficial for diagnosing TAAAD in all 2DE findings and TAAAD from STEMI.

    DOI： 10.1161/JAHA.123.029506

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  • Acute Lower Extremity Arterial Thromboembolism Associated with Coronavirus Infection (COVID-19): Case Report and Literature Analysis

    Aga Kenichiro, Nemoto Hiroko, Minowa Kazuaki, Fushimi Kenichi, Karube Norihisa, Hashiyama Naoki, Yasuda Shota, Uchida Keiji, Suzuki Shinichi, Mo Makoto

    The Journal of Japanese College of Angiology   63 ( 1 )   1 - 7   2023.2

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    Language：Japanese   Publisher：Japanese College of Angiology  

    A 26-year-old man with mild coronavirus infection (COVID-19) was presented with left lower limb ischemia. The acute thromboembolism was found in the terminal aorta, bilateral iliac and popliteal arteries. Repeated embolectomies were performed three times in addition to surgical fasciotomy of the lower extremity because of re-occlusion. However, he was complicated with toe necrosis and paralysis. Additional percutaneous angioplasty to the bilateral popliteal and calf arteries were performed to prevent toe amputation. In the present study, We experienced a case of arterial thrombosis in mild COVID-19 patient, even though he is young and without significant atherosclerosis or congenital coagulopathy. In a literature search, we also found reports of lower extremity arterial thromboembolism even in mild cases of COVID-19.

    DOI： 10.7133/jca.22-00031

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  • Ratio of Left Ventricular Outflow Tract Area and Aortic Annulus Area Predicts Atrioventricular Block in Transcatheter Aortic Valve Implantation(和訳中)

    Kikuchi Shinnosuke, Hibi Kiyoshi, Minamimoto Yugo, Cho Tomoki, Terasaka Kengo, Okada Kozo, Matsuzawa Yasushi, Iwahashi Noriaki, Kosuge Masami, Ebina Toshiaki, Uchida Keiji, Tamura Kouichi, Kimura Kazuo

    日本循環器学会学術集会抄録集   86回   MPE08 - 6   2022.3

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    Language：English   Publisher：(一社)日本循環器学会  

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  • Angle between Aortic Annulus and Myocardium in LVOT and Artioventricular Block in Patients with Aortic Stenosis Undergoing TAVI(和訳中)

    Kikuchi Shinnosuke, Hibi Kiyoshi, Minamimoto Yugo, Cho Tomoki, Terasaka Kengo, Okada Kozo, Matsuzawa Yasushi, Iwahashi Noriaki, Kosuge Masami, Ebina Toshiaki, Uchida Keiji, Tamura Kouichi, Kimura Kazuo

    日本循環器学会学術集会抄録集   86回   MPE08 - 9   2022.3

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  • Store-operated calcium entry via ORAI1 regulates doxorubicin-induced apoptosis and prevents cardiotoxicity in cardiac fibroblasts. International journal

    Hiroko Nemoto, Masanari Umemura, Fumina Suzuki, Akane Nagasako, Kagemichi Nagao, Yuko Hidaka, Rina Nakakaji, Keiji Uchida, Shinichi Suzuki, Munetaka Masuda, Yoshihiro Ishikawa

    PloS one   17 ( 12 )   e0278613   2022

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    Language：English   Publishing type：Research paper (scientific journal)  

    Despite exhibiting cardiotoxicity, doxorubicin (DOX) is widely used for cancer treatments. Cardiac fibroblasts (CFs) are important in the pathogenesis of heart failure. This necessitates the study of the effect of DOX on CFs. The impairment of calcium (Ca2+) homeostasis is a common mechanism of heart failure. Store-operated Ca2+ entry (SOCE) is a receptor-regulated Ca2⁺ entry pathway that maintains calcium balance by sensing reduced calcium stores in the endoplasmic reticulum. ORAI1, a calcium channel protein and the most important component of SOCE, is highly expressed in human cardiac fibroblasts (HCFs). It is upregulated in CFs from failing ventricles. However, whether ORAI1 in HCFs is increased and/or plays a role in DOX-induced cardiotoxicity remains unknown. In this study, we aimed to elucidate the relationship between ORAI1/SOCE and DOX-induced heart failure. Induction of apoptosis by DOX was characterized in HCFs. Apoptosis and cell cycle analyses were performed by fluorescence-activated cell sorting (FACS). Reactive oxygen species (ROS) production was measured using fluorescence. YM-58483 was used as an ORAI1/SOCE inhibitor. ORAI1-knockdown cells were established by RNA interference. In vivo experiments were performed by intraperitoneally injecting YM-58483 and DOX into mice. We first demonstrated that DOX significantly increased the protein expression level of p53 in HCFs by western blotting. FACS analysis revealed that DOX increased early apoptosis and induced cell cycle arrest in the G2 phase in fibroblasts. DOX also increased ROS production. DOX significantly increased the expression level of ORAI1 in CFs. Both YM-58483 and ORAI1 gene knockdown attenuated DOX-induced apoptosis. Similarly, YM-58483 attenuated cell cycle arrest in the G2 phase, and ORAI1 knockdown attenuated DOX-induced ROS production in HCFs. In the animal experiment, YM-58483 attenuated DOX-induced apoptosis. In HCFs, ORAI1/SOCE regulates p53 expression and plays an important role in DOX-induced cardiotoxicity. ORAI1 may serve as a new target for preventing DOX-induced heart failure.

    DOI： 10.1371/journal.pone.0278613

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  • Surgical Fenestration for Acute Type A Aortic Dissection with Visceral and Lower Limb Ischemia and Paraplegia

    Suzuki Kiyotaka, Uchida Keiji, Minami Tomoyuki, Cho Tomoki, Matsuki Yusuke, Nemoto Hiroko, Kobayashi Yoshiyuki, Matsumoto Atsushi, Masuda Munetaka

    Japanese Journal of Cardiovascular Surgery   50 ( 6 )   405 - 409   2021.11

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    Language：Japanese   Publisher：The Japanese Society for Cardiovascular Surgery  

    A 70-year-old man developed sudden chest, back, abdominal, and lower extremity pain, and clinical findings and contrast-enhanced computed tomography (CT) revealed acute type A aortic dissection with visceral, lower leg, and spinal cord ischemia. The false lumen of the ascending aorta was thrombosed, and the entry site was observed in the proximal descending aorta without a re-entry tear. The true lumen of the aorta extended from the descending thoracic aorta to the abdominal aorta and was significantly narrowed. The celiac and superior mesenteric arteries received blood supply from the narrowed true lumen and several intercostal arteries from the partially thrombosed false lumen. Central repair for resection of the entry tear could impair blood flow through the false lumen and the intercostal arteries ; therefore, we performed open aortic fenestration. Postoperative contrast-enhanced CT revealed that the width of the true lumen and blood flow through the false lumen of the descending aorta were adequately improved with resolution of the patient's clinical symptoms. The patient's postoperative course was uneventful, and he was discharged on postoperative day 30. Emergency central repair has been reported as a first-line approach for acute type A aortic dissections ; however, surgical fenestration may be useful for patients who receive conservative treatment for the ascending aorta and present with multiple sites of malperfusion that causes spinal cord ischemia.

    DOI： 10.4326/jjcvs.50.405

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    Other Link： https://search.jamas.or.jp/link/ui/2022045771

  • Results of ascending aortic and arch replacement for type A aortic dissection

    Keiji Uchida, Tomoyuki Minami, Tomoki Cho, Shota Yasuda, Keiichiro Kasama, Shinichi Suzuki, Munetaka Masuda, Kiyotaka Imoto, Norihisa Karube, Motohiko Goda, Yusuke Matsuki, Hiroko Nemoto, Ryo Izubuchi, Yoshiyuki Kobayashi, Atsushi Matsumoto, Yokohama City University CVS Group

    Journal of Thoracic and Cardiovascular Surgery   162 ( 4 )   1025 - 1031   2021.10

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    Language：English   Publishing type：Research paper (international conference proceedings)   Publisher：Mosby Inc.  

    DOI： 10.1016/j.jtcvs.2020.02.087

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  • Early coronary reperfusion using only guidewires for acute type A aortic dissection

    Tomoki Cho, Keiji Uchida, Shota Yasuda, Yasushi Matsuzawa, Yoshiyuki Kobayashi

    General Thoracic and Cardiovascular Surgery   69 ( 9 )   1344 - 1346   2021.9

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Japan  

    DOI： 10.1007/s11748-021-01662-w

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  • Veno-arterio-pulmonary-arterial extracorporeal membrane oxygenation in descending aortic surgery.

    Tomoyuki Minami, Keiji Uchida, Shota Yasuda, Tomoki Cho, Yusuke Matsuki, Hiroko Nemoto, Yoshiyuki Kobayashi, Keiichiro Kasama, Daisuke Machida, Munetaka Masuda

    General thoracic and cardiovascular surgery   69 ( 4 )   727 - 730   2021.4

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    Hypoxia during one-lung ventilation is a significant problem in descending aortic surgery via left thoracotomy. Veno-arterio-pulmonary-arterial extracorporeal membrane oxygenation (VAPa-ECMO), which consists of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and an additional arterial branch to perfuse a pulmonary artery (Pa), is useful.

    DOI： 10.1007/s11748-020-01518-9

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  • Brachiocephalic artery dissection is a marker of stroke after acute type A aortic dissection repair

    Tomoki Cho, Keiji Uchida, Keiichiro Kasama, Daisuke Machida, Tomoyuki Minami, Shota Yasuda, Yusuke Matsuki, Shinichi Suzuki, Munetaka Masuda

    Journal of Cardiac Surgery   36 ( 3 )   902 - 908   2021.3

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：Blackwell Publishing Inc.  

    DOI： 10.1111/jocs.15322

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  • 心機能および大動脈弁閉鎖不全症は重症大動脈弁狭窄症患者における経カテーテル大動脈弁置換術後の左室リバースリモデリングを予測する(Cardiac Function and Aortic Regurgitation Predict Left Ventricular Reverse-Remodeling after Transcatheter Aortic Valve Replacement in Patients with Severe Aortic Stenosis)

    Minamimoto Yugo, Hibi Kiyoshi, Choh Tomoki, Iwahashi Noriaki, Kikuchi Shinnosuke, Kirigaya Jin, Akiyama Eiichi, Okada Kozo, Matsuzawa Yasushi, Maejima Nobuhiko, Kosuge Masami, Ebina Toshiaki, Uchida Keiji, Tamura Kouichi, Kimura Kazuo

    日本循環器学会学術集会抄録集   85回   OE136 - 6   2021.3

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  • Validation of Acute Myocardial Infarction and Heart Failure Diagnoses in Hospitalized Patients With the Nationwide Claim-Based JROAD-DPC Database.

    Michikazu Nakai, Yoshitaka Iwanaga, Yoko Sumita, Koshiro Kanaoka, Rika Kawakami, Masanobu Ishii, Keiji Uchida, Nobutaka Nagano, Takeo Nakayama, Kunihiro Nishimura, Kazufumi Tsuchihashi, Kazuo Kimura, Yoshihiro Saito, Kenichi Tsujita, Hisao Ogawa, Yoshihiro Miyamoto, Satoshi Yasuda

    Circulation reports   3 ( 3 )   131 - 136   2021.2

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    Language：English   Publishing type：Research paper (scientific journal)  

    Background:
    Big data systems such as diagnosis procedure combination (DPC) datasets have recently been used for research purposes. However, there have been few validation studies to determine the accuracy of diagnoses. The aim of this study was to validate and evaluate 2 diagnoses, namely acute myocardial infarction (AMI) and heart failure (HF), using International Classification of Diseases, 10th revision (ICD-10) codes in the Japanese Registry Of All cardiac and vascular Disease (JROAD)-DPC database.
    Methods and Results:
    ICD-10 codes I21.0-I21.9 and I50.0-I50.9 were used to identify AMI and HF, respectively, in the JROAD-DPC database. Diagnoses of AMI and HF were validated in clinical datasets assessing sensitivity and positive predictive value (PPV). Over 1-2 years, 742 patients hospitalized for AMI and 1,368 patients hospitalized for HF were identified in the DPC dataset. Sensitivity and PPV for AMI were 78.9% and 78.8%, respectively. When emergency hospitalization was included as a criterion, PPV increased to 84.9%. For HF, sensitivity and PPV were 84.7% and 57.0%, respectively. When emergency hospitalization and acute HF were included as criteria, PPV increased to 83.0%.
    Conclusions:
    Using ICD-10 codes for AMI and HF diagnoses among hospitalized patients, the DPC dataset showed acceptable concordance with clinical datasets. PPV increased when any conditions of hospitalization were included, especially in HF.

    DOI： 10.1253/circrep.CR-21-0004

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  • 右室梗塞と乳頭筋断裂による急性僧帽弁逆流を合併した急性心筋梗塞の一例

    中山 尚貴, 吉井 智洋, 松本 淳, 南本 祐吾, 松澤 泰志, 岩橋 徳明, 前島 信彦, 内田 敬二, 日比 潔, 木村 一雄

    日本心血管インターベンション治療学会抄録集   29回   604 - 604   2021.2

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  • A massive postoperative stroke caused by a carotid thrombus that occurred during the surgical repair of an aortic dissection. International journal

    Hiroko Nemoto, Keiji Uchida, Tomoyuki Minami, Shota Yasuda, Tomoki Cho, Munetaka Masuda

    SAGE open medical case reports   9   2050313X211025215   2021

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    A 59-year-old man with no prior neurological deficits developed a massive stroke during the repair of a double-barreled acute type A aortic dissection with major entry in the ascending aorta and an occluded brachiocephalic artery. As right cerebral ischemia was alleviated by the circle of Willis, the patient was alert and conscious preoperatively. Nevertheless, the thrombus in the right carotid artery induced a severe postoperative right cerebral embolism. In conclusion, occlusion of the carotid artery is a risk factor of postoperative severe stroke, even in patients without neurological symptoms preoperatively.

    DOI： 10.1177/2050313X211025215

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  • Proposal of a new classification: “sealed type” postinfarction left ventricular free wall rupture

    Keiji Uchida, Shota Yasuda, Tomoki Cho, Yoshiyuki Kobayashi, Atsushi Matsumoto, Yusuke Matsuki, Tomoyuki Minami, Keiichiro Kasama, Daisuke Machida, Shinichi Suzuki

    General Thoracic and Cardiovascular Surgery   2021

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Japan  

    DOI： 10.1007/s11748-021-01730-1

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  • 大動脈食道瘻に対して有茎空腸を用いたダブルトラクト再建を二期的に施行した1例

    佐藤 渉, 國崎 主税, 小坂 隆司, 秋山 浩利, 土屋 伸広, 佐藤 圭, 湯川 ひろお, 根本 寛子, 内田 敬二, 遠藤 格

    日本食道学会学術集会プログラム・抄録集   74回   412 - 412   2020.12

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    Language：Japanese   Publisher：(NPO)日本食道学会  

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  • 中枢吻合"Pouch法"を用いたfree RITAの1年及び5年成績の検討

    南 智行, 内田 敬二, 長 知樹, 松木 佑介, 根本 寛子, 小林 由幸, 松本 淳, 鈴木 清貴, 鈴木 光恵, 松下 直彦, 益田 宗孝

    日本胸部外科学会定期学術集会   73回   CTA3 - 2   2020.10

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    Language：Japanese   Publisher：(一社)日本胸部外科学会  

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  • A two-stage reconstruction for aortoesophageal fistula after replacement of thoracic aorta for Stanford Type B dissecting aortic aneurysm: esophagectomy and a double-tract reconstruction using the pedicled jejunum: a case report and literature review.

    Sho Sato, Chikara Kunisaki, Yusaku Tanaka, Kei Sato, Hiroshi Miyamoto, Norio Yukawa, Hiroko Nemoto, Keiji Uchida, Teppei Nishii, Takashi Kosaka, Hirotoshi Akiyama, Itaru Endo

    Clinical journal of gastroenterology   13 ( 5 )   722 - 727   2020.10

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    An aortoesophageal fistula (AEF) is a rare, potentially fatal condition, and esophagectomy is usually performed simultaneously with aortic surgery. However, esophageal reconstruction method has not been established. This case report describes a two-stage operation for AEF after replacement of thoracic aorta for Stanford Type B dissecting aortic aneurysm. A 61-year-old man who had underwent total arch replacement with frozen elephant trunk for Stanford Type B dissecting aortic aneurysm 3 years ago admitted to the hospital with high fever. Based on the computed tomography and endoscopic findings, he was diagnosed with having aortoesophageal fistula (AEF). After administration of antibiotics with fasting foods and drinks for a month, he underwent the second aortic replacement, thoracic esophagectomy, cervical esophagostomy, gastrostomy and omental wrapping. After 3 months, he underwent double-tract reconstruction using the pedicled jejunal transfer with supercharge and superdrainage via the subcutaneous route. After reconstruction surgery, the patient was doing well. Two-stage reconstruction was a safe procedure for AEF case who underwent aortic replacement, esophagectomy and omental wrapping. The pedicled jejunum reconstruction via subcutaneous route is an optional procedure for second reconstruction surgery.

    DOI： 10.1007/s12328-020-01158-9

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  • 腹部大動脈開窓術を選択した急性A型大動脈解離の1例

    鈴木 清貴, 内田 敬二, 南 智行, 長 知樹, 松木 佑介, 根本 寛子, 小林 由幸, 松本 淳, 鈴木 光恵, 松下 直彦, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 183回 )   29 - 29   2020.7

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    Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

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  • 感染性胸部大動脈瘤に対してリファンピシン浸漬人工血管を用いて上行弓部大動脈置換術を施行した一例

    松本 淳, 内田 敬二, 南 智行, 長 知樹, 松木 佑介, 根本 寛子, 小林 由幸, 鈴木 清貴, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 183回 )   31 - 31   2020.7

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  • 出生時の心臓マッサージを原因とする収縮性心膜炎の1手術例

    小林 由幸, 内田 敬二, 南 智行, 長 知樹, 松木 祐介, 根本 寛子, 松本 淳, 鈴木 清貴, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 183回 )   42 - 42   2020.7

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  • Coronary arteritis: a case series

    Shinnosuke Kikuchi, Kozo Okada, Kiyoshi Hibi, Nobuhiko Maejima, Naoto Yabu, Keiji Uchida, Kouichi Tamura, Kazuo Kimura

    European Heart Journal - Case Reports   4 ( 2 )   1 - 6   2020.6

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    <title>Abstract</title>
    <sec>
    <title>Background</title>
    The present article describes two cases of patients with coronary arteritis (CA) whose identification of CA diagnosis (late vs. early) resulted in different clinical courses and outcomes.


    </sec>
    <sec>
    <title>Case summary</title>
    Case 1 is a 53-year-old woman with multiple coronary risk factors who was admitted with acute coronary syndrome (ACS) and significant stenosis in the left main trunk (LMT). Although clues suggested arteritis (LMT lesion without any other stenosis, occlusion of left internal thoracic artery, etc.), the diagnosis of CA (coronary involvement of unclassified arteritis) was delayed and revascularization, including coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), was performed under uncontrolled inflammatory status. As a result, Case 1 experienced repeated ACS episodes due to graft failure and in-stent restenosis, and repeatedly underwent PCI. Case 2 is a 76-year-old woman with no significant coronary risk factors who was admitted with ACS. This patient was successfully diagnosed with coronary involvement of Takayasu arteritis before revascularization. Coronary artery bypass grafting was performed after stabilizing inflammation with prednisolone, and the patient remains angina-free beyond 1-year post-CABG. In both cases, intravascular imaging clearly identified the localization and degree of inflammation related to CA by demonstrating specific findings (ambiguous typical three-layer structure of arterial wall and extended low-echoic areas within adventitia).


    </sec>
    <sec>
    <title>Discussion</title>
    Accurate and early diagnosis with meticulous diagnostic and therapeutic strategies appear to be important for favourable clinical outcomes in the medical treatment of patients with coronary involvement of arteritis. Intravascular imaging has the potential to contribute to optimizing clinical management of CA.


    </sec>

    DOI： 10.1093/ehjcr/ytaa011

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  • Excessive EP4 Signaling in Smooth Muscle Cells Induces Abdominal Aortic Aneurysm by Amplifying Inflammation. Reviewed International journal

    Taro Hiromi, Utako Yokoyama, Daisuke Kurotaki, Al Mamun, Ryo Ishiwata, Yasuhiro Ichikawa, Hiroshi Nishihara, Masanari Umemura, Takayuki Fujita, Shota Yasuda, Tomoyuki Minami, Motohiko Goda, Keiji Uchida, Shinichi Suzuki, Ichiro Takeuchi, Munetaka Masuda, Richard M Breyer, Tomohiko Tamura, Yoshihiro Ishikawa

    Arteriosclerosis, thrombosis, and vascular biology   40 ( 6 )   ATVBAHA120314297 - 1573   2020.4

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    OBJECTIVE: Excessive prostaglandin E2 production is a hallmark of abdominal aortic aneurysm (AAA). Enhanced expression of prostaglandin E2 receptor EP4 in vascular smooth muscle cells (VSMCs) has been demonstrated in human AAAs. Although moderate expression of EP4 contributes to vascular homeostasis, the roles of excessive EP4 in vascular pathology remain uncertain. We aimed to investigate whether EP4 overexpression in VSMCs exacerbates AAAs. Approach and Results: We constructed mice with EP4 overexpressed selectively in VSMCs under an SM22α promoter (EP4-Tg). Most EP4-Tg mice died within 2 weeks of Ang II (angiotensin II) infusion due to AAA, while nontransgenic mice given Ang II displayed no overt phenotype. EP4-Tg developed much larger AAAs than nontransgenic mice after periaortic CaCl2 application. In contrast, EP4fl/+;SM22-Cre;ApoE-/- and EP4fl/+;SM22-Cre mice, which are EP4 heterozygous knockout in VSMCs, rarely exhibited AAA after Ang II or CaCl2 treatment, respectively. In Ang II-infused EP4-Tg aorta, Ly6Chi inflammatory monocyte/macrophage infiltration and MMP-9 (matrix metalloprotease-9) activation were enhanced. An unbiased analysis revealed that EP4 stimulation positively regulated the genes binding cytokine receptors in VSMCs, in which IL (interleukin)-6 was the most strongly upregulated. In VSMCs of EP4-Tg and human AAAs, EP4 stimulation caused marked IL-6 production via TAK1 (transforming growth factor-β-activated kinase 1), NF-κB (nuclear factor-kappa B), JNK (c-Jun N-terminal kinase), and p38. Inhibition of IL-6 prevented Ang II-induced AAA formation in EP4-Tg. In addition, EP4 stimulation decreased elastin/collagen cross-linking protein LOX (lysyl oxidase) in both human and mouse VSMCs. CONCLUSIONS: Dysregulated EP4 overexpression in VSMCs promotes inflammatory monocyte/macrophage infiltration and attenuates elastin/collagen fiber formation, leading to AAA exacerbation.

    DOI： 10.1161/ATVBAHA.120.314297

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  • 冠動脈malperfusionを伴うA型急性大動脈解離の正診率向上は可能か

    小林 由幸, 内田 敬二, 南 智行, 長 知樹, 松木 祐介, 根本 寛子, 松本 淳, 浦田 望, 増田 拓, 山崎 龍人, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   50回   P8 - 1   2020.3

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  • 収縮性心膜炎に対し心膜剥皮術を施行した一例

    鈴木 光恵, 内田 敬二, 南 智行, 長 知樹, 松木 佑介, 根本 寛子, 小林 由幸, 松本 淳, 鈴木 清貴, 松下 直彦, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 182回 )   30 - 30   2020.3

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  • 心室中隔穿孔・左室破裂:ここまでなら救命できる(または、救命できなかった症例から学ぶ) 心室中隔穿孔・左室破裂に対する手術成績と生体糊の有用性

    内田 敬二, 南 智行, 長 知樹, 松木 佑介, 根本 寛子, 小林 由幸, 松本 淳, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   50回   VS5 - 4   2020.3

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  • 腹部大動脈開窓術を選択した急性A型大動脈解離の1例

    鈴木 清貴, 内田 敬二, 南 智行, 長 知樹, 松木 佑介, 根本 寛子, 小林 由幸, 松本 淳, 鈴木 光恵, 松下 直彦, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 182回 )   13 - 13   2020.3

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  • Zone0, 1 TEVARにおける脳梗塞リスク因子の検討

    長 知樹, 内田 敬二, 南 智行, 松木 佑介, 根本 寛子, 小林 由幸, 松本 淳, 浦田 望, 増田 拓, 山崎 龍人, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   50回   P11 - 4   2020.3

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  • 胸部感染性動脈瘤に対する治療選択

    根本 寛子, 内田 敬二, 南 智行, 長 知樹, 松木 佑介, 小林 由幸, 松本 淳, 浦田 望, 増田 拓, 山崎 龍人, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   50回   PR7 - 2   2020.3

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  • 当院における人工弁感染性心内膜炎に対する保存治療成績 手術治療成績との比較

    南 智行, 内田 敬二, 長 知樹, 松木 佑介, 根本 寛子, 小林 由幸, 松本 淳, 浦田 望, 増田 拓, 山崎 龍人, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   50回   O13 - 2   2020.3

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  • Tracheo-innominate artery fistula with continuous bleeding successfully treated through the suprasternal approach: A case report

    Shotaro Kaneko, Keiji Uchida, Norihisa Karube, Keiichiro Kasama, Tomoyuki Minami, Tomoki Cho, Ryo Izubuchi, Kenichi Fushimi, Naoto Yabu, Motohiko Goda, Munetaka Masuda

    Journal of Cardiothoracic Surgery   15 ( 1 )   2020.2

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：BioMed Central Ltd.  

    DOI： 10.1186/s13019-020-1080-y

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  • 内臓機能不全をどう克服するか(How to conquer the visceral malperfusion?)

    内田 敬二, 南 智行, 長 知樹, 松木 佑介, 根本 寛子, 小林 由幸, 松本 淳, 鈴木 清貴, 鈴木 光恵, 松下 直彦, 益田 宗孝

    日本血管外科学会雑誌   29 ( Suppl. )   SY8 - 6   2020

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  • 急性大動脈解離Stanford A型による左冠動脈急性閉塞からCPAとなり緊急PCIを行って救命しえた1例

    松本 淳, 内田 敬二, 南 智行, 長 知樹, 松木 佑介, 根本 寛子, 小林 由幸, 鈴木 清貴, 鈴木 光恵, 松下 直彦, 益田 宗孝

    日本血管外科学会雑誌   29 ( Suppl. )   P43 - 5   2020

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  • EVAR術後の大動脈イベントに関与する因子の検討

    松木 佑介, 内田 敬二, 南 智行, 長 知樹, 根本 寛子, 小林 由幸, 松本 淳, 鈴木 清貴, 鈴木 光恵, 松下 直彦, 益田 宗孝

    日本血管外科学会雑誌   29 ( Suppl. )   SF21 - 2   2020

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  • 上行置換術直後に下行大動脈の内膜重積を起こし,追加手術を要した急性大動脈解離の1例

    小林 由幸, 内田 敬二, 南 智行, 長 知樹, 松木 祐介, 根本 寛子, 松本 淳, 鈴木 清貴, 鈴木 光恵, 松下 直彦, 益田 宗孝

    日本血管外科学会雑誌   29 ( Suppl. )   CR1 - 4   2020

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  • 大動脈弓部動脈瘤修復術における孤立性脳灌流法の臨床成績(Clinical Outcomes of Isolated Cerebral Perfusion Technique for Aortic Arch Aneurysm Repair)

    南 智行, 内田 敬二, 長 知樹, 松木 佑介, 根本 寛子, 小林 由幸, 松本 淳, 鈴木 清貴, 鈴木 光恵, 松下 直彦, 益田 宗孝

    日本血管外科学会雑誌   29 ( Suppl. )   OP6 - 3   2020

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  • 2型エンドリークを有する動脈瘤拡大に対する積極的な後期開腹術の実施(Aggressive late open conversion for aneurysm enlargement with type 2 endoleak)

    長 知樹, 内田 敬二, 南 智行, 松木 佑介, 根本 寛子, 小林 由幸, 松本 淳, 鈴木 光恵, 鈴木 清貴, 松下 直彦, 益田 宗孝

    日本血管外科学会雑誌   29 ( Suppl. )   OP18 - 4   2020

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  • Valsalva洞動脈瘤破裂術後左室流出路仮性瘤の1手術例

    松木 佑介, 内田 敬二, 輕部 義久, 南 智行, 長 知樹, 根本 寛子, 藪 直人, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 180回 )   20 - 20   2019.6

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  • 急性大動脈解離に対する上行弓部置換術後の脳梗塞

    根本 寛子, 内田 敬二, 輕部 義久, 南 智行, 長 知樹, 松木 佑介, 藪 直人, 池松 真人, 小野 由香利, 杉山 敦彦, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 180回 )   18 - 18   2019.6

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  • An appropriately sized soft polyester external stent prevents enlargement and neointimal hyperplasia of a saphenous vein graft in a canine model. International journal

    Shota Yasuda, Motohiko Goda, Taisuke Shibuya, Keiji Uchida, Shinichi Suzuki, Yasuharu Noishiki, Utako Yokoyama, Yoshihiro Ishikawa, Munetaka Masuda

    Artificial organs   43 ( 6 )   577 - 583   2019.6

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    Although the efficacy of external stents for vein grafts in coronary artery bypass grafting has been recognized, the ideal diameter and material of the stent remain controversial. We created a new external stent made of soft polyester mesh and performed an animal experiment using canines. Bilateral saphenous vein grafts were interposed in the bilateral common carotid artery of 10 beagles. The grafts in the left carotid artery were designated as the control group, and those in the right rolled by a soft polyester mesh external stent were designated as mesh group. Two of the 10 animals were sacrificed due to severe wound infection. The other eight were observed by echography for 6 months, and then grafts were extracted and thickness of the neointima of the grafts was measured. The control group showed 146% ± 26% postoperative enlargement of the internal diameter of the vein grafts after 6 months, whereas the mesh group showed only 115% ± 15% after the same duration (P = 0.0003). The median thickness of the neointima in the mesh group (170 µm [range: 150-190]) was significantly thinner than that in the control group (260 µm [range: 220-310], P < 0.0001). Some degree of correlation between the thickness of neointima and proportion of enlargement was noted (r = 0.518, P = 0.0024). A soft polyester mesh external stent for vein grafts successfully suppressed the enlargement of the vein grafts and thickness of the neointima after 6 months.

    DOI： 10.1111/aor.13399

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  • Life-threatening acute coronary obstruction caused by the commissure of a Sapien 3 prosthesis during transcatheter aortic valve implantation. Reviewed

    Matsushita K, Hibi K, Uchida K, Masuda M, Tamura K, Kimura K

    Cardiovascular intervention and therapeutics   35 ( 2 )   203 - 204   2019.5

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    DOI： 10.1007/s12928-019-00585-x

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  • 心肺停止蘇生後に三尖弁位感染性心内膜炎に対して三尖弁置換術を施行した一例

    杉山 敦彦, 内田 敬二, 輕部 義久, 南 智行, 長 知樹, 松木 佑介, 根本 寛子, 藪 直人, 池松 真人, 小野 由香里, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 179回 )   28 - 28   2019.3

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  • Coil embolization of intercostal arteries accessed by surgical exposure for type II endoleak after thoracic endovascular aortic repair. Reviewed

    Karube N, Uchida K, Cho T, Minami T, Masuda M

    J Vasc Surg. 2019 Mar 6. pii: S0741-5214(19)30076-X. doi: 10.1016/j.jvs.2018.11.040.   2019.3

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  • DVR術後に僧帽弁周囲逆流による溶血性貧血を認め自己心膜ロールを用いて修復した一例

    池松 真人, 内田 敬二, 軽部 義久, 南 智行, 長 知樹, 松木 佑介, 根本 寛子, 藪 直人, 小野 由香利, 杉山 敦彦, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 179回 )   26 - 26   2019.3

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  • 中枢吻合"Pouch法"を用いたfree RITAの早期、中期成績の検討

    南 智行, 内田 敬二, 輕部 義久, 長 知樹, 松木 佑介, 根本 寛子, 藪 直人, 串田 好宏, 菊西 啓雄, 朱 美和, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   49回   [PR04 - 3]   2019.2

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  • 感染性大動脈瘤に対するステントグラフト治療

    根本 寛子, 内田 敬二, 輕部 義久, 南 智行, 長 知樹, 松木 佑介, 藪 直人, 串田 好宏, 菊西 啓雄, 朱 美和, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   49回   [PR14 - 8]   2019.2

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  • Impact of Isolated Cerebral Perfusion Technique for Aortic Arch Aneurysm Repair in Elderly Patients. Reviewed

    Kasama K, Uchida K, Karube N, Takebayashi S, Imoto K, Masuda M

    The Annals of thoracic surgery   107 ( 2 )   533 - 538   2019.2

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  • 当院における破裂性腹部大動脈瘤に対するOpen surgery

    藪 直人, 内田 敬二, 輕部 義久, 南 智行, 長 知樹, 松木 佑介, 根本 寛子, 串田 好宏, 菊西 啓雄, 朱 美和, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   49回   [PP - 194]   2019.2

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  • device選択の観点からみたTAVI初期成績の検討

    輕部 義久, 内田 敬二, 南 智行, 長 知樹, 松木 佑介, 根本 寛子, 藪 直人, 串田 好宏, 菊西 啓雄, 朱 美和, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   49回   [PP - 066]   2019.2

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  • EVAR後type2エンドリークに対する治療戦略

    長 知樹, 内田 敬二, 輕部 義久, 南 智行, 松木 祐介, 根本 寛子, 藪 直人, 串田 好宏, 菊西 啓雄, 朱 美和, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   49回   [PR39 - 3]   2019.2

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  • 透析患者ASに対するAVRの治療成績と人工弁選択

    松木 佑介, 内田 敬二, 輕部 義久, 南 智行, 長 知樹, 根本 寛子, 藪 直人, 串田 好宏, 朱 美和, 菊西 啓雄, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   49回   [PP - 052]   2019.2

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  • 破裂性腹部大動脈瘤に対する最善の治療 破裂性腹部大動脈瘤に対するOpen Surgery

    藪 直人, 内田 敬二, 輕部 義久, 南 智行, 長 知樹, 松木 佑介, 根本 寛子, 池松 真人, 小野 由香利, 杉山 敦彦, 益田 宗孝

    日本血管外科学会雑誌   28 ( Suppl. )   SY11 - 2   2019

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  • 高齢者(80歳以上)腹部大動脈瘤に対するOpen surgeryとEVARの治療成績

    松木 佑介, 内田 敬二, 輕部 義久, 南 智行, 長 知樹, 根本 寛子, 藪 直人, 池松 真人, 小野 由香利, 杉山 敦彦, 益田 宗孝

    日本血管外科学会雑誌   28 ( Suppl. )   P53 - 2   2019

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  • 感染性大動脈瘤に対する治療方針

    根本 寛子, 内田 敬二, 輕部 義久, 南 智行, 長 知樹, 藪 直人, 池松 真人, 小野 由香利, 杉山 敦彦, 益田 宗孝

    日本血管外科学会雑誌   28 ( Suppl. )   P11 - 4   2019

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  • 急性A型大動脈解離におけるDavid手術成績

    南 智行, 内田 敬二, 輕部 義久, 長 知樹, 松木 佑介, 根本 寛子, 藪 直人, 池松 真人, 小野 由香利, 杉山 敦彦, 益田 宗孝

    日本血管外科学会雑誌   28 ( Suppl. )   P1 - 2   2019

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  • 傍腎動脈腹部大動脈瘤に対する開腹人工血管置換術の成績

    長 知樹, 内田 敬二, 輕部 義久, 南 智行, 松木 佑介, 根本 寛子, 藪 直人, 池松 真人, 小野 由香利, 杉山 敦彦, 益田 宗孝

    日本血管外科学会雑誌   28 ( Suppl. )   P52 - 1   2019

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  • 大動脈に粥腫を認める開心術において脳梗塞予防目的にICP法を用いた一例

    菊西 啓雄, 朱 美和, 串田 好宏, 藪 直人, 根本 寛子, 松木 佑介, 長 知樹, 南 智行, 輕部 義久, 内田 敬二, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 178回 )   23 - 23   2018.11

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  • Treatment of coronary malperfusion in type A acute aortic dissection. Reviewed

    Uchida K, Karube N, Minami T, Cho T, Matsuki Y, Nemoto H, Yabu N, Yasuda S, Suzuki S, Masuda M

    General thoracic and cardiovascular surgery   66 ( 11 )   621 - 625   2018.11

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    Coronary malperfusion is one of the most dreadful complications of acute aortic dissection because it causes catastrophic acute myocardial infarction in patients who are already severely ill. Our strategy was as follows. After the administration of heparin, emergency percutaneous coronary intervention (PCI) was urgently performed at the same time as starting to prepare the operating room. A stent was then placed to cover the full length of dissected coronary artery. Patients whose cardiac function improved after successful coronary artery reperfusion were transferred to the operating room to undergo central repair surgery. If the cardiac function did not recover even after coronary reperfusion, and the patient required extracorporeal membrane oxygenation, we considered the best supportive care without performing central repair surgery. In patients with left coronary malperfusion, we believe that preoperative PCI must be performed immediately. Preoperative PCI might delay central repair surgery and potentially increase the risk of catastrophic cardiac tamponade. However, the benefit of PCI in preserving cardiac function exceeds the risk of cardiac tamponade. The indications of PCI before central repair in patients with right coronary malperfusion should be considered after assessing each patient's condition, including the presence or absence of cardiac tamponade and right ventricular infarction, left ventricular function, the immediate availability of cardiologists or cardiac surgeons, and the speed of preparing the operating room.

    DOI： 10.1007/s11748-018-1014-y

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  • 4D-CTによる左室瘤症例の左室定量評価

    南 智行, 串田 好宏, 菊西 啓雄, 朱 美和, 藪 直人, 根本 寛子, 松木 佑介, 長 知樹, 軽部 義久, 内田 敬二, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 178回 )   7 - 7   2018.11

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  • Proteomic analysis of aortic smooth muscle cell secretions reveals an association of myosin heavy chain 11 with abdominal aortic aneurysm. International journal

    Utako Yokoyama, Noriaki Arakawa, Ryo Ishiwata, Shota Yasuda, Tomoyuki Minami, Motohiko Goda, Keiji Uchida, Shinichi Suzuki, Masataka Matsumoto, Nobusato Koizumi, Masataka Taguri, Hisashi Hirano, Koichi Yoshimura, Hitoshi Ogino, Munetaka Masuda, Yoshihiro Ishikawa

    American journal of physiology. Heart and circulatory physiology   315 ( 4 )   H1012-H1018   2018.10

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    Abdominal aortic aneurysm (AAA) is a life-threatening disease, and no disease-specific circulating biomarkers for AAA screening are currently available. We have identified a smooth muscle cell (SMC)-specific biomarker for AAA. We cultured aneurysmal tunica media that were collected from eight patients undergoing elective open-repair surgeries. Secreted proteins in culture medium were subjected to liquid chromatography/tandem mass spectrometry. Myosin heavy chain 11 (myosin-11) was identified as a SMC-specific protein in the tunica media-derived secretions of all patients. We then examined myosin-11 protein concentrations by ELISA in plasma samples from patients with AAA ( n = 35) and age-matched healthy control subjects ( n = 34). Circulating myosin-11 levels were significantly higher in patients with AAA than control subjects. The area under the receiver-operating characteristic curve (AUC) of myosin-11 was 0.77, with a specificity of 65% at a sensitivity of 91%. Multivariate logistic regression analysis showed a significant association between the myosin-11 level and presence of AAA. When the myosin-11 level was combined with hypertension, it improved the prediction of AAA (AUC 0.88) more than hypertension per se. We then investigated the correlation between aortic diameter and circulating myosin-11 levels using AAA serum samples from patients undergoing endovascular aneurysm repair ( n = 20). Circulating myosin-11 levels were significantly correlated with maximum aortic diameter. Furthermore, changes in myosin-11 concentrations from the baseline 12 mo after endovascular aneurysm repair were associated with those in aortic diameter. These data suggest that circulating levels of myosin-11, which is a SMC-specific myosin isoform, may be useful as a biomarker for AAA. NEW & NOTEWORTHY Extensive studies have revealed that inflammation- or proteolysis-related proteins are proposed as biomarkers for abdominal aortic aneurysm (AAA). Changes in these protein concentrations are not specific for smooth muscle, which is a major part of AAA pathologies. Hence, no disease-specific circulating markers for AAA are currently available. We found, using secretome-based proteomic analysis on human AAA tunica media, that myosin heavy chain 11 was associated with AAA. Circulating myosin heavy chain 11 may be a new tissue-specific AAA marker.

    DOI： 10.1152/ajpheart.00329.2018

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  • ステントグラフト時代の急性大動脈解離に対する治療戦略 Stanford A型急性大動脈解離に対する上行弓部置換術にFrozen Elephant Trunkは必要か

    内田 敬二, 輕部 義久, 南 智行, 長 知樹, 松木 佑介, 根本 寛子, 藪 直人, 益田 宗孝

    日本臨床外科学会雑誌   79 ( 増刊 )   325 - 325   2018.10

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  • Differences of patients' characteristics in acute type A aortic dissection - surgical data from Belgian and Japanese centers-

    Motohiko Goda, Tomoyuki Minami, Kiyotaka Imoto, Keiji Uchida, Munetaka Masuda, Bart Meuris

    Journal of Cardiothoracic Surgery   13 ( 1 )   2018.9

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    DOI： 10.1186/s13019-018-0782-x

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  • A selective antagonist of prostaglandin E receptor subtype 4 attenuates abdominal aortic aneurysm Reviewed

    Mamun Al, Utako Yokoyama, Junichi Saito, Satoko Ito, Taro Hiromi, Masanari Umemura, Takayuki Fujita, Shota Yasuda, Tomoyuki Minami, Motohiko Goda, Keiji Uchida, Shinichi Suzuki, Munetaka Masuda, Yoshihiro Ishikawa

    Physiological Reports   6 ( 18 )   e13878 - e13878   2018.9

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    DOI： 10.14814/phy2.13878

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  • Stanford type B aortic dissection is more frequently associated with coronary artery atherosclerosis than type A Reviewed

    Naoki Hashiyama, Motohiko Goda, Keiji Uchida, Yukihisa Isomatsu, Shinichi Suzuki, Makoto Mo, Takahiro Nishida, Munetaka Masuda

    Journal of Cardiothoracic Surgery   13 ( 1 )   2018.6

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    DOI： 10.1186/s13019-018-0765-y

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  • aVR誘導のST部分上昇によりA型急性大動脈解離患者の1年死亡率が高度に予測される(ST-Segment Elevation in Lead aVR Strongly Predicts 1-Year Mortality in Patients with Type A Acute Aortic Dissection)

    小菅 雅美, 内田 敬二, 日比 潔, 益田 宗孝, 田村 功一, 木村 一雄

    日本循環器学会学術集会抄録集   82回   PJ049 - 1   2018.3

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  • Early reperfusion strategy improves the outcomes of surgery for type A acute aortic dissection with malperfusion Reviewed

    Keiji Uchida, Norihisa Karube, Keiichiro Kasama, Tomokazu Minami, Shota Yasuda, Motohiko Goda, Shinichi Suzuki, Kiyotaka Imoto, Munetaka Masuda

    Journal of Thoracic and Cardiovascular Surgery   2018

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    DOI： 10.1016/j.jtcvs.2018.02.007

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  • Clinical Implications of Electrocardiograms for Patients With Type A Acute Aortic Dissection Reviewed

    Masami Kosuge, Kazuo Kimura, Keiji Uchida, Munetaka Masuda, Kouichi Tamura

    CIRCULATION JOURNAL   81 ( 9 )   1254 - 1260   2017.9

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  • 急変時の対応、合併症への対処 経カテーテル大動脈弁留置術直後に心タンポナーデを発症し、緊急開胸になった1例 大動脈造影からいち早く合併症を予測する

    塩入 知子, 櫻田 尚武, 井川 健, 杉山 昌弘, 森 幸絵, 坂野 智一, 石川 栄二, 菊地 達也, 日比 潔, 輕部 義久, 松下 絢介, 南本 祐吾, 笠間 啓一郎, 岩橋 徳明, 内田 敬二, 益田 宗孝, 木村 一雄

    日本心血管インターベンション治療学会抄録集   26回   CPD1 - 2   2017.7

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  • MalperfusionをともなうA型解離の手術戦略

    内田 敬二, 輕部 義久, 笠間 啓一郎, 出淵 亮, 伏見 謙一, 阿賀 健一郎, 齋藤 文美恵, 小林 由幸, 高橋 大志, 益田 宗孝

    日本血管外科学会雑誌   26 ( Suppl. )   S6 - S6   2017.6

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  • 急性A型大動脈解離手術症例における脳梗塞発症患者の検討

    出淵 亮, 内田 敬二, 輕部 義久, 笠間 啓一郎, 伏見 謙一, 齋藤 文美恵, 阿賀 健一郎, 小林 由幸, 高橋 大志, 益田 宗孝

    日本血管外科学会雑誌   26 ( Suppl. )   P2 - 7   2017.6

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  • complicated type B急性大動脈解離に対するstrategy

    輕部 義久, 内田 敬二, 笠間 啓一郎, 出淵 亮, 伏見 謙一, 阿賀 健一郎, 齋藤 文美恵, 小林 由幸, 高橋 大志, 益田 宗孝

    日本血管外科学会雑誌   26 ( Suppl. )   S7 - 5   2017.6

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  • アルガトロバン持続投与患者に対するCABGの経験

    出淵 亮, 内田 敬二, 輕部 義久, 笠間 啓一郎, 伏見 謙一, 齋藤 文美恵, 阿賀 健一郎, 小林 由幸, 高橋 大志, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 174回 )   30 - 30   2017.6

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  • 多臓器虚血を伴ったA型急性大動脈解離の1救命例

    伏見 謙一, 内田 敬二, 輕部 義久, 笠間 啓一郎, 出淵 亮, 齋藤 文美恵, 阿賀 健一郎, 小林 由幸, 高橋 大志, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 174回 )   12 - 12   2017.6

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  • 当院における生体弁使用大動脈基部再建術(BioBentall術)の検討

    笠間 啓一郎, 内田 敬二, 輕部 義久, 斎藤 文美恵, 出淵 亮, 伏見 謙一, 阿賀 健一郎, 小林 由幸, 高橋 大志, 益田 宗孝

    日本血管外科学会雑誌   26 ( Suppl. )   P17 - 2   2017.6

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  • Pitfalls for the “Sandwich technique” via a right ventricular incision to repair post-infarction ventricular septal defects Reviewed

    Susumu Isoda, Kiyotaka Imoto, Keiji Uchida, Norihisa Karube, Keiichiro Kasama, Ichiya Yamazaki, Shinichi Suzuki, Yoshimi Yano, Yusuke Matsuki, Munetaka Masuda

    General Thoracic and Cardiovascular Surgery   65 ( 4 )   187 - 193   2017.4

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    DOI： 10.1007/s11748-016-0722-4

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  • 巨大左房を伴う僧帽弁閉鎖不全症に対し、僧帽弁形成術を施行した1例

    阿賀 健一郎, 内田 敬二, 高橋 大志, 小林 由幸, 伏見 謙一, 出渕 亮, 齋藤 文美恵, 笠間 啓一郎, 軽部 義久, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 173回 )   8 - 8   2017.3

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  • 急性A型解離に対する上行弓部置換術後早期に、下行残存解離の破裂を来した一例

    富田 啓人, 内田 敬二, 輕部 義久, 笠間 啓一郎, 出淵 亮, 伏見 謙一, 齋藤 文美恵, 阿賀 健一郎, 小林 由幸, 高橋 大志, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 173回 )   33 - 33   2017.3

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  • B型急性解離の治療戦略

    輕部 義久, 内田 敬二, 笠間 啓一郎, 齋藤 文美恵, 出淵 亮, 伏見 謙一, 阿賀 健一郎, 小林 由幸, 高橋 大志, 郷田 素彦, 鈴木 伸一, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   47回   859 - 859   2017.2

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  • Pouch法による右内胸動脈遊離グラフトを用いた回旋枝領域へのACバイパス

    内田 敬二, 輕部 義久, 笠間 啓一郎, 出淵 亨, 伏見 謙一, 齋藤 文美恵, 阿賀 健一郎, 小林 由幸, 高橋 大志, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   47回   67 - 67   2017.2

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  • 70歳以上高齢者に対する基部手術の検討

    伏見 謙一, 内田 敬二, 輕部 義久, 笠間 啓一郎, 出淵 亮, 齋藤 文美恵, 阿賀 健一郎, 小林 由幸, 高橋 大志, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   47回   783 - 783   2017.2

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  • 腹部大動脈瘤に対するステントグラフト内挿術施行後に開腹手術を必要とした症例の検討

    阿賀 健一郎, 内田 敬二, 軽部 義久, 笠間 啓一郎, 齋藤 文美恵, 出渕 亮, 伏見 謙一, 小林 由幸, 高橋 大志, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   47回   685 - 685   2017.2

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  • Evaluation and Influence of Brachiocephalic Branch Re-entry in Patients With Type A Acute Aortic Dissection Reviewed

    Shota Yasuda, Kiyotaka Imoto, Keiji Uchida, Norihisa Karube, Tomoyuki Minami, Motohiko Goda, Shinichi Suzuki, Munetaka Masuda

    CIRCULATION JOURNAL   81 ( 1 )   30 - 35   2017.1

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    DOI： 10.1253/circj.CJ-16-0462

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  • Impact of preoperative dual antiplatelet therapy on bleeding complications in patients with acute coronary syndromes who undergo urgent coronary artery bypass grafting Reviewed

    Zenko Nagashima, Kengo Tsukahara, Keiji Uchida, Kiyoshi Hibi, Norihisa Karube, Toshiaki Ebina, Kiyotaka Imoto, Kazuo Kimura, Satoshi Umemura

    JOURNAL OF CARDIOLOGY   69 ( 1-2 )   156 - 161   2017.1

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    DOI： 10.1016/j.jjcc.2016.02.013

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  • 梅毒性大動脈炎に起因した急性発症の大動脈弁閉鎖不全症の一例

    高橋 大志, 内田 敬二, 輕部 義久, 笠間 啓一郎, 出淵 亮, 伏見 謙一, 阿賀 健一郎, 齋藤 文美恵, 小林 由幸, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 172回 )   9 - 9   2016.11

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  • 多発感染性動脈瘤に対し、ステントグラフト内挿術が奏効した1例

    小林 由幸, 内田 敬二, 輕部 義久, 笠間 啓一郎, 齋藤 文美恵, 出淵 亮, 伏見 謙一, 阿賀 健一郎, 高橋 大志, 安田 章沢, 浦中 康子, 西田 誉浩, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 172回 )   34 - 34   2016.11

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  • 高齢者(75歳以上)に対する心臓大血管手術の適応と工夫 高齢者shaggy aorta症例に対するICP法を用いた大動脈弓部置換術

    内田 敬二, 輕部 義久, 笠間 啓一郎, 出淵 亮, 伏見 謙一, 阿賀 健一郎, 齋藤 文美恵, 小林 由幸, 高橋 大志, 益田 宗孝

    日本臨床外科学会雑誌   77 ( 増刊 )   371 - 371   2016.10

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  • EVAR術後遠隔期に発生した左脚脱落に対し開腹手術を選択した一例

    長 知樹, 軽部 義久, 岩城 秀行, 禹 哲漢, 古波蔵 かおり, 井元 清隆, 内田 敬二, 磯田 晋, 坂本 哲, 益田 宗孝

    日本血管外科学会雑誌   25 ( Suppl. )   451 - 451   2016.6

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  • EVARにおける末梢Landingの位置決めにおけるPitfall 当院で経験した2例からの検討

    出淵 亮, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 笠間 啓一郎, 根本 寛子, 伏見 謙一, 松本 淳, 森田 順也, 益田 宗孝

    日本血管外科学会雑誌   25 ( Suppl. )   460 - 460   2016.6

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  • 逆行性Stanford A型急性大動脈解離に対するステントグラフト治療

    根本 寛子, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 笠間 啓一郎, 出淵 亮, 伏見 謙一, 松本 淳, 森田 順也, 益田 宗孝

    日本血管外科学会雑誌   25 ( Suppl. )   320 - 320   2016.6

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  • A型急性大動脈解離に対するフィブリン糊を用いた冠動脈上再建の遠隔成績

    内田 敬二, 井元 清隆, 磯田 晋, 輕部 義久, 笠間 啓一郎, 出淵 亨, 根本 寛子, 伏見 謙一, 松本 淳, 森田 順也, 鈴木 伸一, 益田 宗孝

    日本血管外科学会雑誌   25 ( Suppl. )   196 - 196   2016.6

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  • 脳梗塞0%を目指して 大動脈弓部置換術におけるIsolated Cerebral Perfusion(ICP)法の検討

    笠間 啓一郎, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 根本 寛子, 伏見 謙一, 出淵 亮, 松本 淳, 森田 順也, 益田 宗孝

    日本血管外科学会雑誌   25 ( Suppl. )   365 - 365   2016.6

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  • 冠動脈-肺動脈瘻の異常血管に冠動脈瘤を合併した一例

    伏見 謙一, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 笠間 啓一郎, 出淵 亮, 根本 寛子, 松本 淳, 森田 順也

    日本胸部外科学会関東甲信越地方会要旨集   ( 171回 )   30 - 30   2016.6

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  • complicated B型急性大動脈解離に対する治療戦略

    輕部 義久, 井元 清隆, 内田 敬二, 磯田 晋, 笠間 啓一郎, 出淵 亮, 根本 寛子, 伏見 謙一, 松本 淳, 森田 順也, 郷田 素彦, 鈴木 伸一, 益田 宗孝

    日本血管外科学会雑誌   25 ( Suppl. )   163 - 163   2016.6

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  • 弓部置換遠位側吻合部仮性瘤破裂にTEVARが奏効した1例

    出淵 亮, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 笠間 啓一郎, 根本 寛子, 伏見 謙一, 松本 淳, 森田 順也, 永島 琢也, 乾 健二, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 171回 )   14 - 14   2016.6

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  • 低体温循環停止を要した外傷性大動脈損傷の一例

    松本 淳, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 笠間 啓一郎, 出淵 亮, 根本 寛子, 伏見 謙一, 森田 順也, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 170回 )   13 - 13   2016.3

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  • 左総頸動脈完全閉塞を伴った急性大動脈解離の1治験例

    出淵 亮, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 笠間 啓一郎, 伏見 謙一, 根本 寛子, 松本 淳, 森田 順也, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 170回 )   12 - 12   2016.3

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  • Subclavian artery aneurysm in a patient with vascular Ehlers-Danlos syndrome Reviewed

    Shota Yasuda, Kiyotaka Imoto, Keiji Uchida, Yasuko Uranaka, Kenji Kurosawa, Munetaka Masuda

    Asian Cardiovascular and Thoracic Annals   24 ( 2 )   187 - 189   2016.2

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    DOI： 10.1177/0218492314553993

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  • 梗塞後心室中隔穿孔に対する経右室サンドイッチ法のシャント残存とパッチサイズの関係

    磯田 晋, 井元 清隆, 内田 敬二, 輕部 義久, 笠間 啓一郎, 根本 寛子, 松本 淳, 森田 順也, 鈴木 伸一, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   46回   OP17 - 4   2016.2

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  • 65歳以上の大動脈基部手術戦略 65歳以上に対する大動脈基部再建術の検討

    笠間 啓一郎, 内田 敬二, 磯田 晋, 輕部 義久, 根本 寛子, 伏見 謙一, 松本 淳, 森田 順也, 井元 清隆, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   46回   PD1 - 4   2016.2

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  • 急性・慢性B型大動脈解離の治療戦略 TEVARの位置付け Aortic remodelingの観点から考慮したB型大動脈解離に対するTEVARの有用性

    輕部 義久, 井元 清隆, 内田 敬二, 磯田 晋, 笠間 啓一郎, 伏見 謙一, 根本 寛子, 松本 淳, 森田 順也, 郷田 素彦, 鈴木 伸一, 益田 宗孝

    日本心臓血管外科学会学術総会抄録集   46回   PR24 - 3   2016.2

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  • Pathophysiology and Surgical Treatment of Type A Acute Aortic Dissection

    Uchida Keiji, Karube Norihisa, Yasuda Shota, Miyamoto Takuma, Matsuki Yusuke, Isoda Susumu, Goda Motohiko, Suzuki Shinichi, Masuda Munetaka, Imoto Kiyotaka

    Annals of Vascular Diseases   9 ( 3 )   160 - 167   2016

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    <p><b>Objectives:</b> We report the pathophysiology and treatment results of type A acute aortic dissection from our 20-year experience. Methods: We studied 673 patients with type A acute aortic dissection who underwent initial treatment from 1994 through July 2014. We divided these patients into two groups. The former group comprised 448 patients from 1994 through 2008, and the latter group comprised 225 patients from 2009 onward, when the current strategy of initial treatment and surgical technique including the early organ reperfusion therapies were established.</p><p><b>Results:</b> Women were significantly often presented than men in patients over 60 years of age. Thrombosed-type dissection accounted for more than half in patients over 70 years, and significantly often complicated pericardial effusion and cardiac tamponade than patent type. Malperfusion occurred in 26% of patients. Central repair operations were performed in 579 patients. In-hospital mortality for all patients was 15%, and for the patients who underwent central repair operations was 10%. Former period of operation, malperfusion, and preoperative cardiopulmonary arrest were significant risk factor of in-hospital death. Preoperative left main trunk (LMT) stents were placed in eight patients and superior mesenteric artery (SMA) intervention was performed in five, they were effective to improve the outcome. From 2009 onward, in-hospital mortality was 5.0% and there was no significant risk factor.</p><p><b>Conclusion:</b> Surgical results of type A acute aortic dissection were dramatically improved in the past 20 years. Early reperfusion strategy for the patients with malperfusion improved the outcomes. (This article is a translation of Jpn J Vasc Surg 2015; 24: 127–134.)</p>

    DOI： 10.3400/avd.oa.16-00075

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  • Heparin-Induced-Thrombocytopenia Causing Massive Aortic Thrombosis after Ascending Aortic Replacement for Type A Acute Aortic Dissection Reviewed

    Yusuke Matsuki, Kiyotaka Imoto, Keiji Uchida, Susumu Isoda, Norihisa Karube, Shota Yasuda, Munetaka Masuda

    ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY   22 ( 5 )   318 - 321   2016

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    DOI： 10.5761/atcs.cr.15-00345

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  • 悪性リンパ腫に胸部・腹部大動脈瘤を合併し、ステントグラフト手術を施行した1例

    森田 順也, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 笠間 啓一郎, 伏見 謙一, 根本 寛子, 松本 淳, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 169回 )   18 - 18   2015.11

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  • 内膜重積を来したStanford A型急性大動脈解離の一例

    松本 淳, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 笠間 啓一郎, 宮本 卓馬, 根本 寛子, 伏見 謙一, 森田 順也, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 169回 )   12 - 12   2015.11

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  • Stanford A型急性大動脈解離に対しTEVARを施行した1例

    根本 寛子, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 宮本 卓馬, 松木 佑介, 富永 訓央, 山崎 春彦, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 168回 )   21 - 21   2015.6

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  • Debranching TEVARに総腸骨動脈破裂、A型急性解離を合併した1例

    山崎 春彦, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 宮本 卓馬, 松木 佑介, 富永 訓央, 根本 寛子, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 168回 )   21 - 21   2015.6

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  • EVAR術後遠隔期にopen repairを要した症例の検討

    安田 章沢, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 宮本 卓馬, 松木 佑介, 富永 訓央, 根本 寛子, 山崎 晴彦, 益田 宗孝

    日本血管外科学会雑誌   24 ( 3 )   385 - 385   2015.5

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  • 抗凝固療法・抗血小板療法がEVAR後の瘤径変化に及ぼす影響

    富永 訓央, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 安田 章沢, 宮本 卓馬, 松木 佑介, 根本 寛子, 益田 宗孝

    日本血管外科学会雑誌   24 ( 3 )   466 - 466   2015.5

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  • 高齢者(80歳以上)のA型急性大動脈解離の治療成績

    松木 佑介, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 安田 章沢, 宮本 卓馬, 富永 訓央, 根本 寛子, 山崎 春彦, 益田 宗孝

    日本血管外科学会雑誌   24 ( 3 )   519 - 519   2015.5

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  • TEVAR後再手術症例の検討

    輕部 義久, 井元 清隆, 内田 敬二, 磯田 晋, 安田 章沢, 宮本 卓馬, 松木 佑介, 富永 訓央, 根本 寛子, 山崎 春彦, 益田 宗孝

    日本血管外科学会雑誌   24 ( 3 )   373 - 373   2015.5

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  • 術後Abdominal compartment syndrome予防のため、Open managementにより二期的閉腹を施行した破裂性腹部大動脈瘤の3症例

    根本 寛子, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 安田 章沢, 宮本 卓馬, 松木 佑介, 富永 訓央, 山崎 春彦, 益田 宗孝

    日本血管外科学会雑誌   24 ( 3 )   472 - 472   2015.5

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  • A型解離における頸部分枝解離の評価と上行置換術後弓部偽腔開存に及ぼす影響

    安田 章沢, 井元 清隆, 内田 敬二, 輕部 義久, 磯田 晋, 宮本 卓馬, 松木 佑介, 富永 訓央, 根本 寛子, 増田 晴彦, 益田 宗孝

    日本心臓血管外科学会雑誌   44 ( 3 )   xvii - xix   2015.5

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  • 機械弁血栓弁に対し血栓溶解療法を施行した2症例

    富永 訓央, 井元 清隆, 内田 敬二, 磯田 晋, 軽部 義久, 安田 章沢, 宮本 卓馬, 松木 佑介, 根本 寛子, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 167回 )   7 - 7   2015.3

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  • 右椎骨動脈低形成合併のdebranched TEVAR術後人工血管感染に対し左椎骨-左総頸動脈吻合を施行した1例

    根本 寛子, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 安田 章沢, 宮本 卓馬, 松木 佑介, 富永 訓央, 山崎 春彦, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 167回 )   20 - 20   2015.3

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  • 下行大動脈浸潤が疑われた左下葉肺癌に対し大動脈ステント内挿術後、左肺全摘術を施行した1例

    菅野 健児, 永島 琢也, 椎野 王久, 乾 健二, 富永 訓央, 根本 寛子, 松木 佑介, 宮本 卓馬, 安田 章沢, 安恒 亨, 輕部 義久, 磯田 晋, 内田 敬二, 井元 清隆, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 167回 )   27 - 27   2015.3

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  • 破裂性腹部大動脈瘤に対する開腹手術の成績

    内田 敬二, 井元 清隆, 磯田 晋, 輕部 義久, 安田 章沢, 宮本 卓馬, 松木 佑介, 富永 訓央, 根本 寛子, 増田 晴彦, 益田 宗孝

    日本心臓血管外科学会雑誌   44 ( Suppl. )   284 - 284   2015.1

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  • TEVAR時代の急性B型解離の治療戦略

    軽部 義久, 井元 清隆, 内田 敬二, 磯田 晋, 安田 章沢, 宮本 卓馬, 松木 佑介, 根本 寛子, 富永 訓央, 増田 晴彦, 鈴木 伸一, 益田 宗孝

    日本心臓血管外科学会雑誌   44 ( Suppl. )   180 - 180   2015.1

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  • A型解離における頸部分枝解離の評価と上行置換術後弓部偽腔開存に及ぼす影響

    安田 章沢, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 宮本 卓馬, 松木 佑介, 富永 訓央, 根本 寛子, 増田 晴彦, 益田 宗孝

    日本心臓血管外科学会雑誌   44 ( Suppl. )   186 - 186   2015.1

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  • 急性心筋梗塞後心室中隔穿孔に対する経右室サンドイッチ法の成績

    磯田 晋, 井元 清隆, 内田 敬二, 輕部 義久, 安田 章沢, 宮本 卓馬, 松木 祐介, 根本 寛子, 富永 訓央, 増田 晴彦, 鈴木 伸一, 益田 宗孝

    日本心臓血管外科学会雑誌   44 ( Suppl. )   262 - 262   2015.1

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  • SJM rigid saddle ringを用いた僧帽弁形成術の中期成績の検討

    宮本 卓馬, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 安田 章沢, 松木 佑介, 富永 訓央, 根本 寛子, 増田 晴彦, 益田 宗孝

    日本心臓血管外科学会雑誌   44 ( Suppl. )   452 - 452   2015.1

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  • Stanford A型急性大動脈解離の緊急手術症例における術前DIC

    根本 寛子, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 安田 章沢, 宮本 卓馬, 松木 佑介, 富永 訓央, 増田 晴彦, 益田 宗孝

    日本心臓血管外科学会雑誌   44 ( Suppl. )   337 - 337   2015.1

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  • 腹部大動脈瘤に対するステントグラフト内挿術後の瘤径変化の検討

    富永 訓央, 井元 清隆, 内田 敬二, 磯田 晋, 軽部 義久, 安田 章沢, 宮本 卓馬, 松木 佑介, 根本 寛子, 益田 宗孝

    日本心臓血管外科学会雑誌   44 ( Suppl. )   263 - 263   2015.1

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  • Pathophysiology and Surgical Treatment of Type A Acute Aortic Dissection

    Uchida Keiji, Karube Norihisa, Yasuda Shota, Miyamoto Takuma, Matsuki Yusuke, Isoda Susumu, Goda Motohiko, Suzuki Shinichi, Masuda Munetaka, Imoto Kiyotaka

    Jpn. J. Vasc. Surg.   24 ( 3 )   127 - 134   2015

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    <b>Objectives</b>: We report the pathophysiology and treatment results of type A acute aortic dissection from our 20-year experience. <b>Methods</b>: We studied 673 patients with type A acute aortic dissection who underwent initial treatment from 1994 through July 2014. We divided these patients into two groups. The former group comprised 448 patients from 1994 through 2008, and the latter group comprised 225 patients from 2009 onward, when the current strategy of initial treatment and surgical technique including the early organ reperfusion therapies were established. <b>Results</b>: Women were significantly often presented than men in patients over 60 years of age. Thrombosed type dissection accounted for more than half in patients over 70 years, and significantly often complicated pericardial effusion and cardiac tamponade than patent type. Malperfusion occurred in 26% of patients. Central repair operations were performed in 579 patients. In-hospital mortality for all patients was 15%, and for the patients who underwent central repair operations was 10%. Former period of operation, malperfusion, and preoperative cardiopulmonary arrest were significant risk factor of in-hospital death. Preoperative LMT stents were placed in 8 patients and SMA intervention was performed in 5, they were effective to improve the outcome. From 2009 onward, in-hospital mortality was 5.0% and there was no significant risk factor. <b>Conclusion</b>: Surgical results of type A acute aortic dissection were dramatically improved in past 20 years. Early reperfusion strategy for the patients with malperfusion improved the outcomes.

    DOI： 10.11401/jsvs.15-00005

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    Other Link： http://search.jamas.or.jp/link/ui/2015267088

  • 重症僧帽弁閉鎖不全症を伴った閉塞性肥大型心筋症患者に左室流出路心筋切除術を施行した1例

    富永 訓央, 井元 清隆, 内田 敬二, 磯田 晋, 軽部 義久, 安田 章沢, 宮本 卓馬, 松木 佑介, 根本 寛子, 増田 晴彦

    日本胸部外科学会関東甲信越地方会要旨集   ( 166回 )   14 - 14   2014.11

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  • 肺血管抵抗上昇と右心機能低下を伴った僧帽弁閉鎖不全症の1例

    根本 寛子, 井元 清隆, 内田 敬二, 磯田 晋, 輕部 義久, 安田 章沢, 宮本 卓馬, 松木 佑介, 富永 訓央, 増田 晴彦, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 166回 )   13 - 13   2014.11

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  • 緊急冠動脈バイパスグラフト術を施行された急性冠症候群患者の術前P2Y12阻害薬使用と周術期出血量の関係

    永嶋 善幸, 塚原 健吾, 内田 敬二, 日比 潔, 海老名 俊明, 井元 清隆, 木村 一雄

    日本冠疾患学会雑誌   19 ( Suppl. )   206 - 206   2013.12

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  • Risk analysis and improvement of strategies in patients who have acute type A aortic dissection with coronary artery dissection Reviewed

    Kiyotaka Imoto, Keiji Uchida, Norihisa Karube, Toru Yasutsune, Tonoki Cho, Kazuo Kimura, Munetaka Masuda, Satoshi Morita

    EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY   44 ( 3 )   419 - 424   2013.9

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    DOI： 10.1093/ejcts/ezt060

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  • 僧帽弁前尖逸脱症に合併した心室頻拍の一例

    内山 護, 井元 清隆, 内田 敬二, 輕部 義久, 安恒 亨, 長 知樹, 梅田 悦嗣, 合田 真海, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 162回 )   24 - 24   2013.6

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  • 巨大冠動脈瘤に対して手術を行った一例

    合田 真海, 井元 清隆, 内田 敬二, 軽部 義久, 安恒 亨, 長 知樹, 梅田 悦嗣, 内山 護, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 162回 )   16 - 16   2013.6

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  • 急性・慢性B型解離における治療戦略の進歩 TEVARの位置づけ B型急性大動脈解離における治療戦略の進歩 TEVARの位置づけ

    輕部 義久, 井元 清隆, 内田 敬二, 安恒 亨, 長 知樹, 梅田 悦嗣, 合田 真海, 内山 護, 益田 宗孝

    日本血管外科学会雑誌   22 ( 2 )   200 - 200   2013.4

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  • IFU遵守の有無から検討したEVARの中期成績

    長 知樹, 井元 清隆, 内田 敬二, 軽部 義久, 安恒 亨, 梅田 悦嗣, 合田 真海, 内山 護, 益田 宗孝

    日本血管外科学会雑誌   22 ( 2 )   410 - 410   2013.4

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  • 当院における孤立性腸骨動脈瘤の検討

    長 知樹, 井元 清隆, 内田 敬二, 軽部 義久, 安恒 亨, 梅田 悦嗣, 合田 真海, 内山 護, 益田 宗孝

    日本血管外科学会雑誌   22 ( 2 )   296 - 296   2013.4

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  • たこつぼ型心筋症による心室中隔穿孔に対する一手術例

    内山 護, 井元 清隆, 内田 敬二, 輕部 義久, 安恒 亨, 長 知樹, 梅田 悦嗣, 合田 真海, 益田 宗孝

    日本胸部外科学会関東甲信越地方会要旨集   ( 161回 )   15 - 15   2013.3

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  • A CASE REPORT OF AORTOPULMONARY FISTULA CAUSED BY RUPTURE OF AN AORTIC ARCH ANEURYSM

    SHIRAI Junya, IMOTO Kiyotaka, UCHIDA Keiji, MINAMI Tomoyuki, YASUDA Shouta, MASUDA Munetaka

    The journal of the Japanese Practical Surgeon Society   73 ( 12 )   3086 - 3090   2012.12

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    Language：Japanese   Publisher：Japan Surgical Association  

    An 81-year-old man was scheduled to undergo surgery for an aortic arch aneurysm. The patient was admitted to a local hospital because of congestive heart failure. Computed tomography showed an aortopulmonary fistula due to an aortic arch aneurysm. The patient was therefore transferred to our hospital for undergoing total arch replacement with closure of the fistula and coronary artery bypass grafting (AO-SVG-#4PD). It was difficult to maintain circulation during the cardiopulmonary bypass because of an aortopulmonary shunt. The patient required percutaneous cardiopulmonary support for 2 days and was discharged 49 days after the operation. Aortopulmonary fistula is a rare, potentially fatal condition that can lead to death because of right heart failure.

    DOI： 10.3919/jjsa.73.3086

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  • Distal Aortic Perfusion and Cerebrospinal Fluid Drainage for Thoracoabdominal Aortic Repair Reviewed

    Shinichi Suzuki, Kiyotaka Imoto, Keiji Uchida, Kensuke Kobayashi, Kouichiro Date, Motohiko Gouda, Toshiki Hatsune, Makoto Okiyama, Takayuki Kosuge, Yutaka Toyoda, Munetaka Masuda

    ADVANCES IN UNDERSTANDING AORTIC DISEASES   255 - +   2009

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    Language：English   Publishing type：Research paper (international conference proceedings)  

    DOI： 10.1007/978-4-431-99237-0_48

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  • Coronary Artery Bypass Grafting in a Patient with Malignant Rheumatoid Arthritis

    Choh Tomoki, Imoto Kiyotaka, Suzuki Shinichi, Uchida Keiji, Yanagi Hiromasa, Kobayashi Kensuke, Date Kouichirou, Gouda Motohiko, Masuda Munetaka

    Japanese Journal of Cardiovascular Surgery   37 ( 5 )   259 - 263   2008.9

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    Language：Japanese   Publisher：The Japanese Society for Cardiouascular Surgery  

    The patient was a 39-year-old woman. Malignant rheumatoid arthritis was diagnosed when she was 32 years old, and the patient was treated with oral steroids. She presented at our center with sudden precordial pain. Coronary angiography revealed severe stenosis of the left main coronary artery (segment 5,99%). Acute myocardial infarction and pulmonary edema were diagnosed. The patient underwent off-pump coronary-artery bypass grafting, with anastomosis of the left internal thoracic artery to the left anterior descending artery. One year 3 months later, the patient was readmitted to the hospital because of recurrent angina pectoris and heart failure. Coronary angiography showed patency of the left internal thoracic artery and severe stenoses of the left main coronary artery (segment 5,100%), circumflex artery (segment 11,99%), and right coronary artery (segment 1,90%), suggesting angiitis. On-pump coronary-artery bypass grafting was done, with anastomosis of the right internal thoracic artery to the right coronary artery (segment 2) and the gastro-omental artery to the obtuse marginal branch (segment 12). The patient is being followed up on an outpatient basis. There are few reports describing patients with rheumatoid arthritis who underwent coronary artery bypass surgery. However, the most common cause of death in patients with rheumatoid arthritis is coronary-artery disease. Although the patient was still young, coronary-artery disease progressed rapidly. Such rapid progression was attributed to difficulty in controlling the inflammatory response after initial surgery, as well as to changes in vascular endothelial cells caused directly by treatment with steroids. Possible adverse effects of such treatment should be carefully considered.

    DOI： 10.4326/jjcvs.37.259

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    Other Link： http://search.jamas.or.jp/link/ui/2008337375

  • A Case of Intravenous Leiomyomatosis with Intracardiac Progression

    Hirayama Yuko, Imoto Kiyotaka, Suzuki Shinichi, Uchida Keiji, Kobayashi Kensuke, Date Koichiro, Goda Motohiko, Hatsune Toshiki, Okiyama Makoto, Kato Makoto

    Japanese Journal of Cardiovascular Surgery   37 ( 1 )   60 - 64   2008.1

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    A 76-year-old woman presented because of bilateral lower-extremity edema and dyspnea. Transthoracic echocardiography revealed a mobile mass in the right atrium. A right atrial mass associated with heart failure was diagnosed. Surgery was performed. Intraoperative transesophageal echocardiography showed that the mass was contiguous with the inferior vena cava. However, the primary lesion was unclear. Therefore, only the intracardiac mass was resected. The margins of the residual tumor were marked with clips. Computed tomography performed immediately after surgery revealed a clip in structures contiguous with the region from a uterine myoma to the inferior vena cava. Intravenous leiomyomatosis was diagnosed on histopathological examination of the resected specimens. Computed tomography 6 months after surgery showed that the clip had moved from the inferior vena cava to a vein contiguous with the uterus. The tumor regressed slightly. Close follow-up is required. Jpn. J. Cardiovasc. Surg. 37: 60-64 (2008)

    DOI： 10.4326/jjcvs.37.60

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    Other Link： http://search.jamas.or.jp/link/ui/2008109456

  • A Case of Blow-Out Type Cardiac Rupture after Acute Myocardial Infarction

    Goda Motohiko, Imoto Kiyotaka, Suzuki Shinichi, Uchida Keiji, Kobayashi Kensuke, Date Koichiro, Hatsune Toshiki, Okiyama Makoto, Kato Makoto

    J. J. C. V. S.   36 ( 5 )   269 - 272   2007

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    Language：Japanese   Publisher：The Japanese Society for Cardiovascular Surgery  

    A 83-year-old woman suffered pulseless-electrical-activity (PEA) because of cardiac tamponade after acute myocardial infarction with blow-out type cardiac rupture. Immediately median sternotomy was performed and active bleeding from the postero-lateral wall was found. It was impossible to stop bleeding only by putting pressure on the aperture of the myocardium with a piece of TachoComb coated with gelatin-resorcinol-formaldehyde (GRF) glue, however, the chemical action of GRF glue made the delicate myocardium after acute infarction stronger and we managed to stop that bleeding with mattress sutures that had initially seemed to be impossible. She was discharged on POD 103 uneventfully. We think this is a useful and safe operation procedure for blow-out type cardiac rupture.

    DOI： 10.4326/jjcvs.36.269

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  • A Patient Who Underwent Mitral Annuloplasty for Mitral-Valve Insufficiency due to Calcification of the Mitral-Valve Annulus

    Minami Tomoyuki, Imoto Kiyotaka, Suzuki Shin-ichi, Uchida Keiji, Karube Norihisa, Date Koichiro, Goda Motohiko, Hatsune Toshiki, Masuda Munetaka

    J. J. C. V. S.   36 ( 6 )   333 - 336   2007

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    Language：Japanese   Publisher：The Japanese Society for Cardiovascular Surgery  

    A 74-year-old woman presented with shortness of breath. Cardiac ultrasonography showed that left-ventricular-wall motion was good (left ventricular ejection fraction, 70.2%). The left atrium and ventricle were enlarged (left anterior dimension, 53.4mm; left ventricular enddiastolic dimension, 58.5mm). The posterior cusp of the mitral valve was thickened; the flexibility was decreased. Color Doppler ultrasonography revealed a regurgitant jet toward the posterior cusp of the left atrium. However, there was no deviation of the anterior cusp. Severe mitral-valve insufficiency was diagnosed, and surgery was performed. The second heart sound (P2) of the posterior cusp was shortened because of localized calcification of the posterior mitral annulus. This site may have caused the regurgitation. Mitral annuloplasty with rectangular resection of the valve cusps and annulorrhaphy was performed. The patient had an uneventful recovery after surgery. Postoperative cardiac ultrasonography showed that mitral-valve insufficiency had improved and was regarded as trivial. Mitral annuloplasty is generally considered unsuitable for mitral-valve insufficiency with calcification of the valve annulus. In patients such as the present case who have localized calcification, however, mitral annuloplasty can be performed by resection of the valve cusps with annulorrhaphy.

    DOI： 10.4326/jjcvs.36.333

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  • A型急性大動脈解離手術 GRFglueの組織壊死

    鈴木 伸一, 井元 清隆, 内田 敬二, 郷田 素彦, 初音 俊樹, 足立 広幸, 沖山 信, 高梨 吉則

    日本外科学会雑誌   106 ( 臨増 )   160 - 160   2005.4

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  • 当院における大動脈三腔解離の外科治療経験5例の検討

    初音 俊樹, 井元 清隆, 鈴木 伸一, 内田 敬二, 郷田 素彦, 足立 広幸, 沖山 信, 高梨 吉則

    日本心臓血管外科学会雑誌   34 ( Suppl. )   390 - 390   2005.1

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  • ステントグラフトの功罪 経カテーテル的胸部大動脈ステントグラフト(SG)内挿術の功罪 低侵襲性と遠隔予後

    鈴木 伸一, 井元 清隆, 内田 敬二, 郷田 素彦, 正津 晶子, 初音 俊樹, 足立 広幸, 沖山 信, 高梨 吉則

    日本心臓血管外科学会雑誌   34 ( Suppl. )   205 - 205   2005.1

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  • 左前下行枝に吻合した内胸動脈グラフトの流量に関する検討

    郷田 素彦, 井元 清隆, 鈴木 伸一, 内田 敬二, 森 琢磨, 初音 俊樹, 足立 広幸, 沖山 信, 高梨 吉則

    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY   52 ( Suppl. )   406 - 406   2004.9

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  • A型急性大動脈解離 弓部entry症例に対するHemiarch replacement(HAR)の妥当性

    鈴木 伸一, 井元 清隆, 内田 敬二, 森 琢磨, 郷田 素彦, 初音 俊樹, 足立 広幸, 沖山 信, 高梨 吉則

    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY   52 ( Suppl. )   458 - 458   2004.9

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  • Approach for Drainage of Descending Necrotizing Mediastinitis on the Basis of the Extending Progression from Deep Neck Infection to Mediastinitis Reviewed

    Yoshihiro Moriwaki, Mitsugi Sugiyama, Goro Matsuda, Koichiro Date, Norihisa Karube, Keiji Uchida, Toshiro Yamamoto, Satoshi Hasegawa

    Journal of Trauma   53 ( 1 )   112 - 116   2002

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    Language：English   Publishing type：Research paper (scientific journal)  

    DOI： 10.1097/00005373-200207000-00023

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  • Undertriage for Blunt Trauma Victims with Deteriorated Short-term Outcome in An Urban Trauma System.

    Morimura Naoto, Fukuzawa Kuniyasu, Karube Yoshihisa, Uchida Keiji, Yamamoto Toshiro, Anze Masaki, Sugiyama Mitsugi

    Nihon Kyukyu Igakukai Zasshi   12 ( 7 )   350 - 359   2001

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    Language：Japanese   Publisher：Japanese Association for Acute Medicine  

    The practical triage for trauma victims is not organized in Japan yet. To identify the importance of field triage in the city of Yokohama, we studied the influence of undertriage on outcome in seriously blunt trauma victims referred to our advanced trauma center from April 1997 to March 1999. We studied the differences in outcome and inhospital clinical course between patients with an injury severity score (ISS) >15 sent directly from the scene (DT group: n=10) and through interhospital transfer (IT group: n=16). Those two groups showed no difference in age, gender, ISS, revised trauma score (RTS) or abbreviated injury scale (AIS) scores at each injury site. Patients in the IT group who required ICU support experienced relatively longer length (3.7±3.3 vs 9.0±11.2 days, p=0.09) and significantly detrimental outcome estimated as severe disability (SD) on the Glasgow Outcome Scale ((GR or MD)/SD: 8/2 vs 5/11, p=0.04). These results demonstrated that undertriage worsened patient outcome and clinical course. The problem in trauma care will be clarified by further study of undertriage. We should study all trauma incidents, hospital transfer, and outcome in our clinical area in cooperation with the Fire Bureau and establish triage tools as a form of medical control.

    DOI： 10.3893/jjaam.12.350

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  • Prolonged Inflammatory Reaction with Thrombosis in the False Lumen and Edema around the Descending Thoracic Aorta after Endovascular Stent-Graft Repair of Dissecting Aortic Aneurysms

    SUZUKI Shin-ichi, KONDO Jiro, IMOTO Kiyotaka, TOBE Michio, IWAI Yoshio, ICHIKAWA Yukio, ISODA Susumu, UCHIDA Keiji, YAMAZAKI Kazuya, TAKANASHI Yoshinori

    J. J. C. V. S.   29 ( 5 )   326 - 331   2000.9

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    Language：Japanese   Publisher：The Japanese Society for Cardiovascular Surgery  

    The purpose of this study was to consider the cause of the prolonged inflammatory reaction that sometimes appears after endovascular stent-graft repair for dissecting aortic aneurysm. Endovascular stent-grafting was performed in 12 patients (11 men and 1 woman, mean age 60±9.8). Endovascular stent-grafting was indicated to close the entry of type B dissections in 10 patients and to exclude ulcer-like projections (ULP) in 2 patients. On the 7th postoperative day (POD), aortography showed no endoleak in 7 type B cases (A-group), remaining endoleak in 3 type B cases (B-group), and complete exclusion in 2 ULP cases (C-group). The value of FDP-E in the A-group was high on the first POD and then decreased gradually. FDP-E also increased up to the 7th POD in the B-group, and increased very slightly after the operation in the C-group. The values of WBC and CRP increased up to the 3rd POD in all groups, but in the A-group it was still high on the 7th POD. On contrast-enhanced CT performed after the procedure and on the 7th POD, edema (over 10mm in thickness) around the descending thoracic aorta was demonstrated in 5 out of 7 cases in the A-group, but in none of the cases in the B- and C-groups. A segmental atelectasis in the left lung was detected in 6 out of 7 cases in the A-group, but in none of the cases in the Band C-groups. In the A-group, endovascular stent-grafting influenced thrombus formation, and the thickened edema around the descending thoracic aorta and the atelectasis produced in the left lung were prominent more than in the other groups. These results suggest that the Inflammation around aortic wall induced by thrombosis in the false lumen, might contribute to the development of the edema around the descending thoracic aorta and the atelectasis in the left lung. We conclude that the inflammatory reaction might have prolonged the postoperative course in the A-group patients.

    DOI： 10.4326/jjcvs.29.326

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    Other Link： http://search.jamas.or.jp/link/ui/2001039666

  • A Surgically Treated Extrancardiac Aneurysm of the Sinus of Valsalva

    HAMADA Toshiyuki, TOBE Michio, OZAKI Tadashi, UCHIDA Keiji, SATOH Sunao

    J. J. C. V. S.   24 ( 3 )   193 - 196   1995.5

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    The patient was a 43-year-old male who presented with heart murmur. Echocardiography, chest CT, and cardiac catheterization data showed extracardiac extension of an aneurysm of the noncoronary sinus, compressing the right atrium, right ventricular outflow tract, and superior vena cava. Severe aortic regurgitation was also recognized. The aneurysm was incised under extracorporeal circulation. The orifice of the aneurysm was closed, and the elongated annulus of the noncoronary sinus was corrected with woven Dacron patch. Mild aortic regurgitation was shown on postoperative aortogram, and the case is being carefully followed up.

    DOI： 10.4326/jjcvs.24.193

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    Other Link： http://search.jamas.or.jp/link/ui/1996022571

  • Two Surgically Treated Cases of Aneurysm of the Innominate Artery after Surgey for Aortic Aneurysm.

    TOBE Michio, SAKAMOTO Akira, HAMADA Toshiyuki, KUBO Nobuhide, UCHIDA Keiji, SATO Sunao

    J. J. C. V. S.   22 ( 4 )   376 - 379   1993

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    Language：Japanese   Publisher：The Japanese Society for Cardiovascular Surgery  

    Two cases that were surgically treated with atherosclerotic aortic aneurysm, followed by innominate artery aneurysm are reported. The causes of these aneurysms were determined to be arteriosclerosis and idiopathic inflammation. Blood flow reconstruction surgery using grafts was performed on these two patients. In one case, we also employed an internal shunt technique to prevent brain ischemia. It was speculated that this type of aneurysm develops not only in cases of inflammation, but also in multifocal arteriosclerotic vascular diseases. This type of aneurysm will probably increase in the future.

    DOI： 10.4326/jjcvs.22.376

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  • Surgical treatment of ruptured aneurysms of the sinus of Valsalva.

    Uchida K.

    J. J. C. V. S.   20 ( 4 )   813 - 815   1991

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    DOI： 10.4326/jjcvs.20.813

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  • Assisted circulation. Tissue blood flow measurement of skeletal muscle graft for myocardial repair. Experimental study applying a laser flowmeter.:Experimental study applying a laser flowmeter

    Isoda S.

    J. J. C. V. S.   20 ( 5 )   1030 - 1032   1991

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    Language：Japanese   Publisher：The Japanese Society for Cardiovascular Surgery  

    DOI： 10.4326/jjcvs.20.1030

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  • Comparison of intravenous nitroglycerin and phentolamine as vasodilator after cardiac surgery.

    Suzuki S.

    J. J. C. V. S.   20 ( 3 )   588 - 590   1990

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    Language：Japanese   Publisher：The Japanese Society for Cardiovascular Surgery  

    DOI： 10.4326/jjcvs.20.588

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  • Endotoxin levels after cardiac surgery. Comparison between cardiopulmonary bypass and surface induced deep hypothermia.:Comparison between cardiopulmonary bypass and surface induced deep hypothermia

    Kajiwara H.

    J. J. C. V. S.   20 ( 3 )   590 - 592   1990

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    Language：Japanese   Publisher：The Japanese Society for Cardiovascular Surgery  

    DOI： 10.4326/jjcvs.20.590

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Research Projects

  • A型急性大動脈解離発症予防のための大動脈壁プロテオーム解析と疫学的検討

    Grant number：24K11955  2024.4 - 2028.3

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    内田 敬二, 水原 敬洋, 斎藤 綾, 清水 沙友里, 木村 弥生

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    Grant amount：\4420000 （ Direct Cost: \3400000 、 Indirect Cost：\1020000 ）

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  • Establishment of prophylactic treatment for aortic disease form analyzing the mechanism of aortic aneurysmal formation and aortic dissection

    Grant number：17K10761  2017.4 - 2020.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    SUZUKI SHINICHI

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    Grant amount：\4680000 （ Direct Cost: \3600000 、 Indirect Cost：\1080000 ）

    No effective pharmacological therapy to attenuate AAA progression is currently available. We reported that the prostaglandin E receptor EP4 plays roles in AAA progression.
    Here, we show the effect of CJ-42794, a selective EP4 antagonist, on AAA using two mouse models (angiotensin II- and CaCl2-induced AAAs) . CJ-42794 prevented aneurysmal formation of the two mouse models.
    Additionally, in smooth muscle cells isolated from human AAA tissues, stimulation of CJ-42794 inhibited PGE2-induced IL-6 secretion in a dose-dependent manner and decreased PGE2-induced MMP-2 activity. These data suggest that inhibition of EP4 has the potential to be a pharmacological strategy for attenuation of AAA progression.

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  • Integrated analysis followed by establishment of treatment strategy of Aortic aneurysm using genetic analysis and its derivatives.

    Grant number：26462114  2014.4 - 2017.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    MASUDA Munetaka

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    Grant amount：\4940000 （ Direct Cost: \3800000 、 Indirect Cost：\1140000 ）

    ① Basic research:MYH11 chosen as a possible gene for aneurysm formation in human being using human aneurysm tissue by genetic analysis. . Proteomics analysis of human aneurysmal tissue revealed MYH11 is a useful biomarker of aneurysm formation and a useful predictor of atherosclerosis in human being.
    ② Clinical research:We revealed characteristics of patients with acute type A dissection of the aorta, and showed recent progress of surgical outcome of acute type A dissection in Japan. Impact of re-entry at the brachiocephalic artery after surgical repair on its prognosis evaluated. Various improvement of diagnosis tools and surgical technique reported.

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  • Clinical analysis of the elastic desmoplasia abnormality in the aortic disease

    Grant number：25462165  2013.4 - 2016.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    SUZUKI Shinichi, MASUDA Munetaka, IMOTO Kiyotaka, UCHIDA Keiji, YOKOYAMA Utako

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    Grant amount：\4940000 （ Direct Cost: \3800000 、 Indirect Cost：\1140000 ）

    The purpose of the study is to produce the first drug which is able to inhibit aneurysmal formation. In human tissue samples obtained from AAA(abdominal aortic aneurysm) sugery, we found that EP4 expression and elastic fiber degradation were both enhanced in the aneurismal area relative to that in the normal area. When human AAA smooth muscle cells (hAAASMCs) were stimulated by PGE, antagonist EP4 , or PGE+antagonist EP4, IL-6, MMP or other protease were detected from hAAASMCs, which suggested signal of PGE-EP4 might play a role to aneurysmal formation. Value of a protein which has been found in blood was decreased after endovascular therapy and reduced size of AAA in AAA patients. The protein might be one of biomarker of aortic aneurysm. We already applied for a patent of the biomarker.

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  • Clinical analysis of the responsibility gene in the aortic aneurysm outbreak aiming at an early operation and the prevention

    Grant number：23592045  2011 - 2013

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    MASUDA MUNETAKA, MATSUMOTO Naomichi, SUZUKI Shinichi, IMOTO Kiyotaka, UCHIDA Keiji

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    Grant amount：\5200000 （ Direct Cost: \4000000 、 Indirect Cost：\1200000 ）

    This study analyzes the abnormality of the responsibility gene cluster of the Mendel hereditary disease to bring about a dissociative aortic aneurysm and a genuine aortic aneurysm with high probability and is intended that I clarify a genotype and the love poem of clinical manifestations (canceration, dissociation and cancer explosion). Using this love poem, I switch it to the custom tailoring treatment that they put together in the risk that the genotype of individual cases shows the decision of the treatment policy to, and I establish the adaptation of the operation in the early stage that is low aggressions such as the stent graft interpolation art, and the death rate is high, and medical expenses aim at the evasion of the large amount of emergency surgery. In addition, I examine the clinical effects such as angiotensin receptor repressors and am intended to contribute to medical expenses reduction.

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  • Study of elastic fiber dysplasia on aortic aneurysm outbreak aiming at tailor-made medicine.

    Grant number：22591549  2010 - 2012

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    SUZUKI Shinichi, MASUDA Munetaka, IMOTO Kiyotaka, UCHIDA Keiji, YOKOYAMA Utako

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    Grant amount：\4420000 （ Direct Cost: \3400000 、 Indirect Cost：\1020000 ）

    Aortic aneurysm is a common but life-threatening disease among the elderly, for which no effective medical therapy is currently available. Activation of prostaglandin E2 (PGE2) is known to increase the expression of matrix metalloproteinase (MMP) and may thus exacerbate abdominal aortic aneurism (AAA) formation. An EP4 antagonist that prevents the activation of MMP and thereby the degeneration of aortic elastic fiber may serve as a new strategy for medical treatment of AAA.

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