Faculty Profiles - KOTANI Yasuhiro

Papers - KOTANI Yasuhiro

Division display 81 - 100 of about 134 ／ All the affair displays >>

The natural and surgically modified history of anomalous pulmonary veins from the left lung. Reviewed International journal

Yasuhiro Kotani, Devin Chetan, Jiaquan Zhu, Vijay Anand, Christopher A Caldarone, Glen S Van Arsdell, John G Coles, Osami Honjo

The Annals of thoracic surgery 96 ( 5 ) 1711 - 8 2013.11

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Reconstruction of anomalous left pulmonary veins (ALPV) requires an anastomosis at a nonanatomic position, posing the potential risk of pulmonary vein obstruction (PVO). METHODS: The 514 patients who were diagnosed with a pulmonary vein abnormality from 1990 to 2010 were reviewed. Thirty-eight patients (7.4%; median age, 1.4 years; interquartile range, 0.1 to 5.7 years) were identified. ALPV was diagnosed as an isolated anomaly in 23 (61%) or as part of mixed total anomalous pulmonary venous drainage in 15 (39%). Patients were divided into 3 groups (group 1: partial ALPV, treated; group 2: total ALPV, treated; or group 3: partial ALPV, untreated). Freedom from poor clinical (death/reoperation) and functional (any PVO, mean pressure gradient > 3 mm Hg) outcomes were analyzed. RESULTS: Repair in 30 ALPV patients (79%) was performed with direct anastomosis to the left atrium (n = 26 [68%]) or by sutureless repair (n = 4 [11%]). Two deaths occurred in group 2 (heart failure and PVO). The 4 reoperations in group 2 were prompted by PVO and occurred within 6 months of the initial repair. There was a nonsignificant trend of lower freedom from poor outcomes in group 2 (74.6%) vs group 1 (100%) at 10 years (p = 0.105). There was no difference in the incidence of any left PVO among the groups (p = 0.381). Severe left PVO did not develop in group 3 (n = 8 [21%]). CONCLUSIONS: Total ALPV carries a high risk of early PVO. Thus, the optimal surgical approach remains elusive. Untreated partial ALPV remained unobstructed during midterm follow-up. Therefore, surgical treatment may not be necessary in patients with partial ALPV.

DOI： 10.1016/j.athoracsur.2013.05.101

Anatomical Risk Factors Associated With Left-Sided Pulmonary Vein Obstruction in Single Ventricle Patients Reviewed

Yasuhiro Kotani, Jiaquan Zhu, Lars Grosse-Wortmann, Osami Honjo, John Coles, Glen S. Van Arsdell, Christopher A. Caldarone

CIRCULATION 128 ( 22 ) 2013.11

Salvage Hybrid Palliation for Critically-Ill Infants With Functionally Single-Ventricle Physiology Reviewed

Devin Chetan, Diana Magee, Yasuhiro Kotani, Alejandro Floh, Steven Schwartz, Glen Van Arsdell, Christopher Caldarone, Osami Honjo

CIRCULATION 128 ( 22 ) 2013.11

Outcomes of Mechanical Circulatory Support for Patients With Functionally Single-Ventricle Physiology at Different Stages of Surgical Palliation Reviewed

Arezou Saedi, Devin Chetan, Yasuhiro Kotani, Nishanthi Liyanage, Lisa Zhao, Christopher Caldarone, Glen Van Arsdell, Osami Honjo

CIRCULATION 128 ( 22 ) 2013.11

Determinants and clinical significance of flow via the fenestration in the Fontan pathway: a multimodality study. Reviewed International journal

Lars Grosse-Wortmann, Andreea Dragulescu, Christian Drolet, Rajiv Chaturvedi, Yasuhiro Kotani, Luc Mertens, Katherine Taylor, Gustavo La Rotta, Glen van Arsdell, Andrew Redington, Shi-Joon Yoo

International journal of cardiology 168 ( 2 ) 811 - 7 2013.9

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

BACKGROUND: The use of a fenestration in the Fontan pathway remains controversial, partly because its hemodynamic effects and clinical consequences are insufficiently understood. The objective of this study was to quantify the magnitude of fenestration flow and to characterize its hemodynamic consequences after an intermediate interval after surgery. METHODS: Twenty three patients with a fenestrated extracardiac conduit prospectively underwent investigation by cardiac magnetic resonance (CMR), echocardiography, and invasive manometry under the same general anesthetic 12 ± 4 months after Fontan surgery. Fenestration flow was determined using phase contrast CMR by subtracting flow in the Fontan pathway above the fenestration from Fontan flow below the fenestration. RESULTS: Fenestration flow constituted a mean of 31 ± 12% (range 8-50%) of ventricular preload. It was associated with a lower Qp/Qs (r = -0.64, p=0.001) and oxygen saturation (r = -0.74, p<0.0001). Fenestration flow volume was correlated with pulmonary vascular resistance (r = 0.45, p = 0.04) and markers of ventricular diastolic function (early diastolic strain rate r = 0.57, p = 0.008 and ventricular untwist rate r = 0.54, p = 0.02). In 14 patients (61%) all of the net inferior vena cava flow and part of the superior vena cava flow were diverted into the systemic atrium and did not reach the lungs. CONCLUSIONS: Fenestration flow can be measured accurately with CMR. In two-thirds of the patients not only all of the inferior vena cava flow, but also some of the superior vena cava flow is diverted through the fenestration. Fenestration flow is driven by a balance between pulmonary vascular resistance and early diastolic ventricular function.

DOI： 10.1016/j.ijcard.2012.10.008

Surgical palliation strategy does not affect interstage ventricular dysfunction or atrioventricular valve regurgitation in children with hypoplastic left heart syndrome and variants. Reviewed International journal

Devin Chetan, Yasuhiro Kotani, Frederic Jacques, Jeffrey A Poynter, Lee N Benson, Kyong-Jin Lee, Rajiv R Chaturvedi, Mark K Friedberg, Glen S Van Arsdell, Christopher A Caldarone, Osami Honjo

Circulation 128 ( 11 Suppl 1 ) S205-12 - S212 2013.9

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

BACKGROUND: All 3 palliation strategies, Norwood, Sano, and Hybrid, currently used for hypoplastic left heart syndrome pose a risk of myocardial injury at different times and through different mechanisms. We sought to compare these strategies to understand longitudinal differences in interstage ventricular dysfunction and their subsequent impact on transplant-free survival and atrioventricular valve regurgitation (AVVR) as well as the relationship between adverse events and ventricular function. METHODS AND RESULTS: Serial echocardiographic reports and clinical data were reviewed for 138 children with hypoplastic left heart syndrome who underwent stage I surgical palliation (Sano: 11; Norwood: 73; Hybrid: 54) between 2004 and 2011. Stage II palliation was achieved in 92 (67%) patients (Sano: 7; Norwood: 51; Hybrid: 34). Interstage transplant-free survival, ventricular dysfunction, and AVVR were equivalent among palliation strategies. Patients with preserved ventricular function had a higher rate of transplant-free survival and freedom from AVVR, regardless of palliation strategy. Patients who had cardiac arrest, cardiopulmonary resuscitation, or extracorporeal membrane oxygenation (adverse events) experienced more transient and persistent ventricular dysfunction compared to those without adverse events. Surgical palliation strategies were not identified as risk factors for ventricular dysfunction or AVVR. CONCLUSIONS: Surgical palliation strategy does not affect mortality, interstage ventricular function, or interstage AVVR in children with hypoplastic left heart syndrome. Therefore, the different timing and mechanisms of myocardial injury among palliation strategies do not affect outcomes. Ventricular dysfunction adversely affects transplant-free survival and atrioventricular valve function. Adverse events are associated with the development of ventricular dysfunction. To improve outcomes, interstage treatment should focus on the preservation of ventricular function.

DOI： 10.1161/CIRCULATIONAHA.112.000380

Current cardioplegia practice in pediatric cardiac surgery: a North American multiinstitutional survey. Reviewed International journal

Yasuhiro Kotani, James Tweddell, Peter Gruber, Christian Pizarro, Erle H Austin 3rd, Ronald K Woods, Colleen Gruenwald, Christopher A Caldarone

The Annals of thoracic surgery 96 ( 3 ) 923 - 9 2013.9

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: There are a wide variety of reported techniques with few comparative trials and no current data available by which surgeons can compare their myopreservation strategies across the specialty. We therefore surveyed congenital heart surgeons to develop a profile of current practice. METHODS: One hundred twenty-two members of the Congenital Heart Surgeons' Society were surveyed, and 56 responses were analyzed. The survey focused on cardioplegia formulations, dosage and administration, and perfusion strategies for four age groups: neonates, infants, children, and adolescents. All percentages are expressed as percentage of the entire reporting cohort (n=56). RESULTS: Eighty-six percent of surgeons use blood-based cardioplegia versus crystalloid cardioplegia. Microplegia is used in 5%. Blood-based cardioplegia additives include del Nido (38%), customized solutions (32%), St. Thomas, Plegisol, or Baxter (11%), and microplegia (5%). Crystalloid cardioplegia types are Custodiol (7%), St. Thomas, Plegisol, or Baxter (5%), and customized solutions (2%). Cold (<10°C) cardioplegia is most common (93%), and "hot shots" are used in 21%. Moderate (26° to 30°C) hypothermic cardiopulmonary bypass is more common in neonates and infants compared with older children and adolescents. Antegrade administration is most common (89%). Longer intervals between cardioplegia doses were associated with surgeons using del Nido and Custodiol solutions, and these solutions were commonly administered with a single dose regardless of aortic cross-clamp time. CONCLUSIONS: Myocardial protection techniques still remained highly variable among congenital heart surgeons. This survey demonstrates that there is a perception that del Nido and Custodiol solutions can offer appropriate myocardial protection for longer intervals with decreased repeat dosing. An observational study correlating markers of postoperative myocardial performance with myocardial preservation strategies should be considered.

DOI： 10.1016/j.athoracsur.2013.05.052

Medical errors: the performance gap in hypoplastic left heart syndrome and physiologic equivalents? Reviewed International journal

Frederic Jacques, Vijay Anand, Edward J Hickey, Yasuhiro Kotani, Mrinal Yadava, Abdullah Alghamdi, Christopher A Caldarone, Andrew N Redington, Steven Schwartz, Glen S Van Arsdell

The Journal of thoracic and cardiovascular surgery 145 ( 6 ) 1465 - 73 2013.6

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

BACKGROUND: The frequency and impact of medical errors during staged palliation are unknown. METHODS: All patients with hypoplastic left heart syndrome and physiologic equivalents (N = 191) who underwent staged palliation (2001-2011) were studied. Stage 1, interstage, and stage 2 were reviewed to identify diagnostic, technical, judgment, and management errors. The impact of errors on transplant-free survival was examined by parametric competing risks and risk-adjusted regressions using bootstrapping. RESULTS: Stage 1 (N = 191) errors (n = 111, 58%) were common and predominantly intraoperative (n = 84, 44%) or postoperative (n = 43, 23%). Postoperative errors were determinants of death/transplant (hazard ratio, 1.7; P = .01), whereas technical errors (n = 65, 34%) were not, but they delayed recovery and discharge (extra 24 days approximately, P = .0024). Postoperative stage 1 errors led to decrements in total strategy success of approximately 30% (78% vs 48%, P = .004). Stage 2 (N = 134) errors (n = 66, 49%) were common. Intraoperative errors were the most prevalent (n = 61, 46%) but did not compromise survival. Postoperative errors (n = 11, 8%) were determinants of death/transplant (hazard ratio, 2.4; P < .0001). Interstage errors (n = 21, 16%) led to twice the intensive care unit stay (16 vs 7 days, P < .0001) and hospital stay (30 vs 17 days, P < .02) after stage 2. Overall, a child presenting with ideal morphology and managed with no postoperative errors at stage 1 or 2 would have a predicted late survival in excess of 80%. CONCLUSIONS: Technical errors are common and delay recovery. Their effects on survival are mitigated. Intraoperative judgment errors are associated with strategy failure in a univariate model and lead to increased postoperative errors in a multivariate model. Postoperative errors are independently associated with a decrease in univentricular strategy survival.

DOI： 10.1016/j.jtcvs.2012.12.065

Late functional outcomes after repair of tetralogy of Fallot with atrioventricular septal defect: a double case-match control study. Reviewed International journal

Yasuhiro Kotani, Devin Chetan, Naoki Ono, Luc L Mertens, Christopher A Caldarone, Glen S Van Arsdell, Osami Honjo

The Journal of thoracic and cardiovascular surgery 145 ( 6 ) 1477 - 84 2013.6

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVES: We sought to elucidate late functional outcomes of the right ventricular outflow tract and atrioventricular valves after repair of tetralogy of Fallot with atrioventricular septal defect. METHODS: From 1990 to 2010, the data from 41 patients who underwent repair were retrospectively reviewed. The median age at repair was 22.4 months (interquartile range, 10.8-41.6 months). Of the 41 patients, 13 (32%) had received previous palliations. The preoperative anatomic differences, physiologic differences, and long-term functional outcomes were determined using a double case-matched control with isolated tetralogy of Fallot and isolated atrioventricular septal defect. RESULTS: The right ventricular outflow tract was reconstructed, with the pulmonary valve preserved in 23 patients (56%). There were 3 early deaths and no late deaths. Survival was 92.1% at 15 years. During a median follow-up period of 5.9 years (interquartile range, 0.14-13.7 years), 29 reinterventions were performed in 13 (32%) patients. Freedom from all reintervention at 15 years was 52.8%. Of the 29 procedures, 12 (41%) were related to the right ventricular outflow tract. Freedom from right ventricular outflow tract-related reintervention was greater in patients who had their pulmonary valve preserved (95% vs 70% at 10 years; P = .046). Reinterventions were performed for the atrioventricular valve in 2 (5%) patients and subaortic stenosis in 1 (2%) patient. Freedom from right ventricular outflow tract-related reintervention (tetralogy of Fallot with atrioventricular septal defect, 88.6% vs tetralogy of Fallot alone, 83.9% at 5 years; P = .809) and atrioventricular valve/left ventricular outflow tract-related reintervention (tetralogy of Fallot with atrioventricular septal defect, 95.2% vs atrioventricular septal defect alone, 86.0% at 5 years; P = .332) were comparable between the tetralogy of Fallot with atrioventricular septal defect and matched control groups. CONCLUSIONS: Late survival and atrioventricular valve function after repair of tetralogy of Fallot with atrioventricular septal defect were excellent. Pulmonary valve preservation and avoidance of an artificial conduit were associated with greater freedom from right ventricular outflow tract reintervention. In the current era, the surgically modified history of tetralogy of Fallot with atrioventricular septal defect is not significantly different from that of isolated tetralogy of Fallot or isolated atrioventricular septal defect.

DOI： 10.1016/j.jtcvs.2013.01.007

Evolution of technology, establishment of program, and clinical outcomes in pediatric extracorporeal membrane oxygenation: the "sickkids" experience. Reviewed International journal

Yasuhiro Kotani, Osami Honjo, Lisa Davey, Devin Chetan, Anne-Marie Guerguerian, Colleen Gruenwald

Artificial organs 37 ( 1 ) 21 - 8 2013.1

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

Technological development has had a tremendous impact on the management of patients who require extracorporeal membrane oxygenation (ECMO). Team development and education are a vital component of a successful extracorporeal life support (ECLS) Program to reduce complications and subsequently improve clinical outcomes. We sought to review the evolution in technology, importance of team development and training, and report our experience at The Hospital for Sick Children, Toronto. There were a total of 576 ECMO runs in 534 patients (42 repeat ECMO runs) between January 1988 and June 2012. The use of ECMO for cardiac disease has increased in the last decade due to an expanded indication for ECMO in patients with single-ventricle physiology. Cardiac ECMO still remains a challenge in terms of survival (177/392, 45%). Although development of an ECLS program and team education facilitated extracorporeal cardiopulmonary resuscitation, clinical outcomes were not satisfactory (survival, 33%). The most common complications were hemorrhagic (13.8%), followed by renal (10.6%) and pulmonary dysfunction (6.9%). Advances in technology made management during ECMO safer, and the mechanical complications related to the ECMO system were 6.1%, including circuit changes due to thrombus formation, cannula repositioning, or optimization of size.

DOI： 10.1111/aor.12032

Left atrial decompression during venoarterial extracorporeal membrane oxygenation for left ventricular failure in children: current strategy and clinical outcomes. Reviewed International journal

Yasuhiro Kotani, Devin Chetan, Warren Rodrigues, V Ben Sivarajan, Colleen Gruenwald, Anne-Marie Guerguerian, Glen S Van Arsdell, Osami Honjo

Artificial organs 37 ( 1 ) 29 - 36 2013.1

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

From 2005 to 2011, 23 of 178 (12.9%) patients with venoarterial (VA) extracorporeal membrane oxygenation (ECMO) had left atrial (LA) decompression to help improve left ventricular (LV) function, LA/LV dilatation, and/or lung edema. LA decompression was achieved with LA cannulation (n = 16), surgically created adjustable atrial septal defect (n = 3), or balloon atrial septostomy (n = 4). Sixteen (70%) patients had LA decompression at the time of ECMO initiation and all had LA decompression within 12 hours of ECMO initiation. ECMO duration was 5.9 ± 4.5 days and 16 (70%) patients were successfully decannulated. Subsequent intensive care unit and hospital survival was achieved in 13 (57%) and 12 (52%) patients, respectively. Earlier timing of LA decompression appeared to be associated with a high probability of weaning from ECMO and reasonable LV functional recovery.

DOI： 10.1111/j.1525-1594.2012.01534.x

Aortopulmonary collateral flow volume affects early postoperative outcome after Fontan completion: a multimodality study. Reviewed International journal

Lars Grosse-Wortmann, Christian Drolet, Andreea Dragulescu, Yasuhiro Kotani, Rajiv Chaturvedi, Kyong-Jin Lee, Luc Mertens, Katherine Taylor, Gustavo La Rotta, Glen van Arsdell, Andrew Redington, Shi-Joon Yoo

The Journal of thoracic and cardiovascular surgery 144 ( 6 ) 1329 - 36 2012.12

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

OBJECTIVE: Aortopulmonary collaterals are a frequent phenomenon in patients after bidirectional cavopulmonary connection. The aortopulmonary collateral flow volume can be quantified using cardiac magnetic resonance imaging. However, the significance of aortopulmonary collateral flow for the postoperative outcome after total cavopulmonary connection is unclear and was sought to be determined. METHODS: The data from 33 patients were prospectively studied with cardiac magnetic resonance, echocardiography, and cardiac catheterization before the total cavopulmonary connection operation. The early postoperative outcomes after total cavopulmonary connection completion were recorded. RESULTS: Aortopulmonary collateral flow was 1.59 L/min/m(2) ± 0.65 L/min/m(2) (range, 0.54 L/min/m(2)-3.34 L/min/m(2)), constituting 43% ± 13% (range, 12-87%) of pulmonary blood flow and 35% ± 12% (range, 11-62%) of the cardiac index, resulting in a pulmonary blood flow/systemic blood flow ratio of 1.06 ± 0.17 (range, 0.79-1.55). The aortopulmonary collateral flow correlated with pulmonary blood flow/systemic blood flow ratio (r = 0.69, P < .0001), oxygen saturation (r = 0.42, P = .018), and cardiac index (r = 0.53, P = .002). Of the 36 patients, 24 underwent fenestrated total cavopulmonary connection during the study period. The aortopulmonary collateral flow, relative to the cardiac index, correlated with the duration of hospital stay (r = 0.48, P = .02) and pleural drainage (r = 0.45, P = .03). Patients whose pleural drainage lasted 1 week or less had less aortopulmonary collateral flow before the Fontan operation than those with a longer period until chest tube removal (1.23 L/min/m(2) ± 0.38 L/min/m(2) vs 1.73 L/min/m(2) ± 0.76 L/min/m(2); P = .03). Compared with a contemporary group of total cavopulmonary connection patients with fenestration in their extracardiac conduit who were studied prospectively, with a similar protocol, the bidirectional cavopulmonary connection had a greater amount of aortopulmonary collateral flow (1.59 L/min/m(2) ± 0.65 L/min/m(2) vs 1.30 L/min/m(2) ± 0.57 L/min/m(2), P = .04). CONCLUSIONS: Patients after bidirectional cavopulmonary connection routinely acquire a large amount of aortopulmonary collateral flow. The hemodynamic consequences of aortopulmonary collateral flow translate into adverse outcomes early after total cavopulmonary connection completion.

DOI： 10.1016/j.jtcvs.2012.03.032

Longevity and durability of atrioventricular valve repair in single-ventricle patients. Reviewed International journal

Yasuhiro Kotani, Devin Chetan, Cori R Atlin, Luc L Mertens, Anusha Jegatheeswaran, Christopher A Caldarone, Glen S Van Arsdell, Osami Honjo

The Annals of thoracic surgery 94 ( 6 ) 2061 - 9 2012.12

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The durability of atrioventricular valve (AVV) repair and risk factors for recurrent AVV regurgitation (AVVR) and reintervention in single-ventricle patients are not well defined. METHODS: Among 66 single-ventricle patients who underwent AVV repair between 1998 and 2011, 58 hospital survivors (88%) were retrospectively reviewed. Freedom from recurrent AVVR and reintervention were analyzed with Kaplan-Meier analysis. Predictors for recurrent AVVR, ventricular dysfunction, and reintervention were analyzed using regression analysis. RESULTS: Significant (more than mild+) AVVR developed in 47 patients (81%) during mean follow-up of 37 months (range, 0.2 to 103 months). Freedom from significant AVVR was 23.8% at 1 year and 16.9% at 5 years. Reintervention was performed in 12 patients (26%) at a mean of 24 months (range, 2 to 64 months) after the initial repair. Freedom from reintervention was 92.3% at 1 year and 75.3% at 5 years. There were 11 late deaths (19%). Predictors for recurrent AVVR included repair at stage II (p=0.020) and cardiopulmonary bypass time (p=0.014). Predictors for reintervention included valvuloplasty as a repair technique (p=0.013), cardiopulmonary bypass time (p=0.002), aortic cross-clamp time (p=0.003), and significant residual intraoperative AVVR (p=0.012). Intraoperative ventricular dysfunction (p<0.001), aortic cross-clamp time (p=0.005), and cleft as the mechanism of regurgitation (p=0.023) predicted postrepair ventricular dysfunction. CONCLUSIONS: Although significant AVVR developed in most patients within 1 year of repair, the need for repeat valve repair is relatively low if ventricular function is preserved. Ventricular function after repair did not predict late survival but was related to the longevity of AVV competence and subsequent risk for reintervention.

DOI： 10.1016/j.athoracsur.2012.04.048

Is indexed preoperative superior vena cava blood flow a risk factor in patients undergoing bidirectional cavopulmonary shunt? Reviewed International journal

Yasuhiro Kotani, Osami Honjo, Kishan Shani, Sandra L Merklinger, Christopher Caldarone, Glen Van Arsdell

The Annals of thoracic surgery 94 ( 5 ) 1578 - 83 2012.11

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: This study evaluated the effect of a new measurement-superior vena cava (SVC) flow-and anatomic factors on postoperative arterial oxygen saturation and clinical outcome in patients who underwent bidirectional cavopulmonary shunt (BCPS). METHODS: We reviewed 19 patients who underwent a BCPS between January 2009 and May 2011 who also had SVC blood flow measurements. Median age was 6 months (range, 2 to 29 months). Body weight was 7.0 ± 1.7 kg. Bilateral SVCs were present in 4. SVC flow was measured at the time of BCPS by a Transonic flow probe (Transonic Systems Inc, Ithaca, NY). SVC flow, preoperative hemodynamics, pulmonary artery size, and clinical outcome were analyzed to determine risk for morbidity and death. RESULTS: Mean absolute and indexed pre-BCPS SVC flow was 0.65 ± 0.23 L/min and 1.63 ± 0.55 L/min/m(2) or 91.1 ± 30.8 mL/kg/min, respectively. In all but 1 patient, the SVC flow was increased after BCPS from 1.63 ± 0.55 to 1.99 ± 0.57 L/min/m(2) (p = 0.005). There was a significant positive correlation between pre-BCPS and post-BCPS SVC flow (r = 0.627, p = 0.029). Pulmonary artery size correlated with post-BCPS SVC flow (r = 0.560, p = 0.016). Two patients with preoperative SVC flow of below 1.0 L/min/m(2) died or required BCPS takedown. SVC size did not correlate with BCPS flow (r = 0.231, p = 0.356). Univariate analysis indicated pre-BCPS pulmonary artery pressure was a risk factor for low arterial oxygen saturation (≤ 75%) immediately after BCPS (p = 0.042) and at discharge (p = 0.030). CONCLUSIONS: A new indicator-low SVC flow, may be a marker for BCPS failure or death, suggesting that the SVC flow vs size is more important in predicting successful BCPS.

DOI： 10.1016/j.athoracsur.2012.05.043

Modes of Failure and Cause of Death in Children with Functional Single Ventricle Physiology Following Contemporary Total Cavopulmonary Connection Completion Reviewed

Yasuhiro Kotani, Devin Chetan, Jiaquan Zhu, Lisa Zhao, Luc Mertens, Andrew Redinoton, John Coles, Christopher Caldarone, Glen Van Arsdell, Osami Honjo

CIRCULATION 126 ( 21 ) 2012.11

Hybrid versus Norwood strategies for single-ventricle palliation. Reviewed International journal

Kenji Baba, Yasuhiro Kotani, Devin Chetan, Rajiv R Chaturvedi, Kyong-Jin Lee, Lee N Benson, Lars Grosse-Wortmann, Glen S Van Arsdell, Christopher A Caldarone, Osami Honjo

Circulation 126 ( 11 Suppl 1 ) S123-31 - S131 2012.9

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

BACKGROUND: Hybrid and Norwood strategies differ substantially in terms of stage II palliative procedures. We sought to compare these strategies with an emphasis on survival and reintervention after stage II and subsequent Fontan completion. METHODS AND RESULTS: Of 110 neonates with functionally single-ventricle physiology who underwent stage I palliation between 2004 and 2010, 75 (69%) infants (Norwood, n=43; hybrid, n=32) who subsequently underwent stage II palliation were studied. Survival and reintervention rates after stage II palliation, anatomic and physiologic variables at pre-Fontan assessment, and Fontan outcomes were compared between the groups. Predictors for reintervention were analyzed. Freedom from death/transplant after stage II palliation was equivalent between the groups (Norwood, 80.4% versus hybrid, 85.6% at 3 years, P=0.66). Hybrid patients had a higher pulmonary artery (PA) reintervention rate (P=0.003) and lower Nakata index at pre-Fontan evaluation (P=0.015). Aortic arch and atrioventricular valve reinterventions were not different between the groups. Ventricular end-diastolic pressure, mean PA pressure, and ventricular function were equivalent at pre-Fontan assessment. There were no deaths after Fontan completion in either group (Norwood, n=25, hybrid, n=14). CONCLUSIONS: Survival after stage II palliation and subsequent Fontan completion is equivalent between the groups. The hybrid group had a higher PA reintervention rate and smaller PA size. Both strategies achieved adequate physiology for Fontan completion. Evolution of the hybrid strategy requires refinement to provide optimal PA growth.

Analysis of Code Division Multiplexing Technique Using a 2 Gchip/s Parallel CCD Matched Filter for 16-Channel ECDM-PON Reviewed

Yasuhiro Kotani, Hideyuki Iwamura, Masahiro Sarashina, Hideaki Tamai, Masayuki Kashima

IEICE TRANSACTIONS ON COMMUNICATIONS E95B ( 8 ) 2568 - 2575 2012.8

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：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

Left main coronary artery compression long term after repair of conotruncal lesions: the bow string conduit. Reviewed International journal

Frederic Jacques, Yasuhiro Kotani, Djeven P Deva, Thomas Moller, Erwin Oechslin, Eric Horlick, Mark Osten, Andrew Crean, Lee N Benson, Bernd J Wintersperger, Christopher A Caldarone

The Annals of thoracic surgery 94 ( 1 ) 283 - 5 2012.7

The Dynamic Characteristics of LIM Using Disc-Shaped Secondary Side Converted into Linear Motion Reviewed

Yasuhiro Kotani, Toshimitsu Morizane, Kosuke Tsujikawa, Noriyuki Kimura, Hideki Omori

2012 15TH INTERNATIONAL CONFERENCE ON ELECTRICAL MACHINES AND SYSTEMS (ICEMS 2012) 2012

Authorship：Lead author Language：English Publishing type：Research paper (international conference proceedings) Publisher：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.

Double-barrel Damus-Kaye-Stansel operation is better than end-to-side Damus-Kaye-Stansel operation for preserving the pulmonary valve function: the importance of preserving the shape of the pulmonary sinus. Reviewed International journal

Yasuhiro Fujii, Shingo Kasahara, Yasuhiro Kotani, Masami Takagaki, Sadahiko Arai, Shin-ichi Otsuki, Shunji Sano

The Journal of thoracic and cardiovascular surgery 141 ( 1 ) 193 - 9 2011.1

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

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

　 PREV - NEXT 　

1
2
3
4
5
6
7