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OKADA Kenji
Graduate School of Medicine / Faculty of Medical Sciences
Professor

Researcher basic information

■ Research Keyword
  • cardiovascular surgery
■ Research Areas
  • Life sciences / Cardiovascular surgery / research for cardiovascular surgry
■ Committee History
  • 2020 - Present, 日本血管外科学会, 理事
  • 2020 - Present, 日本心臓血管外科学会, 理事，国際会員
  • 2020 - Present, 日本循環器学会, 社員
  • 日本冠動脈外科学会, 評議員
  • 日本外科学会, 代議員
  • 関西胸部外科学会, 理事
  • Destination Therapy(DT)研究会, 世話人
  • 日本血管外科学会近畿地方会, 代表世話人
  • American Association for Thoracic Surgery, active member
  • 大動脈解離シンポジウム, 幹事
  • European Association for Cardio-Thoracic Surgery, active member
  • The Asian Society for Cardiovascular and Thoracic Surgery, active member
  • 日本大動脈外科研究会, 常任世話人
  • 日本臨床補助人工心臓研究会（JACVAS）, 世話人
  • 日本人工臓器学会, 評議員
  • 日本冠疾患学会, 評議員，FJCA
  • 日本胸部外科学会, 評議員

Research activity information

■ Award
  • 2007 日本心臓血管外科学会, 第37回日本心臓血管外科学会 最優秀演題, 感染性心内膜炎、大動脈炎症候群によるLV-Ao discontinuityに対する大動脈基部再建術
    Okada Kenji

  • 2002 日本心臓財団, 第28回日本心臓財団研究奨励金賞, 移植後冠動脈硬化症進展におけるPPAR-γの意義
    Okada Kenji

  • Nov. 1999 72nd Scientific Sessions of American Heart Association, Counand and Comroe Young Investigator Award, Council on Cardiopulmonary and Critical Care
    Okada Kenji

■ Paper
  • Masato Ogawa, Seimi Satomi-Kobayashi, Naofumi Yoshida, Kodai Komaki, Takumi Hirabayashi, Kumiko Wakida, Saori Saitoh, Takeshi Inoue, Tomoya Yamashita, Yoshitada Sakai, Michiko Takahashi, Kenji Okada, Ken-ichi Hirata
    Elsevier BV, Dec. 2024, Clinical Nutrition
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Taishi Inoue, Takuo Emoto, Katsuhiro Yamanaka, Shunya Chomei, Shunsuke Miyahara, Hiroaki Takahashi, Ryohei Shinohara, Takeshi Kondo, Masayuki Taniguchi, Tomoyuki Furuyashiki, Tomoya Yamashita, Ken-Ichi Hirata, Kenji Okada
    There is no treatment for acute aortic dissection (AAD) targeting inflammatory cells. We aimed to identify the new therapeutic targets associated with inflammatory cells. We characterized the specific distribution of myeloid cells of both human type A AAD samples and a murine AAD model generated using angiotensin II (ANGII) and β-aminopropionitrile (BAPN) by single-cell RNA sequencing (scRNA-seq). We also examined the effect of an anti-interleukin-1β (IL-1β) antibody in the murine AAD model. IL1B+ inflammatory macrophages and classical monocytes were increased in human AAD samples. Trajectory analysis demonstrated that IL1B+ inflammatory macrophages differentiated from S100A8/9/12+ classical monocytes uniquely observed in the aorta of AAD. We found increased infiltration of neutrophils and monocytes with the expression of inflammatory cytokines in the aorta and accumulation of inflammatory macrophages before the onset of macroscopic AAD in the murine AAD model. In blocking experiments using an anti-IL-1β antibody, it improved survival of murine AAD model by preventing elastin degradation. We observed the accumulation of inflammatory macrophages expressing IL-1β in both human AAD samples and in a murine AAD model. Anti-IL-1β antibody could improve the mortality rate in mice, suggesting that it may be a treatment option for AAD.
    Jun. 2024, Scientific reports, 14(1) (1), 14893 - 14893, English, International magazine
    Scientific journal

  • Masato Ogawa, Seimi Satomi-Kobayashi, Mari Hamaguchi, Kodai Komaki, Hifumi Kusu, Kazuhiro P. Izawa, Shunsuke Miyahara, Yoshitada Sakai, Ken-ichi Hirata, Kenji Okada
    Elsevier BV, Feb. 2024, JTCVS Open
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • 血管疾患のゲノム、トランスクリプトーム解析 シングルセル解析を用いた、免疫をターゲットとした大動脈解離治療法開発
    江本 拓央, 井上 大志, 山中 勝弘, 山下 智也, 岡田 健次, 平田 健一
    (一社)日本脈管学会, Oct. 2023, 脈管学, 63(Suppl.) (Suppl.), S124 - S124, Japanese

  • 井上 大志, 大村 篤史, 中井 秀和, 阪口 和憲, 岡田 翼, 白木 宏長, 岩橋 大輔, 長谷川 翔太, 長命 俊也, 濱口 真里, 河野 敦則, 辻本 貴紀, 村上 優, 幸田 陽次郎, 山中 勝弘, 井上 武, 岡田 健次, 長谷川 寛, 中村 哲, 掛地 吉弘
    兵庫県外科医会, Mar. 2023, 兵庫県外科医会会誌, 57, 42 - 45, Japanese

  • 元津 倫幸, 山口 雅人, 松代 啓吾, 佐々木 康二, 上嶋 英介, 岡田 卓也, 杉本 幸司, 村上 卓道, 中井 秀和, 山中 勝弘, 岡田 健次, 川崎 竜太
    (一社)日本インターベンショナルラジオロジー学会, Feb. 2023, 日本インターベンショナルラジオロジー学会雑誌, 37(1) (1), 2 - 12, Japanese

  • Type 2 endoleakの抑制を目的とした腹部大動脈瘤に対するEndurantを用いたEVAR前の分枝塞栓術に関する多施設共同前向き臨床研究
    元津 倫幸, 山口 雅人, 佐々木 康二, 幸田 陽次郎, 宮原 俊介, 山中 勝弘, 高橋 宏明, 野村 佳克, 林 太郎, 後竹 康子, 岡田 健次
    (NPO)日本血管外科学会, 2023, 日本血管外科学会雑誌, 32(Suppl.) (Suppl.), O14 - 1, Japanese

  • Daiki Kitano, Hiroaki Takahashi, Tadashi Nomura, Kenji Okada, Hiroto Terashi, Shunsuke Sakakibara
    INTRODUCTION: Post-sternotomy surgical site infection (SSI) is a serious complication of cardiovascular surgery. Here, we proposed a new clinical classification and reconstructive strategy for this condition. METHODS: A retrospective study based on medical records was performed on 100 consecutive cases requiring wound management by plastic surgeons for post-sternotomy SSI at Kobe University Hospital between January 2009 and December 2021. We classified 100 cases into four categories according to the anatomical invasiveness of the infection (type 1, superficial SSI; type 2, sternal osteomyelitis; type 3, mediastinitis; and type 4, aortic graft infection). The standard treatment plan comprised initial debridement, negative pressure wound therapy with continuous irrigation, and reconstructive surgery. Reconstructive methods and their outcomes (in-hospital mortality rate, follow-up period, and infection recurrence rate) were investigated for each SSI category. RESULTS: There were nine SSI cases in type 1, 28 in type 2, 25 in type 3, and 38 in type 4. The pectoralis major (PM) muscle advancement flap was mainly selected in types 1 and 2 (100 and 70.4%, respectively), while the omental flap or latissimus dorsi (LD) myocutaneous flaps were mainly selected in types 3 and 4 (77.3 and 81.8%, respectively) for reconstructive surgery. The in-hospital mortality rates for types 1, 2, 3, 4 were 44.4, 3.6, 12.0, and 15.8%, respectively. The mean follow-up periods for types 1, 2, 3, 4 were 542.8, 1514.5, 1154.5, and 831.1 days, respectively. Infection recurrence rates for types 1, 2, 3, 4 were 0, 11.5, 13.3, and 19.2%, respectively. All of these recurrent cases, except for 4 cases of type 4 that required surgical intervention, were treated with conservative wound management. CONCLUSION: A volume-rich flap (omental or LD flap) was required to fill the dead space after debridement in mediastinitis (type 3) or aortic graft infection (type 4), whereas superficial SSI (type 1) or sternal osteomyelitis (type 2) received a less-invasive flap (PM muscle advancement flap). Our new classification method was based on the anatomical invasiveness of the infection, providing both a simple and easy diagnosis and definitive treatment strategy.
    Dec. 2022, Regenerative therapy, 21, 519 - 526, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Ryohei Shinohara, Hitomi Nakashima, Takuo Emoto, Tomoya Yamashita, Yoshihiro Saito, Naofumi Yoshida, Taishi Inoue, Katsuhiro Yamanaka, Kenji Okada, Ken-Ichi Hirata
    BACKGROUND: Abdominal aortic aneurysm (AAA) is a life-threatening cardiovascular disease characterized by dilated abdominal aorta. Immune cells have been shown to contribute to the development of AAA, and that the gut microbiota is associated with numerous diseases, including cardiovascular diseases, by regulating immune systems or metabolic pathways of the host. However, the interaction between the gut microbiota and AAA remains unknown. METHODS: Apolipoprotein E-deficient male mice were fed a high-cholesterol diet and divided into three groups: the control group was maintained under normal water (control group), the oral AVNM group was maintained under drinking water supplemented with ampicillin, vancomycin, neomycin, and metronidazole, and the i.p. AVNM group was injected AVNM intraperitoneally. After 1 week of pretreatment with antibiotics, these mice were administrated Ang II via subcutaneous osmotic pumps for 4 weeks and euthanized to evaluate AAA formation. RESULTS: Depletion of gut microbiota by oral AVNM ameliorated the incidence of AAAs (control group: 58.9% versus oral AVNM group: 28.6% versus i.p. AVNM group: 75.0%, P = 0.0005) and prevented death due to ruptured aneurysms (control group: 11% versus oral AVNM group: 0% versus i.p. AVNM group: 15%). Oral AVNM suppressed monocyte storage in the spleen, but not in other organs. Despite possessing a higher level of cholesterol, recruitment of monocytes into the suprarenal aorta was suppressed in the oral AVNM group. In AVNM drinking mice, NOD1 ligand, a kind of PRR ligands, increased the development of AAAs and accumulation of macrophages in the aortae. CONCLUSIONS: The gut microbiota plays a critical role in AAA formation. Therefore, regulation of the microbiota or the immune system can be a therapeutic approach for AAA.
    Dec. 2022, Hypertension (Dallas, Tex. : 1979), 79(12) (12), 2821 - 2829, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Takanori Tsujimoto, Takeo Tedoriya, Yasushi Yamauchi, Yutaka Okita, Kenji Okada
    BACKGROUND: Three-dimensional aortic root evaluation using virtual reality (VR) techniques for valve-sparing aortic root replacement (VSARR) preparation has not yet been implemented, so we demonstrated VR computed tomography (VR-CT) and assessed its utility for VSARR.Methods and Results: We enrolled 72 patients who underwent multidetector CT before elective VSARR for annuloaortic ectasia with tricuspid aortic valve. The geometries of their aortic roots were measured with a VR-CT workstation. The mean values of geometric height (GH), free margin length (FML), and commissural height (CH) were 17.2±2.4 mm, 36.0±5.2 mm, and 24.0±4.3 mm, respectively. The right coronary/noncoronary CH was significantly greater than the left coronary/right coronary and left coronary/noncoronary CH. The left coronary cusp had the shortest FML, intercommissural distances (ICD), and smallest central angle. Although the right coronary cusp had the largest values for FML, ICD, and central angle, the right coronary cusp had the lowest GH and EH. The VR-CT measurements strongly correlated with intraoperative alternatives, especially with mean GH (R2=0.75) and left coronary/noncoronary CH (R2=0.79). Furthermore, mean GH was observed to be significantly different among the selected graft size groups; therefore, the preoperative mean GH could play a significant role in graft sizing. CONCLUSIONS: VR-CT evaluation allows a thorough understanding of aortic root anatomy, which could facilitate VSAAR.
    Oct. 2022, Circulation journal : official journal of the Japanese Circulation Society, English, Domestic magazine
    [Refereed]
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Masato Ogawa, Seimi Satomi-Kobayashi, Mari Hamaguchi, Kodai Komaki, Kazuhiro P Izawa, Shunsuke Miyahara, Takeshi Inoue, Yoshitada Sakai, Ken-ichi Hirata, Kenji Okada
    Abstract Aims Post-extubation dysphagia (PED), an often overlooked problem, is a common and serious complication associated with mortality and major morbidity after cardiovascular surgery. Dysphagia is considered an age-related disease, and evaluating its long-term effects is a pressing issue with rapidly progressing ageing worldwide. Therefore, we examined the effect of PED on functional status and long-term cardiovascular events in patients undergoing cardiovascular surgery. Methods and results This single-centre, retrospective cohort study included 712 patients who underwent elective cardiovascular surgery and met the inclusion criteria. Patients were divided into PED and non-PED groups based on their post-operative swallowing status. The swallowing status was assessed using the Food Intake Level Scale. Functional status was evaluated as hospital-associated disability (HAD), defined as a decrease in activities of daily living after hospital discharge compared with preoperative values. The patients were subsequently followed up to detect major adverse cardiac and cerebrovascular events (MACCEs). Post-extubation dysphagia was present in 23% of the 712 patients and was independently associated with HAD (adjusted odds ratio, 2.70). Over a 3.5-year median follow-up period, MACCE occurred in 14.1% of patients. Multivariate Cox proportional hazard analysis revealed HAD to be independently associated with an increased risk of MACCE (adjusted hazard ratio, 1.85), although PED was not significantly associated with MACCE. Conclusion Post-extubation dysphagia was an independent HAD predictor, with the odds of HAD occurrence being increased by 2.7-fold due to PED. Hospital-associated disability accompanied by PED is a powerful predictor of poor prognosis. Perioperative evaluation and management of the swallowing status, and appropriate therapeutic interventions, are warranted.
    Oxford University Press (OUP), Sep. 2022, European Journal of Cardiovascular Nursing, 22(6) (6), 602 - 609
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Yojiro Koda, Katsuhiro Yamanaka, Atsushi Omura, Tomoyuki Gentsu, Masato Yamaguchi, Kenji Okada
    Spinal cord ischemia (SCI) after endovascular abdominal aortic aneurysm repair is a rare but devastating complication. Occlusion of the artery of Adamkiewicz or feeders to the collateral network for spinal cord circulation (such as the subclavian, intercostal, lumbar, and internal iliac arteries) is associated with the onset of SCI. We present a case of monoplegia owing to SCI after elective endovascular abdominal aortic aneurysm repair with coil embolization of the left internal iliac artery in an elderly patient with a history of arteriosclerosis obliterans and aortic dissection, preoperatively occluding multiple intercostal arteries and the right internal iliac artery.
    Sep. 2022, Journal of vascular surgery cases and innovative techniques, 8(3) (3), 447 - 449, English, International magazine
    Link to Kobe Univ. Repository (Kernel)

  • Kenichi Yanaka, Kazuhiko Nakayama, Yu Taniguchi, Hiroyuki Onishi, Yoichiro Matsuoka, Hidekazu Nakai, Kenji Okada, Toshiro Shinke, Noriaki Emoto, Ken-Ichi Hirata
    BACKGROUND: Right ventricular (RV) afterload is widely assessed by pulmonary vascular resistance (PVR). However, RV afterload is underestimated because PVR does not account for the pulsatile load. The pulsatile load is often evaluated by pulmonary arterial compliance (PAC). The RC (resistance-compliance) time, which is calculated from the product of PVR and PAC, is considered to remain constant under medical therapy. However, little is known on how RC time is affected by invasive therapy in chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed to evaluate change of RC time in patients underwent pulmonary endarterectomy (PEA). Furthermore, we investigated the clinical relevance of RC time. METHODS: We reviewed consecutive 50 patients except for death case underwent PEA. Baseline clinical parameters including RC time before performing PEA and follow-up were evaluated. Patients was classified as decrease or non-decrease according to change of RC time. Furthermore, we classified patients into a NYHA I group who had no symptom after treatment and a residual symptom group in order to investigate the relationship of RC time to residual symptoms. RESULTS: RC time was significantly decreased after PEA (0.54 ± 0.16 to 0.45 ± 0.12 sec, p < 0.001). Residual symptom after PEA of Decrease group were significantly better than that of Non-decrease group in RC time (12 patients, 40% vs. 11 patients, 78.6%, p < 0.02). Furthermore, multivariate analysis revealed that only RC time after PEA was independently associated with residual symptom (OR 1.026, 95% CI 1.005-1.048; p = 0.017). CONCLUSIONS: RC time was decreased after PEA, and might be a possible indicator for predicting PEA success.
    Jun. 2022, International journal of cardiology. Heart & vasculature, 40, 101031 - 101031, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • 腹部大動脈ステントグラフト留置術後早期に腹部大動脈十二指腸瘻を来した一例
    井上 大志, 大村 篤史, 中井 秀和, 長命 俊也, 濱口 真里, 河野 敦則, 辻本 貴紀, 村上 優, 幸田 陽次郎, 山中 勝弘, 井上 武, 岡田 健次, 長谷川 寛, 掛地 吉弘
    兵庫県外科医会, Mar. 2022, 兵庫県外科医会会誌, 56, 38 - 38, Japanese

  • Masato Ogawa, Seimi Satomi-Kobayashi, Naofumi Yoshida, Kodai Komaki, Kazuhiro P Izawa, Mari Hamaguchi, Takeshi Inoue, Yoshitada Sakai, Ken-Ichi Hirata, Kenji Okada
    BACKGROUND: Postextubation dysphagia (PED) is a serious postoperative complication following cardiovascular surgery that can lead to a worse prognosis. On the other hand, frailty is a prognostic factor in patients who undergo cardiac surgery. OBJECTIVES: This study investigated the effect of frailty status on PED and impact of PED on postoperative complications. METHODS: This single-center retrospective cohort study included 644 consecutive patients who underwent elective cardiovascular surgery between May 1, 2014, and December 31, 2020; they were assigned to the PED or non-PED group based on postoperative swallowing status, and postoperative complications were investigated. Frailty status and physical functions, including walking speed, grip strength, Short Physical Performance Battery, and 6-minute walking distance, were preoperatively assessed; the frailty-status cutoff for predicting PED was determined from the receiver-operating characteristic curve. RESULTS: In this study cohort (mean age 67.7 years), the overall PED prevalence was 14.8%; preoperative frailty had a significantly higher prevalence in the PED group (50.0%) than in the non-PED group (20.3%; P < 0.001). PED correlated with a higher incidence of postoperative pneumonia and prolonged intensive care unit or hospital stay (P < 0.05 for all). After adjustment for confounders, multiple regression analysis revealed that preoperative frailty was independently associated with PED (P < 0.001). CONCLUSIONS: PED occurred commonly after cardiovascular surgery and increased the risk of postoperative complications. Preoperative frailty was independently associated with PED. The 6-minute walking distance was the most powerful predictor of PED. Evaluation of preoperative frailty status is important for risk stratification and prevention of postoperative morbidity in patients undergoing surgery.
    Feb. 2022, JACC. Asia, 2(1) (1), 104 - 113, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • 辻本 貴紀, 山中 勝弘, 長命 俊也, 山口 雅人, 杉本 幸司, 岡田 健次
    大動脈緊急症の治療において初診時から治療までの時間を短くすることは非常に重要である.その一方で,大動脈緊急症は治療できる施設が限られており,しばしば初診の病院から専門施設への転送を必要とする.今回,破裂性胸部大動脈瘤の患者に対して詳細な患者情報を施設間でシームレスに共有できるクラウド型モバイルネットワークを用いて,施設間の搬送に要する時間を利用して手術準備を行った.症例は85歳,男性.突然の背部痛を自覚し前医へ救急搬送された.前医にてCTを撮影し,当院へ電話連絡後,クラウド型モバイルネットワークを通じて患者情報を共有した.下行大動脈瘤破裂と診断すると同時に当院で胸部ステントグラフト内挿術の準備を開始した.当院到着時に患者はショック状態であったが,手術準備は完了していたため,迅速に治療し救命し得た.クラウド型モバイルネットワークは大動脈緊急症の治療において欠かせないものになると思われる.(著者抄録)
    (NPO)日本血管外科学会, 2022, 日本血管外科学会雑誌, 31(2) (2), 97 - 101, Japanese

  • 腹部大動脈瘤に対するEVARの長期成績と今後の改善点 EVARの長期成績を改善するための予防的大動脈分枝動脈塞栓術の有効性・安全性の検討(多施設共同前向き介入研究)
    山口 雅人, 山中 勝弘, 中井 秀和, 岡田 健次, 林 太郎, 野村 佳克, 杉本 幸司, 福田 哲也, 森 岳樹
    (NPO)日本血管外科学会, 2022, 日本血管外科学会雑誌, 31(Suppl.) (Suppl.), SY10 - 2, Japanese

  • Gore Excluder Iliac Branch Endprothesis(IBE)52例の中期成績の検討
    後竹 康子, 高橋 宏明, 松尾 二郎, 杉本 貴樹, 林 太郎, 山口 雅人, 杉本 幸司, 岡田 健次
    (NPO)日本血管外科学会, 2022, 日本血管外科学会雑誌, 31(Suppl.) (Suppl.), PR16 - 2, Japanese

  • 急性A型大動脈解離の治療戦略 急性A型大動脈解離に対するaggressive arch repair and direct carotid perfusion strategy
    大村 篤史, 村上 優, 長命 俊也, 岩橋 大輔, 阪口 和憲, 河野 敦則, 岡田 翼, 白木 宏長, 長谷川 翔太, 濱口 真理, 井上 大志, 辻本 貴紀, 幸田 陽次郎, 中井 秀和, 山中 勝弘, 井上 武, 岡田 健次
    (一社)日本脈管学会, Oct. 2021, 脈管学, 61(Suppl.) (Suppl.), S132 - S133, Japanese

  • AAA未来へ向けたミッション 腹部大動脈瘤の治療成績 医療費にかかる問題は無視できるか?
    山中 勝弘, 坂口 和憲, 岡田 翼, 白木 宏長, 長谷川 翔太, 濱口 真里, 長命 俊哉, 井上 大志, 河野 敦規, 辻本 貴紀, 村上 優, 幸田 陽次郎, 中井 秀和, 大村 篤史, 井上 武, 岡田 健次
    (一社)日本脈管学会, Oct. 2021, 脈管学, 61(Suppl.) (Suppl.), S140 - S140, Japanese

  • 大動脈手術におけるオープンステントグラフトの有用性と今後の課題 急性A型大動脈解離に使用するFrozen elephant trunkのステントサイズ6cmと9cm以上の比較成績
    河野 敦則, 井上 大志, 辻本 貴紀, 村上 優, 幸田 陽次郎, 中井 秀和, 山中 勝弘, 大村 篤史, 井上 武, 岡田 健次
    (一社)日本人工臓器学会, Oct. 2021, 人工臓器, 50(2) (2), S - 25, Japanese

  • Masataka Suzuki, Takayoshi Toba, Yu Izawa, Hiroshi Fujita, Keisuke Miwa, Yu Takahashi, Hiroyuki Toh, Hiroyuki Kawamori, Hiromasa Otake, Hidekazu Tanaka, Sei Fujiwara, Yoshiaki Watanabe, Atsushi K Kono, Kenji Okada, Ken-Ichi Hirata
    Background Myocardial extracellular volume fraction (ECV), measured by cardiac magnetic resonance imaging, is a useful prognostic marker for patients who have undergone aortic valve replacement (AVR) for aortic stenosis. However, the prognostic significance of ECV measurements based on computed tomography (CT) is unclear. This study evaluated the association between ECV measured with dual-energy CT and clinical outcomes in patients with aortic stenosis who underwent transcatheter or surgical AVR. Methods and Results We retrospectively enrolled 95 consecutive patients (age, 84.0±5.0 years; 75% women) with severe aortic stenosis who underwent preprocedural CT for transcatheter AVR planning. ECV was measured using iodine density images obtained by delayed enhancement dual-energy CT. The primary end point was a composite outcome of all-cause death and hospitalization for heart failure after AVR. The mean ECV measured with CT was 28.1±3.8%. During a median follow-up of 2.6 years, 22 composite outcomes were observed, including 15 all-cause deaths and 11 hospitalizations for heart failure. In Kaplan-Meier analysis, the high ECV group (≥27.8% [median value]) had significantly higher rates of composite outcomes than the low ECV group (<27.8%) (log-rank test, P=0.012). ECV was the only independent predictor of adverse outcomes on multivariable Cox regression analysis (hazards ratio, 1.25; 95% CI, 1.10‒1.41; P<0.001). Conclusions Myocardial ECV measured with dual-energy CT in patients who underwent aortic valve intervention was an independent predictor of adverse outcomes after AVR.
    Sep. 2021, Journal of the American Heart Association, 10(18) (18), e020655, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • 大村 篤史, 井上 大志, 濱口 真理, 村上 優, 長命 俊也, 河野 敦則, 松尾 二郎, 辻本 貴紀, 幸田 陽次郎, 山中 勝弘, 井上 武, 岡田 健次
    当院で動脈硬化性胸部大動脈瘤に対し弓部全置換術を行った346例(平均年齢73.6±10.2歳)を対象に、術者の経験値が手術成績に与える影響を検討した。卒後年数が20年以上の3名をA群、卒後15〜20年未満の6名をB群、卒後15年未満の8名をC群とし比較した結果、早期・遠隔成績ともに3群間で有意差はなく、各群ともに病院死亡率は約3%前後、脳梗塞発生率は約5%前後と、良好な成績を示していた。また、CUSUM法を用いて検討すると、3群ともに10例程度の手術を経験すれば安定した成績が得られることが示唆された。
    (株)南江堂, Apr. 2021, 胸部外科, 74(4) (4), 297 - 303, Japanese

  • 慢性B型解離性大動脈瘤に対する治療-オープンからステントグラフトまで- 慢性B型大動脈解離、広範囲大動脈瘤に対するopen surgery
    大村 篤史, 中井 秀和, 長命 俊也, 井上 大志, 濱口 真理, 河野 敦則, 松尾 二郎, 辻本 貴紀, 幸田 陽次郎, 村上 優, 山中 勝弘, 井上 武, 岡田 健次
    (一社)日本外科学会, Apr. 2021, 日本外科学会定期学術集会抄録集, 121回, DB - 1, Japanese

  • Masato Ogawa, Seimi Satomi-Kobayashi, Naofumi Yoshida, Yasunori Tsuboi, Kodai Komaki, Nagisa Nanba, Kazuhiro P. Izawa, Takeshi Inoue, Yoshitada Sakai, Masaya Akashi, Ken ichi Hirata, Kenji Okada
    Background: Poor oral health status can lead to a deteriorated level of general health and is common among patients undergoing cardiovascular surgery. However, the effect of oral health status on postoperative outcomes in cardiovascular surgery patients remains unclear. Thus, we investigated the effect of preoperative oral health status on postoperative complications and functional recovery after cardiovascular surgery. Methods: This single-centre retrospective cohort study included 884 inpatients undergoing elective cardiovascular surgery. Oral health status was assessed based on the number of remaining teeth, use of dentures, occlusal support, and periodontal status. We investigated postoperative complications related to surgery and postoperative functional recovery by measuring the reacquisition of walking ability, activities of daily living, and length of postoperative hospital stay. Results: In this cohort (age 66.9 ± 13.4 years), the mean number of remaining teeth was 18.7 ± 9.4. Patients were grouped based on tertiles of the data distribution of remaining teeth: ≥ 20 teeth (470 patients); 10-19 teeth (137 patients); < 10 teeth (185 patients). The number of missing teeth was associated with age (P < 0.001). The prevalence of postoperative pneumonia and reintubation after surgery was 3.2% and 2.5%, respectively, which was significantly higher in patients with severe tooth loss (P < 0.05 for both). After adjusting for age and other confounding factors, the number of remaining teeth was a statistically significant predictor of functional recovery (P < 0.05). Conclusions: Preoperative oral health status was related to postoperative respiratory complications and independently associated with functional recovery. Preoperative oral intervention may improve functional recovery after cardiovascular surgery.
    Mar. 2021, CJC Open, 3(3) (3), 276 - 284
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Yu Taniguchi, Yoichiro Matsuoka, Hiroyuki Onishi, Kenichi Yanaka, Noriaki Emoto, Hidekazu Nakai, Kenji Okada, Kenichi Hirata
    BACKGROUND: The management of non-operable chronic thromboembolic pulmonary hypertension (CTEPH) has evolved with the availability of balloon pulmonary angioplasty (BPA) and pulmonary vasodilators. We launched the BPA program in 2011. The aim was to analyze the survival and treatment efficacy of our CTEPH treatment program in the modern management era. METHODS AND RESULTS: We retrospectively reviewed data from 143 consecutive CTEPH patients diagnosed from January 2011 (i.e. after the availability of BPA) to December 2019. Of forty-one patients who underwent pulmonary endarterectomy (PEA), 25 underwent additional BPA (Combination group) and the others were treated with only PEA (PEA group). Ninety patients underwent BPA (BPA group). The remaining 12 patients did not undergo any interventional treatments. The 1- and 5-year survival rates of operated patients (n = 41) were 97.4% and 90.0%, compared to 96.9% and 86.9% in not-operated patients (n = 102), respectively (p = 0.579). There was no mortality in the Combination group. Mean pulmonary artery pressure after treatments in the PEA only, Combination, and BPA only groups was 20.5 ± 6.7, 17.9 ± 4.9, and 20.7 ± 4.6 mmHg, respectively (p = 0.067, one-way ANOVA). Percent decrease of pulmonary vascular resistance in each treatment groups was -73.7 ± 11.3%, -74.3 ± 11.8%, and - 54.9 ± 22.5%, respectively (p < 0.01, one-way ANOVA). CONCLUSION: There was no significant difference in long-term survival between operated and not-operated CTEPH. Moreover, the Combination approach might have the potential to introduce notable improvements in the prognosis of CTEPH. BPA and PEA appear to be mutually complementary therapies in the modern management era.
    Mar. 2021, International journal of cardiology, 326, 170 - 177, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Kodai Komaki, Naofumi Yoshida, Seimi Satomi-Kobayashi, Yasunori Tsuboi, Masato Ogawa, Kumiko Wakida, Takayoshi Toba, Hiroyuki Kawamori, Hiromasa Otake, Atsushi Omura, Katsuhiro Yamanaka, Takeshi Inoue, Tomoya Yamashita, Yoshitada Sakai, Kazuhiro P Izawa, Kenji Okada, Ken-Ichi Hirata
    Assessment of frailty is important for risk stratification among the elderly with severe aortic stenosis (AS) when considering interventions such as surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). However, evidence of the impact of preoperative frailty on short-term postoperative outcomes or functional recovery is limited. This retrospective study included 234 consecutive patients with severe AS who underwent SAVR or TAVR at Kobe University Hospital between Dec 2013 and Dec 2019. Primary outcomes were postoperative complications, postoperative 6-min walking distance (6MWD), and home discharge rates. The mean age was 82 ± 6.6 years. There were 169 (SAVR: 80, TAVR: 89) and 65 (SAVR: 20, TAVR: 45) patients in the non-frail and frail groups, respectively (p = 0.02). The postoperative complication rates in the frail group were significantly higher than those in the non-frail group [30.8% (SAVR: 35.0%, TAVR: 28.9%) vs. 10.7% (SAVR: 15.0%, TAVR: 6.7%), p < 0.001]. The home discharge rate in the non-frail group was significantly higher than that in the frail group [85.2% (SAVR: 81.2%, TAVR: 88.8%) vs. 49.2% (SAVR: 55.0%, TAVR: 46.7%), p < 0.001]. The postoperative 6MWD in the non-frail group was significantly longer than that in the frail group [299.3 ± 87.8 m (SAVR: 321.9 ± 90.8 m, TAVR: 281.1 ± 81.3 m) vs. 141.9 ± 92.4 m (SAVR: 167.8 ± 92.5 m, TAVR: 131.6 ± 91.3 m), p < 0.001]. The TAVR group did not show a decrease in the 6MWD after intervention, regardless of frailty. We report for the first time that preoperative frailty was strongly associated with postoperative complications, 6MWD, and home discharge rates following both SAVR and TAVR. Preoperative frailty assessment may provide useful indications for planning better individualized therapeutic interventions and supporting comprehensive intensive care before and after interventions.
    Feb. 2021, Heart and vessels, 36(8) (8), 1234 - 1245, English, Domestic magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Saki Todo, Takayoshi Toba, Kenji Okada, Ken-Ichi Hirata
    Feb. 2021, European heart journal cardiovascular Imaging, English, International magazine
    Scientific journal

  • 辻本 貴紀, 大村 篤史, 岡田 卓也, 山口 雅人, 杉本 幸司, 岡田 健次
    膵十二指腸動脈瘤(PDAA)は瘤径に関係なく破裂する可能性が示唆されており,発見次第治療を考慮する必要がある.また,解剖学的に複雑な位置に存在するため,低侵襲治療である血管内治療による塞栓術(TAE)が選択される機会が増加している.しかしながら,主要血管を閉塞させる可能性があるなどの解剖学的な理由でTAEだけでは治療を完遂することが難しい症例がある.今回TAEと従来の外科手術を組み合わせたハイブリッド治療を行った2症例を経験したので報告する.1例目のPDAAに対しては,TAEと外科的瘤切除を2期的に分割して手術治療を行い,2例目のPDAAに対しては,TAEと外科的バイパス術を同時に施行し,2例共に良好な経過を辿った.ハイブリッド治療は膵十二指腸動脈瘤に対して非常に有用な選択肢であると思われた.しかしながら,本治療の長期成績についての報告は少なく,注意深いフォローアップが必要である.(著者抄録)
    (NPO)日本血管外科学会, Feb. 2021, 日本血管外科学会雑誌, 30(1) (1), 7 - 12, Japanese

  • Yuki Ikeno, Koki Yokawa, Katsuhiro Yamanaka, Takeshi Inoue, Hiroshi Tanaka, Kenji Okada, Yutaka Okita
    BACKGROUND: The aim of this study was to evaluate the fate of the preserved aortic root after supracoronary aortic replacement for acute type A aortic dissection. METHODS: Between October 1999 and March 2018, 339 patients underwent supracoronary aortic replacement for acute type A aortic dissection at our institution. Late outcomes were evaluated, including overall survival, aortic-related death, and aortic root-related reoperation. The median follow-up was 3.7 years (1.4-8.4 years). RESULTS: Operative mortality was 46 patients (13.6%). The cumulative incidences at 5 years for aortic root-related reoperation, aortic-related death, and non-aortic related death were 2.5%, 14.5% and 12.4%, respectively. Multivariable Cox hazard regression analysis demonstrated greater sinus of Valsalva diameter and number of commissural detachments to be significant risk factors for a composite outcome consisting of aortic-related death or aortic root-related reoperation. Mixed-effects regression demonstrated that sinus of Valsalva diameter significantly increased with time (P < .001), and aortic regurgitation significantly worsened (P < .001). CONCLUSIONS: Sinus of Valsalva diameter and commissural detachment were independent predictors of unfavorable outcomes after supracoronary aortic replacement. Close follow-up is particularly necessary for these patients, and aortic root replacement at the time of initial operation may lead to more favorable late outcomes.
    Feb. 2021, The Journal of thoracic and cardiovascular surgery, 161(2) (2), 483 - 493, English, International magazine
    Scientific journal

  • Hiroshi Tanaka, Kenji Okada, Yutaka Okita
    OBJECTIVES: To review the outcomes of bicuspid aortic valve repair with the reimplantation technique. PATIENTS AND METHODS: From 2006 to 2018, 46 patients with bicuspid aortic valve underwent the reimplantation procedure for aortic valve repair. Those patients were included in this study. The mean age was 45 ± 15 years and 44 were male. Preoperative echocardiography showed a mean ventriculoaortic junction diameter of 28 ± 3 mm. The mean diameter at the sinus of Valsalva was 41 ± 9 mm. The minimum cusp height was 19 ± 3 mm. Regarding cusp repair technique, central plication was used in 45 patients, free margin reinforcement in 10 patients, and patch repair in 4 patients. Follow-up was performed by annual echocardiography. RESULTS: There were no hospital deaths. All patients were found with either no/trivial or mild AR on postoperative transesophageal echocardiography. The postoperative ventriculoaortic junction diameter was 23 ± 2 mm and 83 ± 17% preoperatively. Freedom from moderate AR was 85 ± 6% at 5 years, and freedom from reoperation was 93 ± 4% at 5 years. CONCLUSIONS: Reimplantation for bicuspid aortic valve repair showed acceptable mid-term outcomes.
    Feb. 2021, General thoracic and cardiovascular surgery, 69(2) (2), 260 - 266, English, Domestic magazine
    Scientific journal

  • Yutaka Okita, Yuki Ikeno, Kenji Okada
    Jan. 2021, The Journal of thoracic and cardiovascular surgery, English, International magazine

  • Yu Izawa, Shumpei Mori, Justin T Tretter, James A Quintessenza, Hiroyuki Toh, Takayoshi Toba, Yoshiaki Watanabe, Atsushi K Kono, Kenji Okada, Ken-Ichi Hirata
    BACKGROUND: A thorough understanding of the anatomy of the aortic valve is necessary for aortic valve-sparing surgery. Normal valvar dimensions and their relationships in the living heart, however, have yet to be fully investigated in a 3-dimensional fashion.Methods and Results:In total, 123 consecutive patients (66±12 years, Men 63%) who underwent coronary computed tomographic angiography were enrolled. Mid-diastolic morphology of the aortic roots, including height of the interleaflet triangles, geometric height, free margin length of each leaflet, effective height, and coaptation length were measured using multiplanar reconstruction images. Average height of the interleaflet triangle, geometric height, free margin length, effective height, and the coaptation length were 17.3±1.8, 14.7±1.3, 32.6±3.6, 8.6±1.4, and 3.2±0.8 mm, respectively. The right coronary aortic leaflet displayed the longest free margin length and shortest geometric height. Geometric height, free margin length, and effective height showed positive correlations with aortic root dimensions. Coaptation length, however, remained constant regardless of aortic root dimensions. CONCLUSIONS: Diversities, as well as characteristic relationships among each value involving the aortic root, were identified using living-heart datasets. The aortic leaflets demonstrated compensatory elongation along with aortic root dilatation to maintain constant coaptation length. These measurements will serve as the standard value for revealing the underlying mechanism of aortic regurgitation to plan optimal aortic valve-sparing surgery.
    Jan. 2021, Circulation journal : official journal of the Japanese Circulation Society, 85(7) (7), 1059 - 1067, English, Domestic magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Malperfusionを伴う急性A型大動脈解離に対する治療戦略 頸動脈解離が急性A型大動脈解離の脳神経合併症に与える影響当院の手術戦略の変遷
    井上 大志, 大村 篤史, 山中 勝弘, 濱口 真里, 長命 俊也, 河野 敦則, 辻本 貴紀, 村上 優, 幸田 陽次郎, 中井 秀和, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2021, 日本血管外科学会雑誌, 30(Suppl.) (Suppl.), SY3 - 8, Japanese

  • ステントによる内膜損傷をめぐる問題(RTADとd-SINE) 急性A型大動脈解離におけるFrozen elephant trunkのサイズ選択と遠隔成績 術前詳細なplanningは必要か?
    河野 敦則, 大村 篤志, 濱口 真里, 長命 俊也, 井上 大志, 辻本 貴紀, 幸田 陽次郎, 村上 優, 中井 秀和, 山中 勝弘, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2021, 日本血管外科学会雑誌, 30(Suppl.) (Suppl.), SY6 - 6, Japanese

  • 若年者AAAの治療戦略(EVAR vs OS) 遠隔成績からみた腹部大動脈瘤の治療戦略
    山中 勝弘, 大村 篤史, 濱口 真里, 長命 俊也, 井上 大志, 河野 敦規, 辻本 貴紀, 村上 優, 幸田 陽次郎, 中井 秀和, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2021, 日本血管外科学会雑誌, 30(Suppl.) (Suppl.), SY7 - 1, Japanese

  • 腹部大動脈瘤破裂に対する治療成績向上への取り組み 術式選択よりも重要なこと
    大村 篤史, 山中 勝弘, 中井 秀和, 長命 俊也, 井上 大志, 濱口 真理, 河野 敦則, 辻本 貴紀, 幸田 陽次郎, 村上 優, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2021, 日本血管外科学会雑誌, 30(Suppl.) (Suppl.), PR5 - 1, Japanese

  • 胸部大動脈ステントグラフト内挿術後proximal adverse aortic eventに対するopen surgery
    大村 篤史, 山中 勝弘, 中井 秀和, 長命 俊也, 井上 大志, 濱口 真理, 河野 敦則, 辻本 貴紀, 幸田 陽次郎, 村上 優, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2021, 日本血管外科学会雑誌, 30(Suppl.) (Suppl.), O1 - 2, Japanese

  • 再大動脈基部置換術の手術成績
    幸田 陽次郎, 長命 俊也, 井上 大志, 濱口 真里, 河野 敦則, 辻本 貴紀, 村上 優, 中井 秀和, 山中 勝弘, 大村 篤史, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2021, 日本血管外科学会雑誌, 30(Suppl.) (Suppl.), O3 - 2, Japanese

  • 3次元フローティング画像を用いた大動脈基部の術前計測
    辻本 貴紀, 大村 篤史, 濱口 真里, 長命 俊也, 井上 大志, 河野 敦則, 松尾 二郎, 村上 優, 幸田 陽次郎, 中井 秀和, 山中 勝弘, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2021, 日本血管外科学会雑誌, 30(Suppl.) (Suppl.), O3 - 3, Japanese

  • 当院におけるKommerell憩室に対する外科的治療の成績
    村上 優, 井上 大志, 長命 俊也, 濱口 真里, 河野 敦則, 辻本 貴紀, 松尾 二郎, 幸田 陽次郎, 中井 秀和, 山中 勝弘, 大村 篤史, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2021, 日本血管外科学会雑誌, 30(Suppl.) (Suppl.), O4 - 7, Japanese

  • 急性A型大動脈解離に対する出血合併症減少の取り組み
    大村 篤史, 山中 勝弘, 中井 秀和, 長命 俊也, 井上 大志, 濱口 真理, 河野 敦則, 辻本 貴紀, 幸田 陽次郎, 村上 優, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2021, 日本血管外科学会雑誌, 30(Suppl.) (Suppl.), O12 - 5, Japanese

  • 胸部大動脈瘤破裂に対するThoracic Endovascular Aortic Repairの遠隔予後の検討
    中井 秀和, 大村 篤史, 長命 俊也, 井上 大志, 濱口 真里, 河野 敦則, 辻本 貴紀, 幸田 陽次郎, 村上 優, 山中 勝弘, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2021, 日本血管外科学会雑誌, 30(Suppl.) (Suppl.), O28 - 2, Japanese

  • Toshihito Gomibuchi, Tatsuichiro Seto, Kazuki Naito, Shuji Chino, Toru Mikoshiba, Masaki Komatsu, Haruki Tanaka, Hajime Ichimura, Takateru Yamamoto, Ko Nakahara, Noburo Ohashi, Megumi Fuke, Yuko Wada, Kenji Okada
    OBJECTIVES: We aimed to identify predictors of postoperative permanent neurological deficits (PNDs) and evaluate the early management of cerebral perfusion in patients undergoing surgical repair of acute type A aortic dissection with cerebral malperfusion. METHODS: Between October 2009 and September 2018, a total of 197 patients with acute type A aortic dissection underwent aortic replacement. Of these, 42 (21.3%) patients had an imaging cerebral malperfusion (ICM). ICM was assessed preoperatively, which also revealed whether dissected supra-aortic branch vessels were occluded or narrowed by a thrombosed false lumen. After September 2017, early reperfusion and extra-anatomic revascularization were performed in cases with ICM. RESULTS: Hospital mortality rates for cases with ICM were 4.8% (2/42). Before September 2017, PND were observed in 6 patients (54.5%) with preoperative neurological symptoms (n = 11), and 7 patients (33.3%) without neurological symptoms (n = 21) in patients with ICM. Occlusion or severe stenosis of supra-aortic branch vessels (odds ratio, 7.66; P < 0.001), regardless of preoperative clinical neurological symptoms, was a risk factor for PND. After September 2017, 7 of 10 patients with ICM underwent early reperfusion and extra-anatomic revascularization. PND did not occur in any of these 7 patients. CONCLUSIONS: Occlusion or severe stenosis of supra-aortic branch vessels is a predictor of PND risk in patients undergoing surgery for acute type A aortic dissection. Early reperfusion and extra-anatomic revascularization may reduce the risk of neurological complications in patients with ICM, with or without neurological symptoms.
    Nov. 2020, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, English, International magazine
    Scientific journal

  • Noriyuki Abe, Kenji Okada, Hiroshi Tanaka, Yutaka Okita
    OBJECTIVE: Aortic root reoperation after aortic dissection repair sometimes requires aortic root replacement. A valve-preserving technique should be applied when the aortic cusp is normal. Valve-sparing aortic root reconstruction using the reimplantation technique resolves aortic valve regurgitation, root dilatation, and pseudoaneurysm in the proximal anastomosis. Our experience in aortic root reoperation is presented. METHODS: From January 2000 to March 2019, 26 patients underwent reoperative valve-sparing aortic root reconstruction using the reimplantation technique. The time from the initial operation to reoperation was 69.3 ± 51.6 months. Aortic root reoperation was required for a fragile wall at the previous proximal anastomosis or aortic root dilatation. We aimed to stabilize the aortic root without valve regurgitation. The native aortic cusp was aggressively preserved when nearly normal. Indications included root dilatation (n = 13), pseudoaneurysm of the previous proximal anastomosis (n = 11), and aortic valve regurgitation (n = 4). RESULTS: There was no early postoperative mortality. Follow-up was 49 ± 47 months (range 4-161 months). The 3, 5, and 10-year survival was 88.9% ± 7.4%, 88.9% ± 7.4%, and 77.8% ± 12.2%, respectively. Freedom from recurrence of a greater than moderate degree of aortic valve regurgitation at 3, 5, and 10 years was 86.5% ± 8.9%, 86.5% ± 8.9%, and 86.5% ± 8.9%, respectively. One patient underwent aortic valve replacement for recurrent aortic valve regurgitation 15 months after the valve-sparing reoperation. CONCLUSIONS: Midterm outcomes of reoperative valve-sparing aortic root reconstruction using the reimplantation technique and postoperative aortic valve performance were satisfactory.
    Nov. 2020, Asian cardiovascular & thoracic annals, 218492320977981 - 218492320977981, English, International magazine
    Scientific journal

  • Shun Yokota, Kensuke Matsumoto, Hidekazu Tanaka, Hidekazu Nakai, Kenji Okada, Ken-Ichi Hirata
    We present an extremely rare case of mitral Ebstein's anomaly that resulted in severe mitral regurgitation (MR). A 41-year-old woman with a history of tuberous sclerosis underwent surgery. Preoperatively, it was assumed that MR had occurred due to leaflet tethering related to left ventricular posterior wall motion asynergy due to a scarred rhabdomyoma. However, surgical inspection revealed a dysplastic posterior leaflet adhering to the ventricular wall, which was completely covered by the endocardium. Both congenital mitral Ebstein's anomaly and acquired wall motion abnormality due to a scarred rhabdomyoma may have contributed to the development of severe MR in this case.
    Nov. 2020, Internal medicine (Tokyo, Japan), English, Domestic magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • 後竹 康子, 杉本 貴樹, 殿城 秀人, 高橋 宏明, 魚谷 健祐, 山口 雅人, 杉本 幸司, 岡田 健次
    (一社)日本胸部外科学会, Oct. 2020, 日本胸部外科学会定期学術集会, 73回, CLO10 - 1, Japanese

  • 中村 哲, 瀧口 豪介, 山中 勝弘, 大村 篤史, 押切 太郎, 井上 武, 岡田 健次, 掛地 吉弘
    (一社)日本胸部外科学会, Oct. 2020, 日本胸部外科学会定期学術集会, 73回, CWS3 - 3, Japanese

  • 急性循環不全に対する最新の補助循環治療 急性冠症候群に対する冠動脈バイパス術後ECMO導入例におけるCentral ECMOの有効性
    中井 秀和, 井上 大志, 長命 俊哉, 河野 敦則, 辻本 貴紀, 松尾 二郎, 村上 優, 山中 勝弘, 大村 篤史, 井上 武, 岡田 健次
    (一社)日本人工臓器学会, Oct. 2020, 人工臓器, 49(2) (2), S - 87, Japanese

  • Koki Yokawa, Yuki Ikeno, Soichiro Henmi, Katsuhiro Yamanaka, Kenji Okada, Yutaka Okita
    BACKGROUND: The aim of this study was to evaluate the impact of diffuse aortic atherosclerosis-related thrombosis, or "shaggy aorta" on the outcomes of open thoracoabdominal aortic aneurysm repair (TAAA). METHODS: From October 1999 to March 2018, 251 patients underwent open TAAA repair using segmental-staged aortic clamping. Twenty-eight patients (11.2%) received emergent or urgent operations. Patients were classified into 3 groups: dissection aneurysm (139 patients, 55.4%), degenerative aneurysm without shaggy aorta (76 patients, 30.3%), and degenerative aneurysm with shaggy aorta (36 patients, 14.3%). Shaggy aorta was assessed using enhanced computed tomography and defined as patients with atheroma thickness ≥5 mm with irregular atheroma surface. Mean follow-up was 4.3 ± 4.1 years. RESULTS: Operative mortality was 8% (20 patients) and spinal cord injury occurred in 25 patients (10.0%), 16 of whom (6.4%) had permanent neurologic dysfunction. Operative mortality was significantly worse in patients with shaggy aorta (dissection: 2.2%, non-shaggy: 6.6%, and shaggy: 33.3%, P < .001) and shaggy aorta was a significant risk factor for spinal cord injury (dissection: 7.2%, non-shaggy: 6.6%, and shaggy: 27.8%, P < .003). Multivariable analysis demonstrated that shaggy aorta was a significant risk factor for composite outcome consisted of operative mortality, spinal cord injury, and acute renal failure (odds ratio, 4.78; 95% confidence interval, 1.91-12.3, P < .001). CONCLUSIONS: Preoperative enhanced computed tomography assessment of shaggy aorta could predict high-risk patients for open TAAA repair.
    Oct. 2020, The Journal of thoracic and cardiovascular surgery, 160(4) (4), 889 - 897, English, International magazine
    Scientific journal

  • Kazuya Matsuo, Atsushi Fujita, Masaaki Kohta, Katsuhiro Yamanaka, Takeshi Inoue, Kenji Okada, Eiji Kohmura
    It is essential to establish cardiopulmonary bypass by percutaneous insertion of a large-bore catheter via both the femoral vein and internal jugular vein (IJV) for minimally invasive cardiac surgery (MICS). Complications associated with IJV catheterization during MICS have been reported in the literature; however, vascular injury of the subclavian artery (SCA) is rare. We herein present a rare case in which an iatrogenic arteriovenous fistula (AVF) between the right SCA and IJV after MICS was successfully treated by endovascular coil embolization. A 61-year-old man who had undergone mitral valve repair by MICS 10 months before presentation was referred because of pulsatile cervical bruit and tinnitus. Radiographic examination revealed a right SCA pseudoaneurysm associated with an AVF located between the right common carotid artery and vertebral artery. The AVF was completely occluded with detachable coils using a double-catheter technique to avoid coil migration into the IJV. This technique has been used to treat high-flow or complex AVFs, including pulmonary and renal AVFs. As shown in the present case, it is also useful to treat an iatrogenic AVF between the SCA and IJV.
    Oct. 2020, Annals of vascular surgery, 68, 571.e15-571.e20, English, International magazine
    Link to Kobe Univ. Repository (Kernel)

  • Yutaka Okita, Kenji Okada
    OBJECTIVE: Presenting our experience of treating patients with organ malperfusion secondary to acute aortic dissection. PATIENTS: Among 383 patients who underwent aortic repair for acute type A aortic dissection from 1999 to 2017, 107 patients were operated on because of vascular complications. Fourteen patients had coronary, 50 had brain, 3 had paraplegia, 13 had superior mesenteric artery, 21 had lower limb, and 16 had combined organ malperfusion. Age was 65.8 years. RESULTS: In coronary malperfusion, three had a preoperative percutaneous coronary intervention, and two had mechanical support. All underwent repair of the aorta. Hospital mortality was 28.5%. Fifty patients had brain malperfusion. Hemiplegia was found in 28 patients, transient ischemic attack in 10, and coma in 12. The level of consciousness was severe in 12, moderate in 18, and mild in 20. Twenty-eight percent died of a stroke. Nine had direct perfusion from the right common carotid artery, and the consciousness level was improved in 5 patients. Eight patients had mesenteric malperfusion. Four patients had a central aorta repair first, and four patients had peripheral intervention first. Three patients had a bypass grafting to the superior mesenteric artery, and one had a catheter intervention. Postoperative mortality was found in four patients due to bowel necrosis and six required resections of the bowel. CONCLUSION: Acute organ malperfusion caused by the aortic dissection requires accurate and prompt diagnosis to proceed with an appropriate intervention before repairing the central aorta for preventing irreversible organ damage.
    Oct. 2020, Journal of cardiac surgery, English, International magazine
    Scientific journal

  • Soichiro Henmi, Hidekazu Nakai, Katsuhiro Yamanaka, Atsushi Omura, Takeshi Inoue, Kenji Okada
    Aneurysmal change of reconstructed intercostal arteries is believed to be a rare complication after thoracoabdominal aortic repair. To our knowledge, there is no guideline or randomized controlled trials regarding intercostal patch aneurysm management. Therefore, the optimal treatment is still controversial. We describe a successful case of emergent thoracic endovascular aortic repair for ruptured intercostal patch aneurysm in an 83-year-old man following thoracoabdominal aortic aneurysm repair. Our experience illustrated that gradual expansion of large blocks of aortic wall reconstruction should be closely monitored after primary thoracoabdominal aortic replacement.
    Sep. 2020, Annals of vascular diseases, 13(3) (3), 316 - 318, English, Domestic magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Keiko Sumimoto, Kensuke Matsumoto, Kenji Okada, Ken-Ichi Hirata
    Sep. 2020, European heart journal, 41(35) (35), 3378 - 3378, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • ラジオ波血管内焼灼術導入後の当院における成績と術後圧迫療法における重要性
    浜口 真里, 岡田 健次, 井上 大志, 辻本 貴紀, 邊見 宗一郎, 中井 秀和, 山中 勝弘, 大村 篤史, 井上 武
    日本静脈学会, Sep. 2020, 静脈学, 31(2) (2), 193 - 193, Japanese

  • 若年者腹部大動脈瘤に対する治療戦略-開腹 vs EVAR-【開腹】遠隔成績からみた腹部大動脈瘤の治療戦略 EVAR vs. open
    山中 勝弘, 大村 篤史, 孟 順, 濱口 真里, 井上 大志, 辻本 貴紀, 邉見 聡一郎, 中井 秀和, 井上 武, 岡田 健次
    (一社)日本外科学会, Aug. 2020, 日本外科学会定期学術集会抄録集, 120回, DB - 1, Japanese

  • 領域横断的チームで挑む高難度手術【Video】心臓大血管手技および人工心肺を要した肺・縦隔悪性腫瘍に対する手術戦略と成績
    井上 武, 孟 順, 濱口 真理, 井上 大志, 辻本 貴紀, 邉見 宗一郎, 中井 秀和, 山中 勝弘, 大村 篤史, 岡田 健次
    (一社)日本外科学会, Aug. 2020, 日本外科学会定期学術集会抄録集, 120回, WS - 8, Japanese

  • Yuki Ikeno, Koki Yokawa, Katsuhiro Yamanaka, Takeshi Inoue, Hiroshi Tanaka, Kenji Okada, Yutaka Okita
    BACKGROUND: This study evaluates our 18-year experience of total arch replacement in the octogenarian and nonagenarian population. METHODS: Between October 1999 and March 2018, a total of 740 patients underwent total arch replacement at our institution. A total of 139 patients were aged 80 years or more (83.1 ± 2.8 years), and 601 patients were aged less than 80 years (66.9 ± 11.3 years). Early and late outcomes were compared between the groups. RESULTS: In the group aged 80 years or more, operative mortality occurred in 12 patients (8.6%) and significantly improved over time (P = .010). Operative mortality was significantly higher in the group aged 80 years or more (P = .033) when compared with the group aged less than 80 years (4.0%). Regarding postoperative complications, deep sternal wound infection, pneumonia, and tracheostomy occurred in significantly more patients in the group aged 80 years or more. In the group aged 80 years or more, there were 52 late deaths, with 4 aortic-related deaths. Overall survival was 55.4% ± 5.0% at 5 years and 32.2% ± 6.1% at 8 years. Multivariable Cox-hazard regression analysis demonstrated that chronic kidney disease, nonelective surgery, and concurrent procedures were significant risk factors for overall survival in the group aged 80 years or more. Cumulative incidence for reoperation was significantly lower in the group aged 80 years or more (8.7% at 5 years) compared with the group aged less than 80 years (14.2% at 5 years). CONCLUSIONS: Total arch replacement was performed with an acceptable overall survival in octogenarians and nonagenarians, although operative mortality was higher than in younger patients. However, older patients had a lesser burden of reoperation compared with younger patients.
    Aug. 2020, The Journal of thoracic and cardiovascular surgery, 160(2) (2), 346 - 356, English, International magazine
    Scientific journal

  • Hajime Ichimura, Shin Kadota, Toshihide Kashihara, Mitsuhiko Yamada, Kuniaki Ito, Hideki Kobayashi, Yuki Tanaka, Naoko Shiba, Shinichiro Chuma, Shugo Tohyama, Tatsuichiro Seto, Kenji Okada, Koichiro Kuwahara, Yuji Shiba
    Accumulating evidence suggests that human pluripotent stem cell-derived cardiomyocytes can affect "heart regeneration", replacing injured cardiac scar tissue with concomitant electrical integration. However, electrically coupled graft cardiomyocytes were found to innately induce transient post-transplant ventricular tachycardia in recent large animal model transplantation studies. We hypothesised that these phenomena were derived from alterations in the grafted cardiomyocyte characteristics. In vitro experiments showed that human embryonic stem cell-derived cardiomyocytes (hESC-CMs) contain nodal-like cardiomyocytes that spontaneously contract faster than working-type cardiomyocytes. When transplanted into athymic rat hearts, proliferative capacity was lower for nodal-like than working-type cardiomyocytes with grafted cardiomyocytes eventually comprising only relatively matured ventricular cardiomyocytes. RNA-sequencing of engrafted hESC-CMs confirmed the increased expression of matured ventricular cardiomyocyte-related genes, and simultaneous decreased expression of nodal cardiomyocyte-related genes. Temporal engraftment of electrical excitable nodal-like cardiomyocytes may thus explain the transient incidence of post-transplant ventricular tachycardia, although further large animal model studies will be required to control post-transplant arrhythmia.
    Jul. 2020, Scientific reports, 10(1) (1), 11883 - 11883, English, International magazine
    Scientific journal

  • Koki Yokawa, Soichiro Henmi, Hidekazu Nakai, Katsuhiro Yamanaka, Atsushi Omura, Takeshi Inoue, Yutaka Okita, Kenji Okada
    OBJECTIVES: Valve repair for aortic insufficiency (AI) requires a tailored surgical approach determined by the leaflet and aortic disease. In this study, we used a repair-oriented system for the classification of AI, and we elucidated long-term outcomes of aortic root reimplantation with this classification system. METHODS: From 1999 to 2018, a total of 197 patients underwent elective reimplantation (mean age: 52.7 ± 17.7 years; 80% male). The aortic valve was tricuspid in 143 patients, bicuspid in 51 patients and quadricuspid in 3 patients. A total of 93 patients had type I AI (aortic dilatation), 57 patients had type II AI (cusp prolapse) and 47 patients had type III AI (restrictive). In total, 104 of the 264 patients (39%) had more than 1 identified mechanism. RESULTS: In-hospital mortality was 0.5% (1/197). Mid-term follow-up (mean follow-up duration: 5.5 years) revealed a late mortality rate of 4.2% (9/197). Aortic valve reoperation was performed on 16 patients (8.0%). Rates of freedom from aortic valve replacement and freedom from aortic valve-related events at 10 years of follow-up were 87.0 ± 4.0% and 60.6 ± 6.0%, respectively; patients with type Ib AI (98.3 ± 1.7%; 80.7 ± 7.5%) had better outcomes than patients with type III AI (59.6 ± 15.6%; 42.2 ± 13.1%, P = 0.01). In patients with types II and III AI who had bicuspid aortic valves, rates of freedom from aortic valve-related events at 5 years of follow-up were 95.2 ± 4.7% and 71.7 ± 9.1%, respectively (P = 0.03). CONCLUSIONS: This repair-oriented system for classifying AI could help to predict the durable aortic valve repair techniques. Patient selection according to the classification is particularly important for long-term durability. CLINICAL TRIAL REGISTRATION NUMBER: B190050.
    Jul. 2020, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 58(1) (1), 138 - 144, English, International magazine
    Scientific journal

  • Toshihito Gomibuchi, Tatsuichiro Seto, Shuji Chino, Toru Mikoshiba, Masaki Komatsu, Haruki Tanaka, Hajime Ichimura, Takateru Yamamoto, Noburo Ohashi, Megumi Fuke, Yuko Wada, Kenji Okada
    OBJECTIVES: Although skeletal muscle quantity is linked to surgical outcomes, quality remains unexamined. In this study, we evaluated whether skeletal muscle quality and quantity could predict surgical outcomes in acute type A aortic dissection (ATAAD). METHODS: Skeletal muscle quality and quantity were evaluated using computed tomography (CT) values and the psoas muscle mass index, respectively. From May 2004 to December 2017, 324 ATAAD patients underwent aortic replacement after CT scans and psoas muscle mass index measurements. Patients were grouped into intramuscular fat (IMF; n = 55) and non-IMF (n = 269) deposition groups. RESULTS: The mean ages of the patients were 72.3 ± 9.7 and 66.8 ± 12.1 years (P = 0.002), and hospital mortality rates were 3.6% (2/55) and 7.4% (20/269; P = 0.393) for IMF and non-IMF deposition groups, respectively. IMF deposition was a risk factor for a deterioration in activities of daily living at discharge by multivariable analysis [odds ratio 0.33, 95% confidence interval (CI) 0.16-0.69; P = 0.003]. The mean follow-up was 43.9 ± 36.8 months. The 5-year survival was significantly worse for the IMF deposition group (IMF 73.8% vs non-IMF 88.2%; P = 0.010). The multivariable Cox proportional hazard analysis showed that IMF deposition significantly predicted poor survival (hazard ratio 3.26, 95% CI 1.47-7.24; P = 0.004), unlike psoas muscle mass index and age. CONCLUSIONS: Skeletal muscle quality, defined by IMF deposition, was an independent predictor of overall survival and postoperative activities of daily living dependence risk in patients undergoing surgery for ATAAD. Thus, IMF deposition may be an additional risk factor for estimating late outcomes of ATAAD surgery.
    May 2020, Interactive cardiovascular and thoracic surgery, 30(5) (5), 739 - 745, English, International magazine
    Scientific journal

  • Hiroki Horinouchi, Takuya Okada, Masato Yamaguchi, Koji Maruyama, Koji Sasaki, Tomoyuki Gentsu, Eisuke Ueshima, Keitaro Sofue, Ryota Kawasaki, Yoshikatsu Nomura, Atsushi Omura, Kenji Okada, Koji Sugimoto, Takamichi Murakami
    PURPOSE: To evaluate the mid-term outcomes of transarterial embolization (TAE) for type II endoleak after endovascular abdominal aortic aneurysm repair (EVAR) and investigate the predictors of sac enlargement after embolization. MATERIALS AND METHODS: We conducted a retrospective analysis of 55 patients [48 men and 7 women, median age 79.0 (interquartile ranges 74-82) years] who underwent TAE for type II endoleak from 2010 to 2018. The aneurysmal sac enlargement, endoleaks, aneurysm-related adverse event rate, and reintervention rate were evaluated. Patients' characteristics and clinical factors were evaluated for their association with sac enlargement. RESULTS: Fifty-five patients underwent TAE with technical success and were subsequently followed for a median of 636 (interquartile ranges 446-1292) days. The freedom from sac enlargement rates at 1, 3, and 5 years was 73.2%, 32.0%, and 26.7%, respectively. After initial TAE, the recurrent type II, delayed type I, and occult type III endoleak were identified in 39 (71%), 5 (9%), and 3 (5%) patients, respectively. Although a patient had aorto-duodenal fistula, there was no aneurysm-related death. The freedom from reintervention rates was 84.6%, 35.7%, and 17.0%, respectively. In the multivariate analysis, sac diameter > 55 mm at initial TAE (hazard ratios, 3.23; 95% confidence intervals, 1.22-8.58; P < 0.05) was a significant predictor of sac enlargement. CONCLUSION: TAE for type II endoleak was not effective in preventing sac enlargement, and reinterventions were required among the mid-term follow-up. The sac diameter > 55 mm at initial TAE was a significant predictor of sac enlargement.
    May 2020, Cardiovascular and interventional radiology, 43(5) (5), 696 - 705, English, International magazine
    [Refereed]
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Hiromu Kehara, Syuichi Urashita, Toshihito Gomibuchi, Kazunori Komatsu, Kouhei Takahashi, Katsuaki Tsukioka, Takamitsu Terasaki, Tetsuya Kono, Naomichi Wada, Yukinari Kakizawa, Jun-Ichi Koyama, Kenji Okada
    Mechanical thrombectomy has been proposed to expand the treatment time window and enhance revascularization. However, it is unclear whether its use can be extended to patients with occlusions in acute aortic dissection, especially the thoracic aorta. A 55-year-old man underwent graft replacement for acute aortic dissection type A. On postoperative day 2, he developed stroke and computed tomography showed occlusion of the right middle cerebral artery. Mechanical thrombectomy was performed by transbrachial approach. Although successful recanalization was achieved, he suffered hemorrhagic stroke. Since there is no other effective treatment and the neurologic outcome with conservative management is poor, we consider mechanical thrombectomy to be a viable therapeutic option for the treatment of postoperative stroke in patients with acute aortic dissection type A. However, further study is warranted regarding the safety of this technique.
    Apr. 2020, NMC case report journal, 7(2) (2), 71 - 74, English, Domestic magazine

  • 大動脈基部病変に対する治療戦略 大動脈基部膿瘍に対する大動脈基部再建の方法及び成績
    辻本 貴紀, 大村 篤史, 殿城 秀斗, 孟 順, 井上 大志, 浜口 真里, 陽川 孝樹, 邉見 宗一郎, 中井 秀和, 山中 勝弘, 井上 武, 岡田 健次
    (NPO)日本心臓血管外科学会, Mar. 2020, 日本心臓血管外科学会学術総会抄録集, 50回, SY2 - 8, Japanese

  • 重症大動脈弁狭窄症に対する外科的大動脈弁置換術の術前frail評価の有用性
    浜口 真里, 岡田 健次, 孟 順, 井上 大志, 辻本 貴紀, 陽川 孝樹, 邊見 宗一郎, 中井 秀和, 山中 勝弘, 大村 篤史, 井上 武
    (NPO)日本心臓血管外科学会, Mar. 2020, 日本心臓血管外科学会学術総会抄録集, 50回, PR19 - 5, Japanese

  • 当院の急性A型大動脈解離の手術成績
    大村 篤史, 中井 秀和, 邉見 宗一郎, 孟 順, 井上 大志, 浜口 真理, 辻本 貴紀, 陽川 孝樹, 山中 勝弘, 井上 武, 岡田 健次
    (NPO)日本心臓血管外科学会, Mar. 2020, 日本心臓血管外科学会学術総会抄録集, 50回, PR24 - 2, Japanese

  • 遠隔予後から見た70歳未満への冠動脈バイパス術における動脈グラフトの意義
    井上 武, 孟 順, 濱口 真理, 井上 大志, 辻本 貴紀, 陽川 孝樹, 邉見 宗一郎, 中井 秀和, 山中 勝弘, 大村 篤史, 岡田 健次
    (NPO)日本心臓血管外科学会, Mar. 2020, 日本心臓血管外科学会学術総会抄録集, 50回, O7 - 4, Japanese

  • 当院の肺動脈血栓内膜摘除術の成績
    中井 秀和, 殿城 秀人, 孟 順, 濱口 真里, 井上 大志, 辻本 貴紀, 陽川 孝樹, 邉見 宗一郎, 山中 勝弘, 大村 篤史, 井上 武, 岡田 健次
    (NPO)日本心臓血管外科学会, Mar. 2020, 日本心臓血管外科学会学術総会抄録集, 50回, O11 - 2, Japanese

  • ファロー四徴症術後遠隔期肺動脈弁逆流に対する肺動脈弁置換術の予後
    孟 順, 殿城 秀人, 濱口 真里, 井上 大志, 辻本 貴紀, 陽川 孝樹, 邉見 宗一郎, 中井 秀和, 山中 勝弘, 大村 篤史, 井上 武, 岡田 健次
    (NPO)日本心臓血管外科学会, Mar. 2020, 日本心臓血管外科学会学術総会抄録集, 50回, P44 - 6, Japanese

  • 胸腹部大動脈瘤術後急性腎障害と早期遠隔期成績の検討
    邉見 宗一郎, 孟 順, 濱口 真里, 井上 大志, 辻本 貴紀, 陽川 孝樹, 中井 秀和, 山中 勝弘, 大村 篤史, 井上 武, 岡田 健次
    (NPO)日本心臓血管外科学会, Mar. 2020, 日本心臓血管外科学会学術総会抄録集, 50回, P52 - 3, Japanese

  • Hamada MAS, Okada T, Yamaguchi M, Gotake Y, Okada K, Sugimoto K, Murakami T
    Feb. 2020, Interventional Radiology, 5(1) (1), 19 - 22, English
    [Refereed]
    Scientific journal

  • 当院におけるIliac Branch Endoprosthesisを用いたステントグラフト内挿術の成績
    濱口 真里, 中井 秀和, 殿城 秀斗, 孟 順, 井上 大志, 辻本 貴紀, 邊見 宗一郎, 山中 勝弘, 大村 篤史, 井上 武, 岡田 健次, 山口 雅人, 杉本 幸司
    (NPO)日本血管外科学会, 2020, 日本血管外科学会雑誌, 29(Suppl.) (Suppl.), P8 - 4, Japanese

  • 慢性血栓塞栓症性肺高血圧症に対する肺動脈血栓内膜摘除術の脳合併症の検討
    中井 秀和, 大村 篤史, 殿城 秀人, 孟 順, 濱口 真里, 井上 大志, 辻本 貴紀, 邉見 宗一郎, 山中 勝弘, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2020, 日本血管外科学会雑誌, 29(Suppl.) (Suppl.), SY5 - 4, Japanese

  • 二尖弁に対するReimplantation法の形態学的検討
    辻本 貴紀, 殿城 秀斗, 孟 順, 濱口 真里, 井上 大志, 邉見 宗一郎, 中井 秀和, 山中 勝弘, 大村 篤史, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2020, 日本血管外科学会雑誌, 29(Suppl.) (Suppl.), SY7 - 5, Japanese

  • 胸部下行大動脈解離に対するTEVAR後の再手術成績
    井上 武, 殿城 秀斗, 孟 順, 濱口 真理, 井上 大志, 辻本 貴紀, 邉見 宗一郎, 中井 秀和, 山中 勝弘, 大村 篤史, 岡田 健次
    (NPO)日本血管外科学会, 2020, 日本血管外科学会雑誌, 29(Suppl.) (Suppl.), OP5 - 2, Japanese

  • Tear-oriented plus aggressive arch strategy for acute type A aortic dissection(和訳中)
    大村 篤史, 山中 勝弘, 中井 秀和, 邉見 宗一郎, 殿城 秀斗, 孟 順, 濱口 真理, 井上 大志, 辻本 貴紀, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2020, 日本血管外科学会雑誌, 29(Suppl.) (Suppl.), OP15 - 2, English

  • 大動脈関連感染における有茎大網充填術および広背筋・大胸筋皮弁移植術の治療成績
    孟 順, 邉見 宗一郎, 殿城 秀斗, 濱口 真里, 井上 大志, 辻本 貴紀, 中井 秀和, 山中 勝弘, 大村 篤史, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2020, 日本血管外科学会雑誌, 29(Suppl.) (Suppl.), OP16 - 1, Japanese

  • 慢性解離性大動脈瘤手術の遠隔成績
    山中 勝弘, 殿城 秀斗, 孟 順, 濱口 真里, 井上 大志, 辻本 貴紀, 邉見 宗一郎, 中井 秀和, 大村 篤史, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2020, 日本血管外科学会雑誌, 29(Suppl.) (Suppl.), SF1 - 3, Japanese

  • 炎症性血管疾患患者に対する冠動脈バイパス術の成績
    井上 大志, 大村 篤史, 殿城 秀人, 孟 順, 濱口 真里, 辻本 貴紀, 邉見 宗一郎, 中井 秀和, 山中 勝弘, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2020, 日本血管外科学会雑誌, 29(Suppl.) (Suppl.), SF2 - 2, Japanese

  • 大動脈感染性疾患の治療成績
    山中 勝弘, 殿城 秀斗, 孟 順, 濱口 真里, 井上 大志, 辻本 貴紀, 邉見 宗一郎, 中井 秀和, 大村 篤史, 井上 武, 岡田 健次
    (NPO)日本血管外科学会, 2020, 日本血管外科学会雑誌, 29(Suppl.) (Suppl.), SF15 - 1, Japanese

  • 当院におけるIliac Branch Endoprosthesisを用いたステントグラフト内挿術の成績
    濱口 真里, 中井 秀和, 殿城 秀斗, 孟 順, 井上 大志, 辻本 貴紀, 邊見 宗一郎, 山中 勝弘, 大村 篤史, 井上 武, 岡田 健次, 山口 雅人, 杉本 幸司
    (NPO)日本血管外科学会, 2020, 日本血管外科学会雑誌, 29(Suppl.) (Suppl.), P8 - 4, Japanese

  • Masato Ogawa, Seimi Satomi-Kobayashi, Naofumi Yoshida, Yasunori Tsuboi, Kodai Komaki, Kumiko Wakida, Yasuko Gotake, Kazuhiro P Izawa, Yoshitada Sakai, Kenji Okada
    OBJECTIVES: The provision of inpatient programs that reduce the incidence of readmission after cardiac surgery remains challenging. Investigators have focused on multidisciplinary cardiac rehabilitation (CR) because it reduces the postoperative readmission rate; however, most previous studies used outpatient models (phase II CR). We retrospectively investigated the effect of comprehensive multidisciplinary interventions in the acute inpatient phase (phase I CR) on unplanned hospital readmission. METHODS: In a retrospective cohort study, we compared consecutive patients after cardiac surgery. We divided them into the multidisciplinary CR (multi-CR) group or conventional exercise-based CR (conv-CR) group according to their postoperative intervention during phase I CR. Multi-CR included psychological and educational intervention and individualized counseling in addition to conv-CR. The primary outcome was unplanned readmission rates between the groups. A propensity score-matching analysis was performed to minimize selection biases and the differences in clinical characteristics. RESULTS: In our cohort (n = 341), 56 (18.3%) patients had unplanned readmission during the follow-up period (median, 419 days). Compared with the conv-CR group, the multi-CR group had a significantly lower unplanned readmission rate (multivariable regression analysis; hazard ratio, 0.520; 95% confidence interval, 0.28-0.95; P = .024). A Kaplan-Meier analysis of our propensity score-matched cohort showed that, compared with the conv-CR group, the multi-CR group had a significantly lower incidence of readmission (stratified log-rank test, P = .041). CONCLUSIONS: In phase I, compared to conv-CR alone, multi-CR reduced the incidence of unplanned readmission. Early multidisciplinary CR can reduce hospitalizations and improve long-term prognosis after cardiac surgery.
    Dec. 2019, The Journal of thoracic and cardiovascular surgery, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Koki Yokawa, Takeshi Inoue, Katsuhiro Yamanaka, Kenji Okada
    Aortic angiosarcoma is an exceedingly rare clinical entity. A significant delay in diagnosis can occur due to its rareness and lack of specific clinical manifestation. A 71-year-old woman was admitted to the emergency department owing to an acute episode of abdominal pain. A computed tomography (CT) scan showed thoraco-abdominal aortic occlusion and splenic infarction. The patient was initially treated with descending aortic replacement for degenerative atherothrombotic aneurysm. An FDG-positron emission tomography-CT scan and biopsy ultimately confirmed the diagnosis of aortic angiosarcoma. This case highlights the difficulties of making an early diagnosis of aortic angiosarcoma.
    Dec. 2019, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 56(6) (6), 1204 - 1205, English, International magazine
    Scientific journal

  • 破裂性大動脈瘤に対する治療戦略 下行大動脈瘤破裂に対する胸部ステントグラフト内挿術の早期および遠隔成績
    中井 秀和, 殿城 秀人, 孟 順, 井上 大志, 陽川 孝樹, 邉見 宗一郎, 後竹 康子, 山中 勝弘, 大村 篤史, 井上 武, 山口 雅人, 杉本 幸司, 岡田 健次
    (一社)日本脈管学会, Oct. 2019, 脈管学, 59(Suppl.) (Suppl.), S133 - S133, Japanese
    [Refereed]

  • Iliac Branch Endoprosthesisを用いたステントグラフト内挿術の初期成績
    元津 倫幸, 山口 雅人, Hamada Mostafa, 佐々木 康二, 堀之内 宏樹, 上嶋 英介, 岡田 卓也, 祖父江 慶太郎, 後竹 康子, 中井 秀和, 山中 勝弘, 大村 篤史, 岡田 健次, 杉本 幸司, 村上 卓道
    (一社)日本脈管学会, Oct. 2019, 脈管学, 59(Suppl.) (Suppl.), S175 - S175, Japanese
    [Refereed]

  • 腹部大動脈瘤ステントグラフト内挿術後open conversionに至った症例の検討
    山中 勝弘, 大村 篤史, 中井 秀和, 邉見 宗一郎, 陽川 孝樹, 岡田 卓也, 山口 雅人, 杉本 幸司, 井上 武, 岡田 健次
    (一社)日本脈管学会, Oct. 2019, 脈管学, 59(Suppl.) (Suppl.), S179 - S179, Japanese
    [Refereed]

  • Yuki Michinaga, Tamaki Takano, Takamitsu Terasaki, Souma Miyazaki, Noritoshi Kikuchi, Kenji Okada
    INTRODUCTION: We have been developing a closed-circuit cardiopulmonary bypass (CPB) system ("Dihead CPB") for application during coronary artery bypass grafting (CABG) and valve surgery. To strive for minimal hemolysis during Dihead CPB, we compared the hemolysis caused by three different suction systems and performed a clinical study with the newly applied suction system. MATERIALS & METHODS: We evaluated the hemolysis caused by roller-pump suction, the SmartSuction® Harmony® and wall suction systems with respect to suction speed and compared the systems by means of in vitro studies. A clinical study was also performed on 15 volunteers to assess hemolysis and the adequacy of the newly applied suction system with Dihead CPB. RESULTS: Pressure inside the suction cannula was -22.5 ± 0.1 mmHg at a maximum flow of 1.5 L/min for roller-pump suction and -43.4 ± 0.1 mmHg at -150 mmHg of the set vacuum pressure of wall suction. With the SmartSuction, the pressure inside the cannula varied from -76.3 ± 1.0 to -130.3 ± 1.5 mmHg, depending on suctioning conditions. Suction speed (to suction 50 ml of blood) was fastest with the SmartSuction (69.7 ± 3.58 s) whereas, with roller suction, it was 117.3 ± 8.47 s and with wall suction 96.9 ± 7.10 s. The SmartSuction had the highest hemolysis rate (2.00 ± 0.33%) vs. 0.61 ± 0.10% for roller suction and 0.41 ± 0.11% for wall suction (p<0.001). The clinical study with wall suction showed no significant increase in plasma free hemoglobin during or after CPB compared with before surgery. CONCLUSIONS: Wall suction had less hemolysis than roller suction or the SmartSuction in the in vitro study and the clinical study with wall suction showed efficient suction speed and acceptable hemolysis, suggesting that Dihead CPB with wall suction is feasible for CABG.
    Mar. 2019, Perfusion, 34(2) (2), 136 - 142, English, International magazine
    Scientific journal

  • Hirohiko Motoki, Satoshi Yasukochi, Kiyohiro Takigiku, Kohta Takei, Toru Okamura, Kazuhiro Kimura, Masatoshi Minamisawa, Ayako Okada, Tatsuya Saigusa, Soichiro Ebisawa, Tatsuichiro Seto, Morio Shoda, Kenji Okada, Koichiro Kuwahara
    BACKGROUND: Despite the best efforts of pediatricians, healthcare for adult patients with congenital heart disease (ACHD) has proven challenging because of the increased numbers. This study presents the process of establishing an ACHD care system as a collaborative effort between Shinshu University Hospital and Nagano Children's Hospital. Methods and Results: Establishing an outpatient clinic for transition, a cooperation agreement for in-patient care between the 2 hospitals, and quality management of diagnostic imaging and educational meetings for adult cardiologists were the 3 major challenges. Of the 99 patients who visited the transition clinic in the children's hospital between May 2014 and December 2016, 3 returned to the pediatrician's clinic. Between June 2013 and December 2017, 273 patients visited the ACHD center in Shinshu University Hospital. Until December 2017, mortality and fatal arrhythmia were noted in 3 and 2 cases, respectively. Catheter ablation for arrhythmia was performed in 12 cases, and 4 cases of pregnancy with moderate/severe ACHD or estimated as high risk were managed with healthy livebirths. Surgical interventions for moderate/severe ACHD were performed in collaboration with the children's hospital or Sakakibara Heart Institute. CONCLUSIONS: Patients were successfully transferred to adult cardiology departments. Surgical and nonsurgical interventions for ACHD were provided. Collaboration between adult and pediatric cardiologists assists in the establishment of healthcare systems for ACHD.
    Jan. 2019, Circulation journal : official journal of the Japanese Circulation Society, 83(2) (2), 424 - 431, English, Domestic magazine
    Scientific journal

  • EVARにおける内腸骨動脈血流温存の意義・適応 腹部ステントグラフト内挿術における内腸骨動脈塞栓の影響
    後竹 康子, 河本 達也, 孟 順, 陽川 孝樹, 邊見 宗一郎, 中井 秀和, 山中 勝弘, 井上 武, 山口 雅人, 岡田 健次
    (NPO)日本血管外科学会, 2019, 日本血管外科学会雑誌, 28(Suppl.) (Suppl.), PR4 - 6, Japanese

  • Kazutoshi Hamanaka, Tsutomu Koyama, Shunichiro Matsuoka, Tetsu Takeda, Kentaro Miura, Kyoko Yamada, Akira Hyogotani, Tatsuichiro Seto, Kenji Okada, Ken-Ichi Ito
    OBJECTIVE: The purpose of this study is to elucidate the outcomes after surgical resection of Masaoka stage III-IV thymic epithelial tumors. METHODS: We retrospectively reviewed patients with Masaoka stage III-IV thymic epithelial tumor who underwent surgical resection from January 1995 to January 2017. The clinicopathological features, surgical procedures, and postoperative outcomes were investigated. RESULTS: Thirteen patients with thymoma and 18 patients with thymic carcinoma were assessed. The postoperative Masaoka stages were III/IVa/IVb = 8/4/1 in thymoma and III/IVa/IVb = 11/2/5 in thymic carcinoma. In patients with thymoma, the World Health Organization pathological subtypes were A/B1/B2/B3 = 2/1/4/6. We performed combined resection and reconstruction for brachiocephalic vein or superior vena cava in 3 patients with thymoma and 7 patients with thymic carcinoma. In all patients, the patency rate of the grafts was very low for the left brachiocephalic vein and well maintained for the right brachiocephalic vein. Macroscopically and pathologically complete resection was achieved in 11 and 6 patients with thymoma, respectively, and in 15 and 9 patients with thymic carcinoma, respectively. The 10-year survival rates were 85.7% in thymoma and 70.3% in thymic carcinoma. Postoperative recurrences were observed in 2 and 9 patients with thymoma and thymic carcinoma, respectively. Recurrences were observed within 5 and 10 years after surgery in 2 patients with thymoma and within 2 years in all patients with thymic carcinoma. CONCLUSIONS: Patients with Masaoka stage III-IV thymic epithelial tumor showed relatively favorable long-term survival after surgical treatment. Therefore, aggressive surgical resection for complete resection may be a treatment option for these conditions.
    Dec. 2018, General thoracic and cardiovascular surgery, 66(12) (12), 731 - 735, English, Domestic magazine
    Scientific journal

  • Toshihito Gomibuchi, Tatsuichiro Seto, Masaki Komatsu, Haruki Tanaka, Hajime Ichimura, Takateru Yamamoto, Noburo Ohashi, Yuko Wada, Kenji Okada
    BACKGROUND: Although frailty is used to predict morbidity and mortality, its effect on the outcomes of acute type A aortic dissection has not been examined. Therefore, the objective of this study was to evaluate the role of frailty in predicting postoperative morbidity and mortality of patients with acute type A aortic dissection. METHODS: A retrospective analysis of a prospectively maintained database was undertaken for all patients (n = 310) undergoing aortic surgery between May 2004 and March 2017. Frailty was evaluated using an index consisting of age more than 70 years, body mass index less than 18.5 kg/m2, serum creatinine greater than 1.2 mg/dL, anemia, history of stroke, hypoalbuminemia, and the psoas muscle area index. One point was given for each criterion met, for a frailty score between 0 and 7. Frailty was defined as a score of 3 or more. RESULTS: Of all patients, 106 (34.2%) were defined as frail. Inhospital mortality rates of frail versus nonfrail patients were not significantly different (10.4% versus 8.3%, respectively; p = 0.54). Incidences of postoperative major morbidities without reexploration for bleeding were also not statistically different. Five-year survival rates were significantly worse for frail patients than for nonfrail patients (57.7% versus 85.1%, respectively; p = 0.0001). A frailty score of 3 or greater was associated with late mortality, and long-term outcomes were clearly stratified by frailty score. CONCLUSIONS: Frailty, as defined using a seven-component frailty index, can serve as an independent predictor of the risk of late mortality for patients undergoing surgery for acute type A aortic dissection. Such frailty markers, all of which are easily assessed preoperatively, may provide valuable information for patient counseling and risk stratification before aortic surgery.
    Nov. 2018, The Annals of thoracic surgery, 106(5) (5), 1349 - 1355, English, International magazine
    Scientific journal

  • Norimichi Koitabashi, Tomomi Yamaguchi, Daisuke Fukui, Takahide Nakano, Atsushi Umeyama, Kazuyoshi Toda, Ryuichi Funada, Masumi Ishikawa, Rie Kawamura, Kenji Okada, Atsushi Hatamochi, Tomoki Kosho, Masahiko Kurabayashi
    Vascular Ehlers-Danlos syndrome (vEDS), a genetic disorder caused by mutations in procollagen type III gene (COL3A1), may lead to fatal vascular complication during peripartum period because of the arterial fragility. We experienced a case of vEDS with peripartum life-threatening arterial rapture diagnosed by next-generation sequencing (NGS) and successfully treated the vascular complications. A 25-year-old female in pregnancy at 34 weeks had sudden and acute pain in the left lower abdomen. After successful delivery, her computed tomography scan showed a dissecting aneurysm of the left common iliac artery (CIA). Four days after delivery, she presented in hemorrhagic shock induced by arterial rupture in the CIA. Since her clinical presentations inferred vEDS even in the absence of familial history, we performed NGS-based genetic screening for inherited connective tissue disorders including vEDS with informed consent. Even though we started intensive medication, her iliac aneurysm was progressively enlarging within 3 weeks. After an urgent molecular diagnosis for vEDS (a splice-site mutation), cautious endovascular therapy for her CIA aneurysm was successfully performed. This is the first report for pretreatment molecular diagnosis of vEDS using NGS in an emergent situation of severe vascular complications.
    Sep. 2018, International heart journal, 59(5) (5), 1180 - 1185, English, Domestic magazine
    Scientific journal

  • Toshihito Gomibuchi, Kenji Okada, Tatsuichiro Seto, Yutaka Okita
    Mosby Inc., Jun. 2018, The Journal of thoracic and cardiovascular surgery, 155(6) (6), e175-e176 - e176, English, International magazine
    Scientific journal

  • Tomonori Minagawa, Daisuke Fukui, Kunihiko Shingu, Teruyuki Ogawa, Kenji Okada, Osamu Ishizuka
    A 67-year-old man consulted our department with gross hematuria. Computed tomography (CT) revealed a huge renal tumor with a paracaval metastatic lymph node (mLN). Right total nephrectomy was planned for the renal tumor diagnosed as renal cell carcinoma preoperatively. Just before the resection of the renal vein and artery, intraoperative ultrasonography revealed an inferior vena caval tumor thrombus (IVCTT) extending from the mLN. Ultrasonography clearly and dynamically demonstrated a rhythmic flapping movement of the IVCTT with blood flow in the inferior vena cava. Following right radical nephrectomy, IVCTT resection with the vessel wall was performed to reduce the risk of pulmonary tumor thrombus. Histopathological diagnosis of the renal tumor was clear cell renal cell carcinoma, and the resected IVCTT was confirmed histopathologically as tumor involvement from the mLN of the renal cell carcinoma. Intraoperative ultrasonography can detect IVCTT extending from the mLN, whereas CT cannot.
    Springer Tokyo, Apr. 2018, Journal of medical ultrasonics (2001), 45(2) (2), 367 - 370, English, Domestic magazine
    Scientific journal

  • Hiromu Kehara, Yuko Wada, Daisuke Fukui, Kunihiko Shingu, Tatsuichiro Seto, Kenji Okada
    Aneurysm of the proximal ulnar artery is extremely rare. Ultrasonography, computed tomography, and magnetic resonance imaging generally provide accurate diagnosis of aneurysm. A 29-year-old woman who had undergone an excision biopsy of a mass in her right arm by an orthopedic surgeon was referred to our department. We resected the mass and interposed it with a reversed great saphenous vein. Histopathological examination suggested that the mass was a pseudoaneurysm consisting of organized thrombi with recanalization. Clinicians should be aware of the possibility of misdiagnosis of soft tissue tumor in cases of pseudoaneurysm, especially if imaging examination reveals a density consistent with organized thrombus with recanalization.
    Feb. 2018, Annals of vascular surgery, 47, 279.e1-279.e5, English, International magazine
    Scientific journal

  • Megumi Fuke, Makoto Narita, Yuko Wada, Tatsuichiro Seto, Kenji Okada, Jun Nakayama, Hiroto Izumi, Ken-Ichi Ito
    Critical limb ischemia (CLI) is the most severe complication of peripheral arterial disease (PAD). Understanding the molecular mechanisms underlying tissue repair after CLI is necessary for preventing PAD progression. Y-box binding protein-1 (YB-1) regulates the expression of many genes in response to environmental stresses. We aimed to determine whether YB-1 is involved in ischemic muscle regeneration. A mouse ischemic hind-limb model was generated; namely, the femoral, saphenous, and popliteal arteries in the left hind limb were ligated. The right hind limb, with skin incisions alone, served as control. Hind limbs (n = 3-5 for each time point) were examined on day 0 (before the operation) and on postoperative days 1, 2, 7, 10, and 14, and the biceps femoris, adductor, rectus femoris, and gracilis muscles were subjected to histopathological and immunohistochemical analyses. In ischemic limbs, myogenesis, triggered by an increase in myotubes, began on day 7; thereafter, regenerated muscles gradually increased in volume. RT-PCR analysis showed that YB-1 mRNA levels were increased in the limbs after ischemic injury, peaked on day 2, and subsequently decreased. On day 7, expression levels of MyoD and alpha-smooth muscle actin (αSMA) mRNAs were significantly higher in ischemic muscles than in control muscles. Immunohistochemical analysis revealed increased YB-1 immunoreactivity in myoblasts and myotubes on day 7, which was decreased by day 14. The immunoreactive αSMA and smooth muscle myosin heavy chain were transiently increased in myotubes. This is the first report showing the increased expression of YB-1 during muscle regeneration after ischemic injury.
    Jan. 2018, The Tohoku journal of experimental medicine, 244(1) (1), 53 - 62, English, Domestic magazine
    Scientific journal

  • Toshihito Gomibuchi, Tatsuichiro Seto, Takateru Yamamoto, Ko Nakahara, Noburo Ohashi, Yoshinori Ohtsu, Yuko Wada, Daisuke Fukui, Kenji Okada
    We report the successful surgical repair of a cervical aortic arch and diverticulum with a brain circulation anomaly through a clamshell incision. Because of the reliability of selective antegrade cerebral perfusion and superior exposure, we chose an approach through a clamshell incision. We describe the utility of this approach for treating a cervical aortic arch with a diverticulum.
    ELSEVIER SCIENCE INC, Sep. 2017, The Annals of thoracic surgery, 104(3) (3), e235-e237 - E237, English, International magazine
    Scientific journal

  • Tatsuki Ogasawara, Satomi Okano, Hajime Ichimura, Shin Kadota, Yuki Tanaka, Itsunari Minami, Motonari Uesugi, Yuko Wada, Naoto Saito, Kenji Okada, Koichiro Kuwahara, Yuji Shiba
    Pluripotent stem cell-derived cardiomyocytes show great promise in regenerating the heart after myocardial infarction; however, several uncertainties exist that must be addressed before clinical trials. One practical issue is graft survival following transplantation. Although a pro-survival cocktail with Matrigel has been shown to enhance graft survival, the use of Matrigel may not be clinically feasible. The purpose of this study was to test whether a hyaluronan-based hydrogel, HyStem, could be a substitute for Matrigel. Human induced pluripotent stem cell-derived cardiomyocytes diluted with HyStem alone, HyStem plus pro-survival factors, or a pro-survival cocktail with Matrigel (PSC/MG), were transplanted into a rat model of acute myocardial infarction. Histological analysis at 4 weeks post transplantation revealed that, among the three groups, recipients of PSC/MG showed the largest graft size. Additionally, the grafted cardiomyocytes in the recipients of PSC/MG had a more matured phenotype compared to those in the other two groups. These findings suggest that further studies will be required to enhance not only graft size, but also the maturation of grafted cardiomyocytes.
    NATURE PUBLISHING GROUP, Aug. 2017, Scientific reports, 7(1) (1), 8630 - 8630, English, International magazine
    Scientific journal

  • [Brain Protection for Shaggy Aorta During Aortic Arch Surgery].
    Kenji Okada
    Although short and long-term outcomes of aortic surgeries have been improving over the past decade, the procedure is likely to be asscociated with life-threatening complications such as neurological deficits caused by suboptimal brain protection or heavily diseased aorta. Contemporary strategies for brain protection are deep hypothermic arrest with or without retrograde cerebral perfusion retrograde cerebral perfusion or selective antegrade cerebral perfusion. At the moment, majority of evidences failed to show the superiority of selective antegrade cerebral perfusion to retrograde one. Shaggy aorta( atherothrombotic aorta) was defined as very extensive atheromatous disease with diffuse ulcers associated with soft, loosely held debris and a paucity of actual thrombus and is the prototypical potential embolic source for neurological deficits. Non-physiological flow during cardiopulmonary bypass causes the detachment of atheroma and consequently the debris was washed away into the carotid arteries. Therefore, meticulous selection of cannulation site and type of cannula (a dispersion cannula) and complete exclusion of the diseased aorta contributed to avoiding permanent neurological deficits even when atherothrombotic aorta was present. Shaggy aorta combined with leukoaraiosis, extracranial carotid artery stenosis, and prolonged cardiopulmonary bypass time exponentially increased postoperative transient neurological deficits in patients undergoing total aortic arch replacement, and may therefore deserve special attention.
    Jul. 2017, Kyobu geka. The Japanese journal of thoracic surgery, 70(8) (8), 571 - 577, Japanese, Domestic magazine
    Scientific journal

  • 岡田 健次
    Jul. 2017, 胸部外科 = The Japanese journal of thoracic surgery, 70(8) (8), 571-577

  • Hiromu Kehara, Tamaki Takano, Takamitsu Terasaki, Kenji Okada
    We experienced a case of ventricular assist with both a pulsatile-flow and a continuous-flow pump in a pediatric patient, and herein report the clinical course and characteristics of the pumps. A 6-year-old female was diagnosed with fulminant myocarditis and transferred to our hospital for mechanical support. After 12 days of extracorporeal membrane oxygenation, we implanted a left ventricular assist device (LVAD) and a right ventricular assist device (RVAD) using centrifugal Gyro pumps with a membrane oxygenator in a paracorporeal fashion. The membrane oxygenator was removed on postoperative day (POD) 4, and the patient was weaned from the respirator on POD 6. The LVAD was exchanged on POD 13 and 17, and the RVAD was exchanged on POD 14 because of thrombus formation inside the pumps. The RVAD was removed on POD 25. On POD 32, the patient experienced cerebral infarction and the centrifugal Gyro pump was switched to an extracorporeal pulsatile pump. No thromboembolic event occurred after pump conversion, although continuous administration of vasodilators was required to avoid hypertension. She underwent successfully heart transplantation in the USA after 8 months of ventricular support. A centrifugal pump is considered useful for pediatric patients, as pump flow and blood pressure can be relatively easily controlled in the postoperative acute phase compared with the pulsatile pump. However, special care should be taken to monitor for thrombus formation when support length becomes longer than 13 days, and a switch to a pulsatile pump should be considered once the hemodynamic status stabilizes.
    SPRINGER JAPAN KK, Jun. 2017, Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs, 20(2) (2), 166 - 169, English, Domestic magazine
    Scientific journal

  • [Current Status of Thoracic Endovascular Aortic Repair in Our Institution].
    Daisuke Fukui, Kenji Okada
    Within 8-year period between 2009 and 2016, we treated 215 patient with a strategy of primary thoracic endovascular aortic repair( TEVAR). In-hospital mortality was 4.4%( 8 cases). Thirty-two emergency cases was included and we treated 23 cases of zone 0 debranching TEVAR with chimney techinique in this period. In recent 2-year period between 2015 and 2016, we treated 44 cases of TEVAR without type I a endoleaks with 0% mortality(most of the them was zone 2~3 TEVAR in this period) on the one hand, and the number of open surgery for thoracic aorta was 80 on the other. TEVAR was also indicated for emergency and high risk cases even if their anatomical conditions were outside of instruction for use, and utilized for bridging or staged therapy for open surgery in our series. Standardization and refinement of endovascular procedures is considered to be important to improvement outcomes, and hybrid therapy or back up of open surgery should be collaborated with TEVAR for thoracic aortic aneurysm treatment.
    Apr. 2017, Kyobu geka. The Japanese journal of thoracic surgery, 70(4) (4), 244 - 250, Japanese, Domestic magazine
    Scientific journal

  • 福井 大祐, 岡田 健次
    Apr. 2017, 胸部外科 = The Japanese journal of thoracic surgery, 70(4) (4), 244-250

  • Yuji Shiba, Toshihito Gomibuchi, Tatsuichiro Seto, Yuko Wada, Hajime Ichimura, Yuki Tanaka, Tatsuki Ogasawara, Kenji Okada, Naoko Shiba, Kengo Sakamoto, Daisuke Ido, Takashi Shiina, Masamichi Ohkura, Junichi Nakai, Narumi Uno, Yasuhiro Kazuki, Mitsuo Oshimura, Itsunari Minami, Uichi Ikeda
    Induced pluripotent stem cells (iPSCs) constitute a potential source of autologous patient-specific cardiomyocytes for cardiac repair, providing a major benefit over other sources of cells in terms of immune rejection. However, autologous transplantation has substantial challenges related to manufacturing and regulation. Although major histocompatibility complex (MHC)-matched allogeneic transplantation is a promising alternative strategy, few immunological studies have been carried out with iPSCs. Here we describe an allogeneic transplantation model established using the cynomolgus monkey (Macaca fascicularis), the MHC structure of which is identical to that of humans. Fibroblast-derived iPSCs were generated from a MHC haplotype (HT4) homozygous animal and subsequently differentiated into cardiomyocytes (iPSC-CMs). Five HT4 heterozygous monkeys were subjected to myocardial infarction followed by direct intra-myocardial injection of iPSC-CMs. The grafted cardiomyocytes survived for 12 weeks with no evidence of immune rejection in monkeys treated with clinically relevant doses of methylprednisolone and tacrolimus, and showed electrical coupling with host cardiomyocytes as assessed by use of the fluorescent calcium indicator G-CaMP7.09. Additionally, transplantation of the iPSC-CMs improved cardiac contractile function at 4 and 12 weeks after transplantation; however, the incidence of ventricular tachycardia was transiently, but significantly, increased when compared to vehicle-treated controls. Collectively, our data demonstrate that allogeneic iPSC-CM transplantation is sufficient to regenerate the infarcted non-human primate heart; however, further research to control post-transplant arrhythmias is necessary.
    NATURE PUBLISHING GROUP, Oct. 2016, Nature, 538(7625) (7625), 388 - 391, English, International magazine
    Scientific journal

  • Closed Circuit Systemの低侵襲化に関する検討
    道永 祐希, 高野 環, 寺崎 貴光, 宮嵜 聡磨, 菊池 紀敏, 岡田 健次
    (一社)日本人工臓器学会, Oct. 2016, 人工臓器, 45(2) (2), S - 86, Japanese

  • Katsuhiro Yamanaka, Takashi Matsueda, Shunsuke Miyahara, Yoshikatsu Nomura, Toshihito Sakamoto, Naoto Morimoto, Takeshi Inoue, Masamichi Matsumori, Kenji Okada, Yutaka Okita
    A 30-year-old man with Marfan syndrome who underwent Crawford type II extension aneurysm repair about 9 years ago was referred to our hospital with persistent fever. Computed tomography (CT) showed air around the mid-descending aortic prosthetic graft. Because the air did not disappear in spite of intravenous antibiotics, (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) was performed. FDG-PET/CT revealed four high-uptake lesions. After dissecting the aortic graft particularly focusing on the high-uptake lesions, this patient underwent in situ graft re-replacement of descending aortic graft with a rifampicin-bonded gelatin-impregnated Dacron graft and omentopexy. The patient remains well without recurrent infection at 3 months after surgery.
    Sep. 2016, General thoracic and cardiovascular surgery, 64(9) (9), 549 - 51, English, Domestic magazine
    Scientific journal

  • Jie Yu, Keisuke Morimoto, Wulan Bao, Zhenhai Yu, Yutaka Okita, Kenji Okada
    PURPOSE: To demonstrate the protective effect of glucagon-like peptide 1 (GLP-1) signaling on the cardiovascular system, we conducted this study to show that the GLP-1 receptor analog (lixisenatide) could inhibit abdominal aortic aneurysm (AAA) development in rats. METHODS: Lixisenatide was injected subcutaneously 7 days after aneurysm preparation. We evaluated reactive oxygen species (ROS) expression by dihydroethidium staining and 8-hydroxydeoxyguanosine (8-OHdG; the oxidation product of DNA) by immunohistochemical staining. We also analyzed the effect of GLP-1 signaling on the inflammatory response. Histopathological examination was done on day 28, and the AAA dilatation ratio was calculated. RESULTS: On day 14, ROS expression and 8-OHdG-positive cells in the aneurysm walls were seen to have been significantly decreased by lixisenatide treatment. Western blot analysis showed decreased ERK expression. There was significantly reduced tumor necrosis factor-α mRNA expression in the aneurysm walls and CD68-positive cell infiltration in the aneurysm walls. On day 28, it was evident that the lixisenatide had dramatically reduced aneurysm development in the rats. CONCLUSION: GLP-1 elevation inhibits AAA development in rats through its anti-oxidant and anti-inflammatory effects. Thus, GLP-1 could be a potent pharmacological target for AAA treatment.
    SPRINGER, Sep. 2016, Surgery today, 46(9) (9), 1099 - 107, English, Domestic magazine
    Scientific journal

  • Zhenhai Yu, Keisuke Morimoto, Jie Yu, Wulan Bao, Yutaka Okita, Kenji Okada
    OBJECTIVE: Vitamin B2 (riboflavin) reportedly has an antioxidant effect through superoxide dismutase (SOD) activation. However, the effect of riboflavin on abdominal aortic aneurysm (AAA) has never been investigated. In the present study, we examined the hypothesis that riboflavin has a protective effect on AAA formation in an experimental rat model. METHODS: The AAA model, which was induced with intraluminal elastase and extraluminal calcium chloride, was created in 36 rats. The 36 rats were divided into a riboflavin group (group R; 25 mg/kg/d), and control group (carboxymethyl cellulose). Riboflavin administration by gastric gavage once per day was started at 3 days before aneurysm preparation. On day 3, SOD activity in aneurysm walls was assayed. On day 7, reactive oxygen species (ROS) levels were semiquantified by dihydroethidium staining, and the oxidation product of DNA produced by ROS, 8-hydroxydeoxyguanosine (8-OHdG), was measured by immunohistochemical staining. Histopathologic examination (hematoxylin/eosin and elastica Van Gieson staining) was performed on day 28, and the AAA dilatation ratio was calculated to evaluate the protective effect of riboflavin. RESULTS: On day 3, SOD activity was significantly increased in aneurysm walls by riboflavin administration (370 ± 204 U/mL in normal, 334 ± 86 U/mL in control, 546 ± 143 U/mL in group R; P = .021). On day 7, ROS levels and 8-OHdG-positive cells in aneurysm walls were significantly decreased by riboflavin treatment (ROS levels: 1.0 ± 0.1 in normal, 4.5 ± 0.4 in control, 3.1 ± 0.5 in group R, P < .01; 8-OHdG-positive cells: 30 ± 2 cells in normal, 148 ± 20 cells in control, 109 ± 15 cells in group R, P < .01). Riboflavin treatment significantly reduced matrix metalloproteinase (MMP)-9 messenger RNA expression in aneurysm walls (relative expression: MMP-9: 0.4 ± 0.7 in normal, 2.6 ± 1.3 in control, 0.5 ± 0.3 in group R, P < .01). On day 28, the aortic walls were less dilated and had higher elastin content in group R than in control (dilatation ratio: 194.9% ± 10.9% in control, 158.6% ± 2.5% in group R; P <.01). CONCLUSIONS: Riboflavin treatment prevents AAA formation in a rat model through an antioxidant effect and might be a potent pharmacologic agent for AAA treatment in clinical practice.
    MOSBY-ELSEVIER, Sep. 2016, Journal of vascular surgery, 64(3) (3), 737 - 45, English, International magazine
    Scientific journal

  • Atsushi Omura, Shunsuke Miyahara, Katsuhiro Yamanaka, Toshihito Sakamoto, Masamichi Matsumori, Kenji Okada, Yutaka Okita
    OBJECTIVE: The present study aimed to determine the impact of the extent of graft replacement on early and late outcomes in acute DeBakey type I aortic dissection. METHODS: Between October 1999 and July 2014, 197 consecutive patients were surgically treated for acute DeBakey type I aortic dissection. The extent of graft replacement (hemiarch, partial, or total arch replacement) was mainly determined by the location of the primary entry. Early and late results were compared in patients after total arch replacement (n = 88) and combined hemiarch and partial arch replacement: non-total arch replacement (n = 109). RESULTS: The in-hospital mortality rates of the total arch replacement and non-total arch replacement groups were 10.2% and 14.7%, respectively (P = .47). Multivariate analysis revealed preoperative cardiopulmonary resuscitation and visceral organ malperfusion as significant risk factors for in-hospital mortality, but not total arch replacement. During a mean follow-up period of 60 ± 48 months, the 5-year survivals in the total arch replacement and non-total arch replacement groups were 88.6% ± 4.2% and 83.8% ± 4.4%, respectively (P = .54). Rates of distal aortic events (defined as freedom from surgery for distal aorta dilation or distal arch diameter expanding to 50 mm) at 5 years were significantly better in the total arch replacement group than in the non-total arch replacement group (94.9% ± 3.5% vs 83.6% ± 4.9%, P = .01). CONCLUSIONS: The operative mortality of patients with acute DeBakey type I aortic dissection treated by total arch replacement was acceptable with good long-term survival after both total arch replacement and non-total arch replacement. The frequency of distal aortic events might be reduced in patients after total arch replacement compared with non-total arch replacement.
    MOSBY-ELSEVIER, Feb. 2016, The Journal of thoracic and cardiovascular surgery, 151(2) (2), 341 - 8, English, International magazine
    Scientific journal

  • OKADA Kenji
    The Shinshu Medical Society, 2016, THE SHINSHU MEDICAL JOURNAL, 64(3) (3), 101 - 102, Japanese

  • 当院ICUにおける植え込み型補助人工心臓HeartMate II植込術後管理導入プロセスの報告
    大津 義徳, 清水 彩里, 三田 篤義, 今村 浩, 山田 真理, 金子 香代, 塩原 まゆみ, 道永 祐希, 瀬戸 達一郎, 岡田 健次
    (一社)日本集中治療医学会, Jan. 2016, 日本集中治療医学会雑誌, 23(Suppl.) (Suppl.), 492 - 492, Japanese

  • Akiko Tanaka, Toshihito Sakamoto, Masamichi Matsumori, Tatsuya Imanishi, Tetsu Nakamura, Kenji Okada, Yutaka Okita
    Aortoesophageal fistula is a fatal disease which needs immediate control of bleeding and infection. We report a case of aortoesophageal fistula successfully treated with extra-anatomical bypass and complete resection of infected aorta and esophagus following endovascular repair. He was discharged after reconstruction of esophagus and recurrence of infection has not been observed for the past 5 years.
    Jan. 2016, General thoracic and cardiovascular surgery, 64(1) (1), 28 - 30, English, Domestic magazine
    Scientific journal

  • Shunsuke Miyahara, Takashi Matsueda, Naoto Izawa, Katsuhiro Yamanaka, Toshihito Sakamoto, Yoshikatsu Nomura, Naoto Morimoto, Takeshi Inoue, Masamichi Matsumori, Kenji Okada, Yutaka Okita
    BACKGROUND: The mid-term results of valve-sparing aortic root reimplantation (VSRR) for various indications were investigated. METHODS: From 2000 to 2013, 183 consecutive patients undergoing VSRR were enrolled. Expanded indications, defined as a patient on the marginal operative indication, included age 65 years or older (n = 33), age 15 years or younger (n = 4), acute type A aortic dissection (AAAD) (n = 21), aortitis (n = 8), reoperative root replacement (n = 11), cusp prolapse (n = 67), large aortoventricular junction of greater than 28 mm (AVJ) (n = 42), preoperative severe aortic regurgitation (AR) (n = 89), left ventricular ejection fraction 0.40 or less (n = 12), LV dilation (n = 66), New York Heart Association class III or greater (n = 5), need for total arch replacement (n = 29), and concomitant mitral valve repair (n = 12). RESULTS: The overall survival at 5 years was 96.6%. Freedom from greater than mild AR and reoperation at 5 years was 85.8% and 92.9%, respectively. Cox proportional hazard model revealed that AAAD, cusp prolapse, AVJ 28 mm or greater, and operation before 2009 were at risk for late AR recurrence (p = 0.015, p = 0.0041, p = 0.032, and p = 0.014, respectively). After 2009, freedom from late AR in the cusp prolapse group improved (p = 0.055, versus control). Both freedom from recurrent AR and reoperation were worse as the number of expanded indications increased (log-rank trend p = 0.00017 and p = 0.00067, respectively). CONCLUSIONS: Surgical outcomes of VSRR in these patient cohorts were satisfactory with some room for improvement in patients with cusp prolapse. Although the indications for VSRR are being expanded, a larger number of expanded indications were associated with poor outcomes in terms of longevity of valve function.
    ELSEVIER SCIENCE INC, Sep. 2015, The Annals of thoracic surgery, 100(3) (3), 845 - 51, English, International magazine
    Scientific journal

  • Hiromu Kehara, Tamaki Takano, Kazunori Komatsu, Takamitsu Terasaki, Kenji Okada
    We discuss a rare case of an ascending aorta pseudoaneurysm fistulating into the right atrium following prior aortic and mitral valve replacement. Transthoracic echocardiography and computed tomography revealed a pseudoaneurysm of the ascending aorta attached to the right atrium with fistulous communication. The pseudoaneurysm arose from the center of the former aortotomy. Emergency remedian sternotomy was performed without aneurysmal injury and with exposure of the left femoral artery and femoral vein. Aneurysmal resection and ascending aorta repair were performed without complication. Exposing peripheral vessels, and initiating cardiopulmonary bypass only after reentry, might be effective in resternotomy to approach ascending aorta pseudoaneurysms.
    Aug. 2015, The heart surgery forum, 18(4) (4), E143-5, English, International magazine
    Scientific journal

  • Hitoshi Minami, Shunsuke Miyahara, Kenji Okada, Masamichi Matsumori, Hiroya Kano, Takeshi Inoue, Toshihito Sakamoto, Yutaka Okita
    OBJECTIVES: The goal of this study was to evaluate early and late outcomes of combined valve-sparing aortic root replacement and total arch replacement (TAR). METHODS: From October 1999 to May 2014, 195 patients underwent valve-sparing operations using the David reimplantation technique. Thirty-one patients underwent combined TAR for aortic regurgitation (AR) with extended aortic aneurysm from the aortic root to the aortic arch. Aetiologies included acute type A aortic dissection in 12 cases, chronic aortic dissection in 8 cases and non-dissecting aneurysm in 11 cases. There were 9 patients with Marfan syndrome. The preoperative severity of AR was mild in 4, moderate in 16 and severe in 11. Even though half of those were emergent operations for acute aortic dissection, preoperative haemodynamic conditions were stable in all patients. RESULTS: No hospital deaths occurred. Postoperative complications included prolonged mechanical ventilation (>48 h) in 1 case and re-exploration for bleeding in 2 cases. Other complications, such as neurological dysfunction or low cardiac output syndrome, were not observed. At hospital discharge, 2 patients had mild AR, 22 had trace AR and 7 had no AR. During follow-up, 2 patients had moderate AR, 7 had mild AR, 18 had trace AR and 3 had no AR. Follow-up was completed in 95.1% of patients, and the mean follow-up period was 60.5 ± 9.1 months. No late death and thromboembolic complication occurred during follow-up. One patient required reoperation for AR. Freedom from reoperation at 5 and 10 years was 100 ± 0 and 83.3 ± 3.5%, respectively. Freedom from moderate or severe AR at 3 and 5 years was 83.3 ± 3.5 and 83.3 ± 3.5%, respectively. CONCLUSIONS: Early outcomes of combined aortic root reimplantation and TAR were satisfactory and provided excellent freedom from thromboembolic complication. The rate of freedom from reoperation during long-term follow-up was acceptable. Further follow-up is required to evaluate this procedure.
    OXFORD UNIV PRESS INC, Jul. 2015, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 48(1) (1), 152 - 7, English, International magazine
    Scientific journal

  • Shunsuke Miyahara, Hiroya Kano, Kenji Okada, Yutaka Okita
    OXFORD UNIV PRESS, May 2015, Interactive cardiovascular and thoracic surgery, 20(5) (5), 687 - 687, English, International magazine
    Scientific journal

  • B型大動脈解離に対する治療戦略 遠隔成績と問題点 心臓血管 B型解離に対する治療戦略
    松森 正術, 辻本 貴紀, 山本 真由子, 池野 友基, 後竹 康子, 松枝 崇, 井澤 直人, 山里 隆浩, 山中 勝弘, 宮原 俊介, 野村 佳克, 坂本 敏仁, 森本 直人, 井上 武, 岡田 健次, 大北 裕
    (一社)日本外科学会, Apr. 2015, 日本外科学会定期学術集会抄録集, 115回, SY - 7, Japanese

  • 心臓血管 TEVAR後open conversionの治療戦略と成績
    池野 友基, 宮原 俊介, 辻本 貴紀, 山本 真由子, 後竹 康子, 松枝 崇, 井澤 直人, 山里 隆浩, 山中 勝弘, 坂本 敏仁, 野村 佳克, 森本 直人, 井上 武, 松森 正術, 岡田 健次, 大北 裕
    (一社)日本外科学会, Apr. 2015, 日本外科学会定期学術集会抄録集, 115回, PLS - 4, Japanese

  • Katsuhiro Yamanaka, Kenji Okada, Yutaka Okita
    A 67-year old man with ascending aortic aneurysm was referred because of a quadricuspid aortic valve. He underwent aortic root replacement with a valve-sparing technique. Under deep hypothermic circulatory arrest, replacement of the ascending aorta was successfully performed. The postoperative course was uneventful without recurrence of aortic regurgitation.
    OXFORD UNIV PRESS INC, Apr. 2015, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 47(4) (4), 741 - 3, English, International magazine
    Scientific journal

  • Akiko Tanaka, Tomonori Shirasaka, Kenji Okada, Yutaka Okita
    We describe our experience with a patient who had metastasized pulmonary artery sarcoma, but survived 7 years after diagnosis. A 61-year-old man was diagnosed with pulmonary artery intimal sarcoma after resection of metastatic tumours to the bilateral lungs. The primary lesion in the pulmonary artery trunk extending into the bilateral branches was treated by tumour endoarterectomy followed by chemotherapy. He underwent resections of lung metastases two more times before detection of recurrent obstructive pulmonary artery sarcoma 4 years after the tumour endoarterectomy. En bloc resection of the tumour including the pulmonary artery trunk, valve and interventricular septum was performed, and the right ventricular out flow tract was reconstructed with a stentless pulmonary valve and equine pericardium. He died of the disease soon after an operation for metastatic brain tumour 3 years later. Pulmonary artery sarcoma has a dismal prognosis, but aggressively repeated surgical interventions may lengthen survival.
    OXFORD UNIV PRESS INC, Feb. 2015, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 47(2) (2), 384 - 5, English, International magazine
    Scientific journal

  • 再手術に学ぶ初回手術の注意点 特に急性解離術後、中枢再手術症例の検討
    松森 正術, 辻本 貴紀, 山本 真由子, 池野 友基, 後竹 康子, 松枝 崇, 山里 隆浩, 井澤 直人, 山中 勝弘, 宮原 俊介, 野村 佳克, 坂本 敏仁, 森本 直人, 岡田 健次, 大北 裕
    (NPO)日本心臓血管外科学会, Jan. 2015, 日本心臓血管外科学会雑誌, 44(Suppl.) (Suppl.), 159 - 159, Japanese

  • 高度石灰化を有する僧帽弁弁輪部に対する僧帽弁置換術
    松枝 崇, 辻本 貴紀, 池野 友基, 後竹 康子, 山里 隆浩, 伊澤 直人, 山中 勝弘, 宮原 俊介, 野村 佳克, 坂本 敏仁, 森本 直人, 井上 武, 松森 正術, 岡田 健次, 大北 裕
    (NPO)日本心臓血管外科学会, Jan. 2015, 日本心臓血管外科学会雑誌, 44(Suppl.) (Suppl.), 242 - 242, Japanese

  • 再開胸による胸腹部大動脈手術の問題点
    森本 直人, 辻本 貴紀, 山本 真由子, 池野 友基, 後竹 康子, 山里 隆浩, 松枝 崇, 井澤 直人, 山中 勝弘, 宮原 俊介, 野村 佳克, 坂本 敏仁, 松森 正術, 岡田 健次, 大北 裕
    (NPO)日本心臓血管外科学会, Jan. 2015, 日本心臓血管外科学会雑誌, 44(Suppl.) (Suppl.), 286 - 286, Japanese

  • 大動脈炎症候群に伴う大動脈基部病変に対する外科治療の遠隔期成績の検討
    宮原 俊介, 辻本 貴紀, 池野 友基, 後竹 康子, 松枝 崇, 山里 隆浩, 井澤 直人, 山中 勝弘, 坂本 敏仁, 野村 佳克, 森本 直人, 井上 武, 松森 正術, 岡田 健次, 大北 裕
    (NPO)日本心臓血管外科学会, Jan. 2015, 日本心臓血管外科学会雑誌, 44(Suppl.) (Suppl.), 294 - 294, Japanese

  • 大動脈食道瘻手術症例に対する病理学的検討
    山里 隆浩, 辻本 貴紀, 山本 真由子, 池野 友基, 後竹 康子, 松枝 崇, 井澤 直人, 山中 勝弘, 宮原 俊介, 野村 佳克, 坂本 敏仁, 森本 直人, 松森 正術, 岡田 健次, 大北 裕
    (NPO)日本心臓血管外科学会, Jan. 2015, 日本心臓血管外科学会雑誌, 44(Suppl.) (Suppl.), 322 - 322, Japanese

  • 当院における大動脈手術術後急性膵炎に関する検討
    井澤 直人, 松森 正術, 辻本 貴紀, 山本 真由子, 池野 友基, 後竹 康子, 松枝 崇, 山里 隆浩, 山中 勝弘, 宮原 俊介, 野村 佳克, 坂本 敏仁, 森本 直人, 岡田 健次, 大北 裕
    (NPO)日本心臓血管外科学会, Jan. 2015, 日本心臓血管外科学会雑誌, 44(Suppl.) (Suppl.), 386 - 386, Japanese

  • 僧帽弁閉鎖不全症に合併する三尖弁閉鎖不全症による遠隔期心不全に関する検討
    坂本 敏仁, 辻本 貴紀, 池野 友基, 山里 隆浩, 後竹 康子, 松枝 崇, 井澤 直人, 宮原 俊介, 山中 勝弘, 野村 佳克, 森本 直人, 井上 武, 松森 正術, 岡田 健次, 大北 裕
    (NPO)日本心臓血管外科学会, Jan. 2015, 日本心臓血管外科学会雑誌, 44(Suppl.) (Suppl.), 441 - 441, Japanese

  • 中井 秀和, 松枝 崇, 宮原 俊介, 山中 勝弘, 井澤 直人, 坂本 敏仁, 野村 佳克, 井上 武, 松森 正樹, 岡田 健次, 大北 裕
    公益財団法人 日本心臓財団, 2015, 心臓, 47(7) (7), 871 - 871, Japanese

  • Kano H, Okada K, Morimoto K, Bao W, Fukase K, Ito A, Okita Y
    2015, perfusion, 30(8) (8), 617 - 625
    [Refereed]

  • 縦隔炎・胸骨骨髄炎における陰圧閉鎖療法の実際 (特集 陰圧閉鎖療法の理論と実際)
    榊原 俊介, 寺師 浩人, 岡田 健次
    Jan. 2015, Pepars, (97) (97), 64-71

  • Tomonori Shirasaka, Kenji Okada, Hiroya Kano, Masamichi Matsumori, Takeshi Inoue, Yutaka Okita
    OBJECTIVE: Impact of the decrease of regional cerebral oxygen saturation (rSO2) on postoperative delayed awakening after total aortic arch replacement (TAR) was validated. METHODS: From 2008 to 2013, 143 consecutive patients underwent TAR using selective antegrade cerebral perfusion. rSO2 was monitored using near-infrared spectroscopy. We calculated a percent decrease of rSO2 (%-D) immediately after rewarming according to the following formula: %-D=rSO2 (X1)-rSO2 (X2)/rSO2 (X1)×100 (%), where rSO2 (X1) was measured at the beginning of rewarming, and rSO2 (X2) was measured 10 min later. Delayed awakening was defined as patients not waking up for more than 6 h after the termination of anaesthesia. RESULTS: The average time to wake up was 3.6±2.0 h. Fourteen patients showed delayed awakening. %-D showed a positive linear relationship to awakening time (y=0.67x-0.7, r=0.23, P=0.007) and receiver operating characteristic analysis showed %-D had a good predictive value for delayed awakening (area under the curve=0.84). %-D was significantly different between the delayed awakening and the normal group (7.1±5.1 vs 1.3±6.6%, P=0.002). Two patients (1.4%) who had multicomorbidity with higher %-D died in the hospital due to colon necrosis and sepsis. There were significant differences between patients with normal and delayed awakening in hospital mortality (P=0.04) and transient neurological deficit (TND, P=0.007). CONCLUSION: The maintenance of rSO2 at the early phase of rewarming may be important to avoid delayed awakening or TND after TAR.
    OXFORD UNIV PRESS INC, Jan. 2015, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 47(1) (1), 101 - 5, English, International magazine
    Scientific journal

  • Shunsuke Miyahara, Hidekazu Nakai, Naoto Izawa, Katsuhiro Yamanaka, Toshihito Sakamoto, Yoshikatsu Nomura, Takeshi Inoue, Masamichi Matsumori, Kenji Okada, Yutaka Okita
    BACKGROUND: Although an association between chronic obstructive pulmonary disease (COPD) and adverse surgical outcomes has been proposed, the impact of COPD severity on postoperative outcomes remains unclear. Our objective was to analyze the prognostic implication of COPD severity on outcomes after total aortic arch replacement. METHODS: Between October 1999 and December 2012, 269 patients undergoing total arch replacement through median sternotomy, who were elective cases with preoperative spirometry records, were retrospectively reviewed. Patients were divided into four groups: control group, with ratio of forced expiratory volume of air in 1 second (FEV1) to forced vital capacity (FVC) of 70% or greater; mild airflow obstruction, with FEV1/FVC ratio less than 70% and FEV1 80% or greater of predicted; moderate airflow obstruction, FEV1/FVC ratio less than 70% and FEV1 50% to 79% of predicted; severe airflow obstruction, FEV1/FVC ratio less than 70% and FEV1 less than 50% of predicted. Symptoms of functional dyspnea and disability were also assessed. Multivariate logistic and Cox regression methods were used to determine if there was an independent association between COPD and short-term and long-term outcomes, respectively. RESULTS: The in-hospital mortality rate was 2.2% (6 of 269). A consistent trend of increasing frequency of postoperative respiratory complications with advanced airflow obstruction was noted. In multivariate analysis, in-hospital mortality (p = 0.022), incidence of respiratory complications (p = 0.021) and overall mortality (p = 0.025) was significantly associated with the symptoms of COPD, respectively. CONCLUSIONS: The severity of COPD as defined by spirometry and symptoms of functional dyspnea may be an important prognostic marker of patients undergoing total arch replacement.
    ELSEVIER SCIENCE INC, Jan. 2015, The Annals of thoracic surgery, 99(1) (1), 72 - 8, English, International magazine
    Scientific journal

  • Katsuhiro Yamanaka, Atsushi Omura, Yoshikatsu Nomura, Shunsuke Miyahara, Tomonori Shirasaka, Toshihihito Sakamoto, Takeshi Inoue, Masamichi Matsumori, Hitoshi Minami, Kenji Okada, Yutaka Okita
    OBJECTIVES: This report describes our experience with surgical management of aorta-related infections. METHODS: From November 1999 to April 2013, 70 patients underwent surgical management for aorta-related infection, including aortobronchial fistula in 12 patients, aorto-oesophageal fistula in 14 and aortoduodenal fistula in 4. The location of infection was aortic root to arch in 22 patients, descending aorta in 29, thoraco-abdominal aorta in 12 and abdominal aorta in 7. Forty-seven patients had infections of the native aorta and 23 had postoperative graft infections. In situ replacement [bridge thoracic endovascular aortic repair (TEVAR); n = 1] was performed in 45 patients, endovascular aortic repair in 18 and extra-anatomical bypass (bridge TEVAR; n = 2) in 7. Omental flap was installed in 29 patients and a pedicled latissimus dorsi muscle flap was used in 3. Since 2008, we have been trying to resect not only the infected tissues, but also the surrounding aneurysmal wall as well. RESULTS: Hospital mortality was 17.1% (12/70). Late death occurred in 15 patients. Overall survival at 3 years was 60.1 ± 6.7%. Freedom from infection-related death of patients who had in situ graft replacement, endovascular repair or extra-anatomical bypass at 3 years was 88.5 ± 4.9, 75.2 ± 10.9 or 14.3 ± 13.2%, respectively (P < 0.01). In situ graft replacement provided a better freedom from aortic event (recurrent infection and reintervention) at 3 years compared with endovascular repair (85.6 ± 5.5 vs 61.8 ± 12.5%, P = 0.029). Freedom from infection-related death at 3 years improved significantly from 61.1 ± 9.7 (before 2008) to 84.7 ± 5.8% (since 2008) (P = 0.044). CONCLUSIONS: Surgical treatment for aorta-related infection is still associated with high mortality and morbidity. However, our current strategy, which is aggressive surgical management, including resection of infected tissues, extensive debridement, in situ graft replacement of the aorta and omental or muscle installation provided a better patient survival.
    OXFORD UNIV PRESS INC, Dec. 2014, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 46(6) (6), 974 - 80, English, International magazine
    Scientific journal

  • Yutaka Okita, Katsuhiro Yamanaka, Kenji Okada, Masamichi Matsumori, Takeshi Inoue, Keigo Fukase, Toshihito Sakamoto, Shunsuke Miyahara, Tomonori Shirasaka, Naoto Izawa, Taimi Ohara, Yoshikatsu Nomura, Hidekazu Nakai, Yasuko Gotake, Hiroya Kano
    OBJECTIVES: Presenting a surgical strategy for aorto-oesophageal fistula (AEF). METHODS: From October 1999 to August 2013, 16 patients with AEF were treated at Kobe University Hospital. The mean age was 65.5 ± 10.2 years, and the male/female ratio was 13/3. Eight patients had non-dissecting thoracic aneurysm, 3 had chronic aortic dissection, 5 had oesophageal cancer and 1 had fish bone penetration. Five patients were in shock. Four patients had previous thoracic endovascular aortic repair (TEVAR) in the descending aorta and 1 had hemi-arch replacement. As treatment for AEF, 8 patients underwent TEVAR, 2 had a bridge TEVAR to open surgery, 2 had extra-anatomical bypass (EAB) and 5 had in situ reconstruction of the descending aorta. The oesophagus was resected in 8 patients, and an omental flap was installed in 7 patients. For the 4 most recent cases, simultaneous resection of the aorta and oesophagus, in situ reconstruction of the descending aorta using rifampicin-soaked Dacron graft and omental flap installation were performed. RESULTS: Hospital mortality was noted in 4 patients (25.0%; persistent sepsis n = 3 and pneumonia n = 1). However, since 2007, only 1 of 5 patients died (pneumonia). All patients with oesophageal cancer died during follow-up. Two patients underwent oesophageal reconstruction using a pedicled colon graft and one is on the waiting list for oesophageal reconstruction. CONCLUSIONS: Bridging TEVAR is a useful adjunct in treating AEF patients with shock. One-stage surgery consisting of resection of the aneurysm and oesophagus, in situ reconstruction of the descending aorta and omental flap installation provided a better outcome in the AEF surgical strategy compared with conservative treatment.
    OXFORD UNIV PRESS INC, Nov. 2014, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 46(5) (5), 894 - 900, English, International magazine
    Scientific journal

  • Kenji Okada, Katsuhiro Yamanaka, Toshihito Sakamoto, Takeshi Inoue, Masamichi Matsumori, Fumi Kawakami, Yutaka Okita
    BACKGROUND: We present a series of patients who underwent in situ total aortic arch replacement for infected distal aortic arch aneurysms. METHODS: Between 2002 and 2013, 9 patients with infected distal aortic arch aneurysms underwent total aortic arch replacement using antegrade selective cerebral perfusion. There were 4 male and 5 female patients with a mean age of 72.7±9.0 years. All patients had penetrating atherosclerotic ulcer in the distal aortic arch, which formed saccular aneurysms. Four patients had preoperative hoarseness. Maximum preoperative white blood cell count was 10,211±4375/μL, and mean serum C-reactive protein concentration was 12.7±7.2 mg/dL. Causative microorganisms were identified by blood culture or aortic wall culture and were as follows: Candida albicans, Pseudomonas aeruginosa, Edwardsiella tarda, Streptococcus dysgalactiae, Listeria monocytogenes, Staphylococcus aureus (2 cases), and unknown (2 cases). Radical debridement with in situ total aortic arch replacement was performed in all patients, followed by the omental flap grafting in 7 patients. All surgery was performed on an urgent or emergency basis. RESULTS: Average cardiopulmonary bypass time and lower body circulatory arrest time were 199.7±50.7 minutes and 66.6±13.8 minutes, respectively. There was no in-hospital mortality, but 1 patient died of asphyxia 5 months after hospital discharge. Freedom from recurrence of infection was 100%. CONCLUSIONS: Surgical treatment with the combination of radical debridement with in situ total aortic arch replacement using antegrade selective cerebral perfusion and omental flap grafting was a reliable procedure for the treatment of infected distal aortic arch aneurysms.
    MOSBY-ELSEVIER, Nov. 2014, The Journal of thoracic and cardiovascular surgery, 148(5) (5), 2096 - 100, English, International magazine
    Scientific journal

  • Efficacy of nafamostat mesilate as anticoagulation during cardiopulmonary bypass for early surgery in patients with active infective endocarditis complicated by stroke.
    Toshihito Sakamoto, Hiroya Kano, Shunsuke Miyahara, Takeshi Inoue, Naoto Izawa, Yasuko Gotake, Masamichi Matsumori, Kenji Okada, Yutaka Okita
    BACKGROUND AND AIM OF THE STUDY: Recent brain complications (e.g., bleeding or infarction) in patients with active infective endocarditis (AIE) are recognized as a contraindication for early surgery. Nafamostat mesilate (NM) is a synthetic protease-inhibiting agent that has not only potent inhibitory activity against coagulation factors (Xlla, Xa) but also an anti-inflammatory action. Herein is reported the authors' successful surgical experience using NM with low-dose heparinization in patients with AIE complicated by recent cerebral complications. METHODS: Twenty-eight patients (mean age 54.9 +/- 18.7 years) who had undergone surgery for AIE of the native valve (n = 21) or prosthetic valve (n = 7) were reviewed retrospectively. AIE was present in the aortic (n = 8), mitral (n = 16), aortic/mitral (n = 4) and tricuspid (n = 1) valves. Twenty-two of 28 patients had preoperative stroke, and six had active brain bleeding. Surgery was performed at a mean of 2.4 +/- 2.1 days after the onset of stroke. NM (209 +/- 152 mg) with low-dose heparin (3796 +/- 1218 IU; 67.4 +/- 20.3 IU/kg) was used for anticoagulation during cardiopulmonary bypass (CPB). The activated clotting time (ACT) was maintained at 350-450 s by the precise administration of NM into a cardiotomy reservoir (0.5 mg/kg/h) and a venous reservoir (sliding controlled dose at 1.5 mg/kg/h). RESULTS: The CPB time was 181.3 +/- 92.6 min. Five patients (17.8%) died during hospitalization due to persistent sepsis (n = 3), brain death caused by massive brain embolism before CPB establishment (n = 1), and pneumonia (n = 1). There was no further aggravation of intracranial bleeding, and no new hemorrhagic stroke. CONCLUSION: Nafamostat mesilate, administered in conjunction with low-dose heparinization, served as an effective anticoagulant for early surgery in patients with AIE complicated by stroke, and caused no further deterioration of the cerebral lesions.
    I C R PUBLISHERS, Nov. 2014, The Journal of heart valve disease, 23(6) (6), 744 - 51, English, International magazine
    Scientific journal

  • Akiko Tanaka, Tomomi Hasegawa, Keisuke Morimoto, Wulan Bao, Jie Yu, Yutaka Okita, Yasuhiko Tabata, Kenji Okada
    OBJECTIVE: Abdominal aortic aneurysms (AAAs) are associated with oxidative stress and inflammatory response. We investigated the hypothesis that the known antioxidant ascorbic acid, which can also promote elastin and collagen production by smooth muscle cells, would prevent AAA formation in a rat model. METHODS: An intraluminal elastase and extraluminal calcium chloride-induced rat AAA model was used, and the animals were divided into three groups: control (group C, n = 18), the aorta wrapped with a saline-impregnated gelatin hydrogel sheet (group G, n = 18), and the aorta wrapped with a gelatin hydrogel sheet incorporating ascorbic acid (group A, n = 18). Wrapping of the sheet was completed at the end of treatment for AAA creation. The aortic dilatation ratio was measured, and aortic tissues were further examined for oxidative stress and oxidative DNA damage using biochemical and histologic techniques. RESULTS: Aortic dilatation at both 4 and 8 weeks was inhibited in group A (dilatation ratio [%] at 4 weeks: 186.2 ± 21.8 in group C, 152.3 ± 10.2 in group G, 126.8 ± 11.6 in group A; P < .0001; dilatation ratio [%] at 8 weeks: 219.3 ± 37.5 in group C, 194.0 ± 11.6 in group G, 145.7 ± 8.3 in group A; P = .0002). Elastin and collagen content were significantly preserved in group A (elastin, P = .0015; collagen, P < .0001). The messenger RNA expressions of matrix metalloproteinase (MMP)-9, monocyte chemotactic protein-1, interleukin-1β, and tissue necrosis factor-α (P = .0024, P < .0001, P < .0001, and P < .0001, respectively) were downregulated in group A (P = .0024), whereas tissue inhibitors of metalloproteinase (TIMP)-1 and TIMP-2 were both upregulated in group A (TIMP-1, P = .0014; TIMP-2, P < .0001). Gelatin zymography showed activities of pro-MMP-2, MMP-2, and MMP-9 were significantly suppressed in group C (P < .0001 for each). Reactive oxygen species expression and 8-hydroxydeoxyguanosine and cluster of differentiation 68 staining were significantly suppressed in group A (reactive oxygen species expression, P < .0001; 8-hydroxydeoxyguanosine-positive cells, P < .0001; cluster of differentiation 68 positive cells, P < .0001). CONCLUSIONS: Controlled release of ascorbic acid using gelatin hydrogel sheet-attenuated AAA formation through antioxidant and anti-inflammatory effect, regulation of MMP-2, TIMP-1, and TIMP-2, and preserving elastin and collagen in this animal model.
    MOSBY-ELSEVIER, Sep. 2014, Journal of vascular surgery, 60(3) (3), 749 - 58, English, International magazine
    [Refereed]
    Scientific journal

  • Akiko Tanaka, Tomomi Hasegawa, Keisuke Morimoto, Wulan Bao, Jie Yu, Yutaka Okita, Yasuhiko Tabata, Kenji Okada
    Objective: Abdominal aortic aneurysms (AAAs) are associated with oxidative stress and inflammatory response. We investigated the hypothesis that the known antioxidant ascorbic acid, which can also promote elastin and collagen production by smooth muscle cells, would prevent AAA formation in a rat model. Methods: An intraluminal elastase and extraluminal calcium chloride-induced rat AAA model was used, and the animals were divided into three groups: control (group C, n = 18), the aorta wrapped with a saline-impregnated gelatin hydrogel sheet (group G, n = 18), and the aorta wrapped with a gelatin hydrogel sheet incorporating ascorbic acid (group A, n = 18). Wrapping of the sheet was completed at the end of treatment for AAA creation. The aortic dilatation ratio was measured, and aortic tissues were further examined for oxidative stress and oxidative DNA damage using biochemical and histologic techniques. Results: Aortic dilatation at both 4 and 8 weeks was inhibited in group A (dilatation ratio [%] at 4 weeks: 186.2 +/- 21.8 in group C, 152.3 +/- 10.2 in group G, 126.8 +/- 11.6 in group A; P < .0001; dilatation ratio [%] at 8 weeks: 219.3 +/- 37.5 in group C, 194.0 +/- 11.6 in group G, 145.7 +/- 8.3 in group A; P = .0002). Elastin and collagen content were significantly preserved in group A (elastin, P = .0015; collagen, P < .0001). The messenger RNA expressions of matrix metalloproteinase (MMP)-9, monocyte chemotactic protein-1, interleukin-1 beta, and tissue necrosis factor-alpha (P = .0024, P < .0001, P < .0001, and P < .0001, respectively) were downregulated in group A (P = .0024), whereas tissue inhibitors of metalloproteinase (TIMP)-1 and TIMP-2 were both upregulated in group A (TIMP-1, P = .0014; TIMP-2, P < .0001). Gelatin zymography showed activities of pro-MMP-2, MMP-2, and MMP-9 were significantly suppressed in group C (P <.0001 for each). Reactive oxygen species expression and 8-hydroxydeoxyguanosine and cluster of differentiation 68 staining were significantly suppressed in group A (reactive oxygen species expression, P < .0001; 8-hydroxydeoxyguanosine-positive cells, P < .0001; cluster of differentiation 68 positive cells, P <.0001). Conclusions: Controlled release of ascorbic acid using gelatin hydrogel sheet-attenuated AAA formation through antioxidant and anti-inflammatory effect, regulation of MMP-2, TIMP-1, and TIMP-2, and preserving elastin and collagen in this animal model.
    MOSBY-ELSEVIER, Sep. 2014, JOURNAL OF VASCULAR SURGERY, 60(3) (3), 749 - 758, English
    Scientific journal

  • Yu Taniguchi, Kazuya Miyagawa, Kazuhiko Nakayama, Hiroto Kinutani, Toshiro Shinke, Kenji Okada, Yutaka Okita, Ken-ich Hirata, Noriaki Emoto
    AIMS: To evaluate the efficacy and safety of balloon pulmonary angioplasty (BPA) in patients with non-operable chronic thromboembolic pulmonary hypertension (CTEPH) using the results of pulmonary endarterectomy (PEA) for operable patients as a reference, and annotate the role of BPA in the management of CTEPH. METHODS AND RESULTS: Data from 53 CTEPH patients were collected retrospectively. Twenty-four operable patients underwent PEA, and 29 non-operable patients underwent BPA. Patients who underwent BPA showed improved mean pulmonary arterial pressure, pulmonary vascular resistance, and cardiac output (39.4±6.9 to 21.3±5.6 mmHg, 763±308 to 284±128 dyn·s-1·cm-5, 3.47±0.80 to 4.26±1.15 L/min, respectively); patients who received PEA showed similar efficacy (44.4±11.0 to 21.6±6.7 mmHg, 781±278 to 258±125 dyn·s-1·cm-5, 3.35±1.11 to 4.44±1.58 L/min, respectively). The mortality rates of BPA and PEA patients were 3.4% and 8.3%, respectively. CONCLUSIONS: The efficacy and safety of BPA for non-operable cases were similar to those achieved using PEA for operable cases. BPA could be an additional treatment option for non-operable CTEPH patients, and most CTEPH patients can be satisfactorily treated by BPA or PEA.
    EUROPA EDITION, Aug. 2014, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 10(4) (4), 518 - 25, English, International magazine
    Scientific journal

  • Atsushi Omura, Katsuhiro Yamanaka, Shunsuke Miyahara, Toshihito Sakamoto, Takeshi Inoue, Kenji Okada, Yutaka Okita
    Objectives: The present study analyzes the early patency of intercostal artery reconstruction, using graft interposition and aortic patch anastomosis, and determines the fate of reattached intercostal arteries after repair of thoracoabdominal aortic aneurysms. Methods: We selected 115 patients (mean age, 63 +/- 15 years; range, 19-83 years; male, n = 83) treated by thoracoabdominal aortic aneurysm repair with 1 or more reconstructed intercostal arteries at the Kobe University Graduate School of Medicine between October 1999 and December 2012. The intercostal arteries were reconstructed using graft interposition (n = 66), aortic patch anastomosis (n = 42), or both (n = 7). Results: The hospital mortality rate was 7.8% (n = 9). Eleven patients (9.6%) developed spinal cord ischemic injury (permanent, n = 6, transient, n = 5). The average number of reconstructed intercostal arteries per patient was 3.0 +/- 1.5 (1-7), and 345 intercostal arteries were reattached. The overall patency rate was 74.2% (256/345) and that of aortic patch anastomosis was significantly better than that of graft interposition (90.8% [109/120] vs 65.3% [147/225], P < .01), but significantly worse for patients with than without spinal cord ischemic injury (51.9% [14/27] vs 76.1% [242/318], P = .01). There was no patch aneurysm in graft interposition during a mean of 49 +/- 38 (range, 2-147) postoperative months, but aortic patch anastomosis including 4 intercostal arteries became dilated in 2 patients. Conclusions: Aortic patch anastomosis might offer better patency rates and prevent spinal cord ischemic injury compared with graft interposition. Although aneurysmal changes in intercostal artery reconstructions are rare, large blocks of aortic wall reconstruction should be closely monitored.
    MOSBY-ELSEVIER, Jun. 2014, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 147(6) (6), 1861 - 1867, English
    Scientific journal

  • Atsushi Omura, Katsuhiro Yamanaka, Shunsuke Miyahara, Toshihito Sakamoto, Takeshi Inoue, Kenji Okada, Yutaka Okita
    OBJECTIVES: The present study analyzes the early patency of intercostal artery reconstruction, using graft interposition and aortic patch anastomosis, and determines the fate of reattached intercostal arteries after repair of thoracoabdominal aortic aneurysms. METHODS: We selected 115 patients (mean age, 63 ± 15 years; range, 19-83 years; male, n = 83) treated by thoracoabdominal aortic aneurysm repair with 1 or more reconstructed intercostal arteries at the Kobe University Graduate School of Medicine between October 1999 and December 2012. The intercostal arteries were reconstructed using graft interposition (n = 66), aortic patch anastomosis (n = 42), or both (n = 7). RESULTS: The hospital mortality rate was 7.8% (n = 9). Eleven patients (9.6%) developed spinal cord ischemic injury (permanent, n = 6, transient, n = 5). The average number of reconstructed intercostal arteries per patient was 3.0 ± 1.5 (1-7), and 345 intercostal arteries were reattached. The overall patency rate was 74.2% (256/345) and that of aortic patch anastomosis was significantly better than that of graft interposition (90.8% [109/120] vs 65.3% [147/225], P < .01), but significantly worse for patients with than without spinal cord ischemic injury (51.9% [14/27] vs 76.1% [242/318], P = .01). There was no patch aneurysm in graft interposition during a mean of 49 ± 38 (range, 2-147) postoperative months, but aortic patch anastomosis including 4 intercostal arteries became dilated in 2 patients. CONCLUSIONS: Aortic patch anastomosis might offer better patency rates and prevent spinal cord ischemic injury compared with graft interposition. Although aneurysmal changes in intercostal artery reconstructions are rare, large blocks of aortic wall reconstruction should be closely monitored.
    MOSBY-ELSEVIER, Jun. 2014, The Journal of thoracic and cardiovascular surgery, 147(6) (6), 1861 - 7, English, International magazine
    [Refereed]
    Scientific journal

  • Shunsuke Miyahara, Takeshi Inoue, Hitoshi Minami, Kenji Okada, Yutaka Okita
    Midsternotomy in patients with a coexisting tracheostomy is associated with a risk of deep sternal wound infection (DSWI) or mediastinitis. We herein present two cases of total arch replacement using a surgical technique designed to avoid the danger of DSWI. Total arch replacement via an antero-lateral thoracotomy with partial sternotomy can be one of the options for patients with a tracheostoma or after laryngectomy, and can both protect organs and avoid DSWI.
    SPRINGER, May 2014, SURGERY TODAY, 44(5) (5), 972 - 975, English
    Scientific journal

  • Shunsuke Miyahara, Takeshi Inoue, Hitoshi Minami, Kenji Okada, Yutaka Okita
    Midsternotomy in patients with a coexisting tracheostomy is associated with a risk of deep sternal wound infection (DSWI) or mediastinitis. We herein present two cases of total arch replacement using a surgical technique designed to avoid the danger of DSWI. Total arch replacement via an antero-lateral thoracotomy with partial sternotomy can be one of the options for patients with a tracheostoma or after laryngectomy, and can both protect organs and avoid DSWI.
    SPRINGER, May 2014, Surgery today, 44(5) (5), 972 - 5, English, Domestic magazine
    [Refereed]
    Scientific journal

  • Wulan Bao, Keisuke Morimoto, Tomomi Hasegawa, Naoto Sasaki, Tomoya Yamashita, Kenichi Hirata, Yutaka Okita, Kenji Okada
    Objective: Dipeptidyl peptidase-4 (DPP-4) inhibitor, a novel antidiabetic drug, has a cardioprotective effect on ischemia-reperfusion injury through an antioxidant effect. However, the effect of DPP-4 inhibitor on aneurysm formation has not been investigated. We aimed to test the hypothesis that the DPP-4 inhibitor, alogliptin, attenuates vascular oxidative stress and thus inhibits abdominal aortic aneurysm (AAA) formation. Methods: AAAs were created with intraluminal elastase and extraluminal calcium chloride in 36 male rats. Rats were divided into three groups: a low dose of alogliptin group (group LD; 1 mg/kg/d), a high-dose group (group HD; 3 mg/kg/d), and a control group (group C, water). Alogliptin was administered by gastric gavage once daily beginning 3 days before surgery. On day 7 after aneurysm preparation, reactive oxygen species (ROS) expression was semiquantified by dihydroethidium staining, and the oxidation product of DNA produced by ROS, 8-hydroxydeoxyguanosine (8-OHdG), was measured by immunohistochemical staining. Blood glucose concentrations were measured. Hematoxylin and eosin and elastica Van Gieson stainings were performed on day 28, and the AAA dilatation ratio was calculated. Results: On day 7 (six in each group), dihydroethidium staining of the aneurysm wall showed a reduced level of ROS expression (4.6 +/- 0.6 in group C, 2.7 +/- 0.3 in group LD, and 1.7 +/- 0.5 in group HD; P<.0001) and showed fewer 8-OHdG-positive cells in alogliptin-treated samples (138.1 +/- 7.4 cells in group C, 102.5 +/- 4.5 cells in group LD, and 66.1 +/- 4.5 cells in group HD; P<.0001) The treatment significantly reduced messenger RNA expression of matrix metalloproteinases (MMPs) in aneurysm walls (relative expression: MMP-2: 2.1 +/- 0.4 in group C, 1.3 +/- 0.3 in group LD, and 0.9 +/- 0.2 in group HD; P<.001; MMP-9: 2.0 +/- 0.5 in group C, 0.3 +/- 0.3 in group LD, and 0.3 +/- 0.2 in group HD; P<.001). On day 28 (six in each group), the aortic wall in groups LD and HD was less dilated (dilatation ratio: 199.2% +/- 11.8% in group C, 159.6% +/- 2.8% in group LD, and 147.1% +/- 1.9% in group HD; P<.02 group C vs HD) and had higher elastin content than in group C. The difference in blood glucose levels among the three groups was not significant. Conclusions: The DPP-4 inhibitor, alogliptin, attenuates aneurysm formation and expansion dose-dependently in a rat AAA model via an antioxidative action.
    MOSBY-ELSEVIER, Apr. 2014, JOURNAL OF VASCULAR SURGERY, 59(4) (4), 1098 - 1108, English
    Scientific journal

  • Wulan Bao, Keisuke Morimoto, Tomomi Hasegawa, Naoto Sasaki, Tomoya Yamashita, Kenichi Hirata, Yutaka Okita, Kenji Okada
    OBJECTIVE: Dipeptidyl peptidase-4 (DPP-4) inhibitor, a novel antidiabetic drug, has a cardioprotective effect on ischemia-reperfusion injury through an antioxidant effect. However, the effect of DPP-4 inhibitor on aneurysm formation has not been investigated. We aimed to test the hypothesis that the DPP-4 inhibitor, alogliptin, attenuates vascular oxidative stress and thus inhibits abdominal aortic aneurysm (AAA) formation. METHODS: AAAs were created with intraluminal elastase and extraluminal calcium chloride in 36 male rats. Rats were divided into three groups: a low dose of alogliptin group (group LD; 1 mg/kg/d), a high-dose group (group HD; 3 mg/kg/d), and a control group (group C, water). Alogliptin was administered by gastric gavage once daily beginning 3 days before surgery. On day 7 after aneurysm preparation, reactive oxygen species (ROS) expression was semiquantified by dihydroethidium staining, and the oxidation product of DNA produced by ROS, 8-hydroxydeoxyguanosine (8-OHdG), was measured by immunohistochemical staining. Blood glucose concentrations were measured. Hematoxylin and eosin and elastica Van Gieson stainings were performed on day 28, and the AAA dilatation ratio was calculated. RESULTS: On day 7 (six in each group), dihydroethidium staining of the aneurysm wall showed a reduced level of ROS expression (4.6 ± 0.6 in group C, 2.7 ± 0.3 in group LD, and 1.7 ± 0.5 in group HD; P < .0001) and showed fewer 8-OHdG-positive cells in alogliptin-treated samples (138.1 ± 7.4 cells in group C, 102.5 ± 4.5 cells in group LD, and 66.1 ± 4.5 cells in group HD; P < .0001) The treatment significantly reduced messenger RNA expression of matrix metalloproteinases (MMPs) in aneurysm walls (relative expression: MMP-2: 2.1 ± 0.4 in group C, 1.3 ± 0.3 in group LD, and 0.9 ± 0.2 in group HD; P < .001; MMP-9: 2.0 ± 0.5 in group C, 0.3 ± 0.3 in group LD, and 0.3 ± 0.2 in group HD; P < .001). On day 28 (six in each group), the aortic wall in groups LD and HD was less dilated (dilatation ratio: 199.2% ± 11.8% in group C, 159.6% ± 2.8% in group LD, and 147.1% ± 1.9% in group HD; P < .02 group C vs HD) and had higher elastin content than in group C. The difference in blood glucose levels among the three groups was not significant. CONCLUSIONS: The DPP-4 inhibitor, alogliptin, attenuates aneurysm formation and expansion dose-dependently in a rat AAA model via an antioxidative action.
    MOSBY-ELSEVIER, Apr. 2014, Journal of vascular surgery, 59(4) (4), 1098 - 108, English, International magazine
    [Refereed]
    Scientific journal

  • Yu Taniguchi, Noriaki Emoto, Kazuya Miyagawa, Kazuhiko Nakayama, Hiroto Kinutani, Hidekazu Tanaka, Toshiro Shinke, Kenji Okada, Yutaka Okita, Ken-ich Hirata
    Secundum atrial septal defect (ASD) is the most common form of congenital heart disease in adults. Surgical and transcatheter closures of ASD are widely accepted therapeutic approaches. In patients with severe pulmonary arterial hypertension (PAH), however, the closure of the defect is still controversial. We report two cases of ASD patients with severe PAH successfully repaired subsequent to effective medical therapy. Subsequent shunt closure after targeted medical therapy can be an effective strategy in selected ASD patients with severe PAH.
    SPRINGER, Mar. 2014, Heart and vessels, 29(2) (2), 282 - 5, English, Domestic magazine
    [Refereed]
    Scientific journal

  • Yu Taniguchi, Noriaki Emoto, Kazuya Miyagawa, Kazuhiko Nakayama, Hiroto Kinutani, Hidekazu Tanaka, Toshiro Shinke, Kenji Okada, Yutaka Okita, Ken-ich Hirata
    Secundum atrial septal defect (ASD) is the most common form of congenital heart disease in adults. Surgical and transcatheter closures of ASD are widely accepted therapeutic approaches. In patients with severe pulmonary arterial hypertension (PAH), however, the closure of the defect is still controversial. We report two cases of ASD patients with severe PAH successfully repaired subsequent to effective medical therapy. Subsequent shunt closure after targeted medical therapy can be an effective strategy in selected ASD patients with severe PAH.
    SPRINGER, Mar. 2014, HEART AND VESSELS, 29(2) (2), 282 - 285, English
    Scientific journal

  • Kenji Okada, Atsushi Omura, Hiroya Kano, Hidekazu Nakai, Shunsuke Miyahara, Hitoshi Minami, Yutaka Okita
    Objective: Little is known about the impact of preoperative renal function stratified by estimated glomerular filtration rate (eGFR) on outcomes of total aortic arch replacement (TAR). The current study addressed this issue and identified a cutoff value of eGFR for the requirement of postoperative renal replacement therapy. Methods: From January 2000 to May 2011, 229 consecutive patients who did not require preoperative hemodialysis were retrospectively studied after elective TAR. Patients were grouped into the following categories: those with normal renal function (eGFR >90 mL/min/1.73 m(2); n = 11) and those with mild (eGFR, 60-90 mL/min/1.73 m(2); n = 86), moderate (eGFR, 30-59 mL/min/1.73 m(2); n = 111), or severe (eGFR <30 mL/min/1.73 m(2); n = 21) renal dysfunction. Linear trend tests demonstrated that the lower categories of eGFR were associated with a higher age, hypertension, coronary artery disease, peripheral arterial disease, and a higher EuroSCORE II. Results: The overall hospital mortality was 2.2%. A lower categories of eGFR were an independent risk factor for hospital mortality (odds ratio, 0.91; P = .002) and postoperative renal replacement therapy (odds ratio, 0.94; P <. 002). A cutoff value for the requirement of postoperative renal replacement therapy was 26.0 mL/min/1.73 m(2). Patients in the lower categories of eGFR had significantly higher hospital mortality (P = .03) and more morbidities, such as renal replacement therapy (P < .01), postoperative permanent neurologic deficits (P = .013), and prolonged mechanical ventilatory support (P < .01). Midterm survival and freedom from major adverse cerebrocardiovascular events were worse across the levels of the lower categories of eGFR. Conclusions: Preoperative eGFR is a strong predictor of short-and midterm outcomes in contemporary TAR.
    MOSBY-ELSEVIER, Mar. 2014, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 147(3) (3), 966 - +, English
    Scientific journal

  • Kenji Okada, Atsushi Omura, Hiroya Kano, Hidekazu Nakai, Shunsuke Miyahara, Hitoshi Minami, Yutaka Okita
    OBJECTIVE: Little is known about the impact of preoperative renal function stratified by estimated glomerular filtration rate (eGFR) on outcomes of total aortic arch replacement (TAR). The current study addressed this issue and identified a cutoff value of eGFR for the requirement of postoperative renal replacement therapy. METHODS: From January 2000 to May 2011, 229 consecutive patients who did not require preoperative hemodialysis were retrospectively studied after elective TAR. Patients were grouped into the following categories: those with normal renal function (eGFR >90 mL/min/1.73 m(2); n = 11) and those with mild (eGFR, 60-90 mL/min/1.73 m(2); n = 86), moderate (eGFR, 30-59 mL/min/1.73 m(2); n = 111), or severe (eGFR <30 mL/min/1.73 m(2); n = 21) renal dysfunction. Linear trend tests demonstrated that the lower categories of eGFR were associated with a higher age, hypertension, coronary artery disease, peripheral arterial disease, and a higher EuroSCORE II. RESULTS: The overall hospital mortality was 2.2%. A lower categories of eGFR were an independent risk factor for hospital mortality (odds ratio, 0.91; P = .002) and postoperative renal replacement therapy (odds ratio, 0.94; P < .002). A cutoff value for the requirement of postoperative renal replacement therapy was 26.0 mL/min/1.73 m(2). Patients in the lower categories of eGFR had significantly higher hospital mortality (P = .03) and more morbidities, such as renal replacement therapy (P < .01), postoperative permanent neurologic deficits (P = .013), and prolonged mechanical ventilatory support (P < .01). Midterm survival and freedom from major adverse cerebrocardiovascular events were worse across the levels of the lower categories of eGFR. CONCLUSIONS: Preoperative eGFR is a strong predictor of short- and midterm outcomes in contemporary TAR.
    MOSBY-ELSEVIER, Mar. 2014, The Journal of thoracic and cardiovascular surgery, 147(3) (3), 966 - 972, English, International magazine
    [Refereed]
    Scientific journal

  • Kazunori Yoshida, Kenji Okada, Shunsuke Miyahara, Atsushi Omura, Takeshi Inoue, Hitoshi Minami, Yutaka Okita
    OBJECTIVES: To improve the clinical outcome of patients with severe functional mitral regurgitation (FMR) associated with ischemic cardiomyopathy (ICM), we compared the therapeutic efficacy of mitral annuloplasty (MAP) with that of mitral valve replacement (MVR). METHODS: In a retrospective observation 63 consecutive patients underwent mitral valve surgery for severe ICM-FMR from November 1999 to March 2012. All patients had severe FMR (regurgitant volume >60 ml/beat) with Carpentier type I and type IIIb disease. Mean RV was 74.0 ± 35.0 ml/beat and coaptation depth was 12.7 ± 3.0 mm. Twenty-six patients (41.3 %) were treated by MVR with sparing of the subvalvular apparatus and 37 (58.7 %) by MAP. RESULTS: Total in-hospital mortality was 6.3 %. Kaplan-Meier survival estimates at 1 and 5 years were 84.2 and 78.6 % in the MVR group and 82.6 and 71.6 % in the MAP group, with no significant difference between groups (p = 0.758). Freedom from major adverse cardiac and cerebrovascular events (MACCE) at 5 years was 66.9 % for patients treated by MVR and 64.1 % for those treated by MAP (p = 0.866). At the last follow-up visit, >grade II MR had recurred in 4 annuloplasty patients (10.8 %). In multivariate analysis, independent predictors of increased late death and MACCE were significantly associated with residual pulmonary hypertension (late death: odds ratio = 25.0, p = 0.0009; MACCE: odds ratio = 31.3, p = 0.0001). CONCLUSIONS: Mitral valve replacement with sparing of the subvalvular apparatus is a safe and effective surgical alternative for patients with severe FMR.
    Jan. 2014, General thoracic and cardiovascular surgery, 62(1) (1), 38 - 47, English, Domestic magazine
    Scientific journal

  • Mid-Term Results of Aortic Root Reimplantation in Patients with Severe Aortic Regurgitation
    Shunsuke Miyahara, Katsuhiro Yamanaka, Toshihito Sakamoto, Yoshikatsu Nomura, Takeshi Inoue, Masamichi Matsumori, Kenji Okada, Yutaka Okita
    KARGER, 2014, CARDIOLOGY, 128(2) (2), 127 - 127, English

  • Efficacy of Nafamostat Mesilate as Anticoagulation During Cardiopulmonary Bypass on Early Surgery in Patients with Active Infective Endocarditis Complicated by Stroke
    Yutaka Okita, Toshihito Sakamoto, Kenji Okada, Hiroya Kano, Katsuhiro Yamanaka, Shunsuke Miyahara, Takeshi Inoue, Naoto Izawa, Yasuko Gotake, Masamichi Matsumori
    KARGER, 2014, CARDIOLOGY, 128(2) (2), 173 - 173, English

  • Balloon Pulmonary Angioplasty Improves Clinical Status and Hemodynamics in Patients With Non-operable Chronic Thromboembolic Pulmonary Hypertension in Comparison to Pulmonary Endarterectomy in Operable Patients
    Kazuya Mivagawa, Noriaki Fmoto, Yu Taniguachi, Hiroto Kinutani, Kazuhiko Nakayama, Toshiro Shinke, Ken-ichi Hirata, Kenji Okada, Yutaka Okita
    LIPPINCOTT WILLIAMS & WILKINS, Nov. 2013, CIRCULATION, 128(22) (22), -, English

  • Naoto Morimoto, Kenji Okada, Yutaka Okita
    Background. We aimed to evaluate the severity of cirrhosis as a predictor of early and late outcomes after cardiovascular operations. Methods. We retrospectively reviewed patients who underwent cardiovascular operations in our institute between October 1999 and April 2009. The severity of liver cirrhosis was assessed using the Child-Pugh classification and the Model for End-stage Liver Disease (MELD) score. Results. Liver cirrhosis was identified in 32 consecutive patients. Averages of Child-Pugh and MELD scores were 7.2 +/- 1.9 and11.5 +/- 5.1, respectively: 14patientswere classified as Child-Pugh classA, 14 as class B, and 4 as class C. TheMELD scorewas less than 10 (category 1) in 10 patients, between 10 and 14.9 (category 2) in 14, and 15 or higher (category 3) in 8. The hospital mortality rate was 16% (5 of 32). Hospital mortality increased significantly as the MELD score category increased: category 1, 0%; category 2, 7%; and category 3, 50% (p [ 0.005). There was no significant association between hospital mortality and Child-Pugh classification: class A, 7%; class B, 21%; and class C, 0% (p = 0.60). Overall survival was 72% +/- 8% at 5 years and 47% +/- 13% at 10 years. The survival rate decreased significantly as theMELDscore category increased (p = 0.004). No relationship was found between the Child-Pugh classification and long-term survival. Conclusions. Our results suggest that the MELD score is useful to predict hospital death and long-term survival after cardiac operations for patients with liver cirrhosis.
    ELSEVIER SCIENCE INC, Nov. 2013, ANNALS OF THORACIC SURGERY, 96(5) (5), 1672 - 1678, English
    Scientific journal

  • Naoto Morimoto, Kenji Okada, Yutaka Okita
    BACKGROUND: We aimed to evaluate the severity of cirrhosis as a predictor of early and late outcomes after cardiovascular operations. METHODS: We retrospectively reviewed patients who underwent cardiovascular operations in our institute between October 1999 and April 2009. The severity of liver cirrhosis was assessed using the Child-Pugh classification and the Model for End-stage Liver Disease (MELD) score. RESULTS: Liver cirrhosis was identified in 32 consecutive patients. Averages of Child-Pugh and MELD scores were 7.2 ± 1.9 and 11.5 ± 5.1, respectively: 14 patients were classified as Child-Pugh class A, 14 as class B, and 4 as class C. The MELD score was less than 10 (category 1) in 10 patients, between 10 and 14.9 (category 2) in 14, and 15 or higher (category 3) in 8. The hospital mortality rate was 16% (5 of 32). Hospital mortality increased significantly as the MELD score category increased: category 1, 0%; category 2, 7%; and category 3, 50% (p = 0.005). There was no significant association between hospital mortality and Child-Pugh classification: class A, 7%; class B, 21%; and class C, 0% (p = 0.60). Overall survival was 72% ± 8% at 5 years and 47% ± 13% at 10 years. The survival rate decreased significantly as the MELD score category increased (p = 0.004). No relationship was found between the Child-Pugh classification and long-term survival. CONCLUSIONS: Our results suggest that the MELD score is useful to predict hospital death and long-term survival after cardiac operations for patients with liver cirrhosis.
    ELSEVIER SCIENCE INC, Nov. 2013, The Annals of thoracic surgery, 96(5) (5), 1672 - 8, English, International magazine
    [Refereed]
    Scientific journal

  • [Total aortic arch replacement;our current surgical management and outcomes].
    Atsushi Omura, Kenji Okada, Hiroya Kano, Toshihito Sakamoto, Takeshi Inoue, Masamichi Matsumori, Yutaka Okita
    OBJECTIVE: We report our current surgical management and early and late outcomes of total arch replacement. METHOD: From October 1999 to December 2012, 372 consecutive patients (mean age 71.8±12.0) underwent total arch replacement through a median sternotomy at our institute. Mean Japan score (predicted 30 day mortality) was 8.0±9.2( median 4.4). Our current surgical approach included the following:(1) meticulous selection of arterial cannulation site and type of arterial cannula;(2) circulatory arrest at tympanic temperature (below 23 °C) and rectal temperature (below 30 °C);(3) antegrade selective cerebral perfusion and cerebral monitoring of regional cerebral saturation;(4) early rewarming just after distal anastomosis;(5)maintaining fluid balance below 1,000 ml during cardiopulmonary bypass. RESULTS: Overall 30 day and in-hospital mortality was 1.6%( 6/372) and 3.8%( 14/372), and was 1.0%(3/308)and 2.6% (8/308) in elective cases. Permanent neurologic deficit occurred in 2.2%(8/372) of patients. The mean follow up period were46±39months(range2~165 months). Survival at 5 and 10 years after surgery was 75.8±2.8% and 66.0±3.8%, respectively. During follow up period, there was only one total arch replacement related problem (proximal anastomosis aneurysm). Freedom from additional aortic surgery and aortic related event at 5 and 10 years was 90.8 ±2.2% and 86.1±3.4%,respectively. CONCLUSION: Our current approach for total aortic arch replacement was associated with low hospital mortality and morbidities and with favorable long-term outcome.
    Oct. 2013, Kyobu geka. The Japanese journal of thoracic surgery, 66(11) (11), 969 - 75, Japanese, Domestic magazine
    Scientific journal

  • 慢性血栓塞栓性肺高血圧症に対する肺動脈カテーテル治療と血栓内膜摘除術の比較
    谷口 悠, Shinke Toshiro, 絹谷 洋人, 宮川 一也, 中山 和彦, 大竹 寛雅, 江本 憲昭, Hirata Ken-ichi, 岡田 健次, 大北 裕
    Sep. 2013, 日本心臓病学会誌, 8(Suppl.I) (Suppl.I), 389, Japanese
    Research society

  • 山中 勝弘, 大村 篤史, 白坂 知識, 宮原 俊介, 野村 佳克, 坂本 敏仁, 井上 武, 南 一司, Okada Kenji, Okita Yutaka
    Sep. 2013, 日本心臓血管外科学会雑誌, 42(5号) (5号), 412 - 415, Japanese
    [Refereed]
    Scientific journal

  • Akiko Tanaka, Toshihito Sakamoto, Kenji Okada, Yutaka Okita
    The elephant trunk technique is used as a standard method in the approach to staged repair of extensive thoracic aneurysms. Here, we present a rare case of a graft infection, in which vegetation was attached to the distal end of the elephant trunk. A 36-year old male who had undergone total arch replacement with elephant trunk installation for type A aortic dissection was readmitted for high-grade fever. At the time of admission, Osler's nodules were present and brain magnetic resonance imaging showed multiple small emboli and haemorrhages. Transoesophageal echocardiography could not locate any sign of infection within the cardiac chambers, but disclosed vegetation attached to the elephant trunk. He underwent successful emergent graft replacement of the lesion, and no recurrence of the infection has been observed.
    OXFORD UNIV PRESS INC, Sep. 2013, EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 44(3) (3), 565 - 566, English

  • Akiko Tanaka, Toshihito Sakamoto, Kenji Okada, Yutaka Okita
    The elephant trunk technique is used as a standard method in the approach to staged repair of extensive thoracic aneurysms. Here, we present a rare case of a graft infection, in which vegetation was attached to the distal end of the elephant trunk. A 36-year old male who had undergone total arch replacement with elephant trunk installation for type A aortic dissection was readmitted for high-grade fever. At the time of admission, Osler's nodules were present and brain magnetic resonance imaging showed multiple small emboli and haemorrhages. Transoesophageal echocardiography could not locate any sign of infection within the cardiac chambers, but disclosed vegetation attached to the elephant trunk. He underwent successful emergent graft replacement of the lesion, and no recurrence of the infection has been observed.
    OXFORD UNIV PRESS INC, Sep. 2013, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 44(3) (3), 565 - 6, English, International magazine
    [Refereed]
    Scientific journal

  • Hiroshi Munakata, Katsuhiro Yamanaka, Kenji Okada, Yutaka Okita
    MOSBY-ELSEVIER, Jul. 2013, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 146(1) (1), 235 - 237, English

  • Hiroshi Munakata, Katsuhiro Yamanaka, Kenji Okada, Yutaka Okita
    MOSBY-ELSEVIER, Jul. 2013, The Journal of thoracic and cardiovascular surgery, 146(1) (1), 235 - 7, English, International magazine
    [Refereed]
    Scientific journal

  • Impact of Postoperative Cusp Configuration on Mid-Term Durability after Aortic Root Reimplantation
    Miyahara, Shunsuke, Omura, Atsushi, Sakamoto, Toshihito, Nomura, Yoshikatsu, Inoue, Takeshi, Minami, Hitoshi, Okada, Kenji, Okita, Yutaka
    Jul. 2013, JOURNAL OF HEART VALVE DISEASE, 22(4) (4), 509-516

  • Impact of postoperative cusp configuration on midterm durability after aortic root reimplantation.
    Shunsuke Miyahara, Atsushi Omura, Toshihito Sakamoto, Yoshikatsu Nomura, Takeshi Inoue, Hitoshi Minami, Kenji Okada, Yutaka Okita
    BACKGROUND AND AIM OF THE STUDY: The study aim was to examine the echocardiographic features associated with recurrent aortic regurgitation (AR) after valve-preserving aortic root reconstruction surgery. METHODS: Echocardiographic data from 86 patients who underwent aortic root replacement with or without cusp repair were retrospectively reviewed. An analysis was conducted of the height difference between the level of the ventriculoaortic junction (VAJ) and the central free margin of the cusp, defined as the effective height (EH), and the length from the aortic annulus to the edge of the body of Arantius, defined as the geometric height (GH), in addition to root dimensions (diameter of VAJ, sinus of Valsalva, and sinotubular junction). RESULTS: All patients presented with < or = mild AR at discharge. After a median follow up duration of 46.4 months, the development of moderate AR or greater was observed in 14 patients. The overall actuarial freedom from moderate AR or greater, and freedom from reoperation at three and five years were 86.2 +/- 4.4% and 81.8 +/- 5.2%, and 94.0 +/- 3.0% and 91.8 +/- 3.6%, respectively. The postoperative EH (7.47 +/- 3.3 mm in > mild AR group, versus 8.81 +/- 2.1 mm in < or = mild AR group, p = 0.049), the incidence of postoperative eccentric jet (57.1% in > mild AR group versus 12.5% in < or = mild AR group, p = 0.0005) and cusp billowing (78.6% in > mild AR group versus 20.8% in < or = mild AR group, p < 0.0001) were significantly correlated with > mild AR in the follow up. There was also correlation between postoperative EH and the severity of recurrent AR at follow up (p = -0.33, p = 0.0019). CONCLUSION: Objective information on cusp configuration, such as EH, should play an important role in stabilizing the outcome of valve-sparing surgery.
    Jul. 2013, The Journal of heart valve disease, 22(4) (4), 509 - 16, English, International magazine
    [Refereed]
    Scientific journal

  • Shunsuke Miyahara, Yoshikatsu Nomura, Tomonori Shirasaka, Hideto Taketoshi, Katsuhiro Yamanaka, Atsushi Omura, Toshihito Sakamoto, Takeshi Inoue, Hitoshi Minami, Kenji Okada, Yutaka Okita
    Background. We present a single center's experience of secondary interventions after thoracic endovascular aortic repair (TEVAR). Methods. One hundred and forty-seven patients underwent TEVAR at our institution between 2000 and 2012. A total of 26 patients (19 male, mean age 68.4 +/- 12.7 years), including 7 patients with primary TEVAR at other centers, underwent secondary interventions. The median interval to secondary intervention was 17.2 months (range, 0.22 to 36.1). The indications for secondary interventions included procedure-related dissection (n = 1), collapse of the endovascular device (n = 1), aortoesophageal fistula (n = 1), residual dissection (n = 3), and endoleaks causing dilation of the sac (n = 17) or aortic rupture (n = 3). Sixteen patients underwent open conversion including total arch replacement (n = 2), extensive replacement of the aortic arch or descending aorta (n = 10), and thoracoabdominal aortic replacement (n = 4). Second-time TEVAR was performed in the remaining 10 patients. Results. The in-hospital mortality rate was 11.5% (3 patients; 1 case of multiorgan failure after open conversion, and 1 case of mesenteric ischemia and 1 case of aortic rupture after second-time TEVAR). Postoperative stroke after second-time TEVAR occurred in 1 patient. The cumulative survival rate of the 26 patients was 80.0% +/- 8.0% at 5 years after secondary intervention. Short proximal neck (p = 0.0036), steep angulation of landing zones (p = 0.033), and nonuse of commercially available devices (p = 0.011) were significantly correlated with incidence of TEVAR failure. Conclusions. Secondary surgical procedures after TEVAR can be performed with low mortality and morbidity, despite the precarious preoperative conditions and complex aortic pathologies of patients. (C) 2013 by The Society of Thoracic Surgeons
    ELSEVIER SCIENCE INC, May 2013, ANNALS OF THORACIC SURGERY, 95(5) (5), 1584 - 1590, English
    Scientific journal

  • Shunsuke Miyahara, Yoshikatsu Nomura, Tomonori Shirasaka, Hideto Taketoshi, Katsuhiro Yamanaka, Atsushi Omura, Toshihito Sakamoto, Takeshi Inoue, Hitoshi Minami, Kenji Okada, Yutaka Okita
    BACKGROUND: We present a single center's experience of secondary interventions after thoracic endovascular aortic repair (TEVAR). METHODS: One hundred and forty-seven patients underwent TEVAR at our institution between 2000 and 2012. A total of 26 patients (19 male, mean age 68.4 ± 12.7 years), including 7 patients with primary TEVAR at other centers, underwent secondary interventions. The median interval to secondary intervention was 17.2 months (range, 0.22 to 36.1). The indications for secondary interventions included procedure-related dissection (n = 1), collapse of the endovascular device (n = 1), aortoesophageal fistula (n = 1), residual dissection (n = 3), and endoleaks causing dilation of the sac (n = 17) or aortic rupture (n = 3). Sixteen patients underwent open conversion including total arch replacement (n = 2), extensive replacement of the aortic arch or descending aorta (n = 10), and thoracoabdominal aortic replacement (n = 4). Second-time TEVAR was performed in the remaining 10 patients. RESULTS: The in-hospital mortality rate was 11.5% (3 patients; 1 case of multiorgan failure after open conversion, and 1 case of mesenteric ischemia and 1 case of aortic rupture after second-time TEVAR). Postoperative stroke after second-time TEVAR occurred in 1 patient. The cumulative survival rate of the 26 patients was 80.0% ± 8.0% at 5 years after secondary intervention. Short proximal neck (p = 0.0036), steep angulation of landing zones (p = 0.033), and nonuse of commercially available devices (p = 0.011) were significantly correlated with incidence of TEVAR failure. CONCLUSIONS: Secondary surgical procedures after TEVAR can be performed with low mortality and morbidity, despite the precarious preoperative conditions and complex aortic pathologies of patients.
    ELSEVIER SCIENCE INC, May 2013, The Annals of thoracic surgery, 95(5) (5), 1584 - 90, English, International magazine
    [Refereed]
    Scientific journal

  • EVAR後type 2 endoleakに対する治療
    野村 佳克, 後竹 康子, 竹歳 秀人, 宮原 俊介, 白坂 知識, 坂本 敏仁, 大村 篤史, 井上 武, 南 一司, 岡田 健次, 宮本 直和, 山口 雅人, 井戸口 孝二, Sugimoto Koji, 大北 裕
    Apr. 2013, 日本血管外科学会雑誌, 22(2号) (2号), 455, Japanese
    Research society

  • Kenji Okada, Atsushi Omura, Hiroya Kano, Takeshi Inoue, Takanori Oka, Hitoshi Minami, Yutaka Okita
    OBJECTIVE: The effect of an atherothrombotic aorta on the short- and long-term outcomes of total aortic arch replacement, including postoperative neurologic deficits, remains unknown. We evaluated this relationship and also elucidated the synergistic effect of multiple other risk factors, in addition to an atherothrombotic aorta, on the neurologic outcome. METHODS: A group of 179 consecutive patients undergoing total aortic arch replacement were studied. An atherothrombotic aorta was present in 34 patients (19%), more than moderate leukoaraiosis in 71 (39.7%), and significant extracranial carotid artery stenosis in 27 (15.1%). In-hospital deaths occurred in 2 patients, 1 (2.9%) of 34 patients with and 1 (0.7%) of 145 patients without an atherothrombotic aorta (P = .26). Permanent neurologic deficits occurred in 4 (2.2%) and transient neurologic deficits in 17 (9.5%) patients. Multivariate analysis demonstrated that the risk factors for transient neurologic deficits were an atherothrombotic aorta (odds ratio, 4.4), extracranial carotid artery stenosis (odds ratio, 5.5), moderate/severe leukoaraiosis (odds ratio, 3.6), and cardiopulmonary bypass time (odds ratio, 1.02). To calculate the probability of transient neurologic deficits, the following equation was derived: probability of transient neurologic deficits = {1 + exp [7.276 - 1.489 (atherothrombotic aorta) - 1.285 (leukoaraiosis) - 1.701 (extracranial carotid artery stenosis) - 0.017 (cardiopulmonary bypass time)]}(-1). An exponential increase occurred in the probability of transient neurologic deficits with presence of an atherothrombotic aorta and other risk factors in relation to the cardiopulmonary bypass time. Survival at 3 years after surgery was significantly reduced in patients with vs without an atherothrombotic aorta (75.0% ± 8.8% vs 89.2% ± 3.1%, P = .01). CONCLUSIONS: Patients with an atherothrombotic aorta and associated preoperative comorbidities might be predisposed to adverse short- and long-term outcomes, including transient neurologic deficits.
    MOSBY-ELSEVIER, Apr. 2013, The Journal of thoracic and cardiovascular surgery, 145(4) (4), 984 - 991, English, International magazine
    [Refereed]
    Scientific journal

  • Kenji Okada, Tomonori Shirasaka, Hiroya Kano, Yutaka Okita
    A 19-year-old woman, who had a recent extensive cerebral infarction caused by a septic embolization in the left-sided territory of the middle cerebral artery, successfully underwent mitral valve repair for severe mitral regurgitation caused by active infective endocarditis, 24 h after the onset of stroke. Anticoagulation during cardiopulmonary bypass was maintained with low-dose heparin and additional nafamostat mesilate. She had no further aggravation of the brain complication and recovered well with midterm mitral valve durability.
    Apr. 2013, Asian cardiovascular & thoracic annals, 21(2) (2), 215 - 7, English, International magazine
    [Refereed]
    Scientific journal

  • Kenji Okada, Atsushi Omura, Hiroya Kano, Takeshi Inoue, Takanori Oka, Hitoshi Minami, Yutaka Okita
    Objective: The effect of an atherothrombotic aorta on the short-and long-term outcomes of total aortic arch replacement, including postoperative neurologic deficits, remains unknown. We evaluated this relationship and also elucidated the synergistic effect of multiple other risk factors, in addition to an atherothrombotic aorta, on the neurologic outcome. Methods: A group of 179 consecutive patients undergoing total aortic arch replacement were studied. An atherothrombotic aorta was present in 34 patients (19%), more than moderate leukoaraiosis in 71 (39.7%), and significant extracranial carotid artery stenosis in 27 (15.1%). In-hospital deaths occurred in 2 patients, 1 (2.9%) of 34 patients with and 1 (0.7%) of 145 patients without an atherothrombotic aorta (P=.26). Permanent neurologic deficits occurred in 4 (2.2%) and transient neurologic deficits in 17 (9.5%) patients. Multivariate analysis demonstrated that the risk factors for transient neurologic deficits were an atherothrombotic aorta (odds ratio, 4.4), extracranial carotid artery stenosis (odds ratio, 5.5), moderate/severe leukoaraiosis (odds ratio, 3.6), and cardiopulmonary bypass time (odds ratio, 1.02). To calculate the probability of transient neurologic deficits, the following equation was derived: probability of transient neurologic deficits = {1+exp [7.276-1.489 (atherothrombotic aorta)-1.285 (leukoaraiosis)-1.701 (extracranial carotid artery stenosis)-0.017 (cardiopulmonary bypass time)]}(-1). An exponential increase occurred in the probability of transient neurologic deficits with presence of an atherothrombotic aorta and other risk factors in relation to the cardiopulmonary bypass time. Survival at 3 years after surgery was significantly reduced in patients with vs without an atherothrombotic aorta (75.0% +/- 8.8% vs 89.2% +/- 3.1%, P=.01). Conclusions: Patients with an atherothrombotic aorta and associated preoperative comorbidities might be predisposed to adverse short-and long-term outcomes, including transient neurologic deficits. (J Thorac Cardiovasc Surg 2013;145:984-91)
    MOSBY-ELSEVIER, Apr. 2013, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 145(4) (4), 984 - +, English
    Scientific journal

  • 大動脈瘤に対するステントグラフト内挿術の適応拡大における問題点 IFU外症例に対するステントグラフト内挿術の治療成績
    Sugimoto Koji, 井戸口 孝二, 山口 雅人, 野村 佳克, 大北 裕
    (一社)日本外科学会, Mar. 2013, 日本外科学会雑誌, 114(臨増2) (臨増2), 737 - 737, Japanese
    Research society

  • Yutaka Okita, Kenji Okada, Atsushi Omura, Hiroya Kano, Hitoshi Minami, Takeshi Inoue, Toshihito Sakamoto, Shunsuke Miyahara, Tomonori Shirasaka, Katsuhiro Yamanaka, Taimi Ohara, Yoshikatsu Nomura, Hidekazu Nakai
    BACKGROUND: Optimal neuro-protection strategy in aortic arch surgery is a controversial issue. The present study reported surgical outcomes of total arch replacement using selective antegrade cerebral perfusion (SACP). METHODS: From January 2002 to December 2012, 438 consecutive patients (mean age 69.1±13.4 years) underwent total arch replacement using SACP through a median sternotomy. Acute aortic dissection was present in 86 patients (18.3; 80 type A, 6 type B) and shaggy aorta in 36 (8.2%). Emergent/urgent surgery was required in 144 (32.9%). Our current approach included: (I) meticulous selection of arterial cannulation site and type of arterial cannula; (II) selective antegrade cerebral perfusion; (III) maintenance of minimal tympanic temperature between 20 and 23 °C; (IV) early re-warming after distal anastomosis; and (V) maintaining fluid balance below 1,000 mL during cardiopulmonary bypass. A woven Dacron four branch graft was used in all patients. RESULTS: Overall hospital mortality was 4.6% (20/438). Hospital mortality was 9.7% (14/144) in urgent/emergent surgery and 2.0% (6/294) in elective cases. Permanent neurological deficit occurred in 5.3% (23/438) of patients. Prolonged ventilation was necessary in 58 patients (13.2%). Multivariate analysis demonstrated that risk factors for hospital mortality were octogenarian (OR 4.45, P=0.03), brain malperfusion (OR 23.52, P=0.002) and cardiopulmonary bypass time (OR 1.07, P=0.04). The follow-up was completed in 97.9% with mean follow up of 2.3±2.3 years. Survival at 5 and 10 years after surgery was 79.6±3.3% and 71.2±5.0% respectively. In the acute type A dissection group, 10-year survival was 96.8±2.9%, while in the elective non-dissection group 5- and 10-year survival were 81.4±7.2% and 77.0±5.9% respectively. CONCLUSIONS: Our current approach for total aortic arch replacement utilizing SACP was associated with low hospital mortality and morbidities leading to favorable long-term outcome.
    Mar. 2013, Annals of cardiothoracic surgery, 2(2) (2), 169 - 74, English, International magazine
    [Refereed]
    Scientific journal

  • Yutaka Okita, Kenji Okada, Atsushi Omura, Hiroya Kano, Hitoshi Minami, Takeshi Inoue, Shunsuke Miyahara
    Objective: The technical details of total arch replacement using antegrade cerebral perfusion are presented. Methods: From January 2002 to May 2012, 423 consecutive patients (mean age, 69.2 +/- 13.1 years) underwent total arch replacement using antegrade selective cerebral perfusion through a median sternotomy. Acute aortic dissection was present in 81 patients (19.1%; 75 type A, 6 type B), and a shaggy aorta was present in 37 patients (8.7%). Emergency/urgent surgery was required in 135 patients (31.9%). Our current approach included meticulous selection of the arterial cannulation site and type of arterial cannula, antegrade selective cerebral perfusion, maintenance of the minimal tympanic temperature between 20 degrees C and 23 degrees C, early rewarming immediately after distal anastomosis, and maintenance of the fluid balance at less than 1000 mL during cardiopulmonary bypass. A woven Dacron 4-branch graft was used in all patients. Results: The overall hospital mortality was 4.5% (19/423): 9.6% (13/135) in urgent/emergency surgery cases and 2.1% (6/288) in elective cases. Permanent neurologic deficits occurred in 3.3% patients (14/423). Prolonged ventilation was necessary in 57 patients (13.4%). A multivariate analysis demonstrated the risk factors for hospital mortality to be age (octogenarian; odds ratio, 4.45; P = .02), brain malperfusion (odds ratio, 22.5; P = .002), and cardiopulmonary bypass time (odds ratio, 1.06; P = .04). The follow-up was completed in 97.2% of patients (mean, 29 +/- 27; 1-126) and included 2.3 patients per year. Survival at 5 and 10 years after surgery was 79.6% +/- 3.3% and 71.2% +/- 5.0%, respectively. In the acute A dissection group, the 10-year survival was 96.6% +/- 2.4%. In the elective nondissection group, the 5- and 10-year survivals were 80.3% +/- 4.2% and 76.1% +/- 5.7%, respectively. Conclusions: Our current approach for total aortic arch replacement is associated with low hospital mortality and morbidity, thus leading to a favorable long-term outcome. (J Thorac Cardiovasc Surg 2013;145:S63-71)
    MOSBY-ELSEVIER, Mar. 2013, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 145(3) (3), S63 - S71, English
    Scientific journal

  • Yutaka Okita, Kenji Okada, Atsushi Omura, Hiroya Kano, Hitoshi Minami, Takeshi Inoue, Shunsuke Miyahara
    OBJECTIVE: The technical details of total arch replacement using antegrade cerebral perfusion are presented. METHODS: From January 2002 to May 2012, 423 consecutive patients (mean age, 69.2 ± 13.1 years) underwent total arch replacement using antegrade selective cerebral perfusion through a median sternotomy. Acute aortic dissection was present in 81 patients (19.1%; 75 type A, 6 type B), and a shaggy aorta was present in 37 patients (8.7%). Emergency/urgent surgery was required in 135 patients (31.9%). Our current approach included meticulous selection of the arterial cannulation site and type of arterial cannula, antegrade selective cerebral perfusion, maintenance of the minimal tympanic temperature between 20 °C and 23 °C, early rewarming immediately after distal anastomosis, and maintenance of the fluid balance at less than 1000 mL during cardiopulmonary bypass. A woven Dacron 4-branch graft was used in all patients. RESULTS: The overall hospital mortality was 4.5% (19/423): 9.6% (13/135) in urgent/emergency surgery cases and 2.1% (6/288) in elective cases. Permanent neurologic deficits occurred in 3.3% patients (14/423). Prolonged ventilation was necessary in 57 patients (13.4%). A multivariate analysis demonstrated the risk factors for hospital mortality to be age (octogenarian; odds ratio, 4.45; P = .02), brain malperfusion (odds ratio, 22.5; P = .002), and cardiopulmonary bypass time (odds ratio, 1.06; P = .04). The follow-up was completed in 97.2% of patients (mean, 29 ± 27; 1-126) and included 2.3 patients per year. Survival at 5 and 10 years after surgery was 79.6% ± 3.3% and 71.2% ± 5.0%, respectively. In the acute A dissection group, the 10-year survival was 96.6% ± 2.4%. In the elective nondissection group, the 5- and 10-year survivals were 80.3% ± 4.2% and 76.1% ± 5.7%, respectively. CONCLUSIONS: Our current approach for total aortic arch replacement is associated with low hospital mortality and morbidity, thus leading to a favorable long-term outcome.
    MOSBY-ELSEVIER, Mar. 2013, The Journal of thoracic and cardiovascular surgery, 145(3 Suppl) (3 Suppl), S63-71 - S71, English, International magazine
    [Refereed]
    Scientific journal

  • Yutaka Okita, Kenji Okada, Atsushi Omura, Hiroya Kano, Hitoshi Minami, Takeshi Inoue, Toshihito Sakamoto, Shunsuke Miyahara, Tomonori Shirasaka, Katsuhiro Yamanaka, Taimi Ohara, Yoshikatsu Nomura, Hidekazu Nakai
    Mar. 2013, Annals of cardiothoracic surgery, 2(2) (2), 222 - 8, English, International magazine
    [Refereed]
    Scientific journal

  • Naoto Morimoto, Kenji Okada, Yutaka Okita
    PURPOSE: Cardiac surgery for the patients with advanced liver cirrhosis is still challenging. High mortality has been reported in the literature. We evaluate the clinical outcome of cardiac surgery in patients with advanced liver cirrhosis. METHODS: Patients with advanced liver cirrhosis who underwent cardiac surgery between October 1999 and April 2009 were reviewed. The severity of liver cirrhosis was assessed using Child-Pugh class, Child-Pugh score, and MELD score. Advanced liver cirrhosis was defined as Child-Pugh class B or C. Cardiopulmonary bypass (CPB) was carried out at higher flow rate (2.4-3.2 L/min/m(2)), and hematocrit (25-30 %). Moderate and more tricuspid regurgitation were aggressively treated. Dilutional ultrafiltration was performed at the termination of CPB. RESULTS: Eighteen patients (mean age 70 years, male:female = 14:4) were identified. Twelve patients had hepatitis virus infection and 6 cases were alcohol-related. Fourteen patients were graded as Child-Pugh class B and 4 in class C. Seventeen patients underwent cardiac surgery with the use of cardiopulmonary bypass, and 1 patient underwent off-pump coronary artery bypass surgery. The overall mortality rate was 17 % (3 of 18). The cause of death was liver failure, esophageal variceal bleeding and bacteremia. The mortality of redo surgery was high (50 %). The incidence of postoperative liver failure was 11 % (2 of 18). Child-Pugh class or score was not correlated with hospital mortality. MELD score was significantly higher in hospital mortality (10.8 ± 4.0 vs. 17.3 ± 2.1, p = 0.001). CONCLUSIONS: Although the mortality of redo surgery was high, cardiac surgery could be safely performed in selected patients with advanced liver cirrhosis.
    Feb. 2013, General thoracic and cardiovascular surgery, 61(2) (2), 79 - 83, English, Domestic magazine
    [Refereed]
    Scientific journal

  • Yutaka Hino, Kenji Okada, Takanori Oka, Takeshi Inoue, Akiko Tanaka, Atsushi Omura, Hiroya Kano, Yutaka Okita
    We present our experience of total aortic arch replacement. Twenty-nine patients (21 males and 8 females; mean age 63.3 +/- 13.3 years) with extended thoracic aortic aneurysms underwent graft replacement. The pathology of the diseased aorta was non-dissecting aneurysm in 11 patients, including one aortitis and aortic dissection in 18 patients (acute type A: one, chronic type A: 11, chronic type B: six). Five patients had Marfan syndrome. In their previous operation, two patients had undergone the Bentall procedure, three had endovascular stenting, one had aortic root replacement with valve sparing and 12 had hemi-arch replacement for acute type A dissection. Approaches to the aneurysm were as follows: posterolateral thoracotomy with rib-cross incision in 16, posterolateral thoracotomy extended to the retroperitoneal abdominal aorta in seven, mid-sternotomy and left pleurotomy in three, anterolateral thoracotomy with partial lower sternotomy in two and clam-shell incision in one patient. Extension of aortic replacement was performed from the aortic root to the descending aorta in 4, from the ascending aorta to the descending aorta in 17 and from the ascending to the abdominal aorta in eight patients. Arterial inflow for cardiopulmonary bypass consisted of the femoral artery in 15 patients, ascending aorta and femoral artery in seven, descending or abdominal aorta in five and ascending aorta in two. Venous drainage site was the femoral vein in 10, pulmonary artery in eight, right atrium in five, femoral artery with right atrium/pulmonary artery in four and pulmonary artery with right atrium in two patients. The operative mortality, 30-day mortality and hospital mortality was one (cardiac arrest due to aneurysm rupture), one (rupture of infected aneurysm) and one (brain contusion), respectively. Late mortality occurred in three patients due to pneumonia, ruptured residual aneurysm and intracranial bleeding. Actuarial survival at 5 years after the operations was 80.6 +/- 9.0%. Freedom from the subsequent aortic events was 96.0 +/- 3.9% at 5 years. Our treatment method for extensive thoracic aneurysms achieved satisfactory results using specific strategies and appropriate organ protection according to the aneurysm extension in the selected patients.
    OXFORD UNIV PRESS INC, Jan. 2013, EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 43(1) (1), 176 - 181, English
    Scientific journal

  • Yutaka Hino, Kenji Okada, Takanori Oka, Takeshi Inoue, Akiko Tanaka, Atsushi Omura, Hiroya Kano, Yutaka Okita
    OBJECTIVES: We present our experience of total aortic arch replacement. METHODS: Twenty-nine patients (21 males and 8 females; mean age 63.3 ± 13.3 years) with extended thoracic aortic aneurysms underwent graft replacement. The pathology of the diseased aorta was non-dissecting aneurysm in 11 patients, including one aortitis and aortic dissection in 18 patients (acute type A: one, chronic type A: 11, chronic type B: six). Five patients had Marfan syndrome. In their previous operation, two patients had undergone the Bentall procedure, three had endovascular stenting, one had aortic root replacement with valve sparing and 12 had hemi-arch replacement for acute type A dissection. Approaches to the aneurysm were as follows: posterolateral thoracotomy with rib-cross incision in 16, posterolateral thoracotomy extended to the retroperitoneal abdominal aorta in seven, mid-sternotomy and left pleurotomy in three, anterolateral thoracotomy with partial lower sternotomy in two and clam-shell incision in one patient. Extension of aortic replacement was performed from the aortic root to the descending aorta in 4, from the ascending aorta to the descending aorta in 17 and from the ascending to the abdominal aorta in eight patients. Arterial inflow for cardiopulmonary bypass consisted of the femoral artery in 15 patients, ascending aorta and femoral artery in seven, descending or abdominal aorta in five and ascending aorta in two. Venous drainage site was the femoral vein in 10, pulmonary artery in eight, right atrium in five, femoral artery with right atrium/pulmonary artery in four and pulmonary artery with right atrium in two patients. RESULTS: The operative mortality, 30-day mortality and hospital mortality was one (cardiac arrest due to aneurysm rupture), one (rupture of infected aneurysm) and one (brain contusion), respectively. Late mortality occurred in three patients due to pneumonia, ruptured residual aneurysm and intracranial bleeding. Actuarial survival at 5 years after the operations was 80.6 ± 9.0%. Freedom from the subsequent aortic events was 96.0 ± 3.9% at 5 years. CONCLUSIONS: Our treatment method for extensive thoracic aneurysms achieved satisfactory results using specific strategies and appropriate organ protection according to the aneurysm extension in the selected patients.
    OXFORD UNIV PRESS INC, Jan. 2013, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 43(1) (1), 176 - 81, English, International magazine
    [Refereed]
    Scientific journal

  • Yutaka Okita, Takanori Oka, Shunsuke Miyahara, Kenji Okada
    MOSBY-ELSEVIER, Oct. 2012, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 144(4) (4), 981 - 982, English

  • Yutaka Okita, Takanori Oka, Shunsuke Miyahara, Kenji Okada
    MOSBY-ELSEVIER, Oct. 2012, The Journal of thoracic and cardiovascular surgery, 144(4) (4), 981 - 2, English, International magazine
    [Refereed]
    Scientific journal

  • Yutaka Okita, Atsushi Omura, Katsuaki Yamanaka, Takeshi Inoue, Hiroya Kano, Rei Tanioka, Hitoshi Minami, Toshihito Sakamoto, Shunsuke Miyahara, Tomonori Shirasaka, Taimi Ohara, Hidekazu Nakai, Kenji Okada
    Technical details of our strategy for reconstructing the thoracoabdominal aorta are presented. Between October 1999 and June 2012, 152 patients underwent surgery for thoracoabdominal aortic aneurysms (Crawford classification type I =21, type II =43, type III =73, type IV =15). Mean age was 64.6±13.9 years. Sixty-three (41.4%) patients had aortic dissection, including acute type B dissection in 2 (1.2%) and ruptured aneurysms in 17 (11.2%). Eight (5.3%) patients had mycotic aneurysms, and 3 (2.0%) had aortitis. Emergent or urgent surgery was performed in 25 (16.4%) patients. Preoperative computed tomography (CT) scan or magnetic resonance (MR) angiography detected the Adamkiewicz artery in 103 (67.8%) patients. Cerebrospinal fluid drainage (CSFD) was performed in 115 (75.7%) patients and intraoperative motor evoked potentials were recorded in 97 (63.8%). One hundred and seven (70.4%) patients had reconstruction of the intercostal arteries from T7 to L2, 35 of which were reconstructed with the aortic patch technique and 72 with branched grafts. The mean number of reconstructed intercostal arteries was 3.1±2.5 pairs. Mild hypothermic partial cardiopulmonary bypass at 32-34 °C was used in 105 (69.1%) patients, left heart bypass was used in 4 (2.6%), and deep hypothermic cardiopulmonary bypass below 20 °C was used in 42 (27.6%). Thirty-day mortality was 9 (5.9%), and hospital mortality was 20 (13.2%). Independent risk factors for hospital mortality were emergency surgery (OR 13.4, P=0.003) and aortic cross clamping over 2 hours (OR 5.7, P=0.04). Postoperative spinal cord ischemia occurred in 16 (10.5%, 8 patients with paraplegia and 8 with paraparesis). Risk factors for developing spinal cord ischemic complications were prior surgery involving either the descending thoracic or the abdominal aorta (OR 3.75, P=0.05), diabetes mellitus (OR 5.49, P=0.03), and post-bypass hypotension <80 mmHg (OR 1.06, P=0.03). Postoperative survival at 5 years was 83.6±4.5%; 5-year survival was 47.5±8.6% in patients with spinal cord ischemia and 88.9±10.4% in those without spinal cord ischemia.
    Sep. 2012, Annals of cardiothoracic surgery, 1(3) (3), 373 - 80, English, International magazine
    Scientific journal

  • Atsushi Omura, Akiko Tanaka, Shunsuke Miyahara, Toshihito Sakamoto, Yoshikatsu Nomura, Takeshi Inoue, Takanori Oka, Hitoshi Minami, Kenji Okada, Yutaka Okita, John H. Calhoon
    Background. When treating dissecting aneurysm of the thoracoabdominal aorta surgically in patients with Marfan syndrome, we have usually performed graft replacement-including the entire thoracoabdominal aorta and reconstruction of all visceral branches, even if dilatation is mild in some segments-to avoid further aortic operations in the follow-up period. Methods. From October 1999 through July 2011, 20 consecutive patients with Marfan syndrome underwent repair of dissecting aneurysm of the thoracoabdominal aorta (median age, 45 years; range, 19-65 years). All patients underwent surgical intervention with cerebrospinal fluid (CSF) drainage and distal aortic and selective organ perfusion. Deep hypothermia was used in 13 patients for spinal cord protection. Results. No in-hospital mortality was observed. One patient had temporary spinal cord ischemia but was fully recovered by discharge. Other complications included exploration for bleeding (n = 1), prolonged ventilation (n = 1), and graft infection (n = 1). At a mean follow-up of 54 months (range, 9-129 months), 1 patient had died of interstitial pneumonia at 38 months postoperatively. Survival at 8% years was 91.2 +/- 9.0%. Two patients required additional aortic procedures (total arch replacement and aortic valve-sparing surgery). Actuarial rate of freedom from aortic operations at 8 years was 83.9% +/- 10.5%, but no patient needed required repeated thoracotomy for an aortic procedure. Neither false nor patch aneurysms were observed using computed tomography (CT) during follow-up surveillance. Conclusions. Graft replacement for dissecting aneurysm of the thoracoabdominal aorta in Marfan syndrome offers good early and long-term results. We believe total aortic replacement including the entire thoracoabdominal aorta and reconstruction of all visceral arteries should be recommended for selected patients with Marfan syndrome.
    ELSEVIER SCIENCE INC, Sep. 2012, ANNALS OF THORACIC SURGERY, 94(3) (3), 759 - 765, English
    Scientific journal

  • Atsushi Omura, Akiko Tanaka, Shunsuke Miyahara, Toshihito Sakamoto, Yoshikatsu Nomura, Takeshi Inoue, Takanori Oka, Hitoshi Minami, Kenji Okada, Yutaka Okita
    BACKGROUND: When treating dissecting aneurysm of the thoracoabdominal aorta surgically in patients with Marfan syndrome, we have usually performed graft replacement- including the entire thoracoabdominal aorta and reconstruction of all visceral branches, even if dilatation is mild in some segments-to avoid further aortic operations in the follow-up period. METHODS: From October 1999 through July 2011, 20 consecutive patients with Marfan syndrome underwent repair of dissecting aneurysm of the thoracoabdominal aorta (median age, 45 years; range, 19-65 years). All patients underwent surgical intervention with cerebrospinal fluid (CSF) drainage and distal aortic and selective organ perfusion. Deep hypothermia was used in 13 patients for spinal cord protection. RESULTS: No in-hospital mortality was observed. One patient had temporary spinal cord ischemia but was fully recovered by discharge. Other complications included exploration for bleeding (n=1), prolonged ventilation (n=1), and graft infection (n=1). At a mean follow-up of 54 months (range, 9-129 months), 1 patient had died of interstitial pneumonia at 38 months postoperatively. Survival at 8% years was 91.2±9.0%. Two patients required additional aortic procedures (total arch replacement and aortic valve-sparing surgery). Actuarial rate of freedom from aortic operations at 8 years was 83.9%±10.5%, but no patient needed required repeated thoracotomy for an aortic procedure. Neither false nor patch aneurysms were observed using computed tomography (CT) during follow-up surveillance. CONCLUSIONS: Graft replacement for dissecting aneurysm of the thoracoabdominal aorta in Marfan syndrome offers good early and long-term results. We believe total aortic replacement including the entire thoracoabdominal aorta and reconstruction of all visceral arteries should be recommended for selected patients with Marfan syndrome.
    ELSEVIER SCIENCE INC, Sep. 2012, The Annals of thoracic surgery, 94(3) (3), 759 - 65, English, International magazine
    [Refereed]
    Scientific journal

  • Hiroaki Takahashi, Kenji Okada, Masamichi Matsumori, Hiroya Kano, Atsushi Kitagawa, Yutaka Okita
    Background. Acute high-risk pulmonary embolism is a life-threatening condition with high early mortality rates resulting from acute right ventricular failure and cardiogenic shock. We retrospectively analyzed the outcomes of surgical embolectomy among patients with circulatory collapse. Methods. Between July 2000 and September 2011, 24 consecutive patients (17 women and 7 men; mean age, 59.9 +/- 17.2 years) underwent emergency surgical embolectomy to treat acute pulmonary embolism with circulatory collapse. Nineteen (79.2%) patients were in cardiogenic shock, and 16 (66.7%) patients received preoperative percutaneous cardiopulmonary support. Eleven (45.8%) patients were in cardiac arrest. The preoperative pulmonary artery obstruction index was 76.9% +/- 16.4% (median, 88.9%; range, 44.4%-88.9%). The indications for surgical intervention were cardiogenic shock (n = 16 [66.7%]), failed medical therapy or catheter embolectomy (n = 4 [16.7%]), or contraindication for thrombolysis (n = 4 [16.7%]). Follow-up was 100% complete with a mean of 6.8 +/- 3.9 years (median, 5.6 years). Results. The in-hospital mortality rate was 12.5% (n = 3). One patient underwent a repeated embolectomy on postoperative day 6. The postoperative course was complicated by cerebral infarction and by mediastinitis in 1 patient each. The 5-year cumulative survival rate was 87.5% +/- 6.8%. Mean right ventricular pressure significantly decreased from 66.9 to 28.5 mm Hg among the survivors. Conclusions. Surgical pulmonary embolectomy is an excellent approach to treating acute pulmonary embolism with circulatory collapse. Providing immediate percutaneous cardiopulmonary support to patients with cardiogenic shock could help to resuscitate and stabilize cardiopulmonary function and allow for a good outcome of pulmonary embolectomy. (Ann Thorac Surg 2012;94:785-91) (C) 2012 by The Society of Thoracic Surgeons
    ELSEVIER SCIENCE INC, Sep. 2012, ANNALS OF THORACIC SURGERY, 94(3) (3), 785 - 791, English
    Scientific journal

  • Hiroaki Takahashi, Kenji Okada, Masamichi Matsumori, Hiroya Kano, Atsushi Kitagawa, Yutaka Okita
    BACKGROUND: Acute high-risk pulmonary embolism is a life-threatening condition with high early mortality rates resulting from acute right ventricular failure and cardiogenic shock. We retrospectively analyzed the outcomes of surgical embolectomy among patients with circulatory collapse. METHODS: Between July 2000 and September 2011, 24 consecutive patients (17 women and 7 men; mean age, 59.9±17.2 years) underwent emergency surgical embolectomy to treat acute pulmonary embolism with circulatory collapse. Nineteen (79.2%) patients were in cardiogenic shock, and 16 (66.7%) patients received preoperative percutaneous cardiopulmonary support. Eleven (45.8%) patients were in cardiac arrest. The preoperative pulmonary artery obstruction index was 76.9%±16.4% (median, 88.9%; range, 44.4%-88.9%). The indications for surgical intervention were cardiogenic shock (n=16 [66.7%]), failed medical therapy or catheter embolectomy (n=4 [16.7%]), or contraindication for thrombolysis (n=4 [16.7%]). Follow-up was 100% complete with a mean of 6.8±3.9 years (median, 5.6 years). RESULTS: The in-hospital mortality rate was 12.5% (n=3). One patient underwent a repeated embolectomy on postoperative day 6. The postoperative course was complicated by cerebral infarction and by mediastinitis in 1 patient each. The 5-year cumulative survival rate was 87.5%±6.8%. Mean right ventricular pressure significantly decreased from 66.9 to 28.5 mm Hg among the survivors. CONCLUSIONS: Surgical pulmonary embolectomy is an excellent approach to treating acute pulmonary embolism with circulatory collapse. Providing immediate percutaneous cardiopulmonary support to patients with cardiogenic shock could help to resuscitate and stabilize cardiopulmonary function and allow for a good outcome of pulmonary embolectomy.
    ELSEVIER SCIENCE INC, Sep. 2012, The Annals of thoracic surgery, 94(3) (3), 785 - 91, English, International magazine
    [Refereed]
    Scientific journal

  • Kenji Okada, Atsushi Omura, Hiroya Kano, Taimi Ohara, Tomonori Shirasaka, Katsuhiro Yamanaka, Shunsuke Miyahara, Toshihito Sakamoto, Akiko Tanaka, Takeshi Inoue, Takanori Oka, Hitoshi Minami, Yutaka Okita
    Background. This study was performed to investigate the early and late outcomes of total aortic arch replacement (TAR) with or without coronary artery bypass grafting (CABG). Methods. From October 1999 to December 2010, 200 consecutive patients underwent elective TAR for nondissecting aneurysm through a median sternotomy. Of this number, 131 (65.5%) had isolated TAR (TAR group) and 69 (34.5%) underwent concomitant CABG (TAR/CABG group). Patients in the TAR/CABG group were older and had more advanced chronic kidney disease and higher additive/logistic European System for Cardiac Operative Risk Evaluation and Japan scores than patients in the TAR group. Results. Overall 30-day mortality was 0.5% (1 of 200) and hospital mortality was 3.5% (7 of 200). Hospital mortality was 1.5% (2 of 131) in the TAR group and 7.2% (5 of 69) in the TAR/CABG group (p = 0.036). Multivariate analysis showed that operation time (odds ratio [ OR] 1.01, p = 0.013) was a risk factor for hospital mortality, but failed to demonstrate concomitant CABG as a risk factor. Cox proportional hazard analysis showed that age (OR 1.08, p = 0.05), female sex (OR 3.58, p = 0.0004), chronic kidney disease (OR 7.70, p < 0.0001), and operation time (OR 1.01, p = 0.0002) were risk factors for midterm mortality, whereas concomitant CABG was not (OR 0.92, p = 0.87). There was a significant difference in midterm survival and freedom from major cerebrocardiovascular events in the TAR group versus the TAR/CABG group. Conclusions. Concomitant CABG was not a risk factor for hospital morality with TAR. However, patients with concomitant CABG have more preoperative comorbidities, which may adversely affect outcomes, and which may therefore deserve special attention. (Ann Thorac Surg 2012;94:530-6) (c) 2012 by The Society of Thoracic Surgeons
    ELSEVIER SCIENCE INC, Aug. 2012, ANNALS OF THORACIC SURGERY, 94(2) (2), 530 - 536, English
    Scientific journal

  • Kenji Okada, Atsushi Omura, Hiroya Kano, Taimi Ohara, Tomonori Shirasaka, Katsuhiro Yamanaka, Shunsuke Miyahara, Toshihito Sakamoto, Akiko Tanaka, Takeshi Inoue, Takanori Oka, Hitoshi Minami, Yutaka Okita
    BACKGROUND: This study was performed to investigate the early and late outcomes of total aortic arch replacement (TAR) with or without coronary artery bypass grafting (CABG). METHODS: From October 1999 to December 2010, 200 consecutive patients underwent elective TAR for nondissecting aneurysm through a median sternotomy. Of this number, 131 (65.5%) had isolated TAR (TAR group) and 69 (34.5%) underwent concomitant CABG (TAR/CABG group). Patients in the TAR/CABG group were older and had more advanced chronic kidney disease and higher additive/logistic European System for Cardiac Operative Risk Evaluation and Japan scores than patients in the TAR group. RESULTS: Overall 30-day mortality was 0.5% (1 of 200) and hospital mortality was 3.5% (7 of 200). Hospital mortality was 1.5% (2 of 131) in the TAR group and 7.2% (5 of 69) in the TAR/CABG group (p=0.036). Multivariate analysis showed that operation time (odds ratio [OR] 1.01, p=0.013) was a risk factor for hospital mortality, but failed to demonstrate concomitant CABG as a risk factor. Cox proportional hazard analysis showed that age (OR 1.08, p=0.05), female sex (OR 3.58, p=0.0004), chronic kidney disease (OR 7.70, p<0.0001), and operation time (OR 1.01, p=0.0002) were risk factors for midterm mortality, whereas concomitant CABG was not (OR 0.92, p=0.87). There was a significant difference in midterm survival and freedom from major cerebrocardiovascular events in the TAR group versus the TAR/CABG group. CONCLUSIONS: Concomitant CABG was not a risk factor for hospital morality with TAR. However, patients with concomitant CABG have more preoperative comorbidities, which may adversely affect outcomes, and which may therefore deserve special attention.
    ELSEVIER SCIENCE INC, Aug. 2012, The Annals of thoracic surgery, 94(2) (2), 530 - 6, English, International magazine
    [Refereed]
    Scientific journal

  • 田中 亜紀子, 坂本 敏仁, Okada Kenji, 大北 裕
    Japan Heart Foundation, Jul. 2012, 心臓, 44(7号) (7号), 872 - 873, Japanese
    [Refereed]
    Scientific journal

  • Kenji Okada, Atsushi Omura, Hiroya Kano, Toshihito Sakamoto, Akiko Tanaka, Takeshi Inoue, Yutaka Okita
    Objective: Recent advancements in total aortic arch replacement achieved by our approach were presented. Methods: From January 2002 to December 2010, 321 consecutive patients (mean age 69.8 +/- 13.3 years) underwent total arch replacement through a median sternotomy at our institute. Aortic dissection was present in 94 (28.3%) patients and shaggy aorta in 36 (11.2%), with emergency/urgent surgery required in 106 (33.0%). Our current approach included the following: (1) meticulous selection of arterial cannulation site and type of arterial cannula; (2) antegrade selective cerebral perfusion; (3) maintenance of minimal tympanic temperature between 20 degrees C and 23 degrees C; (4) early rewarming just after distal anastomosis; (5) after 2004, bolus injection of 100 mg of sivelestat sodium hydrate into the pump circuit at the initiation of cardiopulmonary bypass; (6) after 2006, maintaining fluid balance below 1000 mL during cardiopulmonary bypass. Results: Overall hospital mortality was 4.4% (14/321) and was 1.9% (4/215) in elective cases. Permanent neurologic deficit occurred in 4.4% (14/321) of patients and in 2.8% (6/215) of elective cases. Prolonged ventilation was necessary in 53 (16.5%), with a significant reduction after 2006 (22.8% vs 12.6%; P = .02). Multivariate analysis demonstrated that risk factors for hospital mortality were octogenarian (odds ratio, 4.32; P = .03), brain malperfusion (odds ratio, 21.2; P = .001) and cardiopulmonary bypass time (odds ratio, 1.01; P = .04). Survival at 3 and 5 years after surgery was 82.4% +/- 2.5% and 78.5% +/- 3.1%, respectively. Conclusions: Our current approach for total aortic arch replacement was associated with low hospital mortality and morbidities and with favorable long-term outcome. (J Thorac Cardiovasc Surg 2012;144:139-45)
    MOSBY-ELSEVIER, Jul. 2012, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 144(1) (1), 139 - 145, English
    Scientific journal

  • Kenji Okada, Atsushi Omura, Hiroya Kano, Toshihito Sakamoto, Akiko Tanaka, Takeshi Inoue, Yutaka Okita
    OBJECTIVE: Recent advancements in total aortic arch replacement achieved by our approach were presented. METHODS: From January 2002 to December 2010, 321 consecutive patients (mean age 69.8 ± 13.3 years) underwent total arch replacement through a median sternotomy at our institute. Aortic dissection was present in 94 (28.3%) patients and shaggy aorta in 36 (11.2%), with emergency/urgent surgery required in 106 (33.0%). Our current approach included the following: (1) meticulous selection of arterial cannulation site and type of arterial cannula; (2) antegrade selective cerebral perfusion; (3) maintenance of minimal tympanic temperature between 20 °C and 23 °C; (4) early rewarming just after distal anastomosis; (5) after 2004, bolus injection of 100 mg of sivelestat sodium hydrate into the pump circuit at the initiation of cardiopulmonary bypass; (6) after 2006, maintaining fluid balance below 1000 mL during cardiopulmonary bypass. RESULTS: Overall hospital mortality was 4.4% (14/321) and was 1.9% (4/215) in elective cases. Permanent neurologic deficit occurred in 4.4% (14/321) of patients and in 2.8% (6/215) of elective cases. Prolonged ventilation was necessary in 53 (16.5%), with a significant reduction after 2006 (22.8% vs 12.6%; P = .02). Multivariate analysis demonstrated that risk factors for hospital mortality were octogenarian (odds ratio, 4.32; P = .03), brain malperfusion (odds ratio, 21.2; P = .001) and cardiopulmonary bypass time (odds ratio, 1.01; P = .04). Survival at 3 and 5 years after surgery was 82.4% ± 2.5% and 78.5% ± 3.1%, respectively. CONCLUSIONS: Our current approach for total aortic arch replacement was associated with low hospital mortality and morbidities and with favorable long-term outcome.
    MOSBY-ELSEVIER, Jul. 2012, The Journal of thoracic and cardiovascular surgery, 144(1) (1), 139 - 45, English, International magazine
    [Refereed]
    Scientific journal

  • Keisuke Morimoto, Tomomi Hasegawa, Akiko Tanaka, Bao Wulan, Jie Yu, Naoto Morimoto, Yutaka Okita, Kenji Okada
    Objective: An ideal pharmaceutical treatment for abdominal aortic aneurysm (AAA) is to prevent aneurysm formation and development (further dilatation of pre-existing aneurysm). Recent studies have reported that oxidative stress with reactive oxygen species (ROS) is crucial in aneurysm formation. We hypothesized that edaravone, a free-radical scavenger, would attenuate vascular oxidative stress and inhibit AAA formation and development. Methods: An AAA model induced with intraluminal elastase and extraluminal calcium chloride was created in 42 rats. Thirty-six rats were divided three groups: a low-dose (group LD; 1 mg/kg/d), high-dose (group HD; 5 mg/kg/d), and control (group C, saline). Edaravone or saline was intraperitoneally injected twice daily, starting 30 minutes before aneurysm preparation. The remaining six rats (group DA) received a delayed edaravone injection (5 mg/kg/d) intraperitoneally, starting 7 days after aneurysm preparation to 28 days. AAA dilatation ratio was calculated. Pathologic examination was performed. ROS expression was semi-quantified by dihydroethidium staining and the oxidative product of DNA induced by ROS, 8-hydroxydeoxyguanosine (8-OHdG), by immunohistochemical staining. Results: At day 7, ROS expression and 8-OHdG-positive cells in aneurysm walls were decreased by edaravone treatment (ROS expression: 3.0 +/- 0.5 in group LD, 1.7 +/- 0.3 in group HD, and 4.8 +/- 0.7 in group C; 8-OHdG-positive cells: 106.2 +/- 7.8 cells in group LD, 64.5 +/- 7.7 cells in group HD, and 136.6 +/- 7.4 cells in group C; P < .0001), compared with group C. Edaravone treatment significantly reduced messenger RNA expressions of cytokines and matrix metalloproteinases (MMPs) in aneurysm walls (MMP-2: 1.1 +/- 0.5 in group LD, 0.6 +/- 0.1 in group HD, and 2.3 +/- 0.4 in group C; P < .001; MMP-9: 1.2 +/- 0.1 in group LD, 0.2 +/- 0.6 in group HD, and 2.4 +/- 0.2 in group C; P < .001). At day 28, aortic walls in groups LD and HD were less dilated, with increased wall thickness and elastin content than those in group C (dilatation ratio: 204.7% +/- 16.0% in group C, 156.5% +/- 6.6% in group LD, 136.7% +/- 2.0% in group HD; P < .0001). Delayed edaravone administration significantly prevented further aneurysm dilatation, with increased elastin content (155.2% +/- 2.9% at day 7, 153.1% +/- 11.6% at day 28; not significant). Conclusions: Edaravone inhibition of ROS can prevent aneurysm formation and expansion in the rat AAA model. Free-radical scavenger edaravone might be an effective pharmaceutical agent for AAA in clinical practice. (J Vasc Surg 2012;55:1749-58.)
    MOSBY-ELSEVIER, Jun. 2012, JOURNAL OF VASCULAR SURGERY, 55(6) (6), 1749 - 1758, English
    Scientific journal

  • Keisuke Morimoto, Tomomi Hasegawa, Akiko Tanaka, Bao Wulan, Jie Yu, Naoto Morimoto, Yutaka Okita, Kenji Okada
    OBJECTIVE: An ideal pharmaceutical treatment for abdominal aortic aneurysm (AAA) is to prevent aneurysm formation and development (further dilatation of pre-existing aneurysm). Recent studies have reported that oxidative stress with reactive oxygen species (ROS) is crucial in aneurysm formation. We hypothesized that edaravone, a free-radical scavenger, would attenuate vascular oxidative stress and inhibit AAA formation and development. METHODS: An AAA model induced with intraluminal elastase and extraluminal calcium chloride was created in 42 rats. Thirty-six rats were divided three groups: a low-dose (group LD; 1 mg/kg/d), high-dose (group HD; 5 mg/kg/d), and control (group C, saline). Edaravone or saline was intraperitoneally injected twice daily, starting 30 minutes before aneurysm preparation. The remaining six rats (group DA) received a delayed edaravone injection (5 mg/kg/d) intraperitoneally, starting 7 days after aneurysm preparation to 28 days. AAA dilatation ratio was calculated. Pathologic examination was performed. ROS expression was semi-quantified by dihydroethidium staining and the oxidative product of DNA induced by ROS, 8-hydroxydeoxyguanosine (8-OHdG), by immunohistochemical staining. RESULTS: At day 7, ROS expression and 8-OHdG-positive cells in aneurysm walls were decreased by edaravone treatment (ROS expression: 3.0 ± 0.5 in group LD, 1.7 ± 0.3 in group HD, and 4.8 ± 0.7 in group C; 8-OHdG-positive cells: 106.2 ± 7.8 cells in group LD, 64.5 ± 7.7 cells in group HD, and 136.6 ± 7.4 cells in group C; P < .0001), compared with group C. Edaravone treatment significantly reduced messenger RNA expressions of cytokines and matrix metalloproteinases (MMPs) in aneurysm walls (MMP-2: 1.1 ± 0.5 in group LD, 0.6 ± 0.1 in group HD, and 2.3 ± 0.4 in group C; P < .001; MMP-9: 1.2 ± 0.1 in group LD, 0.2 ± 0.6 in group HD, and 2.4 ± 0.2 in group C; P < .001). At day 28, aortic walls in groups LD and HD were less dilated, with increased wall thickness and elastin content than those in group C (dilatation ratio: 204.7% ± 16.0% in group C, 156.5% ± 6.6% in group LD, 136.7% ± 2.0% in group HD; P < .0001). Delayed edaravone administration significantly prevented further aneurysm dilatation, with increased elastin content (155.2% ± 2.9% at day 7, 153.1% ± 11.6% at day 28; not significant). CONCLUSIONS: Edaravone inhibition of ROS can prevent aneurysm formation and expansion in the rat AAA model. Free-radical scavenger edaravone might be an effective pharmaceutical agent for AAA in clinical practice.
    MOSBY-ELSEVIER, Jun. 2012, Journal of vascular surgery, 55(6) (6), 1749 - 58, English, International magazine
    [Refereed]
    Scientific journal

  • 腹部大動脈瘤ステントグラフト内挿術の治療成績 IFU内vs IFU外
    Nomura Yoshikatsu, Yamaguchi Masato, Miyahara Shunsuke, Shirasaka Tomonori, Sakamoto Toshihito, Omura Atsushi, Tanaka Akiko, Inoue Takeshi, Oka Takanori, Minami Hitoshi, Sugimoto Koji, Okada Kenji, Okita Yutaka
    (NPO)日本血管外科学会, May 2012, 日本血管外科学会雑誌, 21(3) (3), 400 - 400, Japanese
    Research society

  • 内臓動脈瘤に対する治療方針の検討
    Sakamoto Toshihito, Shirasaka Tomonori, Miyahara Shunsuke, Omura Atsushi, Nomura Yoshikatsu, Tanaka Akiko, Inoue Takeshi, Oka Takanori, Minami Hitoshi, Okada Kenji, Okita Yutaka, Yamaguchi Masato, Sugimoto Koji
    (NPO)日本血管外科学会, May 2012, 日本血管外科学会雑誌, 21(3) (3), 424 - 424, Japanese
    Research society

  • 総腸骨動脈瘤に対するステントグラフト内挿術の治療成績
    Nomura Yoshikatsu, Miyahara Shunsuke, Shirasaka Tomonori, Sakamoto Toshihito, Omura Atsushi, Tanaka Akiko, Inoue Takeshi, Oka Takanori, Minami Hitoshi, Yamaguchi Masato, Sugimoto Koji, Okada Kenji, Okita Yutaka
    (NPO)日本血管外科学会, May 2012, 日本血管外科学会雑誌, 21(3) (3), 469 - 470, Japanese
    Research society

  • Gianturco Z stent graftによるTEVARの遠隔期type III endoleakの治療経験
    Nomura Yoshikatsu, Shirasaka Tomonori, Miyahara Shunsuke, Omura Atsushi, Sakamoto Toshihito, Tanaka Akiko, Oka Takanori, Minami Hitoshi, Okada Kenji, Okada Takuya, Idoguchi Koji, Yamaguchi Masato, Sugimoto Koji, Okita Yutaka
    (NPO)日本血管外科学会, Apr. 2012, 日本血管外科学会雑誌, 21(2) (2), 162 - 162, Japanese
    Research society

  • 腹部大動脈瘤の治療成績 EVAR vs Open Surgery
    Nomura Yoshikatsu, Shirasaka Tomonori, Miyahara Shunsuke, Sakamoto Toshihito, Omura Atsushi, Tanaka Akiko, Inoue Takeshi, Oka Takanori, Okada Kenji, Okita Yutaka, Yamaguchi Masato, Sugimoto Koji
    (NPO)日本心臓血管外科学会, Mar. 2012, 日本心臓血管外科学会雑誌, 41(Suppl.) (Suppl.), 444 - 444, Japanese
    Research society

  • Kohei Yamawaki, Hidekazu Tanaka, Kensuke Matsumoto, Mana Hiraishi, Tatsuya Miyoshi, Akihiro Kaneko, Takayuki Tsuji, Keiko Ryo, Kazuko Norisada, Yuko Fukuda, Kazuhiro Tatsumi, Tetsuari Onishi, Kenji Okada, Yutaka Okita, Hiroya Kawai, Ken-ichi Hirata
    BACKGROUND: The purpose of this study was to investigate whether patients with severe aortic stenosis (AS) and preserved ejection fraction (EF) have dyssynchrony and whether it improves after aortic valve replacement (AVR). METHODS AND RESULTS: We studied 30 consecutive patients with severe AS and preserved EF undergoing AVR. For baseline comparison, we studied 17 EF-matched patients with mild-to-moderate AS, and 18 EF-matched normal volunteers. Longitudinal dyssynchrony was determined as the standard deviation for time-to-peak speckle-tracking strain in apical 4- and 2-chamber views at the basal- and mid-levels. Radial and circumferential dyssynchrony was determined as the difference for time-to-peak strain between the anteroseptum and posterior wall from the mid-left ventricular (LV) short-axis view. Each of the myocardial functions was also evaluated by averaging each peak systolic strain. Longitudinal dyssynchrony and function in patients with severe AS was significantly worse than in the patients with mild-to-moderate AS and the controls (94 ± 46 vs. 66 ± 18 ms* and 52 ± 17 ms*, and 12.5 ± 3.7% vs. 16 ± 3.5%* and 18.7 ± 3.7%*, respectively, *P<0.05, vs. severe AS). In contrast, radial and circumferential dyssynchrony were similar for the 3 groups. Importantly, the dyssynchrony of patients with severe AS significantly improved after AVR from 94 ± 46 ms to 68 ± 22 ms (P<0.005). CONCLUSIONS: Significant longitudinal dyssynchrony was present in patients with severe AS and preserved EF, and it improved after AVR.
    JAPANESE CIRCULATION SOC, 2012, Circulation journal : official journal of the Japanese Circulation Society, 76(3) (3), 744 - 51, English, Domestic magazine
    Scientific journal

  • 狭小大動脈に発症した外傷性断裂に対すTEVAR施行例
    Shirasaka Tomonori, Miyahara Shunsuke, Nomura Yoshikatsu, Omura Atsushi, Sakamoto Toshihito, Tanaka Akiko, Munakata Hiroshi, Inoue Takeshi, Oka Takanori, Minami Hitoshi, Kitagawa Atsushi, Okada Kenji, Okita Yutaka, Okada Takuya, Idoguchi Koji, Yamaguchi Masato, Sugimoto Koji
    (NPO)日本血管外科学会, Dec. 2011, 日本血管外科学会雑誌, 20(7) (7), 1011 - 1011, Japanese
    Research society

  • Naoto Morimoto, Kenji Okada, Yutaka Okita
    Background: Surgical treatment of acute type A aortic dissection complicated by cerebral malperfusion remains challenging. This study evaluated predictors of lack of neurologic improvement after aortic repair for acute type A dissection complicated by cerebral malperfusion and assessed relationship with survival. Methods: We retrospectively reviewed 41 consecutive patients operated on between 1999 and 2008 for acute type A dissection complicated by cerebral malperfusion. Lack of postoperative neurologic improvement was defined as a difference between baseline and postoperative National Institutes of Health Stroke Scale scores of 3 points or less. Results: Lack of neurologic improvement was seen in 15 patients (37%). Logistic regression analysis, baseline National Institutes of Health Stroke Scale score (odds ratio, 6.7; 95% confidence interval, 1.4-32.4; P = .02), and time to surgery (odds ratio, 14.6; 95% confidence interval, 2.7-8.5; P = .002) were significantly associated with lack of neurologic improvement. In receiver operating characteristic analysis, National Institutes of Health Stroke Scale score greater than 11 and time to surgery longer than 9.1 hours were best cutoffs for predicting lack of neurologic improvement. Thirty-day mortality was 14.6%. All early deaths were caused by large hemispheric infarction. Postoperative computed tomography or magnetic resonance imaging revealed cerebral infarction in 21 patients (51%). Five-year survival was significantly lower in patients without neurologic improvement (33% +/- 12% vs 84% +/- 7%, log-rank P < .001). Conclusions: Time to surgery and baseline National Institutes of Health Stroke Scale score were predictors of lack of improvement, which was associated with poor survival. (J Thorac Cardiovasc Surg 2011;142:1540-4)
    MOSBY-ELSEVIER, Dec. 2011, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 142(6) (6), 1540 - 1544, English
    Scientific journal

  • Naoto Morimoto, Kenji Okada, Yutaka Okita
    BACKGROUND: Surgical treatment of acute type A aortic dissection complicated by cerebral malperfusion remains challenging. This study evaluated predictors of lack of neurologic improvement after aortic repair for acute type A dissection complicated by cerebral malperfusion and assessed relationship with survival. METHODS: We retrospectively reviewed 41 consecutive patients operated on between 1999 and 2008 for acute type A dissection complicated by cerebral malperfusion. Lack of postoperative neurologic improvement was defined as a difference between baseline and postoperative National Institutes of Health Stroke Scale scores of 3 points or less. RESULTS: Lack of neurologic improvement was seen in 15 patients (37%). Logistic regression analysis, baseline National Institutes of Health Stroke Scale score (odds ratio, 6.7; 95% confidence interval, 1.4-32.4; P = .02), and time to surgery (odds ratio, 14.6; 95% confidence interval, 2.7-8.5; P = .002) were significantly associated with lack of neurologic improvement. In receiver operating characteristic analysis, National Institutes of Health Stroke Scale score greater than 11 and time to surgery longer than 9.1 hours were best cutoffs for predicting lack of neurologic improvement. Thirty-day mortality was 14.6%. All early deaths were caused by large hemispheric infarction. Postoperative computed tomography or magnetic resonance imaging revealed cerebral infarction in 21 patients (51%). Five-year survival was significantly lower in patients without neurologic improvement (33% ± 12% vs 84% ± 7%, log-rank P <.001). CONCLUSIONS: Time to surgery and baseline National Institutes of Health Stroke Scale score were predictors of lack of improvement, which was associated with poor survival.
    MOSBY-ELSEVIER, Dec. 2011, The Journal of thoracic and cardiovascular surgery, 142(6) (6), 1540 - 4, English, International magazine
    [Refereed]
    Scientific journal

  • Takanori Oka, Yutaka Okita, Masamichi Matsumori, Kenji Okada, Hitoshi Minami, Hiroshi Munakata, Takeshi Inoue, Akiko Tanaka, Toshihito Sakamoto, Atsushi Omura, Takuo Nomura
    Background. Despite the positive clinical results of valve-sparing aortic root replacement, little is known about the causes of reoperations and the modes of failure. Methods. From October 1999 to June 2010, 101 patients underwent valve-sparing aortic root replacement using the David reimplantation technique. The definition of aortic root repair failure included the following: (1) intraoperative conversion to the Bentall procedure; (2) reoperation performed because of aortic regurgitation; and (3) aortic regurgitation equal to or greater than a moderate degree at the follow-up. Sixteen patients were considered to have repair failure. Three patients required intraoperative conversion to valve replacement, 3 required reoperation within 3 months, and another 8 required reoperation during postoperative follow-up. At initial surgery 5 patients had moderate to severe aortic regurgitation, 6 patients had acute aortic dissections, 3 had Marfan syndrome, 2 had status post Ross operations, 3 had bicuspid aortic valves, and 1 had aortitis. Five patients had undergone cusp repair, including Arantius plication in 3 and plication at the commissure in 2. Results. The causes of early failure in 6 patients included cusp perforation (3), cusp prolapse (3), and severe hemolysis (1). The causes of late failure in 10 patients included cusp prolapse (4), commissure dehiscence (3), torn cusp (2), and cusp retraction (1). Patients had valve replacements at a mean of 23 +/- 20.9 months after reimplantation and survived. Conclusions. Causes of early failure after valve-sparing root replacement included technical failure, cusp lesions, and steep learning curve. Late failure was caused by aortic root wall degeneration due to gelatin-resorcin-formalin glue, cusp degeneration, or progression of cusp prolapse. (Ann Thorac Surg 2011;92:1639-45) (C) 2011 by The Society of Thoracic Surgeons
    ELSEVIER SCIENCE INC, Nov. 2011, ANNALS OF THORACIC SURGERY, 92(5) (5), 1639 - U504, English
    Scientific journal

  • Takanori Oka, Yutaka Okita, Masamichi Matsumori, Kenji Okada, Hitoshi Minami, Hiroshi Munakata, Takeshi Inoue, Akiko Tanaka, Toshihito Sakamoto, Atsushi Omura, Takuo Nomura
    BACKGROUND: Despite the positive clinical results of valve-sparing aortic root replacement, little is known about the causes of reoperations and the modes of failure. METHODS: From October 1999 to June 2010, 101 patients underwent valve-sparing aortic root replacement using the David reimplantation technique. The definition of aortic root repair failure included the following: (1) intraoperative conversion to the Bentall procedure; (2) reoperation performed because of aortic regurgitation; and (3) aortic regurgitation equal to or greater than a moderate degree at the follow-up. Sixteen patients were considered to have repair failure. Three patients required intraoperative conversion to valve replacement, 3 required reoperation within 3 months, and another 8 required reoperation during postoperative follow-up. At initial surgery 5 patients had moderate to severe aortic regurgitation, 6 patients had acute aortic dissections, 3 had Marfan syndrome, 2 had status post Ross operations, 3 had bicuspid aortic valves, and 1 had aortitis. Five patients had undergone cusp repair, including Arantius plication in 3 and plication at the commissure in 2. RESULTS: The causes of early failure in 6 patients included cusp perforation (3), cusp prolapse (3), and severe hemolysis (1). The causes of late failure in 10 patients included cusp prolapse (4), commissure dehiscence (3), torn cusp (2), and cusp retraction (1). Patients had valve replacements at a mean of 23 ± 20.9 months after reimplantation and survived. CONCLUSIONS: Causes of early failure after valve-sparing root replacement included technical failure, cusp lesions, and steep learning curve. Late failure was caused by aortic root wall degeneration due to gelatin-resorcin-formalin glue, cusp degeneration, or progression of cusp prolapse.
    ELSEVIER SCIENCE INC, Nov. 2011, The Annals of thoracic surgery, 92(5) (5), 1639 - 44, English, International magazine
    Scientific journal

  • [Repair versus replacement of mitral valve for treating severe functional mitral regurgitation].
    Kazunori Yoshida, Takeshi Inoue, Hiroshi Munakata, Hitoshi Minami, Takanori Oka, Kenji Okada, Yutaka Okita
    BACKGROUND: The purpose of this study is to compare mitral valve replacement (MVR) to anuloplasty (MAP) in patients with severe functional mitral regurgitation (FMR). METHODS: Data of 43 patients with significant chronic FMR who underwent mitral valve operations from November 1999 through May 2011 were retrospectively analyzed. This reference group included patients who underwent MVR (n = 18) and MAP (undersized restrictive annuloplasty, n = 25). The mitral valve is replaced sparing the continuity between mitral valve and subvalvular apparatus. All patients had severe FMR, and 71.4% had New York Heart Association (NYHA) III or IV symptoms of heart failure, and 20% had preoperative intraaortic balloon pumping (IABP) insertion. The MVR group had significantly higher risk patients with complex jet and advanced coaptation depth (13.3 +/- 2.1 versus 11.1 +/- 2.3 mm, p = 0.04). RESULTS: Hospital mortality was 9.3%. No statistical difference was found between the 2 groups in term of intraoperative data. Kaplan-Meier survival estimates at 1, 5 years was 82.6, 72.3% in MVR group, and 77.8, 69.7% in MAP group (p = 0.98). Freedom from Cardiac-related event at 5 years was 62.7% for MVR compared to 56.8 % for MAP (p = 0.75). At the last follow-up, recurrence of MR II or greater was present in 4 (14.8%) patients in the MAP group and only one patient required re-operation because of worsening heart failure. In multivariable analysis, independent predictor of increased cardiac-related event was associated with residual pulmonary hypertension (HR, 3.0: p = 0.021). CONCLUSIONS: In high-risk patients with severe FMR. MVR seems to be a reasonable option.
    Oct. 2011, Kyobu geka. The Japanese journal of thoracic surgery, 64(11) (11), 963 - 7, Japanese, Domestic magazine
    Scientific journal

  • Tomomi Hasegawa, Kenji Okada, Yutaka Okita, David J Pinsky
    BACKGROUND: Many non-immunologic factors contribute to the development of cardiac allograft vasculopathy (CAV), chief among them being ischemia-reperfusion injury associated with oxidative stress. We hypothesized that pioglitazone, a peroxisome proliferator-activated receptor (PPAR)-γ agonist, could attenuate graft oxidant stress in cardiac transplantation. METHODS: Experiments were performed using a murine heterotopic cardiac allotransplantation model. Pioglitazone was administered to recipients once daily, beginning 1 day before transplantation. RESULTS: At 4 hours after transplantation, pioglitazone significantly reduced the expression of endothelial cell adhesion receptors and infiltration of polymorphonuclear leukocytes (PMNs). The anti-oxidant balance in pioglitazone-treated cardiac allografts was significantly bolstered by reduced nicotinamide adenine dinucleotide phosphate hydrogen (NADPH) oxidase (Nox1 and p22(phox) sub-units) activity and preservation of manganese superoxide dismutase (SOD) activity, resulting in the mitigation of oxidative damage at the level of lipids, proteins, and DNA. At 7 days after transplantation, PPAR-γ was significantly up-regulated by pioglitazone, but nuclear factor-κB and inducible nitric oxide synthase were significantly down-regulated. A concomitant reduction of inflammatory cytokines and chemokines and graft leukosequestration was noted. Pioglitazone consequently prolonged cardiac allograft survival and attenuated CAV development. In vitro experiments demonstrated that pioglitazone decreased transendothelial PMN migration, NADPH oxidase activity, and loss of SOD activity in PMNs and endothelial cells. CONCLUSIONS: Pioglitazone can suppress the oxidative stress and damage and can stimulate antioxidant capacity in cardiac allografts after transplantation. Mitigation of graft oxidant stress could be an important mechanism through which pioglitazone confers benefit after cardiac transplantation.
    ELSEVIER SCIENCE INC, Oct. 2011, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 30(10) (10), 1186 - 96, English, International magazine
    [Refereed]
    Scientific journal

  • Naoto Morimoto, Keisuke Morimoto, Yoshihisa Morimoto, Akiko Tanaka, Toshihito Sakamoto, Kenji Okada, Yutaka Okita
    A 39-year-old woman with familial homozygous hypercholesterolemia had supravalvular and valvular aortic stenosis. Modified Nick's procedure and aortic valve replacement was performed to relieve both the supravalvular and annular stenoses. At surgery, the ascending aorta was found to be narrowing at the level of the sinotubular junction, which was compatible with congenital supravalvular aortic stenosis. Histological examination of the aortic cusps showed sclerotic change due to hypercholesterolemia. These findings indicated that familial homozygous hypercholesterolemia caused valvular aortic stenosis and exacerbated congenital supravalvular aortic stenosis.
    Aug. 2011, General thoracic and cardiovascular surgery, 59(8) (8), 569 - 71, English, Domestic magazine
    Scientific journal

  • Hiroaki Takahashi, Kenji Okada, Masamichi Matsumori, Yutaka Okita
    Dextrocardia associated with situs inversus totalis is a rare condition. A small number of patients with the condition have been reported after undergoing myocardial revascularization. We experienced a case of this rare disorder in an 83-year-old man. He was successfully treated by off-pump coronary artery bypass grafting with bilateral internal thoracic arteries and a saphenous vein. Except for the mirror-image anatomy, the surgical technique was similar to that used for a patient with situs solitus.
    SPRINGER, Aug. 2011, Surgery today, 41(8) (8), 1130 - 2, English, Domestic magazine
    Scientific journal

  • Naoto Morimoto, Kenji Okada, Yutaka Okita
    A 72-year-old woman with a known history of homozygous familial hyperlipidemia (IIa) was referred to our hospital for an operation necessitated by aortic and mitral stenosis and paroxysmal atrial fibrillation. Computed tomography and cardiac catheterization revealed a heavily calcified aortic root and mitral annulus as well as a high-grade stenosis of the left anterior descending and right coronary arteries. Double aortic and mitral valve replacement concomitant with replacement of ascending aorta, maze III procedure, and coronary artery bypass were performed. Temporary hypothermic arrest was employed to reduce the risk of cerebral emboli.
    Jul. 2011, General thoracic and cardiovascular surgery, 59(7) (7), 491 - 4, English, Domestic magazine
    [Refereed]
    Scientific journal

  • 腹部大動脈瘤に対するEVAR後の機種別治療成績
    Nomura Yoshikatsu, Miyahara Shunsuke, Omura Atsushi, Sakamoto Toshihito, Tanaka Akiko, Fujita Yasuyuki, Munakata Hiroshi, Inoue Takeshi, Oka Takanori, Minami Hitoshi, Kitagawa Atsushi, Okada Kenji, Okita Yutaka, Yamaguchi Masato, Sugimoto Koji
    (一社)日本外科学会, May 2011, 日本外科学会雑誌, 112(臨増1-2) (臨増1-2), 833 - 833, Japanese
    Research society

  • TEVARにおける脊髄虚血症例の検討
    Kitagawa Atsushi, Okita Yutaka, Okada Kenji, Minami Hitoshi, Oka Takanori, Inoue Takeshi, Munakata Hiroshi, Omura Atsushi, Nomura Yoshikatsu, Yamaguchi Masato, Sugimoto Koji, Sugimura Kazuro
    (一社)日本外科学会, May 2011, 日本外科学会雑誌, 112(臨増1-2) (臨増1-2), 832 - 832, Japanese
    Research society

  • 当院における浅大腿動脈病変に対する治療成績
    Nomura Yoshikatsu, Sakamoto Toshihito, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Inoue Takeshi, Oka Takanori, Minami Hitoshi, Kitagawa Atsushi, Okada Kenji, Okita Yutaka, Yamaguchi Masato, Sugimoto Koji
    (NPO)日本血管外科学会, Apr. 2011, 日本血管外科学会雑誌, 20(2) (2), 350 - 350, Japanese
    Research society

  • 大動脈気管支瘻、食道瘻、感染性胸部大動脈瘤に対するTEVAR
    Kitagawa Atsushi, Nomura Yoshikatsu, Omura Atsushi, Munakata Hiroshi, Inoue Takeshi, Oka Takanori, Minami Hitoshi, Yamaguchi Masato, Okada Kenji, Sugimoto Koji, Sugimura Kazuro, Okita Yutaka
    (NPO)日本血管外科学会, Apr. 2011, 日本血管外科学会雑誌, 20(2) (2), 304 - 304, Japanese
    Research society

  • TEVARの急性期、遠隔期イベント発生に及ぼす危険因子の検討
    Kitagawa Atsushi, Yamaguchi Masato, Sugimoto Koji, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Inoue Takeshi, Oka Takanori, Minami Hitoshi, Okada Kenji, Sugimura Kazuro, Okita Yutaka
    (NPO)日本心臓血管外科学会, Jan. 2011, 日本心臓血管外科学会雑誌, 40(Suppl.) (Suppl.), 261 - 261, Japanese
    Research society

  • Masayuki Nakagawa, Junya Shite, Toshiro Shinke, Hiromasa Otake, Kenji Okada, Yutaka Okita, Ken-ichi Hirata
    JAPANESE CIRCULATION SOC, 2011, Circulation journal : official journal of the Japanese Circulation Society, 75(10) (10), 2505 - 7, English, Domestic magazine
    Scientific journal

  • Hiroshi Munakata, Kenji Okada, Hiroya Kano, So Izumi, Yutaka Hino, Masamichi Matsumori, Yutaka Okita
    ELSEVIER SCIENCE INC, Nov. 2010, ANNALS OF THORACIC SURGERY, 90(6) (6), 2089 - 2089, English

  • Takashi Munezane, Tomomi Hasegawa, Suritala, Akiko Tanaka, Kenji Okada, Yutaka Okita
    OBJECTIVE: The altered structure and composition of the vascular extracellular matrix (ECM) influences the formation of abdominal aortic aneurysms (AAA). Transglutaminase type 2 (TG2), which is a Ca(2+)-dependent cross-linking enzyme, has been proven the importance for ECM homeostasis, but there is no evidence of TG2 in AAA formation. The hypothesis was investigated that TG2 contributes to protect aortic walls during remodeling of the AAAs. METHODS: In a rat abdominal aortic aneurysm model using a combination of intraluminal elastase infusion and extraluminal calcium chloride, TG2 expression and activity were evaluated at 1 and 8 weeks after the AAA preparation (n = 6 at each endpoint), compared with those of the non-prepared aorta (n = 6). Additionally, ex vivo experiments of isolated AAA tissue culture with recombinant human TG2, TG2 inhibitor cystamine, or tissue necrosis factor (TNF)-α were performed. RESULTS: TG2 mRNA expression in the AAAs was significantly upregulated at both 1 and 8 weeks (22.4-fold and 5.4-fold increases of the non-prepared aorta, P = .0022 and P = .0048, respectively). TG2 protein expression and activity were also enhanced by fluorescent staining of the AAAs. Similar mRNA upregulation of TNF-α, interleukin-1β, matrix metalloproteinases (MMP)-2, MMP-9, and tissue inhibitors of metalloproteinases (TIMP)-1 and TIMP-2 was observed in the AAAs, and TG2 and TNF-α were colocalized in the aortic walls at 1 week. Ex vivo experiments showed that mRNA expressions of TNF-α, MMP-2, and MMP-9 in the cultured AAA tissue were decreased by exogenous TG2, whereas were increased by cystamine. TNF-α exposure to the AAA tissues was significantly upregulated TG2 mRNA expression (P = .0333). CONCLUSION: TG2 expression and activity in AAA formation were enhanced, possibly due to compensatory reaction. TG2 has a potential role of ECM protector in aortic walls during remodeling of the AAAs.
    MOSBY-ELSEVIER, Oct. 2010, Journal of vascular surgery, 52(4) (4), 967 - 74, English, International magazine
    Scientific journal

  • Yohei Funakoshi, Toru Mukohara, Tomoko Kataoka, Hideo Tomioka, Naoko Chayahara, Yutaka Fujiwara, Naomi Kiyota, Tomonori Shirasaka, Takanori Oka, Kenji Okada, Yutaka Okita, Shigeo Hara, Tomoo Itoh, Soichi Fumita, Kazuhiko Nakagawa, Hironobu Minami
    Extension of metastatic lung tumors into the left atrium via pulmonary veins is rare. Here, we report the first case of Ewing sarcoma exhibiting such extension. A 31-year-old man with pulmonary metastasis from Ewing sarcoma presented with a mass in the left lung, extending to the left atrium through the left inferior pulmonary vein. As the patient was considered to be at risk of tumor embolism, the mass was excised surgically.
    Sep. 2010, Rare tumors, 2(3) (3), e53, English, International magazine

  • Hideki Takahashi, Kenji Okada, Masamichi Matsumori, Yutaka Okita
    A 59-year-old woman had undergone total arch replacement, followed by the mediastinal omental flap installation because of postoperative mediastinitis. One year later, she was diagnosed with annuloaortic ectasia with mitral regurgitation and underwent aortic root replacement (modified Bentall procedure) plus mitral valve annuloplasty through the right anterolateral thoracotomy. Her postoperative course was uneventful. The approach could be an alternative for the aortic root replacement in patients with previous median sternal wound complications.
    OXFORD UNIV PRESS, Sep. 2010, Interactive cardiovascular and thoracic surgery, 11(3) (3), 345 - 7, English, International magazine
    Scientific journal

  • Zhi Chen, Tomomi Hasegawa, Akiko Tanaka, Yutaka Okita, Kenji Okada
    OBJECTIVE: Improvement of vein graft patency may be highly beneficial in coronary artery bypass grafting, but graft degeneration is considered to be one of the main pathophysiologic causes for vein graft failure. Because peroxisome proliferator-activated receptor-gamma activator pioglitazone was recently reported to possess pleiotropic protective effects on various organs and tissues, we conducted experiments to test the hypothesis that pioglitazone could prevent graft degeneration, leading to the preservation of vein graft integrity. METHODS: In a rat aortic interposition model with autologous femoral vein, pioglitazone (3 mg/kg/d) or vehicle (normal saline) was given to rats by gastric gavage once per day beginning 3 days before surgery and ending 8 weeks after surgery. Vein graft degeneration and remodeling were assessed at 24 hours, 7 days, 8 weeks, and 6 months after surgery. RESULTS: At 24 hours, pioglitazone significantly reduced endothelial desquamation, reactive oxygen species generation, myeloperoxidase activity, and lipid peroxidation in vein grafts. At 7 days, mRNA expression and gelatinolytic activity of matrix metalloproteinase-2 and 9 in vein grafts were significantly suppressed by pioglitazone treatment. Immunofluorescent staining showed that pioglitazone enhanced peroxisome proliferator-activated receptor-gamma expression in vein grafts at 8 weeks, especially in their intimal side. At 6 months, pioglitazone treatment prevented graft dilation (52.3% +/- 3.1% vs 90.7% +/- 9.9%, P = .0041) and neointimal hyperplasia (14.6% +/- 1.3% vs 29.9% +/- 2.9%, P = .0008), and increased graft flow velocity ratio (0.86 +/- 0.03 vs 0.59 +/- 0.04, P < .0001), compared with vehicle treatment. CONCLUSION: Pioglitazone prevents graft degeneration under arterial pressure stress and preserves the vein graft integrity in a rat aortic interposition model.
    MOSBY-ELSEVIER, Aug. 2010, The Journal of thoracic and cardiovascular surgery, 140(2) (2), 408 - 416, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Zhi Chen, Tomomi Hasegawa, Akiko Tanaka, Yutaka Okita, Kenji Okada
    Objective: Improvement of vein graft patency may be highly beneficial in coronary artery bypass grafting, but graft degeneration is considered to be one of the main pathophysiologic causes for vein graft failure. Because peroxisome proliferator-activated receptor-gamma activator pioglitazone was recently reported to possess pleiotropic protective effects on various organs and tissues, we conducted experiments to test the hypothesis that pioglitazone could prevent graft degeneration, leading to the preservation of vein graft integrity. Methods: In a rat aortic interposition model with autologous femoral vein, pioglitazone (3 mg/kg/d) or vehicle (normal saline) was given to rats by gastric gavage once per day beginning 3 days before surgery and ending 8 weeks after surgery. Vein graft degeneration and remodeling were assessed at 24 hours, 7 days, 8 weeks, and 6 months after surgery. Results: At 24 hours, pioglitazone significantly reduced endothelial desquamation, reactive oxygen species generation, myeloperoxidase activity, and lipid peroxidation in vein grafts. At 7 days, mRNA expression and gelatinolytic activity of matrix metalloproteinase-2 and 9 in vein grafts were significantly suppressed by pioglitazone treatment. Immunofluorescent staining showed that pioglitazone enhanced peroxisome proliferator-activated receptor-gamma expression in vein grafts at 8 weeks, especially in their intimal side. At 6 months, pioglitazone treatment prevented graft dilation (52.3% +/- 3.1% vs 90.7% +/- 9.9%, P=.0041) and neointimal hyperplasia (14.6% +/- 1.3% vs 29.9% +/- 2.9%, P=.0008), and increased graft flow velocity ratio (0.86 +/- 0.03 vs 0.59 +/- 0.04, P<.0001), compared with vehicle treatment. Conclusion: Pioglitazone prevents graft degeneration under arterial pressure stress and preserves the vein graft integrity in a rat aortic interposition model. (J Thorac Cardiovasc Surg 2010; 140: 408-16)
    MOSBY-ELSEVIER, Aug. 2010, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 140(2) (2), 408 - e1, English
    [Refereed]
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Bishow Pokhrel, Tomomi Hasegawa, So Izumi, Atsushi Ohmura, Hiroshi Munakata, Yutaka Okita, Kenji Okada
    OBJECTIVE: We have demonstrated that therapeutic augmentation of systemic blood pressure during spinal cord ischemia plays an important role in minimizing spinal cord injury in both experimental and clinical aortic surgery. However, there remain concerns that excessively high blood pressure during spinal cord reperfusion may aggravate the reperfusion injury. The purpose of this study is to investigate the effect of high blood pressure during spinal cord reperfusion on postoperative neurologic outcomes after aortic surgery in rabbits. METHODS: Experiments were performed using a rabbit spinal cord ischemia-reperfusion model in 2 randomly divided groups: (1) In the HR group, the mean blood pressure was maintained at a high level (121 +/- 1.3 mm Hg) during reperfusion with intravenously administered phenylephrine; and (2) in the CR group, the mean blood pressure was not medically controlled (75 +/- 9.1 mm Hg) during reperfusion. Neurologic and histologic assessments and evaluation of early reperfusion injury were performed. RESULTS: In the HR group, slow and incomplete recovery of transcranial motor-evoked potentials (P = .02) and low neurologic scores (P < .005) were observed during spinal cord reperfusion compared with the CR group. At 48 hours of reperfusion, there were significantly fewer viable neuron cells, more apoptosis, and more perivascular edema with gray matter vacuolation in the HR group (P < .001 for each). At 3 hours, myeloperoxidase activity (P = .0021), vascular permeability (P = .0012), and superoxide generation (P < .0001) were significantly increased in the HR group. CONCLUSION: Excessively high blood pressure in the early phase of spinal cord reperfusion increased reperfusion injury in the spinal cord, leading to exacerbation of early-onset paraplegia. Avoidance of spinal cord reperfusion with high blood pressure may be one management strategy in thoracoabdominal aortic surgery.
    MOSBY-ELSEVIER, Aug. 2010, The Journal of thoracic and cardiovascular surgery, 140(2) (2), 400 - 7, English, International magazine
    Scientific journal

  • Bishow Pokhrel, Tomomi Hasegawa, So Izumi, Atsushi Ohmura, Hiroshi Munakata, Yutaka Okita, Kenji Okada
    Objective: We have demonstrated that therapeutic augmentation of systemic blood pressure during spinal cord ischemia plays an important role in minimizing spinal cord injury in both experimental and clinical aortic surgery. However, there remain concerns that excessively high blood pressure during spinal cord reperfusion may aggravate the reperfusion injury. The purpose of this study is to investigate the effect of high blood pressure during spinal cord reperfusion on postoperative neurologic outcomes after aortic surgery in rabbits. Methods: Experiments were performed using a rabbit spinal cord ischemia-reperfusion model in 2 randomly divided groups: (1) In the HR group, the mean blood pressure was maintained at a high level (121 +/- 1.3 mm Hg) during reperfusion with intravenously administered phenylephrine; and (2) in the CR group, the mean blood pressure was not medically controlled (75 +/- 9.1 mm Hg) during reperfusion. Neurologic and histologic assessments and evaluation of early reperfusion injury were performed. Results: In the HR group, slow and incomplete recovery of transcranial motor-evoked potentials (P=.02) and low neurologic scores (P<.005) were observed during spinal cord reperfusion compared with the CR group. At 48 hours of reperfusion, there were significantly fewer viable neuron cells, more apoptosis, and more perivascular edema with gray matter vacuolation in the HR group (P<.001 for each). At 3 hours, myeloperoxidase activity (P=.0021), vascular permeability (P=.0012), and superoxide generation (P<.0001) were significantly increased in the HR group. Conclusion: Excessively high blood pressure in the early phase of spinal cord reperfusion increased reperfusion injury in the spinal cord, leading to exacerbation of early-onset paraplegia. Avoidance of spinal cord reperfusion with high blood pressure may be one management strategy in thoracoabdominal aortic surgery. (J Thorac Cardiovasc Surg 2010; 140: 400-7)
    MOSBY-ELSEVIER, Aug. 2010, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 140(2) (2), 400 - 407, English
    [Refereed]
    Scientific journal

  • Atsushi Kitagawa, Hitoshi Matsuda, Kenji Okada, Yutaka Okita
    MOSBY-ELSEVIER, Jun. 2010, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 139(6) (6), E128 - E130, English
    Scientific journal

  • Atsushi Kitagawa, Hitoshi Matsuda, Kenji Okada, Yutaka Okita
    MOSBY-ELSEVIER, Jun. 2010, The Journal of thoracic and cardiovascular surgery, 139(6) (6), e128-30 - E130, English, International magazine
    [Refereed]
    Scientific journal

  • Hiroshi Munakata, Kenji Okada, Tomomi Hasegawa, Yutaka Hino, Hiroya Kano, Masamichi Matsumori, Yutaka Okita
    Background: Acute occlusion of the carotid artery caused by acute type A aortic dissection (AAD) induces on-going warm brain ischemia. The purpose of this study was to elucidate the hypothesis that low-flow reperfusion could mitigate reperfusion injury after warm ischemic damage to the brain. Methods: Experiments were performed using a canine global brain ischemia model, with 15 minutes of ischemia followed by 3 hours reperfusion, which was established by a simple brain reperfusion circuit with a roller pump. The right common carotid artery (RCCA) flow ratio was determined as the mean RCCA flow during reperfusion divided by the mean RCCA flow during pre-ischemia. Animals were divided into two groups according to the RCCA flow ratio; low RCCA flow ratio of 0.3 to 0.6 (Group L, n=5) and control RCCA flow ratio of 1.0 to 1.4 (Group C, n=5). At the 3-hour reperfusion time point, physiological and histopathological assessments were performed in both groups. Results: Electroencephalographic activity recovered in four of five animals (80%) animals in Group L, whereas no recovery (0%) in activity was observed in Group C. Brain water content in Group L animals was significantly less than that in Group C. Apoptosis, number of perivascular edematous regions and NF kappa B expression were apparently suppressed in Group L compared with Group C. There were significant positive correlations of RCCA flow with brain water content, apoptosis and number of perivascular edematous regions. Conclusions: Controlled low-flow reperfusion mitigated reperfusion-induced brain edema and apoptosis, leading to rescue of brain function in the canine model.
    SAGE PUBLICATIONS LTD, May 2010, PERFUSION-UK, 25(3) (3), 159 - 168, English
    Scientific journal

  • Hiroshi Munakata, Kenji Okada, Tomomi Hasegawa, Yutaka Hino, Hiroya Kano, Masamichi Matsumori, Yutaka Okita
    BACKGROUND: Acute occlusion of the carotid artery caused by acute type A aortic dissection (AAD) induces on-going warm brain ischemia. The purpose of this study was to elucidate the hypothesis that low-flow reperfusion could mitigate reperfusion injury after warm ischemic damage to the brain. METHODS: Experiments were performed using a canine global brain ischemia model, with 15 minutes of ischemia followed by 3 hours reperfusion, which was established by a simple brain reperfusion circuit with a roller pump. The right common carotid artery (RCCA) flow ratio was determined as the mean RCCA flow during reperfusion divided by the mean RCCA flow during pre-ischemia. Animals were divided into two groups according to the RCCA flow ratio; low RCCA flow ratio of 0.3 to 0.6 (Group L, n=5) and control RCCA flow ratio of 1.0 to 1.4 (Group C, n=5). At the 3-hour reperfusion time point, physiological and histopathological assessments were performed in both groups. RESULTS: Electroencephalographic activity recovered in four of five animals (80%) animals in Group L, whereas no recovery (0%) in activity was observed in Group C. Brain water content in Group L animals was significantly less than that in Group C. Apoptosis, number of perivascular edematous regions and NFkappaB expression were apparently suppressed in Group L compared with Group C. There were significant positive correlations of RCCA flow with brain water content, apoptosis and number of perivascular edematous regions. CONCLUSIONS: Controlled low-flow reperfusion mitigated reperfusion-induced brain edema and apoptosis, leading to rescue of brain function in the canine model.
    SAGE PUBLICATIONS LTD, May 2010, Perfusion, 25(3) (3), 159 - 68, English, International magazine
    [Refereed]
    Scientific journal

  • So Izumi, Kenji Okada, Tomomi Hasegawa, Atsushi Omura, Hiroshi Munakata, Masamichi Matsumori, Yutaka Okita
    Objective: Paraplegia from spinal cord ischemia remains an unresolved complication in thoracoabdominal aortic surgery, with high morbidity and mortality. This study investigated postoperative effects of systemic blood pressure augmentation during ischemia. Methods: Spinal cord ischemia was induced in rabbits by infrarenal aortic occlusion for 15 minutes with infused phenylephrine (high blood pressure group, n = 8) or nitroprusside (low blood pressure group, n = 8) or without vasoactive agent (control, n = 8). Spinal cord blood flow, transcranial motor evoked potentials, neurologic outcome, and motor neuron cell damage (apoptosis, necrosis, superoxide generation, myeloperoxidase activity) were evaluated. Results: Mean arterial pressures during ischemia were controlled at 121.9 +/- 2.8, 50.8 +/- 4.3, and 82.3 +/- 10.7 mm Hg in high blood pressure, low blood pressure, and control groups, respectively. In high blood pressure group, high spinal cord blood flow (P < . 01), fast recovery of transcranial motor evoked potentials (P < . 01), and high neurologic score (P < . 05) were observed after ischemia relative to low blood pressure and control groups. At 48 hours after ischemia, there were significantly more viable neurons, fewer terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling-positive neurons, and less alpha-fodrin expression in high blood pressure group than low blood pressure and control groups. Superoxide generation and myeloperoxidase activity at 3 hours after ischemia were suppressed in high blood pressure group relative to low blood pressure group. Conclusions: Augmentation of systemic blood pressure during spinal cord ischemia can reduce ischemic insult and postoperative neurologic adverse events. (J Thorac Cardiovasc Surg 2010; 139: 1261-8)
    MOSBY-ELSEVIER, May 2010, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 139(5) (5), 1261 - 1268, English
    Scientific journal

  • So Izumi, Kenji Okada, Tomomi Hasegawa, Atsushi Omura, Hiroshi Munakata, Masamichi Matsumori, Yutaka Okita
    OBJECTIVE: Paraplegia from spinal cord ischemia remains an unresolved complication in thoracoabdominal aortic surgery, with high morbidity and mortality. This study investigated postoperative effects of systemic blood pressure augmentation during ischemia. METHODS: Spinal cord ischemia was induced in rabbits by infrarenal aortic occlusion for 15 minutes with infused phenylephrine (high blood pressure group, n = 8) or nitroprusside (low blood pressure group, n = 8) or without vasoactive agent (control, n = 8). Spinal cord blood flow, transcranial motor evoked potentials, neurologic outcome, and motor neuron cell damage (apoptosis, necrosis, superoxide generation, myeloperoxidase activity) were evaluated. RESULTS: Mean arterial pressures during ischemia were controlled at 121.9 +/- 2.8, 50.8 +/- 4.3, and 82.3 +/- 10.7 mm Hg in high blood pressure, low blood pressure, and control groups, respectively. In high blood pressure group, high spinal cord blood flow (P < .01), fast recovery of transcranial motor evoked potentials (P < .01), and high neurologic score (P < .05) were observed after ischemia relative to low blood pressure and control groups. At 48 hours after ischemia, there were significantly more viable neurons, fewer terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling-positive neurons, and less alpha-fodrin expression in high blood pressure group than low blood pressure and control groups. Superoxide generation and myeloperoxidase activity at 3 hours after ischemia were suppressed in high blood pressure group relative to low blood pressure group. CONCLUSIONS: Augmentation of systemic blood pressure during spinal cord ischemia can reduce ischemic insult and postoperative neurologic adverse events.
    MOSBY-ELSEVIER, May 2010, The Journal of thoracic and cardiovascular surgery, 139(5) (5), 1261 - 8, English, International magazine
    [Refereed]
    Scientific journal

  • TEVARの適応と限界 Shaggy aortaはcontraindicationか?
    Kitagawa Atsushi, Okita Yutaka, Okada Kenji, Hasegawa Tomoki, Matsumori Masamichi, Minami Hitoshi, Munakata Hiroshi, Yamaguchi Masato, Sugimoto Koji, Sugimura Kazuro
    (一社)日本外科学会, Mar. 2010, 日本外科学会雑誌, 111(臨増2) (臨増2), 532 - 532, Japanese
    Research society

  • 当院における企業製EVARの早期中期成績
    Kitagawa Atsushi, Okita Yutaka, Okada Kenji, Hasegawa Tomoki, Minami Hitoshi, Matsumori Masamichi, Munakata Hiroshi, Oka Takanori, Nomura Yoshikatsu, Omura Atsushi, Yamaguchi Masato, Sugimoto Koji, Sugimura Kazuro
    (NPO)日本心臓血管外科学会, Jan. 2010, 日本心臓血管外科学会雑誌, 39(Suppl.) (Suppl.), 373 - 373, Japanese
    Research society

  • IZUMI So, MUNAKATA Hiroshi, MATSUMORI Masamichi, KITAGAWA Atsushi, OKADA Kenji, OKITA Yutaka
    A 69-year-old woman with back pain was admitted to our hospital 3 months previously due to a type-A acute aortic dissection with megaaorta syndrome. The aortic aneurysm extended from the ascending aorta to the bilateral iliac arteries. Initially, a total arch replacement with elephant trunk installation and an abdominal aortic aneurysm repair were performed simultaneously. One month after the first stage operation, the thoracoabdominal aortic aneurysm was repaired, applying distal perfusion, mild hypothermia, CSF drainage, segmental aortic clamping, reconstruction of intercostal and lumbar arteries, and edaravone for spinal cord protection. Transcranial motor evoked potentials (tc-MEP) were monitored during the operation. Although tc-MEPs disappeared due to spinal cord ischemia during aortic cross-clamping, the amplitude of tc-MEP recovered after hypertension treatment and a quick reattachment of the intercostal arteries. The 8th, 10th and 11th intercostal arteries and the 1st lumbar artery were reconstructed. This patient was discharged 20 days postoperatively without any neurologic deficit.
    JAPANESE SOCIETY FOR VASCULAR SURGERY, Dec. 2009, Jpn. J. Vasc. Surg., 18(7) (7), 695 - 700, Japanese

  • Akiko Tanaka, Tomomi Hasegawa, Zhi Chen, Yutaka Okita, Kenji Okada
    OBJECTIVE: An ideal animal model of abdominal aortic aneurysm (AAA) is of great importance for clarifying unknown complex mechanisms of the pathogenesis. We introduce a new, simple technique to create reliable AAAs that simulate human aneurysms. METHODS: Experimental models of AAAs were created in 71 rats by means of a 20-minute application of intraluminal elastase (30 U) and extraluminal calcium chloride (0.5M) in the 1-cm segment of infrarenal abdominal aorta (group EC, n = 26). A single application of elastase (group E, n = 24) or calcium chloride (group C, n = 21) was used as control. The treated aorta in each group was measured under physiologic conditions and harvested at 1 and 4 weeks. Successful AAA formation was defined as a dilation ratio >50%. Inflammatory response, elastolytic activity, and histology in the treated aorta were evaluated among the three groups. RESULTS: The surgical procedure in each group was similarly completed for approximate 30 minutes and performed without any technical failure or operative death. At 4 weeks, the dilation ratio and wall thickness were 94.8% +/- 9.9% and 125.4 +/- 5.6 microm in group EC, 43.3% +/- 6.3% and 149.6 +/- 6.5 microm in group E, and 10.9% +/- 4.2% and 152.9 +/- 7.2 microm in group C. The success rate of AAA formation in group EC (92.7%) was significantly higher than that in group E (25.0%) and group C (0.0%). Less elastin content in the aortic wall was observed in group EC. At 1 week, tumor necrosis factor-alpha and interleukin-1beta messenger RNA (mRNA) expressions were significantly upregulated, and CD3+ and CD11b+ cells were significantly infiltrated into the treated aorta of group EC, compared with groups E or C. Gelatinolytic activities and mRNA expressions of matrix metalloproteinase (MMP)-2 and MMP-9 were also significantly activated in group EC. CONCLUSION: The rat AAA model using a combination of intraluminal elastase infusion and extraluminal calcium chloride exposure is simple and easy to perform and is highly reliable and reproducible to create a saccular aneurysm similar to human AAAs. This model could be more useful to clarify AAA pathogenesis, mechanisms, and treatment interventions in experimental researches.
    MOSBY-ELSEVIER, Dec. 2009, Journal of vascular surgery, 50(6) (6), 1423 - 32, English, International magazine
    Scientific journal

  • Kitagawa Atsushi, Okada Kenji
    【目的】日本人の腹部大動脈瘤ステントグラフト内挿術(EVAR)の適応と限界についてZenith AAAステントグラフトの適応基準に従い検討した。【方法】2006年1月から2007年12月の間、当科で評価した腹部大動脈瘤(AAA)125人のうち、CT評価可能であった106人(男性88人、平均年齢73歳)を対象とした。マルチスライスCTスキャンを用い、以下について計測、解析を行った。1)腹部大動脈瘤最大短径、2)Proximal neck外径、長、3)総腸骨動脈外径、長、4)Proximal neckの腎動脈上方大動脈に対する角度、大動脈瘤長軸に対する角度、5)外腸骨動脈径、6)低位腎動脈から大動脈分岐部までの腹部大動脈長。【結果】EVAR可能症例27例(25.5%)、除外症例79例(74.5%)であった。男女別EVAR適応率は男性29.5%(26/88例)、女性5.6%(1/18例)であり、女性でよりEVAR除外例が多かった(P=0.04)。おもな除外理由は、short proximal neck 32例(40.5%)、腸骨動脈狭小24例(30.4%)、腎動脈下proximal neck高度屈曲23例(29.1%)であった。【結論】文献上、欧米人のEVAR適応率は48〜66%と報告されているが、日本人においてZenith AAAステントグラフトの適応基準を順守すると、short proximal neck、腸骨動脈狭小、proximal neck高度屈曲等の問題から、とくに女性においてEVARの適応は限界があると言わざるを得ない。(著者抄録)
    (NPO)日本血管外科学会, Oct. 2009, 日本血管外科学会雑誌, 18(6) (6), 595 - 602, Japanese
    [Refereed]
    Scientific journal

  • 【大動脈基部置換術】 自己弁温存 自己弁温存大動脈基部置換術における弁形成の有効性
    Okada Kenji
    Oct. 2009, 胸部外科, 62巻, 11号, pp. 971-977, Japanese
    [Refereed]
    Scientific journal

  • Hiroaki Takahashi, Takenori Yokota, Eiichiro Uchimura, Shigeru Miyagawa, Takeyoshi Ota, Kei Torikai, Atsuhiro Saito, Koichiro Hirakawa, Katsukiyo Kitabayashi, Kenji Okada, Yoshiki Sawa, Yutaka Okita
    BACKGROUND: We have developed a tissue-engineered patch for cardiovascular repair. Tissue-engineered patches facilitated site-specific in situ recellularization and required no pretreatment with cell seeding. This study evaluated the patches implanted into canine pulmonary arteries. METHODS: Tissue-engineered patches are biodegradable sheets woven with double-layer fibers. The fiber is composed of polyglycolic acid and poly-L-lactic acid, and compounding collagen microsponges. The patches (20- x 25-mm) were implanted into the canine pulmonary arterial trunks. At 1, 2, and 6 months after implantation (n = 4), they were explanted and characterized by histologic and biochemical analyses. Commercially available patches served as the control. No anticoagulant therapy was administered postoperatively. RESULTS: No aneurysm or thrombus was present within the patch area in all groups. The remodeled tissue predominantly consisted of elastic and collagen fibers, and the endoluminal surface was covered with a monolayer of endothelial cells and multilayers of smooth muscle cells beneath the endothelial layer. The elastic and collagen fibers and smooth muscle cells kept increasing with a maximum at 6 months, while a monolayer of endothelial cells was preserved. The expression levels of messenger RNA of several growth factors in the tissue-engineered patches were higher than those of native tissue at 1 and 2 months and decreased to normal level at 6 months. No regenerated tissue was found on the endoluminal surface in the control group. CONCLUSIONS: The novel tissue-engineered patches showed in situ repopulation of host cells without prior ex vivo cell seeding. This is promising material for repair of the cardiovascular system.
    ELSEVIER SCIENCE INC, Oct. 2009, The Annals of thoracic surgery, 88(4) (4), 1269 - 76, English, International magazine
    Scientific journal

  • Hiroaki Takahashi, Takenori Yokota, Eiichiro Uchimura, Shigeru Miyagawa, Takeyoshi Ota, Kei Torikai, Atsuhiro Saito, Koichiro Hirakawa, Katsukiyo Kitabayashi, Kenji Okada, Yoshiki Sawa, Yutaka Okita
    Background. We have developed a tissue-engineered patch for cardiovascular repair. Tissue-engineered patches facilitated site-specific in situ recellularization and required no pretreatment with cell seeding. This study evaluated the patches implanted into canine pulmonary arteries. Methods. Tissue-engineered patches are biodegradable sheets woven with double-layer fibers. The fiber is composed of polyglycolic acid and poly-L-lactic acid, and compounding collagen microsponges. The patches (20- x 25-mm) were implanted into the canine pulmonary arterial trunks. At 1, 2, and 6 months after implantation (n = 4), they were explanted and characterized by histologic and biochemical analyses. Commercially available patches served as the control. No anticoagulant therapy was administered postoperatively. Results. No aneurysm or thrombus was present within the patch area in all groups. The remodeled tissue predominantly consisted of elastic and collagen fibers, and the endoluminal surface was covered with a monolayer of endothelial cells and multilayers of smooth muscle cells beneath the endothelial layer. The elastic and collagen fibers and smooth muscle cells kept increasing with a maximum at 6 months, while a monolayer of endothelial cells was preserved. The expression levels of messenger RNA of several growth factors in the tissue-engineered patches were higher than those of native tissue at 1 and 2 months and decreased to normal level at 6 months. No regenerated tissue was found on the endoluminal surface in the control group. Conclusions. The novel tissue-engineered patches showed in situ repopulation of host cells without prior ex vivo cell seeding. This is promising material for repair of the cardiovascular system. (Ann Thorac Surg 2009; 88: 1269-76) (C) 2009 by The Society of Thoracic Surgeons
    ELSEVIER SCIENCE INC, Oct. 2009, ANNALS OF THORACIC SURGERY, 88(4) (4), 1269 - 1276, English
    [Refereed]
    Scientific journal

  • Naoto Morimoto, Masamichi Matsumori, Akiko Tanaka, Hiroshi Munakata, Kenji Okada, Yutaka Okita
    Background. Dilatation of the sinotubular junction (STJ) causes aortic regurgitation (AR) in patients with ascending aneurysm. These patients can regain valve competence by simple reduction of the diameter of STJ. Results of this technique were investigated clinically and echocardiographically. Methods. Replacement of the ascending aorta with reduction of the diameter of the STJ to correct AR (mean grade, 2.7 +/- 0.7) was performed in 29 consecutive patients (mean age, 73.2 +/- 6.2). Two required repair of cusp prolapse. All underwent ascending aortic aneurysm replacement. Echocardiographic studies were performed at discharge and during latest clinical follow-up (mean follow-up, 3.8 +/- 2.5 years). Results. No hospital deaths occurred. The AR grade at discharge was 0.7 +/- 0.5. No valve related-deaths occurred. Actual survival at 8 years was 91% +/- 9%. Failure occurred 4.1 years postoperatively in a patient with bicuspid valve. Three patients had late recurrence of AR that was caused by aortic root dilatation in bicuspid valves in 2. Multivariate analysis showed bicuspid aortic valve was the predictor of late progression of AR. The freedom from more than grade II AR at 8 years was 79.5% +/- 10.7%. Conclusions. Adjustment of the diameter of STJ could treat AR secondary to ascending aortic aneurysm with nearly normal aortic cusps. Midterm results of this procedure were acceptable. Although bicuspid aortic valve is the risk factor for late AR due to dilation of remaining aortic root, this procedure provides satisfactory long-term outcomes among the patients with tricuspid valve. (Ann Thorac Surg 2009; 88: 1238-43) (C) 2009 by The Society of Thoracic Surgeons
    ELSEVIER SCIENCE INC, Oct. 2009, ANNALS OF THORACIC SURGERY, 88(4) (4), 1238 - 1243, English
    Scientific journal

  • Naoto Morimoto, Masamichi Matsumori, Akiko Tanaka, Hiroshi Munakata, Kenji Okada, Yutaka Okita
    BACKGROUND: Dilatation of the sinotubular junction (STJ) causes aortic regurgitation (AR) in patients with ascending aneurysm. These patients can regain valve competence by simple reduction of the diameter of STJ. Results of this technique were investigated clinically and echocardiographically. METHODS: Replacement of the ascending aorta with reduction of the diameter of the STJ to correct AR (mean grade, 2.7 +/- 0.7) was performed in 29 consecutive patients (mean age, 73.2 +/- 6.2). Two required repair of cusp prolapse. All underwent ascending aortic aneurysm replacement. Echocardiographic studies were performed at discharge and during latest clinical follow-up (mean follow-up, 3.8 +/- 2.5 years). RESULTS: No hospital deaths occurred. The AR grade at discharge was 0.7 +/- 0.5. No valve related-deaths occurred. Actual survival at 8 years was 91% +/- 9%. Failure occurred 4.1 years postoperatively in a patient with bicuspid valve. Three patients had late recurrence of AR that was caused by aortic root dilatation in bicuspid valves in 2. Multivariate analysis showed bicuspid aortic valve was the predictor of late progression of AR. The freedom from more than grade II AR at 8 years was 79.5% +/- 10.7%. CONCLUSIONS: Adjustment of the diameter of STJ could treat AR secondary to ascending aortic aneurysm with nearly normal aortic cusps. Midterm results of this procedure were acceptable. Although bicuspid aortic valve is the risk factor for late AR due to dilation of remaining aortic root, this procedure provides satisfactory long-term outcomes among the patients with tricuspid valve.
    ELSEVIER SCIENCE INC, Oct. 2009, The Annals of thoracic surgery, 88(4) (4), 1238 - 43, English, International magazine
    [Refereed]
    Scientific journal

  • Yosuke Tanaka, Tomomi Hasegawa, Zhi Chen, Yutaka Okita, Kenji Okada
    Objective: The peroxisome proliferator-activated receptor gamma activator pioglitazone has recently been reported to possess pleiotropic cardioprotective and renoprotective actions. We hypothesized that pioglitazone would reduce a dose of the immunosuppressant cyclosporine after heart transplantation, resulting in beneficial protective effects for both cardiac allografts and recipient kidneys. Methods: Experiments were performed by using an allomismatched rat heterotopic heart transplantation model. Recipients were treated with cyclosporine with or without pioglitazone and were divided into one of 4 groups: group I, no treatment; group II, low-dose cyclosporine (2 mg . kg(-1) . d(-1)); group III, high-dose cyclosporine (5 mg . kg(-1) . d(-1)); and group IV, low-dose cyclosporine with pioglitazone (3 mg . kg(-1) . d(-1)). Results: Cyclosporine-treated rats showed significantly longer graft survival and less graft rejection but severe renal damage in a dose-dependent manner. Compared with group II, treatment with pioglitazone with low-dose cyclosporine (group IV) significantly suppressed graft infiltration of CD4/CD8 T lymphocytes and serum concentrations of interleukin 2 and interferon gamma, leading to extended graft survival up to 60 days. These immunosuppressive effects in group IV were equivalent to those in group III. In addition, recipient kidneys in group IV had few apoptotic cells, possibly through upregulation of peroxisome proliferator-activated receptor gamma and down-regulation of transforming growth factor beta 1, and maintained stable renal functions, as evidenced by a normalization of blood urea nitrogen, creatinine, and creatinine clearance values. In vitro experiments also confirmed the renoprotective effects of pioglitazone on cyclosporine-induced toxicity. Conclusions: Collectively, pioglitazone can reduce a dose of cyclosporine with sufficient immunosuppressive effects. Pioglitazone treatment with low-dose cyclosporine has synergistic protective effects for cardiac allografts and recipient kidneys, leading to improvement of graft survival with a minimal cyclosporine-induced nephrotoxicity.
    MOSBY-ELSEVIER, Sep. 2009, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 138(3) (3), 744 - 751, English
    Scientific journal

  • Yosuke Tanaka, Tomomi Hasegawa, Zhi Chen, Yutaka Okita, Kenji Okada
    OBJECTIVE: The peroxisome proliferator-activated receptor gamma activator pioglitazone has recently been reported to possess pleiotropic cardioprotective and renoprotective actions. We hypothesized that pioglitazone would reduce a dose of the immunosuppressant cyclosporine after heart transplantation, resulting in beneficial protective effects for both cardiac allografts and recipient kidneys. METHODS: Experiments were performed by using an allomismatched rat heterotopic heart transplantation model. Recipients were treated with cyclosporine with or without pioglitazone and were divided into one of 4 groups: group I, no treatment; group II, low-dose cyclosporine (2 mg x kg(-1) x d(-1)); group III, high-dose cyclosporine (5 mg x kg(-1) x d(-1)); and group IV, low-dose cyclosporine with pioglitazone (3 mg x kg(-1) x d(-1)). RESULTS: Cyclosporine-treated rats showed significantly longer graft survival and less graft rejection but severe renal damage in a dose-dependent manner. Compared with group II, treatment with pioglitazone with low-dose cyclosporine (group IV) significantly suppressed graft infiltration of CD4/CD8 T lymphocytes and serum concentrations of interleukin 2 and interferon gamma, leading to extended graft survival up to 60 days. These immunosuppressive effects in group IV were equivalent to those in group III. In addition, recipient kidneys in group IV had few apoptotic cells, possibly through upregulation of peroxisome proliferator-activated receptor gamma and downregulation of transforming growth factor beta1, and maintained stable renal functions, as evidenced by a normalization of blood urea nitrogen, creatinine, and creatinine clearance values. In vitro experiments also confirmed the renoprotective effects of pioglitazone on cyclosporine-induced toxicity. CONCLUSIONS: Collectively, pioglitazone can reduce a dose of cyclosporine with sufficient immunosuppressive effects. Pioglitazone treatment with low-dose cyclosporine has synergistic protective effects for cardiac allografts and recipient kidneys, leading to improvement of graft survival with a minimal cyclosporine-induced nephrotoxicity.
    MOSBY-ELSEVIER, Sep. 2009, The Journal of thoracic and cardiovascular surgery, 138(3) (3), 744 - 51, English, International magazine
    [Refereed]
    Scientific journal

  • Naoto Morimoto, Kenji Okada, Kensuke Uotani, Fumio Kanda, Yutaka Okita
    BACKGROUND: This retrospective study determined whether leukoaraiosis and hippocampal atrophy seen in preoperative magnetic resonance imaging (MRI) predict neurologic outcome after total aortic arch replacement. METHODS: From August 2001 to November 2007, 131 consecutive patients (22% women) who underwent elective total arch replacement with selective cerebral perfusion were enrolled. Mean patient age was 71 +/- 17 years (range, 27 to 88 years). On preoperative MRI, mean leukoaraiosis score and hippocampal atrophy score, rated according to the Scheltens scale, were 11.0 +/- 9.2 and 1.5 +/- 1.9, respectively. Forty-three patients (32.8%) had carotid or basilica arterial stenosis, 18 (12.6%) had a stroke, and 6 (4.2%) had a transient ischemic attack. RESULTS: One hospital death (0.8%) occurred. Adverse perioperative neurologic events included intraoperative stroke in 8 (6.1%), postoperative stroke in 2 (1.5%), and temporary neurologic dysfunction (TND) in 11 (8.4%). On multivariate logistic regression, significant predictors of postoperative intraoperative stroke were leukoaraiosis (odds ratio [OR], 1.1, p = 0.02) and aortic arch atheroma (OR, 2.4; p = 0.001). TND was significantly associated with leukoaraiosis (OR, 1.1, p = 0.03) and hippocampal atrophy (OR, 1.6, p = 0.01). The best cutoff value for predicting intraoperative stroke was a leukoaraiosis score exceeding 16 (sensitivity, 70%; specificity, 70%); that for predicting TND was a leukoaraiosis score exceeding 18 (sensitivity, 82%; specificity, 77%) and a hippocampal atrophy score exceeding 2 (sensitivity, 82%; specificity, 76%). CONCLUSIONS: Leukoaraiosis and hippocampal atrophy are significant independent factors for adverse neurologic outcome after total arch replacement.
    ELSEVIER SCIENCE INC, Aug. 2009, The Annals of thoracic surgery, 88(2) (2), 476 - 81, English, International magazine
    Scientific journal

  • Naoto Morimoto, Kenji Okada, Kensuke Uotani, Fumio Kanda, Yutaka Okita
    Background. This retrospective study determined whether leukoaraiosis and hippocampal atrophy seen in preoperative magnetic resonance imaging (MRI) predict neurologic outcome after total aortic arch replacement. Methods. From August 2001 to November 2007, 131 consecutive patients (22% women) who underwent elective total arch replacement with selective cerebral perfusion were enrolled. Mean patient age was 71 +/- 17 years (range, 27 to 88 years). On preoperative MRI, mean leukoaraiosis score and hippocampal atrophy score, rated according to the Scheltens scale, were 11.0 +/- 9.2 and 1.5 +/- 1.9, respectively. Forty-three patients (32.8%) had carotid or basilica arterial stenosis, 18 (12.6%) had a stroke, and 6 (4.2%) had a transient ischemic attack. Results. One hospital death (0.8%) occurred. Adverse perioperative neurologic events included intraoperative stroke in 8 (6.1%), postoperative stroke in 2 (1.5%), and temporary neurologic dysfunction (TND) in 11 (8.4%). On multivariate logistic regression, significant predictors of postoperative intraoperative stroke were leukoaraiosis (odds ratio [OR], 1.1, p = 0.02) and aortic arch atheroma (OR, 2.4; p = 0.001). TND was significantly associated with leukoaraiosis (OR, 1.1, p = 0.03) and hippocampal atrophy (OR, 1.6, p = 0.01). The best cutoff value for predicting intraoperative stroke was a leukoaraiosis score exceeding 16 (sensitivity, 70%; specificity, 70%); that for predicting TND was a leukoaraiosis score exceeding 18 (sensitivity, 82%; specificity, 77%) and a hippocampal atrophy score exceeding 2 (sensitivity, 82%; specificity, 76%). Conclusions. Leukoaraiosis and hippocampal atrophy are significant independent factors for adverse neurologic outcome after total arch replacement.
    ELSEVIER SCIENCE INC, Aug. 2009, ANNALS OF THORACIC SURGERY, 88(2) (2), 476 - 481, English
    [Refereed]
    Scientific journal

  • Hiroshi Tanaka, Kenji Okada, Yujiro Kawanishi, Masamichi Matsumori, Yutaka Okita
    'Anastomotic leak' after ascending aortic replacement for acute aortic dissection, which is determined as direct forward blood flow into the false lumen at the distal anastomosis, prevents the false lumen from being thrombosed. The aim of this study is to determine whether the leak influences on residual aortic growth. Between October 1999 and May 2006, 100 patients presenting for acute type A aortic dissection underwent surgery at our institution. Among the population, 34 patients who underwent ascending aortic replacement and have been followed by computed tomography (CT) for over 6 months were reviewed. On the follow-up CT, maximum diameter of aortic arch and descending aorta were measured and the presence of anastomotic leak was determined. The growth rates of aortic arch and descending aorta in patients diagnosed as having anastomotic leak were greater than patients not having leak (P=0.003, P<0.001, respectively). Initial maximum diameter just after ascending aortic replacement was greater in patients with anastomotic leak than without anastomotic leak in aortic arch and descending aorta (P=0.013, P=0.06). Anastomotic leak after ascending aortic replacement for acute type A aortic dissection contributed to remnant aortic growth. More sophisticated method for reapproximation of dissected aorta should be dictated.
    Aug. 2009, Interactive cardiovascular and thoracic surgery, 9(2) (2), 209 - 12, English, International magazine
    [Refereed]
    Scientific journal

  • Hiroaki Takahashi, Kenji Okada, Mitsuru Asano, Masamichi Matsumori, Yoshihisa Morimoto, Yutaka Okita
    Carcinoid tumors usually originate in the gastrointestinal tract, but in rare instances they may arise in other organs. A patient with severe tricuspid and pulmonary regurgitation because of carcinoid syndrome successfully underwent double valve replacement using bioprostheses. The patient was finally diagnosed with carcinoid heart disease from an isolated ovarian carcinoid cancer. The diagnosis of carcinoid syndrome should be recognized as an etiology in patients with organic tricuspid and pulmonary regurgitation without left valvular disease.
    JAPANESE CIRCULATION SOC, Aug. 2009, Circulation journal : official journal of the Japanese Circulation Society, 73(8) (8), 1554 - 6, English, Domestic magazine
    [Refereed]
    Scientific journal

  • Naoto Morimoto, Kenji Okada, Yutaka Okita
    ELSEVIER SCIENCE BV, Jul. 2009, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 36(1) (1), 189 - 90, English, International magazine
    Scientific journal

  • Naoto Morimoto, Kenji Okada, Yutaka Okita
    ELSEVIER SCIENCE BV, Jul. 2009, EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 36(1) (1), 189 - 190, English
    [Refereed]
    Scientific journal

  • 内臓動脈瘤に対する治療方針の検討
    坂本 敏仁, 白坂 知識, 大村 篤史, 野村 拓生, 野村 佳克, 田中 亜紀子, 高橋 宏明, 宗像 宏, 松森 正術, 北川 敦士, 南 一司, 長谷川 智巳, 岡田 健次, 大北 裕, 山口 雅人
    (NPO)日本血管外科学会, Apr. 2009, 日本血管外科学会雑誌, 18(2) (2), 386 - 386, Japanese
    [Refereed]

  • Hiroshi Munakata, Kenji Okada, Hiroya Kano, Sou Izumi, Yutaka Hino, Masamichi Matsumori, Yutaka Okita
    Brain malperfusion caused by acute type A aortic dissection is a life threatening situation that should be relieved as early as possible with minimal reperfusion injury prior to aortic repair. The patient was 72-year-old woman with acute type A aortic dissection. She was referred to us 2.5 hours after onset of chest pain, and she was unconscious with a complete left paralysis. The true lumen of internal carotid artery was severely stenosed. A simple bypass circuit was installed from the femoral artery to the true lumen of the right common carotid artery, which consisted with a roller pump and cold bath for blood cooling. Regional oxygen saturation of the right frontal brain was immediately raised after initiation of the bypass, and she underwent emergency ascending hemi-arch replacement. The postoperative course was complicated with a right brain stroke; however, brain computed tomography and magnetic resonance imaging disclosed minimum brain edema. She was discharged on foot on the 35th postoperative day, and she was walking with a stick after 7 months.
    ELSEVIER SCIENCE INC, Apr. 2009, ANNALS OF THORACIC SURGERY, 87(4) (4), E27 - E28, English
    Link to Kobe Univ. Repository (Kernel)

  • Hiroshi Munakata, Kenji Okada, Hiroya Kano, Sou Izumi, Yutaka Hino, Masamichi Matsumori, Yutaka Okita
    Brain malperfusion caused by acute type A aortic dissection is a life threatening situation that should be relieved as early as possible with minimal reperfusion injury prior to aortic repair. The patient was 72-year-old woman with acute type A aortic dissection. She was referred to us 2.5 hours after onset of chest pain, and she was unconscious with a complete left paralysis. The true lumen of internal carotid artery was severely stenosed. A simple bypass circuit was installed from the femoral artery to the true lumen of the right common carotid artery, which consisted with a roller pump and cold bath for blood cooling. Regional oxygen saturation of the right frontal brain was immediately raised after initiation of the bypass, and she underwent emergency ascending hemi-arch replacement. The postoperative course was complicated with a right brain stroke; however, brain computed tomography and magnetic resonance imaging disclosed minimum brain edema. She was discharged on foot on the 35th postoperative day, and she was walking with a stick after 7 months.
    ELSEVIER SCIENCE INC, Apr. 2009, The Annals of thoracic surgery, 87(4) (4), e27-8 - E28, English, International magazine
    [Refereed]
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Naoto Morimoto, Keisuke Morimoto, Yoshihisa Morimoto, Toshihito Sakamoto, Akiko Tanaka, Masamichi Matsumori, Kenji Okada, Yutaka Okita
    MOSBY-ELSEVIER, Mar. 2009, The Journal of thoracic and cardiovascular surgery, 137(3) (3), 775 - 7, English, International magazine
    Scientific journal

  • Naoto Morimoto, Keisuke Morimoto, Yoshihisa Morimoto, Toshihito Sakamoto, Akiko Tanaka, Masamichi Matsumori, Kenji Okada, Yutaka Okita
    MOSBY-ELSEVIER, Mar. 2009, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 137(3) (3), 775 - 777, English
    [Refereed]
    Scientific journal

  • Kenji Okada, Akiko Tanaka, Hiroshi Munakata, Masamichi Matsumori, Yoshihisa Morimoto, Yoshiaki Tanaka, Tadaaki Maehara, Yutaka Okita
    Objective: To present our experience of total aortic arch replacement through a left posterolateral thoracotomy. Methods: Sixteen patients (13 males; mean age 62.1 +/- 11.3 years) with extended thoracic aortic aneurysms, including those in the thoracoabdominal aorta, underwent replacement through a left posterolateral thoracotomy. The pathology of the diseased aorta was non-dissecting aneurysm due to aortitis in 1 patient and aortic dissection in 15 patients (acute type A: 1, chronic type A: 12, chronic type B: 2). In a prior operation, the patient with aortitis had undergone the Bentall procedure with endovascular stenting of the brachiocephalic artery, and among the other 15 patients, one previously had endovascular stenting for the aortic arch and 12 had hemi-arch replacement for acute type A dissection. Extension of arch replacement was the aortic arch and descending aorta in eight patients, the ascending arch and descending aorta in five patients and the descending arch, and thoracoabdominal aorta in three patients. Additional retroperitoneal dissection was required for the repair of a thoracoabdominal aortic aneurysm. Results: One patient died of traumatic cerebral hemorrhage on day 145 (hospital mortality 6.3%). Average duration of ventilation support was 19.4 +/- 17.0 h and length of ICU stay was 3.6 +/- 1.6 days. Actuarial survival at 2 years after the operations was 67.7%. However, no aortic-related mortality was observed during follow-up. Conclusions: Early results of extended aortic arch replacement through a left posterolateral thoracotomy were satisfactory in selected patients. (C) 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
    ELSEVIER SCIENCE BV, Feb. 2009, EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 35(2) (2), 270 - 275, English
    Scientific journal

  • Kenji Okada, Akiko Tanaka, Hiroshi Munakata, Masamichi Matsumori, Yoshihisa Morimoto, Yoshiaki Tanaka, Tadaaki Maehara, Yutaka Okita
    OBJECTIVE: To present our experience of total aortic arch replacement through a left posterolateral thoracotomy. METHODS: Sixteen patients (13 males; mean age 62.1+/-11.3 years) with extended thoracic aortic aneurysms, including those in the thoracoabdominal aorta, underwent replacement through a left posterolateral thoracotomy. The pathology of the diseased aorta was non-dissecting aneurysm due to aortitis in 1 patient and aortic dissection in 15 patients (acute type A: 1, chronic type A: 12, chronic type B: 2). In a prior operation, the patient with aortitis had undergone the Bentall procedure with endovascular stenting of the brachiocephalic artery, and among the other 15 patients, one previously had endovascular stenting for the aortic arch and 12 had hemi-arch replacement for acute type A dissection. Extension of arch replacement was the aortic arch and descending aorta in eight patients, the ascending arch and descending aorta in five patients and the descending arch, and thoracoabdominal aorta in three patients. Additional retroperitoneal dissection was required for the repair of a thoracoabdominal aortic aneurysm. RESULTS: One patient died of traumatic cerebral hemorrhage on day 145 (hospital mortality 6.3%). Average duration of ventilation support was 19.4+/-17.0h and length of ICU stay was 3.6+/-1.6 days. Actuarial survival at 2 years after the operations was 67.7%. However, no aortic-related mortality was observed during follow-up. CONCLUSIONS: Early results of extended aortic arch replacement through a left posterolateral thoracotomy were satisfactory in selected patients.
    ELSEVIER SCIENCE BV, Feb. 2009, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 35(2) (2), 270 - 5, English, International magazine
    Scientific journal

  • Hiroshi Munakata, Kenji Okada, Akiko Tanaka, Masamichi Matsumori, Mitsuru Asano, Yoshihisa Morimoto, Yutaka Okita
    Objective: Surgical strategy for extensive thoracic aortic aneurysms (ETAA) was investigated. Methods: Forty-three consecutive patients underwent the repair of ETAA from 1999 to 2007. There were 17 patients in one stage group (63.2 +/- 11.3y), while 21 patients in staged repair group (60.3 +/- 16.6y). All patients in one stage group, underwent the ascending aorta and aortic arch replacement in combined with various extensions of descending aortic replacement (proximal 5, middle 8, total descending 1, or thoracoabdominal aorta 3). In staged repair group, second-stage repair were performed (Surgery: 14, Stent graft 7) after the first-stage graft replacement (total arch replacement (TAR) 7, TAR + aortic root replacement (ARR) 7, TAR + Coronary artery bypass grafting +/- ARR 7). Results: Hospital mortality was 12.0% (2/17) in one stage repair and 9.0% (4/21) in staged repair. There was no significant difference in morbidity, late mortality and freedom from vascular related death between two groups. Conclusion: Surgical outcome for ETTA was satisfactory in both one stage and staged repair groups. One stage surgery could be first choice in carefully selected patients.
    SPRINGER-VERLAG TOKYO, 2009, ADVANCES IN UNDERSTANDING AORTIC DISEASES, 215 - +, English
    [Refereed]
    International conference proceedings

  • Yutaka Okita, Masamichi Matsumori, Kenji Okada, Yoshihisa Morimoto, Mitsuru Asano, Hiroshi Munakata, Naoto Morimoto, Hiroaki Takahashi, Akiko Tanaka
    From October 1999 to December 2007, 61 patients with annulo-aortic ectasia underwent aortic root replacement with aortic cusp sparing procedure. The mean age was 48.7 +/- 15.1 years old and there were 42 male and 19 females. Preoperative aortic regurgitation was measured as none in 6, grade I in 11, grade 2 in 8, grade 3 in 20, and grade 4 in 16. Twenty patients had Marfan syndrome, I I had acute aortic dissection, and I had Takayasu's aortitis. Root remodeling procedure was performed in only one patient with aortic monocuspid valve and the other 60 patients had the reimplantation technique. Initial 12 patients had a straight Dacron graft for aortic root. Since July 2002, the bulging-sinus graft (22 hand-made and 26 DePaulis's anteflo Vaskteck graft) was used. Repair techniques for abnormal aortic cusps consisted with plication of the free margins at the Arantius body (15 patients), reinforcement of the free margin of the cusp (5), patch plasty using the autologous pericardium (3), and plication at the commissure (2). The size of the implanted Dacron graft was 24 mm (9), 26 mm (45), and 28 mm (7). Simultaneous surgery consisted with total arch replacement in 12 patients, hemiarch replacement in 6, mitral valve repair in 3, Maze procedure in 2, axillo-femoral bypass in 1 and repair of aortic coarctation in 2. [Results] There no early and late death. Echocardiogram 1 month after surgery disclosed that aortic regurgitation was none (26), grade 1 (29), and grade H (6). During hospitalization, 2 patients required reoperation because of residual or recurrent aortic regurgitation. Follow-up was 41.8 +/- 10.6 months, ranging 2 months to 8.4 yrs. Echocardiogram at latest follow-up demonstrated that aortic regurgitation was none (15), grade 1 (18), grade 11 (3), grade 111 (1), and grade IV (2) and 2 patients required reoperation
    SPRINGER-VERLAG TOKYO, 2009, ADVANCES IN UNDERSTANDING AORTIC DISEASES, 173 - +, English
    [Refereed]
    International conference proceedings

  • Akiko Tanaka, Kenji Okada, Hiroshi Munakata, Masamichi Matsumori, Yutaka Okita
    Objectives: The purpose of this study was to investigate our current surgical strategy in treating aortic disease in Marfan syndrome. Methods: Thirty-one patients with Marfan syndrome underwent aortic repair in past eight years. Our current strategy is to apply aortic root replacement with David valve-sparing procedure in patients with annuloaortic ectasia (AAE) whose root diameter exceeds 40 mm, total arch replacement with elephant trunk installation (TAR+ET) in addition to ascending or root replacement to type A dissection (AD-A), and one-stage thoracoabdominal aortic replacement to type B dissection (AD-B). In 28 patients with AAE, 19 David's reimplantation technique and 8 Bentall's operation were performed. In 6 AD-A patients, 3 Bentall operation and 1 one reimplantation operation were performed and 5 concomitant TAR+ETs were applied in 5 cases. In 12 AD-B patients, one-stage repair was performed in 7 cases. Results: There was no mortality, paraplegia or stroke in this series. Subsequent operations were required in 16 patients for newly developed AD-B or AAE, enlargement of the residual dissection, and failure of valve-sparing technique estimated by the Kaplan-Meier method was 86.7% at 1 year and 54.4% in 5 years. Conclusions: Our surgical results for aortic patients with Marfan was satisfactory.
    SPRINGER-VERLAG TOKYO, 2009, ADVANCES IN UNDERSTANDING AORTIC DISEASES, 221 - +, English
    [Refereed]
    International conference proceedings

  • Takeshi Yuki, Yoshimasa Maniwa, Takefumi Doi, Kenji Okada, Wataru Nishio, Yoshitake Hayashi, Yutaka Okita
    DNA damage sensor proteins are recognized as upstream components of the DNA damage checkpoint signaling pathway and are required for cell cycle control and the induction of apoptosis. hRad9 plays an important role as an upstream regulator of checkpoint signaling. In our previous studies, we confirmed the significant accumulation of hRad9 in the nuclei of tumor cells in surgically-resected non-small cell lung cancer (NSCLC) specimens. We also found that the capacity to produce a functional hRad9 protein was intact in lung cancer cells, a finding which suggests that hRad9 would be a vital component in the pathways that lead to the survival and progression of NSCLC. Small interfering RNA targeting hRad9 was transfected into human lung adenocarcinoma A549 and PC3 cells. After the hRad9 knockdown, the cytotoxicity of the transfected cells was measured by a neutral red uptake test, and the G2-M arrest of irradiated cells was examined by flow cytometry. Significant cytotoxicity was observed in the cancer cells in which hRad9 expression was down-regulated. We also detected the inhibition of Chk1 phosphorylation by Western blot analysis. This suggested that hRad9 silencing leads to the impairment of the DNA damage checkpoint signaling pathway in tumor cells. Flow cytometry indicated a reduced population of cells in the G2-M phase, an observation consistent with the findings of several studies that indicated that hRad9 is necessary for G2-M arrest. In conclusion, the current study demonstrated that RNA interference targeting hRad9 in cancer cells leads to the impairment of the DNA damage checkpoint signaling pathway, which appears to be essential for maintaining tumor cell proliferation, and induces cell death. Therefore, hRad9 may be a novel molecular target for lung cancer treatment.
    PROFESSOR D A SPANDIDOS, Nov. 2008, ONCOLOGY REPORTS, 20(5) (5), 1047 - 1052, English
    Scientific journal

  • Naoto Morimoto, Keisuke Morimoto, Yoshihisa Morimoto, Hiroaki Takahashi, Mitsuru Asano, Masamichi Matsumori, Kenji Okada, Yutaka Okita
    BACKGROUND: Total arch replacement necessitating deep hypothermia with circulatory arrest has a greater effect on pulmonary function than other cardiac surgery using cardiopulmonary bypass (CPB). Since April 2004, 100mg of sivelestat sodium hydrate was administrated by bolus injection into pulp circuit at the initiation of CPB in every case performed total arch replacement. We investigated the hypothesis that prophylactic use of the drug attenuates post-pump pulmonary dysfunction. METHODS: A retrospective analysis of 120 consecutive patients who underwent total arch replacement from August 2001 to December 2006 was conducted. Patients were divided into two groups according to the date of surgery, April 2004, when we started sivelestat administration. Group A (n=60), operated after April 2004, was administrated sivelestat at the initiation of CPB. Group B (n=60), before April 2004, was not administrated. Time courses of hemodynamic variables were evaluated until 24h after surgery and those of respiratory variables and inflammatory markers until 48 h after surgery. RESULTS: There were no significant differences in patient age, sex, prevalence of chronic obstructive lung disease, preoperative lung function, time of operation and CPB, minimum temperature, and aprotinin usage. Hospital mortality occurred in two patients in the group B (3.3%) and no patient in group A (0%). Postoperative hemodynamic variables were not different between the two groups. Respiratory index, oxygenation index were significantly better in patients pretreated with sivelestat (respiratory index; p<0.001, oxygenation index; p<0.001, respectively). CRP was significantly lower in patients pretreated with sivelestat (p=0.022). Except for patients who required tracheostomy or re-exploration for bleeding, patients pretreated with sivelestat were extubated significantly shorter (group A: 12.6+/-10.8h, group B: 25.5+/-12.9h, p=0.033). No patient with postoperative respiratory failure requiring tracheostomy was noted in sivelestat group. CONCLUSION: Prophylactic administration of sivelestat at the initiation of CPB results in better postoperative pulmonary function, leading to earlier extubation time. Our study suggests that sivelestat was effective in facilitating postoperative respiratory management in total arch replacement.
    ELSEVIER SCIENCE BV, Oct. 2008, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 34(4) (4), 798 - 804, English, International magazine
    Scientific journal

  • Naoto Morimoto, Keisuke Morimoto, Yoshihisa Morimoto, Hiroaki Takahashi, Mitsuru Asano, Masamichi Matsumori, Kenji Okada, Yutaka Okita
    Background: Total arch replacement necessitating deep hypothermia with circulatory arrest has a greater effect on pulmonary function than other cardiac surgery using cardiopulmonary bypass (CPB). Since April 2004, 100 mg of sivelestat sodium hydrate was administrated by bolus injection into pulp circuit at the initiation of CPB in every case performed total arch replacement. We investigated the hypothesis that prophylactic use of the drug attenuates post-pump pulmonary dysfunction. Methods: A retrospective analysis of 120 consecutive patients who underwent total arch replacement from August 2001 to December 2006 was conducted. Patients were divided into two groups according to the date of surgery, April 2004, when we started sivelestat administration. Group A (n = 60), operated after April 2004, was administrated sivelestat at the initiation of CPB. Group B (n = 60), before April 2004, was not administrated. Time courses of hemodynamic variables were evaluated until 24 h after surgery and those of respiratory variables and inflammatory markers until 48 h after surgery. Results: There were no significant differences in patient age, sex, prevalence of chronic obstructive lung disease, preoperative lung function, time of operation and CPB, minimum temperature, and aprotinin usage. Hospital mortality occurred in two patients in the group B (3.3%) and no patient in group A (0%). Postoperative hemodynamic variables were not different between the two groups. Respiratory index, oxygenation index were significantly better in patients pretreated with sivelestat (respiratory index; p < 0.001, oxygenation index; p < 0.001, respectively). CRP was significantly tower in patients pretreated with sivelestat (p = 0.022). Except for patients who required tracheostomy or re-exploration for bleeding, patients pretreated with sivelestat were extubated significantly shorter (group A: 12.6 +/- 10.8 h, group B: 25.5 +/- 12.9 h, p = 0.033). No patient with postoperative respiratory failure requiring tracheostomy was noted in sivelestat group. Conclusion: Prophylactic administration of sivelestat at the initiation of CPB results in better postoperative pulmonary function, leading to earlier extubation time. Our study suggests that sivelestat was effective in facilitating postoperative respiratory management in total arch replacement. (C) 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
    ELSEVIER SCIENCE BV, Oct. 2008, EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 34(4) (4), 798 - 804, English
    Scientific journal

  • Yujiro Kawanishi, Hiroshi Tanaka, Keitaro Nakagiri, Teruo Yamashita, Kenji Okada, Yutaka Okita
    A 56-year-old man was referred because of severe aortic regurgitation. He had a quadricuspid aortic valve with a small accessory cusp between the right coronary and noncoronary cusps. The ostium of the right coronary artery was deviated toward the accessory cusp commissure. Aortic valve replacement was performed with a bioprosthesis. The resected cusps showed fibrotic thickening with calcification and fenestration.
    Oct. 2008, Asian cardiovascular & thoracic annals, 16(5) (5), e40-1 - e41, English, International magazine
    Scientific journal

  • Hiroaki Takahashi, Yoshihiro Oshima, Masahiro Yoshida, Masahiro Yamaguchi, Kenji Okada, Yutaka Okita
    OBJECTIVES: Sinus node dysfunction is known as a major complication after repair of partial anomalous pulmonary venous connection. We retrospectively analyzed the results of the atrial wall flap technique compared with the results of patch repair or direct suturing in the intra-atrial tunnel technique. METHODS: Between 1991 and 2007, 23 patients (mean age, 6 years; range, 5 months-17 years) with partial anomalous pulmonary venous connection underwent surgical intervention. The right anomalous pulmonary veins drained to either the right atrium or superior vena cava in 8 and 15 patients, respectively. Patients were divided into 2 groups: group F (n = 14), who had repair with an atrial flap, and group N (n = 9), who had repair without an atrial flap. All patients had normal sinus rhythm preoperatively. RESULTS: No patients had signs of superior vena cava or pulmonary venous obstruction within a mean follow-up of 4.8 years. One patient in group F required pacemaker implantation. In the early postoperative period, sinus node dysfunction developed in 93% of group F and 44% of group N patients (P < .01) and was prolonged until discharge in 57% of group F and 0% of group N patients (P < .01). At the most recent clinical visit, sinus node dysfunction was identified in 50% of group F patients, whereas all patients in group N had normal sinus rhythm (P < .02). CONCLUSIONS: The atrial flap technique, which requires incision or suture crossing the crista terminalis, could cause sinus node dysfunction, whereas the intra-atrial rerouting method with a patch or direct suture maintains normal sinus node function postoperatively.
    Aug. 2008, The Journal of thoracic and cardiovascular surgery, 136(2) (2), 329 - 34, English, International magazine
    Scientific journal

  • Hiroaki Takahashi, Yoshihiro Oshima, Masahiro Yoshida, Masahiro Yamaguchi, Kenji Okada, Yutaka Okita
    Objectives: Sinus node dysfunction is known as a major complication after repair of partial anomalous pulmonary venous connection. We retrospectively analyzed the results of the atrial wall flap technique compared with the results of patch repair or direct suturing in the intra-atrial tunnel technique. Methods: Between 1991 and 2007, 23 patients (mean age, 6 years; range, 5 months-17 years) with partial anomalous pulmonary venous connection underwent surgical intervention. The right anomalous pulmonary veins drained to either the right atrium or superior vena cava in 8 and 15 patients, respectively. Patients were divided into 2 groups: group F (n = 14), who had repair with an atrial flap, and group N (n = 9), who had repair without an atrial flap. All patients had normal sinus rhythm preoperatively. Results: No patients had signs of superior vena cava or pulmonary venous obstruction within a mean follow-up of 4.8 years. One patient in group F required pacemaker implantation. In the early postoperative period, sinus node dysfunction developed in 93% of group F and 44% of group N patients (P <.01) and was prolonged until discharge in 57% of group F and 0% of group N patients (P <.0 1). At the most recent clinical visit, sinus node dysfunction was identified in 50% of group F patients, whereas all patients in group N had normal sinus rhythm (P <.02). Conclusions: The atrial flap technique, which requires incision Or Suture crossing the crista terminalis, could cause sinus node dysfunction, whereas the intra-atrial rerouting method with a patch or direct suture maintains normal sinus node function postoperatively.
    MOSBY-ELSEVIER, Aug. 2008, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 136(2) (2), 329 - 334, English
    Scientific journal

  • Abdominal aortic aneurysm associated with horseshoe kidney.
    Yujiro Kawanishi, Hiroshi Tanaka, Keitaro Nakagiri, Teruo Yamashita, Kenji Okada, Yutaka Okita
    The optimal approach to abdominal aortic aneurysm with horseshoe kidney is still debated. We describe a successful abdominal aortic aneurysm repair through a left retroperitoneal approach in a 77-year-old woman with a horseshoe kidney.
    Jun. 2008, Asian cardiovascular & thoracic annals, 16(3) (3), e28-9, English, International magazine
    Scientific journal

  • 急性肺動脈塞栓症に対する肺動脈内血栓摘除術の遠隔期成績の検討
    Okada Kenji
    May 2008, Therapeutic Research, 29巻, 5号, pp. 754-757, Japanese
    Scientific journal

  • Naoto Morimoto, Keisuke Morimoto, Yoshihisa Morimoto, Toshihito Sakamoto, Masamichi Matsumori, Kenji Okada, Yutaka Okita
    MOSBY-ELSEVIER, May 2008, The Journal of thoracic and cardiovascular surgery, 135(5) (5), 1176 - 7, English, International magazine
    Scientific journal

  • Naoto Morimoto, Keisuke Morimoto, Yoshihisa Morimoto, Toshihito Sakamoto, Masamichi Matsumori, Kenji Okada, Yutaka Okita
    MOSBY-ELSEVIER, May 2008, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 135(5) (5), 1176 - 1177, English
    Scientific journal

  • Kenji Okada, Hiroshi Tanaka, Hideki Takahashi, Naoto Morimoto, Hiroshi Munakata, Mitsuru Asano, Masamichi Matsumori, Yujiro Kawanishi, Keitaro Nakagiri, Yutaka Okita
    BACKGROUND: Destructive aortic valve endocarditis causes the development of left ventricular-aortic discontinuity. Our experience of aortic root replacement in patients with the left ventricular-aortic discontinuity is presented. METHODS: Between 1999 and 2006, 8 patients (7 men, 1 woman) with left ventricular-aortic discontinuity underwent aortic root replacement in our institute. Their mean age was 56 years. Six patients were in New York Heart Association functional class III or higher. Four patients were diagnosed to have native valve endocarditis, and 4 had prosthetic valve endocarditis (previous aortic valve replacements in 2 patients, aortic root replacements in 2). Radical débridement of the aortic root abscess was performed in all patients, followed by reconstruction of the aortic annulus using autologous or xenogenic pericardium in 2 patients. Fibrin glue saturated with antibiotics was applied into the cavity in 5 patients. Aortic root replacement was achieved with pulmonary autograft (Ross procedure) in 4 patients and stentless aortic root xenograft in 3. One patient who had advanced liver cirrhosis underwent aortic valve replacement with a stentless xenograft by subcoronary fashion. RESULTS: No patients died during hospitalization or follow-up. Freedom from major adverse cardiac events was noted in 67% of the patients at 5 years. CONCLUSIONS: An excellent outcome can be achieved by radical exclusion of abscess in the cavity, followed by root replacement with viable pulmonary autograft or flexible stentless aortic root xenograft in patients with left ventricular-aortic discontinuity.
    ELSEVIER SCIENCE INC, Mar. 2008, The Annals of thoracic surgery, 85(3) (3), 940 - 5, English, International magazine
    Scientific journal

  • Kenji Okada, Hiroshi Tanaka, Hideki Takahashi, Naoto Morimoto, Hiroshi Munakata, Mitsuru Asano, Masamichi Matsumori, Yujiro Kawanishi, Keitaro Nakagiri, Yutaka Okita
    Background. Destructive aortic valve endocarditis causes the development of left ventricular-aortic discontinuity. Our experience of aortic root replacement in patients with the left ventricular-aortic discontinuity is presented. Methods. Between 1999 and 2006, 8 patients (7 men, 1 woman) with left ventricular-aortic discontinuity underwent aortic root replacement in our institute. Their mean age was 56 years. Six patients were in New York Heart Association functional class III or higher. Four patients were diagnosed to have native valve endocarditis, and 4 had prosthetic valve endocarditis (previous aortic valve replacements in 2 patients, aortic root replacements in 2). Radical debridement of the aortic root abscess was performed in all patients, followed by reconstruction of the aortic annulus using autologous or xenogenic pericardium in 2 patients. Fibrin glue saturated with antibiotics was applied into the cavity in 5 patients. Aortic root replacement was achieved with pulmonary autograft (Ross procedure) in 4 patients and stentless aortic root xenograft in 3. One patient who had advanced liver cirrhosis underwent aortic valve replacement with a stentless xenograft by subcoronary fashion. Results. No patients died during hospitalization or follow-up. Freedom from major adverse cardiac events was noted in 67% of the patients at 5 years. Conclusions. An excellent outcome can be achieved by radical exclusion of abscess in the cavity, followed by root replacement with viable pulmonary autograft or flexible stentless aortic root xenograft in patients with left ventricular-aortic discontinuity.
    ELSEVIER SCIENCE INC, Mar. 2008, ANNALS OF THORACIC SURGERY, 85(3) (3), 940 - 945, English
    Scientific journal

  • Hiroshi Munakata, Kenji Okada, Hiroshi Tanaka, Teruo Yamashita, Keitaro Nakagiri, Yutaka Okita
    A 61-year-old man developed a ruptured innominate artery associated with localized acute dissection. The innominate artery was reconstructed with a bifurcated prosthetic graft without brain complication.
    Mar. 2008, General thoracic and cardiovascular surgery, 56(3) (3), 131 - 3, English, Domestic magazine
    Scientific journal

  • Takeyoshi Ota, Kenji Okada, Mitsuru Asano, Keitaro Nakagiri, Yutaka Okita
    We report a rare case of isolated pulmonary stenosis in a 66-year-old woman. The patient underwent successful pulmonary valve replacement with a stentless bioprosthetic valve. The pulmonary valve was exposed with a longitudinal incision from the right ventricular outflow tract to the pulmonary trunk. The proximal posterior part of the bioprosthetic valve was anastomosed to the pulmonary valve annulus and the distal side was anastomosed to the pulmonary artery with an inclusion technique. The defect from the pulmonary artery to the right ventricular outflow tract was closed using an equine pericardium patch. The patient had an uneventful postoperative course.
    SPRINGER, 2008, Surgery today, 38(12) (12), 1117 - 9, English, Domestic magazine
    Scientific journal

  • Yujiro Kawanishi, Kenji Okada, Keitaro Nakagiri, Atsushi Kitagawa, Hiroshi Tanaka, Masamichi Matsumori, Yutaka Okita
    Postoperative paraplegia after repairing type A acute aortic dissection has been rarely reported and the causes have not been clearly elucidated. We had three cases of newly developed paraplegia after repair of type A acute aortic dissection. In these cases, we speculated that some intercostal arteries were occluded by completely thrombosed false lumen with late onset of systemic hypotension, which might have reduced spinal cord perfusion followed by paraplegia.
    ELSEVIER SCIENCE INC, Nov. 2007, The Annals of thoracic surgery, 84(5) (5), 1738 - 40, English, International magazine
    Scientific journal

  • Yujiro Kawanishi, Kenji Okada, Keitaro Nakagiri, Atsushi Kitagawa, Hiroshi Tanaka, Masamichi Matsumori, Yutaka Okita
    Postoperative paraplegia after repairing type A acute aortic dissection has been rarely reported and the causes have not been clearly elucidated. We had three cases of newly developed paraplegia after repair of type A acute aortic dissection. In these cases, we speculated that some intercostal arteries were occluded by completely thrombosed false lumen with late onset of systemic hypotension, which might have reduced spinal cord perfusion followed by paraplegia.
    ELSEVIER SCIENCE INC, Nov. 2007, ANNALS OF THORACIC SURGERY, 84(5) (5), 1738 - 1740, English
    Scientific journal

  • Takeyoshi Ota, Kenji Okada, Yoshihisa Morimoto, Yutaka Okita
    Unicuspid aortic valve is a rare congenital cardiac abnormality, leading to aortic stenosis or regurgitation. We report the case of a 55-year-old man with severe aortic regurgitation caused by a unicuspid valve mimicking quadricuspid valve.
    SPRINGER, Sep. 2007, Heart and vessels, 22(5) (5), 352 - 4, English, Domestic magazine
    Scientific journal

  • Yujiro Kawanishi, Kenji Okada, Masamichi Matsumori, Hiroshi Tanaka, Teruo Yamashita, Keitaro Nakagiri, Yutaka Okita
    BACKGROUND: The purpose of this study is to investigate the influence of perioperative circulation on spinal cord during the repair of descending thoracic or thoracoabdominal aortic aneurysms. METHODS: From October 1999, 92 patients (aged 66 +/- 13 years; 65 men) underwent the repair of descending thoracic (n = 30) or thoracoabdominal aortic aneurysm (Crawford I, 9; II, 14; III, 35; IV, 4). We measured the time duration of hypotension, defined as follows, and evaluated the relationship between the incidence of paraplegia and each duration: T1, systolic arterial pressure less than 80 mm Hg, or mean pressure less than 60 mm Hg during aortic cross-clamping; T2, distal aortic pressure less than 60 mm Hg during aortic cross-clamping; T3, systolic arterial pressure less than 80 mm Hg after coming off bypass; T4, systolic arterial pressure less than 80 mm Hg in the intensive care unit. RESULTS: Hospital mortality was 8% (7 patients). Neurologic deficits occurred in 10 patients (10.9%). The T1 and T2 periods showed no difference between paraplegia cases (group P) and normal cases (group N). The T3 periods in both groups were 54 +/- 52 and 6.6 +/- 18, and the T4 periods were 62 +/- 89 and 2.3 +/- 14, respectively. The T3 and T4 periods in group P were significantly longer than in group N (p < 0.0001). Multivariate analysis demonstrated that T3 was an independent risk factor for paraplegia. When divided according to body temperature, the T2 period under mild hypothermia was significantly longer in group P than in group N, as well as the T3 and T4 periods. CONCLUSIONS: Perioperative hemodynamics stability is of vital importance for spinal cord protection during thoracoabdominal aortic surgery. In particular, the duration of hypotension after coming off bypass was an independent risk factor for paraplegia.
    ELSEVIER SCIENCE INC, Aug. 2007, The Annals of thoracic surgery, 84(2) (2), 488 - 92, English, International magazine
    Scientific journal

  • Yujiro Kawanishi, Kenji Okada, Masamichi Matsumori, Hiroshi Tanaka, Teruo Yamashita, Keitaro Nakagiri, Yutaka Okita
    Background. The purpose of this study is to investigate the influence of perioperative circulation on spinal cord during the repair of descending thoracic or thoracoabdominal aortic aneurysms. Methods. From October 1999, 92 patients ( aged 66 +/- 13 years; 65 men) underwent the repair of descending thoracic ( n = 30) or thoracoabdominal aortic aneurysm ( Crawford I, 9; II, 14; III, 35; IV, 4). We measured the time duration of hypotension, defined as follows, and evaluated the relationship between the incidence of paraplegia and each duration: T1, systolic arterial pressure less than 80 mm Hg, or mean pressure less than 60 mm Hg during aortic cross-clamping; T2, distal aortic pressure less than 60 mm Hg during aortic cross-clamping; T3, systolic arterial pressure less than 80 mm Hg after coming off bypass; T4, systolic arterial pressure less than 80 mm Hg in the intensive care unit. Results. Hospital mortality was 8% ( 7 patients). Neurologic deficits occurred in 10 patients ( 10.9%). The T1 and T2 periods showed no difference between paraplegia cases ( group P) and normal cases ( group N). The T3 periods in both groups were 54 +/- 52 and 6.6 +/- 18, and the T4 periods were 62 +/- 89 and 2.3 +/- 14, respectively. The T3 and T4 periods in group P were significantly longer than in group N ( p < 0.0001). Multivariate analysis demonstrated that T3 was an independent risk factor for paraplegia. When divided according to body temperature, the T2 period under mild hypothermia was significantly longer in group P than in group N, as well as the T3 and T4 periods. Conclusions. Perioperative hemodynamics stability is of vital importance for spinal cord protection during thoracoabdominal aortic surgery. In particular, the duration of hypotension after coming off bypass was an independent risk factor for paraplegia.
    ELSEVIER SCIENCE INC, Aug. 2007, ANNALS OF THORACIC SURGERY, 84(2) (2), 488 - 492, English
    Scientific journal

  • Mitsuru Asano, Kenji Okada, Keitaro Nakagiri, Hiroshi Tanaka, Yujiro Kawanishi, Masamichi Matsumori, Hiroshi Munakata, Yutaka Okita
    Total arch replacement (TAR) for aneurysm of the aortic arch through the midsternotomy has several advantages over left thoracotomy. The purpose of this study was to identify the factors that might have an effect on the distal anastomosis through midsternotomy. From October 1999 to August 2005, 125 patients underwent TAR for aneurysm of the aortic arch through midsternotomy. Ninety-four patients with antegrade cerebral perfusion were selected. Distal anastomosis was performed under circulatory arrest (CA) of the lower body. Preoperatively, the diameter of aneurysm, the depth of distal end of aneurysm from anterior skin surface and the anteroposterior diameter of body trunk were measured. Postoperatively, the distance from the carina to the distal anastomosis was measured. There were six early deaths (6.4%). Duration of CA was 37+/-7.6 min. Diameter of the aneurysm was 60.6+/-13.2 mm and the depth of the distal end of aneurysm was 139+/-20.6 mm. There was no correlation between CA time and these factors. The anteroposterior diameter of body trunk was 200+/-18.0 mm and has a correlation with CA time. The depth of distal end of aneurysm from anterior skin surface was the only factor that affected duration for distal anastomosis.
    Jun. 2007, Interactive cardiovascular and thoracic surgery, 6(3) (3), 283 - 7, English, International magazine
    Scientific journal

  • Yujiro Kawanishi, Kenji Okada, Hiroshi Tanaka, Teruo Yamashita, Keitaro Nakagiri, Yutaka Okita
    OBJECTIVE: The purpose of this study was to evaluate the adverse effect of back-bleeding from the lumbar arteries on spinal cord pathophysiology in a rabbit model. METHODS: White rabbits were divided into 3 groups. Through laparotomy, the abdominal aorta was clamped below the renal artery and above the aortic bifurcation for 15 minutes. In group 1 (n = 13), back-bleeding from the lumbar arteries was drained from the aorta during aortic clamping. In group 2 (n = 10), back-bleeding was not drained. Group 3 (n = 6) was the sham-operated group. Postoperative hind limb function was evaluated using the modified Tarlov scale, and cell damage was analyzed by counting the number of intact motor neurons and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL)-positive neurons. RESULTS: At 4 hours after operation, all animals were neurologically impaired in group 1 and normal in group 2. Motor neurons were significantly damaged in group 1 compared with groups 2 and 3 (P < .05). Forty-eight hours later, almost all animals were neurologically and pathologically damaged in groups 1 and 2. There was no difference in the number of normal motor neurons between the two groups, but the number of TUNEL-positive cells in group 2 was significantly larger than those in group 1. CONCLUSIONS: Rabbits with 15-minute aortic clamping in the infrarenal portion showed delayed paraplegia, and those with back-bleeding from lumbar arteries showed early onset of paraplegia. The prevention of back-bleeding from intercostal arteries and lumbar arteries during thoracoabdominal aortic surgery was considered to reduce spinal ischemic injury.
    MOSBY-ELSEVIER, Jun. 2007, The Journal of thoracic and cardiovascular surgery, 133(6) (6), 1553 - 8, English, International magazine
    Scientific journal

  • Yujiro Kawanishi, Kenji Okada, Hiroshi Tanaka, Teruo Yamashita, Keitaro Nakagiri, Yutaka Okita
    Objective: The purpose of this study was to evaluate the adverse effect of back-bleeding from the lumbar arteries on spinal cord pathophysiology in a rabbit model. Methods: White rabbits were divided into 3 groups. Through laparotomy, the abdominal aorta was clamped below the renal artery and above the aortic bifurcation for 15 minutes. In group 1 (n = 13), back-bleeding from the lumbar arteries was (trained from the aorta during aortic clamping. In group 2 (n = 10), back-bleeding was not drained. Group 3 (n = 6) was the sham-operated group. Postoperative hind limb function was evaluated using the modified Tarlov scale, and cell damage was analyzed by counting the number of intact motor neurons and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL)-positive neurons. Results: At 4 hours after operation, all animals were neurologically impaired in group 1 and normal in group 2. Motor neurons were significantly damaged in group 1 compared with groups 2 and 3 (P < .05). Forty-eight hours later, almost all animals were neurologically and pathologically damaged in groups 1 and 2. There was no difference in the number of normal motor neurons between the two groups, but the number of TUNEL-positive cells in group 2 was significantly larger than those in group 1. Conclusions: Rabbits with 15-minute aortic clamping in the infrarenal portion showed delayed paraplegia, and those with back-bleeding from lumbar arteries showed early onset of paraplegia. The prevention of back-bleeding from intercostal arteries and lumbar arteries during thoracoabdominal aortic surgery was considered to reduce spinal ischemic injury.
    MOSBY-ELSEVIER, Jun. 2007, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 133(6) (6), 1553 - 1558, English
    [Refereed]
    Scientific journal

  • Hiroshi Tanaka, Kenji Okada, Keitaro Nakagiri, Yujiro Kawanishi, Masamichi Matsumori, Yutaka Okita
    MOSBY-ELSEVIER, Jun. 2007, The Journal of thoracic and cardiovascular surgery, 133(6) (6), 1633 - 5, English, International magazine
    Scientific journal

  • Hiroshi Tanaka, Kenji Okada, Keitaro Nakagiri, Yujiro Kawanishi, Masamichi Matsumori, Yutaka Okita
    MOSBY-ELSEVIER, Jun. 2007, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 133(6) (6), 1633 - 1635, English
    [Refereed]
    Scientific journal

  • Takeyoshi Ota, Kenji Okada, Hiroya Kano, Yutaka Okita
    Infective endocarditis is a life threatening disease with high mortality and morbidity, including brain infarction concomitant with intracranial hemorrhage. Generally, patients with a recent intracranial hemorrhage are believed to be a contraindication to undergo cardiac surgery with cardiopulmonary bypass. However, some patients with infective endocarditis occasionally require an unavoidable emergent surgery because of uncontrollable heart failure or on-going thromboembolism even if complicated by intracranial hemorrhage. In this study, a cardiopulmonary bypass strategy using nafamostat mesilate as an anticoagulant for such patients is discussed based on three cases we experienced.
    Jun. 2007, Interactive cardiovascular and thoracic surgery, 6(3) (3), 270 - 3, English, International magazine
    [Refereed]
    Scientific journal

  • [Tricuspid regurgitation associated with heart failure].
    Kenji Okada, Yutaka Okita
    May 2007, Nihon rinsho. Japanese journal of clinical medicine, 65 Suppl 5, 512 - 6, Japanese, Domestic magazine
    Scientific journal

  • Tomomi Hasegawa, Kenji Okada, Yoshihito Takano, Yoshiaki Hiraishi, Yutaka Okita
    Objective: We have recently developed a thrombin-free fibrin-coated vascular prosthesis that has a high performance rate in producing graft antithrombogenicity. We hypothesized that autologous, compared with xenologous, fibrin coatings could improve the antithrombogenicity of grafts by reducing immunologic response. Methods: Autologous fibrin-coated vascular prostheses and/or xenologous fibrin-coated vascular prostheses (internal diameter, 2 mm; length, 2.5 cm) were implanted in the bilateral carotid arteries of 50 Japanese white rabbits. They were classified into 2 groups by the selection of grafts in the individual: group I (autologous fibrin-coated vascular prosthesis and xenologous fibrin-coated vascular prosthesis); and group II (group IIa: both autologous fibrin-coated vascular prostheses, or group IIx: both xenologous fibrin-coated vascular prostheses). During a maximum of 180 days after implantation, we evaluated the thrombotic, inflammatory, and immunologic responses associated with both types of graft. Results: All grafts were patent at each end point. In group I, both platelet deposition and anti-graft antibodies in autologous fibrin-coated vascular prostheses were significantly less than those in xenologous fibrin-coated vascular prostheses until postoperative day 30. At postoperative day 10, there were significantly fewer CD45-positive infiltrating cells in autologous fibrin-coated vascular prostheses, and intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and nuclear factor-kappa B expression in autologous fibrin-coated vascular prostheses were less than those in xenologous fibrin-coated vascular prostheses. The neointimal hyperplasia in autologous fibrin-coated vascular prostheses was significantly decreased at postoperative day 180. In group II, serial changes of serum levels of immunoglobulin M, immunoglobulin G, interleukin-1 beta, and tissue-type plasminogen activator/plasminogen activator inhibitor-1 ratio in autologous fibrin-coated vascular prostheses were significantly less than those in xenologous fibrin-coated vascular prostheses. In both grafts, platelet deposition significantly correlated with serum immunoglobulin G level and tissue-type plasminogen activator/plasminogen activator inhibitor-1 ratio. Conclusion: These findings suggest that autologous fibrin coating in thrombin-free fibrin-coated vascular prostheses improve antithrombogenicity by reducing immunologic response and have a potential for clinical use in hybrid small-caliber vascular grafts.
    MOSBY-ELSEVIER, May 2007, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 133(5) (5), 1268 - U50, English
    Scientific journal

  • Tomomi Hasegawa, Kenji Okada, Yoshihito Takano, Yoshiaki Hiraishi, Yutaka Okita
    OBJECTIVE: We have recently developed a thrombin-free fibrin-coated vascular prosthesis that has a high performance rate in producing graft antithrombogenicity. We hypothesized that autologous, compared with xenologous, fibrin coatings could improve the antithrombogenicity of grafts by reducing immunologic response. METHODS: Autologous fibrin-coated vascular prostheses and/or xenologous fibrin-coated vascular prostheses (internal diameter, 2 mm; length, 2.5 cm) were implanted in the bilateral carotid arteries of 50 Japanese white rabbits. They were classified into 2 groups by the selection of grafts in the individual: group I (autologous fibrin-coated vascular prosthesis and xenologous fibrin-coated vascular prosthesis); and group II (group IIa: both autologous fibrin-coated vascular prostheses, or group IIx: both xenologous fibrin-coated vascular prostheses). During a maximum of 180 days after implantation, we evaluated the thrombotic, inflammatory, and immunologic responses associated with both types of graft. RESULTS: All grafts were patent at each end point. In group I, both platelet deposition and anti-graft antibodies in autologous fibrin-coated vascular prostheses were significantly less than those in xenologous fibrin-coated vascular prostheses until postoperative day 30. At postoperative day 10, there were significantly fewer CD45-positive infiltrating cells in autologous fibrin-coated vascular prostheses, and intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and nuclear factor-kappa B expression in autologous fibrin-coated vascular prostheses were less than those in xenologous fibrin-coated vascular prostheses. The neointimal hyperplasia in autologous fibrin-coated vascular prostheses was significantly decreased at postoperative day 180. In group II, serial changes of serum levels of immunoglobulin M, immunoglobulin G, interleukin-1beta, and tissue-type plasminogen activator/plasminogen activator inhibitor-1 ratio in autologous fibrin-coated vascular prostheses were significantly less than those in xenologous fibrin-coated vascular prostheses. In both grafts, platelet deposition significantly correlated with serum immunoglobulin G level and tissue-type plasminogen activator/plasminogen activator inhibitor-1 ratio. CONCLUSION: These findings suggest that autologous fibrin coating in thrombin-free fibrin-coated vascular prostheses improve antithrombogenicity by reducing immunologic response and have a potential for clinical use in hybrid small-caliber vascular grafts.
    MOSBY-ELSEVIER, May 2007, The Journal of thoracic and cardiovascular surgery, 133(5) (5), 1268 - 76, English, International magazine
    [Refereed]
    Scientific journal

  • Masamichi Matsumori, Hiroshi Tanaka, Yujiro Kawanishi, Tetsuari Onishi, Keitaro Nakagiri, Teruo Yamashita, Kenji Okada, Yutaka Okita
    The aim of this study is to evaluate distensibility of the aortic root and function of the aortic cusp after aortic root replacement using valve sparing procedure. Between October 1999 and August 2006, valve sparing aortic root replacements were performed in 39 patients who had annuloaortic ectasia (AAE) and aortic valve regurgitation. Reimplantation type of valve-sparing procedure was performed with a tube graft (n=12) or a Valsalva graft (n=27). Echocardiographic studies were performed six months after the operation comparing Valsalva graft (Group V, n=15), tube graft (Group T, n=5), and normal control (Group C, n=5). Percent changes in radius (PCR) of the aortic root were measured as indices of distensibility. Rapid valve opening velocity (RVOV/HR (mm/s/min)) and rapid valve closing velocity (RVCV/HR (mm/s/min)) of the aortic cusp were analyzed in each group. Root distensibility of sinus in Group T (1.9+/-1.1) was significantly smaller than Group C (7.2+/-1.8) (P=0.003). RVOV/HR in Group T was highest among the three groups (T: 48.2+/-6.2, V: 36.2+/-11.9, C: 33.7+/-9.6). RVCV/HR showed no difference among the three groups (T: 26.1+/-6.7, V: 40.7+/-16.6, C: 28.4+/-16.3). In conclusion, sinus distensibility of the Valsalva graft was well preserved and valve-opening characteristics with the Valsalva graft were identical to normal.
    Apr. 2007, Interactive cardiovascular and thoracic surgery, 6(2) (2), 177 - 81, English, International magazine
    [Refereed]
    Scientific journal

  • Tomonori Haraguchi, Kenji Okada, Yasuhiko Tabata, Yoshimasa Maniwa, Yoshitake Hayashi, Yutaka Okita
    Objectives-Autologous vein grafts are still widely used, but their long-term patency is suboptimal. The objective of the current study was to determine whether wrapping a vein graft in gelatin hydrogel sheet incorporating basic fibroblast growth factor improves their mechanical and physiological properties. Methods and Results-Autologous femoral vein was interposed into the abdominal aorta in rats. The rats were divided into 3 groups: nontreated grafts (group A), grafts wrapped in basic fibroblast growth factor-free gelatin hydrogel sheet (group B), and grafts wrapped in basic fibroblast growth factor-impregnated gelatin hydrogel sheet (group C). On day 1, endothelial desquamation was observed in group A, and the media in groups A and B were disrupted, staining positive in the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay. In contrast, the media in group C remained intact and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling-negative, associated with activation of MAPK. Graft dilation was significantly inhibited in groups B and C compared with group A, with those in group C showing the smallest degree of neointimal proliferation. At 8 weeks grafts in group C developed neointima with homogeneous elastic laminae, presence of rigid neoadventitia that displayed neovascularity, and the highest blood flow velocity. Conclusions-Wrapping vein grafts in basic fibroblast growth factor-impregnated gelatin hydrogel sheet improved their structural and physiological properties, and might therefore also improve long-term patency.
    LIPPINCOTT WILLIAMS & WILKINS, Mar. 2007, ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 27(3) (3), 548 - 555, English
    Scientific journal

  • Tomonori Haraguchi, Kenji Okada, Yasuhiko Tabata, Yoshimasa Maniwa, Yoshitake Hayashi, Yutaka Okita
    OBJECTIVES: Autologous vein grafts are still widely used, but their long-term patency is suboptimal. The objective of the current study was to determine whether wrapping a vein graft in gelatin hydrogel sheet incorporating basic fibroblast growth factor improves their mechanical and physiological properties. METHODS AND RESULTS: Autologous femoral vein was interposed into the abdominal aorta in rats. The rats were divided into 3 groups: nontreated grafts (group A), grafts wrapped in basic fibroblast growth factor-free gelatin hydrogel sheet (group B), and grafts wrapped in basic fibroblast growth factor-impregnated gelatin hydrogel sheet (group C). On day 1, endothelial desquamation was observed in group A, and the media in groups A and B were disrupted, staining positive in the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay. In contrast, the media in group C remained intact and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling-negative, associated with activation of MAPK. Graft dilation was significantly inhibited in groups B and C compared with group A, with those in group C showing the smallest degree of neointimal proliferation. At 8 weeks grafts in group C developed neointima with homogeneous elastic laminae, presence of rigid neoadventitia that displayed neovascularity, and the highest blood flow velocity. CONCLUSIONS: Wrapping vein grafts in basic fibroblast growth factor-impregnated gelatin hydrogel sheet improved their structural and physiological properties, and might therefore also improve long-term patency.
    LIPPINCOTT WILLIAMS & WILKINS, Mar. 2007, Arteriosclerosis, thrombosis, and vascular biology, 27(3) (3), 548 - 55, English, International magazine
    Scientific journal

  • Yujiro Kawanishi, Hiroshi Munakata, Masamichi Matsumori, Hiroshi Tanaka, Teruo Yamashita, Keitaro Nakagiri, Kenji Okada, Yutaka Okita
    BACKGROUND: The purpose of this study was to evaluate the efficacy of myogenic transcranial motor evoked potentials (tc-MEPs) for spinal cord ischemia in the repair of descending thoracic or thoracoabdominal aortic aneurysms. METHODS: Intraoperative tc-MEPs was used in 72 patients who underwent the repair of descending thoracic (n = 24) or thoracoabdominal aortic aneurysms (n = 49) classed as Crawford I in 10 patients, II in 12, III in 23, and IV in 3. There were 52 men and 20 women, and their mean age was 64.9 +/- 12.8 years. Tc-MEPs were recorded by transcranial electrical stimulation and compound muscle action potentials. RESULTS: The hospital mortality rate was 5.6% (n = 4), and the incidence of neurologic deficits was 11.1% (n = 8). All patients whose MEP amplitude recovered to more than 75% of the baseline showed normal spinal function, and 8 of 9 patients whose MEP amplitude decreased to below 75% of the baseline at the end of the procedure showed neurologic deficits postoperatively. The sensitivity of tc-MEPs was 100% and specificity was 98.4%. Latency in patients with postoperative paraplegia was 123% +/- 9% and was significantly prolonged at the end of the procedure. CONCLUSIONS: Tc-MEPs were very sensitive and specific to spinal cord ischemia with reduced amplitude and prolongation of the latency period. Tc-MEPs are considered a useful monitor of spinal cord ischemia during descending thoracic or thoracoabdominal aortic surgery.
    ELSEVIER SCIENCE INC, Feb. 2007, The Annals of thoracic surgery, 83(2) (2), 456 - 61, English, International magazine
    Scientific journal

  • Yujiro Kawanishi, Hiroshi Munakata, Masamichi Matsumori, Hiroshi Tanaka, Teruo Yamashita, Keitaro Nakagiri, Kenji Okada, Yutaka Okita
    Background. The purpose of this study was to evaluate the efficacy of myogenic transcranial motor evoked potentials (tc-MEPs) for spinal cord ischemia in the repair of descending thoracic or thoracoabdominal aortic aneurysms. Methods. Intraoperative tc-MEPs was used in 72 patients who underwent the repair of descending thoracic (n = 24) or thoracoabdominal aortic aneurysms ( n = 49) classed as Crawford 1 in 10 patients, II in 12, III in 23, and IV in 3. There were 52 men and 20 women, and their mean age was 64.9 +/- 12.8 years. Tc-MEPs were recorded by transcranial electrical stimulation and compound muscle action potentials. Results. The hospital mortality rate was 5.6% ( n = 4), and the incidence of neurologic deficits was 11.1% ( n = 8). All patients whose MEP amplitude recovered to more than 75% of the baseline showed normal spinal function, and 8 of 9 patients whose MEP amplitude decreased to below 75% of the baseline at the end of the procedure showed neurologic deficits postoperatively. The sensitivity of tc-MEPs was 100% and specificity was 98.4%. Latency in patients with postoperative paraplegia was 123% +/- 9% and was significantly prolonged at the end of the procedure. Conclusions. Tc-MEPs were very sensitive and specific to spinal cord ischemia with reduced amplitude and prolongation of the latency period. Tc-MEPs are considered a useful monitor of spinal cord ischemia during descending thoracic or thoracoabdominal aortic surgery. (c) 2007 by The Society of Thoracic Surgeons.
    ELSEVIER SCIENCE INC, Feb. 2007, ANNALS OF THORACIC SURGERY, 83(2) (2), 456 - 461, English
    [Refereed]
    Scientific journal

  • Okada Kenji, Tanaka Hiroshi, Morimoto Naoto, Munakata Hiroshi, Asano Mitsuru, Matsumori Masamichi, Kitagawa Atsushi, Kawanishi Yujiro, Nakagiri Keitaro, Okita Yutaka
    Destructive aortic valve endocarditis or poor controlled aortitis cause the development of left ventricular-aortic discontinuity. We reported our experience with aortic root replacement for cases of severe aortic annular destruction. Between 1999 and 2006, 9 patients with severe aortic annular destruction underwent aortic root replacement at our institute. There were 8 men and one women with a mean age of 55 years. Seven patients were in New York Heart Association functional class III. Four of 9 patients had native valve endocarditis, 4 had prosthetic valve endocarditis (previous aortic valve replacements in 2, aortic root replacements in 2) and one had active aortitis with a detached mechanical valve. Radical debridement of the infected cavity and necrotic tissue was performed in all cases, followed by reconstruction of the aortic annulus using autologous or xenogenic pericardium in 3 cases. Antibiotic-saturated fibrin glue was applied to the cavity. Aortic root replacement was achieved with a pulmonary autograft (Ross procedure) in 4 and stentless aortic root xenograft in 4. One patient who had advanced liver cirrhosis underwent aortic valve replacement with a stentless xenograft by subcoronary implantation method. No mortality was observed during hospitalization and follow-up. Reoperation within 5 years was not necessary in 66.7% of the patients. Excellent outcome can be achieved by radical exclusion of the abscess cavity and viable pulmonary autograft or stentless aortic root xenograft in patients with severe aortic annular destruction.
    The Japanese Society for Cardiovascular Surgery, 2007, J. J. C. V. S., 36(6) (6), 315 - 320, Japanese

  • Masahiko Takata, Yoshimasa Maniwa, Takefumi Doi, Yugo Tanaka, Kenji Okada, Wataru Nishio, Chiho Ohbayashi, Masahiro Yoshimura, Yoshitake Hayashi, Yutaka Okita
    Although various methods for collagen gel-based cell invasion assays have been described, there continues to be a need for a simpler and more objective assay. Here, we describe an easy-to-prepare double-layered collagen gel hemisphere (DL-CGH) system that satisfies these requirements, and we demonstrate the advantages of this new system for visualizing cell movements during invasion. DL-CGH consists of a central core collagen layer surrounded by an outer cover collagen layer. A droplet of collagen I solution ( containing cells to be examined) naturally forms a small hemisphere on the bottom of the culture dish. After this central core layer gels, a second droplet is placed atop the first gel, encapsulating it completely. The hemisphere is submerged in the medium and cultured. The invasive activity of cells that infiltrate from the inner to the outer layer can be evaluated optically. Using this in vitro system, we measured the inhibitory effect of E-cadherin expression on cancer cell invasion. DL-CGH also allowed visualization of interactions between invading cancer cells and the stroma. Cancer cells, which lack the proteases required for direct entrance into the three-dimensional collagen matrix, were seen to slip like amoebas through matrix gaps generated by the pericellular proteolytic activity of fibroblasts.
    TAYLOR & FRANCIS INC, 2007, CELL COMMUNICATION AND ADHESION, 14(4) (4), 157 - 167, English
    Scientific journal

  • Yutaka Okita, Yujiro Kawanishi, Keitaro Nakagiri, Hiroshi Tanaka, Masamichi Matsumori, Mitsuru Asano, Teruo Yamashita, Kenji Okada
    An extent II thoracoabdominal aortic aneurysm of 60 mm diameter was exposed through the left 6(th) intercostal space and retroperitoneal approach. The partial cardiopulmonary bypass was initiated through the femoral arterial and venous cannulation. A knitted Dacron graft of 22 mm with four spatially orientated branches for the abdominal viscera and five branches for the intercostal arteries was utilized. The thoracoabdominal aorta was replaced with staged segmental aortic clamping. The proximal aorta, just distal to the left subclavian artery, was completely transected and anastomosed to the graft. The descending aorta was clamped at Th 10 level. The Th 8 and 9 intercostal arteries were clamped from the outside of the aorta. After opening the aorta, the left orifice of Th 8(th) and Th 9(th) intercostal arteries were anastomosed to the side branches of the graft, respectively. Similarly, the 10(th) and 11(th) intercostal arteries were reconstructed. After clamping the infra-renal portion of the abdominal aorta, four visceral arteries were perfused using an 8 French size balloon-tipped catheter. Each artery was anastomosed to the side branch of the graft. The distal anastomosis was performed and cardiopulmonary bypass was weaned-off.
    Jan. 2007, Multimedia manual of cardiothoracic surgery : MMCTS, 2007(219) (219), mmcts.2006.002014, English, International magazine
    Scientific journal

  • Ayako Maruo, Yutaka Okita, Kenji Okada, Teruo Yamashita, Satoshi Tobe, Nobuhiro Tanimura
    BACKGROUND: Pulmonary sarcoma arising from the pulmonary artery is a rare disease and its prognosis is disastrous. METHODS: Five patients who underwent surgery for pulmonary artery sarcoma were reviewed. RESULTS: All patients except one were initially diagnosed with pulmonary embolism. One patient with preoperative profound shock could not wean from cardiopulmonary bypass. Two patients are still surviving for 36 and 30 months, respectively. CONCLUSIONS: Early diagnosis and complete surgical resection is perhaps the best way to improve patients with pulmonary artery sarcoma.
    ELSEVIER SCIENCE INC, Dec. 2006, The Annals of thoracic surgery, 82(6) (6), 2014 - 6, English, International magazine
    Scientific journal

  • Ayako Maruo, Yutaka Okita, Kenji Okada, Teruo Yamashita, Satoshi Tobe, Nobuhiro Tanimura
    Background. Pulmonary sarcoma arising from the pulmonary artery is a rare disease and its prognosis is disastrous. Methods. Five patients who underwent surgery for pulmonary artery sarcoma were reviewed. Results. All patients except one were initially diagnosed with pulmonary embolism. One patient with preoperative profound shock could not wean from cardiopulmonary bypass. Two patients are still surviving for 36 and 30 months, respectively. Conclusions. Early diagnosis and complete surgical resection is perhaps the best way to improve patients with pulmonary artery sarcoma.
    ELSEVIER SCIENCE INC, Dec. 2006, ANNALS OF THORACIC SURGERY, 82(6) (6), 2014 - 2016, English
    [Refereed]
    Scientific journal

  • Nobuchika Ozaki, Yutaka Hino, Yuji Hanafusa, Teruo Yamashita, Kenji Okada, Takuro Tsukube, Yutaka Okita
    We report on structural valve deterioration in patients with the Medtronic Freestyle aortic bioprosthesis ( Medtronic, Inc, Minneapolis, MN), including spontaneous perforation of the Valsalva sinus. These occurred in four prosthesis in 3 patients using the modified subcoronary method or full root technique. One patient died of ruptured pseudoaneurysm and the others survived reoperation well. Careful follow-up is required after Freestyle bioprosthesis implantation.
    ELSEVIER SCIENCE INC, Dec. 2006, ANNALS OF THORACIC SURGERY, 82(6) (6), 2282 - 2285, English
    [Refereed]
    Scientific journal

  • Nobuchika Ozaki, Yutaka Hino, Yuji Hanafusa, Teruo Yamashita, Kenji Okada, Takuro Tsukube, Yutaka Okita
    We report on structural valve deterioration in patients with the Medtronic Freestyle aortic bioprosthesis (Medtronic, Inc, Minneapolis, MN), including spontaneous perforation of the Valsalva sinus. These occurred in four prosthesis in 3 patients using the modified subcoronary method or full root technique. One patient died of ruptured pseudoaneurysm and the others survived reoperation well. Careful follow-up is required after Freestyle bioprosthesis implantation.
    ELSEVIER SCIENCE INC, Dec. 2006, The Annals of thoracic surgery, 82(6) (6), 2282 - 5, English, International magazine
    Scientific journal

  • Hiroshi Tanaka, Teruo Yamshita, Kenji Okada, Keitaro Nakagiri, Yujiro Kawanishi, Yutaka Okita
    MOSBY-ELSEVIER, Dec. 2006, The Journal of thoracic and cardiovascular surgery, 132(6) (6), 1470 - 1, English, International magazine
    Scientific journal

  • Hiroshi Tanaka, Teruo Yamshita, Kenji Okada, Keitaro Nakagiri, Yujiro Kawanishi, Yutaka Okita
    MOSBY-ELSEVIER, Dec. 2006, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 132(6) (6), 1470 - 1471, English
    [Refereed]
    Scientific journal

  • Tomomi Hasegawa, Kenji Okada, Yutaka Okita
    MOSBY, INC, Oct. 2006, Journal of vascular surgery, 44(4) (4), 840 - 5, English, International magazine
    Scientific journal

  • Masamichi Matsumori, Ayako Maruo, Hiroshi Tanaka, Keitaro Nakagiri, Teruo Yamashita, Kenji Okada, Yutaka Okita
    MOSBY, INC, Sep. 2006, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 132(3) (3), 681 - 683, English
    Scientific journal

  • Masamichi Matsumori, Ayako Maruo, Hiroshi Tanaka, Keitaro Nakagiri, Teruo Yamashita, Kenji Okada, Yutaka Okita
    MOSBY, INC, Sep. 2006, The Journal of thoracic and cardiovascular surgery, 132(3) (3), 681 - 3, English, International magazine
    [Refereed]
    Scientific journal

  • Hiroshi Tanaka, Kenji Okada, Teruo Yamashita, Yujiro Kawanishi, Masamiti Matsumori, Yutaka Okita
    A 52-year-old man underwent a replacement of the thoracoabdominal aorta. The aorta was severely calcified, and was replaced by a 24-mm woven Dacron (Vascutek, Renfrewshire, Scotland) graft wrapped with the calcificated aneurysmal wall. His postoperative course was uneventful; however, he collapsed on the 18th postoperative day. He underwent an emergent thoracotomy and the wrapped aneurysmal wall was taken down. The prosthesis graft had a 1-mm disruption in the middle portion, which did not relate to the anastomoses. Experimental study ex vivo showed that disruption of the prosthesis could have occurred after a 3-week pulsatile force caused by a seashell simulating aortic calcification.
    ELSEVIER SCIENCE INC, Sep. 2006, ANNALS OF THORACIC SURGERY, 82(3) (3), 1097 - 1099, English
    Scientific journal

  • Hiroshi Tanaka, Kenji Okada, Teruo Yamashita, Yujiro Kawanishi, Masamiti Matsumori, Yutaka Okita
    A 52-year-old man underwent a replacement of the thoracoabdominal aorta. The aorta was severely calcified, and was replaced by a 24-mm woven Dacron (Vascutek, Renfrewshire, Scotland) graft wrapped with the calcificated aneurysmal wall. His postoperative course was uneventful; however, he collapsed on the 18th postoperative day. He underwent an emergent thoracotomy and the wrapped aneurysmal wall was taken down. The prosthesis graft had a 1-mm disruption in the middle portion, which did not relate to the anastomoses. Experimental study ex vivo showed that disruption of the prosthesis could have occurred after a 3-week pulsatile force caused by a seashell simulating aortic calcification.
    ELSEVIER SCIENCE INC, Sep. 2006, The Annals of thoracic surgery, 82(3) (3), 1097 - 9, English, International magazine
    [Refereed]
    Scientific journal

  • Akitoshi Yamada, Kenji Okada, Rei Takahashi, Yutaka Okita
    MOSBY, INC, Jul. 2006, The Journal of thoracic and cardiovascular surgery, 132(1) (1), 203 - 4, English, International magazine
    Scientific journal

  • Hiroshi Tanaka, Kenji Okada, Teruo Yamshita, Keitaro Nakagiri, Masamichi Matsumori, Yutaka Okita
    MOSBY, INC, Jul. 2006, The Journal of thoracic and cardiovascular surgery, 132(1) (1), 160 - 1, English, International magazine
    Scientific journal

  • Takeyoshi Ota, Kenji Okada, Shuichiro Takanashi, Shin Yamamoto, Yutaka Okita
    OBJECTIVE: Kommerell's diverticulum, which is a rare condition, is a congenital abnormality of the aortic arch. The strategy of surgical treatment for Kommerell's diverticulum has not been established. METHODS: Between 1994 and 2004, 6 patients underwent surgery for Kommerell's diverticulum at our institute. Diagnoses included right aortic arch with aberrant left subclavian artery in 4 patients and left aortic arch with aberrant right subclavian artery in 2 patients. Indications for surgery were dilatation of Kommerell's aneurysm (n = 4) and dysphagia (n = 2). One patient underwent total arch replacement through the median sternotomy plus right thoracotomy. Five patients underwent replacement of the descending aorta and reconstruction in situ (n = 4) or ligation (n = 1) of the stenotic aberrant subclavian artery through the right (n = 3) or left (n = 2) thoracotomy. RESULTS: There were no patient deaths or patients who required rehospitalization. Mediastinitis occurred in 1 patient. This patient required mediastinal drainage and an omentopexy. Two patients who had dysphagia became asymptomatic. Postoperative angiographies in all patients were satisfactory. The patient whose aberrant subclavian artery was ligated had no ischemic symptom of the arm. At the midterm outcomes (mean follow-up length was 55.6 +/- 42.2 months, ranging 10-114 months), all patients resumed normal activities without any complications. CONCLUSIONS: Kommerell's diverticulum can be repaired safely with graft replacement concomitant with in situ reconstruction of the aberrant subclavian artery through thoracotomy.
    MOSBY, INC, Mar. 2006, The Journal of thoracic and cardiovascular surgery, 131(3) (3), 574 - 8, English, International magazine
    Scientific journal

  • T Hasegawa, K Okada, Y Morimoto, Y Okita
    Antithrombogenicity is one of the essential factors for successful development of small-caliber prosthetic vascular grafts, and its accurate evaluation is important. The purpose of this study was to investigate the efficacy of indium-111-oxine-labeled (In-111) platelet scintigraphic images in the assessment of graft thrombogenicity. Fibrin-coated knitted polyester vascular prostheses, 2 mm in diameter and 2 cm in length, were implanted in the bilateral common carotid arteries of 18 Japanese white rabbits. The grafts were explanted on postoperative days 1, 3, 7, 10, 14, and 30 (six grafts on each of the days), and In-111 platelet scintigraphy was performed with visual, semiquantitative, and quantitative analysis. The relationships among the three analyses were evaluated. Platelet depositions on the luminal surface were clearly visualized with In-111-platelet scintigraphy if the number of In-111 platelets was more than 4.8 x 10(4) counts per minute, even if a macroscopic thrombus formation was not observed. There was a highly significant correlation between the graft region of interest on the images and the total platelet deposition (p < .0001). The images in the thrombotic grafts have shown a very strong In-111-platelet accumulation, but there were some limitations in the In-111-platelet scintigraphic images. In-111-platelet scintigraphic images are useful for evaluating platelet deposition in small-caliber vascular prostheses if they are performed with a proper understanding of their limitations.
    LIPPINCOTT WILLIAMS & WILKINS, Mar. 2006, ASAIO JOURNAL, 52(2) (2), 140 - 144, English
    Scientific journal

  • Yoshimasa Maniwa, Masahiro Yoshimura, Vladimir P Bermudez, Kenji Okada, Naoki Kanomata, Chiho Ohbayashi, Yoshihiro Nishimura, Yoshitake Hayashi, Jerard Hurwitz, Yutaka Okita
    BACKGROUND: It was previously reported that a functional human (h) Rad9 protein accumulated in the nuclei of non-small cell lung carcinoma (NSCLC) cells. Those experiments, however, did not examine whether the hRad9 gene was mutated in those cells. The sequence of the HRAD9 gene in NSCLC cells was investigated. METHODS: The sequence of the HRAD9 was examined in tumor and peripheral normal lung tissues obtained from 50 lung adenocarcinoma patients during surgery. The expression of its mRNA using reverse transcription polymerase chain reaction (RT-PCR) was also examined. RESULTS: No sequence alterations were detected in the HRAD9 gene, which was found to be normally transcribed in surgically resected lung carcinoma cells. However, in eight (16.0%) cases a single nucleotide polymorphism (SNP) was observed at the second position of codon 239 (His/Arg heterozygous variant) of the gene. This frequency was significantly higher than that found in the normal population. CONCLUSIONS: Whereas the capacity to produce a functional hRad9 protein was intact in lung adenocarcinoma cells, a nonsynonymous SNP of HRAD9 was detected that might be associated with the development of lung adenocarcinoma.
    JOHN WILEY & SONS INC, Mar. 2006, Cancer, 106(5) (5), 1117 - 22, English, International magazine
    Scientific journal

  • 大動脈造影下CTによるAdamkiewicz動脈の術前評価 経静脈造影CTとの比較
    魚谷健祐, TANIGUCHI, Takanori, KAWASAKI, Ryota, TSURUSAKI, Masakatsu, FUJII, Masahiko, SUGIMURA, Kazuro, 森本直人, OKADA, Kenji, OKITA, Yutaka
    Feb. 2006, 日本医学放射線学会雑誌, 65回抄録集, pp.S288-S288, Japanese
    International conference proceedings

  • Naoto Morimoto, Yutaka Okita, Kenji Okada, Teruo Yamashita, Keitaro Nakagiri, Ayako Maruo, Yujiro Kawanishi, Masamichi Matsumori, Mitsuru Asano
    MOSBY, INC, Jan. 2006, The Journal of thoracic and cardiovascular surgery, 131(1) (1), 232 - 3, English, International magazine
    Scientific journal

  • N Morimoto, Y Okita, K Okada, T Yamashita, M Matsumori
    MOSBY, INC, Dec. 2005, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 130(6) (6), 1713 - 1714, English
    Scientific journal

  • Tomomi Hasegawa, Kenji Okada, Yoshihito Takano, Yoshiaki Hiraishi, Yutaka Okita
    Fibrin coatings on prosthetic vascular graft, which are conventionally produced by fibrinogen and thrombin, are expected to improve antithrombogenicity and healing characteristics. Thrombin is one of the factors of blood coagulation cascade; however, it has a possibility to play a negative role in the graft antithrombogenicity. The purpose of this study was to evaluate the performance of our new grafts, thrombin-free fibrin-coated small caliber vascular prostheses. Knitted polyester fabric vascular prostheses 2 mm in internal diameter were coated with fibrin coating with thrombin (Graft I) or without thrombin (Graft II). Both grafts were implanted in bilateral common carotid arteries of 35 Japanese white rabbits, with Graft I in one side and Graft II in the contralateral side. Graft patency, histology, thrombin activity, and platelet deposition were compared between both grafts on postoperative days (PODs) 1, 3, 7, 10, 14, 30, and 60. Both grafts were patent without thrombus or stenosis at each end point (maximal period, POD 60). Macro- and microscopic findings revealed that no obvious difference was observed between both grafts. Before graft implantation, thrombin activities in Grafts I and II were 0.711 +/- 0.086 and 0.009 +/- 0.007 optical density at 405 nm, respectively. Thrombin activity of Graft II was significantly less than that of Graft I in every period after graft implantation, and platelet deposition of Graft II was significantly less than that of Graft I until POD 30. Thrombin-free fibrin-coated vascular prostheses have superior performance of antithrombogenicity to conventional fibrin-coated vascular prostheses with thrombin.
    BLACKWELL PUBLISHING, Nov. 2005, Artificial organs, 29(11) (11), 880 - 6, English, International magazine
    Scientific journal

  • Yoshihiko Tsuji, Naoto Morimoto, Hiroshi Tanaka, Kenji Okada, Hitoshi Matsuda, Takuro Tsukube, Yoshihisa Watanabe, Yutaka Okita
    HYPOTHESIS: Therapeutic strategies for patients who require procedures for both cardiac or aortic diseases and gastric cancer are controversial. Prognostic factors for them should be clearly identified. DESIGN: Retrospective review of 14 patients who underwent surgical intervention for both gastric cancer and cardiac or aortic diseases between January 1, 2000, and June 30, 2004. SETTING: Tertiary referral university hospital. PATIENTS: Cardiac and aortic diseases included coronary artery disease in 5 patients, thoracic aortic aneurysms in 3 patients, and abdominal aortic aneurysms in 6 patients. Coronary artery bypass graftings were performed with an off-pump procedure, and aneurysms were replaced with prosthetic grafts in all of the cases. The surgical stages of gastric cancers were stage I in 8 patients, stage II in 2 patients, stage III in 3 patients, and stage IV in 1 patient. According to our original therapeutic strategies, 4 patients underwent simultaneous procedures and 10 received staged procedures. MAIN OUTCOME MEASURE: Overall survival rates. RESULTS: There was 1 hospital death caused by multiple organ failure. No prosthetic graft infection was noted. Thirteen patients were discharged, and 3 died of cancer recurrence during an average follow-up period of 26.3 months. The cumulative survival rate was 76.6% at 1 year and 68.1% at 3 years. One-year survival rates were 90.0% in stages I and II gastric cancer and 50.0% in stages III and IV gastric cancer. CONCLUSION: Prognosis of patients who underwent surgical intervention for both gastric cancer and cardiac or aortic diseases was mainly limited by the clinical stage of gastric cancer.
    AMER MEDICAL ASSOC, Nov. 2005, Archives of surgery (Chicago, Ill. : 1960), 140(11) (11), 1109 - 14, English, International magazine
    Scientific journal

  • T Hasegawa, K Okada, Y Takano, Y Hiraishi, Y Yoshida, Y Okita
    The potential use of plasmin-treated fibrin-coated vascular prosthesis (PF-V) for coronary artery bypass grafting (CABG) in animal models was investigated. PF-V grafts, 3 mm in internal diameter, were studied on 5 sheep in off-pump CABG model and on 18 rabbits in abdominal aortic bypass grafting (AABG) model. Patency, blood flow, angiography, Indium-111 platelet scintigraphy, and histology of the graft were evaluated. In the sheep CABG model, the PF-V grafts were patent for a range of 12 to 22 days without postoperative antiplatelet therapy. Graft flows ranged 58 to 90 ml/min until the day before graft occlusion by thrombus. In rabbit AABG model, the fibrin coating of the PF-V grafts was completely absorbed and replaced with neofibrin net between 7 and 14 days after implantation. Platelet depositions on the graft between 7 and 14 days after implantation were significantly higher than those at other periods (p < 0.05). The small-caliber PF-V graft in sheep CABG model had a good blood flow with high antithrombogenicity in acute phase, but occluded over 2 to 3 weeks without antiplatelet agents after implantation. The current problem of the PF-V graft was a thrombus formation at the time of the degradation of fibrin coating. Further improvements are needed.
    LIPPINCOTT WILLIAMS & WILKINS, Nov. 2005, ASAIO JOURNAL, 51(6) (6), 725 - 729, English
    Scientific journal

  • Controlled release of basic fibroblast growth factor from gelatin hydrogel sheet promotes the optimal arterilization and increases the blood flow of vein graf in rat
    T Haraguchi, K Okada, Y Tabata, Y Maniwa, Y Okita
    LIPPINCOTT WILLIAMS & WILKINS, Oct. 2005, CIRCULATION, 112(17) (17), U358 - U358, English
    Scientific journal

  • 著明な接合不全を伴う重症僧帽弁閉鎖不全症に対して僧帽弁輪形成術を施行した1例
    辰巳和宏, KAWAI, Hiroya, 片岡俊哉, 大西哲存, 田中秀和, 溝口貴裕, YOKOYAMA, Mitsuhiro, OKADA, Kenji, OKITA, Yutaka
    Jul. 2005, 超音波医学, 32巻, 4号, pp.432-432, Japanese
    International conference proceedings

  • Hiroshi Tanaka, Kenji Okada, Teruo Yamashita, Yoshihisa Morimoto, Yujiro Kawanishi, Yutaka Okita
    BACKGROUND: In patients with acute type A aortic dissection complicated by cerebral malperfusion, the surgical treatment remains challenging. This retrospective study reports the results of surgical interventions and the clinical features of these patients. METHODS: From 1999 to 2004, 63 patients underwent surgical treatment for acute type A aortic dissection. Sixteen patients (25.3%) showed preoperative newly developed neurologic deficits (cerebral malperfusion). In patients with cerebral malperfusion, the characteristics, neurologic symptoms, computed tomography findings, interval from onset to operation, and operative details (procedure, arterial cannulation site, method of brain protection) were reviewed. RESULTS: The hospital mortality rate was 43.7% (7 of 16 patients) for the cerebral malperfusion group and 17.0% (8 of 47 patients) for the noncerebral malperfusion group (all patients, 23.8%). Multivariate analysis showed preoperative cerebral malperfusion as the sole risk factor for hospital mortality. Six patients, including all patients in a preoperative coma, died of severe brain damage within 1 month after surgery. Most patients were diagnosed with right hemispheric cerebral infarction by postoperative brain computed tomography. The operative details and the time interval from onset to operation were not significant predictors of death. The cumulative survival rate at 4 years was 75.5% in patients without cerebral malperfusion and 50.1% with cerebral malperfusion (p = 0.091). CONCLUSIONS: The results of surgical treatment for acute type A dissection complicated with cerebral malperfusion demonstrated high hospital mortality, but the long-term survival was similar to patients without cerebral malperfusion, with an acceptable neurologic outcome, excluding preoperative coma patients. Appropriate protection of ischemic brain tissue should be implemented to improve the surgical results in these patients.
    ELSEVIER SCIENCE INC, Jul. 2005, The Annals of thoracic surgery, 80(1) (1), 72 - 6, English, International magazine
    Scientific journal

  • Kenji Okada, Teruo Yamashita, Masamichi Matsumori, Yutaka Hino, Yuji Hanafusa, Nobuchika Ozaki, Yoshihiko Tsuji, Yutaka Okita
    Left ventricular (LV) free wall rupture particularly in blow-out type is still one of the fatal complications after myocardial infarction. Seven patients had LV rupture following acute myocardial infarction. LV rupture was divided into two categories: blow-out type (true rupture) in 5 cases, or oozing type (incipient rupture) in 2 cases. All patients were in deep shock condition and underwent surgery on emergency basis. Patch and glue (fibrin glue) technique was applied for oozing type patients, while direct closure using buttress sutures with additional sutured patch and glue (including GRF glue) technique for blow-out type patients. Surgery was performed on heart beating without cardioplegic arrest. Complete homeostasis and circulatory recovery were obtained in all cases. One blow-out type patient (14.3%), who had preoperative cardiopulmonary arrest (CPA), died of multiple organ failure. Four patients (57.1%) who had preoperative CPA or were in prolonged deep shock resulted in vegetative condition regardless of rupture type. Two patients (28.5%) of blow-out type were successfully rescued without any severe brain complications. No recurrence of free wall rupture was demonstrated during follow-up in all cases. Fifty-seven percent of patients had postoperative vegetative condition because of inadequacy of cardiopulmonary resuscitation including delayed circulatory support. Our surgical procedure provided sufficient circulatory recovery and survival without recurrence, even in patients with blow-out type rupture, as long as prompt resuscitation was performed.
    Jun. 2005, Interactive cardiovascular and thoracic surgery, 4(3) (3), 203 - 6, English, International magazine
    [Refereed]
    Scientific journal

  • Controlled release of basic fibroblast growth factor from gelatin hydrogel sheet inhibits neointimal hyperplasia and improves the patency of vein graft in rat
    T Haraguchi, K Okada, Y Tabata, Y Maniwa, Y Okita
    LIPPINCOTT WILLIAMS & WILKINS, May 2005, ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 25(5) (5), E69 - E69, English
    Scientific journal

  • Akiko Tanaka, Kenji Okada, Masamichi Matsumori, Nobuchika Ozaki, Yutaka Okita
    A 54-year-old man with congenital bicuspid aortic valve underwent simultaneous valve repair for aortic and mitral regurgitation. Surgical technique consisted of plication of redundant aortic valve repair and mitral annuloplasty with chordal replacement. One-year follow-up transthoracic echocardiography showed no valve regurgitation. Valve repair for both bicuspid aortic valve and mitral valve regurgitation should be the first option in this subset of patients.
    Japanese Association for Thoracic Surgery, May 2005, The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai zasshi, 53(5) (5), 290 - 2, English, Domestic magazine
    Scientific journal

  • Hiroshi Tanaka, Teruo Yamashita, Kenji Okada, Yutaka Okita
    A 42-year-old man complaining of severe chest pain was referred to our hospital. Computed tomography demonstrated acute type A aortic dissection complicated with rupture in the descending aorta and right leg malperfusion. Initial entry was detected in the proximal descending aorta. He underwent aortic arch, and descending thoracic aorta replacement using selective cerebral perfusion through a left thoracotomy. The leg malperfusion was treated successfully by endovascular treatment on 18th day after the operation. The chest computed tomography three month after surgery demonstrated the disappearance of the false lumen proximal to the anastomotic site and satisfactory outcome.
    Apr. 2005, Interactive cardiovascular and thoracic surgery, 4(2) (2), 116 - 7, English, International magazine
    [Refereed]
    Scientific journal

  • Yutaka Okita, Kenji Okada, Takuro Tsukube, Yosuke Tanaka
    A 65-year-old male with four-channel aortic dissection successfully underwent replacement of the thoracoabdominal aorta, reconstruction of the celiac, superior mesenteric artery, renal arteries, and 5 pairs of intercostals or lumbar arteries using deep hypothermic technique.
    ELSEVIER SCIENCE BV, Feb. 2005, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 27(2) (2), 348 - 50, English, International magazine
    [Refereed]
    Scientific journal

  • Yoshimasa Maniwa, Masahiro Yoshimura, Vladimir P Bermudez, Takeshi Yuki, Kenji Okada, Naoki Kanomata, Chiho Ohbayashi, Yoshitake Hayashi, Jerard Hurwitz, Yutaka Okita
    BACKGROUND: DNA damage sensor proteins have received much attention as upstream components of the DNA damage checkpoint signaling pathway that are required for cell cycle control and the induction of apoptosis. Deficiencies in these proteins are directly linked to the accumulation of gene mutations, which can induce cellular transformation and result in malignant disease. METHODS: Using 48 sets of tumor tissue specimens and peripheral normal lung tissue specimens from 48 patients with nonsmall cell lung carcinoma (NSCLC) who underwent surgery, the authors investigated the expression of hRad9 protein, a member of the human DNA damage sensor family, using immunohistochemical and Western blot analyses. RESULTS: Immunohistochemical analysis detected the accumulation of hRad9 in the nuclei of tumor cells in 16 tumor tissue specimens, (33% of tumor tissue specimens examined). Western blot analysis also revealed elevated levels of phosphorylated hRad9 protein in NSCLC cells that was accompanied by the detection of phosphorylated Chk1, a protein kinase that regulates the downstream signaling of the DNA damage checkpoint pathway. Furthermore, strong expression of hRad9 was correlated with an increase in Ki-67 expression index in the tumor cells that were examined. CONCLUSIONS: The findings made in the current study suggest that Rad9 expression may play an important role in cell cycle control in NSCLC cells and may influence NSCLC cell phenotype.
    JOHN WILEY & SONS INC, Jan. 2005, Cancer, 103(1) (1), 126 - 32, English, International magazine
    [Refereed]
    Scientific journal

  • 肺動脈肉腫の外科治療
    HANAFUSA,Yuji, OKADA, Kenji, OZAKI,Nobuchika, YAMASHITA,Teruo, MORIMOTO,Yoshihisa, 日野裕, OKITA, Yutaka, 戸部智, 谷村信宏
    Jun. 2004, Therapeutic Research, 25巻, 6号, pp. 1159-1161, Japanese
    [Refereed]
    Scientific journal

  • GOTOH,Akinobu, SHIRAKAWA, Toshiro, Hinata Nobuyuki, WADA,Yoshitaka, HARA, Isao, FUJISAWA, Masato, KAWABATA,Gaku, OKADA,Hiroshi, Arakawa Soichi, KAMIDONO,Sadao
    May 2004, International Journal Of Urology, Vol. 11, No. 5, pp. 257-263, English
    [Refereed]
    Scientific journal

  • 【大動脈手術における脊髄保護】 脊髄保護に関する集学的アプローチ 胸腹部大動脈瘤の手術成績
    HANAFUSA,Yuji, OKADA, Kenji, 三村剛史, KAWANISHI, Yujiro, OZAKI,Nobuchika, YAMASHITA,Teruo, TSUJI,Yoshihiko, OKITA, Yutaka
    Apr. 2004, 胸部外科, 57巻, 4号, pp. 313-318, Japanese
    [Refereed]
    Scientific journal

  • 脳合併症予知因子の検討
    HANAFUSA,Yuji, TSUKUBE,Takuro, MATSUDA,Hitoshi, OKADA, Kenji, OZAKI,Nobuchika, 日野裕, TANAKA, Hiroshi, 岩崎倫明, 原口知則, 吉田和則, 松森正術, 田中陽介, TSUJI,Yoshihiko, OKITA, Yutaka
    Mar. 2004, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 52巻, Suppl., pp. 87-87, Japanese
    International conference proceedings

  • 透析患者に対する心大血管手術
    KITAGAWA, Atsushi, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Mar. 2004, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 52巻, Suppl., pp. 92-92, Japanese
    International conference proceedings

  • 大動脈弁輪部膿瘍に対する基部置換術
    松森正術, 田中陽介, 岩崎倫明, 原口知則, 吉田和則, TANAKA, Hiroshi, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Mar. 2004, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 52巻, Suppl., pp. 109-109, Japanese
    International conference proceedings

  • 大動脈炎症候群合併病変に対する外科治療
    田中陽介, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Mar. 2004, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 52巻, Suppl., pp. 128-128, Japanese
    International conference proceedings

  • 多腔解離を来たした大動脈解離の手術症例の検討
    国久智成, TSUJI,Yoshihiko, 野村拓生, 橋本章太郎, 宗像宏, 田中陽介, 溝口和博, 日野裕, OZAKI,Nobuchika, OKADA, Kenji, OKITA, Yutaka
    Mar. 2004, 日本外科学会雑誌, 105巻, 臨増, pp. 452-452, Japanese
    International conference proceedings

  • 縦隔炎に対するVAC(Vacuum-assisted suction drainage)の検討
    吉田和則, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Mar. 2004, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 52巻, Suppl., pp. 131-131, Japanese
    International conference proceedings

  • 胸腹部大動脈手術における術中脊髄保護の臨床成績
    岩崎倫明, 田中陽介, 松森正術, 原口知則, 吉田和則, TANAKA, Hiroshi, KITAGAWA, Atsushi, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Mar. 2004, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 52巻, Suppl., pp. 109-109, Japanese
    International conference proceedings

  • 胸部大動脈瘤術前冠動脈病変スクリーニングの検討
    日野裕, HANAFUSA,Yuji, YAMASHITA,Teruo, OZAKI,Nobuchika, OKADA, Kenji, TSUJI,Yoshihiko, OKITA, Yutaka
    Mar. 2004, 日本外科学会雑誌, 105巻, 臨増, pp. 575-575, Japanese
    International conference proceedings

  • 胸部大動脈領域のPenetrating Atherosclerotic Ulcerに対する治療
    日野裕, HANAFUSA,Yuji, 尾崎義就, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Mar. 2004, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 52巻, Suppl., pp. 126-126, Japanese
    International conference proceedings

  • 胸部下行,胸腹部大動脈瘤手術における,術前後の脊髄MRI,MRAの意義
    三村剛史, 太田壮美, 宗像宏, 松森正術, 山田章貴, 原口知則, 溝口和博, 日野裕, ハナフサ・ユウジ, YAMASHITA,Teruo, OZAKI,Nobuchika, OKADA, Kenji, TSUJI,Yoshihiko, OKITA, Yutaka
    Mar. 2004, 日本外科学会雑誌, 105巻, 臨増, pp. 444-444, Japanese
    International conference proceedings

  • 急性B型大動脈解離に合併した大動脈分枝灌流障害(malperfusion)に対する血管内治療
    溝口和博, TSUJI,Yoshihiko, OKADA, Kenji, OZAKI,Nobuchika, HANAFUSA,Yuji, 日野裕, 太田壮美, 山田章貴, 野村佳克, SUGIMOTO,Kouji, OKITA, Yutaka
    Mar. 2004, 日本外科学会雑誌, 105巻, 臨増, pp. 572-572, Japanese
    International conference proceedings

  • 弓部大動脈全置換術の実際
    OKITA, Yutaka, OKADA, Kenji, OZAKI,Nobuchika, YAMASHITA,Teruo, HANAFUSA,Yuji, 日野裕, 溝口和博, 松森正術, 太田壮美, 宗像宏, 原口知則, 山田章貴, 三村剛史, TSUJI,Yoshihiko
    Mar. 2004, 日本外科学会雑誌, 105巻, 臨増, pp. 168-168, Japanese
    International conference proceedings

  • 感染性胸部及び胸腹部大動脈瘤の外科治療
    HANAFUSA,Yuji, TSUJI,Yoshihiko, OKADA, Kenji, OZAKI,Nobuchika, YAMASHITA,Teruo, 日野裕, 溝口和博, 原口知則, 松森正術, 山田章貴, 太田壮美, 三村剛史, 宗像弘, OKITA, Yutaka
    Mar. 2004, 日本外科学会雑誌, 105巻, 臨増, pp. 695-695, Japanese
    International conference proceedings

  • 胃癌を合併した心大血管手術症例の検討
    TSUJI,Yoshihiko, 原口知則, 日野裕, HANAFUSA,Yuji, YAMASHITA,Teruo, OZAKI,Nobuchika, OKADA, Kenji, WATANABE,Yoshihisa, OKITA, Yutaka
    Mar. 2004, 日本外科学会雑誌, 105巻, 臨増, pp. 233-233, Japanese
    International conference proceedings

  • Penetrating Atherosclerotic Ulcerに対するStent Graft内挿術の検討
    太田壮美, TSUJI,Yoshihiko, OKADA, Kenji, OZAKI,Nobuchika, YAMASHITA,Teruo, HANAFUSA,Yuji, 日野裕, OKITA, Yutaka
    Mar. 2004, 日本外科学会雑誌, 105巻, 臨増, pp. 444-444, Japanese
    International conference proceedings

  • Bentall術後の大動脈炎症候群に対し全弓部置換術を施行した一例
    松森正術, 田中陽介, 岩崎倫明, 原口知則, 吉田和則, TANAKA, Hiroshi, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Mar. 2004, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 52巻, Suppl., pp. 128-128, Japanese
    International conference proceedings

  • AMIによるBlow-out LV ruptureの3例
    藤田靖之, 岩崎倫明, 田中陽介, 原口知則, 吉田和則, TANAKA, Hiroshi, 北川敦史, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Mar. 2004, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 52巻, Suppl., pp. 134-134, Japanese
    International conference proceedings

  • AAE,AR症例に対するST junction plicationの検討
    松森正術, YAMASHITA,Teruo, HANAFUSA,Yuji, 日野裕, 溝口和博, OZAKI,Nobuchika, OKADA, Kenji, TSUJI,Yoshihiko, OKITA, Yutaka
    Mar. 2004, 日本外科学会雑誌, 105巻, 臨増, pp. 687-687, Japanese
    International conference proceedings

  • 91歳弓部大動脈瘤破裂の一治験例
    中川暁雄, 田中陽介, 松森正術, 岩崎倫明, 原口知明, 吉田和則, TANAKA, Hiroshi, KITAGAWA, Atsushi, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Mar. 2004, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 52巻, Suppl., pp. 127-127, Japanese
    International conference proceedings

  • 80歳以上の胸部大動脈手術の成績と問題点
    TANAKA, Hiroshi, OKITA, Yutaka, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko
    Mar. 2004, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 52巻, Suppl., pp. 128-128, Japanese
    International conference proceedings

  • 腹部大動脈瘤術後に合併した腸管虚血の検討
    日野裕, HANAFUSA,Yuji, YAMASHITA,Teruo, OZAKI,Nobuchika, OKADA, Kenji, TSUJI,Yoshihiko, OKITA, Yutaka
    Feb. 2004, 日本心臓血管外科学会雑誌, 33巻, Suppl., pp. 474-474, Japanese
    International conference proceedings

  • 腹部大動脈瘤手術を要する弓部大動脈瘤全置換術症例の検討
    山田章貴, 宗像宏, 田中陽介, 三村剛史, 太田壮美, 松森正術, 原口智徳, HANAFUSA,Yuji, OZAKI,Nobuchika, YAMASHITA,Teruo, OKADA, Kenji, TSUJI,Yoshihiko, OKITA, Yutaka
    Feb. 2004, 日本心臓血管外科学会雑誌, 33巻, Suppl., pp. 355-355, Japanese
    International conference proceedings

  • 特発性上腸間膜動脈限局性解離に対する1手術例
    TSUJI,Yoshihiko, 日野裕, OKADA, Kenji, MATSUDA,Hitoshi, OKITA, Yutaka
    Feb. 2004, 日本腹部救急医学会雑誌, 24巻, 2号, pp. 506-506, Japanese
    International conference proceedings

  • 大動脈ステントグラフトの遠隔成績 再手術例の検討を中心に
    TSUJI,Yoshihiko, 宗像宏, 田中陽介, KITAGAWA, Atsushi, 日野裕, HANAFUSA,Yuji, OZAKI,Nobuchika, TANIGUCHI, Takanori, SUGIMOTO,Kouji, OKADA, Kenji, MATSUDA,Hitoshi, OKITA, Yutaka
    Feb. 2004, 日本心臓血管外科学会雑誌, 33巻, Suppl., pp. 376-376, Japanese
    International conference proceedings

  • 消化管-胸部大動脈瘻症例の検討
    宗像宏, TSUJI,Yoshihiko, 国久智成, 三村剛司, 太田壮美, 山田彰貴, 松森正術, 原口知則, 日野裕, HANAFUSA,Yuji, YAMASHITA,Teruo, OZAKI,Nobuchika, OKADA, Kenji, OKITA, Yutaka
    Feb. 2004, 日本心臓血管外科学会雑誌, 33巻, Suppl., pp. 412-412, Japanese
    International conference proceedings

  • 術前肝機能低下症例(ICG15分値≧20%)の手術成績
    田中陽介, HANAFUSA,Yuji, OZAKI,Nobuchika, YAMASHITA,Teruo, OKADA, Kenji, TSUJI,Yoshihiko, OKITA, Yutaka
    Feb. 2004, 日本心臓血管外科学会雑誌, 33巻, Suppl., pp. 475-475, Japanese
    International conference proceedings

  • 左室流出路縫縮術を行ったRoss手術
    YAMASHITA,Teruo, 宗像宏, 三村剛史, 太田壮美, 松森正術, 山田章貴, 国久智成, 原口知則, 溝口和博, 日野裕, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, TSUJI,Yoshihiko, OKITA, Yutaka
    Feb. 2004, 日本心臓血管外科学会雑誌, 33巻, Suppl., pp. 218-218, Japanese
    International conference proceedings

  • 胸腹部大動脈及び腸骨動脈領域に発生した吻合部瘤に対する治療成績
    田中陽介, HANAFUSA,Yuji, OZAKI,Nobuchika, YAMASHITA,Teruo, OKADA, Kenji, TSUJI,Yoshihiko, OKITA, Yutaka
    Feb. 2004, 日本心臓血管外科学会雑誌, 33巻, Suppl., pp. 412-412, Japanese
    International conference proceedings

  • Ross手術の中期成績の検討
    松森正術, YAMASHITA,Teruo, 溝口和博, 日野裕, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, TSUJI,Yoshihiko, OKITA, Yutaka
    Feb. 2004, 日本心臓血管外科学会雑誌, 33巻, Suppl., pp. 199-199, Japanese
    International conference proceedings

  • Kommerell憩室瘤の経験
    太田壮美, OKADA, Kenji, OZAKI,Nobuchika, TSUJI,Yoshihiko, YAMASHITA,Teruo, 日野裕, HANAFUSA,Yuji, 高梨秀一郎, 山本晋, OKITA, Yutaka
    Feb. 2004, 日本心臓血管外科学会雑誌, 33巻, Suppl., pp. 288-288, Japanese
    International conference proceedings

  • Hitoshi Matsuda, Yosuke Tanaka, Yutaka Hino, Ritsu Matsukawa, Nobuchika Ozaki, Kenji Okada, Takuro Tsukube, Yoshihiko Tsuji, Yutaka Okita
    OBJECTIVE: Of 125 surgical patients with abdominal aortic aneurysm (AAA) treated from 1999, 11 patients with deep shock from ruptured AAAs who underwent aortic occlusion balloon catheter (AOBC) insertion before laparotomy were studied. METHODS: With the patients under local anesthesia, the brachial artery was exposed and the balloon catheter was inserted into the thoracic aorta. The balloon was inflated halfway and pulled back gently to the orifice of the left subclavian artery, and was advanced with the aid of blood flow down to the abdominal aorta. After full inflation of the balloon, the catheter was pulled until the balloon was fixed at the proximal shoulder of the AAA. RESULTS: AOBC insertion was completed within 16.1 +/- 5.1 minutes. Systolic blood pressure at presentation was 84.1 +/- 31.7 mm Hg, deteriorated to 60.9 +/- 15.4 mm Hg on arrival in the operating room, and increased significantly (P <.0001) to 123.4 +/- 25.3 mm Hg after AOBC insertion. The balloon burst in three patients. Embolic complications were observed in two patients. There were three deaths, two associated with the balloon bursting. In nine patients whose shock was successfully controlled by AOBC, operative mortality was 11%. CONCLUSION: Transbrachial arterial insertion of an AOBC may be useful to ameliorate hemorrhagic shock in patients with ruptured AAAs.
    MOSBY, INC, Dec. 2003, Journal of vascular surgery, 38(6) (6), 1293 - 6, English, International magazine
    [Refereed]
    Scientific journal

  • 肺動脈瘻を合併した弓部大動脈瘤の一治験例
    藤田靖之, 岩崎倫明, 田中陽介, 原口知則, 吉田和則, TANAKA, Hiroshi, 北川敦史, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Oct. 2003, Circulation Journal, 67巻, Suppl.III, pp. 989-989, Japanese
    International conference proceedings

  • 同時期に発見された肺癌と心大血管病変に対する外科療法の検討
    YOSHIMURA, Masahiro, MANIWA, Yoshimasa, 中井玲子, 岩永幸一郎, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Oct. 2003, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 51巻, 増刊, pp. 457-457, Japanese
    International conference proceedings

  • 大動脈基部病変に対するreimplantation(David法)とRoss手術の術後心エコーの比較検討
    松森正術, 田中陽介, 原口知則, 岩崎倫明, 吉田和則, TANAKA, Hiroshi, KAWANISHI, Yujiro, KITAGAWA, Atsushi, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Oct. 2003, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 51巻, 増刊, pp. 368-368, Japanese
    International conference proceedings

  • 胸部大動脈に対するステントグラフト治療の問題点とその対策
    TSUJI,Yoshihiko, 田中陽介, TANAKA, Hiroshi, 日野裕, HANAFUSA,Yuji, OZAKI,Nobuchika, SUGIMOTO,Kouji, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, OKITA, Yutaka
    Oct. 2003, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 51巻, 増刊, pp. 420-420, Japanese
    International conference proceedings

  • 60歳代症例に対する生体弁移植の中期遠隔期成績
    日野裕, HANAFUSA,Yuji, 尾崎義就, OKADA, Kenji, TSUJI,Yoshihiko, OKITA, Yutaka
    Oct. 2003, The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY, 51巻, 増刊, pp. 412-412, Japanese
    International conference proceedings

  • GOTOH,Akinobu, SHIRAKAWA, Toshiro, WADA,Yoshitaka, FUJISAWA, Masato, OKADA,Hiroshi, KAMIDONO,Sadao, Hamada K
    Aug. 2003, Bju International, Vol. 92, No. 3, pp. 314-318, English
    [Refereed]
    Scientific journal

  • 修正大血管転位症と診断され,19年後に高度左側房室弁逆流症に対して弁置換術を行った成人女性の1例
    田中秀和, KAWAI, Hiroya, 井関治, 野瀬貴久, 溝口貴裕, INOUE,Nobutaka, YOKOYAMA, Mitsuhiro, OKADA, Kenji, OKITA, Yutaka
    Jul. 2003, 日本小児循環器学会雑誌, 19巻, 4号, pp. 445-445, Japanese
    International conference proceedings

  • 閉塞性動脈硬化症に対する血行再建術の治療成績
    KITAGAWA, Atsushi, 田中陽介, 岩崎倫明, 松森正術, TANAKA, Hiroshi, 原口知則, 吉田和則, 日野裕, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Jun. 2003, 日本血管外科学会雑誌, 12巻, 3号, pp. 323-323, Japanese
    International conference proceedings

  • 複雑病変に対するendovascular surgeryの有用性
    MATSUDA,Hitoshi, 田中陽介, TANAKA, Hiroshi, 日野裕, HANAFUSA,Yuji, OZAKI,Nobuchika, SUGIMOTO,Kouji, OKADA, Kenji, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Jun. 2003, 日本血管外科学会雑誌, 12巻, 3号, pp. 408-408, Japanese
    International conference proceedings

  • 腹部大動脈瘤破裂の検討
    吉田和則, OKITA, Yutaka, TSUJI,Yoshihiko, TSUKUBE,Takuro, MATSUDA,Hitoshi, OKADA, Kenji, OZAKI,Nobuchika, HANAFUSA,Yuji
    Jun. 2003, 日本血管外科学会雑誌, 12巻, 3号, pp. 353-353, Japanese
    International conference proceedings

  • 当科における急性肺動脈塞栓症の治療経験
    日野裕, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Jun. 2003, 日本血管外科学会雑誌, 12巻, 3号, pp. 292-292, Japanese
    International conference proceedings

  • 大動脈炎症候群合併病変に対する外科治療
    松森正術, 田中陽介, 岩崎倫明, 原口知則, 吉田和則, TANAKA, Hiroshi, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Jun. 2003, 日本血管外科学会雑誌, 12巻, 3号, pp. 279-279, Japanese
    International conference proceedings

  • 臓器虚血を伴った急性大動脈解離の治療戦略
    TANAKA, Hiroshi, 原口知則, 日野裕, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, SUGIMOTO,Kouji, OKITA, Yutaka
    Jun. 2003, 日本血管外科学会雑誌, 12巻, 4号, pp. 512-512, Japanese
    International conference proceedings

  • 胸腹部大動脈瘤の術後成績についての検討 脊髄保護を中心に
    HANAFUSA,Yuji, 日野裕, 田中陽介, 岩崎倫明, 原口知則, TANAKA, Hiroshi, 松森正術, KITAGAWA, Atsushi, 吉田和則, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Jun. 2003, 日本血管外科学会雑誌, 12巻, 3号, pp. 266-266, Japanese
    International conference proceedings

  • Suprarenal,pararenal大動脈瘤手術における腎機能への影響
    田中陽介, 日野裕, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Jun. 2003, 日本血管外科学会雑誌, 12巻, 3号, pp. 363-363, Japanese
    International conference proceedings

  • MNMSに対する治療法の検討
    岩崎倫明, 田中陽介, 松森正術, 原口知則, 吉田和則, 田中裕, KITAGAWA, Atsushi, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, NAKAMURA,Masahiko, OKITA, Yutaka
    Jun. 2003, 日本血管外科学会雑誌, 12巻, 3号, pp. 345-345, Japanese
    International conference proceedings

  • B型解離性大動脈瘤は手術か保存的治療か
    原口知則, TSUJI,Yoshihiko, TSUKUBE,Takuro, MATSUDA,Hitoshi, OKADA, Kenji, OZAKI,Nobuchika, 花房雅治, 日野裕, 田中陽介, KITAGAWA, Atsushi, 松森正術, 吉田和則, 岩崎倫明, TANAKA, Hiroshi, OKITA, Yutaka
    Jun. 2003, 日本血管外科学会雑誌, 12巻, 3号, pp. 384-384, Japanese
    International conference proceedings

  • KITAGAWA, Atsushi, 田中陽介, 岩崎倫明, 松森正術, TANAKA, Hiroshi, KAWANISHI, Yujiro, 日野裕, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Apr. 2003, 日本心臓血管外科学会雑誌, 32巻, Suppl., pp. 155-155, Japanese
    International conference proceedings

  • 大動脈基部機能温存を目指した再建術の工夫
    松森正術, 田中陽介, 岩崎倫明, TANAKA, Hiroshi, KAWANISHI, Yujiro, KITAGAWA, Atsushi, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Apr. 2003, 日本外科学会雑誌, 104巻, 臨増, pp. 551-552, Japanese
    International conference proceedings

  • 重複大動脈瘤に対する治療戦略
    KITAGAWA, Atsushi, 田中陽介, 松森正術, 岩崎倫明, 原口知則, KAWANISHI, Yujiro, TANAKA, Hiroshi, 日野裕, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Apr. 2003, 日本外科学会雑誌, 104巻, 臨増, pp. 667-667, Japanese
    International conference proceedings

  • 広範囲・多発・再発大動脈瘤症例の検討
    田中陽介, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Apr. 2003, 日本外科学会雑誌, 104巻, 臨増, pp. 667-667, Japanese
    International conference proceedings

  • 血栓閉塞型大動脈解離(IMH)に対する手術適応
    岩崎倫明, 田中陽介, 松森正術, 田中裕, KAWANISHI, Yujiro, 北川敦, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Apr. 2003, 日本心臓血管外科学会雑誌, 32巻, Suppl., pp. 273-273, Japanese
    International conference proceedings

  • ステントレス生体弁(Freestyle弁)の再手術経験
    田中陽介, 松森正術, 岩崎倫明, TANAKA, Hiroshi, KAWANISHI, Yujiro, KITAGAWA, Atsushi, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Apr. 2003, 日本心臓血管外科学会雑誌, 32巻, Suppl., pp. 252-252, Japanese
    International conference proceedings

  • Marfan症候群,AAEに対する自己弁温存術式の検討
    松森正術, 田中陽介, 岩崎倫明, TANAKA, Hiroshi, KAWANISHI, Yujiro, KITAGAWA, Atsushi, HANAFUSA,Yuji, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Apr. 2003, 日本心臓血管外科学会雑誌, 32巻, Suppl., pp. 251-251, Japanese
    International conference proceedings

  • Bentall手術後の大動脈炎症候群に対し弓部全置換術を施行した一例
    松森正術, OZAKI,Nobuchika, OKADA, Kenji, MATSUDA,Hitoshi, TSUKUBE,Takuro, TSUJI,Yoshihiko, OKITA, Yutaka
    Apr. 2003, Circulation Journal, 67巻, Suppl.II, pp. 827-827, Japanese
    International conference proceedings

  • Takuro Tsukube, Masahiro Yoshimura, Hitoshi Matsuda, Kenji Okada, Ritsu Matsukawa, Yutaka Hino, Hirohisa Murakami, Yujiro Kawanishi, Yutaka Okita
    We describe the use of rib-cross thoracotomy and costal coaptation pins made with bioabsorbable poly-L-lactide for rib approximation. This thoracotomy provided an excellent intraoperative exposure of the entire descending aorta and thoracoabdominal aorta in patients with extended thoracoabdominal aortic aneurysm without increase in postoperative morbidity.
    MOSBY, INC, Jan. 2003, Journal of vascular surgery, 37(1) (1), 219 - 21, English, International magazine
    [Refereed]
    Scientific journal

  • 岡田 健次, 大北 裕
    JAPANESE SOCIETY FOR ARTIFICIAL ORGANS, Dec. 2002, 人工臓器, 31(3) (3), 79 - 81, Japanese

  • Reconstruction of right ventricular outflow tract with stentless xenografts in Ross procedure.
    Takuro Tsukube, Yujiro Kawanishi, Hirohisa Murakami, Yutaka Hino, Ritsu Matsukawa, Nobuchika Ozaki, Kenji Okada, Hitoshi Matsuda, Noboru Wakita, Masami Nishiwaki, Yutaka Okita
    To investigate whether the use of a stentless porcine aortic xenograft can be an alternative for right ventricular outflow tract (RVOT) reconstruction during the Ross procedure, 9 patients underwent the Ross procedure and RVOT reconstruction with a stentless xenograft since January 2000. After the aortic valve was replaced with a pulmonary autograft, a stentless xenograft with a xeno- pericardial roll was implanted in the RVOT. One patient required subsequent aortic valve replacement because of severe regurgitation of the pulmonary autograft. All patients recovered well from the operation. The right ventricle-pulmonary arterial pressure gradient was 18 +/- 7 mm Hg at discharge and was not significantly increased during the 2-year follow-up period. Although 1 patient died of ventricular arrhythmia 5 months after, his cardiac function was normal, and transpulmonary valve pressure was 19 mm Hg in the follow-up. The other 7 patients are currently in New York Heart Association functional Class I. Although long-term follow-up is required to explain the durability, the stentless xenograft with a pericardial roll is considered to be an alternative for reconstruction of the RVOT within 2 years after the Ross procedure.
    Dec. 2002, Artificial organs, 26(12) (12), 1055 - 9, English, International magazine
    Scientific journal

■ MISC
  • Iliac Branch Endoprosthesisを用いたステントグラフト内挿術の初期成績
    元津 倫幸, 山口 雅人, Hamada Mostafa, 佐々木 康二, 堀之内 宏樹, 上嶋 英介, 岡田 卓也, 祖父江 慶太郎, 後竹 康子, 中井 秀和, 山中 勝弘, 大村 篤史, 岡田 健次, 杉本 幸司, 村上 卓道
    (一社)日本脈管学会, Oct. 2019, 脈管学, 59(Suppl.) (Suppl.), S175 - S175, Japanese

  • 【エンドリーク】Type II endoleakの制御を目的とした術前塞栓術
    山口 雅人, 元津 倫幸, 佐々木 康二, 岡田 卓也, 小出 裕, 杉本 幸司, 村上 卓道, 後竹 康子, 中井 秀和, 山中 勝弘, 岡田 健次, 林 太郎, 川崎 竜太, 森 岳樹, 魚谷 健祐, 谷口 尚範, 福田 哲也, 宮本 直和, 坂本 憲昭
    (一社)日本インターベンショナルラジオロジー学会, Sep. 2019, 日本インターベンショナルラジオロジー学会雑誌, 34(1) (1), 28 - 35, Japanese

  • Iliac Branch Endoprosthesisを用いたステントグラフト内挿術の初期成績
    元津 倫幸, 山口 雅人, 佐々木 康二, 堀之内 宏樹, 谷 龍一郎, 上嶋 英介, 小出 裕, 岡田 卓也, 祖父江 慶太郎, 後竹 康子, 中井 秀和, 山中 勝弘, 岡田 健次, 杉本 幸司, 村上 卓道
    (一社)日本インターベンショナルラジオロジー学会, May 2019, 日本インターベンショナルラジオロジー学会雑誌, 34(Suppl.) (Suppl.), 255 - 255, Japanese

  • 当院における大動脈解離に対するTEVARの治療成績
    岡田 卓也, 山口 雅人, 佐々木 康二, 堀之内 宏樹, 元津 倫幸, 谷 龍一郎, 上嶋 英介, 小出 裕, 祖父江 慶太郎, 後竹 康子, 中井 秀和, 山中 勝弘, 岡田 健次, 杉本 幸司, 村上 卓道
    (一社)日本インターベンショナルラジオロジー学会, May 2019, 日本インターベンショナルラジオロジー学会雑誌, 34(Suppl.) (Suppl.), 259 - 259, Japanese

  • 急性大動脈解離患者における術前のフレイル評価と生命予後の関係
    山本 周平, 五味渕 俊仁, 酒井 康成, 石田 昂彬, 三澤 加代子, 岡田 健次
    (一社)日本循環器学会, Mar. 2019, 日本循環器学会学術集会抄録集, 83回, CO2 - 6, Japanese

  • Preoperative Embolization for the Prevention of Type II Endoleak
    山口雅人, 元津倫幸, 佐々木康二, 岡田卓也, 小出裕, 杉本幸司, 村上卓道, 後竹康子, 中井秀和, 山中勝弘, 岡田健次, 林太郎, 川崎竜太, 森岳樹, 魚谷健祐, 谷口尚範, 福田哲也, 宮本直和, 坂本憲昭
    2019, 日本インターベンショナルラジオロジー学会雑誌(Web), 34(1) (1)

  • Iliac Branch Endoprosthesisを用いたステントグラフト内挿術の初期成績
    元津倫幸, 山口雅人, HAMADA Mostafa, 佐々木康二, 堀之内宏樹, 上嶋英介, 岡田卓也, 祖父江慶太郎, 後竹康子, 中井秀和, 山中勝弘, 大村篤史, 岡田健次, 杉本幸司, 村上卓道
    2019, 脈管学(Web), 59(supplement) (supplement)

  • Shunsuke Miyahara, Hiroya Kano, Kenji Okada, Yutaka Okita
    OXFORD UNIV PRESS, May 2015, Interactive cardiovascular and thoracic surgery, 20(5) (5), 687 - 8, English, International magazine

  • EVAR後type II endoleakに対する治療成績
    野村 佳克, 山中 勝弘, 深瀬 圭吾, 後竹 康子, 小原 大見, 井澤 直人, 白坂 知識, 宮原 俊介, 坂本 敏仁, 井上 武, 松森 正術, 山口 雅人, 杉本 幸司, 岡田 健次, 大北 裕
    (NPO)日本血管外科学会, Apr. 2014, 日本血管外科学会雑誌, 23(2) (2), 396 - 396, Japanese

  • OP-098-7 異型大動脈縮窄症に対するextra-anatomical bypass(EAB)の検討(OP-098 大血管 胸部・その他,一般演題,第114回日本外科学会定期学術集会)
    村上 優, 松森 正術, 陽川 孝樹, 後竹 康子, 小原 大見, 井澤 直人, 白坂 知識, 宮原 俊介, 山中 勝弘, 坂本 敏仁, 野村 佳克, 深瀬 圭吾, 井上 武, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2014, 日本外科学会雑誌, 115(2) (2), 489 - 489, Japanese

  • OP-097-3 解離性大動脈瘤のTEVAR術後に生じた大動脈食道ろうに対して根治術を思考した1例(OP-097 心臓 その他,一般演題,第114回日本外科学会定期学術集会)
    後竹 康子, 野村 佳克, 宮原 俊介, 山中 勝弘, 村上 優, 陽川 考樹, 小原 大見, 井澤 直人, 白坂 知識, 坂本 敏仁, 深瀬 圭吾, 井上 武, 松森 正術, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2014, 日本外科学会雑誌, 115(2) (2), 486 - 486, Japanese

  • OP-097-7 慢性血栓塞栓性肺高血圧症手術症例の検討(OP-097 心臓 その他,一般演題,第114回日本外科学会定期学術集会)
    中井 秀和, 村上 優, 陽川 孝樹, 後竹 康子, 白坂 知識, 宮原 俊介, 山中 勝弘, 井澤 直人, 坂本 敏仁, 野村 佳克, 井上 武, 松森 正術, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2014, 日本外科学会雑誌, 115(2) (2), 487 - 487, Japanese

  • PS-097-7 急性Stanford A型大動脈解離に対する大動脈基部置換術の遠隔期成績(PS-097 大血管 その他,ポスターセッション,第114回日本外科学会定期学術集会)
    宮原 俊介, 井澤 直人, 白坂 知識, 山中 勝弘, 坂本 敏仁, 野村 佳克, 深瀬 圭吾, 井上 武, 松森 正術, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2014, 日本外科学会雑誌, 115(2) (2), 769 - 769, Japanese

  • PS-095-6 腎動脈下大動脈の屈曲がEVAR後の長期成績に与える影響(PS-095 大血管 ステントグラフト1,ポスターセッション,第114回日本外科学会定期学術集会)
    野村 佳克, 山中 勝弘, 深瀬 圭吾, 井戸口 孝二, 山口 雅人, 杉本 幸司, 村上 優, 陽川 孝樹, 後竹 康子, 小原 大見, 井澤 直人, 宮原 俊介, 白坂 知識, 坂本 敏仁, 井上 武, 松森 正術, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2014, 日本外科学会雑誌, 115(2) (2), 765 - 765, Japanese

  • PS-170-5 人工血管が存在する縦隔洞炎に対する持続吸引洗浄の有用性(PS-170 心臓 その他-2,ポスターセッション,第114回日本外科学会定期学術集会)
    陽川 孝樹, 村上 優, 後竹 康子, 小原 大見, 井澤 直人, 白坂 知識, 宮原 俊介, 山中 勝弘, 坂本 敏仁, 野村 佳克, 深瀬 圭吾, 井上 武, 松森 正術, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2014, 日本外科学会雑誌, 115(2) (2), 915 - 915, Japanese

  • 腎動脈下大動脈の屈曲がEVAR後の長期成績に与える影響
    野村 佳克, 山中 勝弘, 深瀬 圭吾, 井戸口 孝二, 山口 雅人, 杉本 幸司, 村上 優, 陽川 孝樹, 後竹 康子, 小原 大見, 井澤 直人, 宮原 俊介, 白坂 知識, 坂本 敏仁, 井上 武, 松森 正術, 岡田 健次, 大北 裕
    (一社)日本外科学会, Mar. 2014, 日本外科学会雑誌, 115(臨増2) (臨増2), 765 - 765, Japanese

  • 循環器病の診断と治療に関するガイドライン(2011年度合同研究班報告) 【ダイジェスト版】弁膜疾患の非薬物治療に関するガイドライン(2012年改訂版)
    大北 裕, 岡田 行功, 尾辻 豊, 米田 正始, 中谷 敏, 松崎 益徳, 吉田 清, 小林 順二郎, 澤 芳樹, 高梨 秀一郎, 渡辺 弘之, Okada Kenji, 黒澤 博身, 高本 眞一, 鄭 忠和, 吉川 純一
    Jul. 2013, 日本心臓血管外科学会雑誌, 42(4号) (4号), 1 - 27, Japanese
    [Invited]
    Introduction scientific journal

  • Kenji Okada, Yutaka Okita
    Delayed diagnosis or surgery sometimes causes more extensive destruction of aortic periannular abscess, or pseudoaneurysm, resulting in left ventricular-aortic discontinuity, particularly in patients with prosthetic valve endocarditis. The condition complicates the surgical procedures and causes worsening of short- and long-term outcomes. In-hospital mortality in patients with prosthetic valve endocarditis has been reported to be as high as 15-20 %, even at leading hospitals in the world. Contemporary modes of surgery for periannular abscess/pseudoaneurysm involve drainage of the cavity, radical debridement of necrotic tissue, annular reconstruction of the destroyed annulus, and root replacement using an optimal conduit. Radical debridement is of primary importance and is the universally accepted procedure, which frequently requires annular reconstruction using a pericardial patch. Conventional aortic valve replacement using a mechanical or stented biological valve, aortic valve replacement with translocation, aortic root replacement using an allograft, pulmonary autograft (Ross procedure), stentless biological valve, or a composite graft are conduits of choice. All things considered, allograft is believed to be the best conduit for a destroyed annulus because of better fit and its resistance to infection; however, recent reports have failed to confirm the superiority of allograft over other conduits in terms of long-term survival and freedom from reoperation/recurrence of infection. Short- and long-term outcomes have been studies for every type of conduit, but the selection of conduits for aortic root replacement is still controversial.
    Apr. 2013, General thoracic and cardiovascular surgery, 61(4) (4), 175 - 81, English, Domestic magazine
    [Refereed]

  • RSF-12-4 異型大動脈縮窄症に対し非解剖学バイパス術を行った1例(RSF 研修医の発表セッション,第113回日本外科学会定期学術集会)
    村上 優, 大村 篤史, 小原 大見, 山中 勝弘, 南 一司, 中井 秀和, 木下 史子, 後竹 康子, 白坂 知識, 宮原 俊介, 坂本 敏仁, 竹歳 秀人, 野村 佳克, 井上 武, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2013, 日本外科学会雑誌, 114(2) (2), 1079 - 1079, Japanese

  • PS-159-6 腹部大動脈瘤形成過程における酸化ストレスの重要性(PS ポスターセッション,第113回日本外科学会定期学術集会)
    森本 圭介, 岡田 健次, 包 烏蘭, 干 潔, 魚 振海, 田中 亜紀子, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2013, 日本外科学会雑誌, 114(2) (2), 741 - 741, Japanese

  • PS-034-2 活動期感染性心内膜炎に対する僧帽弁形成術(PS ポスターセッション,第113回日本外科学会定期学術集会)
    南 一司, 木下 史子, 後竹 康子, 中井 秀和, 小原 大見, 竹歳 秀人, 山中 勝弘, 宮原 俊介, 白坂 知識, 野村 佳克, 坂本 敏仁, 大村 篤史, 井上 武, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2013, 日本外科学会雑誌, 114(2) (2), 564 - 564, Japanese

  • PS-030-1 超高齢者大動脈弁狭窄に対する大動脈弁置換術からの検討 : どのような症例に低侵襲治療が望まれるか(PS ポスターセッション,第113回日本外科学会定期学術集会)
    井上 武, 木下 史子, 後竹 康子, 中井 秀和, 小原 大見, 竹歳 秀人, 山中 勝弘, 白坂 知識, 野村 佳克, 坂本 敏仁, 大村 篤史, 南 一司, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2013, 日本外科学会雑誌, 114(2) (2), 559 - 559, Japanese

  • PS-279-3 弓部大動脈置換術におけるThromboelastometry(ROTEM(R))の使用経験(PS ポスターセッション,第113回日本外科学会定期学術集会)
    中井 秀和, 木下 史子, 後竹 康子, 小原 大見, 白坂 知識, 宮原 俊介, 竹歳 秀人, 大村 篤史, 坂本 敏仁, 野村 佳克, 井上 武, 南 一司, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2013, 日本外科学会雑誌, 114(2) (2), 910 - 910, Japanese

  • PD-10-5 急性A型大動脈解離の遠隔成績(PD パネルディスカッション,第113回日本外科学会定期学術集会)
    大村 篤史, 山中 勝弘, 小原 大見, 南 一司, 中井 秀和, 木下 史子, 後竹 康子, 白坂 知識, 宮原 俊介, 坂本 敏仁, 竹歳 秀人, 野村 佳克, 井上 武, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2013, 日本外科学会雑誌, 114(2) (2), 254 - 254, Japanese

  • SF-040-5 エダラボンの抗酸化作用によるラット腹部大動脈瘤抑制効果の検討(SF-040 サージカルフォーラム(40)大血管 基礎,第112回日本外科学会定期学術集会)
    森本 圭介, 長谷川 智巳, 田中 亜紀子, 包 鳥蘭, 于 潔, 森本 直人, 大北 裕, 岡田 健次
    一般社団法人日本外科学会, 05 Mar. 2012, 日本外科学会雑誌, 113(2) (2), 339 - 339, Japanese

  • SF-041-1 高齢者における大動脈弓部全置換術(SF-041 サージカルフォーラム(41)大血管 胸部,第112回日本外科学会定期学術集会)
    岡田 健次, 大村 篤史, 佐藤 雅信, 小原 大見, 山中 勝弘, 宮原 俊介, 白坂 知識, 坂本 敏仁, 田中 亜紀子, 井上 武, 岡 隆紀, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2012, 日本外科学会雑誌, 113(2) (2), 339 - 339, Japanese

  • SF-040-3 アスコルビン酸徐放ハイドロゲルシートを用いた大動脈瘤の抑制(続報)(SF-040 サージカルフォーラム(40)大血管 基礎,第112回日本外科学会定期学術集会)
    田中 亜紀子, 小原 大見, 白坂 知識, 宮原 俊介, 山中 勝弘, 大村 篤史, 坂本 敏仁, 野村 佳克, 井上 武, 岡 隆紀, 南 一司, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2012, 日本外科学会雑誌, 113(2) (2), 338 - 338, Japanese

  • VWS-1-5 機能的重症憎帽弁逆流に対する自己弁温存憎帽弁置換術の治療成績(VWS-1 ビデオワークショップ(1)機能的僧帽弁逆流に対する術式の工夫,第112回日本外科学会定期学術集会)
    吉田 和則, 宮原 俊介, 山中 勝弘, 大村 篤史, 坂本 敏仁, 野村 佳克, 田中 亜紀子, 井上 武, 岡 隆紀, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2012, 日本外科学会雑誌, 113(2) (2), 261 - 261, Japanese

  • PS-105-8 脳内酸素モニタリングは大動脈弓部全置換術後の覚醒遅延を予測しうるか?(PS-105 大血管 胸部,ポスターセッション,第112回日本外科学会定期学術集会)
    白坂 知識, 岡田 健次, 加納 寛也, 佐藤 雅信, 小原 大見, 宮原 俊介, 山中 勝弘, 大村 篤史, 坂本 敏仁, 野村 佳克, 田中 亜紀子, 井上 武, 岡 隆紀, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2012, 日本外科学会雑誌, 113(2) (2), 702 - 702, Japanese

  • VSY-6-5 当科における大動脈弁温存手術(VSY-6 ビデオシンポジウム(6)大動脈弁形成術および大動脈弁温存手術-適応と術式-,第112回日本外科学会定期学術集会)
    岡 隆紀, 佐藤 雅信, 竹歳 秀人, 小原 大見, 白坂 知識, 山中 勝弘, 宮原 俊介, 野村 佳克, 坂本 敏仁, 大村 篤史, 田中 亜紀子, 井上 武, 南 一司, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2012, 日本外科学会雑誌, 113(2) (2), 184 - 184, Japanese

  • PS-154-1 自己弁温存大動脈基部置換術前後の弁形状の変化が遠隔期AR再発に及ぼす影響(心臓弁膜症,ポスターセッション,第112回日本外科学会定期学術集会)
    宮原 俊介, 小原 大見, 白坂 知識, 山中 勝弘, 大村 篤史, 坂本 敏仁, 野村 佳克, 田中 亜紀子, 井上 武, 岡 隆紀, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2012, 日本外科学会雑誌, 113(2) (2), 799 - 799, Japanese

  • PS-153-6 ステントレス生体弁を用いた成人期右室流出路再建後の遠隔成績 : Ross手術を含めて(心臓小児・弁膜症,ポスターセッション,第112回日本外科学会定期学術集会)
    井上 武, 小原 大見, 佐藤 雅信, 宮原 俊介, 山中 勝弘, 白坂 知識, 野村 佳克, 坂本 敏仁, 大村 篤史, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2012, 日本外科学会雑誌, 113(2) (2), 798 - 798, Japanese

  • SF-107-3 胸部大動脈感染病変に対する治療経験(SF-107 サージカルフォーラム(107)大血管 胸腹部,第112回日本外科学会定期学術集会)
    山中 勝弘, 佐藤 雅信, 小原 大見, 白坂 知識, 宮原 俊介, 野村 佳克, 坂本 敏仁, 大村 篤史, 田中 亜紀子, 井上 武, 岡 隆起, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2012, 日本外科学会雑誌, 113(2) (2), 431 - 431, Japanese

  • Free Radical Scavenger Edaravone Inhibited Both Aneurysmal Formation and Progression in Rat Abdominal Aortic Aneurysm Model
    Keisuke Morimoto, Tomomi Hasegawa, Akiko Tanaka, Naoto Morimoto, Yutaka Okita, Kenji Okada
    LIPPINCOTT WILLIAMS & WILKINS, Nov. 2011, CIRCULATION, 124(21) (21), English
    Summary international conference

  • WS-5-3 Marfan症候群におけ心大血管病変に対する治療(WS5 ワークショップ(5)心大血管病変を有するマルファン症候群に対する集学的治療,第111回日本外科学会定期学術集会)
    田中 亜紀子, 宮原 俊介, 大村 篤史, 坂本 敏仁, 野村 拓生, 野村 佳克, 藤田 靖之, 宗像 宏, 岡 隆紀, 南 一司, 北川 敦士, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 25 May 2011, 日本外科学会雑誌, 112(1) (1), 294 - 294, Japanese

  • SF-065-2 弁形成術を加えた自己弁温存大動脈基部置換術の中期遠隔成績(SF-065 サージカルフォーラム(65)心臓:手術-1,第111回日本外科学会定期学術集会)
    岡 隆紀, 佐藤 雅信, 宮原 俊介, 野村 拓生, 野村 佳克, 坂本 敏仁, 大村 篤史, 藤田 靖之, 田中 亜紀子, 宗像 宏, 井上 武, 南 一司, 北川 敦士, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 25 May 2011, 日本外科学会雑誌, 112(1) (1), 416 - 416, Japanese

  • PS-007-1 心臓血管外科領域における重症患者の栄養状態悪化の危険因子の検討(PS-007 ポスターセッション(7)心臓:周術期管理-2,第111回日本外科学会定期学術集会)
    宮原 俊介, 佐藤 雅信, 白坂 知識, 大村 厚史, 坂本 敏仁, 野村 拓生, 野村 佳克, 田中 亜紀子, 藤田 靖之, 宗像 宏, 井上 武, 岡 隆紀, 南 一司, 北川 敦士, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 25 May 2011, 日本外科学会雑誌, 112(1) (1), 518 - 518, Japanese

  • PS-006-5 ナファモスタットメシル酸塩併用によるヘパリンを減量した体外循環の検討(PS-006 ポスターセッション(6)心臓:周術期管理-1,第111回日本外科学会定期学術集会)
    坂本 敏仁, 佐藤 雅信, 宮原 俊介, 大村 篤史, 野村 拓生, 野村 佳克, 田中 亜紀子, 藤田 靖之, 宗像 宏, 井上 武, 北川 敦士, 岡 隆紀, 南 一司, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 25 May 2011, 日本外科学会雑誌, 112(1) (1), 517 - 517, Japanese

  • VW-6-8 TEVAR後の合併症に対する再開胸症例の検討(VW6 ビデオワークショップ(6) 胸部大動脈疾患に対する手技的工夫,第111回日本外科学会定期学術集会)
    井上 武, 佐藤 雅信, 白坂 知識, 宮原 俊介, 大村 篤史, 坂本 敏仁, 野村 佳克, 野村 拓生, 田中 亜紀子, 藤田 靖之, 宗像 宏, 岡 隆紀, 南 一司, 北川 敦士, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 25 May 2011, 日本外科学会雑誌, 112(1) (1), 320 - 320, Japanese

  • SF-101-2 急性B型大動脈解離遠隔期の成績(サージカルフォーラム(101)大血管:手術-1,第111回日本外科学会定期学術集会)
    宗像 宏, 佐藤 雅信, 白坂 知識, 宮原 俊介, 野村 拓生, 野村 佳克, 坂本 敏仁, 大村 篤史, 田中 亜紀子, 井上 武, 岡 隆紀, 南 一司, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 25 May 2011, 日本外科学会雑誌, 112(1) (1), 461 - 461, Japanese

  • OP-178-1 大動脈弁形成術の手術・遠隔期成績(心臓-6,一般口演,第110回日本外科学会定期学術集会)
    野村 佳克, 白坂 知識, 野村 拓生, 坂本 敏仁, 大村 篤史, 田中 亜紀子, 宗像 宏, 松森 正術, 岡 隆紀, 長谷川 智巳, 南 一司, 北川 敦士, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2010, 日本外科学会雑誌, 111(2) (2), 560 - 560, Japanese

  • SV-2-3-1 自己弁を温存した大動脈基部置換術(心臓・血管-3,特別ビデオセッション2,第110回日本外科学会定期学術集会)
    大北 裕, 松森 正術, 宗像 宏, 南 和司, 岡 隆紀, 岡田 健次
    一般社団法人日本外科学会, 05 Mar. 2010, 日本外科学会雑誌, 111(2) (2), 51 - 51, Japanese

  • SF-065-4 自己弁温存大動脈基部置換術再手術症例の検討(心臓,サージカルフォーラム,第110回日本外科学会定期学術集会)
    松森 正術, 白坂 知識, 坂本 敏仁, 野村 拓生, 野村 佳克, 大村 篤史, 藤田 靖之, 田中 亜紀子, 宗像 宏, 南 一司, 長谷川 智己, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2010, 日本外科学会雑誌, 111(2) (2), 266 - 266, Japanese

  • OP-160-5 胸腹部大動脈瘤手術における肋間動脈再建の検討(大血管-4,一般口演,第110回日本外科学会定期学術集会)
    大村 篤史, 泉 聡, 田中 亜紀子, 宗像 宏, 松森 正術, 岡 隆紀, 南 一司, 長谷川 智巳, 北川 敦士, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2010, 日本外科学会雑誌, 111(2) (2), 537 - 537, Japanese

  • OP-267-3 大動脈瘤形成における組織型トランスグルタミナーゼの役割に関する実験的検討(血管基礎,一般口演,第110回日本外科学会定期学術集会)
    長谷川 智巳, 宗実 孝, 蘇日 他拉, 田中 亜紀子, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2010, 日本外科学会雑誌, 111(2) (2), 700 - 700, Japanese

  • OP-267-5 ピオグリタゾン徐放ゼラチンシートによる静脈グラフト劣化抑制効果に関する実験的検討(血管基礎,一般口演,第110回日本外科学会定期学術集会)
    陳 志, 長谷川 智巳, 田中 亜紀子, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2010, 日本外科学会雑誌, 111(2) (2), 700 - 700, Japanese

  • SF-050-5 アスコルビン酸徐放ゼラチンシートを用いた大動脈瘤発生の抑制(血管-1,サージカルフォーラム,第110回日本外科学会定期学術集会)
    田中 亜紀子, 陳 志, 長谷川 智巳, 岡田 健次, 田畑 康彦, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2010, 日本外科学会雑誌, 111(2) (2), 246 - 246, Japanese

  • SF-050-3 B型大動脈解離の遠隔期おける偽腔血流形態の重要性(血管-1,サージカルフォーラム,第110回日本外科学会定期学術集会)
    宗像 宏, 白坂 知識, 野村 拓生, 野村 佳克, 大村 篤史, 坂本 敏仁, 藤田 靖之, 松森 正術, 南 一司, 岡 隆紀, 長谷川 智巳, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2010, 日本外科学会雑誌, 111(2) (2), 246 - 246, Japanese

  • OP-007-4 高齢者弁膜症手術の成績と問題点(心・高齢者-2,一般口演,第110回日本外科学会定期学術集会)
    南 一司, 白坂 知識, 野村 拓生, 野村 佳克, 坂本 敏仁, 大村 篤史, 藤田 靖之, 田中 亜紀子, 宗像 宏, 松森 正術, 岡 隆紀, 北川 敦士, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2010, 日本外科学会雑誌, 111(2) (2), 309 - 309, Japanese

  • OP-177-2 両側もしくは片側内胸動脈使用が冠動脈バイパス術遠隔成績に与える影響(心臓-5,一般口演,第110回日本外科学会定期学術集会)
    岡田 健次, 大村 篤志, 白坂 知識, 野村 拓生, 野村 佳克, 坂本 敏仁, 藤田 靖之, 田中 亜紀子, 宗像 宏, 松森 正術, 岡 隆紀, 南 一司, 北川 敦士, 長谷川 智己, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2010, 日本外科学会雑誌, 111(2) (2), 560 - 560, Japanese

  • OP-173-5 上行大動脈遮断を要する心臓手術における術後脳合併症リスクの検討(心臓-1,一般口演,第110回日本外科学会定期学術集会)
    白坂 知識, 田中 亜希子, 宗像 宏, 松森 正術, 岡 隆紀, 南 一司, 長谷川 智巳, 北川 敦士, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2010, 日本外科学会雑誌, 111(2) (2), 556 - 556, Japanese

  • OP-173-4 出血性合併症を有する患者に対する体外循環時ヘパリン減量のための工夫 : メシル酸ナファモスタットを併用した抗凝固による体外循環(心臓-1,一般口演,第110回日本外科学会定期学術集会)
    坂本 敏仁, 白坂 知識, 大村 篤史, 野村 拓生, 野村 佳克, 田中 亜紀子, 藤田 靖之, 宗像 宏, 松森 正術, 岡 隆紀, 北川 敦士, 南 一司, 長谷川 智巳, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2010, 日本外科学会雑誌, 111(2) (2), 556 - 556, Japanese

  • 第40回日本心臓血管外科学術集会印象記
    Okada Kenji
    2010, 循環制御, 31巻, 1, pp. 1-3, Japanese
    Introduction scientific journal

  • Okada Kenji
    2010, 循環器専門医, 18巻, 2, pp. 312-316, Japanese
    Introduction scientific journal

  • 急性A型大動脈解離を未然に防ぐ上行大動脈置換術
    Okada Kenji
    Nov. 2009, 循環器科, 66巻, 5号, pp. 550-554, Japanese
    Introduction scientific journal

  • 人工臓器としてのステントグラフト 素材とデザインの問題点 自作ステントグラフトによるTEVARの遠隔成績
    北川 敦士, 田中 亜希子, 宗像 宏, 松森 正術, 南 一司, 長谷川 智巳, 岡田 健次, 山口 雅人, 杉本 幸司, 杉村 和朗, 大北 裕
    (一社)日本人工臓器学会, Oct. 2009, 人工臓器, 38(2) (2), S - 37, Japanese

  • [Does aortic cusp repair influence the outcome of valve sparing aortic root replacement?]
    Okada Kenji
    Oct. 2009, Kyobu Geka, 62(11) (11), 971 - 7, English
    [Refereed]
    Introduction scientific journal

  • 【臨床に必要な感染性心内膜炎の知識】 外科治療 手術手技を中心に
    Okada Kenji
    Jun. 2009, CIRCULATION Up-to-Date, 4巻, 3号, pp. 347-354, Japanese
    Introduction scientific journal

  • EVAR : Is it Available for Most of Japanese AAA Patients?
    KITAGAWA Atsushi, OKADA Kenji, HASEGAWA Tomomi, MINAMI Kazushi, MATSUMORI Masamichi, MUNAKATA Hiroshi, NOMURA Yoshikatsu, YAMAGUCHI Masato, SUGIYAMA Kazuro, SUGIMOTO Koji
    14 Apr. 2009, 日本血管外科学会雑誌 = The Japanese journal of vascular surgery : official journal of the Japanese Society for Vascular Surgery, 18(2) (2), 145 - 145, English

  • 医療コストからみた血管外科治療 胸部下行大動脈瘤における医療コストの比較 Open surgery vs TEVAR
    野村 佳克, 北川 敦士, 大北 裕, 岡田 健次, 長谷川 智巳, 南 一司, 松森 正術, 宗像 宏, 高橋 宏明, 田中 亜紀子, 大村 篤史, 坂本 敏仁, 山口 雅人, 杉村 和朗, 杉本 幸司
    (NPO)日本血管外科学会, Apr. 2009, 日本血管外科学会雑誌, 18(2) (2), 182 - 182, Japanese

  • 当院に於ける腹部大動脈瘤に対するステントグラフトの早期成績と適応の限界
    野村 佳克, 北川 敦士, 白坂 知識, 坂本 敏仁, 大村 篤史, 野村 拓生, 田中 亜希子, 高橋 宏明, 宗像 宏, 松森 正樹, 長谷川 智巳, 岡田 健次, 大北 裕, 山口 雅人, 杉本 幸司
    (NPO)日本血管外科学会, Apr. 2009, 日本血管外科学会雑誌, 18(2) (2), 292 - 292, Japanese

  • 緊急手術を要する胸部下行大動脈瘤の治療選択 胸部下行大動脈破裂 TEVARとopen surgeryの比較と問題点
    北川 敦士, 大北 裕, 岡田 健次, 長谷川 智己, 南 一司, 松森 正術, 宗像 宏, 野村 佳克, 田中 亜希子, 高橋 宏明, 泉 聡, 大村 篤史, 山口 雅人, 杉村 和朗, 杉本 幸司
    (NPO)日本心臓血管外科学会, Mar. 2009, 日本心臓血管外科学会雑誌, 38(Suppl.) (Suppl.), 134 - 134, Japanese

  • HP-095-7 感染性胸部大動脈瘤に対する治療方針(大血管1,ハイブリッドポスター,第109回日本外科学会定期学術集会)
    中井 秀和, 小原 大見, 白坂 知識, 野村 拓生, 野村 佳克, 坂本 敏仁, 大村 篤史, 泉 聡, 田中 亜紀子, 高橋 宏明, 宗像 宏, 松森 正術, 北川 敦士, 長谷川 智巳, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 25 Feb. 2009, 日本外科学会雑誌, 110(2) (2), 558 - 558, Japanese

  • SF-096-6 ピオグリタゾンによる静脈グラフト劣化抑制効果に関する実験的検討(大血管4,サージカルフォーラム,第109回日本外科学会定期学術集会)
    陳 志, 岡田 健次, 長谷川 智巳, 田中 亜紀子, 大北 裕
    一般社団法人日本外科学会, 25 Feb. 2009, 日本外科学会雑誌, 110(2) (2), 344 - 344, Japanese

  • SF-065-5 自己弁温存大動脈基部置換術に及ぼす大動脈基部径の影響(心臓1,サージカルフォーラム,第109回日本外科学会定期学術集会)
    松森 正術, 中井 秀和, 小原 大見, 白坂 知識, 坂本 敏仁, 野村 拓生, 野村 佳克, 大村 篤史, 田中 亜紀子, 高橋 宏明, 宗像 宏, 長谷川 智巳, 北川 敦士, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 25 Feb. 2009, 日本外科学会雑誌, 110(2) (2), 306 - 306, Japanese

  • VW-2-5 神戸大学病院における弓部大動脈瘤手術のスタンダード(虚血性心臓病と胸部大動脈瘤-教育病院における手術のスタンダード,ビデオワークショップ,第109回日本外科学会定期学術集会)
    長谷川 智巳, 中井 秀和, 白坂 知識, 坂本 敏仁, 大村 篤史, 野村 拓生, 野村 佳克, 田中 亜紀子, 高橋 宏明, 宗像 宏, 松森 正術, 北川 敦志, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 25 Feb. 2009, 日本外科学会雑誌, 110(2) (2), 182 - 182, Japanese

  • SF-096-2 大動脈遮断中の血圧が脊髄虚血に及ぼす影響に関する実験的検討(大血管4,サージカルフォーラム,第109回日本外科学会定期学術集会)
    泉 聡, 岡田 健次, 長谷川 智巳, 大北 裕
    一般社団法人日本外科学会, 25 Feb. 2009, 日本外科学会雑誌, 110(2) (2), 343 - 343, Japanese

  • HP-119-5 狭小大動脈弁輪症例に対する生体弁置換術症例の検討(心臓:後天性疾患(手術1),ハイブリッドポスター,第109回日本外科学会定期学術集会)
    高橋 宏明, 田中 亜紀子, 宗像 宏, 松森 正術, 長谷川 智巳, 北川 敦士, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 25 Feb. 2009, 日本外科学会雑誌, 110(2) (2), 599 - 599, Japanese

  • VSY-3-6 弁輪破壊症例に対する弁膜症再手術症例の検討(心臓弁膜症に対する外科治療-弁膜症再手術のpitfalls-,ビデオシンポジウム,第109回日本外科学会定期学術集会)
    岡田 健次, 高橋 宏明, 中井 秀和, 白坂 知識, 野村 拓生, 坂本 敏仁, 大村 篤志, 田中 亜紀子, 宗像 宏, 松森 正術, 長谷川 智己, 大北 裕
    一般社団法人日本外科学会, 25 Feb. 2009, 日本外科学会雑誌, 110(2) (2), 117 - 117, Japanese

  • 血管外科におけるカテーテル治療 胸部大動脈破裂に対する検討 TEVAR vs open surgery
    北川 敦士, 大北 裕, 岡田 健次, 長谷川 智己, 松森 正術, 宗像 宏, 野村 佳克, 山口 雅人, 杉村 和朗, 杉本 幸司
    (一社)日本外科学会, Feb. 2009, 日本外科学会雑誌, 110(臨増2) (臨増2), 185 - 185, Japanese

  • In situで自己組織化するTissue-Engineered Vascular wall patchの肺動脈移植実験の検討
    高橋宏明, 澤芳樹, 内村英一郎, 齋藤充弘, 加来永一, 平川公一郎, 岡田健次, 大北裕
    2009, 医工学治療, 21(Supplement) (Supplement)

  • 日本人におけるEVAR(Endovascular Aneurysm Repair)の解剖学的適合性
    北川 敦士, 大北 裕, 岡田 健次, 森本 喜久, 松森 正術, 宗像 宏, 川崎 竜太, 山口 雅人, 杉村 和朗, 杉本 幸司
    (一社)日本インターベンショナルラジオロジー学会, Jan. 2009, IVR: Interventional Radiology, 24(Suppl.) (Suppl.), 28 - 29, Japanese

  • 【感染性心臓・大動脈疾患の治療】 感染性心内膜炎 大動脈弁および大動脈弁位人工弁
    Okada Kenji
    Jan. 2009, 日本外科学会雑誌, 110巻, 1号, pp. 7-11, Japanese
    Introduction scientific journal

  • [Surgery for aortic valve endocarditis].
    Kenji Okada, Yutaka Okita
    Infective endocarditis is a life-threatening disease that should be diagnosed based on Duke's criteria as early as possible. A positive blood culture and echocardiographic findings, particularly those of a transesophageal echocardiogram, play a pivotal role in the process of confirming a diagnosis. Medical treatment using appropriate antibiotics against the identified microorganism is of primary importance, although infective endocarditis is often accompanied by intracardiac or extracardiac complications and must be converted to surgery. The timing of surgery for patients with brain complications is crucial but still controversial because the usage of heparin for cardiopulmonary bypass (CPB) may cause the complications to deteriorate. We demonstrated that a novel CPB strategy with nafamostat mesilate as an anticoagulant may be potentially safe and useful in preventing deterioration of recent intracranial hemorrhage. Destructive aortic valve endocarditis causes the development of left ventricular-aortic discontinuity. In the past 8 years, 9 patients with left ventricular-aortic discontinuity underwent aortic root replacement in our institution. Radical debridement of the aortic root abscess was performed in all cases, followed by aortic root replacement with a pulmonary autograft (Ross procedure) or a stentless aortic root xenograft. No mortality was observed during hospitalization and follow-up. Freedom from major adverse cardiac events was noted in 67% of the patients at 5 years.
    Jan. 2009, Nihon Geka Gakkai zasshi, 110(1) (1), 7 - 11, Japanese, Domestic magazine

  • 136) 大動脈弁断裂の1例(第105回日本循環器学会近畿地方会)
    今西 純一, 高野 貴継, 正井 博之, 清水 雅俊, 三輪 陽一, 岡田 健次, 大北 裕
    社団法人日本循環器学会, 20 Oct. 2008, Circulation journal : official journal of the Japanese Circulation Society, 72, 1106 - 1106, Japanese

  • 194) San Diego分類3型慢性肺動脈血栓塞栓症に対する肺動脈内膜摘除術(第105回日本循環器学会近畿地方会)
    森本 直人, 坂本 敏仁, 野村 拓生, 田中 亜紀子, 高橋 宏明, 宗像 宏, 松森 正術, 北川 敦士, 森本 喜久, 岡田 健次, 大北 裕
    社団法人日本循環器学会, 20 Oct. 2008, Circulation journal : official journal of the Japanese Circulation Society, 72, 1112 - 1112, Japanese

  • 【大動脈瘤 基礎と臨床】 急性大動脈解離に対する外科治療と問題点
    Okada Kenji
    Sep. 2008, 医学のあゆみ, 226巻, 10号, pp. 905-913, Japanese
    Introduction scientific journal

  • 【手術手順・看護のポイントがわかる 実践心臓血管外科手術マニュアル】 心臓血管外科領域で扱う疾患 弁膜疾患
    Okada Kenji
    Sep. 2008, オペナーシング, 巻, 2008秋季増刊, pp. 14-23, Japanese
    Introduction scientific journal

  • Stenting of Left Main Trunk Occlusion due to Type A Aortic Dissection as a Bridge to Definitive Surgery
    SHIMIZU Masatoshi, MATSUKAWA Ritsu, OKADA Kenji, TAKANO Takatsugu, MASAI Hiroyuki, OKITA Yutaka
    日本心臓病学会, 15 Jul. 2008, J Cardiol Jpn Ed, 2(1) (1), 62 - 68, Japanese

  • DP-107-2 血栓閉鎖型急性A型大動脈解離に対する治療成績(第108回日本外科学会定期学術集会)
    田中 亜紀子, 小竹 淳一朗, 宮原 俊介, 坂本 敏仁, 野村 拓生, 泉 聡, 高橋 英樹, 高橋 宏明, 宗像 宏, 森本 直人, 浅野 満, 松森 正術, 北川 敦士, 森本 喜久, 岡田 健次
    一般社団法人日本外科学会, 25 Apr. 2008, 日本外科学会雑誌, 109(2) (2), 558 - 558, Japanese

  • DP-109-2 イヌ全脳虚血モデルを使用した再還流障害軽減のための研究(第108回日本外科学会定期学術集会)
    宗像 宏, 岡田 健次, 日野 裕, 泉 聡, 野村 拓生, 坂本 敏仁, 田中 亜紀子, 森本 直人, 高橋 英樹, 松森 正術, 浅野 満, 北川 敦士, 森本 喜久, 大北 裕
    一般社団法人日本外科学会, 25 Apr. 2008, 日本外科学会雑誌, 109(2) (2), 562 - 562, Japanese

  • VS-2-4 活動期感染性心内膜炎,僧帽弁閉鎖不全に対する外科治療のTips and Pitfall(第108回日本外科学会定期学術集会)
    浅野 満, 宮原 俊介, 野村 拓生, 坂本 敏仁, 田中 亜紀子, 泉 聡, 高橋 英樹, 森本 直人, 宗像 宏, 松森 正術, 北川 敦士, 森本 喜久, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 25 Apr. 2008, 日本外科学会雑誌, 109(2) (2), 104 - 104, Japanese

  • PD-2-4 頚動脈病変を伴うCABG症例の周術期脳梗塞予防戦略(第108回日本外科学会定期学術集会)
    岡田 健次, 泉 聡, 野村 拓生, 宮原 俊介, 坂本 敏仁, 田中 亜紀子, 高橋 英樹, 高橋 宏明, 宗像 宏, 森本 直人, 松森 正術, 浅野 満, 森本 喜久, 大北 裕
    一般社団法人日本外科学会, 25 Apr. 2008, 日本外科学会雑誌, 109(2) (2), 122 - 122, Japanese

  • SF-018-5 全身血圧の脊髄虚血に及ぼす影響に関する実験的検討(第108回日本外科学会定期学術集会)
    泉 聡, 岡田 健次, Bishow Pokhrel, 小竹 淳一朗, 宮原 俊介, 坂本 敏仁, 野村 拓生, 田中 亜紀子, 高橋 英樹, 高橋 宏明, 森本 直人, 宗像 宏, 浅野 満, 松森 正術, 北川 敦士, 森本 喜久, 大北 裕
    一般社団法人日本外科学会, 25 Apr. 2008, 日本外科学会雑誌, 109(2) (2), 209 - 209, Japanese

  • VD-008-2 術中大動脈解離の経験に学ぶ(第108回日本外科学会定期学術集会)
    森本 喜久, 岡田 健次, 浅野 満, 松森 正術, 北川 敦士, 森本 直人, 宗像 宏, 泉 聡, 高橋 英樹, 田中 亜紀子, 大北 裕
    一般社団法人日本外科学会, 25 Apr. 2008, 日本外科学会雑誌, 109(2) (2), 331 - 331, Japanese

  • SY-2-3 血管再建後の人工血管感染に対する治療戦略(第108回日本外科学会定期学術集会)
    松森 正術, 小竹 淳一郎, 宮原 俊介, 野村 拓生, 坂本 敏仁, 泉 聡, 田中 亜紀子, 森本 直人, 高橋 英樹, 高橋 宏明, 宗像 宏, 浅野 満, 北川 敦士, 森本 善久, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 25 Apr. 2008, 日本外科学会雑誌, 109(2) (2), 89 - 89, Japanese

  • SF-060-1 Scaffoldのみで生体内で自己組織化するTissue-Engineered Vascular wall patch(第108回日本外科学会定期学術集会)
    高橋 宏明, 澤 芳樹, 齋藤 充弘, 加来 永一, 平川 公一郎, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 25 Apr. 2008, 日本外科学会雑誌, 109(2) (2), Japanese

  • 179) 部分肺静脈還流異常症の一例(第104回日本循環器学会近畿地方会)
    福田 優子, 江本 憲昭, 宮川 一也, 則定 加津子, 川森 裕之, 志手 淳也, 川合 宏哉, 吉田 明弘, 平田 健一, 田中 亜紀子, 松森 正術, 岡田 健次, 大北 裕
    社団法人日本循環器学会, 20 Apr. 2008, Circulation journal : official journal of the Japanese Circulation Society, 72, 1003 - 1003, Japanese

  • 3 Contemporary Surgical Outcome for Thoracic Aortic Aneurysms(Symposium 4 (SY-04) (H) Recent Progress in the Treatment of Aortic Diseases,Special Program,The 72nd Annual Scientific Meeting of the Japanese Circulation Society)
    Okada Kenji, Nakagiri Keitaro, Morimoto Yoshihisa, Asano Mitsuru, Matsumori Masamichi, Okita Yutaka
    Japanese Circulation Society, 01 Mar. 2008, Circulation journal : official journal of the Japanese Circulation Society, 72, 31 - 31, English

  • EVAR for AAA 日本人における適応と限界
    北川 敦士, 大北 裕, 岡田 健次, 森本 喜久, 松森 正術, 浅野 満, 宗像 宏, 川崎 竜太, 杉村 和朗, 杉本 幸司
    (NPO)日本血管外科学会, Mar. 2008, 日本血管外科学会雑誌, 17(2) (2), 369 - 369, Japanese

  • Scaffoldのみで生体内で自己組織化するTissue-Engineered Vascular wall patch
    高橋宏明, 澤芳樹, 齋藤充弘, 加来永一, 平川公一郎, 岡田健次, 大北裕
    2008, 日本外科学会雑誌, 109

  • 143)肺動脈血栓内膜摘除術が奏功した若年発症の慢性肺動脈血栓塞栓症の一例(第103回日本循環器学会近畿地方会)
    浜田 晶子, 山下 智也, 吉田 明弘, 多和 秀人, 川森 裕之, 井上 通彦, 則定 加津子, 江本 憲昭, 川合 宏哉, 志手 淳也, 平田 健一, 横山 光宏, 松森 正術, 田中 裕史, 岡田 健次, 大北 裕
    社団法人日本循環器学会, 20 Oct. 2007, Circulation journal : official journal of the Japanese Circulation Society, 71, 1005 - 1005, Japanese

  • 103)特異な病理所見を呈した大動脈弁閉鎖不全症に対しBentall手術を施行した1例(第103回日本循環器学会近畿地方会)
    山中 勝弘, 田中 亜紀子, 高橋 英樹, 高橋 宏明, 宗像 宏, 森本 直人, 松森 正術, 浅野 満, 北川 敦士, 川西 雄二郎, 田中 裕史, 中桐 啓太郎, 岡田 健次, 大北 裕, 大林 千穂, 植田 初枝, 由谷 親夫
    社団法人日本循環器学会, 20 Oct. 2007, Circulation journal : official journal of the Japanese Circulation Society, 71, 1000 - 1000, Japanese

  • 【心不全 最新の基礎・臨床研究の進歩】 心不全の原因疾患(基礎疾患)別の臨床的事項 病態、発症機序(心不全)、治療 弁膜症 三尖弁閉鎖不全症
    Okada Kenji
    May 2007, 日本臨床, 65巻, 増刊5 心不全(下), pp. 512-516, Japanese
    Introduction scientific journal

  • 腎動脈灌流障害を合併したB型大動脈解離に対する血管内治療の1例
    北川 敦士, 大北 裕, 岡田 健次, 中桐 啓太郎, 田中 裕史, 川西 雄二郎, 松森 正術, 宗像 宏, 山中 勝弘, 谷口 尚範, 川崎 竜太, 杉村 良朗, 杉本 幸司
    (NPO)日本血管外科学会, Apr. 2007, 日本血管外科学会雑誌, 16(3) (3), 603 - 603, Japanese

  • 大動脈瘤に対するステントグラフト治療の遠隔成績と問題点 胸部下行大動脈疾患に対するステントグラフト手術の成績
    北川 敦士, 大北 裕, 岡田 健次, 中桐 啓太郎, 田中 裕史, 川西 雄二郎, 松森 正術, 宗像 宏, 高橋 英樹, 山中 勝宏, 谷口 尚範, 川崎 竜太, 杉本 和朗, 杉本 幸司
    (NPO)日本血管外科学会, Apr. 2007, 日本血管外科学会雑誌, 16(2) (2), 282 - 282, Japanese

  • DP-036-1 B型大動脈解離の急性期手術症例の検討(第107回日本外科学会定期学術集会)
    浅野 満, 岡田 健次, 中桐 啓太郎, 田中 裕史, 川西 雄二郎, 松森 正術, 宗像 宏, 高橋 英樹, 泉 聡, 山中 勝弘, 大北 裕
    一般社団法人日本外科学会, 10 Mar. 2007, 日本外科学会雑誌, 108(2) (2), 400 - 400, Japanese

  • 胸腹部大動脈瘤に対する治療戦略
    川西 雄二郎, 泉 聡, 宗像 宏, 高橋 英樹, 松森 正術, 浅野 満, 田中 裕史, 北川 敦士, 中桐 啓太郎, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 10 Mar. 2007, 日本外科学会雑誌, 108, 120 - 120, Japanese

  • DP-033-6 急性大動脈解離に対する弓部部分置換術施行時の断端形成と遠隔期予後(第107回日本外科学会定期学術集会)
    田中 裕史, 岡田 健次, 中桐 啓太郎, 川西 雄二郎, 北川 敦士, 浅野 満, 松森 正術, 宗像 宏, 泉 聡, 高橋 英樹, 大北 裕
    一般社団法人日本外科学会, 10 Mar. 2007, 日本外科学会雑誌, 108(2) (2), 397 - 397, Japanese

  • DP-103-3 感染性大動脈疾患に対するビタミンC及びバンコマイシン含浸徐放性ゼラチンシート被覆自家静脈グラフトの有用性に関する実験的検討(第107回日本外科学会定期学術集会)
    原口 知則, 岡田 健次, 田畑 泰彦, 真庭 謙昌, 大北 裕
    一般社団法人日本外科学会, 10 Mar. 2007, 日本外科学会雑誌, 108(2) (2), 530 - 530, Japanese

  • 2 Surgical Treatment for Infective Endocarditis(Various Problems Encountered in the Course of Medical Treatment, and Timing of Surgical Therapy for Infective Endocarditis, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
    Okada Kenji, Matsumori Masamichi, Tanaka Hiroshi, Kawanishi Yujiro, Nakagiri Keitaro, Okita Yutaka
    Japanese Circulation Society, 01 Mar. 2007, Circulation journal : official journal of the Japanese Circulation Society, 71, 62 - 62, English

  • 3 Current Surgery for Thoracic Aortic Aneurysm(Open surgery or Endovascular Repair for Aortic Aneurysm, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
    Nakagiri Keitaro, Yamanaka Katsuhiro, Tanaka Akiko, Izumi Satoshi, Takahashi Hideki, Munakata Hiroshi, Takahashi Hiroaki, Morimoto Naoto, Matsumori Masatsugu, Asano Mitsuru, Tanaka Hiroshi, Kawanishi Yujiro, Kitagawa Atsushi, Okada Kenji
    Japanese Circulation Society, 01 Mar. 2007, Circulation journal : official journal of the Japanese Circulation Society, 71, 56 - 56, English

  • 胸部下行大動脈緊急破裂例に対する血管内治療の成績
    北川 敦士, 大北 裕, 岡田 健次, 中桐 啓太郎, 田中 裕史, 川西 雄二郎, 松森 正術, 浅野 満, 宗像 宏, 森本 直人, 泉 聡, 高橋 英樹, 上村 亮介, 山中 勝弘, 杉本 幸司, 谷口 尚範
    (一社)日本外科学会, Mar. 2007, 日本外科学会雑誌, 108(臨増2) (臨増2), 322 - 322, Japanese

  • 97)胸部大動脈瘤に合併した急性B型大動脈解離の一例(第101回日本循環器学会近畿地方会)
    浅野 満, 岡田 健次, 山下 輝夫, 中桐 啓太郎, 田中 裕史, 川西 雄二郎, 松森 正術, 宗像 宏, 森本 直人
    社団法人日本循環器学会, 20 Oct. 2006, Circulation journal : official journal of the Japanese Circulation Society, 70, 1226 - 1226, Japanese

  • 59)左肩急性化膿性関節炎と脳膿瘍を合併した活動性感染性心内膜炎に対する僧帽弁形成術の経験(第101回日本循環器学会近畿地方会)
    宗像 宏, 岡田 健次, 国久 智成, 森本 直人, 前川 貴代, 北原 淳一郎, 松森 正術, 浅野 満, 川西 雄二郎, 田中 裕史, 中桐 啓太郎, 山下 輝夫, 大北 裕
    社団法人日本循環器学会, 20 Oct. 2006, Circulation journal : official journal of the Japanese Circulation Society, 70, 1221 - 1221, Japanese

  • Cell fusion was not essential for cardiomyogenesis from bone marrow stem cells
    Atsushi Kitagawa, Kenji Okada, Yutaka Okita, Richard D. Weisel, Donald A. G. Mickle, Ren-Ke Li
    LIPPINCOTT WILLIAMS & WILKINS, Sep. 2006, CIRCULATION RESEARCH, 99(5) (5), E37 - E37, English
    Summary international conference

  • 慢性肺動脈塞栓症に対する外科治療
    圓尾 文子, 大北 裕, 岡田 健次, 中桐 啓太郎, 山下 輝夫, 川西 雄二郎, 浅野 満, 松森 正術, 大田 壮美, 前川 貴代, 森本 直人, 宗像 宏, 坂本 敏仁
    一般社団法人日本外科学会, 05 Mar. 2006, 日本外科学会雑誌, 107(2) (2), 457 - 457, Japanese

  • 大動脈弁手術における弁形成術の検討
    宗像 宏, 山下 輝夫, 岡田 健次, 坂本 敏仁, 前川 貴代, 森本 直人, 松森 正術, 浅野 満, 川西 雄二郎, 圓尾 文子, 中桐 啓太郎, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2006, 日本外科学会雑誌, 107(2) (2), 456 - 456, Japanese

  • 胸部大動脈瘤に対するステントグラフト挿入術の中期成績
    坂本 敏仁, 森本 直人, 宗像 宏, 前川 貴代, 浅野 満, 松森 正術, 川西 雄二郎, 圓尾 文子, 山下 輝夫, 中桐 啓太郎, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2006, 日本外科学会雑誌, 107(2) (2), 517 - 517, Japanese

  • Marfan症候群における大動脈基部置換術
    大北 裕, 松森 正術, 岡田 健次, 山下 輝夫, 中桐 啓太郎, 圓尾 文子, 田中 裕史, 川西 雄二郎, 浅野 満, 宗像 宏, 北原 淳一郎, 前川 貴代, 森本 直人, 国久 智成
    一般社団法人日本外科学会, 05 Mar. 2006, 日本外科学会雑誌, 107(2) (2), 146 - 146, Japanese

  • 肝硬変合併開心術の術後肝不全発症に関する検討
    森本 直人, 坂本 敏仁, 宗像 宏, 前川 貴代, 松森 正術, 浅野 満, 川西 雄二郎, 中桐 啓太郎, 山下 輝夫, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2006, 日本外科学会雑誌, 107(2) (2), 281 - 281, Japanese

  • 弁形成を追加した自己弁温存大動脈基部置換術の検討
    松森 正術, 坂本 敏仁, 森本 直人, 宗像 宏, 前川 貴代, 浅野 満, 川西 雄二郎, 圓尾 文子, 中桐 啓太郎, 山下 輝夫, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2006, 日本外科学会雑誌, 107(2) (2), 282 - 282, Japanese

  • 変性疾患による僧帽弁閉鎖不全症に対する治療戦略の検討
    山下 輝夫, 大北 裕, 岡田 健次, 中桐 啓太郎, 圓尾 文子, 川西 雄二郎, 浅野 満, 松森 正術, 太田 壮美, 前川 貴代, 森本 直人, 宗像 宏, 坂本 敏仁
    一般社団法人日本外科学会, 05 Mar. 2006, 日本外科学会雑誌, 107(2) (2), 708 - 708, Japanese

  • 肋間動脈を介するsteal現象が脊髄血流に及ぼす影響
    川西 雄二郎, 坂本 敏仁, 森本 直人, 宗像 宏, 前川 貴代, 松森 正術, 浅野 満, 圓尾 文子, 中桐 啓太郎, 山下 輝夫, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2006, 日本外科学会雑誌, 107(2) (2), 211 - 211, Japanese

  • 大動脈基部病変を伴ったMarfan症候群に対する自己弁温存手術の検討
    岡田 健次, 松森 正術, 坂本 敏仁, 森本 直人, 前川 貴代, 宗像 宏, 川西 雄二郎, 浅野 満, 圓尾 文子, 中桐 啓太郎, 山下 輝夫, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2006, 日本外科学会雑誌, 107(2) (2), 212 - 212, Japanese

  • 急性大動脈解離に対するReimplantation法の検討
    浅野 満, 岡田 健次, 坂本 敏仁, 森本 直人, 前川 貴代, 宗像 宏, 松森 正術, 川西 雄二郎, 中桐 啓太郎, 圓尾 文子, 山下 輝夫, 大北 裕
    一般社団法人日本外科学会, 05 Mar. 2006, 日本外科学会雑誌, 107(2) (2), 518 - 518, Japanese

  • bFGF 含浸ゼラチンシートによるラット静脈グラフトの至 適動脈化に関する研究
    原口知則, 岡田健次, 真庭謙昌, 田畑泰彦, 大北裕
    2006, 第9 回日本組織工学会（2006.9.7－8. 京都）, Japanese
    [Refereed]

  • 胸部大動脈瘤に対するステントグラフト内挿術の適応と問題点
    森本 直人, 松本 倫, 松森 正術, 太田 壮美, 川西 雄二郎, 圓尾 文子, 谷口 尚範, 森本 喜久, 山下 輝夫, 杉本 幸司, 岡田 健次, 大北 裕
    (NPO)日本血管外科学会, Jun. 2005, 日本血管外科学会雑誌, 14(3) (3), 360 - 360, Japanese

  • 高齢者に対する胸部大動脈瘤手術の問題点と対策(第105回日本外科学会定期学術集会)
    岡田 健次, 森本 直人, 松森 正術, 山田 章貴, 川西 雄二郎, 田中 裕史, 森本 喜久, 山下 輝夫, 辻 義彦, 大北 裕
    一般社団法人日本外科学会, 05 Apr. 2005, 日本外科学会雑誌, 106, 566 - 566, Japanese

  • 自己フィブリンコート小口径人工血管の開発(第105回日本外科学会定期学術集会)
    長谷川 智巳, 岡田 健次, 高野 良仁, 平石 嘉昭, 大北 裕
    一般社団法人日本外科学会, 05 Apr. 2005, 日本外科学会雑誌, 106, 574 - 574, Japanese

  • Marfan 症候群に対する大動脈基部置換術の検討(第105回日本外科学会定期学術集会)
    松本 倫, 森本 直人, 太田 壮美, 山田 章貴, 松森 正樹, 川西 雄二郎, 田中 裕史, 森本 喜久, 山下 輝夫, 岡田 健次, 辻 義彦, 大北 裕
    一般社団法人日本外科学会, 05 Apr. 2005, 日本外科学会雑誌, 106, 567 - 567, Japanese

  • 僧帽弁位感染性心内膜炎に対する弁形成術(第105回日本外科学会定期学術集会)
    山下 輝夫, 大北 裕, 岡田 健次, 森本 喜久, 田中 裕史, 川西 雄二郎, 松森 正術, 山田 章貴, 太田 壮美, 森本 直人
    一般社団法人日本外科学会, 05 Apr. 2005, 日本外科学会雑誌, 106, 106 - 106, Japanese

  • 頚動脈狭窄を合併した虚血性心疾患に対する治療戦略(第105回日本外科学会定期学術集会)
    森本 直人, 松森 正術, 山田 章貴, 川西 雄二郎, 田中 裕史, 森本 喜久, 山下 輝夫, 辻 義彦, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Apr. 2005, 日本外科学会雑誌, 106, 265 - 265, Japanese

  • 上行大動脈拡大を有する大動脈二尖弁に対する大動脈置換術の検討(第105回日本外科学会定期学術集会)
    松森 正術, 森本 直人, 太田 壮美, 山田 章貴, 田中 裕史, 川西 雄二郎, 森本 喜久, 山下 輝夫, 岡田 健次, 辻 義彦, 大北 裕
    一般社団法人日本外科学会, 05 Apr. 2005, 日本外科学会雑誌, 106, 345 - 345, Japanese

  • 線維芽細胞増殖因子 (bFGF) 含浸ゼラチンシートがラット静脈グラフトの開存性に及ぼす影響(第105回日本外科学会定期学術集会)
    原口 知則, 岡田 健次, 大北 裕, 田畑 泰彦
    一般社団法人日本外科学会, 05 Apr. 2005, 日本外科学会雑誌, 106, 250 - 250, Japanese

  • 胸腹部大動脈瘤手術における脊髄虚血の予測因子の検討(第105回日本外科学会定期学術集会)
    川西 雄二郎, 森本 直人, 松森 正術, 山田 章貴, 田中 裕史, 森本 喜久, 山下 輝夫, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 05 Apr. 2005, 日本外科学会雑誌, 106, 175 - 175, Japanese

  • 胸部・腹部大動脈瘤に対する血管内治療と観血的手術の適応 多発性大動脈瘤に対するHybrid治療戦略
    辻 義彦, 森本 直人, 松森 正術, 山田 章貴, 田中 裕史, 川西 雄二郎, 日野 裕, 谷口 尚範, 森本 喜久, 中桐 啓太郎, 山下 輝夫, 杉本 幸司, 岡田 健次, 松田 均, 大北 裕
    (一社)日本外科学会, Apr. 2005, 日本外科学会雑誌, 106(臨増) (臨増), 81 - 81, Japanese

  • New Platelet Scintigraphy with ^<99m>Technetium Apcitide to Assess Thrombogenicity of Small Caliber Vascular Prostheses(Nuclear Cardiology 6 (I), The 69th Annual Scientific Meeting of the Japanese Circulation Society)
    Hasegawa Tomomi, Okada Kenji, Okita Yutaka
    Japanese Circulation Society, 01 Mar. 2005, Circulation journal : official journal of the Japanese Circulation Society, 69, 281 - 281, English

  • Cutting Edge 人工弁の現況と将来
    OKADA, Kenji, OKITA, Yutaka
    Feb. 2005, Medical Science Digest, 31巻, 2号, pp. 41-42, Japanese
    Introduction scientific journal

  • 胸部・腹部大動脈病変に対するステントグラフト治療の功罪
    辻 義彦, 森本 直人, 山田 章貴, 田中 陽介, 日野 裕, 谷口 尚範, 森本 喜久, 中桐 啓太郎, 山下 輝夫, 岡田 健次, 杉本 幸司, 松田 均, 大北 裕
    (NPO)日本心臓血管外科学会, Jan. 2005, 日本心臓血管外科学会雑誌, 34(Suppl.) (Suppl.), 412 - 412, Japanese

  • 人工血管と感染
    辻 義彦, 森本 直人, 太田 壮美, 山田 章貴, 松森 正術, 川西 雄二郎, 田中 裕史, 森本 喜久, 山下 輝夫, 岡田 健次, 吉村 雅裕, 大北 裕
    15 Sep. 2004, 人工臓器, 33(2) (2), S - 39, Japanese

  • 大動脈弁位における人工弁の選択について
    山下 輝夫, 大北 裕, 辻 義彦, 岡田 健次, 森本 喜久
    15 Sep. 2004, 人工臓器, 33(2) (2), S - 35, Japanese

  • 冠動脈シリーズ 外科的治療
    OKADA, Kenji, OKITA, Yutaka
    Aug. 2004, 兵庫県医師会医学雑誌, 47巻, 1号, pp. 43-48, Japanese
    Introduction scientific journal

  • 58) 冠動脈疾患, 僧帽弁閉鎖不全症, 腹部大動脈瘤をともなった高齢者弓部大動脈瘤の一手術例(第96回日本循環器学会近畿地方会)
    山田 章貴, 田中 亜紀子, 松森 正術, 花房 雄治, 岡田 健次, 築部 卓郎, 大北 裕
    社団法人日本循環器学会, 20 Apr. 2004, Circulation journal : official journal of the Japanese Circulation Society, 68, 812 - 812, Japanese

  • 胸部・腹部大動脈に発生したpenetrating atherosclerotic ulcer(PAU)の診断と外科治療
    辻 義彦, 田中 陽介, 宗像 宏, 太田 壯美, 山田 章貴, 松森 正術, 溝口 和博, 日野 裕, 谷口 尚範, 花房 雄治, 尾崎 喜就, 山下 輝夫, 岡田 健次, 杉本 幸司, 大北 裕
    (NPO)日本血管外科学会, Apr. 2004, 日本血管外科学会雑誌, 13(2) (2), 156 - 156, Japanese

  • 当院における透析シャント不全に対する経皮的血管形成術の経験
    日野 裕, 花房 雄治, 尾崎 喜就, 山下 輝夫, 岡田 健次, 辻 義彦, 山口 雅人, 谷口 尚範, 杉本 幸司, 大北 裕
    (NPO)日本血管外科学会, Apr. 2004, 日本血管外科学会雑誌, 13(2) (2), 339 - 339, Japanese

  • PS-147-5 Peroxisome Proliferator-Activated Receptor(PPAR)-γ活性化薬のラット異所性心移植における免疫抑制効果の検討
    田中 陽介, 岡田 健次, 長谷川 智巳, 岡田 守人, 大北 裕
    一般社団法人日本外科学会, 15 Mar. 2004, 日本外科学会雑誌, 105, 567 - 567, Japanese

  • PS-149-6 当院における心筋梗塞後合併症に対する外科治療成績
    岡田 健次, 松森 正術, 山田 章貴, 原口 知則, 太田 壮美, 三村 剛史, 宗像 宏, 野村 佳克, 溝口 和博, 日野 裕, 花房 雄治, 山下 輝夫, 尾崎 喜就, 大北 裕
    一般社団法人日本外科学会, 15 Mar. 2004, 日本外科学会雑誌, 105, 571 - 571, Japanese

  • PS-073-3 B型大動脈解離の治療成績
    原口 知則, 三村 剛史, 太田 壮美, 松森 正術, 山田 章貴, 国久 智成, 宗像 宏, 溝口 和博, 山下 輝夫, 日野 裕, 花房 雄治, 尾崎 喜就, 岡田 健次, 大北 裕
    一般社団法人日本外科学会, 15 Mar. 2004, 日本外科学会雑誌, 105, 452 - 452, Japanese

  • VS-018-5 ラット胎児心筋上清共培養によるラット骨髄細胞から心筋細胞誘導の試み
    北川 敦士, 岡田 健次, 大北 裕, Li Ren-Ke, Weisel Richard D, Mickle Donald A. G.
    一般社団法人日本外科学会, 15 Mar. 2004, 日本外科学会雑誌, 105, 341 - 341, Japanese

  • PS-225-3 冠動脈バイパス術に有用な小口径(3mm)人工血管の開発をめざして
    長谷川 智巳, 岡田 健次, 高野 良仁, 平石 嘉昭, 大北 裕
    一般社団法人日本外科学会, 15 Mar. 2004, 日本外科学会雑誌, 105, 686 - 686, Japanese

  • PJ-184 Surgical treatment for left ventricular rupture following myocardial infarction(Cardiovascular Surgery/CABG 2 (IHD) : PJ31)(Poster Session (Japanese))
    Yamashita Teruo, Okada Kenji, Matsumori Masamichi, Hino Yutaka, Hanafusa Yuji, Ozaki Nobuchika, Okita Yutaka
    Japanese Circulation Society, 01 Mar. 2004, Circulation journal : official journal of the Japanese Circulation Society, 68, 525 - 525, English

  • OJ-124 Aortic regurgitation and annulus size after aortic valve sparing operation for Marfan syndrome(Cardiovascular Surgery/CABG 1 (IHD) : OJ15)(Oral Presentation (Japanese))
    Ozaki Nobuchika, Okada Kenji, Tsuji Yoshihiko, Okita Yutaka
    Japanese Circulation Society, 01 Mar. 2004, Circulation journal : official journal of the Japanese Circulation Society, 68, 261 - 261, English

  • PE-329 Penetrating Atherosclerotic Ulcer of the Aorta : Clinical Features and Treatments(Atherosclerosis, Clinical 6 (IHD) : PE56)(Poster Session (English))
    Tsuji Yoshihiko, Hino Yutaka, Ozaki Nobuchika, Okada Kenji, Matsuda Hitoshi, Tsukube Takuro, Okita Yutaka
    Japanese Circulation Society, 01 Mar. 2004, Circulation journal : official journal of the Japanese Circulation Society, 68, 442 - 442, English

  • PE-309 The Experiment for improving the patency of the vein graft for CABG(Cardiovascular Surgery/CABG 3 (IHD) : PE53)(Poster Session (English))
    Haraguchi Tomonori, Okada Kenji, Okita Yutaka, Tabata Yasuhiko
    Japanese Circulation Society, 01 Mar. 2004, Circulation journal : official journal of the Japanese Circulation Society, 68, 437 - 437, English

  • 腹部大動脈瘤における血管造影検査の意義
    宗像 宏, 岡田 健次, 杉本 幸司, 国久 智成, 三村 剛史, 太田 壮美, 松森 正術, 山田 章貴, 原口 知則, 日野 裕, 花房 雄治, 山下 輝夫, 尾崎 喜就, 大北 裕
    (一社)日本外科学会, Mar. 2004, 日本外科学会雑誌, 105(臨増) (臨増), 574 - 574, Japanese

  • 【21世紀初頭の循環器医療を取り巻く社会的諸問題 循環器領域を若手にとって魅力的なものにするために】 改善への提言 大学での研究 外科
    OKADA, Kenji, OKITA, Yutaka
    Feb. 2004, Cardiovascular Med-Surg, 6巻, 1号, pp. 94-96, Japanese
    Introduction scientific journal

  • 腸骨動脈ステントグラフト留置後のエンドリークに対しWallstentが有効であった一例
    山口 雅人, 杉本 幸司, Carlos A.Zamora, 岩間 祐基, 伊崎 健太, 鶴崎 正勝, 谷口 尚範, 森 岳樹, 杉村 和朗, 岡田 健次, 松田 均, 辻 義彦, 大北 裕
    (公社)日本医学放射線学会, Jan. 2004, 日本医学放射線学会雑誌, 64(1) (1), 71 - 71, Japanese

  • 腹部大動脈瘤手術に血管造影は必要か?
    岡田 健次, 杉本 幸司, 日野 裕, 田中 裕史, 北川 敦士, 岩崎 倫明, 吉田 和則, 原口 知則, 松森 正術, 田中 陽介, 花房 雄治, 尾崎 喜就, 松田 均, 築部 卓郎, 大北 裕
    (NPO)日本血管外科学会, Jun. 2003, 日本血管外科学会雑誌, 12(3) (3), 247 - 247, Japanese

  • 胸腹部大動脈手術における術中脊髄虚血障害への対策
    川西 雄二郎, 田中 陽介, 松森 正術, 岩崎 倫明, 田中 裕史, 北川 敦士, 日野 裕, 花房 雄治, 尾崎 喜就, 岡田 健次, 松田 均, 築部 卓郎, 大北 裕
    一般社団法人日本外科学会, 30 Apr. 2003, 日本外科学会雑誌, 104, 669 - 670, Japanese

  • 心臓大血管術後感染症対策の標準化
    岡田 健次, 松田 均, 荒川 創一, 木下 承晧, 李 宗子, 黒川 敏子, 西庄 京子, 松川 律, 築部 卓郎, 大北 裕
    一般社団法人日本外科学会, 30 Apr. 2003, 日本外科学会雑誌, 104, 550 - 550, Japanese

  • 虚血性心筋症に対する外科治療戦略
    築部 卓郎, 松森 正術, 原口 知則, 岩崎 倫明, 田中 裕史, 川西 雄二郎, 尾崎 喜就, 岡田 健次, 松田 均, 大北 裕
    一般社団法人日本外科学会, 30 Apr. 2003, 日本外科学会雑誌, 104, 490 - 490, Japanese

  • 三尖弁形成術の遠隔成績についての検討
    松川 律, 杉 利秀, 田中 陽介, 津川 二郎, 川西 雄二郎, 日野 裕, 岡田 健次, 松田 均, 築部 卓郎, 大北 裕
    一般社団法人日本外科学会, 10 Mar. 2002, 日本外科学会雑誌, 103, 442 - 442, Japanese

  • 大動脈弓部置換における左反回神経温存のための工夫
    松田 均, 川西 雄二郎, 日野 裕, 松川 律, 岡田 健次, 築部 卓郎, 大北 裕
    一般社団法人日本外科学会, 10 Mar. 2002, 日本外科学会雑誌, 103, 337 - 337, Japanese

  • 胸部下行大動脈,胸腹部大動脈手術におけるMEPの検討
    川西 雄二郎, 村上 博久, 日野 裕, 松川 律, 岡田 健次, 松田 均, 築部 卓郎, 大北 裕
    一般社団法人日本外科学会, 10 Mar. 2002, 日本外科学会雑誌, 103, 329 - 329, Japanese

  • 成人大動脈病変に対するRoss手術の検討
    築部 卓郎, 松田 均, 岡田 健次, 尾崎 喜就, 松川 律, 日野 裕, 村上 博久, 川西 雄二郎, 杉 利秀, 大北 裕
    一般社団法人日本外科学会, 10 Mar. 2002, 日本外科学会雑誌, 103, 317 - 317, Japanese

  • 胸部・腹部大動脈瘤に対するステントグラフト内挿術の適応条件
    辻 義彦, 宗実 孝, 日野 裕, 松川 律, 岡田 健次, 松田 均, 築部 卓郎, 吉田 正人, 大北 裕
    一般社団法人日本外科学会, 10 Mar. 2002, 日本外科学会雑誌, 103, 107 - 107, Japanese

  • Hepatocellular Carcinoma with a Sarcomatous Appearance : Report of a Case
    TSUJI YOSHIHIKO, OKADA KENJI, FUKUOKA MASATO, WATANABE YOSHIHISA, ATAKA KEIJI, MINAMI RIEKO, HANIOKA KEISUKE, TACHIBANA SHIRO, SAITO HIROSHI, SASADA AKINORI, OKITA YUTAKA
    01 Aug. 2001, Surg Today, 31(8) (8), 735 - 739, English

  • Effectiveness of Dipyridamole Thallium 201 Scintigraphy in Deciding on Surgical Treatment of Abdominal Aortic Aneurysm Combined with Coronary Artery Disease
    OKADA Kenji, ANDO Motomi, OKITA Yutaka, MOROTA Tetsuro, TAKAMOTO Shinichi, KAWASHIMA Yasunaru
    01 Aug. 1995, 日本血管外科学会雑誌 = The Japanese journal of vascular surgery : official journal of the Japanese Society for Vascular Surgery, 4(4) (4), 543 - 547, Japanese

■ Books And Other Publications
  • 創傷のすべて －キズをもつすべての人のためにー / II 慢性創傷 ３．手術に伴う創傷 縦隔炎・胸骨骨髄炎．安部正敏，溝上祐子，寺師浩人（編）
    Okada Kenji
    Others, 克誠堂出版, 2012, Japanese
    Scholarly book

  • 今日の心臓手術の適応と至適時期 / Topics －ステントグラフト治療か人工血管置換術か－
    Okada Kenji
    Joint work, 文光堂, 2011, Japanese
    Scholarly book

  • 循環器疾患 最新の治療 2010-2011 / V章 弁膜疾患 7. 弁膜症の外科治療（感染性心内膜炎を除く）
    Okada Kenji
    Joint work, 南江堂, 2010, Japanese
    Scholarly book

  • 循環器疾患 最新の治療 2008-2009 Current Therapy in Cardiovascular Disease / 循環器疾患 最新の治療 2008-2009 「II-18 冠動脈バイパス術後の外来管理」
    Okada Kenji
    Joint work, 南江堂, 2008, Japanese
    Scholarly book

  • 社会人が学ぶ 医療技術・医療用機器 / 第11章 人工臓器
    Okada Kenji
    Joint work, 財団法人 神戸市産業振興財団, 2008, Japanese
    Textbook

  • 「日本臨床」：2007年増刊、心不全（下）、－最新の基礎・臨床研究の進歩－ / 「三尖弁閉鎖不全症」
    OKADA KENJI
    Joint work, 日本臨床社, 2007, Japanese
    Scholarly book

  • 「臨床心臓病学」 / 大動脈弁閉鎖不全、弁形成術
    OKADA KENJI
    Joint work, 文光堂, 2006, Japanese
    Textbook

  • 「人工臓器・再生医療の最先端」 / ―臨床サイドから見た人工血管の課題―
    OKADA KENJI
    Joint work, 先端医療技術研究所, 2005, Japanese
    Scholarly book

  • 「新 心臓血管外科ハンドブック」 / 術中管理 A. 人工心肺 ４. 脳保護法
    OKADA KENJI
    Joint work, 南江堂, 2005, Japanese
    Scholarly book

  • Knack & Pitfalls 「弁膜症外科の要点と盲点」 / [X] 再手術のKnack & Pitfalls ２．手術術式（到達法、人工心肺アクセス、癒着剥離など）と手術成績
    OKADA KENJI
    Joint work, 文光堂, 2005, Japanese
    Scholarly book

  • 「エキスパートに学ぶ大動脈瘤手術」 / 第Ⅲ章 下行大動脈・胸腹部大動脈瘤 d)超低体温・循環停止（逆行性脳灌流法）
    OKADA KENJI
    Joint work, メディカルレビュー社, 2003, Japanese
    Scholarly book

■ Lectures, oral presentations, etc.
  • 拡張型心筋症に対して植え込み型左室補助人工心臓装着術後、難治性心室頻拍と右心不全加療に難渋した一例
    山下 健太郎, 久松 恵理子, 末廣 英也, 永松 裕一, 黒瀬 潤, TANAKA HIDEKAZU, KIUCHI KUNIHIKO, INOUE TAKESHI, OKADA KENJI, HIRATA KENICHI
    第47回人工心臓と補助循環懇話会学術集会, Feb. 2019, Japanese, 佐賀, 症例は 47 歳女性。20 歳代より労作時呼吸困難を自覚し、39 歳時分娩 中に急性左心不全を発症した。心エコーにて左室拡大を伴うびまん性左 室収縮能低下を認め、拡張型心筋症と考え内服加療を開始したが心機能 の改善を認めず、41 歳時に機能性僧帽弁閉鎖不全症に対して、僧帽弁置 換術および三尖弁輪形成術を施行した。また持続性心室頻拍に対して、 同年 ICD 植込み術を施行した。45 歳時より NYHAⅢ-Ⅳの状態が続き、 BNP 1000-1500pg/mL と高値で推移した。46 歳時に精査加療目的で入院後、 強心剤依存の状態となり、心臓移植適応登録後、同年 11 月植込型左室 補助人工心臓(LVAD)装着術を施行した。術直後は良好な循環動態であっ たが、術後 1 日目より心電図波形が著明な低電位となり、心室頻拍(VT) が出現した。電気的除細動に加, Domestic conference
    Poster presentation

  • 拡張型心筋症に対して左室補助人工心臓装着後、微小なくも膜下出血を繰り返し認めた一例
    久松恵理子, 山下健太郎, 永野雄一朗, TANAKA HIDEKAZU, INOUE TAKESHI, OKADA KENJI, HIRATA KENICHI
    第47回人工心臓と補助循環懇話会学術集会, Feb. 2019, Japanese, 佐賀, Domestic conference
    Poster presentation

  • 慢性血栓塞栓性肺高血圧症に対する血栓内膜摘除術とバルーン肺動脈形成術のハイブリッド治療にて良好な結果を得られた一例
    o Kinutani, Shinke Toshiro, Otake Hiromasa, Takaya Tomofumi, Noriaki Emoto, Nakayama Kazuhiko, Yu Taniguchi, Yuto Shinkura, Hirata Ken-ichi, Yutaka Ohkita, Okada Kenji
    ストラクチャージャパン ライブデモンストレーション2014, Nov. 2014, Japanese, ストラクチャージャパン, 東京, Domestic conference
    Oral presentation

  • Balloon Pulmonary Angioplasty can be an Alternative Treatment Strategy for the Management of Non-Operable Chronic Thromboembolic Pulmonary Hypertension.
    Taniguchi Y, Miyagawa K, Nakayama Kazuhiko, Kinutani H, Shinke Toshiro, Okada Kenji, Okita Yutaka, Hirata Ken-ichi, Emoto N
    INTERNATIONAL CTEPH CONFERENCE 2014, Jun. 2014, English, International CTEPH Association, パリ, フランス, International conference
    Poster presentation

  • The impact of pancreatic fistula grade C on survival after panceatic resection ；analysis of 1,015 patients with pancreatic cancer in multicenter study
    Kawai M, Murakami Y, Tani M, Hirono S, Okada Kenji, Motoi F, Unno M, Sho M, Nakajima Y, Uemura K, Satoi S, A-Hon Kwon, Matsumoto Ippei, Goto Tadahiro, Honda G, Kurata M, Yamaue H
    The Society For Surgery Of The Alimentary Tract 55th Annual Meeting (DDW2014), May 2014, English, The Society for surgery of the Alimentary Tract, Chicago, USA, International conference
    Oral presentation

  • Nephrin-podocin complex as a possible regulator of spermatogenesis
    Enatsu N, Fukuda T, Okada Kenji, Matsushita Kei, Chiba Koji, Miyake Hideaki, Fujisawa Masato
    109thAUA(American Urological Association)annual meeting, May 2014, English, American Urological Association, オーランド, アメリカ, International conference
    Poster presentation

  • Impact of preoperative billiary drainage on short-and long-term outcome after pancreaticoduodenectomy for cancer of the head of pancreas
    Uemura K, Murakami Y, Kawai M, Okada Kenji, Matsumoto Ippei, Asari Sadaki, Satoi S, Yanagimoto H, Sho M, Akahori T, Honda G, Kurata M, Motoi F, Unno M
    The Society For Surgery Of The Alimentary Tract 55th Annual Meeting (DDW2014), May 2014, English, The Society for surgery of the Alimentary Tract, Chicago, USA, International conference
    Oral presentation

  • 腎動脈下大動脈の屈曲がEVAR後の長期成績に与える影響
    Nomura Yoshikatsu, Yamanaka Katsuhiro, 深瀬 圭吾, 井戸口 孝二, Yamaguchi Masato, Sugimoto Koji, 村上 優, 陽川 孝樹, 後竹 康子, 小原 大見, 井澤 直人, Miyahara Shunsuke, 白坂 知識, Sakamoto Toshihito, Inoue Takeshi, Matsumori Masamichi, Okada Kenji, Okita Yutaka
    第115回日本外科学会総会, 2014, Japanese, 日本外科学会, 京都, Domestic conference
    Oral presentation

  • EVAR後type II endoleakに対する治療成績
    Nomura Yoshikatsu, Yamanaka Katsuhiro, 深瀬 圭吾, 後竹 康子, 小原 大見, 井澤 直人, 白坂 知識, Miyahara Shunsuke, Sakamoto Toshihito, Inoue Takeshi, Matsumori Masamichi, Yamaguchi Masato, Sugimoto Koji, Okada Kenji, Okita Yutaka
    第42回日本血管外科学会総会, 2014, Japanese, 日本血管外科学会, 青森, Domestic conference
    Oral presentation

  • Clinical outcome of tricyclic antidepressants in infertile men with ejaculatory disorders.
    Enatsu N, Yamaguchi Kohei, Okada Kenji, Matsushita Kei, Chiba Koji, Miyake Hideaki, Fujisawa Masato
    9hConference of the Pacific Rim Societyfor Fertility and Sterility, Nov. 2013, English, Conference of the Pacific Rim Societyfor Fertility and Sterility, 神戸, International conference
    Poster presentation

  • 慢性肺血栓塞栓症 (CTEPH)治療におけるバルーン肺動脈形成術 (BPA)の位置づけと治療手技の実際
    Shinke Toshiro, 谷口 悠, 絹谷 洋人, 宮川 一也, Takaya Tomofumi, Nakayama Kazuhiko, Otake Hiromasa, 江本 憲昭, Hirata Ken-ichi, Okada Kenji, Okita Yutaka
    日本肺高血圧学会, Oct. 2013, Japanese, 日本肺高血圧学会, 東京, Domestic conference
    Public symposium

  • 慢性血栓塞栓性肺高血圧症に対する薬物治療と経皮的肺動脈バルーン形成術の治療効果の検討
    谷口 悠, Shinke Toshiro, 絹谷 洋人, 宮川 一也, Nakayama Kazuhiko, Otake Hiromasa, 江本 憲昭, Hirata Ken-ichi, Okada Kenji, Okita Yutaka
    第61回心臓病学会, Sep. 2013, Japanese, Japanese College of Cardiology, 熊本, Domestic conference
    Oral presentation

  • 慢性血栓塞栓性肺高血圧症に対する 肺動脈カテーテル形成術と血栓内膜摘除術の比較
    谷口悠, 江本憲昭, 絹谷洋人, 宮川一也, Otake Hiromasa, Shinke Toshiro, Hirata Ken-ichi, Okada Kenji, Okita Yutaka
    日本心臓病学会, Sep. 2013, Japanese, 日本心臓病学会, 熊本, Domestic conference
    Oral presentation

  • Comparison between Balloon Pulmonary Angioplasty and Pulmonary Thromboendarterectomy on Chronic Thromboembolic Pulmonary Hypertension
    谷口 悠, 江本 憲昭, 絹谷 洋人, Nakayama Kazuhiko, Shinke Toshiro, Okada Kenji, Okita Yutaka, Hirata Ken-ichi
    第2回日本肺循環学会学術集会, Jun. 2013, Japanese, Japanease Pulmonary Circulation Society, 東京, Domestic conference
    Oral presentation

  • EVAR後type 2 endoleakに対する治療
    Nomura Yoshikatsu, 後竹 康子, 竹歳 秀人, Miyahara Shunsuke, Shirasaka Tomonori, Sakamoto Toshihito, Omura Atsushi, Inoue Takeshi, 南 一司, Okada Kenji, 宮本 直和, Yamaguchi Masato, Idoguchi Koji, Sugimoto Koji, Okita Yutaka
    The 41st Annual Meating of The Japanese Society for The Vascular Surgery, May 2013, Japanese, The Japanese Society for The Vascular Surgery, 大阪, Domestic conference
    Oral presentation

  • Clusterin has a possibility to protect the injury of testicular cells induced by heat shock stress
    Matsushita Kei, Yamaguchi Kohei, Enatsu N, Fuping Li, Okada Kenji, Chiba Koji, Miyake Hideaki, Fujisawa Masato
    108thAUA(American Urological Association)annual meeting, May 2013, English, AUA(American Urological Association)annual meeting, サンディエゴ, アメリカ, International conference
    Poster presentation

  • Candesartan ameliorates cisplatin induced testicular damage and change of expression pattern of testicular podocin and nephrin
    Enatsu N, Yamaguchi Kohei, Okada Kenji, Matsushita Kei, Chiba Koji, Miyake Hideaki, Fujisawa Masato
    108thAUA(American Urological Association)annual meeting, May 2013, English, AUA(American Urological Association)annual meeting, サンディエゴ, アメリカ, International conference
    Poster presentation

  • 腹部大動脈瘤に対するステントグラフト内挿術の適応拡大における問題点
    Nomura Yoshikatsu, 後竹 康子, 木下 史子, 小原 大見, 中井 秀和, Yamanaka Katsuhiro, Shirasaka Tomonori, 竹歳 秀人, Miyahara Shunsuke, Sakamoto Toshihito, Omura Atsushi, Inoue Takeshi, 南 一司, Okada Kenji, Ueshima Eisuke, Idoguchi Koji, Yamaguchi Masato, Sugimoto Koji, Okita Yutaka
    The 113rd Annual Congress of Japan Surgical Society, Apr. 2013, Japanese, The Japan Surgical Society, 福岡, Domestic conference
    Oral presentation

  • Comprehensive evaluation of androgen replacement therapy for men with late-onset hypogonadism
    Yamaguchi Kohei, Okada Kenji, Enatsu N, Fuping Li, Matsushita Kei, Chiba Koji, Miyake Hideaki, Fujisawa Masato
    14ｔｈBiennial Meeting of the Asia-Pacific Society for Sexual Medicine (APSSM), Apr. 2013, English, Biennial Meeting of the Asia-Pacific Society for Sexual Medicine (APSSM), 金沢, International conference
    Oral presentation

  • Candesartan ameliorates cisplatin induced testicular damage and change of expression pattern of testicular podocin and nephrin
    Enatsu N, Yamamichi F, Okada Kenji, Matsushita Kei, Chiba Koji, Miyake Hideaki, Fujisawa Masato
    28thEAU(European Association of Urology), Mar. 2013, English, EAU(European Association of Urology), ミラノ, イタリア, International conference
    Poster presentation

  • 腹部大動脈瘤の治療成績 EVAR vs Open Surgery
    Nomura Yoshikatsu, 竹歳 秀人, 小原 大見, Shirasaka Tomonori, Miyahara Shunsuke, Yamanaka Katsuhiro, Sakamoto Toshihito, Omura Atsushi, 田中 亜紀子, Inoue Takeshi, 岡 隆紀, Okada Kenji, Okita Yutaka, Yamaguchi Masato, Sugimoto Koji
    The 43rd Annual Meating of the Japanese Society for Cardiovascular Surgery, Feb. 2013, Japanese, The Japanese Society for Cardiovascular Surgery, 東京, Domestic conference
    Oral presentation

  • RA-GEF-2 function in mouse spermatogenesis
    Okada Kenji
    9th International Council on Archives, Feb. 2013, English, International Council on Archives, メルボルン, International conference
    Poster presentation

  • Clusterin has a possibility to protect the injury of testicular cells induced by heat shock stress
    Matsushita Kei, Yamaguchi Kohei, Enatsu N, Fuping Li, Okada Kenji, Chiba Koji, Miyake Hideaki, Fujisawa Masato
    10th International Congress of Andrology ( ICA), Feb. 2013, English, International Congress of Andrology ( ICA), メルボルン, オーストラリア, International conference
    Poster presentation

  • Barlow症候群に対する僧帽弁形成術
    南 一司, Miyahara Shunsuke, Shirasaka Tomonori, 野村拓生, Nomura Yoshikatsu, Sakamoto Toshihito, Omura Atsushi, 田中亜紀子, 宗像 宏, Inoue Takeshi, 北川敦士, Okada Kenji, Okita Yutaka
    関西胸部外科学会, Jun. 2012, Japanese, 香川大学, 香川, Domestic conference
    Oral presentation

  • 胸部大動脈瘤再手術例の検討
    南 一司, 佐藤雅信, Miyahara Shunsuke, Shirasaka Tomonori, Nomura Yoshikatsu, Sakamoto Toshihito, Omura Atsushi, 田中亜紀子, 宗像 宏, Inoue Takeshi, 岡 隆紀, 北川敦士, Okada Kenji, Okita Yutaka
    日本外科学会学術総会, Apr. 2012, Japanese, 琉球大学, 沖縄, Domestic conference
    Poster presentation

  • Survey of outcome and safety with oseltamivir treatment in Japanese infants under 3 months of age with influenza.
    Morioka Ichiro, Nonoyama S, Tanaka-Taya K, Ihara T, Sugaya N, Ueta I, Kumagai T, Okada Kenji, Hosoya M, Okabe N, Morishima T
    Pediatric Academic Societies Annual Meeting, Apr. 2012, English, Boston, Oseltamivir treatments at 1.5-2.0 mg/kg twice daily appear to be safe in infants with influenza less than 3 months of age and lead to positive short-term outcomes with early initiation of oseltamivir at onset of influenza., International conference
    Poster presentation

  • Efficacy of androgen replacement therapy in men with hypogonadal end-stage renal disease
    Yamaguchi Kohei, Okada Kenji, Matsushita Kei, Li F, Ando M, Chiba Koji, Mityake H, Fujisawa Masato
    28th Korea-Japan Urological Congress, Sep. 2011, English, Korea-Japan Urological Congress, スウォン, 韓国, International conference
    Oral presentation

  • A case with spontaneous coronary dissection which entry point was detected by frequency domain OCT.
    Masayuki Nakagawa, Junya Shite, Shinke Toshiro, Otake Hiromasa, Daisuke Matsumoto, Hiroyuki Kawamori, Ryoji Nagoshi, Amane Kozuki, Hirotoshi Hariki, Takumi Inoue, Tsuyoshi Osue, Yuu Taniguchi, Ryo Nishio, Noritoshi Hiranuma, Hirata Ken-ichi, Hitoshi Minami, Okada Kenji, Okita Yutaka
    第20回日本心血管インターベンション治療学会, Jul. 2011, English, 日本心血管インターベンション治療学会, 大阪, Domestic conference
    Oral presentation

  • 自己弁温存大動脈基部置換術後AR 再発の検討
    岡隆紀, 佐藤雅信, Miyahara Shunsuke, Sakamoto Toshihito, 野村拓生, Omura Atsushi, Nomura Yoshikatsu, 藤田靖之, 田中亜紀子, 宗像宏, Inoue Takeshi, 南一司, 北川敦士, Okada Kenji, Okita Yutaka
    第41回日本心臓血管外科学会学術総会, Feb. 2011, Japanese, 日本心臓血管外科学会, 浦安, Domestic conference
    Oral presentation

  • Surgical treatment for distal aortic arch aneurysm
    Okada Kenji, Omura Atsushi, Shirasaka Tomonori, 野村拓生, Nomura Yoshikatsu, 藤田靖之, 田中亜紀子, 宗像 宏, Matsumori Masamichi, 北川敦士, 岡 隆紀, 南 一司, 長谷川智巳, Okita Yutaka
    第41回日本心臓血管外科学会学術総会, Feb. 2011, Japanese, 日本心臓血管外科学会, 東京, Domestic conference
    Public symposium

  • TEVAR の急性期、遠隔期イベント発生に及ぼす危険因子の検討
    北川敦士, Okita Yutaka, Okada Kenji, 岡 隆紀, 南一司, Inoue Takeshi, 宗像宏, 田中亜希子, Yamaguchi Masato, Sugimoto Koji, Sugimura Kazuro
    第41回日本心臓血管外科学会, Feb. 2011, Japanese, 日本心臓血管外科学会, 東京, Domestic conference
    Oral presentation

  • Recent Advancements of Total Arch replacement in TEVAR Era
    Okada Kenji, Omura Atsushi, Shirasaka Tomonori, 野村拓生, Nomura Yoshikatsu, 藤田靖之, 田中亜紀子, 宗像 宏, Matsumori Masamichi, 北川敦士, 岡 隆紀, 南 一司, 長谷川智巳, Okita Yutaka
    The Society of Thoracic Surgeons 47th Annual Meeting, Jan. 2011, English, The Society of Thoracic Surgeons, San Diego, International conference
    Poster presentation

  • Surgical treatment for ischemic mitral regurgitation
    Okada Kenji, 吉田和則, 佐藤雅信, Miyahara Shunsuke, 野村拓生, Nomura Yoshikatsu, Sakamoto Toshihito, Omura Atsushi, 藤田靖之, 田中亜紀子, 宗像 宏, Inoue Takeshi, 岡 隆紀, 南 一司, Okita Yutaka
    第24回日本冠疾患学会学術集会, Dec. 2010, Japanese, 日本冠疾患学会, 東京, Domestic conference
    Public symposium

  • 日本人大動脈弁狭窄症患者におけるカテーテル大動脈弁置換術の適合性
    北川敦士, Okita Yutaka, Okada Kenji, 岡 隆紀, 南一司, Inoue Takeshi, 宗像宏, 田中亜希子, Yamaguchi Masato, Sugimoto Koji, Sugimura Kazuro
    第63回日本胸部外科学会, Oct. 2010, Japanese, 日本胸部外科学会, 岡山, Domestic conference
    Oral presentation

  • 自己弁温存大動脈基部置換術の中期遠隔成績
    岡隆紀, Shirasaka Tomonori, Sakamoto Toshihito, 野村拓生, Omura Atsushi, Nomura Yoshikatsu, 藤田靖之, 田中亜紀子, 宗像宏, 南一司, 長谷川智己, 北川敦士, Okada Kenji, Okita Yutaka
    第63回日本胸部外科学会学術総会, Oct. 2010, Japanese, 日本胸部外科学会, 大阪, Domestic conference
    Others

  • Total arch replacement for shaggy aorta
    Okada Kenji, Omura Atsushi, 佐藤雅信, Miyahara Shunsuke, 野村拓生, Nomura Yoshikatsu, Sakamoto Toshihito, 藤田靖之, 田中亜紀子, Inoue Takeshi, 宗像 宏, 岡 隆紀, 南 一司, 北川敦士, Okita Yutaka
    第63回日本胸部外科学会定期学術集会, Oct. 2010, Japanese, 日本胸部外科学会, 大阪, Domestic conference
    Public symposium

  • 当科における弓部大動脈再建時の脳保護法の工夫
    岡隆紀, Shirasaka Tomonori, Sakamoto Toshihito, 野村拓生, Omura Atsushi, Nomura Yoshikatsu, 藤田靖之, 田中亜紀子, 宗像宏, Matsumori Masamichi, 南一司, 長谷川智己, 北川敦士, Okada Kenji, Okita Yutaka
    第53回関西胸部外科学会学術総会, Jun. 2010, Japanese, 日本胸部外科学会, 名古屋, Domestic conference
    Oral presentation

  • 重症心不全に対する外科治療の中長期成績
    南 一司, Shirasaka Tomonori, 野村拓生, Nomura Yoshikatsu, Sakamoto Toshihito, Omura Atsushi, 田中亜紀子, 宗像 宏, Matsumori Masamichi, 岡 隆紀, 北川敦士, Okada Kenji, Okita Yutaka
    関西胸部外科学会, Jun. 2010, Japanese, 安藤太三, 名古屋, Domestic conference
    Oral presentation

  • 広範囲胸部大動脈瘤に対するハイブリッド手術の問題点
    北川敦士, Okita Yutaka, Okada Kenji, 長谷川智巳, Matsumori Masamichi, 南一司, 宗像宏, 田中亜希子, Yamaguchi Masato, Sugimoto Koji, Sugimura Kazuro
    第53回関西胸部外科学会, Jun. 2010, Japanese, 関西胸部外科学会, 名古屋, Domestic conference
    Public symposium

  • 自己弁温存大動脈基部置換術の遠隔成績
    岡隆紀, Shirasaka Tomonori, Sakamoto Toshihito, 野村拓生, Omura Atsushi, Nomura Yoshikatsu, 藤田靖之, 田中亜紀子, 宗像宏, Matsumori Masamichi, 南一司, 長谷川智己, 北川敦士, Okada Kenji, Okita Yutaka
    第38回日本血管外科学会学術総会, May 2010, Japanese, 日本血管外科学会, 大宮, Domestic conference
    Public symposium

  • Outcome of Total Aortic Arch Replacement with Coronary Artery Disease
    Okada Kenji, Omura Atsushi, Shirasaka Tomonori, 野村拓生, Nomura Yoshikatsu, 藤田靖之, 田中亜紀子, 宗像 宏, Matsumori Masamichi, 北川敦士, 岡 隆紀, 南 一司, 長谷川智巳, Okita Yutaka
    第38回日本血管外科学会学術総会, May 2010, Japanese, 日本血管外科学会, 大宮, Domestic conference
    Public symposium

  • Long-term outcome in CABG: bilateral or single use of IMA
    Okada Kenji, Omura Atsushi, Shirasaka Tomonori, 野村拓生, Nomura Yoshikatsu, Sakamoto Toshihito, 藤田靖之, 田中亜紀子, 宗像 宏, Matsumori Masamichi, 岡 隆紀, 南 一司, 北川敦士, 長谷川智己, Okita Yutaka
    第112回外科学会定期学術集会, Apr. 2010, Japanese, 日本外科学会, 名古屋, Domestic conference
    Oral presentation

  • Activation of transglutaminase type 2 for aortic wall protection in a rat abdominal aortic aneurysm formation.
    長谷川智巳, 宗実 孝, 田中亜紀子, 蘇日他拉, Okada Kenji, Okita Yutaka
    第110回外科学会定期学術集会, Apr. 2010, Japanese, 日本外科学会, 名古屋, Domestic conference
    Oral presentation

  • 自己弁温存大動脈基部置換術再手術症例の検討
    岡隆紀, Shirasaka Tomonori, Sakamoto Toshihito, 野村拓生, Omura Atsushi, Nomura Yoshikatsu, 藤田靖之, 田中亜紀子, 宗像宏, Matsumori Masamichi, 南一司, 長谷川智己, 北川敦士, Okada Kenji, Okita Yutaka
    第110回日本外科学会学術集会, Apr. 2010, Japanese, 日本外科学会, 名古屋, Domestic conference
    Oral presentation

  • 高齢者弁膜症手術の成績と問題点
    南 一司, Shirasaka Tomonori, 野村拓生, Nomura Yoshikatsu, Sakamoto Toshihito, Omura Atsushi, 田中亜紀子, 宗像 宏, Matsumori Masamichi, 長谷川智巳, 北川敦士, Okada Kenji, Okita Yutaka
    日本外科学会学術総会, Apr. 2010, Japanese, 中尾昭公, 名古屋, Domestic conference
    Oral presentation

  • Pioglitazone preserves vein graft integrity in a rat aortic interposition model.
    陳 志, 長谷川智巳, 田中亜紀子, Okada Kenji, Okita Yutaka
    第111回外科学会定期学術集会, Apr. 2010, Japanese, 日本外科学会, 名古屋, Domestic conference
    Oral presentation

  • TEVARの適応と限界 Shaggy aortaはcontraindicationか?
    北川敦士, Okita Yutaka, Okada Kenji, 長谷川智巳, Matsumori Masamichi, 南一司, 宗像宏, 田中亜希子, Yamaguchi Masato, Sugimoto Koji, Sugimura Kazuro
    第110回日本外科学会, Apr. 2010, Japanese, 日本外科学会, 名古屋, Domestic conference
    Oral presentation

  • 当院における80歳以上高齢者の心臓大血管手術の検討－正確なリスクファクターの把握－
    Hasegawa Tomoki, Omura Atsushi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Fujita Yasuyuki, Tanaka Akiko, Munakata Hiroshi, Matsumori Masamichi, Oka Takanori, Minami Hitoshi, Okada Kenji, Okita Yutaka
    日本心臓血管外科学会, Feb. 2010, Japanese, 日本心臓血管外科学会, 神戸, Domestic conference
    Oral presentation

  • 大動脈弁形成術は標準治療となりうるか？
    Matsumori Masamichi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Oka Takanori, Minami Hitoshi, Hasegawa Tomoki, Okada Kenji, Okita Yutaka
    第41回日本心臓血管外科学会総会, Feb. 2010, Japanese, 日本心臓血管外科学会, 神戸, Domestic conference
    Public symposium

  • 大動脈基部手術: valve sparing vs. Bentall procedure
    Matsumori Masamichi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Oka Takanori, Minami Hitoshi, Hasegawa Tomoki, Okada Kenji, Okita Yutaka
    第40回日本心臓血管外科学会総会, Feb. 2010, Japanese, 日本心臓血管外科学会, 神戸, Domestic conference
    [Invited]
    Invited oral presentation

  • 急性大動脈解離における臓器灌流障害合併症例の検討
    Munakata Hiroshi, Omura Atsushi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Fujita Yasuyuki, Tanaka Akiko, Matsumori Masamichi, Oka Takanori, Minami Hitoshi, Hasegawa Tomoki, Kitagawa Atsushi, Okada Kenji, Okita Yutaka
    第40回日本心臓血管外科学会学術総会, Feb. 2010, Japanese, 日本心臓血管外科学会, 神戸, Domestic conference
    Poster presentation

  • Outcomes of surgical intervention for active infective endocarditis
    Minami Hitoshi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Okada Kenji, Okita Yutaka
    日本心臓血管外科学会総会, Feb. 2010, Japanese, 日本心臓血管外科学会, 神戸, Domestic conference
    Oral presentation

  • Which Conduit Is Better For Aortic Infection Disease ? Dacron graft
    Munakata Hiroshi, Shirasaka Tomonori, Nomura Yoshikatsu, Omura Atsushi, Sakamoto Toshihito, Fujita Yasuyuki, Tanaka Akiko, Matsumori Masamichi, Oka Takanori, Minami Hitoshi, Okada Kenji, Okita Yutaka
    第40回日本心臓血管外科学会学術総会, Feb. 2010, Japanese, 日本心臓血管外科学会, 神戸, Domestic conference
    [Invited]
    Invited oral presentation

  • Standardized surgical procedure of total arch replacement in TEVAR era
    Okada Kenji, Omura Atsushi, Shirasaka Tomonori, Nomura Yoshikatsu, Sakamoto Toshihito, Fujita Yasuyuki, Tanaka Akiko, Munakata Hiroshi, Matsumori Masamichi, Oka Takanori, Minami Hitoshi, Kitagawa Atsushi, Okita Yutaka
    第40回日本心臓血管外科学会学術総会, Feb. 2010, Japanese, 日本心臓血管外科学会, 神戸, Domestic conference
    Public symposium

  • 自作ステントグラフトによるTEVARの遠隔成績
    Kitagawa Atsushi, Tanaka Akiko, Munakata Hiroshi, Matsumori Masamichi, Minami Hitoshi, Hasegawa Tomoki, Okada Kenji, Yamaguchi Masato, Sugimoto Koji, Sugimura Kazuro, Okita Yutaka
    第47回日本人工臓器学会総会, Nov. 2009, Japanese, 日本人工臓器学会, 新潟, Domestic conference
    Public symposium

  • Aortic root replacement with annular reconstruction for destructive aortic root abscess
    Okada Kenji
    平成21年度阪神心臓弁膜症シンポジウム, Oct. 2009, Japanese, 阪神心臓弁膜症シンポジウム, 西宮, Domestic conference
    Others

  • Mitral valve repair for bileaflets prolapse and complex leision
    Minami Hitoshi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Okada Kenji, Okita Yutaka
    日本胸部外科学会総会, Oct. 2009, Japanese, 日本胸部外科学会, 仙台, Domestic conference
    Poster presentation

  • The Relation Between The Intracranial Arteries And The Postoperative Brain Low-Perfusion Damage After Total Arch Replacement
    Munakata Hiroshi, Shirasaka Tomonori, Nomura Yoshikatsu, Sakamoto Toshihito, Tanaka Akiko, Matsumori Masamichi, Minami Hitoshi, Okada Kenji, Okita Yutaka
    第62回日本胸部外科学会学術総会, Oct. 2009, Japanese, 日本胸部外科学会, 横浜, Domestic conference
    Oral presentation

  • Shaggy aorta症例に対するTEVAR---SMA閉塞バルーンの有用性
    Kitagawa Atsushi, Okita Yutaka, Okada Kenji, Hasegawa Tomoki, Minami Hitoshi, Matsumori Masamichi, Munakata Hiroshi, Tanaka Akiko, Nomura Yoshikatsu, Yamaguchi Masato, Sugimoto Koji, Sugimura Kazuro
    第62回日本胸部外科学会総会, Oct. 2009, Japanese, 日本胸部外科学会, 横浜, Domestic conference
    Oral presentation

  • Midterm result of aortic cusp repair
    Matsumori Masamichi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Oka Takanori, Minami Hitoshi, Hasegawa Tomoki, Okada Kenji, Okita Yutaka
    第62回日本胸部外科学会総会, Oct. 2009, Japanese, 日本胸部外科学会, 横浜, Domestic conference
    Oral presentation

  • Coronary artery bypass grafting in patients with impaired the left ventricle
    Okada Kenji, Omura Atsushi, Shirasaka Tomonori, Nomura Yoshikatsu, Sakamoto Toshihito, Tanaka Akiko, Munakata Hiroshi, Matsumori Masamichi, Minami Hitoshi, Hasegawa Tomoki, Okita Yutaka
    第62回日本胸部外科学会定期学術総会, Sep. 2009, Japanese, 日本胸部外科学会, 横浜, Domestic conference
    Oral presentation

  • Standardized aortic surgery in TEVAR era
    Okada Kenji, Omura Atsushi, Munakata Hiroshi, Matsumori Masamichi, Kitagawa Atsushi, Okita Yutaka
    第57回日本心臓病学会学術集会, Sep. 2009, Japanese, 日本心臓病学会, 札幌, Domestic conference
    [Invited]
    Invited oral presentation

  • Open Surgical Repair for Failed Thoracic Endovascular Repair
    Tanaka Akiko, Kitagawa Atsushi, Matsumori Masamichi, Okada Kenji, Okita Yutaka
    European Society of Vascular Surgery, Sep. 2009, English, European Society of Vascular Surgery, オスロ, ノルウェー, International conference
    Poster presentation

  • Valve sparing aortic root replacement with aortic valve cusp repai for congenital bicuspid aortic valve
    Okada Kenji, Matsumori Masamichi, Okita Yutaka
    第20回関西心臓手術手技研究会, Jul. 2009, Japanese, CSLベーリング株式会社, 大阪, Domestic conference
    [Invited]
    Invited oral presentation

  • 追加治療を要したTEVAR症例の検討
    Kitagawa Atsushi, Okita Yutaka, Okada Kenji, Hasegawa Tomoki, Minami Hitoshi, Matsumori Masamichi, Munakata Hiroshi, Tanaka Akiko, Nomura Yoshikatsu, Yamaguchi Masato, Sugimoto Koji, Sugimura Kazuro
    第52回関西胸部外科学会, Jun. 2009, Japanese, 関西胸部外科学会, 岡山, Domestic conference
    Oral presentation

  • 成人期に施行された先天的大血管異常の手術成績
    Munakata Hiroshi, Omura Atsushi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Fujita Yasuyuki, Tanaka Akiko, Matsumori Masamichi, Oka Takanori, Minami Hitoshi, Hasegawa Tomoki, Kitagawa Atsushi, Okada Kenji, Okita Yutaka
    第52回関西胸部外科学会学術総会, Jun. 2009, Japanese, 関西胸部外科学会, 岡山, Domestic conference
    Oral presentation

  • Long term results of surgery for ischemic mitral regurgitation
    Minami Hitoshi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Okada Kenji, Okita Yutaka
    関西胸部外科学会, Jun. 2009, Japanese, 関西胸部外科学会, 岡山, Domestic conference
    Oral presentation

  • Marfan症候群に対する胸腹部大動脈瘤の治療戦略
    Matsumori Masamichi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Oka Takanori, Minami Hitoshi, Hasegawa Tomoki, Okada Kenji, Okita Yutaka
    第52回関西胸部外科学会, Jun. 2009, Japanese, 日本胸部外科学会, 岡山, Domestic conference
    Public symposium

  • Does aortic cusp repair influence the outcome of Valve sparing aortic root replacement ?
    Matsumori Masamichi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Oka Takanori, Minami Hitoshi, Hasegawa Tomoki, Okada Kenji, Okita Yutaka
    society of heart valve disease, Jun. 2009, English, The Society for Heart Valve Disease, ベルリン, ドイツ, International conference
    Poster presentation

  • Choradal Preservation in Patients with Mitral Stenosis Undergoing Mitral Valve Replacement
    Tanaka Akiko, Matsumori Masamichi, Okada Kenji, Okita Yutaka
    Society of Heart Valve Disease, Jun. 2009, English, Society of Heart Valve Disease, ベルリン, ドイツ, International conference
    Poster presentation

  • Balloon protection of superior mesenteric artery to prevent mesenteric ischemia during TEVAR for shaggy aorta
    Kitagawa Atsushi, Okita Yutaka, Okada Kenji, Hasegawa Tomoki, Minami Kotaro, Munakata Hiroshi, Tanaka Akiko, Nomura Yoshikatsu, Yamaguchi Masato, Sugimoto Koji, Sugimura Kazuro
    The 10th Multidisciplinary European Endovascular Therapy, Jun. 2009, English, Multidisciplinary European Endovascular Therapy, カンヌ, フランス, International conference
    Oral presentation

  • Aortic arch repair for the patients with renal insufficiency
    Minami Hitoshi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Okada Kenji, Okita Yutaka
    日本血管外科学会総会, May 2009, Japanese, 日本血管外科学会, 名古屋, Domestic conference
    Poster presentation

  • 急性B型大動脈解離遠隔期の成績
    Munakata Hiroshi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Matsumori Masamichi, Kitagawa Atsushi, Hasegawa Tomoki, Okada Kenji, Okita Yutaka
    第34回日本血管外科学会学術総会, May 2009, Japanese, 日本血管外科学会, 名古屋, Domestic conference
    Oral presentation

  • Surgical outcome of patients with renal cell carcinoma extending to the inferior vena cava
    Okada Kenji, Shirasaka Tomonori, Sakamoto Toshihito, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Matsumori Masamichi, Minami Hitoshi, Hasegawa Tomoki, Okita Yutaka
    第37回日本血管外科学会総会, May 2009, Japanese, 日本血管外科学会, 名古屋, Domestic conference
    Oral presentation

  • 炎症性大動脈疾患に対する大動脈基部置換術の検討
    Matsumori Masamichi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Oka Takanori, Minami Hitoshi, Hasegawa Tomoki, Okada Kenji, Okita Yutaka
    第37回日本血管外科学会総会, May 2009, Japanese, 日本血管外科学会, 名古屋, Domestic conference
    Oral presentation

  • エラスターゼ/塩化カルシウム併用による新しいラット腹部大動脈モデルの開発
    Hasegawa Tomoki, Tanaka Akiko, Okada Kenji, Okita Yutaka
    日本血管外科学会, May 2009, Japanese, 日本血管外科学会, 名古屋, Domestic conference
    Oral presentation

  • EVAR --- Is it available for most of Japanese AAA patients?
    Kitagawa Atsushi, Okita Yutaka, Okada Kenji, Hasegawa Tomoki, Minami Kotaro, Matsumori Masamichi, Nomura Yoshikatsu, Yamaguchi Masato, Sugimoto Koji, Sugimura Kazuro
    第36 回日本血管外科学会総会, May 2009, English, 日本血管外科学会, 名古屋, Domestic conference
    Oral presentation

  • Re-do valve surgery complicated by destroyed annulus
    Okada Kenji, Shirasaka Tomonori, Sakamoto Toshihito, Tanaka Akiko, Munakata Hiroshi, Matsumori Masamichi, Okita Yutaka
    第109回日本外科学会定期学術総会, Apr. 2009, Japanese, 日本外科学会, 福岡, Domestic conference
    Public symposium

  • Aortic root replacement with autologous pericardial patch annuloplasty for destructive root abscess
    Okada Kenji, Shirasaka Tomonori, Sakamoto Toshihito, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Matsumori Masamichi, Hasegawa Tomoki, Okita Yutaka
    第39回日本心臓血管外科学会学術総会, Apr. 2009, Japanese, 日本心臓血管外科学会学, 富山, Domestic conference
    Oral presentation

  • 神戸大学病院における弓部大動脈瘤手術のスタンダード
    Hasegawa Tomoki, Shirasaka Tomonori, Sakamoto Toshihito, Omura Atsushi, Nomura Yoshikatsu, Tanaka Akiko, Munakata Hiroshi, Matsumori Masamichi, Okada Kenji, Okita Yutaka
    日本外科学会, Apr. 2009, Japanese, 日本外科学会, 福岡, Domestic conference
    Oral presentation

  • 自己弁温存大動脈基部置換術の遠隔成績に及ぼす大動脈基部径の影響
    Matsumori Masamichi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Oka Takanori, Minami Hitoshi, Hasegawa Tomoki, Okada Kenji, Okita Yutaka
    第109回日本外科学会定期学術集会, Apr. 2009, Japanese, 日本外科学会, 福岡, Domestic conference
    Oral presentation

  • 胸部大動脈破裂に対する検討： TEVAR vs open surgery
    Kitagawa Atsushi, Okita Yutaka, Okada Kenji, Hasegawa Tomoki, Minami Hitoshi, Matsumori Masamichi, Munakata Hiroshi, Tanaka Akiko, Nomura Yoshikatsu, Yamaguchi Masato, Sugimoto Koji, Sugimura Kazuro
    第61回日本外科学会総会, Apr. 2009, Japanese, 日本外科学会, 福岡, Domestic conference
    Public symposium

  • 胸部下行大動脈破裂：TEVAR とopen surgery の比較と問題点
    Kitagawa Atsushi, Okita Yutaka, Okada Kenji, Hasegawa Tomoki, Minami Hitoshi, Matsumori Masamichi, Munakata Hiroshi, Tanaka Akiko, Nomura Yoshikatsu, Yamaguchi Masato, Sugimoto Koji, Sugimura Kazuro
    第39回日本心臓血管外科学会総会, Apr. 2009, Japanese, 日本心臓血管外科学会, 富山, Domestic conference
    Public symposium

  • 急性B型大動脈解離に対する遠隔期保存的加療の限界
    Munakata Hiroshi, Shirasaka Tomonori, Sakamoto Toshihito, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Matsumori Masamichi, Kitagawa Atsushi, Hasegawa Tomoki, Okada Kenji, Okita Yutaka
    第39回日本心臓血管外科学会学術総会, Apr. 2009, Japanese, 日本心臓血管外科学会, 富山, Domestic conference
    Oral presentation

  • Mid-term result of aortic root replacement： Valve sparing vs Bentall
    Matsumori Masamichi, Sakamoto Toshihito, Nomura Yoshikatsu, Omura Atsushi, Tanaka Akiko, Munakata Hiroshi, Oka Takanori, Minami Hitoshi, Hasegawa Tomoki, Okada Kenji, Okita Yutaka
    第39回日本心臓血管外科学会総会, Apr. 2009, Japanese, 日本心臓血管外科学会, 富山, Domestic conference
    Oral presentation

  • Comparative analysis of ruptured descending thoracic aortic aneurysms between TEVAR and open surgery
    Kitagawa Atsushi, Sugimoto Koji, Yamaguchi Masato, Okada Kenji, Okita Yutaka
    The 21th International Symposium on Endovascular Surgery, Jan. 2009, English, International Society of Endovascular Surgery, ハリウッド, アメリカ, International conference
    Poster presentation

  • 肺動脈血栓内膜摘除術が奏功した若年発症の慢性肺動脈血栓塞栓症の一例
    Yamashita Tomoya, Yoshida Akihiro, Emoto Noriaki, Kawai Hiroya, Shite Junya, Hirata Kenichi, Yokoyama Mitsuhiro, Matsumori Masamichi, Okada Kenji, Okita Yutaka
    第103回日本日本循環器学会近畿地方会, Jun. 2007, Japanese, 日本循環器学会, 大阪, Domestic conference
    Oral presentation

  • 下大静脈内腫瘍塞栓を合併した腎悪性腫瘍に対する治療成績の検討
    Nakagiri Keitaro, Tanaka Akiko, Munakata Hiroshi, Matsumori Masamichi, Asano Mitsuru, Tanaka Hiroshi, Kawanishi Yujiro, Kitagawa Atsushi, Okada Kenji, Okita Yutaka, Fujisawa Masato
    第35回日本血管外科学会, May 2007, Japanese, 日本血管外科学会, 名古屋, Domestic conference
    Oral presentation

  • 著明な接合不全を伴う重症僧帽弁閉鎖不全症に対して僧帽弁輪形成術を施行した1例
    辰巳 和宏, KAWAI, Hiroya, 溝口 貴裕, 田中 秀和, 大西 哲存, 片岡 俊哉, YOKOYAMA, Mitsuhiro, OKADA, Kenji, OKITA, Yutaka
    日本心エコー図学会学術集会（第16回）, Apr. 2005, Japanese, 日本心エコー図学会, 神戸, Domestic conference
    Oral presentation

  • 一過性に僧帽弁の可動制限による著明な接合不全を来たした重症僧帽弁閉鎖不全症に対して僧帽弁輪形成術を施行した1例
    辰巳 和宏, KAWAI, Hiroya, 溝口 貴裕, 田中 秀和, 大西 哲存, 片岡 俊哉, YOKOYAMA, Mitsuhiro, OKADA, Kenji, OKITA, Yutaka
    第29回日本超音波医学会関西地方会学術集会, Feb. 2005, Japanese, 日本超音波医学会, 神戸, Domestic conference
    Oral presentation

  • 一過性に僧帽弁の可動制限による著明な接合不全を来たした重症僧帽弁閉鎖不全症に対して僧帽弁輪形成術を施行した1例
    辰巳 和宏, KAWAI, Hiroya, 溝口 貴裕, 田中 秀和, 大西 哲存, 片岡 俊哉, YOKOYAMA, Mitsuhiro, OKADA, Kenji, OKITA, Yutaka
    第2回先進心血管エコー研究会, Aug. 2004, Japanese, 大阪, Domestic conference
    Oral presentation

■ Affiliated Academic Society
  • European Association for Cardio-Thoracic Surgery

  • 日本人工臓器学会

  • 日本冠疾患学会

  • 日本血管外科学会

  • 日本冠動脈外科学会

  • 日本循環器学会

  • 日本心臓血管外科学会

  • 日本胸部外科学会

  • 日本外科学会

■ Research Themes
  • Development of novel immune therapy against abdominal aortic aneurysm.
    江本 拓央, 井上 大志, 山中 勝弘, 岡田 健次, 山下 智也
    Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (B), Kobe University, 01 Apr. 2024 - 31 Mar. 2027

  • Clarifying the mechanisms of atherosclerotic cardiovascular diseases via genome and single cell integrated omics analyses.
    平田 健一, 井上 大志, 大竹 寛雅, 山中 勝弘, 江本 拓央, 岡田 健次, 山下 智也
    Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (B), Kobe University, 01 Apr. 2023 - 31 Mar. 2026
    本研究の目的は、動脈硬化性疾患（冠動脈疾患CAD、大動脈瘤AA、大動脈弁狭窄症AS）のシングルセルアトラスの作成と全ゲノム解析を行い、トランスオミックス統合解析を行うことで、それぞれの疾患の相違点を炙り出し、疾患のリスク層別化を行い、発症メカニズムを解明することである。本研究では、これら3疾患について、1）病変部のシングルセル＋核RNAシークエンス（scRNAseq+snRNAseq）からシングルセルアトラスを作成、各々の疾患特異的マクロファージの同定を行うと同時に、2）T細胞レパトア解析から各々の疾患において、特徴的な抗原が存在するのかを明らかにする。さらには、3）Genotyping of Transcriptomes (GoT)による シングルセルレベルで骨髄のクローン性造血の関与を調べる解析と4）全ゲノム解析による遺伝素因とトランスクリプトームの関連を解析する、expression quantitative locus (eQTL)解析を行う。3)と4)の実施にて、ゲノム・トランスクリプトーム統合解析が達成できる。すでに、3疾患の少数サンプルでのシングルセルトランスクリプトーム解析は終了し、シングルセルアトラスの概要は見えてきている。CADでT細胞受容体レパトア解析が終了し論文報告を行った。AAでは、結果を受けマウスでの実験も同時実施しており、マクロファージやB細胞での疾患特異的な特徴のデータを得ている。ASでのクローン性造血(CH)の原因となる体細胞遺伝子変異の解析数を増加させており、少数患者でのGoT解析を進めている。まずは3)GoTの統合解析手法の確立を目指す。全ゲノム解析は実施できておらず、4)eQTLの実施までには、さらに時間が必要と考えられる。

  • ヒト大動脈解離におけるシングルセルRNAシークエンスによる成因解析
    岡田 健次, 井上 大志, 山中 勝弘, 江本 拓央, 山下 智也
    日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 01 Apr. 2022 - 31 Mar. 2025

  • 大動脈解離の発生と進展に好中球が与える影響の検討
    井上 大志, 山中 勝弘, 江本 拓央, 岡田 健次, 山下 智也
    日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 01 Apr. 2022 - 31 Mar. 2025

  • 胸腹部大動脈術後脊髄再灌流障害の新たな細胞障害機序の解明と治療法の開発
    中井 秀和, 藤田 靖之, 山中 勝弘, 世古 義規, 川本 篤彦, 岡田 健次
    日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 01 Apr. 2021 - 31 Mar. 2024

  • To identify the biomarker in cerebrospinal fluid to prevent the spinal cord ischemia reperfusion injury
    Yamanaka Katsuhiro
    Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Kobe University, 01 Apr. 2019 - 31 Mar. 2022
    We was not able to establish the mouse model of spinal cord ischemia-reperfusion.

  • Construction of human myocardial tissue using biosheet consisting of completely self-tissue
    Wada Yuko
    Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Shinshu University, 01 Apr. 2018 - 31 Mar. 2021
    The purpose of this study was to show that biosheets made using in-body-tissue- architecture (IBTA) can be a new filling material for dysfunctional myocardium. First, a new left ventricular pressure-loaded ectopic heart transplant model was established, and then left ventricular wall replacement with a biosheets was performed using this model. It was shown that this biosheets has sufficient strength and flexibility to withstand anastomosis and sufficient thickness and strength to withstand left ventricular filling pressure. Cardiomyocyte infiltration was not occurred and electrical coupling with the host myocardium became the next issue, but we were able to obtain results that will lead to the future.

  • Basic research on anti-infective properties of biotube
    Okada Kenji
    Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Shinshu University, 01 Apr. 2018 - 31 Mar. 2021
    The purpose of this study was to demonstrate the anti-infection property of biotubes by infection experiments. The biotubes are completely autologous in vivo tissue-engineered connective tissue tubes. Biotubes do not contain any artificial materials and are expected to be anti-infective. If the anti-infection property is demonstrated, it will be an important study for clinical application against infection. A model was created in which biotubes and artificial blood vessels were implanted into the abdominal aorta of rats. Staphylococcus aureus was implanted in those groups, but it was difficult to control the amount of Staphylococcus aureus.The results did not support the expected anti-infection properties of the biotubes.

  • OKADA Kenji, OKITA Yutaka
    Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C), Grant-in-Aid for Scientific Research (C), Kobe University, 01 Apr. 2012 - 31 Mar. 2015, Principal investigator
    An ideal pharmaceutical treatment for abdominal aortic aneurysm (AAA) is to prevent aneurysm formation and development (further dilatation of pre-existing aneurysm). Recent studies have reported that oxidative stress with reactive oxygen species (ROS) is crucial in aneurysm formation. We have demonstrated that edaravone, a free-radical scavenger, attenuated vascular oxidative stress and inhibit AAA formation and development in rat AAA model. Based on the results, we also have proven the efficacy of other anti-oxidants, such as a gelatin hydrogel sheet incorporating ascorbic acid, a novel oral antidiabetic drug of Dipeptidyl peptidase-4 (DPP-4) inhibitor, and oral administration of riboflavin on the treatment of AAA.
    Competitive research funding

  • OKADA Kenji, OKITA Yutaka
    Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C), Grant-in-Aid for Scientific Research (C), Kobe University, 2008 - 2010, Principal investigator
    Small caliber (〓2mm) prosthetic graft for coronary artery bypass grafting has not been developed for clinical use. The major cause of sticking point is the neointimal hyperplasia at the site of anastomosis. In the current study, we used a rat aortic interposition model with autologous femoral vein. Oral dose of Pioglitazone successfully prevented graft degeneration including the neointimal hyperplasia at the anastomosis. We are now under investigation for the prevention of neointimal hyperplasia at the anastomosis of small-caliber vascular prosthesis.
    Competitive research funding

  • Research of "Autologous fibrin coated small caliber vascular prostheses improve the antithrombogenicity by less immunological response"
    OKADA Kenji, OKITA Yutaka
    Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C), Grant-in-Aid for Scientific Research (C), Kobe University, 2003 - 2004
    Introduction : Development of small caliber vascular prostheses is still challenging. Recently we have developed a new technique of fibrin coatings for vascular grafts. We hypothesized that autologous fibrin coatings could improve the antithrombogenicity of grafts by less immunological response. We also examine the graft healing characteristics after implantation. Methods : Knitted polyester fabric vascular prostheses, 2mm in internal diameter, were coated with autologous (rabbit, A-graft) or xenologous (human, X-graft) fibrin by modified ethanol method from plasma. Fifty Japanese white rabbits were implanted with the grafts in bilateral carotid arteries and divided into three groups by the selection of grafts in the individual rabbit : A&X-grafts (group I, n40), A&A-grafts (group II, n=5), X&X-grafts (group III, n=5). To evaluate graft patency, anti-graft serum antibody, ^<111>Indium platelet scintigraphy and histology, the grafts in group I were explanted on postoperative days (PODs) 1, 3, 7, 10, 14, 30, 60, 180 (n=5 for each). Serum levels of immunoglobulin G (IgG) and M (IgM), tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) in group II and III were measured serially to compare immunological, coagulative and fibrinolytic reactions. Rsults : All of grafts except one X-graft on POD 10 were patent without stenosis and thrombus. Monolayer endothelial-like cells were covered on the entire surface of the A-grafts on POD 60. In group I, the maximal anti-graft serum antibodies (0.17±0.02 optical density at 490 nm [O.D.]) and the maximal platelet deposition (10.3±1.6x10^6/mm^2) in A-grafts were significantly less than those in X-grafts (0.46±0.06 O.D. and 17.4±1.4x10^6/mm^2, respectively ; p<0.0001 in both). Although serum levels of IgG, IgM, tPA and PAI-1 were increased at the time of fibrin degradation of grafts during POD 7 to 14, those in group II were significantly less than those in group III (p<0.O1, ANOVA). The PAI-1/tPA ratio in both groups was decreased as platelet deposition of the grafts was increased. Conclusion : These findings suggest that autologous fibrin coatings improve the antithrombogenicity by less immunological response and have a potential use for hybrid small caliber vascular prostheses.

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