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Your search keyword '"Yoshihiko Onishi"' showing total 3 results
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3 results on '"Yoshihiko Onishi"'

1. Anesthetic management for withdrawal from a right ventricular assist device and Fontan procedure in a patient with an implantable left ventricular assist device for fulminant cardiomyopathy

Author

Naka Kida, Masahiro Morinaga, Naoki Tadokoro, Takuma Maeda, and Yoshihiko Onishi

Subjects
Right ventricular assist device withdrawal, Implantable left ventricular assist device, Fontan procedure, Inflow cannula, Suck-down event, Anesthesiology, RD78.3-87.3, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background We herein report the anesthetic management for extracardiac conduit–total cavopulmonary connection (EC-TCPC) for weaning from an extracorporeal right ventricular assist device (RVAD) in a patient with an implantable left ventricular assist device (LVAD) for fulminant cardiomyopathy. Case presentation A 24-year-old man developed fulminant cardiomyopathy and was placed on a biventricular assist device (BiVAD) comprising an implantable LVAD and an extracorporeal RVAD. The Fontan procedure was performed to wean the patient from the RVAD and allow him to be discharged home. Atrial septal defect creation, right ventricular suture, and tricuspid valve closure were then simultaneously performed to ensure sufficient left ventricular preload to drive the LVAD. Furthermore, to keep the central venous pressure lower, the inflow cannula of the LVAD was oriented in the correct direction. Conclusion This is the first report of anesthetic management of the Fontan procedure in a patient with a BiVAD.

Published
2023
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3. Outcomes after Rivaroxaban Treatment of Extensive Deep Vein Thrombosis

Author

Shunichiro Fujioka, Tadashi Kitamura, Fumiaki Shikata, Toshiaki Mishima, Yoshihiko Onishi, Haruna Araki, Hiroshi Goto, Akihiro Sasahara, Masaomi Fukuzumi, Shinzo Torii, and Kagami Miyaji

Subjects
Venous Thrombosis, Treatment Outcome, Rivaroxaban, Anticoagulants, Humans, Thrombolytic Therapy, Thrombosis, Surgery, General Medicine, Iliac Vein, Cardiology and Cardiovascular Medicine, Retrospective Studies
Abstract

Regression of thrombus in response to treatment with direct oral anticoagulants (DOACs) in patients with extensive deep vein thrombosis (DVT) has not been fully evaluated. This study aimed to determine the therapeutic efficacy of rivaroxaban in the treatment of extensive DVT.We retrospectively evaluated 76 patients treated with rivaroxaban among 728 new DVT patients, at our hospital from January 2018 to March 2021. Extensive DVT was defined as thrombus connecting to 2 or more segments of the inferior vena cava (IVC), iliac vein, femoral vein, or popliteal vein. Localized DVT was defined as a thrombus confined to 1 segment of the inferior vena cava (IVC), iliac vein, femoral vein, or popliteal vein. We compared the changes in thrombus between the extensive DVT group (36 patients) and the localized DVT group (40 patients).In the localized DVT group, 14 (37%) had total recanalization within 3 weeks after DOAC initiation, and 30 (79%) had total recanalization within 3 months. In the extensive DVT group, only 3 (9%) had total recanalization within 3 weeks after starting DOAC, and even after 3 months, only 5 (15%) had total recanalization. Symptoms (P = 0.01) and extensive DVT (P 0.01) were significantly associated with the risk for failure of total recanalization.Rivaroxaban was highly effective for total recanalization of localized DVT but not for symptomatic or extensive DVT. In patients with symptomatic extensive DVT, catheter-based thrombolysis may be considered in selected cases.

Published
2022

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