19 results on '"Yuichiro, Hirata"'
Search Results
2. A Surgical Case of Midventricular Hypertrophic Obstructive Cardiomyopathy with Apical Aneurysm
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Tatsushi Onzuka, Kojiro Furukawa, Yuichiro Hirata, Eiki Tayama, Shigeki Morita, and Takuya Nishijima
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Apical aneurysm ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Cardiology ,business ,Obstructive cardiomyopathy - Published
- 2020
3. Extracorporeal membrane oxygenation for the control of a pulmonary artery hemorrhage
- Author
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Tatshushi Onzuka, Ryuya Nomura, Tomofumi Fukuda, Shigeki Morita, Eiki Tayama, Kojiro Furukawa, and Yuichiro Hirata
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Hemodynamics ,medicine.disease ,Bronchial blocker ,law.invention ,Cardiac surgery ,surgical procedures, operative ,law ,Internal medicine ,medicine.artery ,Pulmonary artery ,Cardiopulmonary bypass ,Cardiology ,Extracorporeal membrane oxygenation ,Medicine ,Pulmonary blood flow ,Pulmonary hemorrhage ,business - Abstract
No standard treatments have been established for airway hemorrhage during cardiopulmonary bypass (CPB). Herein, we describe two cases of catheter-induced pulmonary hemorrhage during cardiac surgery. In each case, massive hemoptysis was observed during cardiopulmonary bypass (CPB) weaning. A bronchial blocker was inserted into the right bronchus, and extracorporeal membrane oxygenation (ECMO) was initiated to reduce pulmonary blood flow, and stabilize the hemodynamics. ECMO significantly reduced bleeding from the pulmonary artery (PA). Both cases had favorable outcomes following the implementation of extracorporeal membrane oxygenation (ECMO). ECMO is effective at controlling PA bleeding during and after cardiac surgery.
- Published
- 2021
4. Portosystemic venous shunt in the patients with Fontan circulation
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Hazumu Nagata, Ayako Ishikita, Shouichi Ohga, Kiyoshi Uike, Yusaku Nagatomo, Shouji Fukuoka, Ichiro Sakamoto, Yuichiro Hirata, and Kenichiro Yamamura
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Adult ,Heart Defects, Congenital ,Male ,medicine.medical_specialty ,Adolescent ,Vascular Malformations ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Fontan Procedure ,Vascular anomaly ,Veins ,Fontan procedure ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Internal medicine ,Medicine ,Humans ,Abnormalities, Multiple ,030212 general & internal medicine ,Cardiac catheterization ,Retrospective Studies ,business.industry ,Central venous pressure ,Vascular surgery ,Middle Aged ,medicine.disease ,Cardiac surgery ,medicine.anatomical_structure ,Echocardiography ,Heart failure ,cardiovascular system ,Vascular resistance ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Portosystemic venous shunt (PSVS) is a vascular anomaly between the portal and systemic veins, resulting in several critical complications. Although PSVS is often associated with congenital heart diseases, the clinical association between Fontan circulation and PSVS has not been elucidated. This study aimed to investigate the clinical features of Fontan patients with PSVS. Two hundred thirteen patients who underwent Fontan procedure are being followed up at Adult Congenital Heart Disease clinic in Kyushu University Hospital. Among them, 139 adult patients underwent cardiac catheterization between January 1, 2011 and September 30, 2019. Medical records were reviewed to investigate the laboratory, echocardiography, and cardiac catheterization findings, as well as clinical manifestations and outcomes. Eleven Fontan patients received the diagnosis of PSVS. The median age at cardiac catheterization was 25 (range 18–45) years. Fontan operation was performed using extracardiac conduit or lateral tunnel 22 (16–35) years previously. Ten patients presented with chronic heart failure [New York Heart Association class 2 (n = 5) and 3 (n = 5)]. The median level of peripheral oxygen saturation was 87 (70–95)%. Cardiac catheterization showed increased cardiac index [5.3 (2.72–14.3) L/min/m2] with or without high central venous pressure [18 (9–25) mmHg]. Although the pulmonary vascular resistance was within the normal range, the systemic vascular resistance was decreased [7.08 (1.74–18.6) Wood units]. Fontan patients complicated with PSVS had increased cardiac output. The presence of PSVS in Fontan circulation might be associated with unfavorable long-term outcome.
- Published
- 2020
5. Two Cases of Staged Repair of Anomalous Origin of Right Pulmonary Artery from the Ascending Aorta
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Hazumu Nagata, Yusaku Nagatomo, Kensaku Matsuda, Akira Shiose, Kazuhiro Hinokiyama, Shouichi Ohga, Hideki Tatewaki, and Yuichiro Hirata
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medicine.medical_specialty ,business.industry ,Internal medicine ,medicine.artery ,Ascending aorta ,medicine ,Cardiology ,Staged repair ,business ,Right pulmonary artery - Published
- 2018
6. Endovascular Stent-Graft Repair of a Persistent Sciatic Artery Aneurysm
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Hiroyuki Tanaka, Seiji Onitsuka, Shohei Yoshida, Yuichiro Hirata, Shinichi Hiromatsu, and Hayato Fukuda
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medicine.medical_specialty ,medicine.medical_treatment ,Case Report ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Internal medicine ,medicine ,persistent sciatic artery aneurysm ,cardiovascular diseases ,Thrombus ,Sciatica ,endovascular therapy ,business.industry ,Stent ,General Medicine ,Sciatic nerve injury ,medicine.disease ,Limb ischemia ,Surgery ,Embolism ,acute limb ischemia ,Cardiology ,medicine.symptom ,business ,Sciatic artery ,030217 neurology & neurosurgery - Abstract
Persistent sciatic artery (PSA) is a rare anomaly that may cause various symptoms, such as aneurysm, rupture, thromboembolism, and sciatica. Direct surgery can be performed to treat PSA aneurysm (PSAA), but is associated with complications; e.g., anatomical problems such as sciatic nerve injury. Herein we report a case of a 74-year-old woman with acute limb ischemia that developed from a distal embolism caused by a thrombus in the left PSAA; favorable results were obtained for her by treatment with a stent-graft after rapid anticoagulation therapy for limb salvage.
- Published
- 2017
7. Elevated non-invasive liver fibrosis markers and risk of liver carcinoma in adult patients after repair of tetralogy of Fallot
- Author
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Shouichi Ohga, Hiroyuki Tsutsui, Hazumu Nagata, Yukihiko Okumura, Eiji Morihana, Kazuhiro Koto, Yuzo Yamasaki, Kenichiro Yamamura, Kenichi Kohashi, Ichiro Sakamoto, and Yuichiro Hirata
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Adult ,Collagen Type IV ,Liver Cirrhosis ,Male ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Heart disease ,medicine.medical_treatment ,Biopsy ,Magnetic Resonance Imaging, Cine ,030204 cardiovascular system & hematology ,Fontan procedure ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Japan ,Cardiac magnetic resonance imaging ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Cardiac Surgical Procedures ,Hyaluronic Acid ,Tetralogy of Fallot ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Incidence ,Liver Neoplasms ,Alanine Transaminase ,medicine.disease ,Congestive hepatopathy ,Liver ,Hepatocellular carcinoma ,Cardiology ,Disease Progression ,Female ,Cardiology and Cardiovascular Medicine ,Liver cancer ,business ,Complication ,Biomarkers ,Follow-Up Studies - Abstract
Congestive hepatopathy and hepatocellular carcinoma is a serious complication after Fontan procedure. Liver fibrosis due to hepatic congestion could occur also in adult patients after repair of tetralogy of Fallot (rTOF). However, the incidence and severity remain unclear.A total of 111 patients with adult congenital heart disease between 2009 and 2016 were enrolled. Liver fibrosis markers and hemodynamic parameters assessed by cardiac magnetic resonance imaging and catheterization were analyzed in 50 rTOF patients having significant pulmonary regurgitation and/or stenosis, 50 Fontan patients and 11 controls.Liver fibrosis markers in patients with rTOF were significantly higher than controls, and tended to be lower than Fontan patients (median, hyaluronic acid: 25.8 vs. 15.9 vs. 40.8, type IV collagen: 129 vs. 113 vs. 166, ng/mL, p 0.05, respectively). Patients with rTOF showed abnormal hyaluronic acid levels more frequently than controls, and less frequently than Fontan patients (22% vs. 0% vs. 38%, respectively, p 0.05). Multivariate analyses indicated a positive association of right atrial pressure with type IV-collagen or hyaluronic acid levels (each, p 0.001, p = 0.003). Abdominal ultrasonography revealed hepatic congestion in 50% of rTOF patients tested. Liver biopsy of the two rTOF patients with highest hyaluronic acid levels showed pathological evidence of moderate and severe (F2 and F3) liver fibrosis and one had combined hepatocellular and cholangiocarcinoma.We first demonstrated elevated liver fibrosis markers in adult patients with rTOF. These levels may help to predict the progressive liver disease as well as consider the timing of pulmonary valve replacement.
- Published
- 2018
8. Simple Excision for Cardiac Fibroelastomas Arising from Three Leaflets of the Aortic Valve
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Yuichiro Hirata, Yusuke Shintani, Hidetsugu Hori, Kenichi Kosuga, Teiji Okazaki, Keiichiro Tayama, and Koichiro Shimoishi
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Aortic valve ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,medicine.anatomical_structure ,business.industry ,Simple (abstract algebra) ,030220 oncology & carcinogenesis ,Internal medicine ,Cardiology ,Medicine ,030204 cardiovascular system & hematology ,business - Published
- 2016
9. High incidence of ductal closure or narrowing at birth in patients with right ventricular outflow tract obstruction with normal orientation of the ductus arteriosus
- Author
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Hazumu Nagata, Eiko Terashi, Shouichi Ohga, Hideki Tatewaki, Kenichiro Yamamura, Mamoru Muraoka, Kiyoshi Uike, Yasuyuki Fujita, and Yuichiro Hirata
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congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Hemodynamics ,Prenatal diagnosis ,030204 cardiovascular system & hematology ,Right ventricular outflow tract obstruction ,Shunt operation ,Ventricular Outflow Obstruction ,03 medical and health sciences ,0302 clinical medicine ,Orientation (mental) ,Pregnancy ,Ductus arteriosus ,Internal medicine ,Prenatal Diagnosis ,medicine ,Humans ,In patient ,cardiovascular diseases ,Ductus Arteriosus, Patent ,Retrospective Studies ,Cyanosis ,business.industry ,Incidence ,Infant, Newborn ,General Medicine ,Ductus Arteriosus ,medicine.anatomical_structure ,030228 respiratory system ,Echocardiography ,Pediatrics, Perinatology and Child Health ,cardiovascular system ,Cardiology ,Female ,High incidence ,Cardiology and Cardiovascular Medicine ,business - Abstract
BackgroundDuctal patency is mandatory to manage patients with ductal-dependent pulmonary circulation. The aim of this study is to elucidate the morphological and haemodynamic features of ductus arteriosus with right ventricular outflow tract obstruction, and investigate the appropriate perinatal management.Patients and methodsPatients with prenatal diagnosis of right ventricular outflow tract obstruction at our institution between 2010 and 2015 were included in the study. Reverse orientation of the ductus arteriosus is defined as an inferior angle of 90°. We retrospectively reviewed the shape and flow pattern of ductus arteriosus and the clinical characteristics of the cases.ResultsA total of 39 patients were enrolled. The shape was divided into normal orientation (n=15) and reverse orientation (n=24) of the ductus arteriosus. There was no significant difference in the type of oxygen saturation at birth and age at shunt operation between both the groups. However, the median narrowest diameter of ductus arteriosus in the normal orientation group was significantly smaller than that in the reverse orientation group (2.0 [1.0–5.4] versus 3.0 [1.3–4.4] mm, pConclusionsNormal orientation pattern might have high incidence of an early narrowing or closure of ductus arteriosus at birth. The critical patients need careful evaluation by repeated foetal echocardiography and further maternal interventions.
- Published
- 2018
10. Activation of the AKT Pathway in the Ascending Aorta With Bicuspid Aortic Valve
- Author
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Satoru Tobinaga, Hiroki Aoki, Yoshihiro Fukumoto, Hiroyuki Tanaka, Takahiro Shojima, Yuichiro Hirata, Kohji Akasu, Tohru Takaseya, and Kazuyoshi Takagi
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0301 basic medicine ,Aortic valve ,Male ,medicine.medical_specialty ,Vascular smooth muscle ,Aortic Valve Insufficiency ,Heart Valve Diseases ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Bicuspid aortic valve ,Bicuspid Aortic Valve Disease ,medicine.artery ,Internal medicine ,Ascending aorta ,medicine ,Humans ,Protein kinase B ,PI3K/AKT/mTOR pathway ,Aorta ,Aged ,Aged, 80 and over ,business.industry ,Gene Expression Profiling ,General Medicine ,medicine.disease ,Immunohistochemistry ,030104 developmental biology ,medicine.anatomical_structure ,Aortic valve stenosis ,Aortic Valve ,cardiovascular system ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Proto-Oncogene Proteins c-akt ,Dilatation, Pathologic ,Signal Transduction - Abstract
Background Dilatation of the ascending aorta affects those patients with bicuspid aortic valve (BAV), even after valvular surgery, possibly due to tissue fragility. The goal of the study was the molecular characterization of aorta with BAV compared to that with normal tricuspid aortic valve (TAV). Methods and Results: The subjects were patients who underwent surgery for aortic valve stenosis in 2013 and 2014. Nine patients with BAV and 13 with TAV were examined. There was no difference in the clinical characteristics or grade of aortic valve stenosis, but the diameters of the ascending aorta were significantly higher in the BAV group. The ascending aortic specimens were subjected to transcriptome analyses, which revealed the changes in receptor tyrosine kinase (RTK) pathway-related genes between TAV and BAV samples. Immunohistochemical study revealed higher staining of phosphorylated AKT (pAKT) in the media of the ascending aorta in the BAV group, regardless of the size of ascending aorta, whereas total AKT did not show such a difference. Immunofluorescence staining revealed the AKT activation was mainly in the medial vascular smooth muscle cells. Conclusions The results showed that the RTK-AKT pathway in the medial layer of the ascending aorta is activated in aortae with BAV. Activation of this pathway may be associated with fragility and dilatation of the ascending aorta with BAV.
- Published
- 2018
11. Pediatric Biventricular Assist Device for Myocarditis and Complicated Left Ventricular Thrombus
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Akira Shiose, Hideki Tatewaki, Yoshihisa Tanoue, and Yuichiro Hirata
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Myocarditis ,Fulminant ,medicine.medical_treatment ,Shock, Cardiogenic ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Extracorporeal Membrane Oxygenation ,0302 clinical medicine ,Internal medicine ,medicine ,Extracorporeal membrane oxygenation ,Humans ,cardiovascular diseases ,Thrombus ,Child ,business.industry ,Coronary Thrombosis ,Cardiogenic shock ,Left ventricular thrombus ,medicine.disease ,030228 respiratory system ,Shock (circulatory) ,Circulatory system ,cardiovascular system ,Cardiology ,Female ,Surgery ,Heart-Assist Devices ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,circulatory and respiratory physiology - Abstract
An 8-year-old girl presenting with fulminant myocarditis and cardiogenic shock underwent peripheral extracorporeal membrane oxygenation. She was switched to central extracorporeal membrane oxygenation because of inadequate venous drainage, and an echocardiogram showed left ventricular (LV) thrombus. She underwent removal of the LV thrombus with LV venting. An echocardiogram showed LV thrombus again 2 days later. The LV thrombus was again removed, and a biventricular assist device support was initiated to avoid further thrombus formation. The patient was completely weaned from mechanical circulatory support after 7 days. She recovered fully without any neurologic deficit.
- Published
- 2019
12. Effective infliximab therapy for the early regression of coronary artery aneurysm in Kawasaki disease
- Author
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Yusaku Nagatomo, Jun Muneuchi, Yasutaka Nakashima, Etsuro Nanishi, Hiromitsu Shirozu, Mamie Watanabe, Kiyoshi Uike, Hazumu Nagata, Yuichiro Hirata, Kenichiro Yamamura, Yasuhiko Takahashi, Seigo Okada, Yasuo Suzuki, Shunji Hasegawa, and Shouichi Ohga
- Subjects
Infliximab therapy ,Male ,medicine.medical_specialty ,Adolescent ,030204 cardiovascular system & hematology ,Mucocutaneous Lymph Node Syndrome ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Humans ,030212 general & internal medicine ,Child ,Retrospective Studies ,Coronary artery aneurysm ,business.industry ,Remission Induction ,Coronary Aneurysm ,Immunoglobulins, Intravenous ,Infant ,medicine.disease ,Infliximab ,Antirheumatic Agents ,Child, Preschool ,Cardiology ,Kawasaki disease ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
There is limited information available regarding the role of infliximab (IFX) following the acute phase of Kawasaki disease (KD). We aimed to evaluate whether IFX is associated with coronary artery aneurysm (CAA) regression.Between 2005 and 2016, we identified 971 consecutive patients with KD from 3 tertiary institutions, and 49 (5%) with CAAs were enrolled in our study. Patients were divided into 2 groups: 27 who received IFX and 22 who did not. The persistence rate of CAAs was compared between the groups.Age, sex, and duration of the febrile period did not significantly differ between the groups. The maximum value of C-reactive protein was higher in the IFX- than in the non-IFX group. The maximum z-score of CAAs did not differ between the groups. The 2-, 4- and 6-year cumulative persistence rate of CAA was 24%, 24% and 24% in IFX-group, whereas 67%, 52% and 33% in non-IFX group, respectively (P = 0.03). The median duration of CAA regression was 1.1 vs. 4.6 years. Among those who developed medium- or large-sized CAAs, the 2-, 4- and 6-year cumulative persistence rate of CAA was 33%, 33% and 33% in IFX group, whereas 77%, 51% and 48% in non-IFX group, respectively (P = 0.047). Multivariate logistic regression analysis indicated that the maximum z-score (hazard ratio 0.72, p 0.001) and response to IFX (hazard ratio 4.56, p = 0.017) were independently related to regression.IFX therapy was observed to be effective for the early improvement of CAAs in patients with intravenous immunoglobulin-resistant KD.
- Published
- 2017
13. Long Term Results and Predictors of Left Ventricular Function Recovery after Aortic Valve Replacement for Chronic Aortic Regurgitation
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Hiroyuki Saisho, Kumiko Wada, Koichi Arinaga, Satoshi Kikusaki, Hiroyuki Tanaka, Tatsuyuki Kakuma, and Yuichiro Hirata
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Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Time Factors ,Aortic Valve Insufficiency ,Cardiac index ,Sensitivity and Specificity ,Ventricular Function, Left ,Body Mass Index ,Transcatheter Aortic Valve Replacement ,Chronic aortic regurgitation ,Aortic valve replacement ,Afterload ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,medicine ,Humans ,Aged ,Retrospective Studies ,Ultrasonography ,Aged, 80 and over ,business.industry ,Left ventricular function ,Gastroenterology ,Stroke Volume ,Retrospective cohort study ,General Medicine ,Stroke volume ,Middle Aged ,medicine.disease ,body surface area (BSA) ,Treatment Outcome ,Heart Valve Prosthesis ,Predictive value of tests ,Heart failure ,Chronic Disease ,cardiovascular system ,Cardiology ,Ventricular pressure ,Isolated aortic valve replacement ,Female ,Original Article ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
In most patients with aortic regurgitation (AR), aortic valve replacement (AVR) improves left ventricular (LV) function, but some patients will not have favorable remodeling. Our objectives were to review long term clinical results of AVR for AR and to examine what factors affect the normalization of LV function after AVR for chronic AR.Between 1989 and 2010, 177 patients underwent isolated AVR for chronic pure AR. The patients were divided into 2 groups based on indexed end-systolic LV diameter (iESD): Group L (iESD) ≥25 mm/m(2)) (130 patients) and Group S (iESD25 mm/m(2)) (47 patients).There was no significant difference between groups in late mortality, freedom from cardiac-related death and rehospitalization for heart failure at late follow up after operation. At postoperative follow-up, 16% of patients had not recovered normal LV systolic function. By means of multivariate analysis, iESD and cardiac index (CI) were independent predictors of recovery of LV function and iESD26.7 mm/m(2) and CI2.71 l/min/m(2) were the best cut-off values.Early and late surgical results of AVR for chronic AR were good, but for the preservation of postoperative normal LV function, AVR for AR patients should be performed before iESD reaches 26.7 mm/m(2).
- Published
- 2015
14. A Suspected Case of Heyde Syndrome with Bleeding of the Small Intestine before Aortic Valve Replacement for Severe Aortic Valve Stenosis
- Author
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Toru Takaseya, Takahiro Shojima, Yuichiro Hirata, Koichi Arinaga, Hidetoshi Akashi, Hiroyuki Tanaka, Takanori Kono, Koji Akasu, Kumiko Wada, and Kazuyoshi Takagi
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medicine.medical_specialty ,medicine.anatomical_structure ,Aortic valve replacement ,business.industry ,Aortic valve stenosis ,Internal medicine ,medicine ,Cardiology ,medicine.disease ,business ,Small intestine - Published
- 2015
15. Effective shunt closure for pulmonary hypertension and liver dysfunction in congenital portosystemic venous shunt
- Author
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Yasunari Sakai, Shouichi Ohga, Kanako Ishii, Hazumu Nagata, Eiji Morihana, Kiyoshi Uike, Toshiharu Matsuura, Yuichiro Hirata, Tomoaki Taguchi, Eiko Terashi, Kenichiro Yamamura, and Kazuhiro Ohkubo
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Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Bilirubin ,Vascular Malformations ,Hypertension, Pulmonary ,030204 cardiovascular system & hematology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,medicine.artery ,Internal medicine ,polycyclic compounds ,medicine ,Risk of mortality ,Humans ,Child ,Newborn screening ,Bile acid ,business.industry ,Liver Diseases ,Vascular malformation ,Infant, Newborn ,Infant ,medicine.disease ,Pulmonary hypertension ,medicine.anatomical_structure ,Treatment Outcome ,chemistry ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Pulmonary artery ,Vascular resistance ,Cardiology ,030211 gastroenterology & hepatology ,Female ,business - Abstract
OBJECTIVE Congenital portosystemic venous shunt (CPSVS) is a rare vascular malformation with a high risk of mortality from pulmonary arterial hypertension (PAH), but the treatment outcome of CPSVS closure remains elusive. Our aim was to investigate the clinical features and establish the optimal management of CPSVS with or without PAH. METHODS Twenty-four patients with CPSVS treated in Kyushu University Hospital between 1990 and 2015 were enrolled in this study. The patients were divided into a PAH group (n = 9) and a non-PAH group (n = 15). Clinical characteristics and outcomes were evaluated. RESULTS The first manifestation of CPSVS at diagnosis (28.5 [1-216] months) was hypergalactosemia in 13 (54%) or PAH in six (25%) patients. PAH was the cause of all three deaths. The PAH group had higher levels of serum total bile acid, manganese, and total bilirubin, along with higher pulmonary vascular resistance index (PVRI) than the non-PAH group (7.2 [5.1-38.1] vs 1.2 [0.5-3.3] unit/m2 , P
- Published
- 2017
16. Evaluation of echogenicity of the heart in Kawasaki disease
- Author
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Kiyoshi Uike, Hazumu Nagata, Eiji Morihana, Yasutaka Nakashima, Kenichiro Yamamura, Yumi Mizuno, Yuichiro Hirata, Toshiro Hara, and Shiro Ishikawa
- Subjects
Male ,medicine.medical_specialty ,Myocarditis ,Heart Diseases ,Mucocutaneous Lymph Node Syndrome ,Pericarditis ,Japan ,Internal medicine ,Mitral valve ,medicine ,Humans ,Prospective Studies ,Child ,Papillary muscle ,business.industry ,Immunoglobulins, Intravenous ,Infant ,Echogenicity ,Heart ,medicine.disease ,medicine.anatomical_structure ,Echocardiography ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Cardiology ,Female ,Kawasaki disease ,business ,Vasculitis ,Artery - Abstract
Pathologic studies of the heart in patients with Kawasaki disease (KD) revealed vasculitis, valvulitis, myocarditis, and pericarditis. However, there have been no studies on the quantitative determination of multi-site echogenicity of the heart in KD patients. It is also undetermined whether the degree of echogenicity of each site of the heart in patients with KD might be related to the response to intravenous immunoglobulin (IVIG) treatment. In 81 KD patients and 30 control subjects, we prospectively analyzed echogenicity of the heart. Echogenicity was measured in four sites: coronary artery wall (CAW), mitral valve (MV), papillary muscle (PM), and ascending aortic wall (AAo wall) by the calibrated integrated backscatters (cIBs). The cIB values of all measurement sites at acute phase in KD patients were significantly higher than those in control subjects (KD patients vs control subjects; CAW, 19.8 ± 6.2 dB vs 14.5 ± 2.0 dB, p < 0.05; MV, 23.3 ± 5.3 dB vs 16.0 ± 3.3 dB, p < 0.05; PM, 22.4 ± 5.1 dB vs 12.7 ± 1.9 dB, p < 0.05; AAo wall, 25.3 ± 5.6 dB vs 18.3 ± 3.4 dB, p < 0.05). The cIB values of CAW at the acute phase in IVIG nonresponders were significantly higher than those in responders. Conclusion: Echogenicity of the heart in KD patients at the acute phase increased not only in the coronary artery wall but also in other parts of the heart. Echogenicity of CAW might be helpful in determining the unresponsiveness of IVIG treatment.
- Published
- 2014
17. Surgical Results of Valvular Disease in Hemodialysis Patients
- Author
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Tomokazu Kosuga, Hidetoshi Akashi, Takahiro Shojima, Koichi Arinaga, Hiroyuki Saisho, Hiroyuki Tanaka, Yuichiro Hirata, Hiroshi Tomoeda, Koji Akasu, and Takanori Kono
- Subjects
Surgical results ,medicine.medical_specialty ,Valvular disease ,business.industry ,Internal medicine ,medicine.medical_treatment ,medicine ,Cardiology ,Hemodialysis ,business - Published
- 2013
18. A unique association with persistent truncus arteriosus and partial midline chest wall defect
- Author
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Jun Muneuchi, Yuichiro Hirata, Kunitaka Joo, and Yoshie Ochiai
- Subjects
Heart Defects, Congenital ,Male ,medicine.medical_specialty ,Sternum ,Fatal outcome ,Fatal Outcome ,Scimitar syndrome ,Internal medicine ,Medicine ,Humans ,Thoracic Wall ,Persistent Truncus Arteriosus ,business.industry ,Scimitar Syndrome ,Infant, Newborn ,medicine.disease ,Infant newborn ,Truncus Arteriosus, Persistent ,Tomography x ray computed ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Cardiology ,Female ,business ,Tomography, X-Ray Computed ,Thoracic wall - Published
- 2012
19. The impact of pulmonary valve replacement on left ventricular mechanical efficiency in adult patients with tetralogy of fallot: a study with cardiac energetics
- Author
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Hazumu Nagata, Toshiro Hara, Kenji Sunagawa, Kiyoshi Uike, Yuichi Shiokawa, Ryuji Tominaga, Kenichiro Yamamura, Yuichiro Hirata, Ichiro Sakamoto, and Yoshihisa Tanoue
- Subjects
medicine.medical_specialty ,Ejection fraction ,business.industry ,Pulmonary insufficiency ,Stroke volume ,medicine.disease ,eye diseases ,Afterload ,Anesthesia ,Internal medicine ,Cardiology ,Ventricular pressure ,End-diastolic volume ,Medicine ,cardiovascular diseases ,sense organs ,Systole ,Cardiology and Cardiovascular Medicine ,business ,Tetralogy of Fallot - Abstract
Purpose: Pulmonary valve replacement (PVR) improves right ventricular (RV) function in patients with tetralogy of Fallot (TOF). However, the impact of PVR on left ventricular (LV) function and the mechanism of improvement are still unclear. The purpose of this study is to clarify the impact of PVR on LV mechanical efficiency in adult patients with TOF. Methods: Fourteen patients with TOF (age 30.1±11.5 years) who underwent PVR for significant pulmonary insufficiency were enrolled in this study. We measured left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), contractility (end-systolic elastance; Ees), afterload (effective arterial elastance; Ea), and mechanical efficiency (ventriculoarterial coupling; Ea/Ees and the rate of stroke work and pressure-volume area; SW/PVA) on the basis of the echocardiographic data before, after and late after PVR. Ees, Ea and SW/PVA were approximated as follows: Ees=mean arterial pressure/minimal ventricular volume, Ea = maximal ventricular pressure / (maximal ventricular volume-minimal ventricular volume), and SW/PVA=1 / (1 + 0.5 Ea/Ees). Results: LVEDVI, stroke volume and ejection fraction increased significantly after PVR. Contractility (Ees) did not change but afterload (Ea) decreased, and LV mechanical efficiency (Ea/Ees and SW/PVA) improved significantly. These changes were observed just after PVR, and further improvement was not noted in the late period. ![Figure][1] Hemodynamic changes after PVR Conclusions: LV efficiency improves after PVR. Increased pulmonary forward flow and relief of the compression from the RV increase LVEDVI and stroke volume. LV afterload decreases to adapt the increase of stroke volume without the change of contractility. These changes result in the improvement of LV mechanical efficiency. [1]: pending:yes
- Published
- 2013
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