記述言語：英語  

DOI： 10.1016/j.jtcvs.2023.07.040

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jtcvs.2023.07.003.

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.jtcvs.2023.07.003

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記述言語：英語   出版者・発行元：(一社)日本生理学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: We compared 2-patch repair (TP) with modified single-patch repair (MSP) for complete atrioventricular septal defects and evaluated their effect on the left atrioventricular valve (LAVV) competence. We also identified risk factors for unfavorable functional outcomes. METHODS: This retrospective study included 118 patients with complete atrioventricular septal defects who underwent intracardiac repair from 1998 to 2020 (MSP: 69; TP: 49). The median follow-up period was 10.4 years. The functional outcome of freedom from moderate or greater LAVV regurgitation (LAVVR) was estimated using the Kaplan-Meier method. RESULTS: The hospital mortality was 1.7% (2/118) and late mortality was 0.8% (1/118). Eight patients required LAVV-related reoperation (MSP: 4; TP: 4) and none required left ventricular outflow tract-related reoperation. In the MSP group without LAVV anomaly, the receiver operating characteristic curve analysis revealed that the ventricular septal defect (VSD) depth was strongly associated with moderate or greater postoperative LAVVR, with the best cutoff at 10.9 mm. When stratified according to the combination of intracardiac repair type and VSD depth, the MSP-deep VSD (VSD depth >11 mm) group showed the worst LAVV competence among the 4 groups (P = .002). According to multivariate analysis, weight <4.0 kg, LAVV anomaly, and moderate or greater preoperative LAVVR were independent risk factors for moderate or greater postoperative LAVVR, whereas MSP was not a risk factor. CONCLUSIONS: Postoperative LAVVR remains an obstacle to improved functional outcomes. MSP provides LAVV competence similar to TP unless deep VSD is present. The surgical approach should be selected on the basis of anatomical variations, specifically VSD depth.

DOI： 10.1016/j.jtcvs.2022.07.041

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIMS: Limited data exist on risk factors for the long-term outcome of pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD-PAH). We focused on the index of pulmonary vascular disease (IPVD), an assessment system for pulmonary artery pathology specimens. The IPVD classifies pulmonary vascular lesions into four categories based on severity: (1) no intimal thickening, (2) cellular thickening of the intima, (3) fibrous thickening of the intima, and (4) destruction of the tunica media, with the overall grade expressed as an additive mean of these scores. This study aimed to investigate the relationship between IPVD and the long-term outcome of CHD-PAH. METHODS: This retrospective study examined lung pathology images of 764 patients with CHD-PAH aged <20 years whose lung specimens were submitted to the Japanese Research Institute of Pulmonary Vasculature for pulmonary pathological review between 2001 and 2020. Clinical information was collected retrospectively by each attending physician. The primary endpoint was cardiovascular death. RESULTS: The 5-year, 10-year, 15-year, and 20-year cardiovascular death-free survival rates for all patients were 92.0%, 90.4%, 87.3%, and 86.1%, respectively. The group with an IPVD of ≥2.0 had significantly poorer survival than the group with an IPVD <2.0 (P = .037). The Cox proportional hazards model adjusted for the presence of congenital anomaly syndromes associated with pulmonary hypertension, and age at lung biopsy showed similar results (hazard ratio 4.46; 95% confidence interval: 1.45-13.73; P = .009). CONCLUSIONS: The IPVD scoring system is useful for predicting the long-term outcome of CHD-PAH. For patients with an IPVD of ≥2.0, treatment strategies, including choosing palliative procedures such as pulmonary artery banding to restrict pulmonary blood flow and postponement of intracardiac repair, should be more carefully considered.

DOI： 10.3389/fcvm.2023.1212882

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Texas Heart Institute Journal  

Anomalous origin of the left coronary artery from the opposite sinus of Valsalva with an intramural aortic course (L-ACAOS-IM) can cause syncope, sometimes as a prodrome of lethal events, including sudden cardiac death, in young athletes. The detailed mechanism of syncope in patients with L-ACAOS-IM is still unclear. This case report describes a 17-year-old boy who presented to the hospital because of syncope following chest pain with increasing frequency during exercise, such as playing soccer and running. In a treadmill exercise test, a decrease in blood pressure was seen (from 99/56 mm Hg to 68/38 mm Hg); chest pain and faintness accompanied by ST-segment elevation in lead aVR and ST-segment depression at other leads on electrocardiography were noted. These findings and symptoms disappeared spontaneously within a few minutes while clinicians prepared for emergency medications. Coronary computed tomography angiography (CCTA) showed that the origin of the left coronary artery (LCA) was the opposite sinus of Valsalva, and the course of the LCA was through the aortic wall toward the left coronary sinus. He was diagnosed with L-ACAOS-IM. After surgical treatment by unroofing the intramural part of the LCA and reconstructing a neo-ostium, he no longer experienced syncope during exercise. This case suggests that low cardiac output caused by myocardial ischemia, not life-threatening arrythmia, is a main mechanism of syncope in patients with L-ACAOS-IM. Consideration should be given to performing CCTA before an exercise stress test for young patients with syncope and chest pain to avoid the risk of severe myocardial ischemia.

DOI： 10.14503/THIJ-21-7677

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記述言語：英語  

DOI： 10.1016/j.xjtc.2022.07.020

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We report 3 cases in sinus plication technique utilized to repair aortic or neoaortic root dilation and valve regurgitation after congenital heart disease operation.

DOI： 10.1093/ejcts/ezac456

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: We present our experience with transcatheter vascular occlusion using 0.035-inch hydrogel expandable coils, which has been reported only in a few cases in the pediatric cardiology fields. METHODS: This study is a retrospective analysis of all patients who underwent transcatheter embolization with 0.035-inch hydrogel coils at the Department of Pediatrics, Okayama University Hospital, between October 2018 and September 2020. RESULTS: Twenty patients with a median age of 5.1 years (0.05-26.0 years) and a median weight of 13.8 kg (3.0-56.8 kg) were included. A total of fifty-four 0.035-inch hydrogel coils, including 35 Azur 35 and nineteen Azur CX 35 coils (Terumo, Tokyo, Japan), were successfully deployed in 22 target vessels. The target vessels consisted of 10 aortopulmonary collaterals, 8 veno-venous collaterals, and 4 pulmonary arteriovenous malformations. We achieved technical success in all the target vessels. In total, the mean target vessel diameter was 4.4 mm, the mean number of 0.035-inch hydrogel coils was 2.5 per vessel. The mean device to vessel ratio was 1.6 for the anchor coil and 1.2 for the additional coil. Post-implantation angiograms revealed that the primary occlusion rate was 18/22 (82%). There were no periprocedural complications. CONCLUSIONS: The 0.035-inch hydrogel expandable coils are effective and safe in patients with congenital heart disease and vascular anomalies. These occlusion devices could be valuable options for interventional pediatric cardiologists.

DOI： 10.1016/j.jjcc.2022.04.005

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The disadvantage of right ventricle-to-pulmonary artery (RV-PA) shunt is the need for more unplanned interventions to address stenosis in the shunt or branch pulmonary arteries, as compared to the modified Blalock-Taussig shunt group. Ring-enforced RV-PA PTFE conduit and dunk technique minimized these complications and right ventricle (RV) damage. Aortic arch obstruction increases afterload and leads to ventricular dysfunction and tricuspid regurgitation; therefore, most surgeons prefer to use homograft, autologous pericardium, or bovine pericardium to reconstruct the neoaorta. Artificial materials decrease the elastic properties, increase wall stiffness, and decrease the distensibility of the aorta; and as a result, RV function gradually deteriorates. This inelastic reconstructed aorta may be one of the reasons why long-term outcomes after the Fontan procedure are worse in hypoplastic left heart syndrome (HLHS) patients, in comparison to non-HLHS. Reconstruction of the neoaorta without any patch materials, or at least techniques that largely minimize the use of non-autologous materials, will offer a further refinement of our ability to optimize ventriculoarterial coupling and thereby long-term RV function.

DOI： 10.1177/21501351221116766

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記述言語：英語  

DOI： 10.1016/j.xjtc.2022.02.037

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記述言語：英語  

Coronary artery aneurysm occurs in 0.3%-0.8% of patients with Kawasaki disease, and cases of rupture are extremely rare. Only 2 cases have been reported in which the patients survived. We report a case of ruptured coronary artery aneurysm that was treated with coronary artery bypass grafting and extracorporeal membrane oxygenation. (Level of Difficulty: Advanced.).

DOI： 10.1016/j.jaccas.2022.05.012

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1177/02184923221094958

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記述言語：英語  

DOI： 10.1016/j.jtcvs.2021.08.083

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Repair of total anomalous pulmonary venous connection (TAPVC) in neonates with right atrial isomerism and functional single ventricle is challenging. In our novel strategy, primary draining vein stenting (DVS) was applied to patients with preoperative pulmonary vein obstruction to delay TAPVC repair. This study investigated our initial experience with a strategy of delayed TAPVC repair, incorporating DVS. METHODS: Twenty-nine patients with right atrial isomerism and functional single ventricle who had a severe obstruction in the course of draining veins, who required surgical or catheter intervention in their neonatal period were retrospectively reviewed (primary DVS: n = 11; primary TAPVC repair: n = 18). RESULTS: Patients in the primary DVS group had more mixed type TAPVC (primary DVS: n = 5, 45.5%; primary TAPVC repair: n = 2, 11.1%; P = .03) and required more systemic to pulmonary shunt surgeries during their lifetime (primary DVS: n = 9, 81.8%; primary TAPVC repair: n = 6, 33.3%; P = .047). Kaplan-Meier analysis showed that primary DVS repair was associated with improved survival compared with primary TAPVC repair (survival rates at 90 days, 1 year, 3 years and 5 years: primary DVS: 100%, 80%, 68.6%, and 54.9%; primary TAPVC repair: 55.6%, 38.9%, 38.9%, and 38.9%, respectively [P = .04]). Of the 4 patients who underwent stenting of the ductus venosus, 3 had elevated liver enzymes after surgical repair of TAPVC due to ductus venosus steal, which markedly improved after coil embolization of the stent. CONCLUSIONS: For neonates with obstructive TAPVC and functional single ventricle, our delayed TAPVC repair using primary DVS appeared to improve survival compared with the conventional strategy.

DOI： 10.1016/j.xjon.2021.11.012

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: This study evaluated the impact of a staged surgical strategy incorporating a modified Blalock-Taussig shunt (BTS) for tetralogy of Fallot on pulmonary valve annulus growth, the rate of valve-sparing repair at the time of intracardiac repair, and long-term functional outcomes. METHODS: This retrospective study involved 330 patients with tetralogy of Fallot who underwent intracardiac repair between 1991 and 2019 and included 57 patients (17%) who underwent BTS. The mean follow-up period was 15.0 ± 7.3 years. We compared the data of patients who underwent BTS and patients who did not undergo BTS before intracardiac repair. RESULTS: The median age before BTS was 71 days (range, 28 to 199) and the median body weight was 4.3 kg (range, 3.3 to 6.8 kg). There were no inhospital or interstage deaths after BTS. The pulmonary valve annulus Z scores of patients with BTS revealed significant growth after BTS (from -4.2 ± 1.8 to -3.0 ± 1.7, P < .001). Valve-sparing repair was eventually performed in 207 patients (63%), including 26 (46%) who underwent staged repair. The overall freedom from pulmonary regurgitation-related reintervention was 99.7%, 99.1%, and 95.8% at 1, 5, and 20 years, respectively. CONCLUSIONS: A staged surgical strategy incorporating BTS as the first palliation for symptomatic patients resulted in no mortality. Blalock-Taussig shunt may have contributed to the avoidance of primary transannular patch repair and facilitated pulmonary valve annulus growth; therefore, approximately half of the symptomatic neonates and infants were recruited for valve-sparing repair. Staged repair may have led to functionally reliable delayed transannular patch repair, thereby resulting in fewer surgical reinterventions.

DOI： 10.1016/j.athoracsur.2021.01.087

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Pulmonary artery coarctation may pose a risk for pulmonary stenosis and subsequent failure to achieve definitive repair. We sought to assess the impact of pulmonary artery coarctation on pulmonary artery growth. METHODS: A retrospective chart review was performed in 130 patients, including 37 single ventricles with a modified Blalock-Taussig shunt as first palliation. Pulmonary artery coarctation was defined as discrete stenosis of the pulmonary artery, with a diameter of less than 3 mm and with the ductus arteriosus connected. Preoperative echocardiography showed pulmonary artery coarctation in 29 patients (22%). Concomitant pulmonary artery plasty was performed in 14 patients with discrete stenosis having a diameter of less than 2 mm. RESULTS: Pre-modified Blalock-Taussig shunt left pulmonary artery z-scores were lower in patients with pulmonary artery coarctation than in those without (-4.0 [-5.8, -2.1] vs -1.7 [-2.6, -0.8], P < .001), and this remained the same even after modified Blalock-Taussig shunt (-2.5 [-5.1, -0.5] vs -0.5 [-2.4, 0.8], P = .010). Concomitant pulmonary artery plasty did not result in catch-up growth of the left pulmonary artery (post-modified Blalock-Taussig shunt left pulmonary artery z-score in patients with pulmonary artery plasty: -3.0 (-6.5, -2.0) versus those without: -1.8 (-3.3, -0.3), P = .279). Definitive repair/Fontan completion was achieved in 111 patients (85%), and this was not affected by the presence of pulmonary artery coarctation. CONCLUSIONS: Pulmonary artery coarctation affected disproportionate pulmonary artery growth throughout the staged repair, but did not result in failure of definitive repair/Fontan completion. Pulmonary artery plasty during the neonatal period did not contribute to catch-up growth of the left pulmonary artery; therefore, surgical indications and timing should be carefully considered.

DOI： 10.1016/j.jtcvs.2021.09.070

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Even today, when the surgical outcome of congenital heart disease in the neonatal period has improved, the prognosis for heterotaxy syndrome and functional single ventricle complicated with total anomalous pulmonary venous connection (TAPVC), especially the infra-cardiac type, is catastrophic. We describe a strategy that combines percutaneous ductus venosus (DV) stent placement and occlusion after TAPVC repair to ensure survival from initial surgery to bidirectional cavopulmonary shunt (BCPS) procedure and facilitate subsequent treatment. Three consecutive patients with heterotaxy syndrome and functional single ventricle complicated by infra-cardiac TAPVC treated with our own strategy were retrospectively studied. In two infants, DV stent placement was performed on the day of birth. In one case at 11 days of age. The risk of pulmonary vein obstruction was reduced, and on-pump surgery, including TAPVC repair, was performed on a standby basis. Since the rapid increase in hepatic enzymes occurred on postoperative day 0 to 1 in all cases, percutaneous stent occlusion was performed until postoperative day 3. The procedure improved liver function. One patient died due to severe atrioventricular valve regurgitation, one case underwent BCPS, and one patient was waiting to undergo. DV stent placement can avoid TAPVC repair in the early neonatal period. After TAPVC repair, the portosystemic shunt remained, resulting in hepatic dysfunction, but this could be improved by stent and vertical vein occlusion. A series of stepwise treatments can be useful to help such critically ill infants survive the high-risk neonatal period and achieve good BCPS circulation.

DOI： 10.1007/s00246-021-02782-z

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記述言語：英語  

DOI： 10.1016/j.xjon.2021.08.024

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Surgical restoration of subvalvular geometry is very important to prevent recurrence of ischemic/functional mitral regurgitation (MR). We evaluated an approach to the radical repair of left ventricular (LV) remodeling for three different cases with responsible coronary lesions. Leaflet tethering was corrected by tugging of the papillary-ventricular complex, which consists of the base of papillary muscles and posterior LV wall. The main lesion of the postinfarction scar was concomitantly excluded. Restoration of LV remodeling diminished MR with minimal leaflet tethering and improved systolic LV function. This technique may be an aggressive and encouraged approach for patients with ischemic/functional MR.

DOI： 10.1016/j.athoracsur.2021.03.095

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1053/j.optechstcvs.2022.06.008

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1053/j.optechstcvs.2022.03.003

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Congenital heart disease (CHD) is the most common neonatal and pediatric cardiac indication for extracorporeal membrane oxygenation (ECMO). Risk factors of survival and neurologic complication were different in many centers. We sought to evaluate survival and neurological outcome after ECMO in patients with CHD. METHODS: We retrospectively reviewed the medical records of 37 patients (<16 years old) who received ECMO. Indications for ECMO were failure to wean from cardiopulmonary bypass in 18 patients, extracorporeal cardiopulmonary resuscitation (ECPR) in 13 patients, and others in 6 patients. The median cardiopulmonary resuscitation (CPR) duration in ECPR patients was 48 min (interquartile range: 38-53 min). Neurological outcomes were evaluated using the Pediatric Cerebral Performance Category (PCPC) scale one year after hospital discharge. RESULTS: The median ECMO duration was 160 (91-286) h. Twenty-nine patients (78%) were successfully weaned off ECMO. Overall survival to hospital discharge was 59%. Risk factors of mortality were as follows: ECMO duration >1 week and urine output <1 mL/kg/h in the first 24 h after ECMO induction by multivariable analysis. Of the 22 survivors, 15 (68%) patients had a favorable outcome (PCPC ≤2). Risk factors for unfavorable outcomes (PCPC ≥3) included ECPR as indication and CPR of longer than 40 min. CONCLUSIONS: Longer ECMO duration and lower urine output were associated with increased mortality. Neurologic outcomes were not satisfactory when CPR was required for a longer period before ECMO establishment.

DOI： 10.1177/0218492321997379

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: This study aimed to evaluate whether recoarctation of the aorta (reCoA) after the Norwood procedure for hypoplastic left heart syndrome correlates with pre- and postoperative anatomic factors. METHODS: This retrospective study included 48 patients who underwent Norwood procedure with right ventricle-to-pulmonary artery conduit between 2009 and 2017. Anatomical factors such as preoperative length, diameter of the main pulmonary artery (MPA), and postoperative neoaortic arch angle stratified by arch reconstruction technique were analysed using the receiver operating characteristic analysis. RESULTS: Eleven patients needed surgical intervention for reCoA at stage 2. Out of the 30 patients who underwent direct anastomosis during arch reconstruction, 7 developed reCoA. Seven patients received the full patch augmentation (patch augmentation for both lesser and greater curvatures) and were all spared from reCoA. Among the patients who had direct anastomosis, the preoperative MPA length was correlated with the postoperative arch angle (P = 0.021) and was associated with the occurrence of reCoA (P = 0.002) and the best cutoff value for MPA length was 10 mm. The postoperative arch angle was also correlated with the incidence of reCoA (P < 0.001) and was larger in patients who underwent the full patch augmentation than in patients who had direct anastomosis (126° vs 112°, P = 0.005) despite comparable MPA length. CONCLUSIONS: ReCoA after the Norwood procedure correlates with MPA length when a direct anastomosis was used. Direct anastomosis can be considered in patients with a longer preoperative MPA. In other cases, the full patch augmentation should be considered for obtaining a large and smooth neoaortic arch.

DOI： 10.1093/icvts/ivab170

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記述言語：英語  

Aortic root abscess is one of the most catastrophic complications of aortic valve endocarditis. Complete débridement is recommended regardless of the kind of infected lesion. A 37-year-old man with extensive aortic root abscess due to prosthetic aortic valve endocarditis was surgically treated. The main lesion was the aortomitral continuity extending to the commissure between the left and right coronary cusps. After débridement, the aortic annulus underneath the left coronary artery was reconstructed using a handmade aortomitral monobloc valve without aortic annuloplasty. This valve was required for the extensive root abscess of the left and noncoronary sinus to achieve complete débridement.

DOI： 10.1016/j.athoracsur.2020.11.046

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: The aim of this study was to investigate whether milrinone infusion improved one-year survival in patients who underwent the Norwood-Sano procedure. DESIGN: A retrospective observational study. SETTING: A single-institution university hospital. PARTICIPANTS: Children who underwent the Norwood-Sano procedure from January 2008 to December 2014. INTERVENTIONS: Patients were categorized into two groups: group E+D, who received routine epinephrine and dopamine infusion, and group M, who received routine milrinone infusion for intra- and postoperative inotropic support. MEASUREMENTS AND MAIN RESULTS: The primary outcome of this study was one-year survival after the Norwood-Sano procedure. A total of 45 patients were included (group E+D, 22; group M, 23). One-year survival in group M was significantly higher than that in group E+D (95.7% [22/23] v 72.7% [16/22], p = 0.03). A Kaplan-Meier curve also showed that one-year survival in group M was significantly higher than that in group E+D (p = 0.04), from the result of the log-rank test. The number of patients who had any arrhythmias in the intensive care unit (ICU) was significantly lower in group M than in group E+D (21.7% [5/23] v 50% [11/22], p = 0.03). The duration of ICU stay did not have statistical difference between groups (group M 19; interquartile range [IQR], 15-28) v group E+D 19.5 (IQR, 16.3-35.5) days, p = 0.57). CONCLUSIONS: Perioperative milrinone infusion improved the mortality after the Norwood-Sano procedure. Potential advantages of milrinone compared with epinephrine are fewer arrhythmias and better systemic perfusion, which could decrease lethal cardiac events in the ICU.

DOI： 10.1053/j.jvca.2021.02.017

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: This study aimed to determine the factors related to reintervention, especially for pulmonary stenosis (PS), in patients with Taussig-Bing anomaly (TBA) after the arterial switch operation. METHODS: This retrospective study included 34 patients with TBA who underwent the arterial switch operation between 1993 and 2018. Preoperative anatomic and physiologic differences and long-term outcomes were determined using a case-matched control with transposition of the great arteries with ventricular septal defect and TBA with an anterior and rightward aorta. RESULTS: At arterial switch operation, median age was 43 days (range, 16 to 102) and median body weight was 3.6 kg (range, 2.8 to 3.8 kg). Aortic arch obstruction and coronary anomalies were present in 64% and 41% of patients, respectively. The hospital mortality rate was 11%, including one cardiac death, and the late mortality rate was 2.9%. Furthermore, 41% patients underwent 26 reinterventions for PS. Patients undergoing PS-related reintervention had a significantly larger native pulmonary artery to aortic annulus size ratio than patients not receiving reintervention (1.69 vs 1.41, P = .02). This ratio was the only predictor of PS-related reintervention; it was significantly higher in the TBA group than in the transposition of great arteries/ventricular septal defect group. The PS-related reintervention was required more in the TBA group than in the transposition of great arteries/ventricular septal defect group. CONCLUSIONS: Regardless of complex coronary anatomy and associated anomalies, early and late survival were acceptable. Postoperative PS was strongly associated with having a larger native pulmonary valve, suggesting that an optimal surgical reconstruction was required for achieving an appropriate aortopulmonary anatomic relationship during the arterial switch operation.

DOI： 10.1016/j.athoracsur.2020.06.016

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Primary cardiac tumor can arise from any location in the right and left cardiac chamber. Complete excision is generally recommended because of uncertainty regarding malignancy; however it is important to minimize the resultant functional deterioration after surgery. We report a case of endocardial hemangioma (4 × 3 × 3 cm) on the free wall of the right ventricle, located between the anterior and posterior papillary muscles. We describe details of the procedure to preserve the right ventricular volume and competence of the tricuspid valve.

DOI： 10.1016/j.athoracsur.2020.09.078

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記述言語：英語  

Takeuchi repair is a unique surgical approach in anomalous left coronary artery from the pulmonary artery. We present an adult patient with anomalous left coronary artery from the pulmonary artery with multiple late structural complications after Takeuchi repair who was evaluated using multimodality imaging, including newly developed cardiac fusion imaging with computed tomography and echocardiography. (Level of Difficulty: Advanced.).

DOI： 10.1016/j.jaccas.2021.02.035

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/ejcts/ezaa483

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/aor.13834

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/aor.13823

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00246-020-02458-0

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記述言語：英語  

DOI： 10.1016/j.case.2020.08.002

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s11748-019-01171-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/ejcts/ezaa041

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jjcc.2020.01.008

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.32604/CHD.2020.011579

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1177/0218492318811557

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/ped.13716

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jcin.2018.06.055

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jtcvs.2017.11.046

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.athoracsur.2017.10.047

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1177/0218492318759153

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jtcvs.2017.09.018

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1177/0218492317748091

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1161/CIRCRESAHA.116.310253

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/ejcts/ezw124

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1136/heartjnl-2015-308787

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記述言語：英語   出版者・発行元：ELSEVIER SCIENCE INC  

DOI： 10.1016/S0735-1097(16)30948-2

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1177/0218492315606581

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.athoracsur.2014.08.066

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.athoracsur.2015.01.066

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jtcvs.2014.11.089

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jtcvs.2014.06.062

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.athoracsur.2014.05.042

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.athoracsur.2014.01.051

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/ejcts/ezt283

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.athoracsur.2013.05.101

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.ijcard.2012.10.008

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1161/CIRCULATIONAHA.112.000380

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.athoracsur.2013.05.052

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jtcvs.2012.12.065

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jtcvs.2013.01.007

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/aor.12032

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/j.1525-1594.2012.01534.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.athoracsur.2012.04.048

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jtcvs.2012.03.032

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.athoracsur.2012.05.043

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記述言語：英語   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：IEICE-INST ELECTRONICS INFORMATION COMMUNICATIONS ENG  

In this paper, a novel charge coupled device matched filter (CCD-MF) for Electrical code division multiplexing (ECDM) decoder is proposed and experimentally demonstrated. Simulation results clarify the influence of low charge transfer efficiency (CTE) and the validity of a parallel CCD-MF we proposed. A 15-channel ECDM system using a 2 Gchip/s, 2-parallel CCD-MF is experimentally demonstrated.

DOI： 10.1587/transcom.E95.B.2568

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.athoracsur.2011.12.048

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）   出版者・発行元：IEEE  

Linear motors have many applications because of their unique characteristic which are different from rotary machines. In particular, Linear Induction Motors (LIMs) have a simple and strong structure, a flexible mechanism, and so on. The most popular application of LIMs is in transportation systems. It is important to investigate the dynamic characteristics of LIMs in order for them to be successfully applied in transportation systems. However, it is difficult to measure the dynamic characteristics of LIMs. Long enough span or large enough diameter of a cylindrical drum is necessary for the secondary side in the ordinary measurement system.In this paper, the use of a disc-shaped secondary side to measure the dynamic characteristics of LIMs are proposed. The rotating dynamic characteristics of disc-shaped LIMs are converted into linear motion.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: The Damus-Kaye-Stansel operation sometimes results in deteriorating semilunar valve insufficiency. We verified the semilunar valve function after the Damus-Kaye-Stansel operation and compared the end-to-side Damus-Kaye-Stansel with the double-barrel Damus-Kaye-Stansel. METHODS: Forty-seven patients who underwent the Damus-Kaye-Stansel operation between June 1993 and August 2008 were retrospectively reviewed. Any patient who underwent a Norwood-type operation was excluded. The median age at operation was 19 months (range, 0-276 months). Forty-five patients were Fontan candidates. Thirty-nine patients underwent pulmonary artery banding before the Damus-Kaye-Stansel operation. Twenty-two patients had undergone an arch repair previously. The semilunar valve function was evaluated by echocardiography. RESULTS: Thirteen patients underwent the end-to-side Damus-Kaye-Stansel operation, and 34 patients underwent the double-barrel Damus-Kaye-Stansel operation. The mean follow-up period was 71 ± 50 months (range, 1-188 months). Although there were 4 deaths, no death was related to the Damus-Kaye-Stansel procedure. Two of the patients with early death could not undergo a postoperative evaluation of the semilunar valves. The semilunar valve regurgitation mildly deteriorated in 7 patients (pulmonary regurgitation in 5 patients and aortic regurgitation in 2 patients). Pulmonary regurgitation deteriorated from none to mild in 1 patient, none to trivial in 2 patients, and trivial to mild in 2 patients. Both deteriorations in aortic regurgitation ranged from none to trivial. Semilunar valve regurgitation did not affect patients' circulatory condition. The end-to-side Damus-Kaye-Stansel operation more frequently caused a deterioration in pulmonary regurgitation than the double-barrel Damus-Kaye-Stansel operation (4/11 vs 1/34, P = .001). No surgical intervention for a systemic ventricular outflow obstruction was observed in the follow-up period. CONCLUSIONS: The double-barrel Damus-Kaye-Stansel operation was found to be superior to the end-to-side Damus-Kaye-Stansel operation for the prevention of postoperative pulmonary regurgitation.

DOI： 10.1016/j.jtcvs.2010.06.007

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We developed a new cardiopulmonary bypass (CPB) method to minimize myocardial damage during aortic arch reconstruction. In this method, coronary flow and heartbeat were stabilized by maintaining the aortic root pressure with an adjusted preload of the ventricle during aortic cross-clamping. This study was performed to determine the appropriate root pressure to maintain the heartbeat without causing deterioration of ventricular function. Study 1. Under partial CPB, the ascending aorta was cross-clamped in 6 pigs (group 1). Experimental data at various systolic aortic root pressures was analysed to determine the appropriate root pressure. Study 2. In group 2 (control, n＝6), the aorta was not clamped, while in group 3 (n＝6), the aorta was cross-clamped for 60 min and the systolic aortic root pressure was maintained at the pressure determined in study 1. Study 1. The diastolic coronary flow was stabilized at values comparable to that before initiation of CPB (6.6±1.4 ml/beat) when the systolic aortic root pressure was above 80 mmHg. Intracardiac pressure and the myocardial oxygen consumption (MvO2) seemed to be acceptable when the systolic aortic root pressure was below 100 mmHg. Therefore, 90 mmHg was selected for study 2. Study 2. Perioperative cardiac function did not differ between the groups. We concluded that 90 mmHg was the systolic aortic root pressure appropriate for this method.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Extracorporeal membrane oxygenation (ECMO) is an important circulatory assist for children with refractory cardiopulmonary dysfunction, but its role and indications after a stage 1 Norwood procedure are controversial. We assessed outcomes and risk factors in patients who underwent a Norwood palliation and ECMO at our institution. We retrospectively reviewed all patients who underwent a Norwood procedure and were supported with ECMO between January 1998 and January 2010. Of the 91 children who underwent a Norwood procedure during the study period, there were 15 postoperative runs of ECMO in 12 patients. The diagnoses of the patients included five with hypoplastic left heart syndrome, five with a hypoplastic left heart syndrome variant, and two with critical aortic stenosis. A total of four patients underwent bilateral pulmonary artery banding, and two patients underwent aortic valvuloplasty before the stage 1 Norwood procedure. The mean age of the patients was 28±30 days, and mean body weight was 2.6±0.5kg at the induction of ECMO. The indications for ECMO were low cardiac output in six children, circulatory collapse needing cardiopulmonary resuscitation in six children, and hypoxemia in three children. Five of the 12 patients were successfully weaned from ECMO. The significant risk factors for the inability to be weaned from ECMO were a history of circulatory collapse requiring cardiopulmonary resuscitation, and the induction of ECMO in the intensive care unit. Induction of ECMO may be considered earlier when hemodynamics are unstable in impaired patients following a stage 1 Norwood procedure to avoid circulatory collapse.

DOI： 10.1111/j.1525-1594.2010.01141.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: A lateral tunnel-total cavopulmonary connection (LT-TCPC) using a right atrial (RA) free wall is the first choice of treatment for patients with a small body weight in this institute. Whether the growth of the LT is appropriate or not according to the growth of the body remains controversial. In addition, the optimal initial diameter of an LT is unknown. The purpose of this study was to verify the growth of the LT. METHODS: Ninety-one patients of a total of 267 TCPC cases underwent an LT-TCPC at less than 5 years of age in this institute between March 1991 and June 2008. The data on 47 of the 91 patients, which were available to investigate the LT growth, were retrospectively reviewed. The mean age at LT-TCPC was 37+/-11 months (16-57 months). The mean body weight at TCPC was 12.4+/-2.4 kg (7.6-20.0 kg). The initial LT diameter was determined with Hegar's sizer of the estimated half-pulmonary arterial (PA) diameter, which is a diameter that results in half of the dimension of the normal pulmonary valve. The measured maximum LT diameter (mm) divided by the estimated half-PA diameter (mm) was considered as the LT index. The size of the LT was evaluated using either echocardiography or angiography. RESULTS: The mean follow-up period was 7.4+/-3.5 years (1.6-13.5 years). The LT index was initially 2.0+/-0.7 (1.3-4.5), 2.0+/-0.4 (1.3-3.2) at 1 year after operation, 2.1+/-0.5 (1.5-3.2) at 5 years after operation, 1.9+/-0.4 (1.5-2.8) at 10 years after operation and 2.1+/-0.5 (1.6-2.5) at 13 years after operation, respectively. CONCLUSIONS: LT growth suitable for the body growth can be expected. Although there was some variation in the initial LT diameter, the LT index tended to converge at 2.0 with growth.

DOI： 10.1016/j.ejcts.2010.01.014

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jtcvs.2009.07.021

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The purpose of this study was to establish a useful cut-off level for performing an original Rastelli-type operation in patients with transposition of the great arteries (TGA)/ventricular septal defect (VSD) or double outlet right ventricle (DORV). A total of 43 patients with TGA/VSD or DORV who underwent an original Rastelli-type operation in this institute between March 1993 and January 2009 were reviewed retrospectively. These patients were divided into two groups using the length between the top of the interventricular septum and the aortic valve (IVS-AV length); Group A; IVS-AV length <80% of normal left ventricular end-diastolic diameter (LVDd). Group B; IVS-AV length > or =80% of normal LVDd. Group A had a significantly better survival than Group B (100% vs. 56%, P=0.001). The cardiac event-free survival were 89.1% at 7.2 years in Group A and 26.3% at 8.4 years in Group B (P<0.0001). The Group B had a higher incidence of left ventricular outflow tract obstruction (LVOTO; 3% vs. 33%, P=0.02). The IVS-AV length was found to be a significant risk factor for mortality and LVOTO. The IVS-AV length should, therefore, be taken into consideration when selecting the optimal surgical procedures for these patients.

DOI： 10.1510/icvts.2009.223982

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC  

In this letter, 1.25 Gb/s x 8-channels simultaneous multiplexing using 8-chip electrical codes is experimentally demonstrated for the downlink of a 10-Gb/s electrically code-division-multiplexing passive optical network (ECDM-PON) system. For electrical encoding and decoding, 10-Gb/s multilevel signal generation and 10 Gchip/s correlator as a decoder are utilized. We demonstrate 10-Gb/s ECDM error-free optical transmission over 20 km of single-mode fiber.

DOI： 10.1109/LPT.2010.2047010

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: To determine diagnosis-based differences in the response of global ventricular performance to modified ultrafiltration (MUF) using transesophageal echocardiography during congenital heart surgery. METHODS AND RESULTS: The study included 38 children with atrial septal defect (n=10), ventricular septal defect (VSD) (n=8), tetralogy of Fallot (TOF) (n=9), or a single ventricle (n=11). Arteriovenous MUF was performed for 10-15 min after cardiopulmonary bypass (CPB). The myocardial performance index (MPI) of the systemic ventricles and the % change in MPI before and after MUF were assessed. Impairment of MPI was noted at termination of CPB compared with baseline values in the VSD and TOF groups (P<0.05). MUF resulted in an improvement in MPI in all groups (P<0.01). There was a weak correlation between aortic cross-clamping or CPB time, and the degree of improvement in MPI (r= 0.385, P=0.019; r= 0.348, P=0.037, respectively). MUF improved fractional shortening in all groups (P<0.05) and reversed abnormal relaxation in the VSD and TOF groups. CONCLUSIONS: Modified ultrafiltration ameliorated MPI in all groups, indicating improved systemic ventricular function with MUF. The MPI recovery rate differed among the groups. MUF may be particularly useful for restoring the global ventricular performance of patients undergoing longer CPB and may have minimal advantages for simple open-heart surgery. (Circ J 2010; 74: 86 - 92).

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）   出版者・発行元：IEEE  

First time, we have experimentally demonstrated 1.25-Gbps/subscriber 10-Gchip/s ECDM-PON upstream transmission over 20-km SSMF using WDM light sources. Additionally, optical beating induced performance degradation was investigated by varying WDM channel spacing from 100-GHz to 10-GHz.

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）   出版者・発行元：IEEE  

First time 8-channels electrically code division multiplexing technique for optical access networks is demonstrated at a chip-rate of 10 Gchip/s. The technique enables error-free transmission of 1.25 Gbit/s x 8-channels over 20 km single-mode-fiber. (C) 2010 Optical Society of America

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Tricuspid valve size is the major determinant of outcomes for patients with pulmonary atresia with intact ventricular septum. Lack of right ventricle-pulmonary artery continuity is associated with poor tricuspid valve growth (decrement in Z-value). However, most reports did not show evidence for disproportionate growth of the tricuspid valve after establishment of right ventricle-pulmonary artery continuity. METHODS: We studied 40 patients with pulmonary atresia with intact ventricular septum who underwent initial right ventricular decompression for planned staged repair. The initial Z-value of the tricuspid valve diameter (Zt1) was obtained from the echocardiography-derived normal value. The late Z-value (Zt2) was measured before definitive repair or the last available Z-value, if definitive repair was not yet reached. The factors associated with the changes of Z-values (Zt2 - Zt1) were analyzed. RESULTS: The mean initial tricuspid Z-value (Zt1) was -6.2 +/- 3.5. After treatment (Zt2), the mean Z-value was -6.0 +/- 3.4 (n = 34). Overall, the tricuspid Z-values did not change. Individually, the change in Z-value (Zt2 - Zt1) was larger than +2 in 11 (32%) patients and smaller than -2 in 6 (18%) patients. Increases in Z-value (Zt2 - Zt1) were significantly associated with right ventricular pressure/left ventricular pressure ratio measured after initial palliation (r = -0.54; P = .001) and the initial tricuspid valve Z-value (Zt1) (r = -0.40; P = .02). CONCLUSIONS: Disproportional growth of the tricuspid valve can occur, especially in patients with small tricuspid valves and lower right ventricular pressures after decompression. The findings support the possibility of neonates with small tricuspid valves undergoing biventricular repair after right ventricular decompression surgery.

DOI： 10.1016/j.jtcvs.2009.05.015

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The cognitive impairment and hemodynamic instability after neonatal cardiac surgery with cardiopulmonary bypass (CPB) might be exacerbated by hemodilution. Therefore, this study investigated the impact of different bloodless prime volumes on the hemodynamics and the inflammatory response by a miniaturized CPB system in neonatal piglets. The bypass circuit consisted of a Capiox RX05 (Capiox Baby RX, Terumo Corp., Tokyo, Japan) oxygenator and 3/16 internal diameter arterial and venous polyvinyl chloride tubing lines, with a minimum 75 mL prime volume. Twelve 1-week-old piglets were placed on a mild hypothermic CPB (32 degrees C) at 120 mL/kg/min for 2 h. The animals were divided into two groups, based on the volume of the prime solution. The priming volume was 75 mL in Group I and 175 mL in Group II. No blood transfusions were performed, and no inotropic or vasoactive drugs were used. The interleukin-6 (IL-6) and thrombin-antithrombin (TAT) complex levels, as well as right ventricular and pulmonary functions, were measured before and after CPB. Group I had low levels of IL-6 and TAT immediately after CPB (4370 +/- 2346 vs. 9058 +/- 2307 pg/mL, P < 0.01 and 9.9 +/- 7.7 vs. 25.1 +/- 8.8 ng/mL, P < 0.01, respectively). Group I had significantly improved cardiopulmonary function, cardiac index (0.22 +/- 0.03 vs. 0.11 +/- 0.05 L/kg/min, P < 0.001), and pulmonary vascular resistance index (7366 +/- 2860 vs. 28 620 +/- 15 552 dynes/cm(5)/kg, P < 0.01) compared with Group II. The miniaturized bloodless prime circuit for neonatal CPB demonstrated that the influence of hemodilution can reduce the subsequent inflammatory response. In addition, a low prime volume could therefore be particularly effective for attenuating pulmonary vascular resistance and right ventricular dysfunction in neonates.

DOI： 10.1111/j.1525-1594.2009.00922.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The high-flow management of cardiopulmonary bypass (CPB; >or=2.4 L/min/m(2)) is a standard strategy used at this institute for children with pulmonary atresia (PA) due to a fear that the blood flow may be diverted by the major/minor aortopulmonary-collateral-arteries and hypervascularization due to long-term hypoxia. The purpose of this study was to describe the validity of high-flow management in children with PA. The CPB records of 23 children with PA who underwent a definitive biventricular repair between Feb 2006 and Nov 2008 were retrospectively reviewed. The mean age at the operation was 33 +/- 22 months. The blood-pressure during bypass was controlled with the same protocol. The mean cooling-temperature was 28.4 +/- 3.7 degrees C. The mean minimum hematocrit was 25.0 +/- 3.4%. The mean maximum bypass flow index at the initiation, the mean maximum flow index during aortic cross-clamping, the mean minimum flow index during aortic cross-clamping, and the mean maximum flow index after rewarming were 3.1 +/- 0.5, 3.1 +/- 0.5, 2.6 +/- 0.4, and 3.2 +/- 0.4 L/min/m(2), respectively. The higher bypass flow indexes significantly correlated with the lower serum lactate levels. The lowest oxygen delivery during CPB had significant influences on the urine output during bypass (R = 0.547, P = 0.007), the serum lactate levels at the end of CPB (R = -0.442, P = 0.035), and the postoperative thoracic effusion (R = -0.459, P = 0.028). A bypass flow index of 2.4 L/min/m(2) may not be sufficient and the maximum requirement of bypass flow index may be 3.2 L/min/m(2) or more in this patient population.

DOI： 10.1111/j.1525-1594.2009.00895.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Although a staged Fontan strategy allows for an excellent outcome in high-risk patients, an impaired ventricular function remains a significant factor of early/late mortality and morbidity. This study evaluated the clinical outcome of the Fontan operation in patients with impaired ventricular function. METHODS: A retrospective review was performed on 217 patients who had undergone the Fontan operation between 1991 and 2007. RESULTS: Twenty-nine (13%) of the 217 patients had an impaired ventricular function (ejection fraction (EF) <50%). The median age at the time of the operation was 3 (range: 1-31 years) years. There were five adult patients. The ventricular morphology was right in 20 patients (including five hypoplastic left heart syndrome (HLHS)) and others (left and two-ventricle) in nine patients. Heterotaxy syndrome was present in eight patients. Previous surgical interventions included bidirectional Glenn anastomoses in 24, modified Blalock-Taussig shunts in two and pulmonary artery banding in two. The preoperative EF was 43+/-6%. Significant (moderate or severe) atrioventricular valve regurgitation was noted in four patients. The percutaneous oxygen saturation (SpO(2)) was 82+/-5%. The pulmonary artery pressure and pulmonary artery index were 11+/-3 mmHg and 296+/-102 mm(2)m(-2), respectively. All 29 patients underwent the Fontan operation without any early mortality. There were two late mortalities and two re-operations. EF was maintained at 59+/-15% at a median follow-up of 7.5 (range: 1-19) years. The percent normal systemic ventricular end-diastolic volume decreased from 174+/-95% to 124+/-39% (p<0.05). The SpO(2) increased to 92+/-2%. The mean cardiothoracic ratio in chest X-ray and B-type natriuretic peptide were 51% (range: 35-68%) and 22 pgml(-1) (range: 9-382 pgml(-1)), respectively. Three patients developed congestive heart failure, seven had arrhythmia and two developed protein-losing enteropathy. The New York Heart Association (NYHA) class functional class is I in 21 patients, II in five and III in one. CONCLUSIONS: Acceptable clinical outcomes were observed at an intermediate follow-up of the Fontan operation in patients with an impaired ventricular function.

DOI： 10.1016/j.ejcts.2009.04.042

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: This study analyzed the clinical application of modified low-flow ultrafiltration (MUF) to minimize cardiopulmonary bypass (CPB)-related adverse effects in patients undergoing living-donor lobar lung transplantation (LDLLT). METHOD: The study enrolled 33 consecutive patients who underwent LDLLT from 1999 to 2004: 8 patients underwent conventional CPB without MUF (control group), and 15 underwent arteriovenous MUF (MUF-treated group). Hemodynamics, graft function, blood loss and blood transfusion requirements, and clinical outcomes were analyzed. RESULTS: There was a significant increase in systolic blood pressure and a decrease in pulmonary to systemic pressure ratio in the MUF-treated group (p < 0.05). No hemodynamic changes occurred in the control group. MUF resulted in significant improvements in arterial oxygen tension/fraction of inspired oxygen ratio (PaO(2)/FiO(2;) 411 +/- 107 vs 272 +/- 107 mm Hg, p < 0.05) and the alveolar-arterial oxygen difference (a-aDO(2); 158 +/- 84 vs 315 +/- 127 mm Hg, p < 0.05) at 15 minutes after CPB. There were no differences in PaO(2)/FiO(2) and A-aDO(2) between the groups beyond 6 hours post-operatively. Post-operative blood loss and blood transfusion requirements were lower in the MUF-treated group than in the control group (p < 0.05). There were no differences in survival, duration of ventilation, intensive care unit stay, and hospital stay between the groups. CONCLUSIONS: The low-flow MUF brought improved hemodynamics and gas exchange capacity of transplanted grafts and lowered post-operative blood loss and blood transfusion requirement. This strategy may minimize CPB-related adverse effects in patients undergoing LDLLT.

DOI： 10.1016/j.healun.2009.01.004

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Circulatory load during hypoxia is unavoidable in donation after cardiac death (DCD) hearts, but it causes severe myocardial damage. The impact of circulatory load on donor heart function has not been investigated. The purpose of this study was to evaluate its effect on post-transplant functional recovery of DCD hearts. METHODS: Twelve donor pigs (20 kg) were used. Cardiac arrest was induced by asphyxiation (turning off the ventilator) in the load group (n = 6) and by exsanguination (dividing the vena cava) in the unload group (n = 6). Left ventricle end-diastolic volume (LDEDV) and end-systolic pressure (LVESP) were monitored until cardiac arrest. Orthotopic transplantation was performed after 30-minute warm ischemia following cardiac arrest. After weaning from cardiopulmonary bypass, left ventricular end-diastolic pressure-volume ratio (LV Emax) and creatine kinase (CK-MB) were measured while on 0.1 microg/kg/min epinephrine. RESULTS: During the agonal period, the maximum LVEDV and LVESP in the load group were 132 +/- 1% of baseline at 10 minutes and 148 +/- 16% of baseline at 4 minutes, respectively. Recovery rates of post-transplant cardiac function in the load group were worse than in the unload group (LV Emax: 64 +/- 8 vs 84 +/- 5%, p < 0.05). Levels of post-transplant CK-MB in the load group were higher than in the unload group (639 +/- 119 vs 308 +/- 70 IU/liter, p < 0.05). CONCLUSIONS: Cardiac arrest with circulatory load by asphyxiation caused more myocardial damage than unloaded arrest. This difference between the modes of death should be considered when evaluating the DCD hearts for clinical application.

DOI： 10.1016/j.healun.2008.12.002

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Adult patients who do not fulfill the classical Fontan criteria now undergo total cavopulmonary connection (TCPC). However, limited information is available on the results for high-risk adult TCPC. METHODS: Twenty-five consecutive adult patients (aged 16 years or more) who underwent TCPC were retrospectively reviewed. The mean age at operation was 27 +/- 9 years (range, 16 to 52). The following items were considered as the potential risk factors according to previous reports: (1) aged more than 30 years (7 of 25); (2) heterotaxy (9 of 25); (3) systemic ventricular ejection fraction less than 50% (6 of 25); (4) atrioventricular valve regurgitation moderate or greater (6 of 25); (5) pulmonary arterial index less than 200 (7 of 25); (6) mean pulmonary arterial pressure 15 mm Hg or greater (3 of 25); (7) pulmonary arterial resistance 2.0 wood units or greater (11 of 25); (8) arrhythmias (13 of 25); (9) protein-losing enteropathy (3 of 25); (10) New York Heart Association (NYHA) functional class III or greater (9 of 25); (11) previous Fontan procedure (10 of 25); (12) systemic ventricular outflow obstruction (1 of 25); and (13) end-diastolic pressure of the systemic ventricle 11 mm Hg or higher (4 of 25). RESULTS: The mean follow-up period was 57 +/- 45 months (range, 0 to 154). All patients had at least 2 risk factors (range, 2 to 8). There was 1 early death and 2 late deaths. Comparing the late survivors and nonsurvivors, no statistical significance was identified in the above risk factors. However, the patients with 6 or more risk factors had a significantly higher mortality rate than patients with fewer than 6 risk risk factors (p < 0.01). Age (p = 0.08), NYHA class (p = 0.13), and protein-losing enteropathy (p = 0.08) may be risk factors for late death. CONCLUSIONS: The majority of the adult TCPC candidates tolerated the TCPC procedure in the early postoperative period. However, the accumulation of risk factors influences late mortality.

DOI： 10.1016/j.athoracsur.2008.10.040

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The purpose of this study was to describe the experience with staged surgical reconstruction of the hypoplastic left heart syndrome (HLHS) with a right ventricle to pulmonary artery conduit and to identify the risk factors that influence late outcome. METHODS: Between February 1998 and June 2007, 62 patients with HLHS underwent a Norwood procedure by using right ventricle to pulmonary artery conduit (median age, 9 days [range, 1 to 57]; median body weight 2.7 kg [range, 1.6 to 3.9 kg]). The subsequent 47 patients underwent a bidirectional Glenn procedure (stage 2). Thirty-two patients underwent a modified Fontan procedure (stage 3). Follow-up was complete (median, 32 months; range, 1 to 101). RESULTS: Hospital mortality after the Norwood procedure was 8% (5 of 62 patients). Between stages, 9 patients died, 3 before stage 2 and 6 before stage 3. There was 1 late death after stage 3. Overall survival was 76% (47 of 62). The estimated 1-year and and 5-year survival rates were 80% and 73%, respectively. Using the any-mortality as the endpoint, prematurity (gestational age <37 weeks), body weight less than 2.5 kg at stage 1 operation, and tricuspid regurgitation 2+ or more were associated with mortality. Using Cox regression analysis, body weight less than 2.5 kg and tricuspid regurgitation 2+ or more were two independent factors associated with midterm survival. CONCLUSIONS: From 9 years of experience, despite good early survival after Norwood stage 1 palliation, low body weight and tricuspid valve regurgitation were still associated with worse outcome. More efforts should be made to improve the late results for patients with hypoplastic left heart syndrome.

DOI： 10.1016/j.athoracsur.2008.08.027

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The purpose of the present study was to evaluate the effect of modified ultrafiltration (MUF) on neonates with transposition of the great arteries (TGA) undergoing arterial switch operation. METHODS AND RESULTS: The current study included 36 neonates who underwent an arterial switch operation between 1998 and 2006. Arterio-venous MUF was done in 15 patients (MUF-treated group) and the other 21 patients were controls. Parameters included hematocrit, hemodynamics, pulmonary function, drain loss, leak of peritoneal fluid, length of intubation, and intensive care unit (ICU) stay. The hematocrit increased from 34+/-2% to 47+/-4% in the MUF-treated group. Blood pressure in the MUF-treated group was significantly increased without any change of central venous or left atrial pressure. Post-operative oxygenation in the MUF-treated group was greater than that of the control group (P/F ratio: 258+/-92 vs 170+/-100 mmHg, p<0.05), which did not contribute to decrease in intubation time (54+/-33 vs 52+/-29 h, p=NS). Post-operative chest drain loss and peritoneal fluid leak were comparable. The ICU stay in the MUF-treated group was significantly shorter than that in the controls (101+/-34 vs 139+/-42 h, p<0.05). CONCLUSIONS: MUF brought improvement in blood pressure and gas exchange capacity and subsequent shorter ICU stay. MUF did not have significant impact on intubation time and capillary leak.

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記述言語：英語   出版者・発行元：CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS  

DOI： 10.1016/j.cardfail.2008.07.093

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記述言語：英語   出版者・発行元：ELSEVIER IRELAND LTD  

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記述言語：英語   出版者・発行元：ELSEVIER IRELAND LTD  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The present study analyzes a 15-year experience of repairing persistent truncus arteriosus (PTA) with a consistent policy of right ventricular outflow tract (RVOT) reconstruction (ie, direct anastomosis). METHODS AND RESULTS: This retrospective study included 13 consecutive patients with PTA (8 type I PTA, 5 type II) who underwent primary repair from September 1992 to December 2006. Median age and body weight at surgery were 21 days and 2.9 kg, respectively. All but 1 patient underwent RVOT reconstruction by direct anastomosis with a monocusp patch. There were 2 operative deaths (12%). No patient had a pulmonary hypertensive crisis. The median duration of ventilation was 5 days. Another patient died from cardiogenic shock resulting from late cardiac tamponade 2 months after surgery. Four patients (40%) required balloon angioplasty and 5 (50%) required re-operation for branch pulmonary artery and/or conduit obstruction during the median follow-up period of 70 months (44-174 months). Freedom from all re-interventions and re-operation at 5 years was 50% (95% confidence limits, 19-81%) and 60% (95% confidence limits, 30-91%), respectively. CONCLUSIONS: Reasonable early and long-term results can be achieved with direct anastomosis. Further reduction of the re-intervention rate could be attained by refining the surgical techniques and catheter intervention strategies.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

This study was undertaken to determine the impact of miniaturization of a cardiopulmonary bypass (CPB) circuit on blood transfusion and hemodynamics in neonatal open-heart surgery. Neonates (n = 102) undergoing open-heart surgery between 2002 and 2006 were included and divided into three groups: group 1 (n = 28), Dideco 902 oxygenator + 5/16 '' line; group 2 (n = 29), Dideco 901 oxygenator + 1/4 '' line; group3 (n = 45), Dideco 901 oxygenator + 3/16 '' arterial + 1/4 '' venous line. Amount of priming volume, blood and bicarbonate sodium use during CPB, and hemodynamics were compared. Priming volume in the groups 2 and 3 was significantly less compared with the group 1 (group 1, 575 37 ml; group 2, 328 +/- 12 ml, group 3, 326 +/- 5 ml, p < 0.05). Blood transfusion and bicarbonate sodium use during CPB in groups 2 and 3 were significantly less compared with group 1. Hemodynamics during CPB was comparable. There were no differences between groups 2 and 3 in any parameter. Miniaturization of the CPB circuit resulted in decrease in priming volume and subsequent reduction in blood and bicarbonate sodium use. Downsizing the lines had minimal impact on any of the parameters studied, and further efforts should be made to achieve neonatal open-heart surgery without blood transfusion.

DOI： 10.1097/MAT.0b013e318158ddf6

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

We have developed a miniaturized semiclosed cardiopulmonary bypass (CPB) circuit incorporating a centrifugal blood pump (TinyPump) with a volume of 5 ml. The current study was undertaken to evaluate the hemolytic performance of the TinyPump in comparison with the BioPump and to investigate the impact of different CPB circuit volumes on hemodilution, coagulation, and the inflammatory response. Twelve 1-week-old piglets (3.4 +/- 0.2 kg) were used. The circuit comprised a centrifugal pump, a membrane oxygenator, and a cardiotomy reservoir. Cardiopulmonary bypass was conducted with mild hypothermia at 150 ml/kg/min for 3 hours. Transfusion was not performed. Priming volume was 68 ml for the circuit with the TinyPump and 111 nil for the circuit with the BioPump. Although the TinyPump required higher speed, plasma free hemoglobin levels after CPB were not different between the groups. After CPB, the TinyPump group had a significantly higher hematocrit (27% +/- 3% vs. 23% +/- 3%) and lower platelet reduction rate, lower thrombin-antithrombin complex levels, and lower interleukin-6 levels. Better lung compliance with less water content was observed in the TinyPump group. The TinyPump maintained CPB with acceptable hemolysis and lower inflammatory responses. This miniaturized CPB circuit may make transfusion-free open heart surgery feasible in neonates and would help to prevent postoperative organ dysfunction.

DOI： 10.1097/MAT.0b013e3181590719

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Oxygen-derived free radicals are responsible in part for reperfusion injury in globally ischemic myocardium. In this study, the efficacy for resuscitation of nonbeating donor hearts of MCI-186, a free-radical scavenger and antioxidant, was investigated in a pig transplantation model. METHODS: Cardiac arrest was induced by asphyxiation. After 30 minutes of global ischemia, the hearts were excised and immediately reperfused from the aortic root with normoxemic blood cardioplegia (PO2 100 mm Hg) for 20 minutes, followed by perfusion with hyperoxemic blood (PO2 300 mm Hg). MCI-186 (3 mg/kg) was administered into the aortic root for the first 30 minutes of reperfusion in the treated group (n = 6), and untreated hearts were used as a control group (n = 6). Transplantation was performed with the heart beating. RESULTS: Posttransplantation recovery of cardiac output, end-systolic pressure-volume ratio, and first derivative of pressure of the left ventricle in the treated group were significantly better than those in the control group. The coronary sinus-aortic root difference in malondialdehyde levels remained low throughout reperfusion in the treated group but abruptly increased after initiation of oxygenated blood perfusion in the control group. The MCI-186-treated hearts showed low degree of edema and well-preserved ultrastructure with normal-appearing organelles, whereas the untreated hearts had marked swelling of mitochondria and scant glycogen granules. CONCLUSION: MCI-186 exerts a cardioprotective action at least partly by inhibition of lipid peroxidation. Antioxidant therapy at the initial reperfusion is essential to successful resuscitation of nonbeating hearts by continuous myocardial perfusion.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

In this study, the performances of the TinyPump (priming volume 5 mL) system including the pediatric cannulae (Stöckert Pediatric Arterial Cannulae 2.6, 3.0, and 4.0 mm, Stöckert Instruments GmbH, Munich, Germany; Polystan 20-Fr Venous Catheter, MAQUET GmbH, Rastatt, Germany) and an oxygenator (Terumo Capiox RX05 Baby-RX, Terumo Cardiovascular Systems Co., Tokyo, Japan) were studied in vitro followed with preliminary ex vivo studies in 20-kg piglets. In vitro results revealed that the TinyPump system met the requirements for pump speed, pump flow, and pressure drop as extracorporeal circulatory support during open heart surgery and extracorporeal membrane oxygenation (ECMO) in pediatric patients. In 2-h ex vivo studies using 20-kg piglets where the blood contacting surface of the TinyPump was coated with a biocompatible phospholipid polymer, the plasma-free hemoglobin levels remained less than 5.0 mg/dL and no thrombus formation was observed inside the pump. The TinyPump system including the oxygenator and connecting circuits resulted in an overall priming volume of 68 mL, the smallest ever reported. The TinyPump can be a safe option for pediatric circulatory support during open heart surgery and ECMO without requiring blood transfusion.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Left ventricular (LV) retraining followed by anatomical repair would be a superior alternative in patients with congenitally corrected transposition (ccTGA) having a deconditioned morphologically left ventricle (MLV); however, LV retraining in older children is a challenging task. A retraining process of the MLV in a teenage patient with ccTGA is reported here. Cardiac catheterization at 7 years of age revealed low pressure of the MLV (33/4 mm Hg) and a LV to right ventricular pressure ratio (LVp/RVp ratio) of 0.32. The first pulmonary artery banding (PAB) was performed at 10 years of age. Although the LVp/RVp ratio reached 0.68, there was no evidence of adequate LV hypertrophy. The second PAB was performed 2 years after the initial PAB, resulting in an increase in the LVp/RVp ratio to 0.93 and an adequate LV hypertrophy. The double switch procedure was successfully performed at 13 years of age. Although the ejection fraction of the MLV mildly decreased, the patient has been doing well during a follow-up period of 4 years. The MLV in the teenage patient with ccTGA was successfully trained using a retraining strategy and has sustained systemic circulation after anatomical repair.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The purpose of this study was to investigate the discrepancy between intraoperative transesophageal and postoperative transthoracic echocardiography in assessing residual regurgitation in children undergoing valve repair. METHODS: Forty-two consecutive children (median age, 5.1 years) who underwent valve repair for valvar regurgitation from 2001 to 2004 were retrospectively analyzed. The patients were divided into two groups: atrioventricular valve group (n = 33) and aortic valve group (n = 9). Regurgitation grade, fractional shortening, and atrioventricular inflow velocity obtained by intraoperative transesophageal echocardiography were compared with those obtained by transthoracic echocardiography at discharge (median, 11 days) and at follow-up (median, 8 months). RESULTS: Intraoperative transesophageal echocardiography revealed specific residual lesions in 4 patients, leading to successful re-repair. Fractional shortening obtained by intraoperative transesophageal echocardiography was lower than that obtained by predischarge transthoracic echocardiography (p < 0.01). In the atrioventricular valve group, the regurgitation grade obtained by intraoperative transesophageal echocardiography was lower than that obtained by predischarge transthoracic echocardiography (0.7 +/- 0.8 versus 1.4 +/- 0.9; p < 0.01), and agreement between the two examinations was found in 12 patients (38%). Peak atrioventricular inflow velocity obtained by intraoperative transesophageal echocardiography was lower than that obtained by predischarge transthoracic echocardiography (p < 0.01). In the aortic valve group, there was no significant difference between the regurgitation grades in the two examinations (0.8 +/- 0.8 versus 1.1 +/- 0.9), and complete agreement in regurgitation grade was found in 5 (56%) of 9 patients. CONCLUSIONS: There were considerable discrepancies between the examinations in evaluation of residual atrioventricular valve regurgitation and potential atrioventricular valve stenosis: most of the residual regurgitations were underestimated by intraoperative transesophageal echocardiography. In contrast, reasonable agreement was found between the two examinations in evaluation of aortic valve regurgitation.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Single-ventricle palliation without the use of cardiopulmonary bypass carries advantages that reduce systemic edema and inflammatory responses; however, simple clamping of the superior vena cava (SVC) without a temporary shunt leads to increase in cerebral venous pressure and subsequent decrease in cerebral blood flow during bidirectional cavopulmonary shunt (BCPS). We report our experience of BCPS, using a centrifugal pump-assisted temporary shunt.The criteria included an unrestrictive interatrial communication, the absence of atrioventricular valve regurgitation, and the existence of an antegrade pulmonary blood flow. From August 2000, 14 children with single-ventricle physiology met the criteria. The mean age was 1.0 +/- 0.9 years, and the mean weight was 8.4 +/- 2.6 kg. A temporary shunt was established between the SVC and the right atrium with right-angle cannulae, which were connected to a centrifugal pump to accelerate the blood flow from the SVC to the right atrium.All patients tolerated the procedure. Mean central venous pressure was 17 +/- 4 mm Hg, and transcutaneous oxygen saturation was maintained at 77 +/- 8% during anastomosis. No patients required blood transfusion. There were no postoperative neurological complications.The centrifugal pump-assisted temporary shunt offered safer and more effective circulatory support than other shunt systems, with excellent venous drainage in pediatric patients undergoing BCPS.

DOI： 10.1097/01.mat.0000235454.64316.f3

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

To minimize myocardial ischemia, we repaired aortic arch obstruction with ventricular septal defect, using two different techniques of cerebral and myocardial perfusion.Seventy-one infants, ages 3 to 137 days, underwent primary repair of coarctation of the aorta (n = 49)/interruption of the aortic arch (n = 22) with ventricular septal defect. In 65 patients, an end-to-end arch anastomosis was performed with cerebral and myocardial perfusion through the innominate or the ascending arterial cannula (non-working beating heart: NWBH). In the remaining 6 patients, an arterial cannula was placed into the innominate artery. With partial cardiopulmonary bypass, the innominate artery was snared proximal to the cannulation site and the ascending aorta was cross-clamped. An extended arch anastomosis was carried out with cerebral perfusion and a working beating heart (WBH).Ten patients (15%) undergoing aortic arch repair with the NWBH technique required cardioplegic arrest to complete a proximal anastomosis, whereas in all 6 repairs with the WBH technique, the extended anastomoses were completed without myocardial ischemia. One hospital death and late death occurred, with an overall survival of 98%.End-to-end arch reconstruction is feasible without myocardial ischemia, using the NWBH technique in patients without hypoplastic arch and using the WBH technique in patients with hypoplastic arch.

DOI： 10.1097/01.mat.0000235276.77489.bb

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Warm ischemia is a major cause of cardiac allograft failure in transplants from non-heart-beating donors. To minimize myocardial ischemia, we used a continuous myocardial perfusion technique for resuscitation of donor hearts. The purpose of the present study was to investigate an optimal duration of controlled initial reperfusion. METHODS: Cardiac arrest was induced by asphyxia in 18 donor pigs. The hearts were harvested 30 minutes after global warm ischemia. Continuous myocardial reperfusion was immediately commenced from the aortic root with blood cardioplegic solution (20 degrees C, 40 mm Hg) and then with oxygenated blood (20 degrees to 37 degrees C, 40 to 60 mm Hg). Animals were divided into three groups according to the duration of the initial reperfusion: group I = 5 minutes, group II = 20 minutes, and group III = 60 minutes. Orthotopic transplantation was performed while keeping the heart beating by continuous myocardial perfusion. Cardiac function was evaluated before anoxia and after transplantation. Lactate extractions were determined during reperfusion. Myocardial edema was assessed by heart weight and posterior wall thickness of the left ventricle. RESULTS: Recovery rates of cardiac function in group II hearts after transplantation were better than in groups I and III (cardiac output, 61% +/- 9% versus 41% +/- 5% versus 44% +/- 4%, respectively; p < 0.05; left ventricular end-systolic pressure-volume ratio, 64% +/- 8% versus 36% +/- 9% versus 42% +/- 6%, respectively; p < 0.05). Lactate extractions in groups II and III returned to 0 within 20 minutes of reperfusion. Myocardial edema after transplantation in group II hearts was less than in groups I and III. CONCLUSIONS: The best recovery was observed in the non-beating donor hearts resuscitated by continuous myocardial perfusion when the initial controlled reperfusion with lukewarm blood cardioplegic solution at 40 mm Hg lasted for 20 minutes.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

In the process of establishing a less invasive assessment strategy for coronary artery disease (CAD) in patients with infrarenal abdominal aortic aneurysm (AAA), the incidence of CAD and the surgical and mid-term outcomes were reviewed. From January 1994 through September 2001, 94 elective surgical repairs of AAA were carried out. Preoperative coronary angiography showed 43 patients (45.7%) had CAD: 29 (67.4%) were asymptomatic, 23 had single-vessel disease (1VD), 12 had 2VD and 8 had 3VD. Of the 43 patients with CAD, 19 (44.2%) underwent coronary interventional therapy before aortic surgery (11 percutaneous transluminal coronary angioplasty (PTCA), 8 coronary artery bypass grafting). Eight asymptomatic patients underwent coronary interventional therapy. None of the patients died of cardiac causes or experienced a postoperative cardiac event. During the follow-up period, 10 late deaths occurred: 7 patients with CAD, and 3 cerebrovascular or cardiac deaths. There was no statistical difference in the survival rate between the groups with and without CAD. Two patients with CAD underwent PTCA during the follow-up period. The findings confirm the need for a less invasive assessment strategy of CAD that does not overlook asymptomatic myocardial ischemia, because the incidence of CAD in patients with AAA is high.

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記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本移植学会  

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J00083&link_issn=&doc_id=20221028010420&doc_link_id=%2Fcl8isoke%2F2022%2Fs057s1%2F183%2F0334-0334%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcl8isoke%2F2022%2Fs057s1%2F183%2F0334-0334%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：金原出版(株)  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：日本外科学会  

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CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2021220359

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

症例は女児。在胎28週時に前縦隔に径14mmの嚢胞性病変を指摘された。その後、大きさや性状に変化は認めなかった。在胎38週1日、体重3,036gで出生した。CTやMRIにて胸腺右葉下極に嚢胞を含む内部不均一な腫瘤を認めたが、この腫瘤は胸腺左葉下極の内部均一な嚢胞状腫瘤と正中で接していた。胸腺右葉の奇形腫と、奇形腫が胸腺左葉内に穿破して嚢胞を形成したと考えられた。出生直後は無症状であったが、日齢18頃に啼泣時の経皮動脈血酸素飽和度の低下を認めるようになったため、日齢22に手術を行った。胸骨正中切開にて開胸し、胸腺を温存して腫瘤を切除した。病理検査にて右葉の病変は成熟奇形腫であったが、左葉の病変は単房性胸腺嚢胞と診断され、奇形腫の穿破ではなかった。術後経過は良好である。前縦隔には様々な嚢胞状腫瘤が発生するが、両者ともに出生前に指摘されることはほとんどなく、さらに両者を合併した報告はなかった。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01113&link_issn=&doc_id=20201026200047&doc_link_id=%2Fes5shoge%2F2020%2Fs05606%2F016%2F0992-0997%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fes5shoge%2F2020%2Fs05606%2F016%2F0992-0997%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：英語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：英語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：英語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本外科学会  

CiNii Article

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2021096481

J-GLOBAL

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J-GLOBAL

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：英語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：英語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：英語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：英語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：英語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：英語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：英語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本外科学会  

CiNii Article

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2020037540

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：(株)文光堂  

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記述言語：英語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

背景:左心低形成症候群(HLHS)では左房容積が小さく、心房中隔の形態や心房中隔欠損(ASD)の大きさによってRashkind Balloon Atrial Septostomy(BAS)を行うことが困難な場合もある。目的:当院におけるHLHSに対するBASの有効性について検討した。対象と方法:2006年1月から2015年12月までの10年間にHLHSに対してカテーテル治療・手術を施行した患者におけるBASの有効性について検討した。またcatheter BASを施行した群についてASDの形態別に分けて有効性について両群比較検討した。結果:全HLHS70例中のGlenn手術到達は57例(81%)であり、BAS未施行群では86%(44/51)、catheter BAS群では91%(10/11)、open BAS群では25%(2/8)と統計学的有意差を認めたが(p=0.0002)、BAS未施行群とcatheter BAS群では同等の結果であった。(p=1.0)Glenn手術後にカテーテル検査を施行した56例について検討すると、BAS未施行群、catheter BAS施行群、open BAS施行群の平均肺動脈圧、肺血管抵抗、PAIいずれも3群間に差は認めなかった。次にCatheter BAS施行群をASDの位置・大きさ・atrial septumの厚さからstandard ASD(n=5)、complex ASD(n=5)に分類し、ASDの形態別にBAS施行方法を検討すると、standard ASD群では全例Rashkind BAS単独施行で効果を得たが、complex ASD群ではRashkind BAS単独施行症例は1例のみで、Static BASを先行させRashkind BASに到達した症例が4例であった(p=0.048)。BAS後のASD size、ASD flow、SpO2は2群間で統計学的有意差を認めなかった。結論:catheter BASは有効で、Glenn後のカテーテルデータではBAS未施行群と有意差は認めなかった。またcomplex ASD群の場合には、Static BASを先行し、Rashkind BASを追加することで、standard ASD群と同等の効果を得ることができた。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J02003&link_issn=&doc_id=20180418180002&doc_link_id=%2Fee7shoni%2F2017%2F003306%2F003%2F0423-0430%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fee7shoni%2F2017%2F003306%2F003%2F0423-0430%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

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記述言語：日本語   出版者・発行元：(株)文光堂  

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器外科学会  

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記述言語：日本語   出版者・発行元：岡山医学会  

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記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：南江堂  

CiNii Article

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2017078319

記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(株)メディカル・サイエンス・インターナショナル  

先天性心疾患に対する外科治療は近年,目覚ましい成績向上がみられる一方,そうした患者が成人期を迎え,さまざまな問題を抱えるケースが増加している。特に単心室症に対するFontan手術は,従来"根治術"とされてきたが,この手術が始まってから30年が経過し,さまざまな遠隔期の合併症が顕在化するにつれ,"Fontan palliation"であることが明白になってきた。心機能低下,房室弁逆流,不整脈,蛋白漏出性胃腸症など,Fontan手術後に特有の合併症に加え,長期のFontan循環による多臓器不全も治療を進めていくうえで問題となる。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J02927&link_issn=&doc_id=20160519280006&doc_link_id=10.11477%2Fmf.3101200562&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.3101200562&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：日本語   出版者・発行元：岡山医学会  

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J-GLOBAL

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記述言語：日本語   出版者・発行元：日本静脈学会  

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記述言語：日本語   出版者・発行元：日本静脈学会  

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記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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記述言語：日本語   出版者・発行元：日本成人先天性心疾患学会  

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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記述言語：日本語   出版者・発行元：(NPO)日本心臓血管外科学会  

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記述言語：英語   出版者・発行元：(NPO)日本心臓血管外科学会  

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記述言語：英語   出版者・発行元：(NPO)日本心臓血管外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本心臓血管外科学会  

症例は5ヵ月女児。先天性副腎皮質機能不全にて近医で副腎皮質ホルモン補充療法を行っている。出生時より心雑音を指摘され近医転院、心室中隔欠損症の診断にて薬物療法を行っていた。生後4ヵ月までに心不全の状態は改善し、生後5ヵ月の時点で心カテーテル検査を施行した結果、肺体血流比2.9と高値であり、心不全の急性増悪をきたす恐れが強く、哺乳量が増えず体重増加があまり期待できないこと、易感染性であることから、早期に手術すべきと判断され、当院紹介となった。手術は心室中隔欠損症に対するパッチ閉鎖術を行った。周術期の糖質コルチコイド補充量は体表面積から投与ステロイド量を推定し、周術期の血中コルチゾール濃度の経時的変化を参考にしながら投与することで、良好な結果を得ることができた。乳幼児における開心術における糖質コルチコイド補充療法の報告は少なく、体表面積から投与量を推定することで良好な周術期管理を行うことができた。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2009&ichushi_jid=J01122&link_issn=&doc_id=20090724250010&doc_link_id=10.4326%2Fjjcvs.38.276&url=https%3A%2F%2Fdoi.org%2F10.4326%2Fjjcvs.38.276&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本消化器がん検診学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本循環器病予防学会  

【目的】肥満は動脈硬化の独立した危険因子であるが、頸動脈エコーで評価した動脈硬化の状態と腹部脂肪分布を考慮した肥満との関係についての知見は十分でない。今回、頸動脈内膜中膜複合体厚(Intima-media thickness:IMT)の肥厚の有無に対する内臓脂肪および皮下脂肪蓄積の関係について調査した。【方法】対象は1,089人(女性278人)。日本脳神経超音波学会のガイドライン(案)に従い、頸動脈エコーによりIMT肥厚の有無(プラーク形成の有無に関わらず、max-IMT 1.1mm以上は肥厚あり)を評価した。IMT肥厚の有無と、臍レベルのCT撮影による内臓脂肪面積(visceral fat area:VFA)、皮下脂肪面積(subcutaneous fat area:SFA)との関係について、多重ロジスティック回帰分析を用いて性、年齢、収縮期血圧、脈拍数、LDLコレステロール、HDLコレステロール、中性脂肪、随時血糖で調整の上評価した。【結果】IMT肥厚あり群は760人、IMT肥厚なし群は335人であった。VFAはIMT肥厚あり群(110.1±51.9cm2)がIMT肥厚なし群(102.9±53.4cm2)より有意に高値であり(p=0.0368)、SFAはIMT肥厚あり群(154.3±59.1cm2)がIMT肥厚なし群(163.7±72.9cm2)より有意に低値であった(p=0.0260)。交絡要因で調整したところ、VFAの1SDあたりのオッズ比、95%信頼区間、p値は(1.23,1.03-1.47,p=0.0260)であり、SFAは(0.82,0.70-0.95,p=0.0104)であった。【結語】IMT肥厚に対して、内臓脂肪蓄積は促進的、皮下脂肪蓄積は抑制的であることが示唆された。(著者抄録)

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記述言語：日本語   出版者・発行元：(NPO)日本心臓血管外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本心臓血管外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本心臓血管外科学会  

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記述言語：日本語   出版者・発行元：膜型人工肺研究会  

症例は3ヵ月女児で、高度左室機能低下・僧帽弁逆流を伴う左冠状動脈肺動脈起始異常症と診断された。胸部X線写真は、心胸比70%と右無気肺を示した。心電図で洞性頻脈、軽度ST低下、陰性T波、異常Q波、左室肥大を認めた。左冠状動脈は造影されなかった。経食道心臓超音波検査では、駆出率:測定不能、短縮率:10%、高度〜中等度僧帽弁逆流、左室中隔の壁運動低下がみられた。心房間交通を作成し、大動脈遮断解除後、約30分間の左心補助を行い、右房脱血、上行大動脈送血によるV-A extracorporeal membrane oxygenation(ECMO)へ移行継続した。カテコラミン・血管拡張剤の増量、ECMO補助流量の段階的減量により術後7日目に人工呼吸器から離脱し、短縮率・僧帽弁逆流は改善傾向となり、心胸比も縮小した。修復術後に肺うっ血や肺高血圧の可能性がある症例への心房間交通の作成とECMOを組み合わせた機械的循環補助は、有効であると思われた。

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記述言語：日本語   出版者・発行元：シュプリンガー・ジャパン(株)  

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記述言語：日本語   出版者・発行元：シュプリンガー・ジャパン(株)  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本透析医学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本心臓血管外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：膜型人工肺研究会  

49歳男.胸部圧迫感,呼吸困難が出現した.胸部X線・心電図より急性心筋梗塞による急性左心不全を疑われた.画像所見により前壁から中隔領域にわたる広範囲の陳旧性梗塞に新たな切迫心筋梗塞が加わっていると考え,緊急冠動脈バイパス手術を施行した.吻合終了後,LOSのために人工心肺離脱不能と判断し,左房脱血-大動脈送血による左心バイパスを導入し人工心肺を離脱した.IABPは上室性不整脈が頻発するため効果的に駆動せず,経食道心エコーにてARの増悪も認め,OFFした.VT,Vf等の致死性不整脈を認めるようになり,左心バイパスからPCPSへの移行を行い,ICD埋め込み術を施行した.術後13日目,カテコラミンを増量し補助循環を離脱した.術後128日目,独歩退院となった

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記述言語：日本語   出版者・発行元：シュプリンガー・ジャパン(株)  

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記述言語：日本語   出版者・発行元：シュプリンガー・ジャパン(株)  

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記述言語：日本語   出版者・発行元：シュプリンガー・ジャパン(株)  

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記述言語：日本語   出版者・発行元：(一社)日本移植学会  

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記述言語：日本語   出版者・発行元：(一社)日本循環器学会  

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記述言語：日本語   出版者・発行元：シュプリンガー・ジャパン(株)  

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記述言語：日本語   出版者・発行元：(NPO)日本心臓血管外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本心臓血管外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本心臓血管外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本心臓血管外科学会  

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記述言語：日本語   出版者・発行元：血管外科症例検討会  

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記述言語：日本語   出版者・発行元：シュプリンガー・ジャパン(株)  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：(一社)日本移植学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：岡山医学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：福山市医師会  

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記述言語：日本語   出版者・発行元：岡山医学会  

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記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

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記述言語：日本語   出版者・発行元：シュプリンガー・ジャパン(株)  

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記述言語：日本語   出版者・発行元：広島医学会  

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記述言語：日本語   出版者・発行元：広島医学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

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記述言語：日本語   出版者・発行元：岡山医学会  

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記述言語：日本語   出版者・発行元：金原出版(株)  

溶血性連鎖球菌(溶連菌)による軟部組織炎症の4症例を経験した.症例1は42歳男.右肩痛,背部痛,発熱が出現し,近医を受診したが,そこで血圧低下しプレショック状態となり,紹介入院となった.昇圧剤の投与及び抗ショック療法を行った.同時に抗菌薬としてFOM及びMINOを投与し,次いで,CEZやGCS-Fの投与も行った.後日,細菌培養よりA群溶連菌が同定された.症例2は50歳男.右足背の腫脹と発赤を認め受診した.壊死性筋膜炎と診断し,右足背の減張切開を施行した.後日,A群連鎖球菌を同定した.症例3は49歳男.左足関節外側が腫れ,痛みが出現し,壊死性筋膜炎の診断で入院となった.浮腫液の細菌培養の結果,検出されたのはA群溶連菌であった.症例4は69歳女.発熱,嘔吐により入院となった.抗ショック療法を開始した.細菌培養でC群連鎖球菌が同定された.症例1,4はTSLSと思われ,症例4は早期の診断・治療により治癒した

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記述言語：日本語   出版者・発行元：広島医学会  

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記述言語：日本語   出版者・発行元：広島医学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：日本外科系連合学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：岡山医学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：(一社)国立医療学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：岡山医学会  

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記述言語：日本語   出版者・発行元：岡山医学会  

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記述言語：日本語   出版者・発行元：岡山医学会  

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開催年月日： 2023年11月16日 - 2023年11月18日

記述言語：日本語   会議種別：口頭発表（招待・特別）  

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開催年月日： 2023年11月10日 - 2023年11月11日

記述言語：英語   会議種別：口頭発表（一般）  

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開催年月日： 2023年11月3日

記述言語：日本語   会議種別：公開講演，セミナー，チュートリアル，講習，講義等  

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開催年月日： 2023年10月26日 - 2023年10月28日

記述言語：日本語   会議種別：口頭発表（招待・特別）  

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開催年月日： 2023年10月18日 - 2023年10月21日

記述言語：日本語   会議種別：口頭発表（一般）  

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開催年月日： 2023年10月18日 - 2023年10月21日

記述言語：日本語   会議種別：ポスター発表  

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開催年月日： 2023年10月18日 - 2023年10月21日

記述言語：イヌピアック語   会議種別：シンポジウム・ワークショップ パネル（公募）  

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開催年月日： 2023年10月8日

記述言語：日本語   会議種別：口頭発表（一般）  

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開催年月日： 2023年9月21日 - 2023年9月23日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

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開催年月日： 2023年8月31日 - 2023年9月1日

記述言語：日本語   会議種別：ポスター発表  

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開催年月日： 2023年7月15日

記述言語：日本語   会議種別：口頭発表（一般）  

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開催年月日： 2023年7月8日

記述言語：日本語   会議種別：口頭発表（一般）  

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開催年月日： 2023年7月6日 - 2023年7月8日

記述言語：英語   会議種別：シンポジウム・ワークショップ パネル（公募）  

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開催年月日： 2023年7月6日 - 2023年7月8日

記述言語：日本語   会議種別：ポスター発表  

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開催年月日： 2023年7月6日 - 2023年7月8日

記述言語：日本語   会議種別：ポスター発表  

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開催年月日： 2023年7月6日 - 2023年7月8日

記述言語：日本語   会議種別：口頭発表（一般）  

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開催年月日： 2023年7月6日 - 2023年7月8日

記述言語：日本語   会議種別：ポスター発表  

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開催年月日： 2023年7月6日 - 2023年7月8日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（指名）  

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開催年月日： 2023年7月6日 - 2023年7月8日

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（公募）  

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開催年月日： 2023年6月10日

記述言語：日本語   会議種別：口頭発表（一般）  

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開催年月日： 2023年6月8日 - 2023年6月9日

記述言語：日本語   会議種別：口頭発表（招待・特別）  

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開催年月日： 2023年6月8日 - 2023年6月9日

記述言語：イド語   会議種別：口頭発表（招待・特別）  

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開催年月日： 2023年6月8日 - 2023年6月9日

記述言語：日本語   会議種別：口頭発表（一般）  

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開催年月日： 2023年6月3日 - 2023年6月4日

記述言語：日本語   会議種別：口頭発表（一般）  

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開催年月日： 2023年6月3日 - 2023年6月4日

記述言語：日本語   会議種別：口頭発表（一般）  

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開催年月日： 2023年5月31日 - 2023年6月3日

記述言語：英語   会議種別：口頭発表（一般）  

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開催年月日： 2023年5月31日 - 2023年6月3日

記述言語：英語   会議種別：口頭発表（一般）  

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開催年月日： 2023年5月31日 - 2023年6月2日

記述言語：日本語   会議種別：ポスター発表  

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開催年月日： 2023年5月6日 - 2023年5月9日

記述言語：英語   会議種別：ポスター発表  

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開催年月日： 2023年4月27日 - 2023年4月29日

記述言語：日本語   会議種別：口頭発表（一般）  

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開催年月日： 2023年3月23日 - 2023年3月25日

記述言語：日本語   会議種別：口頭発表（招待・特別）  

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開催年月日： 2023年3月23日 - 2023年3月25日

記述言語：日本語   会議種別：口頭発表（一般）  

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