2024/04/29 更新

写真a

アカギ テイジ
赤木 禎治
AKAGI Teiji
所属
岡山大学病院 准教授
職名
准教授
外部リンク

学位

  • 医学博士 ( 久留米大学 )

  • 博士(医学) ( 久留米大学 )

研究キーワード

  • intervention

  • adult congenital heart disease

  • patent foramen ovale

  • stroke

  • Structual heart disease

  • 成人先天性心疾患

  • カテーテルインターベンション

  • 心房中隔欠損

  • 卵円孔開存

  • 妊娠

  • 出産

研究分野

  • ライフサイエンス / 循環器内科学  / 成人先天性心疾患

  • ライフサイエンス / 循環器内科学

  • ライフサイエンス / 胎児医学、小児成育学

学歴

  • 久留米大学    

    - 1989年

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    国名: 日本国

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  • 久留米大学   Graduate School, Division of Medicine  

    - 1989年

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  • 久留米大学   Faculty of Medicine  

    - 1984年

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  • 久留米大学   School of Medicine  

    - 1984年

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    国名: 日本国

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経歴

  • 岡山大学   成人先天性心疾患センター   センター長   FACC, FAHA, FESC, FSCIA, FAPSC

    2019年4月 - 現在

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  • 岡山大学   循環器疾患集中治療部   准教授

    2004年6月 - 現在

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  • 久留米大学   School of Medicine

    1999年 - 2004年

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  • 久留米大学   School of Medicine

    1984年 - 1989年

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所属学協会

  • 日本循環器学会

    1989年4月 - 現在

  • 日本成人先天性心疾患学会

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  • 日本心血管インターベンション治療学会

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  • 日本小児循環器学会

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  • 日本小児科学会

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  • 日本心臓病学会

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  • 日本循環器学会

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委員歴

  • 日本成人先天性心疾患学会   理事長  

    2020年1月 - 現在   

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    団体区分:学協会

     国内における成人先天性心疾患患者数はすでに50万人を越える状況となっています。その多くの方が社会を支える現役世代であり,これから子育てを考えられる年代でもあります。このような患者さん方が,安心して適切な医療を受けられるよう,日本全国に成人先天性心疾患診療体制を構築していくのが,本学会に課された重要な課題であると考えています。

     新たに策定されました循環器病対策基本計画の中にも,「小児期・若年期から配慮が必要な循環器病への対策」が盛り込まれ,「小児期から成人期にかけて必要な医療が切れ目なく行える医療体制を整備すること」が求められています。日本成人先天性心疾患学会の総合修練施設,連携修練施設が中心となって,全国の診療体制を構築していく必要があります。また実際に成人先天性心疾患の診療の中心となる専門医の養成も重要です。2022年から日本成人先天性心疾患学会専門医制度がスタートします。これからも本領域の診療体制が切れ目なく維持できるよう,専門医を目指す新たな人材を増やしていきたいと思います。

  • 日本成人先天性心疾患学会   理事長  

    2020年1月 - 現在   

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    団体区分:学協会

    日本成人先天性心疾患学会

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  • 日本心血管インターベンション治療学会   評議員  

    2019年7月 - 現在   

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  • 日本小児循環器学会   理事  

    2018年7月 - 現在   

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    団体区分:学協会

    日本小児循環器学会

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  • 日本Congenital Interventioal Cardiology学会   幹事  

    2009年1月   

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    団体区分:学協会

    日本Pediatric Intervention学会

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  • 成人ASD/PFOカテーテル治療研究会   研究会発起人(代表)  

    2007年 - 現在   

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    団体区分:学協会

    成人ASD/PFOカテーテル治療研究会

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論文

  • Relationship between patent foramen ovale anatomical features and residual shunt after patent foramen ovale closure.

    Rie Nakayama, Yoichi Takaya, Teiji Akagi, Rika Takemoto, Madoka Haruna, Mitsutaka Nakashima, Takashi Miki, Koji Nakagawa, Norihisa Toh, Kazufumi Nakamura

    Cardiovascular intervention and therapeutics   39 ( 2 )   200 - 206   2024年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Transcatheter closure of patent foramen ovale (PFO) is an effective strategy for preventing recurrence of paradoxical embolism. However, PFO closure is often associated with residual shunt, which is a risk of recurrent stroke. This study aimed to evaluate the relationship between the anatomical features of PFO and residual shunt. The degree of residual shunt and its relationship with the anatomical features of PFO were evaluated in 106 patients who underwent PFO closure at our institution between March 2011 and January 2022 and in whom contrast transthoracic echocardiography was performed 1 year later. The mean PFO tunnel length was 9.3 ± 3.6 mm and the mean PFO height was 3.2 ± 2.2 mm. Atrial septal aneurysm (ASA) was found in 37 patients. After PFO closure, residual shunt was observed in 28 patients (grade 1, n = 8; grade 2, n = 16; grade 3, n = 3; grade 4, n = 1). Univariate logistic analysis identified ASA to be associated with residual shunt (odds ratio 2.78, 95% confidence interval 1.14 to 6.79; p = 0.024). There was no association of residual shunt with the size of the PFO, the length of PFO tunnel, or the size of the device used for closure. Two of four patients with a large residual shunt of grade 3 or grade 4 were found to have device size mismatch. Residual shunt after PFO closure was observed in a quarter of patients and was related to the presence of ASA. A few patients had a large residual shunt due to the device size mismatch.

    DOI: 10.1007/s12928-023-00979-y

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  • PICS/AEPC/APPCS/CSANZ/SCAI/SOLACI: Expert Consensus Statement on Cardiac Catheterization for Pediatric Patients and Adults With Congenital Heart Disease. 国際誌

    Ralf J Holzer, Lisa Bergersen, John Thomson, Jamil Aboulhosn, Varun Aggarwal, Teiji Akagi, Mazeni Alwi, Aimee K Armstrong, Emile Bacha, Lee Benson, Regina Bökenkamp, Mario Carminati, Bharat Dalvi, James DiNardo, Thomas Fagan, Kenneth Fetterly, Frank F Ing, Damien Kenny, Dennis Kim, Emily Kish, Michael O'Byrne, Clare O'Donnell, Xiangbin Pan, Joseph Paolillo, Carlos Pedra, Alejandro Peirone, Harsimran S Singh, Lars Søndergaard, Ziyad M Hijazi

    JACC. Cardiovascular interventions   2023年12月

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  • Detection of hepatocellular carcinoma during Fontan-associated liver disease follow-up: a report of three cases.

    Hideki Onishi, Norihisa Toh, Teiji Akagi, Kenji Baba, Yasuhiro Kotani, Akinobu Takaki, Shingo Kasahara, Hiroshi Ito

    Clinical journal of gastroenterology   2023年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We herein demonstrate three patients diagnosed with early hepatocellular carcinoma (HCC) during follow-up for Fontan-associated liver disease (FALD). Case 1: Twenty-one years after undergoing the Fontan procedure, a 26-year-old female was diagnosed with FALD. At the initial consultation, her serum alpha-fetoprotein (AFP) levels were markedly elevated, and dynamic enhanced computed tomography (CT) revealed HCC measuring 40 mm in diameter. She underwent partial hepatectomy. Ten months later, she underwent conventional transcatheter arterial chemoembolization (cTACE) for recurrent HCC near the resected hepatic stump as a curative treatment. Case 2: Twenty-one years after undergoing the Fontan procedure, a 25-year-old male was diagnosed with FALD and underwent HCC surveillance every 6 months. Thirteen months after the initial consultation, dynamic enhanced CT revealed HCC measuring 10 mm in diameter. He received cTACE as a curative treatment. Case 3. Twenty-eight years after undergoing the Fontan procedure, a 37-year-old male was diagnosed with FALD and underwent HCC surveillance every 3 months. Fourteen months later, abdominal ultrasonography (US) revealed HCC measuring 13 mm in diameter. He received radiofrequency ablation. These cases showed that HCC surveillance using abdominal US and AFP measurements in patients with FALD enables the detection of HCC and increases the chance of a cure.

    DOI: 10.1007/s12328-023-01892-w

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  • Utility of angiopoietin-2 measured early after the Fontan operation. 国際誌

    Norihisa Toh, Teiji Akagi, Kazufumi Nakamura, Shingo Kasahara

    The American journal of cardiology   205   516 - 516   2023年10月

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  • 循環器内科で取り組む成人先天性心疾患のフォローアップ 成人先天性心疾患診療における他科との診療連携の実際

    杜 徳尚, 中島 充貴, 大森 一弘, 大西 秀樹, 稲垣 兼一, 衛藤 英理子, 小谷 恭弘, 赤木 禎治, 笠原 真悟, 中村 一文

    日本心臓病学会学術集会抄録   71回   S13 - 1   2023年9月

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    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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  • GORE CARDIOFORM Septal Occluderを用いた経皮的卵円孔開存閉鎖術の国内初期成績

    中島 充貴, 赤木 禎治, 三木 崇史, 中山 理絵, 高谷 陽一, 中川 晃志, 杜 徳尚, 中村 一文

    日本心臓病学会学術集会抄録   71回   O - 1   2023年9月

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    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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  • 循環器内科で取り組む成人先天性心疾患のフォローアップ 成人先天性心疾患診療における他科との診療連携の実際

    杜 徳尚, 中島 充貴, 大森 一弘, 大西 秀樹, 稲垣 兼一, 衛藤 英理子, 小谷 恭弘, 赤木 禎治, 笠原 真悟, 中村 一文

    日本心臓病学会学術集会抄録   71回   S13 - 1   2023年9月

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    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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  • Fenestrationを作成したGORE Cardioform ASD Occluderを用いて経皮的心房中隔欠損閉鎖術を施行した高齢男性の一例

    中島 充貴, 三木 崇史, 高谷 陽一, 赤木 禎治

    日本心血管インターベンション治療学会抄録集   31回   MO81 - 4   2023年8月

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    記述言語:英語   出版者・発行元:(一社)日本心血管インターベンション治療学会  

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  • 成人先天性心疾患の心不全に対する多剤併用療法の試み

    杜 徳尚, 中島 充貴, 小谷 恭弘, 馬場 健児, 黒子 洋介, 中村 一文, 赤木 禎治, 笠原 真悟

    日本小児循環器学会総会・学術集会抄録集   59回   [II - 06]   2023年7月

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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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  • Diagnostic Performance of Cardiac Computed Tomography for Detecting Patent Foramen Ovale: Evaluation Using Transesophageal Echocardiography and Catheterization as Reference Standards. 国際誌

    Takashi Miki, Koji Nakagawa, Keishi Ichikawa, Tomofumi Mizuno, Rie Nakayama, Kentaro Ejiri, Satoshi Kawada, Yoichi Takaya, Masakazu Miyamoto, Toru Miyoshi, Teiji Akagi, Hiroshi Ito

    Journal of cardiovascular development and disease   10 ( 5 )   2023年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Patent foramen ovale (PFO) is associated with various diseases such as cryptogenic stroke, migraine, and platypnea-orthodeoxia syndrome. This study aimed to evaluate the diagnostic performance of cardiac computed tomography (CT) for PFO detection. MATERIALS AND METHODS: Consecutive patients diagnosed with atrial fibrillation and who underwent catheter ablation with pre-procedural cardiac CT and transesophageal echocardiography (TEE) were enrolled in this study. The presence of PFO was defined as (1) the confirmation of PFO using TEE and/or (2) the catheter crossing the interatrial septum (IAS) into the left atrium during ablation. CT findings indicative of PFO included (1) the presence of a channel-like appearance (CLA) on the IAS and (2) a CLA with a contrast jet flow from the left atrium to the right atrium. The diagnostic performance of both a CLA alone and a CLA with a jet flow was evaluated for PFO detection. RESULTS: Altogether, 151 patients were analyzed in the study (mean age, 68 years; men, 62%). Twenty-nine patients (19%) had PFO confirmed by TEE and/or catheterization. The diagnostic performance of a CLA alone was as follows: sensitivity, 72.4%; specificity, 79.5%; positive predictive value (PPV), 45.7%; negative predictive value (NPV), 92.4%. The diagnostic performance of a CLA with a jet flow was as follows: sensitivity, 65.5%; specificity, 98.4%; PPV, 90.5%; NPV, 92.3%. The diagnostic performance of a CLA with a jet flow was statistically superior to that of a CLA alone (p = 0.045), and the C-statistics were 0.76 and 0.82, respectively. CONCLUSION: A CLA with a contrast jet flow in cardiac CT has a high PPV for PFO detection, and its diagnostic performance is superior to that of a CLA alone.

    DOI: 10.3390/jcdd10050193

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  • Patent foramen ovale with sail-like Eustachian valve causing recurrent strokes.

    Rie Nakayama, Yoichi Takaya, Teiji Akagi, Fumi Yokohama, Takashi Miki, Hiroshi Ito

    Cardiovascular intervention and therapeutics   38 ( 2 )   264 - 265   2023年4月

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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/s12928-022-00887-7

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  • Pulmonary arteriovenous fistula in a rare location: The importance of excluding patent foramen ovale.

    Mitsutaka Nakashima, Takashi Miki, Yoichi Takaya, Rie Nakayama, Koji Nakagawa, Satoshi Akagi, Norihisa Toh, Teiji Akagi, Hiroshi Ito

    Journal of cardiology cases   27 ( 3 )   124 - 127   2023年3月

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    記述言語:英語  

    UNLABELLED: A 46-year-old woman with a history of repeated thromboembolic stroke and anti-phospholipid antibody syndrome was referred to our hospital. Saline contrast transthoracic echocardiography showed that microbubbles appeared in the left atrium within 4 heartbeats. Thus, she was initially suspected as having a patent foramen ovale with associated paradoxical embolism. However, no evidence of patent foramen ovale or atrial septal defect could be found using transesophageal echocardiography. Saline contrast transesophageal echocardiography showed that microbubbles flowed into the left atrium through the left superior pulmonary vein. Ultimately, she was diagnosed as having a pulmonary arteriovenous malformation located at the upper left pulmonary lobe using contrast computed tomography and pulmonary artery angiography. Pulmonary arteriovenous malformations are typically located in the lower lobe of either lung and, in bubble studies, contrast appears in the left atrium after 4 heartbeats. Here, the pulmonary arteriovenous malformation was in the upper lobe, and contrast appeared in the left atrium at an earlier time point: one associated with patent foramen ovale. These findings made it difficult to differentiate the two diseases initially. This case suggests that pulmonary arteriovenous malformation should be carefully considered, even if microbubbles appear in the left atrium early on a saline contrast transthoracic echocardiograph. LEARNING OBJECTIVE: Pulmonary arteriovenous malformation occasionally appears in the upper lobe. In these cases, microbubbles may appear in the left atrium after detection in the right atrium with a time-course that is suggestive of a patent foramen ovale. Therefore, diagnosis should be carefully confirmed by using other multimodal imaging tests, such as transesophageal echocardiography, contrast computed tomography, or pulmonary artery angiography.

    DOI: 10.1016/j.jccase.2022.11.005

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  • Challenges of Quad Therapy in Adult Congenital Heart Disease Patients with Heart Failure(タイトル和訳中)

    杜 徳尚, 中島 充貴, 高谷 陽一, 中村 一文, 赤木 禎治, 伊藤 浩

    日本循環器学会学術集会抄録集   87回   OJ62 - 5   2023年3月

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    記述言語:英語   出版者・発行元:(一社)日本循環器学会  

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  • Utility of Plasm Volume Status Calculation in Adult Fontan Patients(タイトル和訳中)

    中島 充貴, 杜 徳尚, 川田 哲史, 高谷 陽一, 中川 晃志, 三好 亨, 西井 伸洋, 赤木 禎治, 伊藤 浩

    日本循環器学会学術集会抄録集   87回   OJ62 - 6   2023年3月

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    記述言語:英語   出版者・発行元:(一社)日本循環器学会  

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  • Association between Cardiovascular Disease and Liver Disease, from a Clinically Pragmatic Perspective as a Cardiologist. 国際誌

    Mitsutaka Nakashima, Kazufumi Nakamura, Takahiro Nishihara, Keishi Ichikawa, Rie Nakayama, Yoichi Takaya, Norihisa Toh, Satoshi Akagi, Toru Miyoshi, Teiji Akagi, Hiroshi Ito

    Nutrients   15 ( 3 )   2023年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Cardiovascular diseases and liver diseases are closely related. Non-alcoholic fatty liver disease has the same risk factors as those for atherosclerotic cardiovascular disease and may also be a risk factor for atherosclerotic cardiovascular disease on its own. Heart failure causes liver fibrosis, and liver fibrosis results in worsened cardiac preload and congestion. Although some previous reports regard the association between cardiovascular diseases and liver disease, the management strategy for liver disease in patients with cardiovascular diseases is not still established. This review summarized the association between cardiovascular diseases and liver disease. In patients with non-alcoholic fatty liver disease, the degree of liver fibrosis progresses with worsening cardiovascular prognosis. In patients with heart failure, liver fibrosis could be a prognostic marker. Liver stiffness assessed with shear wave elastography, the fibrosis-4 index, and non-alcoholic fatty liver disease fibrosis score is associated with both liver fibrosis in patients with liver diseases and worse prognosis in patients with heart failure. With the current population ageing, the importance of management for cardiovascular diseases and liver disease has been increasing. However, whether management and interventions for liver disease improve the prognosis of cardiovascular diseases has not been fully understood. Future investigations are needed.

    DOI: 10.3390/nu15030748

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  • 歯内治療が原因で菌血症となった単心室症患者の一症例 査読

    大森 一弘, 杜 徳尚, 井手口 英隆, 岡本 憲太郎, 佐光 秀文, 児玉 加奈子, 山本 直史, 赤木 禎治, 笠原 真悟, 伊藤 浩, 高柴 正悟

    日本成人先天性心疾患学会雑誌   12 ( 2 )   1 - 8   2023年2月

  • Temporary balloon occlusion test can overestimate the risk of acute pulmonary edema after transcatheter atrial septal defect closure. 国際誌

    Koji Nakagawa, Teiji Akagi, Yoichi Takaya, Takashi Miki, Yasufumi Kijima, Rie Nakayama, Norihisa Toh, Nobuhiro Nishii, Kazufumi Nakamura, Hiroshi Morita, Hiroshi Ito

    Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions   2023年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Atrial septal defect (ASD) closure can cause acute pulmonary edema. Before transcatheter closure is performed, temporary balloon occlusion test (BOT) is recommended in patients with left ventricular dysfunction to predict the risk of pulmonary edema. However, the accuracy of BOT has not been verified. This study aimed to compare hemodynamic differences between BOT and transcatheter closure. METHODS: A total of 42 patients with a single ASD over age 18 years who underwent BOT before transcatheter ASD closure between October 2010 and May 2020 were analyzed. Pulmonary capillary wedge pressure (PCWP) was measured using a Swan-Ganz catheter placed in the pulmonary artery at baseline, after 10 min of BOT, and after transcatheter closure. Amplatzer septal occluder was used for all transcatheter closures. RESULTS: Mean patient age was 64 ± 18 years (range, 18-78). Mean ASD diameter and pulmonary to systemic flow ratio were 18 ± 5 and 2.8 ± 1.0 mm, respectively. Mean PCWP at baseline, during BOT, and after transcatheter closure was 8.9 ± 2.9, 13.5 ± 4.2, and 9.5 ± 2.6 mmHg, respectively. The difference between BOT and after transcatheter closure values was significant (p < 0.001). During BOT, PCWP increased ≥18 mmHg in 7 patients, whereas after ASD closure, PCWP was <18 mmHg in all 7 and none developed acute pulmonary edema. CONCLUSION: Temporary balloon occlusion of an ASD and transcatheter ASD closure result in different hemodynamic change. BOT overestimates increase of PCWP after transcatheter ASD closure and requires careful interpretation. Well-designed, larger studies in higher-risk patients are warranted to verify the clinical implications of BOT in more detail.

    DOI: 10.1002/ccd.30556

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  • 修復術後ファロー四徴症・類縁疾患の遠隔期肺動脈弁置換術における右室拡張障害の意義

    中島 充貴, 杜 徳尚, 小谷 恭弘, 川田 哲史, 高谷 陽一, 中川 晃志, 西井 伸洋, 中村 一文, 森田 宏, 赤木 禎治, 笠原 真悟, 伊藤 浩

    日本成人先天性心疾患学会雑誌   12 ( 1 )   149 - 149   2023年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • 成人期Fontan術後症例においてPlasma Volume Statusは中心静脈圧と予後を推定する

    中島 充貴, 杜 徳尚, 川田 哲史, 高谷 陽一, 中川 晃志, 三好 亨, 西井 伸洋, 赤木 禎治, 伊藤 浩

    日本成人先天性心疾患学会雑誌   12 ( 1 )   136 - 136   2023年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • Fantastic4とACHD~エビデンスの構築に向けて~ 成人先天性心疾患の心不全における多剤併用療法の試み

    杜 徳尚, 中島 充貴, 高谷 陽一, 中村 一文, 赤木 禎治, 伊藤 浩

    日本成人先天性心疾患学会雑誌   12 ( 1 )   103 - 103   2023年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • 【<成人先天性心疾患特有の問題>】成人期の心房中隔欠損の特徴と治療戦略を知る

    杜 徳尚, 高谷 陽一, 中川 晃志, 赤木 禎治, 伊藤 浩

    日本小児循環器学会雑誌   38 ( 4 )   229 - 233   2022年12月

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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  

    心房中隔欠損(Atrial septal defect,ASD)は頻度の高い先天性心疾患であり,チアノーゼなどの症状が出ないことも多く,小児期に診断されることなく成人に到達する症例も少なくない.成人期まで到達したASDでは長年の右心系の負荷と肺血流の増加に伴い,心不全,心房細動,肺高血圧,などの合併症を伴い病態が複雑となることがある.従来の外科手術に加えて,近年の経カテーテルASD閉鎖術,心房細動に対するカテーテルアブレーション,肺高血圧治療薬の進歩に伴い治療成績は向上している.(著者抄録)

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    その他リンク: https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J02003&link_issn=&doc_id=20230424230003&doc_link_id=10.9794%2Fjspccs.38.229&url=https%3A%2F%2Fdoi.org%2F10.9794%2Fjspccs.38.229&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • Iatrogenic Atrial Septal Defect Requiring Transcatheter Closure Following Transcatheter Mitral Valve Repair.

    Yoichi Takaya, Teiji Akagi, Hidehiko Hara, Hideaki Kanazawa, Yuji Ikari, Akihiro Isotani, Shinichi Shirai, Shunsuke Kubo, Takao Morikawa, Toru Naganuma, Mike Saji, Shingo Kuwata, Go Hiasa, Yusuke Watanabe, Masahiro Yamawaki, Masao Imai, Takashi Matsumoto, Masanori Yamamoto, Tsutomu Murakami, Masahiko Asami, Isamu Mizote, Tsukasa Okai, Hiroki Bota, Hiroshi Ito

    Circulation journal : official journal of the Japanese Circulation Society   86 ( 11 )   1740 - 1744   2022年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Transcatheter mitral valve repair with the MitraClip system has been established in selected high-risk patients. The MitraClip procedure results in a relatively large iatrogenic atrial septal defect (iASD). This study aimed to investigate the prevalence and clinical course of iASD requiring transcatheter closure following the MitraClip procedure.Methods and Results: This study was conducted at all 59 institutions that perform transcatheter mitral valve repair with the MitraClip system in Japan. The data of patients on whom transcatheter iASD closure was performed were collected. Of the 2,722 patients who underwent the MitraClip procedure, 30 (1%) required transcatheter iASD closure. The maximum iASD size was 9±4 mm (range, 3-18 mm). The common clinical course of transcatheter iASD closure was hypoxemia with right-to-left shunt or right-sided heart failure with left-to-right shunt. Of the 30 patients, 22 (73%) required transcatheter closure within 24 h following the MitraClip procedure, including 12 with hypoxemia and 5 with right-sided heart failure complicated with cardiogenic shock. Of the 5 patients, 2 required mechanical circulatory support devices. Twenty-one patients immediately underwent transcatheter iASD closure, and hemodynamic deteriorations were resolved; however, 1 patient died without having undergone transcatheter closure. CONCLUSIONS: Transcatheter iASD closure was required in 1% of patients who underwent the MitraClip procedure. Many of these patients immediately underwent transcatheter iASD closure because of hypoxemia with right-to-left shunt or right-sided heart failure with left-to-right shunt.

    DOI: 10.1253/circj.CJ-22-0048

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  • 肝腎症候群急性期に冠攣縮によるST上昇型急性下壁心筋梗塞を合併し,集学的治療により救命し得た1例

    長田 栞, 中島 充貴, 戸田 洋伸, 平井 亮佑, 高木 章乃夫, 三木 崇史, 赤木 達, 吉田 賢司, 中村 一文, 赤木 禎治, 森田 宏, 伊藤 浩

    心臓   54 ( 10 )   1164 - 1169   2022年10月

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    記述言語:日本語   出版者・発行元:(公財)日本心臓財団  

    43歳男性.非代償性アルコール性肝硬変のため他院で通院加療を行われていた.特発性細菌性腹膜炎を契機とした肝腎症候群による急性腎障害を発症し当院転院となった.著明なアシドーシスおよび腎不全を認め集中治療室に入室した.入院後,下壁誘導ST上昇および高度房室ブロックを生じショック状態に至った.気管挿管を行いアルブミン補充および昇圧薬を使用して呼吸循環を維持し,持続的血液濾過透析を施行しながら緊急冠動脈造影検査を施行した.右冠動脈中間部90%狭窄,左冠動脈前下行枝近位部90%狭窄,左冠動脈回旋枝中間部90%狭窄を認めたが,血管拡張薬冠注により狭窄は解除され冠攣縮に伴うST上昇型急性下壁心筋梗塞と診断した.ニコランジル持続静脈投与を開始しST変化や房室ブロックの再発を認めなかった.血行動態安定し,全身状態も改善に向かった.肝腎症候群は末期肝硬変に続発する腎皮質血管の攣縮により生じるとされ,肝・腎以外の臓器にも血流障害が併存する可能性を示唆されている.今回我々は肝腎症候群に冠攣縮による急性心筋梗塞を発症し,集学的治療により救命し得た1例を経験したためここに報告する.(著者抄録)

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    その他リンク: https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J00679&link_issn=&doc_id=20221018180015&doc_link_id=%2Fah2sinzd%2F2022%2F005410%2F019%2F1164-1169%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fah2sinzd%2F2022%2F005410%2F019%2F1164-1169%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • JCS 2022 Guideline on Management and Re-Interventional Therapy in Patients With Congenital Heart Disease Long-Term After Initial Repair.

    Hideo Ohuchi, Masaaki Kawata, Hideki Uemura, Teiji Akagi, Atsushi Yao, Hideaki Senzaki, Shingo Kasahara, Hajime Ichikawa, Hirohiko Motoki, Morio Syoda, Hisashi Sugiyama, Hiroyuki Tsutsui, Kei Inai, Takaaki Suzuki, Kisaburo Sakamoto, Syunsuke Tatebe, Tomoko Ishizu, Yumi Shiina, Shigeru Tateno, Aya Miyazaki, Norihisa Toh, Ichiro Sakamoto, Chisato Izumi, Yoshiko Mizuno, Atsuko Kato, Koichi Sagawa, Ryota Ochiai, Fukiko Ichida, Takeshi Kimura, Hikaru Matsuda, Koichiro Niwa

    Circulation journal : official journal of the Japanese Circulation Society   86 ( 10 )   1591 - 1690   2022年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1253/circj.CJ-22-0134

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  • Overview of the 86th Annual Scientific Meeting of the Japanese Circulation Society - Cardiology Spreading Its Wings.

    Kazufumi Nakamura, Toru Miyoshi, Satoshi Akagi, Norihisa Toh, Yukihiro Saito, Yoichi Takaya, Masatoki Yoshida, Koji Nakagawa, Satoshi Kawada, Hironobu Toda, Takashi Miki, Rie Nakayama, Fumi Yokohama, Keishi Ichikawa, Masashi Yoshida, Makiko Taniyama, Nobuhiro Nishii, Teiji Akagi, Hiroshi Morita, Hiroshi Ito

    Circulation journal : official journal of the Japanese Circulation Society   86 ( 8 )   1312 - 1318   2022年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The 86thAnnual Scientific Meeting of the Japanese Circulation Society was held in a web-based format on March 11-13, 2022. In accordance with the internationalization policy of the JCS, the meeting was held with the Asian Pacific Society of Cardiology Congress 2022. The main theme was "Cardiology Spreading its Wings". The number of patients with heart failure and other cardiovascular diseases is increasing dramatically, and the fields dealt with by cardiovascular medicine are also greatly expanding. This conference was both intellectually satisfying and exciting for all participants, who numbered over 14,900. The meeting was completed with great success, and the enormous amount of cooperation and support from all involved was greatly appreciated.

    DOI: 10.1253/circj.CJ-22-0349

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  • 成人に到達した二心室修復術後の純型肺動脈閉鎖における小児期の三尖弁サイズの推移と成人期心不全発症の関連について

    杜 徳尚, 小谷 恭弘, 中島 充貴, 黒子 洋介, 馬場 健児, 赤木 禎治, 笠原 真悟, 伊藤 浩

    日本小児循環器学会総会・学術集会抄録集   58回   [II - 04]   2022年7月

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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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  • Efficacy of treat-and-repair strategy for atrial septal defect with pulmonary arterial hypertension. 国際誌

    Yoichi Takaya, Teiji Akagi, Ichiro Sakamoto, Hideaki Kanazawa, Gaku Nakazawa, Tsutomu Murakami, Atsushi Yao, Mamoru Nanasato, Mike Saji, Mitsugu Hirokami, Yasushi Fuku, Shinobu Hosokawa, Norio Tada, Kensuke Matsumoto, Masao Imai, Koji Nakagawa, Hiroshi Ito

    Heart (British Cardiac Society)   108 ( 5 )   382 - 387   2022年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: Therapeutic strategies for atrial septal defect (ASD) with severe pulmonary arterial hypertension (PAH) are controversial. This study aimed to evaluate the efficacy of PAH-specific medications and subsequent transcatheter closure (ie, treat-and-repair strategy) on clinical outcomes. METHODS: We enrolled 42 patients who were referred to 13 institutions for consideration of ASD closure with concomitant PAH and underwent the treat-and-repair strategy. The endpoint was cardiovascular death or hospitalisation due to heart failure or exacerbated PAH. RESULTS: At baseline prior to PAH-specific medications, pulmonary to systemic blood flow ratio (Qp:Qs), pulmonary vascular resistance (PVR), and mean pulmonary artery pressure (PAP) were 1.9±0.8, 6.9±3.2 Wood units and 45±15 mm Hg. Qp:Qs was increased to 2.4±1.2, and PVR and mean PAP were decreased to 4.0±1.5 Wood units and 35±9 mm Hg at the time of transcatheter ASD closure after PAH-specific medications. Transcatheter ASD closure was performed without any complications. During a median follow-up period of 33 months (1-126 months) after transcatheter ASD closure, one older patient died and one patient was hospitalised due to heart failure, but the other patients survived with an improvement in WHO functional class. PAP was further decreased after transcatheter ASD closure. CONCLUSIONS: The treat-and-repair strategy results in low complication and mortality rates with a reduction in PAP in selected patients with ASD complicated with PAH who have a favourable response of medical therapy.

    DOI: 10.1136/heartjnl-2021-319096

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  • Importance of saline contrast transthoracic echocardiography for evaluating large right-to-left shunt in patent foramen ovale associated with cryptogenic stroke. 国際誌

    Yoichi Takaya, Rie Nakayama, Teiji Akagi, Fumi Yokohama, Takashi Miki, Koji Nakagawa, Norihisa Toh, Hiroshi Ito

    The international journal of cardiovascular imaging   38 ( 3 )   515 - 520   2022年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Transcatheter closure of patent foramen ovale (PFO) is an effective therapy for preventing recurrent stroke in very specific patient cohorts, such as cryptogenic stroke (CS). The identification of high-risk PFO, which is more likely to be linked to CS, is essential. This study aimed to assess the accuracy of saline contrast transthoracic echocardiography (TTE) for evaluating large right-to-left (RL) shunt. We enrolled 119 patients with or without CS who were confirmed to have PFO by transesophageal echocardiography (TEE) or catheterization. The severity of RL shunt evaluated by TTE and TEE was classified as follows: small (< 10 microbubbles), moderate (10-20 microbubbles), and large (> 20 microbubbles). With TTE, large RL shunt was observed in 94 (79%) of 119 patients, including 66 of 74 with CS and 28 of 45 without CS. With TEE, large RL shunt was observed in 33 (28 %) patients, including 26 with CS and 7 without CS. TTE showed large RL shunt more frequently than TEE (p < 0.01). Large RL shunt evaluated by TTE had a sensitivity of 89 % and an accuracy of 70 % for the association with CS, whereas large RL shunt evaluated by TEE had a sensitivity of 35% and an accuracy of 56 %. Accuracy was significantly greater in TTE than in TEE (p = 0.02). In conclusion, TTE identified large RL shunt associated with CS with higher sensitivity and accuracy compared to TEE. Our findings suggest that the decision for device closure should be made based on the severity of RL shunt by TTE.

    DOI: 10.1007/s10554-021-02418-6

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  • 冠動脈起始異常に対する外科治療

    小谷 恭弘, 鈴木 浩之, 木佐森 永理, 枝木 大治, 小松 弘明, 迫田 直也, 辻 龍典, 横田 豊, 村岡 玄哉, 衛藤 弘城, 小林 純子, 川畑 拓也, 黒子 洋介, 廣田 真規, 馬場 健児, 杜 徳尚, 赤木 禎治, 伊藤 浩, 笠原 真悟

    日本成人先天性心疾患学会雑誌   11 ( 1 )   211 - 211   2022年1月

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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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  • 完全型心内膜床欠損の成人期の予後と臨床像についての検討

    杜 徳尚, 小谷 恭弘, 横浜 ふみ, 黒子 洋介, 馬場 健児, 赤木 禎治, 笠原 真悟, 伊藤 浩

    日本成人先天性心疾患学会雑誌   11 ( 1 )   201 - 201   2022年1月

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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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  • 成人先天性心疾患における大動脈弁および弓部治療 成人先天性心疾患領域における複雑心奇形を伴う大動脈・大動脈弁疾患

    黒子 洋介, 鈴木 浩之, 枝木 大治, 木佐森 永理, 小松 弘明, 辻 龍典, 迫田 直也, 横田 豊, 村岡 玄哉, 衛藤 弘城, 小林 純子, 川畑 拓也, 小谷 恭弘, 廣田 真規, 杜 徳尚, 赤木 禎治, 伊藤 浩, 笠原 真悟

    日本成人先天性心疾患学会雑誌   11 ( 1 )   146 - 146   2022年1月

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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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  • 完全型心内膜床欠損の成人期の予後と臨床像についての検討

    杜 徳尚, 小谷 恭弘, 横浜 ふみ, 黒子 洋介, 馬場 健児, 赤木 禎治, 笠原 真悟, 伊藤 浩

    日本成人先天性心疾患学会雑誌   11 ( 1 )   201 - 201   2022年1月

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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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  • チアノーゼ性先天性心疾患に伴うパラガングリオーマの2症例と全国調査の試み

    杜 徳尚, 稲垣 兼一, 岩崎 慶一郎, 宮崎 文, 黒子 洋介, 小谷 恭弘, 赤木 禎治, 笠原 真悟, 伊藤 浩

    日本成人先天性心疾患学会雑誌   11 ( 1 )   247 - 247   2022年1月

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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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  • 冠動脈起始異常に対する外科治療

    小谷 恭弘, 鈴木 浩之, 木佐森 永理, 枝木 大治, 小松 弘明, 迫田 直也, 辻 龍典, 横田 豊, 村岡 玄哉, 衛藤 弘城, 小林 純子, 川畑 拓也, 黒子 洋介, 廣田 真規, 馬場 健児, 杜 徳尚, 赤木 禎治, 伊藤 浩, 笠原 真悟

    日本成人先天性心疾患学会雑誌   11 ( 1 )   211 - 211   2022年1月

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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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  • Eisenmenger症候群の定義を再考する Treat and repair行う心臓血管外科医としてのEisenmenger症候群の定義を再考する

    笠原 真悟, 赤木 達, 小林 純子, 川畑 拓也, 黒子 洋介, 小谷 恭弘, 赤木 禎治, 伊藤 浩

    日本成人先天性心疾患学会雑誌   11 ( 1 )   169 - 169   2022年1月

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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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  • 心房中隔欠損症患者における閉鎖治療前後での肝うっ血評価

    中山 理絵, 高谷 陽一, 赤木 禎治, 武本 梨佳, 杜 徳尚, 伊藤 浩

    日本成人先天性心疾患学会雑誌   11 ( 1 )   197 - 197   2022年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • 心内短絡疾患における経静脈心内膜リードデバイスによる体塞栓イベントへの影響

    中島 充貴, 杜 徳尚, 西井 伸洋, 高谷 陽一, 川田 哲史, 中川 晃志, 森田 宏, 赤木 禎治, 伊藤 浩

    日本成人先天性心疾患学会雑誌   11 ( 1 )   197 - 197   2022年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • Evolution of echocardiography in adult congenital heart disease: from pulsed-wave Doppler to fusion imaging.

    Norihisa Toh, Teiji Akagi, Shingo Kasahara, Hiroshi Ito

    Journal of echocardiography   19 ( 4 )   205 - 211   2021年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The number of patients with adult congenital heart disease (ACHD) has been dramatically increasing and adults with congenital heart disease now outnumber children with congenital heart disease. However, patients with ACHD are still at increased risk of morbidity and mortality due to residua and sequelae. Although echocardiography is an indispensable imaging modality in the comprehensive assessment of ACHD, accurate echocardiographic assessment of ACHD is challenging especially for physicians or sonographers who are not familiar with ACHD because of its complex morphology, physiology, and hemodynamics. A recently developed fusion imaging technology can provide synchronized display of real-time echocardiographic images and multiplanar reconstruction images of computed tomography or magnetic resonance imaging corresponding to the image plane of real-time echocardiography. We have reported the clinical utility of this fusion imaging technology for the precise evaluation of complex ACHD. On the other hand, conventional echocardiographic technology also plays an important role in assessing unique ACHD pathophysiology. For example, restrictive right ventricular physiology is a common finding after tetralogy of Fallot or pulmonary stenosis repair and can be evaluated by conventional pulsed-wave Doppler. In this review, we discuss the clinical usefulness of modern and conventional echocardiographic technologies for the evaluation of ACHD by presenting a case series.

    DOI: 10.1007/s12574-021-00533-w

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  • Usefulness of cardiac fusion imaging with computed tomography and Doppler echocardiography in the assessment of conduit stenosis in complex adult congenital heart disease. 国際誌

    Nobuhisa Watanabe, Norihisa Toh, Yoichi Takaya, Rie Nakayama, Fumi Yokohama, Kazuhiro Osawa, Toru Miyoshi, Teiji Akagi, Susumu Kanazawa, Hiroshi Ito

    Journal of cardiology   78 ( 6 )   473 - 479   2021年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Noninvasive assessment of stenotic lesions in patients with complex adult congenital heart disease (ACHD) is challenging due to its complex morphology. The simultaneous two-screen display of multidetector-computed tomography (MDCT) and real-time echogram (STDME) technology can display a virtual multi-planar reconstruction from MDCT corresponding to the same cross-sectional image from transthoracic echocardiography (TTE). We investigated the usefulness of the STDME technology for stenosis severity assessment in complex ACHD patients. METHODS: Twenty-four complex ACHD patients with stenotic lesions were enrolled in this study. All patients underwent TTE and the STDME technology within a week after MDCT. Peak velocity and pressure gradient (PG) across the stenotic site were measured using continuous wave Doppler. Cardiac catheterization was performed in 17 patients. RESULTS: Nine out of the twenty-four patients had undergone repair with a conduit. Peak velocity and PG from the STDME technology were higher than those from TTE (peak velocity: 3.1 ± 1.1 vs. 2.8 ± 1.0 m/s; peak PG: 43 ± 28 vs. 34 ± 21 mmHg; both p < 0.01). Peak PG from the STDME technology showed significant correlations with those from catheterization in patients with a conduit (n=7) and those without a conduit (n=10) (r = 0.795 and 0.880, respectively; both p < 0.05), while peak PG from TTE was correlated with catheterization measurements only in patients without a conduit (r = 0.850, p < 0.05). CONCLUSIONS: The STDME technology enables more accurate assessment of conduit stenosis severity than does TTE in complex ACHD patients.

    DOI: 10.1016/j.jjcc.2021.06.008

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  • Importance of direct right-to-left shunt as high-risk patent foramen ovale associated with cryptogenic stroke. 国際誌

    Yoichi Takaya, Rie Nakayama, Teiji Akagi, Fumi Yokohama, Takashi Miki, Koji Nakagawa, Norihisa Toh, Hiroshi Ito

    Echocardiography (Mount Kisco, N.Y.)   38 ( 11 )   1887 - 1892   2021年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Because transcatheter closure of patent foramen ovale (PFO) has become effective for preventing cryptogenic stroke (CS), it is necessary to determine high-risk PFO associated with CS. This study aimed to clarify the importance of direct right-to-left (RL) shunt through the PFO for identifying high-risk PFO. METHODS: We analyzed 137 patients with and without CS who were confirmed to have PFO. The timing of RL shunt through the PFO was evaluated by cardiac cycles after right atrium (RA) opacification on saline contrast transesophageal echocardiography. Direct RL shunt was defined as microbubbles crossing the PFO before and at the same time of RA opacification. RESULTS: Cardiac cycles of microbubbles crossing the PFO were shorter in patients with CS than in those without CS (2.0 ± 2.2 vs .5 ± 1.1, p < 0.01). Direct RL shunt was more frequently observed in patients with CS than in those without CS (77% vs 29%, p < 0.01), with a sensitivity of 79% and a specificity of 71% for the association with CS. Multivariate analysis revealed that direct RL shunt was related to atrial septal aneurysm and low-angle PFO. Regarding functional features of PFO, the detection rate of CS was 50% for large RL shunt alone, and was increased to 83% when direct RL shunt was added. CONCLUSION: Direct RL shunt was associated with CS and had the incremental value in detecting PFO associated with CS for large RL shunt. The timing of RL shunt can be valuable for identifying high-risk PFO.

    DOI: 10.1111/echo.15234

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  • Bleeding and thrombotic risk in pregnant women with Fontan physiology. 国際誌

    Andrea Girnius, Dominica Zentner, Anne Marie Valente, Petronella G Pieper, Katherine E Economy, Magalie Ladouceur, Jolien W Roos-Hesselink, Carri Warshak, Sara L Partington, Zhiqian Gao, Nicholas Ollberding, Michelle Faust, Saulius Girnius, Harald Kaemmerer, Nicole Nagdyman, Scott Cohen, Mary Canobbio, Teiji Akagi, Jasmine Grewal, Elisa Bradley, Yonathan Buber, Joseph Palumbo, Niki Walker, Jamil Aboulhosn, Erwin Oechslin, Helmut Baumgartner, Wesam Kurdi, Wendy M Book, Barbara J M Mulder, Gruschen R Veldtman

    Heart (British Cardiac Society)   107 ( 17 )   1390 - 1397   2021年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND/OBJECTIVES: Pregnancy may potentiate the inherent hypercoagulability of the Fontan circulation, thereby amplifying adverse events. This study sought to evaluate thrombosis and bleeding risk in pregnant women with a Fontan. METHODS: We performed a retrospective observational cohort study across 13 international centres and recorded data on thrombotic and bleeding events, antithrombotic therapies and pre-pregnancy thrombotic risk factors. RESULTS: We analysed 84 women with Fontan physiology undergoing 108 pregnancies, average gestation 33±5 weeks. The most common antithrombotic therapy in pregnancy was aspirin (ASA, 47 pregnancies (43.5%)). Heparin (unfractionated (UFH) or low molecular weight (LMWH)) was prescribed in 32 pregnancies (30%) and vitamin K antagonist (VKA) in 10 pregnancies (9%). Three pregnancies were complicated by thrombotic events (2.8%). Thirty-eight pregnancies (35%) were complicated by bleeding, of which 5 (13%) were severe. Most bleeds were obstetric, occurring antepartum (45%) and postpartum (42%). The use of therapeutic heparin (OR 15.6, 95% CI 1.88 to 129, p=0.006), VKA (OR 11.7, 95% CI 1.06 to 130, p=0.032) or any combination of anticoagulation medication (OR 13.0, 95% CI 1.13 to 150, p=0.032) were significantly associated with bleeding events, while ASA (OR 5.41, 95% CI 0.73 to 40.4, p=0.067) and prophylactic heparin were not (OR 4.68, 95% CI 0.488 to 44.9, p=0.096). CONCLUSIONS: Current antithrombotic strategies appear effective at attenuating thrombotic risk in pregnant women with a Fontan. However, this comes with high (>30%) bleeding risk, of which 13% are life threatening. Achieving haemostatic balance is challenging in pregnant women with a Fontan, necessitating individualised risk-adjusted counselling and therapeutic approaches that are monitored during the course of pregnancy.

    DOI: 10.1136/heartjnl-2020-317397

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  • Cost-Effectiveness Analysis of Percutaneous Patent Foramen Ovale Closure Preventing Secondary Ischemic Stroke in Japan. 国際誌

    Sachie Inoue, Ataru Igarashi, Yasuyuki Iguchi, Teiji Akagi

    Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association   30 ( 8 )   105884 - 105884   2021年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: Patent foramen ovale is a hemodynamically insignificant interatrial communication that may cause ischemic stroke. Percutaneous patent foramen ovale closure reduces the risk for recurrent ischemic stroke in patients with a history of cryptogenic ischemic stroke. This study evaluated the cost-effectiveness of patent foramen ovale closure against medical therapy in patients after their first cryptogenic ischemic stroke in Japan. MATERIALS AND METHODS: The cost-effectiveness of patent foramen ovale closure compared with medical therapy was evaluated using the Markov model. The target patients started with patent foramen ovale closure or medical therapy for preventing secondary ischemic stroke under a stable state. Quality-adjusted life year was used as the outcome of effectiveness, and the analysis was conducted with a discount rate of 2% applied to both cost and effectiveness. The results of a multicenter open-label randomized controlled trial (RESPECT trial) evaluating patent foramen ovale closure using the Amplatzer™ PFO Occluder were used as clinical evidence. Cost-effectiveness was evaluated using the incremental cost-effectiveness ratio. It was evaluated as cost-effective if it was lower than 5 million JPY/ quality-adjusted life year. RESULTS: Patent foramen ovale closure was dominant over medical therapy by 2.53 quality-adjusted life years and an estimated cost reduction of 2,353,926 JPY. The probability of patent foramen ovale closure being dominant was 82.9%. CONCLUSIONS: Patent foramen ovale closure was dominant over medical therapy for preventing secondary ischemic stroke in patients with cryptogenic ischemic stroke.

    DOI: 10.1016/j.jstrokecerebrovasdis.2021.105884

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  • Low-Angle Patent Foramen Ovale (PFO): High-Risk PFO Morphology Associated with Paradoxical Embolism. 国際誌

    Rie Nakayama, Yoichi Takaya, Teiji Akagi, Takashi Miki, Koji Nakagawa, Norihisa Toh, Hiroshi Ito

    CASE (Philadelphia, Pa.)   5 ( 3 )   183 - 185   2021年6月

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    記述言語:英語  

    • Identification of high-risk PFO associated with stroke is important. • Low-angle PFO is reported to be one of the high-risk PFO morphologies. • Low-angle PFO can allow venous blood to flow directly from the IVC to the LA. • The case showed direct blood flow from the IVC to LA through the low-angle PFO.

    DOI: 10.1016/j.case.2021.02.008

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  • Efficacy and safety of atrial septal defect closure using Occlutech Figulla Flex II compared with Amplatzer Septal Occluder.

    Rie Nakayama, Yoichi Takaya, Teiji Akagi, Nobuhisa Watanabe, Takashi Miki, Koji Nakagawa, Norihisa Toh, Hiroshi Ito

    Heart and vessels   36 ( 5 )   704 - 709   2021年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Few studies have reported the efficacy of Occlutech Figulla Flex II (FFII) device compared with Amplatzer Septal Occluder (ASO) device. The aim of this study was to examine the efficacy and safety of FFII compared with ASO for transcatheter atrial septal defect (ASD) closure. We retrospectively evaluated 190 patients using FFII and 190 patients using ASO who underwent transcatheter ASD closure. ASD characteristics were evaluated by transesophageal echocardiography. The prevalence of procedural complications, including erosion, device embolization, stroke, and new-onset atrial arrhythmia, and the presence of a residual shunt were evaluated between the two groups during 12-month follow-up. FFII was used more frequently than ASO in patients with a deficient aortic rim or septal malalignment (P = 0.02, P < 0.01, respectively). The procedural complications of erosion, device embolization, and stroke did not occur in any patients. New-onset atrial arrhythmia occurred in 3 patients of the FFII group and 4 patients of the ASO group, and the difference between the two groups was not significant (P = 0.70). A large residual shunt (≥ 3 mm) was observed in 6 patients of the FFII group and 5 patients of the ASO group, and the difference between the two groups was not significant (P = 0.76). FFII was used frequently in patients with high-risk ASD morphology; however, there was no difference in the prevalence of procedural complications or efficacy between patients using FFII and those using ASO.

    DOI: 10.1007/s00380-020-01739-1

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  • Multiple Late Complications After Takeuchi Repair of Anomalous Left Coronary Artery From the Pulmonary Artery. 国際誌

    Fumi Yokohama, Norihisa Toh, Yasuhiro Kotani, Nobuhisa Watanabe, Yoichi Takaya, Teiji Akagi, Shingo Kasahara, Hiroshi Ito

    JACC. Case reports   3 ( 5 )   731 - 735   2021年5月

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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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  • 肺高血圧を合併した心房中隔欠損症に対する治療戦略と長期予後

    赤木 禎治, 高谷 陽一, 赤木 達, 三木 崇史, 中川 晃志, 伊藤 浩

    日本肺高血圧・肺循環学会学術集会・日本小児肺循環研究会プログラム・抄録集   6回・27回   48 - 48   2021年5月

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    記述言語:日本語   出版者・発行元:日本肺高血圧・肺循環学会・日本小児肺循環研究会  

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  • European position paper on the management of patients with patent foramen ovale. Part II - Decompression sickness, migraine, arterial deoxygenation syndromes and select high-risk clinical conditions. 国際誌

    Christian Pristipino, Peter Germonpré, Danilo Toni, Horst Sievert, Bernhard Meier, Fabrizio D'Ascenzo, Sergio Berti, Eustaquio Maria Onorato, Francesco Bedogni, Jean-Louis Mas, Paolo Scacciatella, David Hildick-Smith, Fiorenzo Gaita, Paul A Kyrle, John Thomson, Genevieve Derumeaux, Dirk Sibbing, Massimo Chessa, Marius Hornung, Jose Zamorano, Dariusz Dudek, Fabrizio D'Ascenzo, Pierluigi Omedè, Flavia Ballocca, Umberto Barbero, Francesca Giordana, Sebastiano Gili, Mario Iannaccone, Teiji Akagi, Gianpaolo Anzola, John Carroll, Bharat Dalvi, Claudio De Angelis, Ge Junbo, Scott E Kasner, Ina Michel-Behnke, Giuseppe Musumeci, Lars Søndergaard, Giuseppe Tarantini, Giuseppe G L Biondi-Zoccai, Davide Capodanno, Marco Valgimigli, Robert Byrne, Vijay Kunadian

    European heart journal   42 ( 16 )   1545 - 1553   2021年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Patent foramen ovale (PFO) is implicated in the pathogenesis of a number of medical conditions but to date only one official position paper related to left circulation thromboembolism has been published. This interdisciplinary paper, prepared with the involvement of eight European scientific societies, reviews the available evidence and proposes a rationale for decision making for other PFO-related clinical conditions. In order to guarantee a strict evidence-based process, we used a modified grading of recommendations, assessment, development, and evaluation (GRADE) methodology. A critical qualitative and quantitative evaluation of diagnostic and therapeutic procedures was performed, including assessment of the risk/benefit ratio. The level of evidence and the strength of the position statements were weighed and graded according to predefined scales. Despite being based on limited and observational or low-certainty randomised data, a number of position statements were made to frame PFO management in different clinical settings, along with suggestions for new research avenues. This interdisciplinary position paper, recognising the low or very low certainty of existing evidence, provides the first approach to several PFO-related clinical scenarios beyond left circulation thromboembolism and strongly stresses the need for fresh high-quality evidence on these topics.

    DOI: 10.1093/eurheartj/ehaa1070

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  • Feasibility of transcatheter closure for absent aortic rim in patients with atrial septal defect. 国際誌

    Yoichi Takaya, Teiji Akagi, Koji Nakagawa, Rie Nakayama, Takashi Miki, Norihisa Toh, Hiroshi Ito

    Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions   97 ( 5 )   859 - 864   2021年4月

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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 assess the feasibility of transcatheter atrial septal defect (ASD) closure in patients with absent aortic rim. BACKGROUND: The indication of transcatheter closure for ASD with absent aortic rim is controversial. METHODS: We enrolled 547 patients with ASD who were scheduled for transcatheter closure. Morphologies of aortic rim were evaluated using transesophageal echocardiography (TEE). RESULTS: Aortic rim of <5 mm was observed in 396 (72%) patients; 128 (23%) had absent aortic rim of 0 mm, and 268 (49%) had deficient aortic rim of >0 to <5 mm. Patients with absent aortic rim frequently had aortic rim absence at an angle of 0° on TEE and septal malalignment. Of the 128 patients with absent aortic rim, 126 (98%) successfully underwent transcatheter closure, while 2 (2%) failed transcatheter closure due to a large defect with severe septal malalignment. The success rate of transcatheter closure was similar between patients with absent aortic rim and those with deficient aortic rim (98% vs. 99%, p = .45). After the procedure, no patients had erosion or device embolization during a median follow-up of 24 months. CONCLUSIONS: Transcatheter closure was successfully performed without adverse events in patients with absent aortic rim, as well as in those with deficient aortic rim. Our findings can be valuable to determine the indication of transcatheter closure in patients with ASD.

    DOI: 10.1002/ccd.29457

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  • Percutaneous closure of residual atrial septal defect after surgical closure.

    Soichiro Ogura, Yoichi Takaya, Teiji Akagi, Koji Nakagawa, Hiroshi Ito

    Cardiovascular intervention and therapeutics   36 ( 2 )   256 - 259   2021年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Residual atrial septal defect (ASD) after surgical closure is rare, but some cases are seen during follow-up period. Redo surgery for residual ASD is often declined, while percutaneous closure can be acceptable. However, the indication of percutaneous closure for residual ASD has not been established. We reviewed our experience with percutaneous closure of residual ASD using medical and procedural records. Between 2006 and 2018, residual ASD was seen in seven patients. The median age of patients was 66 years (range 50-81 years), and the median period after surgical closure of ASD was 39 years (range 13-48 years). All patients had symptoms related to ASD. Percutaneous closure of residual ASD was successfully performed in all seven patients. No residual shunts were detected during the median follow-up period of 4.2 years (range 0.5-11 years) after percutaneous closure. Based on transesophageal echocardiographic findings and operative records for surgical closure, we considered two mechanisms causing residual ASD, such as the tear of surgical suture line and the overlooking of defect during surgical closure. Percutaneous closure of residual ASD was safely performed without any complications, suggesting that percutaneous is an effective therapeutic strategy for residual ASD after surgical closure.

    DOI: 10.1007/s12928-020-00671-5

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  • Morphological assessments of deficient posterior-inferior rim for transcatheter closure of atrial septal defect. 国際誌

    Yoichi Takaya, Teiji Akagi, Koji Nakagawa, Rie Nakayama, Takashi Miki, Norihisa Toh, Hiroshi Ito

    Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions   97 ( 1 )   135 - 141   2021年1月

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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 determine morphological characteristics of deficient posterior-inferior rim for transcatheter atrial septal defect (ASD) closure success. BACKGROUND: The feasibility of transcatheter closure of ASD with deficient posterior-inferior rim remains unclear. METHODS: Of 869 patients with ASD who were scheduled transcatheter closure, 121 with posterior-inferior rim of <5 mm were included. Posterior-inferior rim morphologies were evaluated by transesophageal echocardiography. RESULTS: One hundred six patients successfully underwent transcatheter closure, while 15 patients failed. These 15 patients had complete deficient posterior-inferior rim of 0 mm and/or a large defect of ≥38 mm. Multivariate logistic regression analysis showed that transcatheter closure failure was independently related to complete deficient posterior-inferior rim and a large defect of ≥38 mm. Incomplete deficient posterior-inferior rim of >0 to <5 mm was observed in 84 patients. All these patients successfully underwent transcatheter closure, except two patients with a large defect of ≥38 mm. Complete deficient posterior-inferior rim was observed in 37 patients. The frequency of complete deficient posterior-inferior rim was higher in patients who failed transcatheter closure (87% vs. 23%, p < .01), but transcatheter closure was performed successfully if the range of complete deficient rim was ≤30°. After the procedure, no adverse events occurred during a median follow-up of 24 months. CONCLUSIONS: Most patients with deficient posterior-inferior rim successfully underwent transcatheter closure. Transcatheter closure could be performed even in patients with complete deficient posterior-inferior rim if the range was partial. Our findings can help to identify candidates for transcatheter closure.

    DOI: 10.1002/ccd.29182

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  • Transcatheter closure of patent foramen ovale: Current evidence and future perspectives. 国際誌

    Teiji Akagi

    Journal of cardiology   77 ( 1 )   3 - 9   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Recent prospective controlled studies have demonstrated that transcatheter closure of a patent foramen ovale (PFO) reduces recurrent stroke risk in select patients, especially in patients younger than 60 years with PFO and embolic-appearing infarct and where no other mechanism of stroke was identified. Detection of PFO depends on the intensity of the Valsalva maneuver, and not all PFOs can be diagnosed using transesophageal echocardiography. Transthoracic contrast echocardiography using abdominal compression during the Valsalva maneuver is an easy method that can increase the detection sensitivity of PFO shunt. PFO with two or more of the following factors is most likely considered a "high-risk PFO" and as such, has a significantly higher probability of cryptogenic stroke: (1) a long-tunnel PFO (≥10 mm in length), (2) atrial septal aneurysm and/or hypermobile interatrial septum, (3) prominent Eustachian valve or Chiari's network, (4) large right-to-left shunt at rest and during the Valsalva maneuver, and (5) low-angle PFO. In order to establish the benefit of catheter-based PFO closure as a safe and effective treatment in clinical practice, the degree of accuracy of PFO diagnosis and its long-term safety need to be confirmed.

    DOI: 10.1016/j.jjcc.2020.09.005

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  • Efficacy of Saline Contrast Transthoracic Echocardiography for Identifying High-Risk Patent Foramen Ovale. 国際誌

    Kazuki Suruga, Yoichi Takaya, Rie Nakayama, Teiji Akagi, Koji Nakagawa, Nobuhisa Watanabe, Madoka Haruna, Norihisa Toh, Hiroshi Ito

    Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography   34 ( 1 )   97 - 98   2021年1月

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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.echo.2020.08.001

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  • Closure of the patent foramen ovale in patients with embolic stroke of undetermined source: A clinical expert opinion and consensus statement for the Asian-Pacific region 査読

    Diener HC, Akagi T, Durongpisitkul K, Thomson VS, Prabhakar A, Sharpe R, Sharma VK

    Int J Stroke   15 ( 9 )   937 - 944   2020年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  • Closure of the patent foramen ovale in patients with embolic stroke of undetermined source: A clinical expert opinion and consensus statement for the Asian-Pacific region. 国際誌

    Hans-Christoph Diener, Teiji Akagi, Kritvikrom Durongpisitkul, Viji Samuel Thomson, A T Prabhakar, Ross Sharpe, Bert Albers, Thorsten Lewalter, Koichi Oki, Vijay K Sharma

    International journal of stroke : official journal of the International Stroke Society   15 ( 9 )   937 - 944   2020年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Recently published long-term data from randomized controlled trials have provided evidence for the prevention of recurrent embolic stroke of undetermined source by percutaneous closure of the patent foramen ovale. However, most data were obtained from Caucasian populations and evidence on patent foramen ovale closure in Asian-Pacific patients is limited. The relative paucity in clinical data from this population, as well as the fact that Asian-Pacific patients may have higher bleeding risks than Caucasians, complicates clinical decision-making. This document, resulting from a consensus meeting of Asian-Pacific clinical experts, states the consensus among these experts about how to treat Asian-Pacific patients who had an embolic stroke of undetermined source and have a patent foramen ovale, based on currently available evidence and expert opinions. In addition, uncertainties and the need for clinical data regarding patent foramen ovale closure for prevention of recurrent embolic stroke of undetermined source in general, and specifically for Asian-Pacific patients, are identified.

    DOI: 10.1177/1747493020941658

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  • Residual Restrictive Right Ventricular Physiology after One-and-a-Half Ventricular Repair Conversion in Pulmonary Atresia with Intact Ventricular Septum. 国際誌

    Kazuki Suruga, Norihisa Toh, Yasuhiro Kotani, Hideki Onishi, Teiji Akagi, Shingo Kasahara, Hiroshi Ito

    CASE (Philadelphia, Pa.)   4 ( 6 )   523 - 525   2020年12月

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    記述言語:英語  

    • BVR can be used in patients with PA-IVS to avert abnormal hemodynamics. • Restrictive RV physiology is a unique Doppler echocardiographic feature in patients undergoing BVR. • Although 1.5VR conversion from BVR relieves congestive symptoms, restrictive RV physiology is not diminished.

    DOI: 10.1016/j.case.2020.08.002

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  • Transcatheter closure of patent foramen ovale: Current evidence and future perspectives 査読

    Akagi T

    J Cardiol   S0914-5087 ( 20 )   30310 - 30315   2020年10月

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

  • 奇異性脳梗塞と卵円孔開存

    赤木禎治

    37 ( 10 )   1628 - 1629   2020年10月

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    担当区分:責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  • Efficacy of Saline Contrast Transthoracic Echocardiography for Identifying High-Risk Patent Foramen Ovale 査読

    Suruga K, Takaya Y, Nakayama R, Akagi T, Nakagawa K, Watanabe N, Haruna M, Toh N, Ito H

    J Am Soc Echocardiogr   S0894-7317 ( 20 )   30512 - 30515   2020年9月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  • The impact of pulmonary artery banding and cardiac resynchronization therapy for the adult patient with congenitally corrected transposition of the great arteries 査読

    68 ( 9 )   1024 - 1026   2020年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  • 成人先天性心疾患の集中治療に挑む! 高齢者心房中隔欠損症のカテーテル治療における集中治療の必要性と意義

    藤本 竜平, 赤木 禎治, 高谷 陽一, 三木 崇史, 中山 理絵, 中川 晃志, 伊藤 浩

    日本集中治療医学会雑誌   27 ( Suppl. )   323 - 323   2020年9月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • The impact of pulmonary artery banding and cardiac resynchronization therapy for the adult patient with congenitally corrected transposition of the great arteries.

    Sachiko Kadowaki, Yasuhiro Kotani, Norihisa Toh, Yosuke Kuroko, Atsushi Tateishi, Teiji Akagi, Hiroshi Ito, Shingo Kasahara

    General thoracic and cardiovascular surgery   68 ( 9 )   1024 - 1026   2020年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    It has been controversial how to manage severe dysfunction of the systemic right ventricle and severe tricuspid regurgitation for adult patients with congenitally corrected transposition of the great arteries. We reported a 43-year-old man with these disorders, who received pulmonary artery banding and cardiac resynchronization therapy without cardiopulmonary bypass. The degree of the tricuspid regurgitation was improved to mild-moderate and systemic right ventricular ejection fraction was improved from 28 to 45% after surgery. Cardiopulmonary exercise testing showed that the predictive value of anaerobic threshold and peak oxygen uptake improved from 65 to 99% and 59 to 92%, respectively. In conclusion, pulmonary artery banding and cardiac resynchronization therapy can be the first choice of surgery for severe tricuspid regurgitation with severely impaired systemic right ventricular function. After improving systemic right ventricular dysfunction tricuspid surgery could be the next choice as a surgical intervention in the future.

    DOI: 10.1007/s11748-019-01171-x

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  • Morphological assessments of deficient posterior-inferior rim for transcatheter closure of atrial septal defect 査読

    Takaya Y, Akagi T, Nakagawa K, Nakayama R, Miki T, Toh N, Ito H

    Catheter Cardiovasc Interv   2020年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  • Fontan術以外の術後(Fallot術後など)

    赤木禎治

    周産期医学   50 ( 7 )   1023 - 1027   2020年7月

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    担当区分:責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  • Clinical impact of transcatheter atrial septal defect closure on new onset atrial fibrillation in adult patients: Comparison with surgical closure 査読

    Fujii Y, Akagi T, Nakagawa K, Takaya Y, Eto K, Kuroko Y, Kotani Y, Ejiri K, Ito H, Kasahara S

    J Cardiol   76 ( 1 )   94 - 99   2020年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  • 右室拡大が心房中隔欠損閉鎖術の適応に及ぼす影響(Impact of Right Ventricular Dilatation on an Indication for Atrial Septal Defect Closure)

    中山 理絵, 高谷 陽一, 赤木 禎治, 三木 崇史, 中川 晃志, 杜 徳尚, 伊藤 浩

    日本循環器学会学術集会抄録集   84回   OJ32 - 9   2020年7月

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    記述言語:英語   出版者・発行元:(一社)日本循環器学会  

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  • Outcomes of Patients with Pulmonary Atresia with Intact Ventricular Septum Reaching Adulthood 査読

    Norihisa Toh, Yasuhiro Kotani, Teiji Akagi, Yosuke Kuroko, Kenji Baba, Shin-ichi Otsuki, Shingo Kasahara, Hiroshi Ito

    CONGENITAL HEART DISEASE   15 ( 1 )   1 - 12   2020年6月

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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:TECH SCIENCE PRESS  

    Background: There is limited information on outcomes of adult patients with pulmonary atresia with intact ventricular septum (PA-IVS) due to the low incidence of disease and the large variation of surgical histories. Methods: Among 58 patients with repaired PA-IVS, a total of 32 patients aged >= 16 years and who were followed at our institution between January 2003 and December 2018 were reviewed. Surgical history, clinical outcomes, and laboratory, echocardiographic and electrocardiographic data were obtained by chart review. Results: Follow-up was from the age of 16 years and the median age at the latest follow-up was 23.7 years. Twenty-four patients had undergone biventricular repair (BVR), 3 had undergone one-and-a half ventricular repair (1.5VR), and 5 had undergone univentricular repair. Over a median follow-up period of 7.7 years (interquartile range: 4.1-11.0 years), 1 BVR patient died suddenly and 7 patients had heart failure. Arrhythmias were present in 5 patients. Ten patients underwent surgical re-interventions, including 4 BVR take-downs with conversion to 1.5VR and 3 Fontan conversions. Overall survival, heart failure-free, arrhythmia-free, and surgical re-intervention-free rates at 5 years and 10 years from the age of 16 years were 96.2% (95% confidence interval [CI], 77.2-99.4) and 96.2% (95% CI, 77.2-99.4), 81.4% (95% CI, 62.1-92.1) and 74.6% (95%CI, 52.3-88.7), 88.7% (95% CI, 70.1-96.3) and 75.9% (95% CI, 51.7-90.2), and 80.7% (95% CI, 60.8-91.8) and 70.8% (95% CI, 49.7-85.7), respectively. Conclusion: Adults with PA-IVS have preserved long-term survival regardless of the early operative strategy, while they are at risk for heart failure, arrhythmia, and surgical re-intervention. Thus, detailed and continued follow-up is mandatory for all PA-IVS patients from childhood to adulthood.

    DOI: 10.32604/CHD.2020.011579

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  • Percutaneous closure of residual atrial septal defect after surgical closure 査読

    Ogura S, Takaya Y, Akagi T, Nakagawa K, Ito H

    Cardiovasc Interv Ther   2020年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  • Impact of Right Ventricular Dilatation in Patients with Atrial Septal Defect 査読

    Nakayama R, Takaya Y, Akagi T, Nakagawa K, Watanabe N, Nobusada S, Matsushita T, Toh N, Kanazawa S, Ito H

    J Interv Cardiol   2020   9509105   2020年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  • Pregnancy with Fontan circulation: A report of case series in Japan. 査読

    Eriko Eto, Jota Maki, Teiji Akagi, Hiroshi Ito, Hisashi Masuyama

    Journal of cardiology cases   21 ( 4 )   161 - 163   2020年4月

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    記述言語:英語  

    Owing to new surgical procedures and medications, more women who have undergone the Fontan procedure reach childbearing ages. We report five cases of pregnancy with Fontan circulation. Case 1 had subchorionic hematoma (SCH), fetal growth restriction (FGR), and preterm labor (PTL). She delivered a 1073 g infant via cesarean section at gestation week 28 because of hemorrhagic shock. Case 2 delivered 2142 g and 2232 g infants at gestation weeks 37 and 36, respectively. She had FGR, PTL, and postpartum hemorrhage (PPH). Case 3 had SCH, PTL, and heart failure. At 36 weeks, labor was induced and she delivered a 2546 g infant by vacuum extraction with epidural analgesia. Cases 4 and 5 resulted in miscarriage. All subjects experienced obstetrical complications. This report discusses pregnant women with Fontan circulation by focusing on affected Japanese women. <Learning objective: More women who have undergone the Fontan procedure reach childbearing ages due to the new surgical procedures and medications. We report five cases and all of them experienced obstetrical complications. Anticoagulation might be one of the causes of postpartum hemorrhage. Labor epidural analgesia could contribute to minimized dynamic circulatory changes during labor. This report can be the literature regarding pregnant women with Fontan circulation in Japan.>.

    DOI: 10.1016/j.jccase.2019.12.005

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  • Clinical Significance of Septal Malalignment for Transcatheter Closure of Atrial Septal Defect 査読

    Takaya Y, Akagi T, Nakagawa K, Nakayama R, Miki T, Watanabe N, Toh N, Ito H

    J Interv Cardiol   2020   6090612   2020年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  • 【高齢者の心疾患に対する低侵襲的治療の現状と今後】高齢者の心房中隔欠損・動脈管開存に対するカテーテル治療

    赤木禎治

    58 ( 3 )   215 - 220   2020年3月

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    担当区分:責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  • 【奇異性脳塞栓症と深部静脈血栓症】奇異性脳塞栓症の治療

    橋本洋一郎, 井口保之, 河野浩之, 赤木禎治

    7 ( 1 )   6 - 13   2020年3月

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    担当区分:最終著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  • Importance of Abdominal Compression Valsalva Maneuver and Microbubble Grading in Contrast Transthoracic Echocardiography for Detecting Patent Foramen Ovale 査読

    Takaya Y, Watanabe N, Ikeda M, Akagi T, Nakayama R, Nakagawa K, Toh N, Ito H

    J Am Soc Echocardiogr   33 ( 2 )   201 - 206   2020年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  • Importance of Abdominal Compression Valsalva Maneuver and Microbubble Grading in Contrast Transthoracic Echocardiography for Detecting Patent Foramen Ovale. 国際誌

    Yoichi Takaya, Nobuhisa Watanabe, Madoka Ikeda, Teiji Akagi, Rie Nakayama, Koji Nakagawa, Norihisa Toh, Hiroshi Ito

    Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography   33 ( 2 )   201 - 206   2020年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Although transthoracic echocardiography (TTE) may be useful for patent foramen ovale (PFO) screening, the optimal methodologies remain unclear. The aims of this study were to evaluate the efficacy of the abdominal compression Valsalva maneuver and identify the optimal cutoff value of microbubbles in contrast TTE for detecting PFO, compared with transesophageal echocardiography and catheterization as the reference. METHODS: One hundred thirty-four patients with cryptogenic stroke or migraine who had suspected PFO and underwent TTE and transesophageal echocardiography plus catheterization were enrolled. The sensitivity, specificity, and accuracy of TTE for PFO detection were analyzed according to different provocations (spontaneous Valsalva maneuver, abdominal compression Valsalva maneuver) and different cutoff values of microbubbles for a positive result (at least one microbubble, at least five microbubbles). RESULTS: Eighty patients had PFO confirmed by transesophageal echocardiography and catheterization. When the cutoff was at least one microbubble, the sensitivity of TTE in detecting PFO was 93% with the spontaneous Valsalva maneuver and 99% with the abdominal compression Valsalva maneuver. When the cutoff was at least five microbubbles, sensitivity was 85% with the spontaneous Valsalva maneuver and 99% with the abdominal compression Valsalva maneuver. With the abdominal compression Valsalva maneuver, specificity was increased using the cutoff of at least five microbubbles compared with at least one microbubble (89% vs 57%). The abdominal compression Valsalva maneuver with the cutoff of at least 5 microbubbles provided the greatest accuracy of 95%. CONCLUSIONS: TTE with the abdominal compression Valsalva maneuver had excellent sensitivity. The cutoff of at least five microbubbles increased specificity. Our findings suggest that TTE with these criteria is valuable for PFO diagnosis.

    DOI: 10.1016/j.echo.2019.09.018

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  • ACHDに対するInterventional Cardiologyの最新知見と将来展望 卵円孔開存(Update and Prospect on Interventional Cardiology for ACHD Transcatheter Closure of Patent Foramen Ovale)

    高谷陽一, 赤木禎治, 中川晃志, 中山理絵, 三木崇史, 伊藤 浩

    日本成人先天性心疾患学会雑誌   9 ( 1 )   177   2020年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  • 成人先天性心疾患における肺高血圧症の病態と治療 最新知見とガイドラインからみた肺血管拡張療法 高度肺高血圧症を伴う成人先天性心疾患に対するTreat & Repair pre-tricuspid shunt

    高谷陽一, 赤木禎治, 中川晃志, 中山理絵, 三木崇史, 伊藤 浩

    日本成人先天性心疾患学会雑誌   9 ( 1 )   181   2020年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  • ACHDハイリスク患者の妊娠・出産管理 ACHDハイリスク妊娠管理 人工弁術後・抗凝固療法中の妊娠・出産

    赤木禎治, 杜 徳尚, 横濱ふみ, 衛藤英理子, 牧 尉太, 増山 寿, 伊藤 浩

    日本成人先天性心疾患学会雑誌   9 ( 1 )   184   2020年1月

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

  • 生体弁肺動脈弁換術による早期効果(Short-term Outcome after Pulmonary Valve Replacement: The Effects on Anatomy, Physiology, and Clinical Outcome)

    小谷恭弘, 杜 徳尚, 黒子洋介, 川畑拓也, 後藤拓弥, 堀尾直裕, 小林泰幸, 迫田直也, 辻 龍典, 横田 豊, 三浦 望, 赤木禎治, 伊藤 浩, 笠原真悟

    日本成人先天性心疾患学会雑誌   9 ( 1 )   208   2020年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  • タンパク漏出性腸症を伴った心疾患の成人期の予後(Clinical outcomes of adult congenital heart disease patients with protein losing enteropathy)

    杜 徳尚, 小谷恭弘, 赤木禎治, 横濱ふみ, 黒子洋介, 馬場健児, 大月審一, 笠原真悟, 伊藤 浩

    日本成人先天性心疾患学会雑誌   9 ( 1 )   248   2020年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  • 当院におけるccTGAの長期予後(Long-term outcomes of congenitally corrected transposition of the great arteries: A high-volume single center experience)

    横濱ふみ, 杜 徳尚, 赤木禎治, 伊藤 浩, 黒子洋介, 小谷恭弘, 笠原真悟

    日本成人先天性心疾患学会雑誌   9 ( 1 )   249   2020年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  • 【医学的・社会的ハイリスク妊婦のケアと管理】心疾患を伴う母体の妊娠・出産管理

    赤木禎治

    臨床助産ケア: スキルの強化   12 ( 1 )   12 - 16   2020年1月

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    担当区分:責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  • タンパク漏出性腸症を伴った心疾患の成人期の予後(Clinical outcomes of adult congenital heart disease patients with protein losing enteropathy)

    杜 徳尚, 小谷 恭弘, 赤木 禎治, 横濱 ふみ, 黒子 洋介, 馬場 健児, 大月 審一, 笠原 真悟, 伊藤 浩

    日本成人先天性心疾患学会雑誌   9 ( 1 )   248 - 248   2020年1月

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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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  • ACHDハイリスク患者の妊娠・出産管理 ACHDハイリスク妊娠管理 人工弁術後・抗凝固療法中の妊娠・出産 査読

    赤木 禎治, 杜 徳尚, 横濱 ふみ, 衛藤 英理子, 牧 尉太, 増山 寿, 伊藤 浩

    日本成人先天性心疾患学会雑誌   9 ( 1 )   184 - 184   2020年1月

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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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  • 当院におけるccTGAの長期予後(Long-term outcomes of congenitally corrected transposition of the great arteries: A high-volume single center experience)

    横濱 ふみ, 杜 徳尚, 赤木 禎治, 伊藤 浩, 黒子 洋介, 小谷 恭弘, 笠原 真悟

    日本成人先天性心疾患学会雑誌   9 ( 1 )   249 - 249   2020年1月

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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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  • 経皮的卵円孔開存閉鎖術:ViewFlex Xtra ICEカテーテルガイドによる閉鎖術の実際

    赤木禎治

    39   1 - 4   2020年

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    担当区分:責任著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  • Clinical Significance of Septal Malalignment for Transcatheter Closure of Atrial Septal Defect. 国際誌

    Yoichi Takaya, Teiji Akagi, Koji Nakagawa, Rie Nakayama, Takashi Miki, Nobuhisa Watanabe, Norihisa Toh, Hiroshi Ito

    Journal of interventional cardiology   2020   6090612 - 6090612   2020年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Septal malalignment is related to erosion and device embolization in transcatheter closure of atrial septal defect (ASD), but limited information is available. OBJECTIVES: This study aimed to assess clinical significance of septal malalignment and to determine appropriate evaluation of ASD diameter, including the selection of device size. METHODS: Four hundred and seventeen patients with ASD who underwent transcatheter closure were enrolled. Septal malalignment was defined as separation between the septum primum and the septum secundum on transesophageal echocardiography. RESULTS: One hundred and eighty-four patients had septal malalignment. The frequency of septal malalignment increased with age reaching around 50% in adult patients. Septal malalignment was related to aortic rim deficiency. The distance of separation between the septum primum and the septum secundum was 5 ± 2 mm (range, 1-11 mm). In patients with septal malalignment, the ASD diameter measured at the septum primum was 19 ± 6 mm, while the ASD diameter measured at the septum secundum was 16 ± 6 mm. There was a difference of 4 ± 2 mm (range, 0-8 mm) between the ASD diameter measured at the septum primum and that measured at the septum secundum. For transcatheter closure, the Amplatzer Septal Occluder device size 2-3 mm larger and the Occlutech Figulla Flex II device size 4-7 mm larger than the ASD diameter measured at the septum primum were frequently used. During the study period, erosion or device embolization did not occur in all of the patients. CONCLUSIONS: Septal malalignment is highly prevalent in adult patients with aortic rim deficiency. The measurement of ASD diameter at the septum primum can be valuable for the selection of device size in patients with septal malalignment.

    DOI: 10.1155/2020/6090612

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  • Impact of Right Ventricular Dilatation in Patients with Atrial Septal Defect. 国際誌

    Rie Nakayama, Yoichi Takaya, Teiji Akagi, Koji Nakagawa, Nobuhisa Watanabe, Saori Nobusada, Toshi Matsushita, Norihisa Toh, Susumu Kanazawa, Hiroshi Ito

    Journal of interventional cardiology   2020   9509105 - 9509105   2020年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: The aim of this study was to examine the relationship between right ventricular (RV) volume and exercise capacity in adult patients with atrial septal defect (ASD) and to determine the degree of RV dilatation for transcatheter ASD closure. BACKGROUND: RV dilatation is an indication of transcatheter ASD closure; however, few studies have reported the clinical significance of RV dilatation. METHODS: We enrolled 82 consecutive patients (mean age, 49 ± 18 years; female, 68%) who underwent cardiac magnetic resonance imaging and symptom-limited cardiopulmonary exercise test before ASD closure. The relationship between RV volume and peak oxygen uptake (VO2) was evaluated. RESULTS: The mean RV end-diastolic volume index was 108 ± 27 ml/m2 (range, 46 to 180 ml/m2). The mean peak VO2 was 24 ± 7 ml/min/kg (range, 14 to 48 ml/min/kg), and the mean predicted peak VO2 was 90 ± 23%. There were significant negative relationships of RV end-diastolic volume index with peak VO2 (r = -0.28, p < 0.01) and predicted peak VO2 (r = -0.29, p < 0.01). The cutoff value of RV end-diastolic volume index <80% of predicted peak VO2 was 120 ml/m2, with the sensitivity of 49% and the specificity of 89%. CONCLUSIONS: There was a relationship between RV dilatation and exercise capacity in adult patients with ASD. RV end-diastolic volume index ≥120 ml/m2 was related to the reduction in peak VO2. This criterion of RV dilatation may be valuable for the indication of transcatheter ASD closure.

    DOI: 10.1155/2020/9509105

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  • Efficacy of catheter ablation for paroxysmal atrial fibrillation in patients with atrial septal defect: a comparison with transcatheter closure alone. 国際誌

    Koji Nakagawa, Teiji Akagi, Satoshi Nagase, Yoichi Takaya, Yasufumi Kijima, Norihisa Toh, Atsuyuki Watanabe, Nobuhiro Nishii, Kazufumi Nakamura, Hiroshi Morita, Kengo Kusano, Hiroshi Ito

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology   21 ( 11 )   1663 - 1669   2019年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIMS: There is no valid treatment strategy for addressing paroxysmal atrial fibrillation (AF) in patients with unclosed atrial septal defect (ASD). We aimed to assess the efficacy of catheter ablation (CA) compared with transcatheter ASD closure alone for treating pre-existing paroxysmal AF in patients with ASD. METHODS AND RESULTS: Among 908 patients who underwent transcatheter ASD closure, we evaluated 50 consecutive patients (63 ± 12 years) with paroxysmal AF. We compared the AF outcomes of these patients after transcatheter ASD closure between those with and without CA prior to ASD closure. Thirty (60%) patients underwent CA. During the follow-up period after ASD closure (mean: 49 ± 23 months), recurrence of AF was observed in 6/30 (20%) patients with upfront CA and 12/20 (60%) patients with ASD closure alone. Kaplan-Meier analysis showed that the AF-free survival rate was significantly higher for patients with CA than for those with ASD closure alone (79% vs. 37% at 5 years, P = 0.002). Upfront CA and previous heart failure hospitalization were associated with recurrence of AF after ASD closure [hazard ratio (HR) 0.18, 95% confidence interval (CI) 0.06-0.53; P = 0.002 and HR 4.64, 95% CI 1.60-13.49; P = 0.005, respectively]. CONCLUSION: In ASD patient with paroxysmal AF, transcatheter ASD closure alone demonstrated high AF recurrence rate after ASD closure. On the other hand, upfront CA prior to ASD closure substantially suppressed AF recurrence over the long term. A combination of CA and transcatheter ASD closure may be a feasible treatment strategy for paroxysmal AF in patients with ASD.

    DOI: 10.1093/europace/euz207

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  • 健診で発見された肺底動脈大動脈起始症の一例

    横濱 ふみ, 杜 徳尚, 赤木 禎治, 伊藤 浩, 黒子 洋介, 小谷 恭弘, 笠原 真悟

    日本心臓病学会学術集会抄録   67回   P - 265   2019年9月

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    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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  • 右冠動脈完全閉塞の治療が機能性僧帽弁逆流の改善に寄与したCHIP症例 査読

    吉田 雅言, 三木 崇史, 江尻 健太郎, 大塚 寛昭, 戸田 洋伸, 中川 晃志, 三好 亨, 西井 伸洋, 渡邊 あつゆき, 赤木 禎治, 伊藤 浩

    日本心血管インターベンション治療学会抄録集   28回   [MO134 - 003]   2019年9月

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    記述言語:英語   出版者・発行元:(一社)日本心血管インターベンション治療学会  

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  • Impact of Disease Complexity on Cardiovascular Events after the Transition to an Adult Congenital Heart Disease Specialized Medical Unit.

    Sho Takahashi, Teiji Akagi, Norihisa Toh, Yoichi Takaya, Koji Nakagawa, Nobuhiro Nishii, Hiroshi Ito

    Acta medica Okayama   73 ( 4 )   307 - 313   2019年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The follow-up of patients with adult congenital heart disease (ACHD) at a specialized medical unit is necessary for the patients' appropriate medical care. However, limited information is available about cardiovascular events among ACHD patients. Here we investigated the type and frequency of cardiovascular events in ACHD patients in relation to disease complexity. We retrospectively analyzed the cases of 535 patients (median age 35 years) referred to our ACHD center between 2014 and 2017. We divided the patients into 3 groups based on their disease complexity. To evaluate the relationship between disease complexity and cardiovascular events, we performed univariate and multivariate survival analyses. The Simple, moderate, and complex disease groups accounted for 62%, 19%, and 19% of the patients, respectively. Apart from events related to atrial septal defect (ASD) trans-catheter treatment, the frequency of cardiovascular events was dependent on the disease complexity (event-free survival rates at 3 years were 85%, 65%, and 58%, respectively). The hazard ratios were 4.0 and 5.1 in the moderate and complex groups, respectively. With the exception of scheduled transcatheter intervention, cardiovascular events were strongly related to the disease complexity of original heart disease. However, cardiovascular events were not rare even in the simple ACHD group.

    DOI: 10.18926/AMO/56932

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  • Identification of High-Risk Patent Foramen Ovale Associated With Cryptogenic Stroke: Development of a Scoring System. 国際誌

    Rie Nakayama, Yoichi Takaya, Teiji Akagi, Nobuhisa Watanabe, Madoka Ikeda, Koji Nakagawa, Norihisa Toh, Hiroshi Ito

    Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography   32 ( 7 )   811 - 816   2019年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Transcatheter closure of patent foramen ovale (PFO) has become an effective therapeutic strategy for cryptogenic stroke (CS). The identification of high-risk PFO is essential, but the data are limited. This study aimed to clarify the factors related to CS and to develop a score for high-risk PFO. METHODS: We retrospectively analyzed 57 patients with prior CS and 50 without CS who were scheduled for transcatheter closure. PFO characteristics were evaluated by transesophageal echocardiography. Based on factors related to CS, we estimated the risk score. RESULTS: Patients with CS had a greater frequency of large-size PFO (≥2 mm in height), long-tunnel PFO (≥10 mm in length), atrial septal aneurysm, hypermobile interatrial septum, prominent Eustachian valve or Chiari's network, the large right-to-left shunt at rest and during Valsalva maneuver, and low-angle PFO (≤10° of PFO angle from inferior vena cava), compared with patients without CS. Multivariate analysis showed that long-tunnel PFO, the presence of hypermobile interatrial septum, the presence of prominent Eustachian valve or Chiari's network, the large right-to-left shunt during Valsalva maneuver, and low-angle PFO were independently related to CS. When the score was estimated based on 1 point for each factor, the proportion of CS was markedly elevated with a score of ≥2 points. The probability of CS was markedly different between scores of ≤1 or ≥2 points. CONCLUSIONS: PFO risk can be assessed with a score based on high-risk features. The presence of two or more high-risk PFO features is associated with CS.

    DOI: 10.1016/j.echo.2019.03.021

    PubMed

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  • エブスタイン奇形成人 臨床経過および心血管イベントの予測因子(Adults with Ebstein Anomaly: Clinical Course and Predictors of Cardiovascular Events)

    杜 徳尚, 赤木 禎治, 小谷 恭弘, 横濱 ふみ, 高橋 生, 黒子 洋介, 馬場 健児, 大月 審一, 笠原 真悟, 伊藤 浩

    日本循環器学会学術集会抄録集   83回   OJ29 - 8   2019年3月

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    記述言語:英語   出版者・発行元:(一社)日本循環器学会  

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  • 片頭痛に関連する卵円孔開存と比較した潜因性脳卒中に関連する高リスク卵円孔開存の特定(Identification of High-Risk Patent Foramen Ovale Associated with Cryptogenic Stroke in Comparison with Migraine)

    中山 理絵, 高谷 陽一, 赤木 禎治, 池田 まどか, 渡邉 修久, 中川 晃志, 杜 徳尚, 伊藤 浩

    日本循環器学会学術集会抄録集   83回   OJ08 - 9   2019年3月

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    記述言語:英語   出版者・発行元:(一社)日本循環器学会  

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  • Acute Aortic Dissection as a Rare Complication of Percutaneous Closure Using the Amplatzer Vascular Plug II for a Tubular and Enlarged Patent Ductus Arteriosus in an Elderly Patient. 国際誌

    Hiroyuki Yamamoto, Hiromasa Otake, Teiji Akagi, Kensuke Matsumoto, Soichiro Henmi, Takeshi Inoue, Hiroshi Tanaka, Ken-Ichi Hirata

    JACC. Cardiovascular interventions   12 ( 1 )   e5-e7   2019年1月

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  • ご当地ACHDセンター診療の実際;上手くいってることはもちろん、そうでないことも全て見せます 岡山大学病院ACHDセンターの試み(ACHD Management System of Okayama University Hospital)

    赤木 禎治, 杜 徳尚, 大月 審一, 増山 寿, 大西 秀樹, 木野村 賢, 大森 一弘, 笠原 真悟, 伊藤 浩

    日本成人先天性心疾患学会雑誌   8 ( 1 )   79 - 79   2019年1月

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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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  • Fontan循環とその他の成人先天性心疾患での肝病変の特徴の比較(Unique features of hepatic disease in adults with Fontan circulation: A comparison with congenital heart disease patients after two-ventricular repair)

    杜 徳尚, 大西 秀樹, 赤木 禎治, 竹内 康人, 中村 進一郎, 横濱 ふみ, 高谷 陽一, 小谷 恭弘, 黒子 洋介, 笠原 真悟, 岡田 弘之, 伊藤 浩

    日本成人先天性心疾患学会雑誌   8 ( 1 )   105 - 105   2019年1月

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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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  • 当院における成人先天性心疾患患者の口腔状態の現況(Current Oral Condition of Patients with Adult Congenital Heart Disease in ACHD Center/Okayama University Hospital)

    大森 一弘, 杜 徳尚, 高知 信介, 山本 直史, 赤木 禎治, 伊藤 浩, 高柴 正悟

    日本成人先天性心疾患学会雑誌   8 ( 1 )   142 - 142   2019年1月

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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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  • Ebstein病の中長期予後についての検討(Mid-term clinical outcomes in adult patients with surgically operated Ebstein anomaly)

    杜 徳尚, 赤木 禎治, 小谷 恭弘, 横濱 ふみ, 黒子 洋介, 馬場 健児, 大月 審一, 笠原 真悟, 伊藤 浩

    日本成人先天性心疾患学会雑誌   8 ( 1 )   104 - 104   2019年1月

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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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  • 心房中隔欠損症患者における右室容積とexercise capacityの関連性について(Relationship between right ventricular volume and exercise capacity in patients with atrial septal defect)

    中山 理絵, 高谷 陽一, 赤木 禎治, 渡辺 修久, 池田 まどか, 中川 晃志, 杜 徳尚, 伊藤 浩

    日本成人先天性心疾患学会雑誌   8 ( 1 )   111 - 111   2019年1月

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    記述言語:英語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • Infective Endocarditis of Patent Foramen Ovale Closure Device Presenting as an Amoeboid-Like Mass. 査読 国際誌

    Hidenaru Yamaoka, Yoichi Takaya, Nobuhisa Watanabe, Teiji Akagi, Koji Nakagawa, Norihisa Toh, Yasuhiro Kotani, Shingo Kasahara, Hiroshi Ito

    JACC. Cardiovascular interventions   11 ( 22 )   2337 - 2338   2018年11月

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  • ファロー四徴症術後の小児期の肺動脈弁逆流および狭窄が、成人期の右室サイズに与える影響についての検討

    杜 徳尚, 小谷 恭弘, 赤木 禎治, 高橋 生, 黒子 洋介, 馬場 健児, 大月 審一, 笠原 真悟, 伊藤 浩

    日本心臓病学会学術集会抄録   66回   O - 017   2018年9月

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    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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  • 成人先天性心疾患センターにおけるハイリスク妊娠に対するアプローチ 妊娠中の抗凝固療法管理はどうあるべきか?

    赤木 禎治, 杜 徳尚, 高橋 生, 増山 寿, 伊藤 浩

    日本小児循環器学会雑誌   34 ( Suppl.1 )   s1 - 191   2018年7月

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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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  • この症例をどうするか?:妊娠、出産へのアプローチ Fontan手術後に挙児希望をされているが、低酸素血症が持続している1症例 査読

    杜 徳尚, 赤木 禎治, 黒子 洋介, 馬場 健児, 板谷 慶一, 牧 尉太, 小谷 恭弘, 大月 審一, 増山 寿, 笠原 真悟, 伊藤 浩

    日本小児循環器学会雑誌   34 ( Suppl.1 )   s1 - 156   2018年7月

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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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  • 術後ファロー四徴症において小児期の肺動脈弁逆流および狭窄が成人期の右室サイズに与える影響についての検討

    杜 徳尚, 小谷 恭弘, 赤木 禎治, 高谷 陽一, 高橋 生, 黒子 洋介, 馬場 健児, 大月 審一, 笠原 真悟, 伊藤 浩

    日本小児循環器学会雑誌   34 ( Suppl.1 )   s1 - 263   2018年7月

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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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  • Liver Cirrhosis and/or Hepatocellular Carcinoma Occurring Late After the Fontan Procedure - A Nationwide Survey in Japan.

    Masanari Kuwabara, Koichiro Niwa, Tomohiko Toyoda, Takeaki Shirai, Shigeru Tateno, Hideo Ohuchi, Yasuhiko Tanaka, Fukiko Ichida, Tomoo Fujisawa, Teiji Akagi, Yoshiki Mori

    Circulation journal : official journal of the Japanese Circulation Society   82 ( 4 )   1155 - 1160   2018年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Fontan-associated liver disease (FALD) is an important late complication involving liver dysfunction, such as liver cirrhosis (LC) and hepatocellular carcinoma (HCC), in patients undergoing the Fontan procedure. However, the prevalence, clinical manifestation, and methods of diagnosis of FALD are still not well established.Methods and Results:This study comprised 2 nationwide surveys in Japan. First, the prevalence of LC and/or HCC in patients undergoing the Fontan procedure was determined. Second, clinical manifestations in patients with LC and/or HCC were analyzed, along with data from blood tests, echocardiography, and right heart catheterization. In the 1st survey, of the 2,700 patients who underwent the Fontan procedure, 31 were diagnosed with LC and/or HCC (1.15%), and 5 died due to liver diseases (mortality: 0.19%). In the 2nd survey, data were collected from 17 patients (12 with LC, 2 with HCC, and 3 with LC+HCC. Of these 17 patients, 5 died (mortality: 29.4%). The mean age at diagnosis of LC and HCC was 23 and 31 years, respectively. Computed tomography followed by ultrasound was most frequently used for diagnosis. Blood tests revealed low platelet counts, increased hemoglobin, aspartate aminotransferase, γ-guanosine triphosphate, and total bilirubin levels, and an elevated international normalized ratio of prothrombin time. CONCLUSIONS: LC and/or HCC in patients undergoing the Fontan procedure were not rare late complications and were associated with high mortality rates.

    DOI: 10.1253/circj.CJ-17-1053

    PubMed

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  • Treat and Repair Strategyにより治療したVSD-PHの4症例とその経過 査読

    更科 俊洋, 赤木 禎治, 杜 徳尚, 高橋 生, 江尻 健太郎, 高谷 陽一, 中川 晃志, 赤木 達, 中村 一文, 笠原 真悟, 伊藤 浩

    日本成人先天性心疾患学会雑誌   7 ( 1 )   150 - 150   2018年1月

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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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  • 成人期に到達した純型肺動脈閉鎖の臨床経過についての検討

    杜 徳尚, 赤木 禎治, 小谷 恭弘, 高橋 生, 黒子 洋介, 馬場 健児, 大月 審一, 笠原 真吾, 伊藤 浩

    日本成人先天性心疾患学会雑誌   7 ( 1 )   143 - 143   2018年1月

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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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  • Platypnea-orthodeoxia syndrome induced by multiple vertebral compression fractures and an atrial septal defect 査読

    Ko Harada, Koji Nakagawa, Hiroaki Ohtsuka, Yoichi Takaya, Teiji Akagi, Kazufumi Nakamura, Hiroshi Morita, Hiroshi Ito

    Internal Medicine   57 ( 7 )   971 - 973   2018年

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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:Japanese Society of Internal Medicine  

    Platypnea-orthodeoxia syndrome (POS) is a rare condition that is characterized by dyspnea and arterial oxygen desaturation, which worsen on standing and which are relieved by recumbency. We treated an 80-year-old woman with an atrial septal defect (ASD) who demonstrated POS following thoracic and lumbar vertebral compression fractures. The surgical closure of the ASD relieved her symptoms. The etiology might have been multiple compression fractures causing kyphosis and aortic distortion producing right atrial compression and increased right-to-left flow through the ASD. POS should be considered in the differential diagnosis of patients who develop dyspnea after vertebral compression fractures. The careful assessment of the patient’s history and clinical condition helps in the diagnosis of POS.

    DOI: 10.2169/internalmedicine.9904-17

    Scopus

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  • 岡山大学病院における心疾患を有する女性の周産期妊娠転帰と将来に向けて(The Perinatal Outcomes of Pregnancy in Women with Heart Disease in Okayama University Hospital and Towards the Future) 査読

    牧 尉太, 増山 寿, 赤木 禎治, 伊藤 浩, 平松 祐司

    日本循環器学会学術集会抄録集   81回   PL09 - 2   2017年3月

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    記述言語:英語   出版者・発行元:(一社)日本循環器学会  

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  • 当院での心疾患合併妊娠の転帰と今後に向けて 査読

    牧 尉太, 増山 寿, 赤木 禎治, 佐藤 浩, 平松 祐司

    日本成人先天性心疾患学会雑誌   6 ( 1 )   123 - 123   2017年1月

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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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  • 小児インターベンション心臓病学の近年の進歩 研究からカテーテルラボへ 術前に心房細動または動悸が認められなかった40歳以上の患者におけるASD閉鎖手術後の新規心房細動の発症率と危険因子 治療器具と手術による治療の比較(Incidence and risk factors of newly developed atrial fibrillation after ASD closure in patients older than 40 years without history of preoperative atrial fibrillation or flutter: device vs surgery)

    藤井 泰宏, 赤木 禎治, 黒子 洋介, 小谷 恭弘, 新井 禎彦, 笠原 真悟, 中川 晃志, 木島 康文, 高谷 陽一, 伊藤 浩, 佐野 俊二

    日本小児循環器学会雑誌   32 ( Suppl.1 )   s1 - 104   2016年7月

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    記述言語:英語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 大学における血管外科医教育 シームレスな育成のために

    大澤 晋, 川畑 拓也, 黒子 洋介, 藤井 泰宏, 赤木 禎治, 吉積 功, 小谷 恭弘, 増田 善逸, 新井 禎彦, 笠原 真悟, 佐野 俊二

    日本血管外科学会雑誌   24 ( 1 )   74 - 74   2015年2月

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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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  • 奇異性塞栓症の二次予防としての卵円孔開存に対するカテーテル閉鎖術 手技成績と遠隔期予後

    木島 康文, 赤木 禎治, 中川 晃志, 杜 徳尚, 麻植 浩樹, 草野 研吾, 伊藤 浩

    日本心臓病学会誌   8 ( Suppl.I )   333 - 333   2013年9月

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    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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  • 成人期に新たに発見された心房中隔欠損症の臨床像

    中川 晃志, 赤木 禎治, 木島 康文, 草野 研吾, 永瀬 聡, 藤沢 芳基, 岩本 睦, 佐野 俊二, 伊藤 浩

    日本心臓病学会誌   8 ( Suppl.I )   543 - 543   2013年9月

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    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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  • 左心低形成症候群におけるフォンタン術完了を目指した治療戦略(Treatment Strategy Toward Fontan Completion in Hypoplastic Left Heart Syndrome)

    笠原 真悟, 後藤 拓弥, 川畑 拓也, 黒子 洋介, 増田 善逸, 吉積 功, 新井 禎彦, 赤木 禎治, 大月 審一, 佐野 俊二

    日本小児循環器学会雑誌   29 ( Suppl. )   s160 - s160   2013年6月

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    記述言語:英語   出版者・発行元:(NPO)日本小児循環器学会  

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  • Amplatzer PFO Occluderを用いた卵円孔開存のカテーテル閉鎖術 本邦における初期経験

    木島 康文, 赤木 禎治, 中川 晃志, 上岡 亮, 出口 健太郎, 麻植 浩樹, 杜 徳尚, 草野 研吾, 佐野 俊二, 伊藤 浩

    超音波医学   40 ( Suppl. )   S491 - S491   2013年4月

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    記述言語:日本語   出版者・発行元:(公社)日本超音波医学会  

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  • カテーテル治療適応外ASD症例に対し薬物治療後にカテーテル治療を行えた一例

    大澤 晋, 赤木 禎治, 中川 晃志, 木島 康文, 草野 研吾, 伊藤 浩, 佐野 俊二

    超音波医学   40 ( Suppl. )   S646 - S646   2013年4月

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    記述言語:日本語   出版者・発行元:(公社)日本超音波医学会  

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  • NEW THERAPEUTIC STRATEGIES FOR PATIENTS WITH ATRIAL SEPTAL DEFECT AND SEVERE PULMONARY ARTERIAL HYPERTENSION: COMBINATION OF ADVANCED MEDICAL THERAPY AND CATHETER INTERVENTION

    Yasufumi Kijima, Teiji Akagi, Koji Nakagawa, Akira Ueoka, Norihisa Toh, Kengo Kusano, Hiroshi Ito

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   61 ( 10 )   E1914 - E1914   2013年3月

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

    DOI: 10.1016/S0735-1097(13)61914-2

    Web of Science

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  • Collaborative management for PAH 高度肺高血圧を伴う心房中隔欠損症に対する新しい治療戦略 肺血管作動薬とカテーテル治療の併用(Collaborative management for PAH New Strategies for Patients with Atrial Septal Defect and Severe Pulmonary Arterial Hypertension: Combination of Medical Therapy)

    木島 康文, 赤木 禎治, 中川 晃志, 杜 徳尚, 上岡 亮, 得能 智武, 新家 俊郎, 八尾 厚史, 宮地 克維, 松原 広己, 草野 研吾, 佐野 俊二, 伊藤 浩

    日本成人先天性心疾患学会雑誌   2 ( 1 )   41 - 41   2013年1月

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    記述言語:英語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • 心房中隔欠損症に合併した心房細動に対するアブレーション治療

    中川 晃志, 赤木 禎治, 木島 康文, 永瀬 聡, 河野 晋久, 笠原 真悟, 草野 研吾, 佐野 俊二, 伊藤 浩

    日本成人先天性心疾患学会雑誌   2 ( 1 )   70 - 70   2013年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • 最大径40mmを越す心房中隔欠損症をいかにカテーテル閉鎖するか?利尿剤投与の効果

    上岡 亮, 木島 康文, 赤木 禎治, 杜 徳尚, 中川 晃志, 永瀬 聡, 河野 晋久, 森田 宏, 草野 研吾, 伊藤 浩

    日本成人先天性心疾患学会雑誌   2 ( 1 )   70 - 70   2013年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • 心房中隔欠損症に合併した心房細動に対するアブレーション治療

    中川 晃志, 赤木 禎治, 永瀬 聡, 谷口 学, 木島 康文, 大河 啓介, 草野 研吾, 伊藤 浩

    日本心臓病学会誌   7 ( Suppl.I )   282 - 282   2012年8月

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    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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  • 心房中隔欠損症に対するカテーテル閉鎖術における心腔内エコーの使用経験

    木島 康文, 赤木 禎治, 中川 晃志, 杜 徳尚, 麻植 浩樹, 草野 研吾, 佐野 俊二, 伊藤 浩

    日本心臓病学会誌   7 ( Suppl.I )   343 - 343   2012年8月

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  • カテーテル治療を行った多孔性心房中隔欠損症の2例

    大澤 晋, 赤木 禎治, 木島 康文, 中川 晃志, 草野 研吾, 伊藤 浩, 佐野 俊二

    超音波医学   39 ( Suppl. )   S535 - S535   2012年4月

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    記述言語:日本語   出版者・発行元:(公社)日本超音波医学会  

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  • Guidelines for Indication and Management of Pregnancy and Delivery in Women With Heart Disease (JCS 2010) - Digest Version

    Koichiro Niwa, Teiji Akagi, Shigeyuki Aomi, Yoshihito Hata, Tomoaki Ikeda, Yoshio Matsuda, Norifumi Nakanishi, Satoshi Nakatani, Isao Shiraishi, Katsuo Terui, Nobuhisa Hagiwara, Tetsuko Ishii, Chizuko A. Kamiya, Satoru Kawano, Yasutaka Kawasoe, Minoru Nomura, Mayumi Ota, Tokuko Shinohara, Shigeru Tateno, Yoshio Uetsuka, Shigeyuki Echigo, Tsuyomu Ikenoue, Tohru Izumi, Toshikatsu Yagihara

    CIRCULATION JOURNAL   76 ( 1 )   240 - 260   2012年1月

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    記述言語:英語   出版者・発行元:JAPANESE CIRCULATION SOC  

    DOI: 10.1253/circj.CJ-88-0023

    Web of Science

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  • 先天性心疾患患者における右室流出路置換術(repaired TOF, when to intervene adult CHD Right ventricular out flow tract replacement in the patients with congenital heart disease)

    笠原 真悟, 川畑 拓也, 黒子 洋介, 立石 篤史, 藤田 康文, 吉積 功, 高垣 昌巳, 新井 禎彦, 赤木 禎治, 佐野 俊二

    日本成人先天性心疾患学会雑誌   1 ( 1 )   58 - 58   2012年1月

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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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  • 18歳以上で初回Arch repairを行った、成人先天性心疾患の6例の検討

    笠原 真悟, 木村 紘爾, 川畑 拓也, 黒子 洋介, 立石 篤史, 藤田 康文, 吉積 功, 高垣 昌巳, 新井 禎彦, 赤木 禎治, 佐野 俊二

    日本成人先天性心疾患学会雑誌   1 ( 1 )   72 - 72   2012年1月

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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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  • 小児心疾患の最新治療 心房中隔欠損症のカテーテル治療時代における外科治療の役割 カテーテル治療不能例からの検討

    木島 康文, 赤木 禎治, 谷口 学, 中川 晃志, 岡本 吉生, 大月 審一, 草野 研吾, 伊藤 浩, 佐野 俊二

    日本心臓病学会誌   6 ( Suppl.I )   174 - 174   2011年8月

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    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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  • 多孔型心房中隔欠損症の経カテーテル的閉鎖術における三次元経食道心エコー図の有用性

    谷口 学, 赤木 禎治, 渡辺 修久, 岡本 吉生, 木島 康文, 中川 晃志, 杜 徳尚, 大月 審一, 草野 研吾, 伊藤 浩, 佐野 俊二

    日本心臓病学会誌   6 ( Suppl.I )   326 - 326   2011年8月

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    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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  • 小児補助循環の現状と展望 小児心臓手術後にEXTRACORPOREAL MEMBRANE OXYGENATIONを導入した80例の検討

    笠原 真悟, 川畑 拓也, 立石 篤史, 藤田 康文, 高垣 昌巳, 新井 禎彦, 赤木 禎治, 佐野 俊二

    日本小児循環器学会雑誌   27 ( Suppl. )   s161 - s161   2011年6月

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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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  • 3Dエコー リアルタイム三次元経食道心エコー図を用いた心房中隔欠損症のカテーテル閉鎖術

    谷口 学, 岡本 吉生, 赤木 禎治, 渡辺 修久, 大月 審一, 草野 研吾, 伊藤 浩, 佐野 俊二

    日本心臓病学会誌   5 ( Suppl.I )   159 - 159   2010年8月

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    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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  • インターベンションと超音波法 経カテーテル的心房中隔欠損閉鎖術における治療ガイドとしての超音波法

    谷口 学, 赤木 禎治, 草野 研吾, 伊藤 浩, 佐野 俊二

    超音波医学   37 ( Suppl. )   S288 - S288   2010年4月

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    記述言語:日本語   出版者・発行元:(公社)日本超音波医学会  

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  • 循環器診療におけるソノグラファーの貢献とその問題点 経カテーテル的閉鎖術前検査における三次元経胸壁心エコー図による心房中隔欠損の形態評価

    渡辺 修久, 谷口 学, 赤木 禎治, 田辺 康治, 杜 徳尚, 草野 研吾, 小出 典男, 伊藤 浩, 佐野 俊二

    日本心臓病学会誌   4 ( Suppl.I )   157 - 157   2009年8月

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    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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  • 成人における経カテーテル的心房中隔欠損閉鎖術前後における肺動脈楔入圧の変化

    谷口 学, 赤木 禎治, 中川 晃志, 木島 康文, 草野 研吾, 伊藤 浩, 佐野 俊二

    日本心臓病学会誌   4 ( Suppl.I )   435 - 435   2009年8月

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    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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  • 50歳以上の高齢者心房中隔欠損症例における経カテーテル的心房中隔欠損閉鎖術後の運動耐用能の改善

    谷口 学, 赤木 禎治, 信定 さおり, 草野 研吾, 伊藤 浩, 佐野 俊二

    日本心臓病学会誌   4 ( Suppl.I )   298 - 298   2009年8月

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    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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  • 心不全を伴う高齢者心房中隔欠損症に対するカテーテル閉鎖術の有効性

    赤木 禎治, 谷口 学, 中川 晃司, 木島 康文, 草野 研吾, 佐野 俊二

    日本心臓病学会誌   4 ( Suppl.I )   261 - 261   2009年8月

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    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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  • 循環器診療におけるソノグラファーの貢献とその問題点 心房中隔欠損症の経カテーテル的閉鎖術術後におけるソノグラファーの役割

    武本 梨佳, 渡辺 修久, 谷口 学, 田辺 康治, 杜 徳尚, 草野 研吾, 赤木 禎治, 伊藤 浩, 佐野 俊二

    日本心臓病学会誌   4 ( Suppl.I )   157 - 157   2009年8月

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    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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  • 肺高血圧を呈した成人心房中隔欠損症に対する経皮的カテーテル閉鎖術後の短期~中期予後

    中川 晃志, 木島 康文, 谷口 学, 草野 研吾, 赤木 禎治, 佐野 俊二

    Circulation Journal   73 ( Suppl.II )   962 - 962   2009年4月

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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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  • 成人先天性心疾患患者の診療(体制)はどうあるべきか 成人先天性心疾患の診療における循環器内科医の関与 心房中隔欠損症のカテーテル治療における取り組み

    中川 晃志, 赤木 禎治, 谷口 学, 草野 研吾, 大月 審一, 佐野 俊二

    日本心臓病学会誌   2 ( Suppl.I )   139 - 139   2008年8月

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    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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  • 循環器病の診断と治療に関するガイドライン(2005-2006年度合同研究班報告) (ダイジェスト版) 先天性心疾患術後遠隔期の管理・侵襲的治療に関するガイドライン

    越後 茂之, 角 秀秋, 富田 英, 中澤 誠, 丹羽 公一郎, 松田 暉, 村上 新, 八木原 俊克, 市川 肇, 赤木 禎治, 原田 研介, 大内 秀雄, 黒嵜 健一, 白石 修一, 立野 滋, 竹内 功, 中村 真, 山田 修, 山村 英司, 安井 久喬, 山口 徹, 日本循環器学会

    日本心臓病学会誌   2 ( 1 )   591 - 603   2008年7月

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    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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  • 左心低形成症候群の治療戦略と長期予後 両側肺動脈絞扼術の採用とRV-PA shuntによるNorwood手術連続70例の検討

    笠原 真悟, 小谷 恭弘, 大島 祐, 吉積 功, 赤木 禎治, 佐野 俊二, 岡本 吉生, 大月 審一

    日本小児循環器学会雑誌   24 ( 3 )   383 - 383   2008年5月

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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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  • 経皮的ASD閉鎖術におけるリアルタイム3D経食道エコー(RT3D-TEE)の有用性について

    岡本 吉生, 大月 審一, 大野 直幹, 美野 陽一, 近藤 麻衣子, 森島 恒雄, 赤木 禎治, 佐野 俊二, 岩崎 達雄, 戸田 雄一郎, 清水 一好

    日本小児循環器学会雑誌   24 ( 3 )   297 - 297   2008年5月

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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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  • 総肺静脈還流異常症術後で繰り返す肺静脈狭窄症に対しstent in stent techniqueを使用したopen stent graft術の1例

    笠原 真悟, 宮原 義典, 大島 祐, 吉積 功, 赤木 禎治, 佐野 俊二, 大野 直幹, 大月 審一

    日本小児循環器学会雑誌   24 ( 3 )   314 - 314   2008年5月

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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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  • Right ventricular outflow tract reconstruction in patients with persistent truncus arteriosus - A 15-year experience in a single Japanese center 査読

    Osami Honjo, Yasuhiro Kotani, Teiji Akagi, Satoru Osaki, Masaaki Kawada, Kozo Ishino, Shunji Sano

    CIRCULATION JOURNAL   71 ( 11 )   1776 - 1780   2007年11月

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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:JAPANESE CIRCULATION SOC  

    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 H) who underwent primary repair from September 1992 to December 2006. Median age and body weight at surgery were 21 days and 2.9kg, respectively. All but I 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, 19-8 1%) 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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  • 成人心房中隔欠損症における経カテーテル的閉鎖術後の経時的リモデリングについての検討

    谷口 学, 赤木 禎治, 丸尾 健, 田辺 康治, 渡辺 修久, 草野 研吾, 佐野 俊二, 大江 透

    Journal of Cardiology   50 ( Suppl.I )   499 - 499   2007年8月

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    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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  • HLHSに対する新戦略 両側肺動脈絞扼術の採用

    笠原 真悟, 吉積 功, 石野 幸三, 赤木 禎治, 佐野 俊二, 岡本 吉生, 大月 審一

    日本小児循環器学会雑誌   23 ( 3 )   269 - 269   2007年5月

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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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  • 当院における機能的単心室に伴う房室弁逆流に対する治療戦略

    笠原 真悟, 小谷 恭弘, 吉積 功, 石野 幸三, 泉本 浩史, 大月 審一, 赤木 禎治, 河田 政明, 佐野 俊二

    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY   54 ( Suppl. )   337 - 337   2006年9月

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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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  • 生体部分肺移植を行い,救命し得たEisenmenger syndromeの1例

    笠原 真悟, 赤木 禎治, 吉積 功, 神吉 和重, 石野 幸三, 泉本 浩史, 佐野 俊二, 伊達 洋至

    日本小児循環器学会雑誌   22 ( 4 )   478 - 478   2006年7月

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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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  • 左心低形成症候群の段階的治療戦略と遠隔成績

    笠原 真悟, 吉積 功, 神吉 和重, 三井 秀也, 石野 幸三, 泉本 浩史, 赤木 禎治, 岡本 吉生, 大月 審一, 佐野 俊二

    日本小児循環器学会雑誌   22 ( 3 )   266 - 266   2006年5月

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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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  • Fontan循環におけるDamus-Kaye-Stanselの適応と遠隔成績

    笠原 真悟, 藤井 泰宏, 吉積 功, 神吉 和重, 三井 秀也, 石野 幸三, 泉本 浩史, 赤木 禎治, 佐野 俊二

    日本小児循環器学会雑誌   22 ( 3 )   327 - 327   2006年5月

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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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  • Coil Occlusion for Patent Ductus Arteriosus in Japan

    TOMITA Hideshi, FUSE Shigeto, AKAGI Teiji, KOIKE Kazuyuki, KAMADA Masahiro, KAMIYA Tetsuro, MOMMA Kazuo, ISHIZAWA Akira, CHIBA Shunzo

    Japanese circulation journal   61 ( 12 )   997 - 1003   1997年11月

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    記述言語:英語   出版者・発行元:社団法人日本循環器学会  

    We surveyed Japanese experience of coil occlusion of patent ductus arteriosus up to 30 September 1996 by sending questionnaires to 175 hospitals. Thirty-four hospitals reported outcome data for 231 procedures in 218 patients. Successful implantation was achieved in 94% and acute complete closure of the ductus occurred in 71% of those in whom implantation of the coil was successful. Of the latter, 83% reported late complete closure. When those patients who underwent reocclusion for residual shunt are included, 89% attained complete closure. No life-threatening complications have occurred so far. Late reopening was reported in 3 cases. Although the angiographic type of ductus was significantly related to successful implantation (p<0.01), there was no significant correlation with complete occlusion. Ductuses with a minimum diameter greater than 3 mm had a decreased chance of successful implantation, whereas those less than 2 mm had a greater incidence of complete closure. (Jpn Circ J 1997; 61: 997 - 1003)

    DOI: 10.1253/jcj.61.997

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    その他リンク: http://search.jamas.or.jp/link/ui/1998124670

▼全件表示

書籍等出版物

  • 循環器疾患コンプリート 先天性心疾患・肺動脈疾患

    赤木禎治( 担当: 編集 ,  範囲: 循環器疾患コンプリート)

    秀潤社  2021年9月 

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    総ページ数:359   記述言語:日本語 著書種別:学術書

  • 成人先天性心疾患 診断・治療介入に必要な知識

    赤木禎治( 担当: 編集 ,  範囲: 企画・編集)

    メジカルビュー  2022年12月 

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    総ページ数:116   記述言語:日本語 著書種別:学術書

  • 心疾患と妊娠・出産ベストプラクティス : エキスパートが答える現場のコツと工夫

    赤木, 禎治, 伊藤, 浩 (内科医)

    南江堂  2021年6月  ( ISBN:9784524228065

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    総ページ数:ix, 207p   記述言語:日本語

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  • 虚血性心疾患 : 心・腎・脳の視点でとらえる循環器疾患

    山口, 修, 南野, 哲男, 北岡, 裕章 (循環器内科学), 井上, 耕一, 赤木, 禎治, 山本, 一博

    Gakken  2022年10月  ( ISBN:9784780904109

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    総ページ数:295p   記述言語:日本語

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  • 弁膜症 : 心・腎・脳の視点でとらえる循環器疾患

    山本, 一博, 南野, 哲男, 北岡, 裕章 (循環器内科学), 井上, 耕一, 赤木, 禎治, 山口, 修

    学研メディカル秀潤社,学研プラス(発売)  2022年8月  ( ISBN:9784780904116

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    総ページ数:319p   記述言語:日本語

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  • 先天性心疾患・肺動脈疾患 : 心・腎・脳の視点でとらえる循環器疾患

    赤木, 禎治, 南野, 哲男

    学研メディカル秀潤社,学研プラス (発売)  2021年9月  ( ISBN:9784780904093

     詳細を見る

    総ページ数:359p   記述言語:日本語

    CiNii Books

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  • 実践に活きる 臨床心エコー図法

    赤木禎治( 担当: 分担執筆 ,  範囲: 激増する成人先天性心疾患(ACHD))

    南江堂  2020年3月 

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    担当ページ:375-377   記述言語:日本語 著書種別:学術書

  • 循環器疾患最新の治療2020-2021

    赤木禎治( 担当: 分担執筆 ,  範囲: 先天性心疾患と妊娠・出産)

    南江堂  2020年1月 

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    担当ページ:276-279   記述言語:日本語

  • 今日の治療指針vol.62

    赤木禎治( 担当: 分担執筆 ,  範囲: 心房中隔欠損・卵円孔開存に対する欠損孔閉鎖術)

    医学書院  2020年1月 

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    担当ページ:365-366   記述言語:日本語 著書種別:学術書

  • Adult Congenital Heart Disease Therapeutic Catheter Intervention for Adult Patients with Congenital Heart Disease (ASD, PDA).

    Focusing on Intervention. Springer Germany  2017年 

     詳細を見る

  • 今日の治療指針2017 先天性心疾患(内科)

    医学書院  2017年 

     詳細を見る

  • 新 肺高血圧症診療マニュアル-根治を目指す最新の治療指針 先天性シャント性心疾患に伴う肺動脈性肺高血圧症

    南江堂  2017年 

     詳細を見る

  • 1336専門家による私の治療 2017-18年度版 心房中隔欠損症

    日本医事新報社  2017年 

     詳細を見る

  • Integrated Cardiac Imaging 画像で病態に迫る,治療効果を判定する

    メジカルビュー社  2016年 

     詳細を見る

  • 循環器研修医ノート改定第2版

    診断と治療社  2016年 

     詳細を見る

  • 循環器疾患最新の治療2016-2017

    南江堂  2016年 

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  • 右心不全を識り評価して治療に活かす

    文光堂  2016年 

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  • 成人先天性心疾患パーフェクトガイド

    赤木, 禎治, 伊藤, 浩 (内科医)

    文光堂  2015年9月  ( ISBN:9784830619274

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    総ページ数:vii, 278p   記述言語:日本語

    CiNii Books

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  • 成人先天性心疾患で活かす.その他の成人先天性心疾患の診断における有用性

    文光堂  2015年 

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  • 先天性心疾患の経カテーテル治療

    医学書院  2015年 

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  • 小児科から循環器内科への橋渡しの重要性と問題点

    文光堂  2015年 

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  • 未治療の成人先天性心疾患の病態と治療,心房中隔欠損症

    文光堂  2015年 

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  • 成人先天性心疾患の妊娠・出産,妊娠中の薬物治療のポイントと禁忌薬

    文光堂  2015年 

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  • カテーテル治療

    メジカルビュー社  2015年 

     詳細を見る

  • Cardiac catheterization for congenital heart disease, From fetal life to adulthood

    Springer-Verlag  2014年 

     詳細を見る

  • Structural Heart Diseaseインターベンション治療のための心エコー図マニュアル

    メジカルビュー社  2014年 

     詳細を見る

  • Structural Heart Diseaseインターベンション治療のための心エコー図マニュアル

    メジカルビュー社  2014年 

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  • 学校の先生にも知ってほしい慢性疾患の子どもの学校生活

    慶應義塾大学出版会  2014年 

     詳細を見る

  • Atrial Septal Defect

    In Tech  2012年 

     詳細を見る

  • 新・心臓病プラクティス18 大人になった先天性心疾患

    文光堂  2012年 

     詳細を見る

  • 新・心臓病プラクティス18 大人になった先天性心疾患

    文光堂  2012年 

     詳細を見る

  • 新・心臓病プラクティス18 大人になった先天性心疾患

    文光堂  2012年 

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  • 先端医療シリーズ43 循環器疾患の最新医療

    先端医療技術研究所  2012年 

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  • 今日の小児治療指針第15版

    医学書院  2012年 

     詳細を見る

  • 今日の心臓手術の適応と至適時期

    文光堂  2011年 

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  • 内科医・小児科医のための小児救急治療ガイドライン改訂第2版

    診断と治療社  2011年 

     詳細を見る

  • 今日の心臓手術の適応と至適時期

    文光堂  2011年 

     詳細を見る

  • 今日の心臓手術の適応と至適時期

    文光堂  2011年 

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  • 画像でみる成人先天性心疾患 : 診断・治療へのアプローチ = Case presentation with imaging in adult congenital heart disease

    丹羽, 公一郎, 立野, 滋, 豊田, 智彦, 松尾, 浩三, 池田, 亜希, 赤木, 禎治

    メジカルビュー社  2010年3月  ( ISBN:9784758301954

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    総ページ数:287p   記述言語:日本語

    CiNii Books

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  • 心疾患と妊娠・出産 人工心臓弁

    メジカルビュー社  2010年 

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  • 画像でみる成人先天性心疾患 肺動脈弁狭窄 カテーテルインターベンション(バルーン形成術)

    メジカルビュー社  2010年 

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  • 画像でみる成人先天性心疾患 川崎病冠動脈瘤 カテーテルインターベンションと冠動脈バイパス手術

    メジカルビュー社  2010年 

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  • 画像でみる成人先天性心疾患 Fallot四徴症 妊娠・出産の評価(心不全,不整脈,遺伝)

    メジカルビュー社  2010年 

     詳細を見る

  • Cardiology Third edition.Pulmonary stenosis

    Mosby Elsevier  2010年 

     詳細を見る

  • 今日の治療指針2010年版 心疾患患者の妊娠・出産の適応・管理

    医学書院  2010年 

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  • 循環器疾患最新の治療2010-2011 肺動脈弁狭窄症,肺動脈狭窄症

    南江堂  2010年 

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  • 画像でみる成人先天性心疾患 心房中隔欠損症,カテーテルインターベンション(閉鎖術)と手術適応

    メジカルビュー社  2010年 

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  • 画像でみる成人先天性心疾患 動脈管開存症 カテーテルインターベンション

    メジカルビュー社  2010年 

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  • 心疾患と妊娠・出産 正常妊娠における血行動態変化

    メジカルビュー社  2010年 

     詳細を見る

  • 今日の治療指針2009.

    医学書院.2009;  2009年 

     詳細を見る

  • Annual Review循環器2009.

    中外医学社.2009;  2009年 

     詳細を見る

  • 小児救急アトラス.

    西村書店.  2009年 

     詳細を見る

  • 心臓カテーテル室マニュアル―検査と治療の実際―.

    メディカ出版.  2009年 

     詳細を見る

  • ガイドラインに基づくCCU実践マニュアル.

    羊土社.  2009年 

     詳細を見る

  • 小児疾患アルゴリズム.

    中山書店.  2009年 

     詳細を見る

  • 小児疾患アルゴリズム.

    中山書店.  2009年 

     詳細を見る

  • 日本医師会雑誌

    2008年 

     詳細を見る

  • 循環器疾患最新の治療2008-2009.

    南江堂.  2008年 

     詳細を見る

  • AHA Highlights 2007

    協和企画  2008年 

     詳細を見る

  • 循環器疾患最新の治療2008-2009

    南江堂  2008年 

     詳細を見る

  • 日本臨床

    2008年 

     詳細を見る

  • 臨床心エコー図(第3版)

    文光堂  2008年 

     詳細を見る

  • 臨床の現場で役に立つ成人の先天性心疾患診療ブック

    メディカルビュー  2008年 

     詳細を見る

  • 臨床の現場で役に立つ成人の先天性心疾患診療ブック

    メディカルビュー  2008年 

     詳細を見る

  • エキスパートをめざす循環器診療6

    南江堂,東京  2007年 

     詳細を見る

  • エキスパートをめざす循環器診療6

    南江堂,東京  2007年 

     詳細を見る

  • エキスパートをめざす循環器診療6

    南江堂,東京  2007年 

     詳細を見る

  • Annual Review循環器 2006

    中外医学社,東京  2006年 

     詳細を見る

  • エクセルナース改訂版「循環器編」

    メデイカルレビュー社  2005年 

     詳細を見る

  • エクセルナース改訂版「循環器編」

    メデイカルレビュー社  2005年 

     詳細を見る

  • エクセルナース改訂版「循環器編」

    メデイカルレビュー社  2005年 

     詳細を見る

  • エクセルナース改訂版「循環器編」

    メデイカルレビュー社  2005年 

     詳細を見る

  • エクセルナース改訂版「循環器編」

    メデイカルレビュー社  2005年 

     詳細を見る

  • エクセルナース改訂版「循環器編」

    メデイカルレビュー社  2005年 

     詳細を見る

  • エクセルナース改訂版「循環器編」

    メデイカルレビュー社  2005年 

     詳細を見る

  • AHA Highlights 2002.

    TMC company 東京  2003年 

     詳細を見る

  • ベッドサイドの小児の診かた第2版

    南山堂,東京  2001年 

     詳細を見る

  • ガイドラインに基づく成人先天性心疾患の臨床

    中外医学社、東京  2001年 

     詳細を見る

  • ベッドサイドの小児の診かた第2版

    南山堂,東京  2001年 

     詳細を見る

  • 今日の循環器疾患治療指針第2版.

    医学書院,東京  2001年 

     詳細を見る

  • 今日の循環器疾患治療指針第2版.

    医学書院,東京  2001年 

     詳細を見る

  • 循環器疾患最新の治療2000-20001

    南江堂,東京  2000年 

     詳細を見る

  • Cardiology.

    Mosby, London  2000年 

     詳細を見る

  • 今日の小児治療指針第12版

    医学書院,東京  2000年 

     詳細を見る

▼全件表示

MISC

  • 疾患REVIEW 成人先天性心疾患 その現状と課題、そして今後目指すもの

    赤木 禎治

    SRL宝函   44 ( 3 )   11 - 19   2023年10月

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    記述言語:日本語   出版者・発行元:(株)エスアールエル  

    成人に達した先天性心疾患患者数は既に国内で50万人を超える状況となっている。その疾患概要も大きく変化しており、これまでの左右短絡疾患を中心とした比較的単純心疾患から、チアノーゼ心疾患を中心とした複雑心疾患の割合が増加している。先天性心疾患は疾患の多様性に加え、それぞれの心疾患に対する外科手術法の違いによって成人期には異なった病態を呈してくる。またFontan手術のように同じ手術名であっても、時代によって異なる手術方法が取られ、それぞれ違った問題点が存在する手術法もある。循環器内科ではこれまで経験してこなかったこのような複雑心疾患を、これからは循環器内科医が主体となって管理や治療を行わなければいけない時代となっている。成人先天性心疾患患者は幼少期に治療介入が行われているため、患者自身は自己の心疾患を十分に理解できていない場合がある。実際の診療には医師だけではなく多職種にわたる協力体制の確立が重要である。日常診療における日本心エコー図学会認定の超音波検査士(以下、心エコー技師)のかかわる意義は非常に高く、心エコー評価の標準化が必要である。成人先天性心疾患はこれまでなかった新しい医療分野であり、決して避けて通れない領域である。(著者抄録)

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  • 潜因性脳梗塞に対する経皮的卵円孔開存閉鎖術の手引き 第2版 2023年6月

    井口 保之, 岩間 亨, 大木 宏一, 片岡 大治, 河野 浩之, 山上 宏, 河村 朗夫, 福井 重文, 赤木 禎治, 金澤 英明, 原 英彦, 日本脳卒中学会, 日本循環器学会, 日本心血管インターベンション治療学会, 三学会合同手引き作成委員会

    心臓   55 ( 9 )   929 - 954   2023年9月

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    記述言語:日本語   出版者・発行元:(公財)日本心臓財団  

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  • 【循環器疾患カテーテル治療の最前線】医原性心房中隔欠損症のカテーテル閉鎖術

    赤木 禎治

    Precision Medicine   6 ( 10 )   786 - 789   2023年9月

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    記述言語:日本語   出版者・発行元:(株)北隆館  

    MitraClipや左心耳閉鎖のような経心房中隔穿刺によるカテーテル手技に伴い心房中隔に新たな欠損孔が出現することを医原性心房中隔欠損と呼ぶ。多くの医原性心房中隔欠損は無症候で自然閉鎖するといわれていたが,MitraClipに代表されるような重篤な心不全を基礎にもつ病態では,わずかな血行動態の変化が重篤な必不全進行への契機となる可能性がある,特に医原性心房中隔欠損を介して右左短絡が発生し,重篤な低酸素血症へと進行する症例では欠損孔の緊急的閉鎖術が必要となることがある。国内の現状とその対策について報告する。(著者抄録)

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  • 【進歩した低侵襲心臓カテーテル治療】治療の実際 心房中隔欠損症に対するカテーテル閉鎖術

    赤木 禎治

    臨牀と研究   100 ( 9 )   1121 - 1127   2023年9月

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    記述言語:日本語   出版者・発行元:大道学館出版部  

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  • 治療法の再整理とアップデートのために 専門家による私の治療 卵円孔開存症(奇異性脳塞栓症)

    赤木 禎治

    日本医事新報   ( 5176 )   43 - 44   2023年7月

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    記述言語:日本語   出版者・発行元:(株)日本医事新報社  

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  • 【成人先天性心疾患の未来】本邦の成人先天性心疾患診療の現状

    赤木 禎治

    心臓   55 ( 7 )   630 - 636   2023年7月

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    記述言語:日本語   出版者・発行元:(公財)日本心臓財団  

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  • 治療法の再整理とアップデートのために 専門家による私の治療 心房中隔欠損症(成人)

    赤木 禎治

    日本医事新報   ( 5174 )   45 - 46   2023年6月

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    記述言語:日本語   出版者・発行元:(株)日本医事新報社  

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  • 医学と医療の最前線 Structural Heart Intervention 今後の展望 Brain Heart Teamによる新たな診療体制の構築

    赤木 禎治

    日本内科学会雑誌   112 ( 6 )   1020 - 1026   2023年6月

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    記述言語:日本語   出版者・発行元:(一社)日本内科学会  

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  • 成人先天性心疾患診療を確立するための教育プログラムと人材育成

    赤木 禎治

    日本成人先天性心疾患学会雑誌   12 ( 2 )   18 - 24   2023年5月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • 歯内治療が原因で菌血症となった単心室症患者の一症例

    大森 一弘, 杜 徳尚, 井手口 英隆, 岡本 憲太郎, 佐光 秀文, 児玉 加奈子, 山本 直史, 赤木 禎治, 笠原 真悟, 伊藤 浩, 高柴 正悟

    日本成人先天性心疾患学会雑誌   12 ( 2 )   30 - 36   2023年5月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

    歯科治療は,観血的処置にはみえなくても菌血症を起こすリスクが高い.今回,感染性心内膜炎(IE)高リスクに分類されるフォンタン手術後の患者が歯科治療に起因すると考えられる感染症を起こし,緊急入院に至る症例を経験した.患者は20歳の男性.多脾症候群,右室型単心室に対して,両側両方向性グレン手術とフォンタン手術の手術歴がある.2021年6月,近医で下顎左側第二大臼歯(#37)の慢性根尖性歯周炎の診断のもと,予防的抗菌薬の投与なく歯内治療を開始した.2021年7月,治療中の#37部の自発痛,悪寒,戦慄,発熱を自覚し,当院循環器内科を緊急受診した.履歴から歯性感染が疑われたため,当院歯周科へ緊急紹介され,#37急性根尖性歯周炎と診断した.IE高リスク患者のため緊急入院となり,経験的抗菌療法を開始した.入院5日目,抗菌薬持続投与下で#37の歯内治療を再開,入院12日目に歯内治療を終了,入院13日目に退院した.今回の症例を教訓に,患者自身が歯科治療に先立ち予防的抗菌薬投与の必要性を簡便に提示できる患者カードを作成した.本カードが適切に運用され,歯科治療由来のIE発症リスクが軽減されることを期待する.(著者抄録)

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  • 【成人先天性心疾患 診断・治療介入に必要な知識-循環器内科医が厳選した循環器内科医へのアドバイス-】識る 成人先天性心疾患の診断・治療を行う施設と専門医を育成する

    赤木 禎治

    Heart View   26 ( 13 )   1161 - 1167   2022年12月

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    記述言語:日本語   出版者・発行元:(株)メジカルビュー社  

    <文献概要>Point 1 循環器内科医にとって成人先天性心疾患診療は不可避の領域であり,特に中等症から重症先天性心疾患に対する診療体制構築を急ぐ必要がある。2 成人先天性心疾患総合修練施設を核として地域の診療ネットワークを構築し,地域格差のない診療体制の構築が望まれる。3 このような診療体制の中心を担う成人先天性心疾患専門医の養成が急務であり,専門医養成のための学会活動・教育活動が重要である。

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  • 歯科治療に起因する感染性心内膜炎の発症予防を目指す岡山大学病院成人先天性心疾患センターの取り組み

    久保田 萌可, 大森 一弘, 杜 徳尚, 佐光 秀文, 井手口 英隆, 岡本 憲太郎, 山本 直史, 赤木 禎治, 笠原 真悟, 伊藤 浩, 高柴 正悟

    日本未病学会学術総会抄録集   29回   75 - 75   2022年10月

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    記述言語:日本語   出版者・発行元:(一社)日本未病学会  

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  • 【心不全 心不全パンデミックをどう乗り越えるか?】心不全とは何かをよく理解したうえで診断し治療する 成人先天性心疾患の課題 的確な診断と専門医への紹介のタイミング

    赤木 禎治

    Medical Practice   39 ( 9 )   1346 - 1350   2022年9月

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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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  • 【進化するカテーテルインターベンション-適応の広がりとデバイスの革新】構造的心疾患(SHD)に対するインターベンション 卵円孔開存のカテーテル閉鎖術(PFO closure)

    赤木 禎治

    循環器ジャーナル   70 ( 3 )   424 - 430   2022年7月

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    記述言語:日本語   出版者・発行元:(株)医学書院  

    <文献概要>Point ・潜因性脳塞栓の再発予防に対するPFO閉鎖術には,高いエビデンスがある.・PFOの検出には,十分なValsalva負荷を用いた経胸壁バブルスタディーが重要である.・経食道心エコーではハイリスクPFOの評価が重要であり,治療適応判断に重要である.

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  • 奇異性脳塞栓症患者における卵円孔開存(PFO)形態について 年齢や心形態による検討

    中山 理絵, 高谷 陽一, 赤木 禎治, 三木 崇史, 横濱 ふみ, 中川 晃志, 杜 徳尚, 伊藤 浩

    超音波医学   49 ( Suppl. )   S700 - S700   2022年4月

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    記述言語:日本語   出版者・発行元:(公社)日本超音波医学会  

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  • Eisenmenger症候群の定義を再考する Treat and repair行う心臓血管外科医としてのEisenmenger症候群の定義を再考する

    笠原 真悟, 赤木 達, 小林 純子, 川畑 拓也, 黒子 洋介, 小谷 恭弘, 赤木 禎治, 伊藤 浩

    日本成人先天性心疾患学会雑誌   11 ( 1 )   169 - 169   2022年1月

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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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  • 歯内治療が原因で菌血症となった単心室症患者の症例報告と対応策の提案

    大森 一弘, 杜 徳尚, 赤木 禎治, 井手口 英隆, 岡本 憲太郎, 佐光 秀文, 児玉 加奈子, 山本 直史, 笠原 真悟, 伊藤 浩, 高柴 正悟

    日本成人先天性心疾患学会雑誌   11 ( 1 )   256 - 256   2022年1月

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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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  • 成人先天性心疾患における大動脈弁および弓部治療 成人先天性心疾患領域における複雑心奇形を伴う大動脈・大動脈弁疾患

    黒子 洋介, 鈴木 浩之, 枝木 大治, 木佐森 永理, 小松 弘明, 辻 龍典, 迫田 直也, 横田 豊, 村岡 玄哉, 衛藤 弘城, 小林 純子, 川畑 拓也, 小谷 恭弘, 廣田 真規, 杜 徳尚, 赤木 禎治, 伊藤 浩, 笠原 真悟

    日本成人先天性心疾患学会雑誌   11 ( 1 )   146 - 146   2022年1月

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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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  • チアノーゼ性先天性心疾患に伴うパラガングリオーマの2症例と全国調査の試み

    杜 徳尚, 稲垣 兼一, 岩崎 慶一郎, 宮崎 文, 黒子 洋介, 小谷 恭弘, 赤木 禎治, 笠原 真悟, 伊藤 浩

    日本成人先天性心疾患学会雑誌   11 ( 1 )   247 - 247   2022年1月

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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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  • 肺高血圧を合併した心房中隔欠損症に対する治療戦略と長期予後

    赤木禎治, 高谷陽一, 赤木達, 三木崇史, 中川晃志, 伊藤浩

    日本肺高血圧・肺循環学会学術集会抄録集(Web)   6th   2021年

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  • 純型肺動脈閉鎖術後の成人期予後についての検討

    杜 徳尚, 小谷 恭弘, 赤木 禎治, 黒子 洋介, 馬場 健児, 大月 審一, 笠原 真悟, 伊藤 浩

    日本小児循環器学会雑誌   36 ( Suppl.2 )   s2 - 153   2020年11月

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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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  • Clinical impact of transcatheter atrial septal defect closure on new onset atrial fibrillation in adult patients: Comparison with surgical closure. 国際誌

    Yasuhiro Fujii, Teiji Akagi, Koji Nakagawa, Yoichi Takaya, Koki Eto, Yosuke Kuroko, Yasuhiro Kotani, Kentaro Ejiri, Hiroshi Ito, Shingo Kasahara

    Journal of cardiology   76 ( 1 )   94 - 99   2020年7月

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    記述言語:英語  

    BACKGROUND: Previous studies demonstrated that the incidence of atrial fibrillation (AF) was significantly increased when patients aged ≥40 years had surgical atrial septal defect (ASD) closure (sASD). However, limited information is available on such findings in transcatheter ASD closure (tASD). The purpose of this study was to investigate the incidence of newly developed AF after tASD in patients aged ≥40 years in whom preoperative AF or atrial flutter (AFL) had not been detected and to compare with the incidence after sASD. METHODS: The medical records of patients aged ≥40 years without a history of AF or AFL who underwent tASD (n = 281) or sASD (n = 24) were reviewed. Patients who had catheter ablation before the ASD closure were excluded. Patients with a patent foramen ovale were also excluded. The incidence of newly developed AF after ASD closure and the risk factors for that were evaluated statistically. RESULTS: Eleven patients had newly developed AF (5 in tASD and 6 in sASD) postoperatively including 6 persistent AF (3 each after tASD and sASD). The cumulative incidence of newly developed AF was 0.7% in tASD and 16.7% in sASD, and 2.7% and 20.8% at 1 and 5 years, respectively (p < 0.001). ASD diameter ≥30 mm and sASD were potential risk factors for newly developed AF after ASD closure and postoperative persistent AF. CONCLUSIONS: In patients aged ≥40 years without a history of AF or AFL, the incidence of newly developed AF after tASD closure was lower than that after sASD. A large ASD more than 30 mm diameter was a potential risk factor for development of AF even if it is closed by transcatheter procedure. Further long-term evaluation after tASD is required to clarify preventive benefit for new onset AF in adult ASD population.

    DOI: 10.1016/j.jjcc.2020.01.008

    PubMed

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  • 生体弁肺動脈弁置換術による早期効果(Short-term Outcome after Pulmonary Valve Replacement: The Effects on Anatomy, Physiology, and Clinical Outcome)

    小谷 恭弘, 朴 徳尚, 黒子 洋介, 川畑 拓也, 後藤 拓弥, 堀尾 直裕, 小林 泰幸, 迫田 直也, 辻 龍典, 横田 豊, 三浦 望, 赤木 禎治, 伊藤 浩, 笠原 真悟

    日本成人先天性心疾患学会雑誌   9 ( 1 )   208 - 208   2020年1月

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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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  • 高齢者心房中隔欠損症のカテーテル治療における集中治療の必要性と意義

    藤本竜平, 赤木禎治, 高谷陽一, 三木崇史, 中山理絵, 中川晃志, 伊藤浩

    日本集中治療医学会学術集会(Web)   47th   2020年

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  • SHDを知る!-コメディカルが如何に携わるか- 臨床検査技師は心房中隔欠損カテーテル閉鎖術に如何に関わるか

    渡辺 修久, 高谷 陽一, 赤木 禎治, 大塚 文男, 伊藤 浩

    日本冠疾患学会誌   ( Suppl.2019 )   141 - 141   2019年12月

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    記述言語:日本語   出版者・発行元:(NPO)日本冠疾患学会  

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  • 突然死回避のために外科的治療が必要な大動脈壁内走行を伴う左冠動脈起始異常の2症例(Two cases of anomalous aortic origin of a coronary artery with an intramural course which need surgical repair to avoid sudden death)

    辻 龍典, 小谷 恭弘, 迫田 直也, 田井 龍太, 小林 泰幸, 川田 幸子, 堀尾 直裕, 後藤 拓弥, 黒子 洋介, 新井 禎彦, 笠原 真悟, 杜 徳尚, 赤木 禎治, 伊藤 浩

    日本成人先天性心疾患学会雑誌   8 ( 1 )   167 - 167   2019年1月

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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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  • 先天性心疾患複雑性が入院イベントに及ぼす影響 コホート研究(Impact of disease complexity on Hospitalization in Adult Patients with Congenital Heart Disease: retrospective cohort study)

    高橋 生, 赤木 禎治, 杜 徳尚, 高谷 陽一, 笠原 真悟, 馬場 健児, 中村 進一郎, 木野村 賢, 増山 寿, 大森 一弘, 中川 晃志, 西井 伸洋, 伊藤 浩

    日本成人先天性心疾患学会雑誌   7 ( 1 )   158 - 158   2018年1月

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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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  • Functional Tricuspid Regurgitation After Transcatheter Closure of Atrial Septal Defect in Adult Patients Long-Term Follow-Up

    Yoichi Takaya, Teiji Akagi, Yasufumi Kijima, Koji Nakagawa, Hiroshi Ito

    JACC-CARDIOVASCULAR INTERVENTIONS   10 ( 21 )   2211 - 2218   2017年11月

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

    OBJECTIVES This study aimed to assess the fate of tricuspid regurgitation (TR) after transcatheter atrial septal defect (ASD) closure.& para;& para;BACKGROUND Although TR frequently occurs in patients with ASD, the change in TR during long-term follow-up after ASD closure remains unknown.& para;& para;METHODS A total of 419 adult patients who underwent transcatheter ASD closure were enrolled. TR severity was graded by TR jet area on echocardiography.& para;& para;RESULTS At baseline, 113 patients had severe/moderate TR and 306 patients had mild TR. Among the 113 patients with severe/moderate TR, the TR jet area significantly decreased during a median follow-up of 30 months after the procedure; this decrease was related to the improvement in right ventricular morphology. The severity of TR decreased to mild in 79 (70%) patients. Persistent TR, defined as severe or moderate TR after the procedure, was independently associated with the prevalence of permanent atrial fibrillation. Regarding clinical outcomes, 7 patients with severe/moderate TR and 2 with mild TR were hospitalized because of heart failure. Patients with severe/moderate TR had the worse event-free survival rate than those with mild TR, but more than 90 % of them had no cardiovascular events.New York Heart Association functional class and plasma B-type natriuretic peptide levels improved in patients with severe/moderate TR, similar to those with mild TR.& para;& para;CONCLUSIONS Significant TR decreased during the long-term follow-up period after transcatheter ASD closure. Heart failure symptoms improved in patients with severe/moderate TR. Our findings suggest that transcatheter closure alone can be valuable in patients with ASD complicated with TR. (C) 2017 by the American College of Cardiology Foundation.

    DOI: 10.1016/j.jcin.2017.06.022

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  • Transcatheter Closure of Patent Foramen Ovale: Clinical Efficacy for Prevention of Recurrent Cryptogenic Stroke or Migraine Headache

    Teiji Akagi, Yoichi Takaya, Koji Nakagawa, Hiroshi Ito

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   69 ( 16 )   S42 - S43   2017年4月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • Echocardiographic Estimates of Left Ventricular Diastolic Dysfunction Do Not Predict the Clinical Course in Elderly Patients Undergoing Transcatheter Atrial Septal Defect Closure: Impact of Early Diastolic Mitral Annular Velocity

    Yoichi Takaya, Teiji Akagi, Yasufumi Kijima, Koji Nakagawa, Nobuhisa Watanabe, Hiroki Oe, Manabu Taniguchi, Hiroshi Ito

    JOURNAL OF INTERVENTIONAL CARDIOLOGY   30 ( 1 )   79 - 84   2017年2月

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    記述言語:英語   出版者・発行元:WILEY  

    ObjectiveThis study evaluated the effect of echocardiographic left ventricular (LV) diastolic dysfunction on acute congestive heart failure after transcatheter atrial septal defect (ASD) closure in elderly patients.
    BackgroundAlthough there is concern that LV diastolic dysfunction develops acute congestive heart failure after ASD closure, limited information is available regarding the influence, especially in elderly patients with severe LV diastolic dysfunction.
    MethodsTwo hundred consecutive patients older than 60 years were divided into 3 groups according to echocardiographic LV diastolic dysfunction: severe (early diastolic mitral annular velocity [e'] &lt;5.0cm/s), mild (5.0 e'&lt;8.0cm/s), and normal (e'8.0cm/s). Changes in plasma B-type natriuretic peptide (BNP) levels were evaluated.
    ResultsNo patients with severe LV diastolic dysfunction developed acute congestive heart failure immediately after the procedure. BNP levels unchanged after the procedure in patients with severe LV diastolic dysfunction (126181 to 131 +/- 148pg/ml, P=0.885), and this increase in BNP levels was not different from that between the diagnosis of ASD and the procedure. The change in BNP levels in patients with severe LV diastolic dysfunction, who were frequently treated with diuretics before the procedure, was equivalent to that in patients with mild LV diastolic dysfunction and normal LV diastolic function (5 +/- 119 vs. 16 +/- 101 vs. 9 +/- 131pg/ml, P=0.724).
    ConclusionsOur findings suggest that transcatheter ASD closure under volume management is safe and valuable in elderly patients with echocardiographic severe LV diastolic dysfunction.

    DOI: 10.1111/joic.12365

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  • 重症肺高血圧症を伴う心室中隔欠損症に対して"treat and repair"を実施した成人3症例についての検討

    川田 幸子, 笠原 真悟, 井上 喜紀, 枝木 大治, 小林 泰幸, 堀尾 直裕, 石神 修大, 藤井 泰宏, 小谷 恭弘, 増田 善逸, 大澤 晋, 新井 禎彦, 赤木 禎治, 佐野 俊二

    日本成人先天性心疾患学会雑誌   6 ( 1 )   140 - 140   2017年1月

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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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  • 私はここまで評価する : カテーテル治療を念頭においた心房中隔欠損の評価 - 今, その欠損孔を閉鎖してもいいですか -(共著)

    渡辺修久, 高谷陽一, 赤木禎治, 大塚文男, 伊藤 浩

    超音波検査技術   42 ( suppl )   5080 - 5080   2017年

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    記述言語:日本語   出版者・発行元:(一社)日本超音波検査学会  

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  • 奇異性脳塞栓再発予防としての経皮的卵円孔閉鎖術.構造的心疾患(SHD)に対するインターベンション:新たな展開

    赤木禎治

    BIO Clinica   32 ( 12 )   1070 - 1074   2017年

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  • 循環器疾患合併妊婦の妊娠・分娩管理 弁膜症・機械弁(共著)

    杜 徳尚, 赤木禎治

    Heart View   21 ( 4 )   102 - 108   2017年

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  • 特集「成人先天性心疾患と小児科医」肺高血圧,チアノーゼがある場合の管理と予後

    赤木禎治

    小児科   58 ( 2 )   129 - 136   2017年

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    記述言語:日本語   出版者・発行元:金原出版  

    DOI: 10.18888/J00639.2017145609

    CiNii Article

    CiNii Books

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  • カテーテル治療に対する新しいイメージングサポートシステムの有用性と今後

    赤木禎治

    INNERVISION   32 ( 5 )   88 - 90   2017年

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  • 経皮的卵円孔閉鎖栓のデバイスと手技の実際

    赤木禎治

    Coronary Intervention   13 ( 4 )   81 - 85   2017年

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  • 特集 肺高血圧症―診断と治療の新展開―先天性心疾患による肺動脈性兵高血圧症でも欠損孔閉鎖が有用である

    赤木禎治

    最新医学   72 ( 8 )   1135 - 1139   2017年

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  • Cardiac Erosion after the Transcatheter Closure of Atrial Septal Defect Using Amplatzer Septal Occluder: Japanese Nationwide Experience

    Teiji Akagi, Satoshi Yazaki, Hideshi Tomita, Morimasa Takayama, Hidehiko Hara

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   68 ( 18 )   B249 - B249   2016年11月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • Cardiac Fusion Imaging With Computed Tomography and Doppler Echocardiography in the Assessment of Right Ventricular Outflow Tract Obstruction in Oatients With Adult Congenital Heart Disease

    Hiroki Oe, Nobuhisa Watanabe, Toru Miyoshi, Sho Takahashi, Yuko Ohno, Yuji Koide, Takashi Miki, Koji Nakagawa, Nobuhiro Nishii, Teiji Akagi, Hiroshi Ito

    CIRCULATION   134   2016年11月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Influence of transcatheter closure of atrial communication on migraine headache in patients with ischemic stroke

    Yoichi Takaya, Teiji Akagi, Yasufumi Kijima, Koji Nakagawa, Syoichiro Kono, Kentaro Deguchi, Shunji Sano, Hiroshi Ito

    Cardiovascular Intervention and Therapeutics   31 ( 4 )   263 - 268   2016年10月

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    記述言語:英語   出版者・発行元:Springer Tokyo  

    Some types of migraine are associated with ischemic stroke. Although a right-to-left communication is linked with ischemic stroke, a causal relationship between migraine and right-to-left communication remains unclear. Furthermore, the efficacy of transcatheter closure of atrial communication on migraine is controversial. We aimed to evaluate the influence of transcatheter closure of atrial communication on migraine in patients with ischemic stroke. Thirty-eight consecutive patients with ischemic stroke who underwent transcatheter closure of atrial communication were enrolled. The prevalence, frequency, and severity of migraine were prospectively evaluated at baseline, 3 months, and &gt
    6 months after the procedure. Changes in migraine after the procedure were classified according to the frequency and severity of migraine: disappeared, improved, no-change, and worsening. Nineteen (50 %) of 38 patients suffered from migraine at baseline. No significant differences were observed in age, comorbidities, defect diameter, and atrial septal aneurysm between patients with migraine and patients without migraine. Among the 19 patients with migraine, migraine disappeared in 10 (53 %) patients and improved in 8 (42 %) patients at 3 months after transcatheter closure of atrial communication. At mean follow-up of 38 ± 28 months after the procedure, migraine disappeared in 12 (63 %) patients and improved in five (26 %) patients. No patients experienced worsening of migraine during the follow-up period. New-onset migraine was not observed in patients without migraine. Migraine is complicated in a half of patients with ischemic stroke related to atrial communication. Such migraine may disappear or improve after transcatheter closure of atrial communication.

    DOI: 10.1007/s12928-015-0375-8

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  • Feasibility of Repairing Defects Followed by Treatment with Pulmonary Hypertension-specific Drugs (Repair and Treat) in Patients with Pulmonary Hypertension Associated with Atrial Septal Defect: Study Protocol for Interventional Trial

    Satoshi Akagi, Kazufumi Nakamura, Teiji Akagi, Koji Nakagawa, Yoichi Takaya, Toshihiro Sarashina, Kentaro Ejiri, Hiroshi Ito

    ACTA MEDICA OKAYAMA   70 ( 5 )   397 - 400   2016年10月

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    記述言語:英語   出版者・発行元:OKAYAMA UNIV MED SCHOOL  

    A treatment strategy for patients with pulmonary hypertension (PH) and atrial septal defect (ASD) remains unclear. This study was designed to evaluate the effects of initial repair of ASD followed by treatment with PH-specific drugs in patients with PH and ASD. Eligible patients receive transcatheter ASD closure followed by treatment with bosentan and sildenafil. Right heart catheterization is performed at baseline and at 12, 24 and 48 weeks. The primary endpoint is change in pulmonary artery pressure and pulmonary vascular resistance from baseline to follow-up. This study should provide valuable information to establish a therapeutic strategy for PH and ASD.

    DOI: 10.18926/AMO/54600

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  • Deficient Surrounding Rims in Patients Undergoing Transcatheter Atrial Septal Defect Closure

    Yasufumi Kijima, Teiji Akagi, Yoichi Takaya, Manabu Taniguchi, Koji Nakagawa, Kengo Kusano, Shunji Sano, Hiroshi Ito

    JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY   29 ( 8 )   768 - 776   2016年8月

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    記述言語:英語   出版者・発行元:MOSBY-ELSEVIER  

    Background: The influence of deficient rims surrounding atrial septal defects (ASDs) in patients undergoing transcatheter closure has yet to be clarified. The aim of this study was to assess the influence of a deficient surrounding rim on the procedural success and clinical outcome of transcatheter ASD closure using an Amplatzer septal occluder.
    Methods: A total of 474 patients (mean age, 46622 years) with ostium secundum ASDs measuring &lt;= 40 mm in diameter who had undergone attempted transcatheter closure using Amplatzer septal occluders from September 2007 to August 2013 were assessed. A comprehensive transesophageal echocardiographic examination was done to assess the morphologic characteristics of the defects in all patients. Subjects were classified into three groups by the extent and location of rim deficiency (&lt;5 mm): patients without deficient rims (sufficient group, n = 101), patients with single deficient rims, (single group, n = 338), and patients with multiple rim deficiencies (multiple group, n = 35).
    Results: There was a significant difference in the maximal defect diameter among the sufficient, single, and multiple groups (15 +/- 6, 18 +/- 6, and 29 +/- 7 mm, respectively, P &lt; .001). Transcatheter closure was successfully accomplished in 463 patients (98%). The prevalence of procedural success differed significantly among the sufficient, single, and multiple groups (100%, 98%, and 86%, respectively, P &lt; .001). There was no significant difference in the occurrence of cardiovascular events among the three groups during a mean follow-up period of 25 +/- 19 months (P = .926, log-rank test).
    Conclusions: In patients with ASDs with multiple rim deficiencies as determined by transesophageal echocardiography, successful transcatheter ASD closure using Amplatzer septal occluders is more difficult to accomplish. However, if closure is successful, rim deficiencies rarely affect intermediate-term outcomes.

    DOI: 10.1016/j.echo.2016.04.010

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  • Transcatheter closure of atrial septal defect in a patient with absent inferior caval vein connection: a novel technique using a steerable guide catheter

    Yoichi Takaya, Teiji Akagi, Hiroshi Ito

    CARDIOLOGY IN THE YOUNG   26 ( 5 )   1033 - 1035   2016年6月

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    記述言語:英語   出版者・発行元:CAMBRIDGE UNIV PRESS  

    An alternative approach for transcatheter closure of atrial septal defect is necessary in patients with absent inferior caval vein connection. In this report, we describe the successful transcatheter atrial septal defect closure via the transjugular approach using a steerable guide catheter.

    DOI: 10.1017/S1047951116000445

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  • Integrated 3D Echo-X-Ray Navigation Guided Transcatheter Closure of Complex Multiple Atrial Septal Defects

    Yoichi Takaya, Teiji Akagi, Koji Nakagawa, Hiroshi Ito

    JACC-CARDIOVASCULAR INTERVENTIONS   9 ( 12 )   E111 - E112   2016年6月

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

    DOI: 10.1016/j.jcin.2016.03.014

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  • 維持血液透析を要したFontan術後成人先天性心疾患(ACHD)の1症例と透析管理の特徴

    木野村 賢, 森下 美智子, 宮脇 義亜, 益田 加奈, 荒田 夕佳, 秋山 愛由, 大西 章史, 山成 俊夫, 田邊 克幸, 杉山 斉, 赤木 禎治, 和田 淳

    日本透析医学会雑誌   49 ( Suppl.1 )   715 - 715   2016年5月

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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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  • LONG-TERM EFFICACY OF TREAT AND REPAIR STRATEGY FOR ATRIAL SEPTAL DEFECT WITH PULMONARY ARTERY HYPERTENSION

    Teiji Akagi, Yoichi Takaya, Yasufumi Kijima, Koji Nakagawa, Hiroki Oe, Hiroshi Ito, Shunji Sano

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   67 ( 13 )   988 - 988   2016年4月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • 循環器病の診断と治療に関するガイドライン(2009年度合同研究班報告)【ダイジェスト版】心疾患患者の妊娠・出産の適応、管理に関するガイドライン(2010年改訂版)

    丹羽 公一郎, 青見 茂之, 赤木 禎治, 池田 智明, 白石 公, 照井 克生, 中谷 敏, 中西 宣文, 籏 義仁, 松田 義雄, 池ノ上 克, 和泉 徹, 石井 徹子, 上塚 芳郎, 太田 真弓, 神谷 千津子, 川副 泰隆, 河野 了, 篠原 徳子, 立野 滋, 野村 実, 萩原 誠久, 越後 茂之, 八木原 俊克, 日本循環器学会, 日本産科婦人科学会, 日本小児循環器学会, 日本心臓血管外科学会, 日本心臓病学会

    日本心臓血管外科学会雑誌   45 ( 1 )   (1) - (18)   2016年1月

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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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  • 先天性心疾患と成人先天性心疾患の治療概念の違いと総合診療体制

    赤木禎治

    Cardiac Practice   27   17 - 22   2016年

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  • 成人期の動脈管開存症に対するカテーテル治療

    赤木禎治

    心臓   48   921 - 922   2016年

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  • Treat and Repair Strategy in Patients With Atrial Septal Defect and Significant Pulmonary Arterial Hypertension.(共著)

    Kijima Y, Akagi T, Takaya Y, Akagi S, Nakagawa K, Kusano K, Sano S, Ito H

    Circ J   80 ( 1 )   227 - 234   2015年12月

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  • Treat and Repair Strategies for Adult Patients with Atrial Septal Defect and Severe Pulmonary Atrial Hypertension

    Teiji Akagi, Yasufumi Kijima, Yoichi Takaya, Koji Nakagawa, Shunji Sano, Hiroshi Ito

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   66 ( 15 )   B12 - B12   2015年10月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • Fate of mitral regurgitation after transcatheter closure of atrial septal defect in adults.

    Takaya Y, Kijima Y, Akagi T, Nakagawa K, Oe H, Taniguchi M, Sano S, Ito H

    Am J Cardiol   116 ( 3 )   458 - 462   2015年8月

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  • Comprehensive assessment of morphology and severity of atrial septal defects in adults by CT

    Kazuhiro Osawa, Toru Miyoshi, Yusuke Morimitsu, Teiji Akagi, Hiroki Oe, Koji Nakagawa, Yoichi Takaya, Yasufumi Kijima, Shuhei Sato, Susumu Kanazawa, Hiroshi Ito

    JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY   9 ( 4 )   354 - 361   2015年7月

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

    Background: Cardiac CT is an excellent tool for evaluating the anatomy of a secundum atrial septal defect (ASD). However, a comprehensive assessment of its usefulness, including measurement of the pulmonary to systemic blood flow ratio in secundum ASD patients, has not been performed.
    Objective: Therefore, this study was designed to evaluate the usefulness of CT for assessing the hemodynamics of secundum ASD in adults compared with transesophageal echocardiography (TEE), transthoracic echocardiography, and invasive catheterization.
    Methods: Fifty adult patients with secundum ASD were enrolled. Cardiac CT scans (128-slice multidetector CT instrument) were acquired. These were followed by 2-dimensional reconstruction of the secundum ASDs to determine the defect size, the rim length between the outer edge of the defect, and the pulmonary to systemic blood flow (Qp/Qs) ratio.
    Results: The maximum sizes of the secundum ASDs derived from CT and TEE studies were comparable (21.2 +/- 8.0 vs 20.0 +/- 7.3 mm; P = .41; r = 0.960; P &lt; .001). The rim lengths for the aortic, mitral, and tricuspid valves; the inferior vena cava; and posterior atrium were also comparable between CT and TEE measurements. The mean Qp/Qs ratio that was derived from CT measurements was comparable with that found by invasive catheterization (2.3 +/- 0.7 vs 2.3 +/- 0.8; P = .73; r = 0.786; P &lt; .001).
    Conclusion: Cardiac CT is feasible for assessing pathology and the severity of secundum ASD in adults. (C) 2015 Society of Cardiovascular Computed Tomography. All rights reserved.

    DOI: 10.1016/j.jcct.2015.04.007

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  • Long-Term Outcome After Transcatheter Closure of Atrial Septal Defect in Older Patients Impact of Age at Procedure

    Yoichi Takaya, Teiji Akagi, Yasufumi Kijima, Koji Nakagawa, Shunji Sano, Hiroshi Ito

    JACC-Cardiovascular Interventions   8 ( 4 )   600 - 606   2015年4月

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

    OBJECTIVES This study assessed long-term outcome after transcatheter atrial septal defect (ASD) closure in older patients, especially those older than 75 years of age.
    BACKGROUND The clinical benefits of transcatheter ASD closure in this aged population are controversial. METHODS A total of 244 patients older than 50 years of age were divided into 3 groups according to age at procedure (50 to 59 years: n = 69; 60 to 74 years: n = 120; 75 years and older: n = 55). The primary endpoint was defined as all-cause mortality and hospitalization due to heart failure or stroke. Improvements in functional capacity and cardiac remodeling after the procedure were also assessed.
    RESULTS During a median follow-up of 36 months, mortality and hospitalization due to heart failure or stroke occurred in 18 patients (7%). Among patients older than 75 years of age, 2 died of noncardiovascular disease, 2 were hospitalized due to heart failure, and 1 had a stroke. More than 90% of patients older than 75 years of age did not experience these events. Kaplan-Meier analysis showed that the event-free survival rate was not different among the 3 age groups (log-rank test, p = 0.780). New York Heart Association functional class and right ventricular/left ventricular end-diastolic diameter ratio improved in patients older than 75 years of age, similar to the other age groups.
    CONCLUSIONS Long-term outcome after transcatheter ASD closure in patients older than 75 years of age is similar to that in the other, relatively younger age groups. This suggests that transcatheter ASD closure can be considered a valuable therapeutic option in patients older than 75 years of age. (C) 2015 by the American College of Cardiology Foundation.

    DOI: 10.1016/j.jcin.2015.02.002

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  • 2014年版 先天性心疾患、心臓大血管の構造的疾患(structural heart disease)に対するカテーテル治療のガイドライン

    中西 敏雄, 赤木 禎治, 天野 純, 上野 高史, 大月 審一, 吉川 公彦, 木村 剛, 倉谷 徹, 小林 俊樹, 坂本 喜三郎, 杉山 央, 高山 守正, 田島 廣之, 富田 英, 原 英彦, 矢崎 諭, 東 隆, 石井 徹子, 上田 秀明, 金 成海, 古森 公浩, 坂田 芳人, 田崎 淳一, 朴 仁三, 市田 蕗子, 黒澤 博身, 友池 仁暢, 丹羽 公一郎, 日本循環器学会, 日本医学放射線学会, 日本インターベンショナルラジオロジー学会, 日本胸部外科学会, 日本小児循環器学会, 日本心血管インターベンション治療学会, 日本心臓血管外科学会, 日本心臓病学会, 日本Pediatric Interventional Cardiology学会

    循環器病ガイドシリーズ   2014 ( 先天性心疾患,心臓大血管の構造的疾患に対するカテーテル治療のガイドライン )   3 - 120   2015年3月

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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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  • INFLUENCE OF SURROUNDING RIM MORPHOLOGY ON PROCEDURE SUCCESS RATE OF TRANSCATHETER ATRIAL SEPTAL DEFECT CLOSURE

    Teiji Akagi, Yasufumi Kijima, Yoichi Takaya, Koji Nakagawa, Hiroki Oe, Shunji Sano, Hiroshi Ito

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   65 ( 10 )   A1728 - A1728   2015年3月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • 【ダイジェスト版】2014年版 先天性心疾患、心臓大血管の構造的疾患(structural heart disease)に対するカテーテル治療のガイドライン

    中西 敏雄, 赤木 禎治, 天野 純, 上野 高史, 大月 審一, 吉川 公彦, 木村 剛, 倉谷 徹, 小林 俊樹, 坂本 喜三郎, 杉山 央, 高山 守正, 田島 廣之, 富田 英, 原 英彦, 矢崎 諭, 東 隆, 石井 徹子, 上田 秀明, 金 成海, 古森 公浩, 坂田 芳人, 田崎 淳一, 朴 仁三, 市田 蕗子, 黒澤 博身, 友池 仁暢, 丹羽 公一郎, 日本循環器学会, 日本医学放射線学会, 日本インターベンショナルラジオロジー学会, 日本胸部外科学会, 日本小児循環器学会, 日本心血管インターベンション治療学会, 日本心臓血管外科学会, 日本心臓病学会, 日本Pediatric Interventional Cardiology学会

    循環器病ガイドシリーズ   2014 ( 先天性心疾患,心臓大血管の構造的疾患に対するカテーテル治療のガイドライン )   121 - 185   2015年3月

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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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  • Current concept of transcatheter closure of atrial septal defect in adults

    Teiji Akagi

    JOURNAL OF CARDIOLOGY   65 ( 1-2 )   17 - 25   2015年1月

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元:ELSEVIER SCIENCE BV  

    After the introduction of catheter intervention for atrial septal defect (ASD) in the pediatric population, therapeutic advantages of this less invasive procedure were focused on adult through geriatric populations. The most valuable clinical benefits of this procedure are the significant improvement of symptoms and daily activities, which result from the closure of left to right shunt without thoracotomy and cardiopulmonary bypass surgery. These benefits contribute to increase the number of adult patients of this condition who have hesitated over surgical closure. In terms of technical point of view for catheter closure of ASD, the difficulties still exist in some morphological features of defect, or hemodynamic features in the adult population. Morphological features of difficult ASD closure are (1) large (&gt;= 30 mm) ASD, (2) wide rim deficiency, and (3) multiple defects. Hemodynamic features of difficult ASD are (1) severe pulmonary hypertension, (2) ventricular dysfunction, and (3) restrictive left ventricular compliance (diastolic dysfunction) after ASD closure. To complete the catheter ASD closure under these difficult conditions, various procedural techniques have been introduced. These are new imaging modalities such as real-time three-dimensional imaging, new technical modifications, and new concepts for hemodynamic evaluation. Especially, real-time three-dimensional transesophageal echocardiography can provide the high quality imaging for anatomical evaluation including maximum defect size, surrounding rim morphology, and the relationship between device and septal rim. In adult patients, optimal management for their comorbidities is an important issue, which includes cardiac function, atrial arrhythmias, respiratory function, and renal function. Management of atrial arrhythmias is a key issue for the long-term outcome in adult patients. Because the interventional procedures are not complication-free techniques, the establishment of a surgical back-up system is essential for the safe achievement of the procedure. Finally, the establishment of a team approach including pediatric and adult cardiologists, cardiac surgeons, and anesthesiologists is the most important factor for a good therapeutic outcome. (C) 2014 Published by Elsevier Ltd on behalf of Japanese College of Cardiology.

    DOI: 10.1016/j.jjcc.2014.09.002

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  • 積極的な肺高血圧治療により、肺移植が回避可能となった成人心室中隔欠損症の1例

    川畑 拓也, 笠原 真悟, 樽井 俊, 黒子 洋介, 小谷 恭弘, 吉積 功, 新井 禎彦, 更科 俊洋, 伊藤 浩, 赤木 禎治, 佐野 俊二

    日本成人先天性心疾患学会雑誌   4 ( 1 )   134 - 134   2015年1月

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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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  • 動脈管コイル塞栓術後、急性肺動脈解離を来した肺動脈瘤に対し外科治療を施行した1例

    小谷 恭弘, 樽井 俊, 更科 俊洋, 藤井 泰宏, 黒子 洋介, 川畑 拓也, 吉積 功, 新井 禎彦, 赤木 禎治, 笠原 真悟, 伊藤 浩, 佐野 俊二

    日本成人先天性心疾患学会雑誌   4 ( 1 )   128 - 128   2015年1月

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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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  • 心血管インターベンションのニューデバイス総ざらえ:Septal/PFO occluder

    赤木禎治

    Coronary Intervention   2015年

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  • 心不全のすべて:先天性心疾患のカテーテル治療・外科治療

    赤木禎治

    診断と治療増刊号   2015年

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  • 小児先天性心疾患の心不全:病態と治療

    赤木禎治

    循環器内科   2015年

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  • 心房中隔欠損症に対するカテーテル治療

    赤木禎治

    Angiology Frontier   2015年

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  • 心房中隔欠損症,動脈管開存におけるカテーテル治療

    高谷陽一, 赤木禎治

    Geriatric Medicine   2015年

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  • 心房中隔欠損症(ASD)のカテーテル治療

    赤木禎治

    Heart View   2015年

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  • 成人先天性心疾患患者の妊娠・出産管理の諸問題

    赤木禎治

    心臓   2015年

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  • PICS-AICS Asia Pacific 2015 ライブデモの裏話

    赤木禎治

    JPIC News Letter   2015年

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  • 心房中隔欠損症患者における心房細動カテーテルアブレーション後の欠損孔の変化(共著)

    中川晃志, 赤木禎治, 永瀬 聡, 高谷陽一, 西井伸洋, 中村一文, 森田 宏, 伊藤 浩

    日本成人先天性心疾患学会雑誌   4 ( 1 )   118 - 118   2015年

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  • 肺高血圧を伴う心房中隔欠損症例の経カテーテル閉鎖術の治療効果(共著)

    渡辺修久, 麻植浩樹, 赤木禎治, 更科俊洋, 高谷陽一, 木島康文, 赤木 達, 中村一文, 岡田 健, 伊藤 浩

    呼吸と循環   63 ( 8 )   S53-S54   2015年

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  • Three-Dimensional Echocardiography Guided Closure of Complex Multiple Atrial Septal Defects

    Yasufumi Kijima, Teiji Akagi, Koji Nakagawa, Yoichi Takaya, Hiroki Oe, Hiroshi Ito

    ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES   31 ( 10 )   E304 - E306   2014年11月

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    記述言語:英語   出版者・発行元:WILEY-BLACKWELL  

    Mini-Abstract Transcatheter closure of complex multiple atrial septal defects (ASDs) remains a challenge. We describe our clinical experience with staged device deployment in a patient with multiple ASDs using four Amplatzer septal occluder devices. Three-dimensional transesophageal echocardiography imaging contributed not only to the therapeutic guidance of successful device deployment but also to the decision making for the staged device delivery approach in a case of morphologically complex multiple ASDs.
    Transcatheter closure of complex multiple atrial septal defects (ASDs) remains a challenge. We describe our clinical experience with staged device deployment in a patient with multiple ASDs using four Amplatzer septal occluder devices. Three-dimensional transesophageal echocardiography imaging contributed not only to the therapeutic guidance of successful device deployment but also to the decision making for the staged device delivery approach in a case of morphologically complex multiple ASDs.

    DOI: 10.1111/echo.12731

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  • 循環器病の診断と治療に関するガイドライン(2010年度合同研究班報告)【ダイジェスト版】成人先天性心疾患診療ガイドライン(2011年改訂版)

    丹羽 公一郎, 赤木 禎治, 市川 肇, 市田 蕗子, 大嶋 義博, 角 秀秋, 近藤 千里, 佐地 勉, 高橋 長裕, 福嶌 教偉, 松尾 浩三, 松田 義雄, 池田 亜希, 池田 智明, 岩崎 達雄, 牛ノ濱 大也, 大内 秀雄, 太田 真弓, 赤阪 隆史, 中澤 誠, 賀藤 均, 河田 政明, 川俣 和弥, 小垣 滋豊, 坂崎 尚徳, 白石 公, 城尾 邦隆, 高橋 一浩, 立野 滋, 谷口 学, 布田 伸一, 宗内 淳, 八尾 厚史, 安河内 聡, 山岸 敬幸, 山岸 正明, 山村 英司, 芳村 直樹, 松田 暉, 八木原 俊克, 日本循環器学会, 日本胸部外科学会, 日本産科婦人科学会, 日本小児循環器学会, 日本心臓病学会

    日本心臓血管外科学会雑誌   43 ( 6 )   (1) - (17)   2014年11月

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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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  • Transcatheter Closure of Atrial Septal Defect with Inferior Vena Cava Rim Deficiency: Reconsideration of anatomical indication

    Teiji Akagi, Yasufumi Kijima, Koji Nakagawa, Yoichi Takaya, Hiroki Oe, Hiroshi Ito, Shunji Sano

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   64 ( 11 )   B48 - B48   2014年9月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • Long-term Clinical Outcomes After Transcatheter Closure of Atrial Septal Defect in Adult: Influence of Age Procedure

    Yoichi Takaya, Teiji Akagi, Yasufumi Kijima, Koji Nakagawa, Shunji Sano, Hiroshi Ito

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   63 ( 12 )   S16 - S16   2014年4月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • INFLUENCE OF PROCEDURE AGE ON CLINICAL OUTCOMES AFTER TRANSCATHETER CLOSURE OF ATRIAL SEPTAL DEFECT

    Yoichi Takaya, Teiji Akagi, Yasufumi Kijima, Koji Nakagawa, Hiroshi Ito

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   63 ( 12 )   A1750 - A1750   2014年4月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • 成人期に達した川崎病冠動脈病変に対するカテーテル治療

    赤木禎治

    日本川崎病研究センターニュースレター   28   3 - 4   2014年

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  • Structural Heart Diseaseに対するカテーテルインターベンション:卵円孔開存

    赤木禎治, 木島康文

    呼吸と循環   62 ( 1 )   37 - 42   2014年

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    記述言語:日本語   出版者・発行元:医学書院  

    DOI: 10.11477/mf.1404102383

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    その他リンク: http://search.jamas.or.jp/link/ui/2014079059

  • 心房中隔欠損症・卵円孔開存症に対するカテーテル閉鎖術

    赤木禎治

    循環器専門医   21 ( suppl )   23 - 29   2014年

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  • A New Hemostasis Tool after Percutaneous Angioplasty: The Hemcontm Pad Hemostasis Device

    Oozawa S, Akagi T, Sano S

    J Vasc Med Surg   2   125 (e Publish) -125 (e Publish)   2014年

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  • Catheter closure of patent foramen ovale in patients with cryptogenic cerebrovascular accidents: Initial experiences in Japan

    Yasufumi Kijima, Teiji Akagi, Koji Nakagawa, Manabu Taniguchi, Akira Ueoka, Kentaro Deguchi, Norihisa Toh, Hiroki Oe, Kengo Kusano, Shunji Sano, Hiroshi Ito

    Cardiovascular Intervention and Therapeutics   29 ( 1 )   11 - 17   2014年

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    記述言語:英語  

    Although numerous studies have shown an association between a patent foramen ovale (PFO) and cryptogenic cerebrovascular accidents (CVA), there has been no definitive control study that demonstrated the benefit of percutaneous device closure of a PFO compared to medical therapy in patients with CVA. Additionally, few clinical data exist for Japanese patients in this field. We demonstrate the initial experiences in catheter closure of a PFO as secondary prevention of CVA in Japan. Catheter closure of a PFO was attempted in 7 patients who were diagnosed with cryptogenic CVA. Mean age at the procedure was 54 ± 19 years. The presence of spontaneous interatrial right-to-left shunts was demonstrated by transesophageal contrast echocardiography without Valsalva maneuver in all of the patients. Amplatzer Cribriform device (n = 4) or Amplatzer PFO Occluder (n = 3) was used for the procedure and was successfully deployed. Device-related complications were not observed at the time of the procedure or during the follow-up period (mean period of 16 ± 9 months). Catheter closure of a PFO could be safely performed with Amplatzer Cribriform or Amplatzer PFO Occluder. This procedure may contribute to prevention of recurrent cryptogenic CVA in Japanese patients. © 2013 Japanese Association of Cardiovascular Intervention and Therapeutics.

    DOI: 10.1007/s12928-013-0193-9

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  • 卵円孔開存症の臨床的意義と治療

    赤木禎治

    医学のあゆみ   250 ( 2 )   117 - 121   2014年

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  • Cardiac erosion after catheter closure of atrial septal defect: Septal malalignment may be a novel risk factor for erosion

    Yasufumi Kijima, Teiji Akagi, Koji Nakagawa, Worakan Promphan, Norihisa Toh, Kazufumi Nakamura, Shunji Sano, Hiroshi Ito

    Journal of Cardiology Cases   9 ( 4 )   134 - 137   2014年

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    記述言語:英語   出版者・発行元:Elsevier Ltd  

    Pericardial tamponade occurred 3 days after the catheter closure of an atrial septal defect (ASD) using Amplatzer Septal Occluder (St. Jude Medical, St. Paul, MN, USA). Before the closure, two-dimensional and real-time three-dimensional transesophageal echocardiography demonstrated a deficient aortic rim and atrial septal malalignment. Perforation of the right atrium toward the non-coronary sinus of the aortic root was confirmed at the emergent surgery. Cardiac erosion is one of the most catastrophic complications in ASD patients undergoing catheter closure with Amplatzer Septal Occluder. Hence, several risk factors for this complication are discussed and identified. Oversized device deployment and a deficient aortic rim are accepted factors potentially causing cardiac erosion. Besides, atrial septal malalignment, which is a morphological characteristic of ASD, may be a novel risk factor for cardiac erosion.&lt
    . Learning objective: Cardiac erosion is a potentially lethal complication when catheter closure of atrial septal defects using Amplatzer Septal Occluder (St. Jude Medical, St. Paul, MN, USA) is provided to the patients. However, mechanisms of this complication remain to be completely elucidated. Atrial septal malalignment may be one of the novel risk factors for this catastrophic complication.&gt
    . © 2013 Japanese College of Cardiology.

    DOI: 10.1016/j.jccase.2013.12.004

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  • Transcatheter closure of right-to-left atrial shunt in patients with platypnea-orthodeoxia syndrome associated with aortic elongation

    Yoichi Takaya, Teiji Akagi, Yasufumi Kijima, Koji Nakagawa, Manabu Taniguchi, Hayato Ohtani, Shunji Sano, Hiroshi Ito

    Cardiovascular Intervention and Therapeutics   29 ( 3 )   221 - 225   2014年

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    記述言語:英語   出版者・発行元:Springer-Verlag Tokyo  

    Platypnea-orthodeoxia is a rare condition characterized by dyspnea and oxygen desaturation induced by the upright position and relieved by recumbency. The most common cause of this syndrome is right-to-left shunt through interatrial communications such as patent foramen ovale (PFO) or atrial septal defect (ASD). In addition, this syndrome can be caused by other extracardiac components, including pulmonary emphysema, pericardial disease, and prominent Eustachian valve. We experienced 3 cases of this syndrome, including 1 patient with PFO and 2 patients with ASD. Computer tomography imaging revealed aortic elongation and compression of the right atrium by ascending aorta in all of 3 patients. Transcatheter closure of PFO or ASD was successfully performed in all patients, including immediate improvements of symptoms and oxygen saturation without any complications. © 2014 Japanese Association of Cardiovascular Intervention and Therapeutics.

    DOI: 10.1007/s12928-014-0244-x

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  • 先天性心疾患におけるカテーテル治療の最前線

    上岡 亮, 赤木禎治

    循環器内科   75 ( 1 )   59 - 66   2014年

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  • カテーテルインターベンションの長期予後:フォローアップの重要性と情報共有

    赤木禎治

    心臓   46 ( 4 )   509 - 510   2014年

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  • 成人期(40歳以上)に発見されたASD患者の臨床像

    真木明日香, 山口裕己, 中村淳, 中川晃志, 木島康文, 高谷陽一, 麻植浩樹, 藤澤芳基, 伊藤浩, 赤木禎治, 佐野俊二

    日本成人先天性心疾患学会雑誌(Web)   3 ( 1 )   2014年

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  • Echocardiography Underestimates Right Heart Size in Patients With Atrial Septal Defect: Evidence From Fusion Imaging With Multidetector Computed Tomography

    Yasuharu Tanabe, Norihisa Toh, Yasufumi Kijima, Hiroki Oe, Teiji Akagi, Hiroshi Ito

    CIRCULATION   128 ( 22 )   2013年11月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • High Procedure Success Rate in Device Closure of Atrial Septal Defect with Multiple Rim Deficiencies

    Yasufumi Kijima, Teiji Akagi, Koji Nakagawa, Norihisa Toh, Manabu Taniguchi, Shunji Sano, Ito Hiroshi

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   62 ( 18 )   B209 - B210   2013年10月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • Clinical advantage of real-time three-dimensional transesophageal echocardiography for transcatheter closure of multiple atrial septal defects

    Manabu Taniguchi, Teiji Akagi, Yasufumi Kijima, Shunji Sano

    INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING   29 ( 6 )   1273 - 1280   2013年8月

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    記述言語:英語   出版者・発行元:SPRINGER  

    This study sought to evaluate the usefulness of real-time three-dimensional (3D) transesophageal echocardiography (TEE) to guide the repair of multiple atrial septal defects (ASDs). Of 212 consecutive patients with secundum ASD who were scheduled for transcatheter closure of their ASDs, 27 had multiple ASDs. These patients underwent two-dimensional (2D) transthoracic echocardiography, 2D TEE, and 3D TEE. Overall, 18 patients had two defects, and 9 patients had three or more defects. The latter group included three patients with multi-fenestrated defects. Optimal 3D images were obtained in 93 % of the patients. In patients with two defects, information on the positional relation of the defects was obtained using 2D TEE and 3D TEE in 71 and 94 % of patients, respectively (P = 0.22). The positional relations of the defects could not be evaluated with 2D TEE in patients with three or more defects, whereas it could be evaluated with 3D TEE in all of these patients (0 vs. 100 %, P = 0.008). In all patients, 3D TEE proved superior to 2D TEE for providing sufficient information (96 vs. 48 %, P = 0.002). Procedural success was obtained in 26 patients (96.3 %), without complications. Transcatheter closure of multiple ASDs under 3D TEE guidance is effective and safe. Real-time 3D TEE can provide useful information regarding complex ASD morphology. It can thus contribute to developing a successful treatment strategy, especially in patients with three or more defects.

    DOI: 10.1007/s10554-013-0212-z

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  • Clinical features of adult patients with Eisenmenger's syndrome in Japan and Korea. 国際誌

    Hisanori Sakazaki, Koichiro Niwa, Makoto Nakazawa, Tsutomu Saji, Toshio Nakanishi, Motoki Takamuro, Michihiko Ueno, Hitoshi Kato, Shinichi Takatsuki, Masaki Matsushima, Namiko Kojima, Fukiko Ichida, Shigetoyo Kogaki, Sachiko Kido, Yoshio Arakaki, Kenji Waki, Teiji Akagi, Kunitaka Joo, Jun Muneuchi, Kenji Suda, Heung Jae Lee, Haruo Shintaku

    International journal of cardiology   167 ( 1 )   205 - 9   2013年7月

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    記述言語:英語  

    BACKGROUND: There are few articles on mortality and morbidity of adult patients with Eisenmenger's syndrome (ES) in the current era when disease targeting therapy (DTT) has been available. METHODS AND RESULTS: 198 patients (a median age 35 years, 64% female) with ES who visited the 16 participating institutes in Japan and Korea from 1998 to 2009 were enrolled. Clinical data during adulthood were collected from each institutional chart and analyzed centrally. During a median follow-up of 8 years, 30 patients died including 14 sudden deaths. 89 patients took oral medication of DTT and clinical improvement was observed in 54 of them. However, survival rate in patients taking DTT was not different from those without (87% vs 84%, p=0.55). When the clinical data in between first and last clinic visits were compared in 85 patients, the patients with NYHA >/=III increased from 24% to 48% (p<0.001), SpO2 decreased from 89% to 85% (p=0.008) and hematocrit increased from 51.4% to 52.9% (p=0.04). Non-survivors had poorer NYHA function class, lower body weight (BW), lower body mass index (BMI), and higher serum level of Cr at the first visits than survivors. CONCLUSIONS: Long term survival and clinical status of adult patients with ES remains unsatisfactory even in the current era of DTT. Poor NYHA functional class, low BW, low BMI and high serum level of Cr were related to mortality. DTT therapy improved clinical status in many patients with Eisenmenger's syndrome, but no significant impact on survival could be shown.

    DOI: 10.1016/j.ijcard.2011.12.030

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  • What is the best medical management for adult patients with Eisenmenger syndrome?

    Teiji Akagi

    Journal of Cardiology Cases   8 ( 1 )   e63   2013年7月

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  • Long-term effects of transcatheter closure of atrial septal defect on cardiac remodeling and exercise capacity in patients older than 40 years with a reduction in cardiopulmonary function

    Yoichi Takaya, Manabu Taniguchi, Teiji Akagi, Saori Nobusada, Kengo Kusano, Hiroshi Ito, Shunji Sano

    Journal of Interventional Cardiology   26 ( 2 )   195 - 199   2013年4月

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    記述言語:英語  

    Background Although it has been demonstrated that cardiac remodeling and exercise capacity improve after transcatheter closure of atrial septal defect (ASD), little is known about long-term benefits in middle-aged and elderly patients with a reduction in cardiopulmonary function. Objectives To evaluate long-term extent and time course of improvements in cardiac remodeling and exercise capacity in those patients. Methods: Twenty ASD patients ≥ 40 years of age with a reduction in cardiopulmonary function (predicted peak oxygen uptake [VO2] &lt
    65%) were enrolled. Transthoracic echocardiography and cardiopulmonary exercise testing were performed at baseline and at 1 month, 3 months, 6 months, and &gt
    12 months after the procedure. Results At 1 month after the procedure, significant decreases in right ventricular (RV) end-diastolic diameter (38.2 ± 4.4 to 31.9 ± 4.4 mm
    P &lt
    0.001) and RV/left ventricular end-diastolic diameter ratio (0.95 ± 0.17 to 0.71 ± 0.13
    P &lt
    0.001) occurred, and they were maintained during the follow-up period. Normal RV size was achieved in 11 of 18 patients with RV enlargement. Predicted peak VO2 did not change at 1 month and 3 months, but it improved significantly after 6 months (53.6 ± 6.5 to 62.1 ± 12.6%
    P &lt
    0.01). Sixteen of the 20 patients showed improved predicted peak VO2. Conclusions Cardiac remodeling and exercise capacity could be improved over the long-term period after transcatheter closure of ASD in middle-aged and elderly patients with a reduction in cardiopulmonary function. There were differences in the time course of improvement between cardiac remodeling and exercise capacity in those patients. (J Interven Cardiol 2013
    26:195-199) ©2012, Wiley Periodicals, Inc.

    DOI: 10.1111/joic.12002

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  • Long-term effects of transcatheter closure of atrial septal defect on cardiac remodeling and exercise capacity in patients older than 40 years with a reduction in cardiopulmonary function

    Yoichi Takaya, Manabu Taniguchi, Teiji Akagi, Saori Nobusada, Kengo Kusano, Hiroshi Ito, Shunji Sano

    Journal of Interventional Cardiology   26 ( 2 )   195 - 199   2013年4月

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    記述言語:英語  

    Background Although it has been demonstrated that cardiac remodeling and exercise capacity improve after transcatheter closure of atrial septal defect (ASD), little is known about long-term benefits in middle-aged and elderly patients with a reduction in cardiopulmonary function. Objectives To evaluate long-term extent and time course of improvements in cardiac remodeling and exercise capacity in those patients. Methods: Twenty ASD patients ≥ 40 years of age with a reduction in cardiopulmonary function (predicted peak oxygen uptake [VO2] &lt
    65%) were enrolled. Transthoracic echocardiography and cardiopulmonary exercise testing were performed at baseline and at 1 month, 3 months, 6 months, and &gt
    12 months after the procedure. Results At 1 month after the procedure, significant decreases in right ventricular (RV) end-diastolic diameter (38.2 ± 4.4 to 31.9 ± 4.4 mm
    P &lt
    0.001) and RV/left ventricular end-diastolic diameter ratio (0.95 ± 0.17 to 0.71 ± 0.13
    P &lt
    0.001) occurred, and they were maintained during the follow-up period. Normal RV size was achieved in 11 of 18 patients with RV enlargement. Predicted peak VO2 did not change at 1 month and 3 months, but it improved significantly after 6 months (53.6 ± 6.5 to 62.1 ± 12.6%
    P &lt
    0.01). Sixteen of the 20 patients showed improved predicted peak VO2. Conclusions Cardiac remodeling and exercise capacity could be improved over the long-term period after transcatheter closure of ASD in middle-aged and elderly patients with a reduction in cardiopulmonary function. There were differences in the time course of improvement between cardiac remodeling and exercise capacity in those patients. (J Interven Cardiol 2013
    26:195-199) ©2012, Wiley Periodicals, Inc.

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  • 【心不全の診断と治療の現状-最近のガイドラインの把握と臨床判断】 成人先天性心疾患による心不全のとらえ方と治療

    杜 徳尚, 赤木 禎治

    カレントテラピー   31 ( 4 )   400 - 405   2013年4月

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    記述言語:日本語   出版者・発行元:(株)ライフメディコム  

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  • <治療に活かす>カテーテル治療における心エコーの役割 経皮的心房中隔欠損閉鎖術症例でのMDCTフュージョンイメージングを用いた計測

    杜 徳尚, 木島 康文, 麻植 浩樹, 赤木 禎治, 伊藤 浩

    超音波医学   40 ( Suppl. )   S225 - S225   2013年4月

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    記述言語:日本語   出版者・発行元:(公社)日本超音波医学会  

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  • Evaluation of exercise capacity using wave intensity in chronic heart failure with normal ejection fraction

    Yoichi Takaya, Manabu Taniguchi, Motoaki Sugawara, Saori Nobusada, Kengo Kusano, Teiji Akagi, Hiroshi Ito

    HEART AND VESSELS   28 ( 2 )   179 - 187   2013年3月

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    記述言語:英語   出版者・発行元:SPRINGER  

    Impaired exercise capacity has been found in patients with diastolic dysfunction with preserved systolic function. Although conventional transthoracic echocardiography (TTE) provides useful clinical information about systolic and diastolic cardiac function, its capability to evaluate exercise capacity has been controversial. The inertia force of late systolic aortic flow is known to have a tight relationship with left ventricular (LV) performance during the period from near end-systole to isovolumic relaxation. The inertia force and the time constant of LV pressure decay during isovolumic relaxation can be estimated noninvasively using the second peak (W-2) of wave intensity (WI), which is measured with an echo-Doppler system. We sought to determine whether W-2 is associated with exercise capacity in patients with chronic heart failure with normal ejection fraction (HFNEF) and to compare its ability to predict exercise capacity with parameters obtained by conventional TTE including tissue Doppler imaging. Sixteen consecutive patients with chronic HFNEF were enrolled in this study. Wave intensity was obtained with a color Doppler system for measurement of blood velocity combined with an echo-tracking system for detecting changes in vessel diameter. Concerning conventional TTE, we measured LV ejection fraction (EF), peak velocities of early (E) and late (A) mitral inflow using pulse-wave Doppler, and early (Ea) and late (Aa) diastolic velocities using tissue Doppler imaging. Left ventricular EF, E/A ratio, Ea, and E/Ea ratio did not correlate with exercise capacity, whereas W-2 significantly correlated with peak VO2 (r = 0.54, p = 0.03), VE/VCO2 slope (r = -0.53, p = 0.03), and Delta VO2/Delta WR (r = 0.56, p = 0.02). W-2 was associated with exercise capacity in patients with chronic HFNEF. In conclusion, W-2 is considered to be clinically more useful than conventional TTE indices for evaluating exercise capacity in patients with chronic HFNEF.

    DOI: 10.1007/s00380-011-0224-3

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  • Pregnancy and delivery in patients with Fontan circulation: A report of two cases

    Seiji Inoue, Hisashi Masuyama, Teiji Akagi, Yuji Hiramatsu

    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH   39 ( 1 )   378 - 382   2013年1月

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    記述言語:英語   出版者・発行元:WILEY-BLACKWELL  

    Fontan operation is performed to provide palliation for patients with many forms of highly complex congenital heart disease that cannot support a biventricular circulation. Increasing numbers of women who have undergone these connections in childhood are now reaching their childbearing years, and some are becoming pregnant. The low flow and fixed cardiac output of a Fontan circulation poses a number of problems during pregnancy. Here, we report two cases of pregnancy and delivery with Fontan circulation. Case 1, who underwent Fontan procedure for congenital pulmonary atresia with intact vertical septum at age 7, delivered a male infant weighing 1073 g by cesarean section at 286/7 weeks due to massive genital bleeding. Case 2 underwent Fontan procedure for double inlet left ventricle and delivered by vacuum extraction a male infant weighing 2142 g, while monitoring central venous pressure at 375/7 weeks. The former had ascites and dose of diuretic had to be added at early pregnancy, and the latter had no adverse cardiac and obstetric events. These cases suggest that patients after adequate Fontan palliation could complete pregnancy without long-term cardiac sequelae, but might be complicated with cardiac or obstetrical events. Intensive care should be required with specialists, including a neonatologist, anesthesiologist and cardiologist. We have added a literature review of pregnancy with Fontan circulation, referring to previous reports.

    DOI: 10.1111/j.1447-0756.2012.01910.x

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  • 21世紀のアジアにおける小児循環器学:3か国フォーラム10年の流れと日本の使命

    赤木禎治

    日本小児循環器学会雑誌   29 ( 4 )   160 - 161   2013年

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  • 心房中隔欠損症の最新治療戦略

    赤木禎治

    Cardiovascular Contemporary   2 ( 2 )   24 - 29   2013年

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  • 先天性心疾患に伴う肺高血圧症~肺高血圧合併心房中隔欠損症のシャントは閉じるべきではないか~

    木島康文, 赤木禎治

    月刊循環器   3 ( 10 )   53 - 62   2013年

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  • 心不全.古くて新しい心臓病:先人先天性心疾患

    杜 徳尚, 赤木禎治

    成人病と生活習慣病   43 ( 2 )   180 - 185   2013年

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  • 成人先天性心疾患による心不全のとらえ方と治療

    杜 徳尚, 赤木禎治

    Current Therapy   31 ( 4 )   52 - 57   2013年

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  • 心房中隔欠損症を正しく診断する.特集:先天性心疾患に対する苦手意識を克服し強くなろう

    木島康文, 赤木禎治

    心エコー   14 ( 5 )   422 - 431   2013年

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  • Amplatzer Septal Occluderを用いた心房中隔欠損閉鎖術の合併症の検討

    黒子洋介, 赤木禎治, 藤田康文, 奥山倫弘, 川畑拓也, 立石篤史, 吉積功, 高垣昌巳, 新井禎彦, 笠原真悟, 佐野俊二

    Gen Thorac Cardiovasc Surg   60 ( Supplement )   650   2012年9月

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    記述言語:日本語  

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  • Catheter intervention for adult patients with congenital heart disease

    Teiji Akagi

    JOURNAL OF CARDIOLOGY   60 ( 3-4 )   151 - 159   2012年9月

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元:ELSEVIER IRELAND LTD  

    Adult congenital heart disease is one of the most important clinical issues not only for pediatric cardiologists but also adult cardiologists. After the introduction of catheter intervention for atrial septal defect in the pediatric population, therapeutic advantages of this less invasive procedure now focused on even geriatric patients. The most valuable clinical benefit of this procedure is the significant improvement in symptoms and daily activities, which result from the closure of left to right shunt without thoracotomy or cardiopulmonary bypass surgery. Although currently available therapeutic options for device closure for congenital heart disease in Japan are limited to atrial septal defect, patent ductus arteriosus, or some vascular abnormalities such as coronary arteriovenous fistula, various new techniques or devices such as ventricular septal defect device, pulmonary valve implantation, are going to be introduced in the near future. To perform safely and achieve good procedure success, real time imaging plays an important role in interventional procedures. Real time three-dimensional transesophageal echocardiography can provide high quality imaging for anatomical evaluation including defect size, surrounding rim morphology, and the relationship between device and septal rim. In adult patients, optimal management of comorbidities is an important issue, including cardiac function, arrhythmias, pulmonary function, and renal function. In particular, atrial arrhythmias are key issues for long-term outcome. Because the interventional procedures are not complication-free techniques, the establishment of a surgical back-up system is essential for achieving a safe procedure. Finally, the establishment of a team approach including pediatric and adult cardiologists, cardiac surgeons, and anesthesiologists is the most important factor for a good therapeutic outcome. Their roles include pre-interventional hemodynamic evaluation, good imaging technique for anatomical evaluation, management of comorbidities, and surgical back up. (C) 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

    DOI: 10.1016/j.jjcc.2012.06.014

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  • Catheter intervention for adult patients with congenital heart disease

    Teiji Akagi

    Journal of Cardiology   60 ( 3 )   151 - 159   2012年9月

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等  

    Adult congenital heart disease is one of the most important clinical issues not only for pediatric cardiologists but also adult cardiologists. After the introduction of catheter intervention for atrial septal defect in the pediatric population, therapeutic advantages of this less invasive procedure now focused on even geriatric patients. The most valuable clinical benefit of this procedure is the significant improvement in symptoms and daily activities, which result from the closure of left to right shunt without thoracotomy or cardiopulmonary bypass surgery. Although currently available therapeutic options for device closure for congenital heart disease in Japan are limited to atrial septal defect, patent ductus arteriosus, or some vascular abnormalities such as coronary arteriovenous fistula, various new techniques or devices such as ventricular septal defect device, pulmonary valve implantation, are going to be introduced in the near future. To perform safely and achieve good procedure success, real time imaging plays an important role in interventional procedures. Real time three-dimensional transesophageal echocardiography can provide high quality imaging for anatomical evaluation including defect size, surrounding rim morphology, and the relationship between device and septal rim. In adult patients, optimal management of comorbidities is an important issue, including cardiac function, arrhythmias, pulmonary function, and renal function. In particular, atrial arrhythmias are key issues for long-term outcome. Because the interventional procedures are not complication-free techniques, the establishment of a surgical back-up system is essential for achieving a safe procedure. Finally, the establishment of a team approach including pediatric and adult cardiologists, cardiac surgeons, and anesthesiologists is the most important factor for a good therapeutic outcome. Their roles include pre-interventional hemodynamic evaluation, good imaging technique for anatomical evaluation, management of comorbidities, and surgical back up. © 2012 Japanese College of Cardiology.

    DOI: 10.1016/j.jjcc.2012.06.014

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  • Transcatheter closure of atrial septal defect in a geriatric population

    Koji Nakagawa, Teiji Akagi, Manabu Taniguchi, Yasufumi Kijima, Keiji Goto, Kengo F. Kusano, Hiroshi Itoh, Shunji Sano

    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS   80 ( 1 )   84 - 90   2012年7月

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    記述言語:英語   出版者・発行元:WILEY-BLACKWELL  

    Objectives: To evaluate the efficacy and safety of transcatheter closure of atrial septal defects (ASD) in patients over 70 years of age. Background: Transcatheter closure of ASD is an established procedure in children and young adults, but the benefits of this procedure in geriatric patients are still unclear. Methods: Between 2005 and 2010, 430 patients with ASD underwent transcatheter closure in our hospital. Among those patients, 30 consecutive patients older than 70 years of age were prospectively evaluated. Results: Mean age at procedure was 75.8 +/- 3.8 years (range: 7085 years). Mean Qp/Qs was 2.4 +/- 0.7 and mean ASD diameter was 20.3 +/- 6.4 mm. Nine patients (30%) had a history of hospitalization due to heart failure. ASD closure was successfully performed in 28 patients (93%) without significant complications. During the follow-up period (mean period of 19.1 +/- 11.3 months), New York Heart Association (NYHA) functional class was significantly improved in 20 patients (74%). Significant improvements of plasma BNP level, resting heart rate, and systolic pulmonary artery pressure were also observed. Improvement of tricuspid regurgitation was observed in 11 of 17 patients with moderate or severe regurgitation during the follow-up period. Conversely, worsening of mitral regurgitation was observed in 10 of the 27 patients. Conclusion: Transcatheter closure of ASD in geriatric patients can be performed safely. This procedure contributes to significant improvement of symptoms and positive cardiac remodeling. Long-term follow-up is mandatory, especially for patients with mitral regurgitation. (c) 2012 Wiley Periodicals, Inc.

    DOI: 10.1002/ccd.23457

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  • Usefulness of the Right Parasternal Approach to Evaluate the Morphology of Atrial Septal Defect for Transcatheter Closure Using Two-Dimensional and Three-Dimensional Transthoracic Echocardiography

    Nobuhisa Watanabe, Manabu Taniguchi, Teiji Akagi, Yasuharu Tanabe, Norihisa Toh, Kengo Kusano, Hiroshi Ito, Norio Koide, Shunji Sano

    JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY   25 ( 4 )   376 - 382   2012年4月

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    記述言語:英語   出版者・発行元:MOSBY-ELSEVIER  

    Background: The aim of this study was to demonstrate the feasibility and usefulness of addition of the right parasternal approach to the conventional left parasternal and apical approaches using two-dimensional (2D) and three-dimensional (3D) transthoracic echocardiography (TTE) for morphologic evaluation in cases of transcatheter closure of atrial septal defects (ASDs).
    Methods: In 112 consecutive patients with ASDs, the morphology of the defects was evaluated for transcatheter closure in the right parasternal view in addition to the conventional left views using 2D and 3D TTE. Measurements of the maximal ASD diameter and detection of deficient rim obtained on 2D TTE were compared with those obtained by 2D transesophageal echocardiography. The shapes and locations of ASDs visualized by 3D TTE were compared with those visualized by 3D transesophageal echocardiography.
    Results: In 88 patients (80.0%), optimal images from the right parasternal approach for morphologic evaluation of ASDs were obtained. Although there was a significant difference in maximal ASD diameter obtained only in the conventional left approach compared with transesophageal echocardiographic measurements (P &lt; .05), when the right parasternal approach was applied, a significant difference was not found (P = .18), and the diagnostic concordance of the rim deficiency was improved from 85.2% to 90.9%. Three-dimensional TTE from the right parasternal approach improved visualization of the shape and location of ASDs from 65.5% to 74.5%.
    Conclusions: Additional use of the right parasternal approach enables detailed morphologic evaluation for transcatheter closure of ASDs. In patients with suboptimal images on 3D TTE in the left conventional approach, additional 3D TTE in the right parasternal approach can improve the feasibility of obtaining optimal 3D images to evaluate the shapes and locations of ASDs. (J Am Soc Echocardiogr 2012;25:376-82.)

    DOI: 10.1016/j.echo.2012.01.002

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  • Catheter closure of coronary sinus atrial septal defect using Amplatzer Septal Occluder

    Yasufumi Kijima, Manabu Taniguchi, Teiji Akagi

    CARDIOLOGY IN THE YOUNG   22 ( 2 )   223 - 226   2012年4月

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    記述言語:英語   出版者・発行元:CAMBRIDGE UNIV PRESS  

    Coronary sinus defect is a rare type of atrial septal defect. We report two patients who had a coronary sinus atrial septal defect without persistent left superior caval vein, where the orifice of the coronary sinus was closed using the Amplatzer Septal Occluder. The procedure was successful, without any complications including conduction disturbance.

    DOI: 10.1017/S1047951111001077

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  • Transcatheter Closure of a Large Atrial Septal Defect under Microprobe Transesophageal Echocardiographic Guidance

    Manabu Taniguchi, Teiji Akagi, Yasufumi Kijima, Hiroshi Ito, Shunji Sano

    ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES   29 ( 4 )   E94 - E96   2012年4月

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    記述言語:英語   出版者・発行元:WILEY-BLACKWELL  

    We present a case of an atrial septal defect (ASD) in a 59-year-old man with an indication for ASD closure who also had a history of chronic obstructive pulmonary disease. Because of his decreased respiratory function with multiple bullae in his lungs, the procedure was performed without general anesthesia under the guidance of fluoroscopy and two-dimensional (2D) transesophageal echocardiography (TEE) using a transesophageal echocardiographic microprobe (micro-TEE) (S8-3t; Philips Medical Systems, Andover, MA, USA). The micro-TEE probe was inserted into the esophagus smoothly and easily in the supine position without sedation. It revealed a deficient superior-anterior rim and adequate rims elsewhere, and the maximal diameter of ASD was measured to be 25 mm. Balloon sizing resulted in a stretched defect diameter of 29 mm using the stop-flow technique. A 30-mm AMPLATZER Septal Occluder (AGA Medical, Plymouth, MN, USA) was deployed. The micro-TEE demonstrated that both disks were on the appropriate sides of the interatrial septum and the device was not interfering with surround cardiac structures. Residual shunt flow was not detected with color Doppler. The device was released successfully without any complications. Recently introduced multiplane micro-TEE can provide adequate information about a large ASD with a less invasive procedure in adult patients. Micro-TEE has a potential to become a novel imaging option for interventions of the interatrial septum. (Echocardiography 2012;29:E94-E96)

    DOI: 10.1111/j.1540-8175.2011.01600.x

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  • Transcatheter Closure of a Large Atrial Septal Defect under Microprobe Transesophageal Echocardiographic Guidance

    Manabu Taniguchi, Teiji Akagi, Yasufumi Kijima, Hiroshi Ito, Shunji Sano

    ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES   29 ( 4 )   E94 - E96   2012年4月

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    記述言語:英語   出版者・発行元:WILEY-BLACKWELL  

    We present a case of an atrial septal defect (ASD) in a 59-year-old man with an indication for ASD closure who also had a history of chronic obstructive pulmonary disease. Because of his decreased respiratory function with multiple bullae in his lungs, the procedure was performed without general anesthesia under the guidance of fluoroscopy and two-dimensional (2D) transesophageal echocardiography (TEE) using a transesophageal echocardiographic microprobe (micro-TEE) (S8-3t; Philips Medical Systems, Andover, MA, USA). The micro-TEE probe was inserted into the esophagus smoothly and easily in the supine position without sedation. It revealed a deficient superior-anterior rim and adequate rims elsewhere, and the maximal diameter of ASD was measured to be 25 mm. Balloon sizing resulted in a stretched defect diameter of 29 mm using the stop-flow technique. A 30-mm AMPLATZER Septal Occluder (AGA Medical, Plymouth, MN, USA) was deployed. The micro-TEE demonstrated that both disks were on the appropriate sides of the interatrial septum and the device was not interfering with surround cardiac structures. Residual shunt flow was not detected with color Doppler. The device was released successfully without any complications. Recently introduced multiplane micro-TEE can provide adequate information about a large ASD with a less invasive procedure in adult patients. Micro-TEE has a potential to become a novel imaging option for interventions of the interatrial septum. (Echocardiography 2012;29:E94-E96)

    DOI: 10.1111/j.1540-8175.2011.01600.x

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  • Clinical Implications of Real-Time Three-Dimensional Transesophageal Echocardiography for Catheter Closure of Atrial Septal Defect

    Yasufumi Kijima, Teiji Akagi, Koji Nakagawa, Manabu Taniguchi, Norihisa Toh, Kengo Kusano, Hiroshi Ito Shunji Sano

    AMERICAN JOURNAL OF CARDIOLOGY   109 ( 7 )   99S - 99S   2012年4月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC  

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  • 心房中隔欠損症に対する経カテーテル的閉鎖術の合併症の検討

    藤田康文, 赤木禎治, 大澤晋, 川畑拓也, 黒子洋介, 立石篤史, 高垣昌巳, 新井禎彦, 笠原真悟, 佐野俊二

    日本心臓血管外科学会雑誌   41 ( Supplement )   369   2012年3月

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  • BALLOON OCCLUSION TEST OVERESTIMATES THE RISK OF ACUTE PULMONARY CONGESTION AFTER THE TRANSCATHETER CLOSURE OF ATRIAL SEPTAL DEFECT IN ADULTS

    Koji Nakagawa, Yasufumi Kijima, Kengo Kusano, Hiroshi Ito, Teiji Akagi

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   59 ( 13 )   E241 - E241   2012年3月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • Congenital heart disease in Japan

    Teiji Akagi

    EUROPEAN HEART JOURNAL SUPPLEMENTS   14 ( A )   A47 - A48   2012年2月

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    記述言語:英語   出版者・発行元:OXFORD UNIV PRESS  

    As same as other developed countries, prevalence of ACHD in Japan has already dramatically increased. The establishment of the special facilities and resources for ACHD patients is crucial, also the establishment of education and training systems for adult cardiologists in this evolving field has been discussed in Japan. In the field of catheter intervention, the Society of Japanese Pediatric Interventional Cardiology (JPIC) contribute all area of interventional procedures, all procedures for congenital heart disease and procedure related complications have been registered in the society.

    DOI: 10.1093/eurheartj/sur033

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  • Catheter closure of atrial septal defect in patients with cryptogenic stroke: Initial experience in Japan

    Yasufumi Kijima, Teiji Akagi, Manabu Taniguchi, Koji Nakagawa, Kentaro Deguchi, Tomoko Tomii, Kengo Kusano, Shunji Sano, Hiroshi Ito

    Cardiovascular Intervention and Therapeutics   27 ( 1 )   8 - 13   2012年1月

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    記述言語:英語  

    A recent study has shown that cryptogenic stroke can occur even in patients with small or insignificant atrial septal defects (ASD). However, clinical experience in this field is still limited in Japan, also the efficacy and safety of catheter closure of such defects have not been identified. To evaluate the efficacy and safety of catheter closure of interatrial communication in patients with cryptogenic stroke, 13 patients who were diagnosed with cerebrovascular events due to cryptogenic embolism were included in this study. Mean age at procedure was 43 ± 15 (range 17-68) years. In all patients, the presence of spontaneous or provoked interatrial right-to-left shunts was demonstrated by transesophageal contrast echocardiography. Mean defect size evaluated by the balloon sizing technique was 9.2 ± 2.8 mm, and mean size of the Amplatzer Septal Occluder deployed was 9.5 ± 2.8 mm. Devices were successfully deployed in all patients, though one device migrated into the descending aorta was retrieved by a snare catheter. Complete closure was detected by transesophageal contrast echocardiography at 12 months after the procedure was in 11 (85%) of the 13 patients. During the follow-up period (30.1 ± 9.4 months), no recurrent thromboembolic event was observed. Catheter closure of interatrial right-to-left communications can be safely performed. This procedure may contribute to reduction or prevention of recurrent neurological events in this patient population. © 2011 Japanese Association of Cardiovascular Intervention and Therapeutics.

    DOI: 10.1007/s12928-011-0075-y

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  • 成人動脈管開存に対するAmplatzer Duct Occluderを用いたカテーテル閉鎖術

    木島 康文, 赤木 禎治, 中川 晃志, 谷口 学, 草野 研吾, 伊藤 浩, 佐野 俊二

    日本成人先天性心疾患学会雑誌   1 ( 1 )   74 - 74   2012年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • 心房中隔欠損に対するTest Balloon OcclusionはAmplatzerデバイス留置後の急性心不全リスクを過大評価する

    中川 晃志, 赤木 禎治, 木島 康文, 谷口 学, 草野 研吾, 伊藤 浩, 佐野 俊二

    日本成人先天性心疾患学会雑誌   1 ( 1 )   75 - 75   2012年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • 奇異性脳塞栓症に対して経皮的中隔閉鎖デバイス(Amplatzer)による閉鎖術後に頭痛が改善した1例

    河野祥一郎, 出口健太郎, 森本展年, 出口章子, 倉田智子, 池田佳生, 松浦 徹, 伊藤 浩, 赤木禎治, 阿部康二

    Jpn J stroke   34   334 - 339   2012年

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  • 成人先天性心疾患の診療体制確立へ向けて :循環器内科医をいかに取り込むか

    赤木禎治, 杜 徳尚

    日本成人先天性心疾患学会雑誌   1 ( 2 )   24 - 28   2012年

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  • ACDHの診療体制とチーム医療

    赤木禎治

    Heart   2   59 - 63   2012年

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  • 内科医のための成人先天性心疾患.動脈管開存とカテーテル治療

    赤木禎治

    心エコー   13 ( 3 )   284 - 289   2012年

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  • 妊娠・出産時の血行動態を含む母体の変化

    赤木禎治

    月刊循環器   2 ( 8 )   37 - 43   2012年

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  • 奇異性脳塞栓症の原因と考えられた卵円孔開存症に対しカテーテル閉鎖術を行った一例

    上岡亮, 木島康文, 中川晃志, 赤木禎治, 麻植浩樹, 杜徳尚, 河野晋久, 草野研吾, 伊藤浩

    日本循環器学会中国地方会(Web)   101st   2012年

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  • 重度右心不全により右左短絡を呈した心房中隔欠損症合併右室心筋症の一例

    中川晃志, 赤木禎治, 木島康文, 鈴木秀行, 永瀬聡, 河野晋久, 草野研吾, 佐野俊二, 伊藤浩

    日本循環器学会中国地方会(Web)   101st   2012年

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  • Real-time imaging for transcatheter closure of atrial septal defects

    Manabu Taniguchi, Teiji Akagi

    Interventional Cardiology   3 ( 6 )   679 - 694   2011年12月

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等  

    Nowadays transcatheter closure has become the standard treatment for an atrial septal defect (ASD). Since morphologic variation of ASD is common, imaging modalities with high diagnostic ability continue to be required. Meanwhile, experts are required to visualize high-quality images with advanced imaging modalities. Echocardiography plays a pivotal role in patient selection for treatment, recently introduced 3D echocardiography is a promising modality to provide comprehensible en face images of ASD, especially in patients with a complex-shaped ASD. In addition, cardiac MRI and computed tomography can provide complementary information. Transesophageal echocardiography and intracardiac echocardiography can provide images of excellent quality for guidance of the procedure. In this review, we discuss the role of imaging for transcatheter ASD closure, focusing on echocardiography. © 2011 Future Medicine Ltd.

    DOI: 10.2217/ica.11.73

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  • 小児心臓手術後にEXTRACORPOREAL MEMBRANE OXYGERNATIONを導入した80例の検討

    笠原真悟, 川畑拓也, 立石篤史, 藤田康文, 高垣昌巳, 新井禎彦, 赤木禎治, 佐野俊二

    日本小児循環器学会雑誌   27 ( Supplement )   S161   2011年6月

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  • 乳幼児僧帽弁閉鎖不全症に対する僧帽弁形成術の中期遠隔期成績の検討

    笠原真悟, 川畑拓也, 立石篤史, 藤田康文, 高垣昌巳, 新井禎彦, 赤木禎治, 岡本吉生, 大野直幹, 大月審一, 佐野俊二

    日本小児循環器学会雑誌   27 ( Supplement )   S119   2011年6月

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  • 本邦における Eisenmenger 症候群成人例の検討

    坂崎 尚徳, 丹羽 公一郎, 上野 倫彦, 高室 基樹, 中西 敏雄, 賀藤 均, 松島 正気, 小島 奈美子, 市田 蕗子, 小垣 滋豊, 城戸 佐知子, 新垣 義夫, 赤木 禎治, 城尾 邦隆, 須田 憲治, 中澤 誠, 佐地 勉

    日本小児循環器学会雑誌 = Acta cardiologica paediatrica Japonica   27 ( 3 )   121 - 131   2011年5月

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  • CATHETER CLOSURE OF ATRIAL SEPTAL DEFECT IN PATIENTS WITH MULTIPLE RIM DEFICIENCIES

    Yasufumi Kijima, Manabu Taniguchi, Koji Nakagawa, Kengo Kusano, Hiroshi Ito, Shunji Sano, Teiji Akagi

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   57 ( 14 )   E1683 - E1683   2011年4月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • IMPACT OF HYBRID APPROACH INVOLVING PULMONARY VEIN ISOLATION AND TRANSCATHETER DEVICE CLOSURE FOR PATIENTS WITH ATRIAL SEPTAL DEFECT HAVING PAROXYSMAL AND PERSISTENT ATRIAL FIBRILLATION

    Manabu Taniguchi, Satoshi Nagase, Teiji Akagi, Koji Nakagawa, Yasufumi Kijima, Yoshihito Hata, Kengo Kusano, Hiroshi Ito, Shunji Sano

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   57 ( 14 )   E1993 - E1993   2011年4月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • Wave intensityは、慢性心不全患者における運動耐容能の評価に有用である

    谷口 学, 菅原 基晃, 高谷 陽一, 草野 研吾, 伊藤 浩, 赤木 禎治

    超音波医学   38 ( Suppl. )   S266 - S266   2011年4月

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    記述言語:日本語   出版者・発行元:(公社)日本超音波医学会  

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  • Catheter Interventions for Kawasaki Disease: Current Concepts and Future Directions

    Teiji Akagi

    KOREAN CIRCULATION JOURNAL   41 ( 2 )   53 - 57   2011年2月

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元:KOREAN SOC CARDIOLOGY  

    During the past 15 years, clinical experience with catheter interventional treatment in patients with Kawasaki disease, including balloon angioplasty, stent implantation, rotational ablation, and transluminal coronary revascularization, has been gradually increasing. Because the coronary artery lesions in Kawasaki disease involve severe calcifications, the indications or catheter intervention techniques have not been established for adult patients with Kawasaki disease. Satisfactory acute results for coronary balloon angioplasty have been obtained in patients with a relatively short interval from the onset of disease, especially within 6 years; however, the incidence of restenosis after angioplasty is still high. Rotational ablation may be the most appropriate catheter intervention technique for patients with Kawasaki disease. The advantage of rotational ablation is the high success rate, even in patients with calcified coronary artery stenosis. Stent implantation requires larger arterial access and is not possible in younger children. Care should be paid to the detection of newly-formed aneurysms, as the formation of new aneurysms is associated with the use of additional balloon angioplasty using high pressure balloon inflation. Anticoagulation or anti-platelet regimens are essential for long-term management. Coronary intervention in Kawasaki disease requires special techniques and knowledge of cardiovascular involvement. The procedure should be managed under the close collaboration between pediatric cardiologists and coronary interventional cardiologists.

    DOI: 10.4070/kcj.2011.41.2.53

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  • 先天性心臓病をもつ子どもと学校教育:子どもから大人への橋渡しの重要性.

    赤木禎治

    教育と医学   59 ( 2 )   202 - 209   2011年

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    記述言語:日本語   出版者・発行元:慶應義塾大学出版会  

    CiNii Article

    CiNii Books

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    その他リンク: http://search.jamas.or.jp/link/ui/2011140369

  • カテーテル的心房中隔欠損閉鎖術:治療の実際.

    赤木禎治

    心エコー   12 ( 6 )   490 - 501   2011年

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  • 心房細動と先天性心疾患.

    赤木禎治

    成人病と生活習慣病   41 ( 8 )   927 - 932   2011年

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  • 本邦におけるEisenmenger症候群成人例の検討.

    坂崎尚徳, 丹羽公一郎, 上野倫彦, 高室基樹, 中西敏雄, 賀藤 均, 松島正氣, 小島奈美子, 市田蕗子, 小垣滋豊, 城戸佐知子, 新垣義夫, 赤木禎治, 城尾邦隆, 須田憲治, 中澤 誠, 佐地 勉

    日本小児循環器学会雑誌   27 ( 1 )   13 - 23   2011年

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  • 成人期心房中隔欠損に対するカテーテル閉鎖術と外科的閉鎖術の臨床成績比較:単一施設における後方視的非ランダマイズ化検討.

    藤井泰宏, 赤木禎治, 谷口 学, 中川晃志, 木島康文, 大月審一, 富井奉子, 岩崎達雄, 五藤恵次, 戸田雄一郎, 岡本吉生, 新井禎彦, 笠原真悟, 佐野俊二

    日本小児循環器学会雑誌   27 ( 1 )   23 - 30   2011年

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  • 奇異性脳塞栓合併卵円孔開存症に対するカテーテル閉鎖術により片頭痛が改善した一例

    木島康文, 赤木禎治, 谷口学, 中川晃志, 渡邊修久, 草野研吾, 佐野俊二, 伊藤浩

    日本循環器学会中国地方会(Web)   99th   2011年

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  • Amplatzer Cribriformによる卵円孔カテーテル閉鎖術:奇異性脳梗塞再発予防のための新しい治療戦略

    木島康文, 赤木禎治, 谷口学, 中川晃志, 富井靖子, 出口健太郎, 草野研吾, 佐野俊二, 伊藤浩

    日本循環器学会中国地方会(Web)   98th   2011年

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  • Matrix metalloproteinase haplotypes associated with coronary artery aneurysm formation in patients with Kawasaki disease

    Chisato Shimizu, Tomoyo Matsubara, Yoshihiro Onouchi, Sonia Jain, Shelly Sun, Caroline M. Nievergelt, Hiroko Shike, Victoria H. Brophy, Tsuyoshi Takegawa, Susumu Furukawa, Teiji Akagi, Jane W. Newburger, Annette L. Baker, David Burgner, Martin L. Hibberd, Sonia Davila, Michael Levin, Manju Mamtani, Weijing He, Sunil K. Ahuja, Jane C. Burns

    JOURNAL OF HUMAN GENETICS   55 ( 12 )   779 - 784   2010年12月

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    記述言語:英語   出版者・発行元:NATURE PUBLISHING GROUP  

    Aneurysms of the vascular wall represent a final common pathway for a number of inflammatory processes, including atherosclerosis and idiopathic vasculitis syndromes. Kawasaki disease (KD) is an acute, self-limited vasculitis in children and the leading cause of acquired coronary artery aneurysms. We sought to identify shared molecular mechanisms of aneurysm formation by genotyping eight polymorphisms in matrix metalloproteinase (MMP)-1, 3, 7, 12 and 13 in the gene cluster on Chr.11q22, whose gene products have been implicated in aneurysm formation or are known to have elastase activity. We genotyped 482 US-UK KD patients (aneurysm+: n=111, aneurysm : n=371) and tested our findings in an independent cohort of 200 Japanese KD patients (aneurysm+: n=58, aneurysm-: n=142). Analysis of the five MMP genes identified modest trends in allele and genotype frequencies for MMP-3 rs3025058 (-/T) and haplotypes containing MMP-3 rs3025058 (-/T) and MMP-12 rs2276109 (A/G) (nominal P=2 to 4x10(-5)) that conferred increased risk of aneurysm formation in US-UK subjects. This finding was validated in Japanese subjects and suggests the importance of this locus in aneurysm formation in children with KD. The region encompassing these risk haplotypes is a prime candidate for resequencing to look for rare genetic variation that may influence aneurysm formation. Journal of Human Genetics (2010) 55, 779-784; doi:10.1038/jhg.2010.109; published online 9 September 2010

    DOI: 10.1038/jhg.2010.109

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  • Torn Atrial Septum during Transcatheter Closure of Atrial Septal Defect Visualized by Real-Time Three-Dimensional Transesophageal Echocardiography

    Yasufumi Kijima, Manabu Taniguchi, Teiji Akagi, Koji Nakagawa, Kengo Kusano, Hiroshi Ito, Shunji Sano

    JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY   23 ( 11 )   e5-e8   2010年11月

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    記述言語:英語   出版者・発行元:MOSBY-ELSEVIER  

    Transcatheter closure of atrial septal defects (ASDs) has become an accepted and reliable procedure. Although various complications have been recognized, tear of the atrial septal rim is a rare complication. We report a case of atrial septal rim tear that was diagnosed during the procedure by real-time three-dimensional transesophageal echocardiography (TEE). The device was successfully implanted 3 months after the initial intervention. RT3D TEE is more useful for displaying the entire shape of the defect and its spatial relationship (RT3D) with its neighboring structures compared with conventional two-dimensional echocardiography. By using both two-dimensional and RT3D TEE images, especially in cases with complicated ASD morphology, both the echocardiologist and interventionalist gain valuable information on the morphology of the ASD before and during the procedure. (J Am Soc Echocardiogr 2010; 23: 1222.e5-1222.e8.)

    DOI: 10.1016/j.echo.2010.04.004

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  • Predictors of Mortality and the Effect of Disease Specific Therapy on Survival in Adult Patients With Eisenmenger Syndrome

    Hisanori Sakazaki, Koichiro Niwa, Heung Lee, Makoto Nakazawa, Tsutomu Saji, Toshio Nakanishi, Teiji Akagi, Michihiko Ueno, Motoki Takamuro, Fukiko Ichida, Namiko Kojima, Hitoshi Kato, Masaki Matsushima, Shigetoyo Kogaki, Sachiko Kido, Yoshio Aragaki, Kunitaka Joo, Kenji Suda

    CIRCULATION   122 ( 21 )   2010年11月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Association of CCR2-CCR5 Haplotypes and CCL3L1 Copy Number with Kawasaki Disease, Coronary Artery Lesions, and IVIG Responses in Japanese Children

    Manju Mamtani, Tomoyo Matsubara, Chisato Shimizu, Susumu Furukawa, Teiji Akagi, Yoshihiro Onouchi, Akira Hata, Akihiro Fujino, Weijing He, Sunil K. Ahuja, Jane C. Burns

    PLOS ONE   5 ( 7 )   e11458-e11458   2010年7月

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    記述言語:英語   出版者・発行元:PUBLIC LIBRARY SCIENCE  

    Background: The etiology of Kawasaki Disease (KD) is enigmatic, although an infectious cause is suspected. Polymorphisms in CC chemokine receptor 5 (CCR5) and/or its potent ligand CCL3L1 influence KD susceptibility in US, European and Korean populations. However, the influence of these variations on KD susceptibility, coronary artery lesions (CAL) and response to intravenous immunoglobulin (IVIG) in Japanese children, who have the highest incidence of KD, is unknown.
    Methodology/Principal Findings: We used unconditional logistic regression analyses to determine the associations of the copy number of the CCL3L1 gene-containing duplication and CCR2-CCR5 haplotypes in 133 Japanese KD cases [33 with CAL and 25 with resistance to IVIG] and 312 Japanese controls without a history of KD. We observed that the deviation from the population average of four CCL3L1 copies (i.e., or. four copies) was associated with an increased risk of KD and IVIG resistance (adjusted odds ratio (OR) = 2.25, p = 0.004 and OR = 6.26, p = 0.089, respectively). Heterozygosity for the CCR5 HHF*2 haplotype was associated with a reduced risk of both IVIG resistance (OR = 0.21, p = 0.026) and CAL development (OR = 0.44, p = 0.071).
    Conclusions/Significance: The CCL3L1-CCR5 axis may play an important role in KD pathogenesis. In addition to clinical and laboratory parameters, genetic markers may also predict risk of CAL and resistance to IVIG.

    DOI: 10.1371/journal.pone.0011458

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  • d‐TGAに対するarterial switch operationの遠隔期成績

    櫻井茂, 笠原真悟, 宮原義典, 高垣昌巳, 新井禎彦, 赤木禎治, 大月審也, 佐野俊二

    日本小児循環器学会雑誌   26 ( Supplement )   S257   2010年6月

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    記述言語:日本語  

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  • 経カテーテル的ASD閉鎖術(ASO)に対する3次元経食道エコー(RT3DTEE)の限界

    岡本 吉生, 大月 審一, 谷口 学, 赤木 禎治, 大野 直幹, 近藤 麻衣子, 栄徳 隆裕, 岩崎 達雄, 戸田 雄一郎, 清水 一好, 佐野 俊二

    日本小児循環器学会雑誌   26 ( Suppl. )   s326 - s326   2010年6月

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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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  • 奇異性脳塞栓症に対して経皮的中隔閉鎖デバイス(Amplazer)による閉鎖術後に頭痛が改善した一例

    河野 祥一郎, 出口 健太郎, 名古谷 章子, 倉田 智子, 太田 康之, 池田 佳生, 松浦 徹, 阿部 康二, 伊藤 浩, 赤木 禎治

    Neurosonology   23 ( 増刊 )   67 - 67   2010年6月

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    記述言語:日本語   出版者・発行元:(一社)日本脳神経超音波学会  

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  • intramural coronary arteryを呈したd‐TGAに対するarterial switch operationの検討

    櫻井茂, 笠原真悟, 高垣昌巳, 新井貞彦, 三井秀也, 赤木禎治, 佐野俊二

    日本心臓血管外科学会雑誌   39 ( Supplement )   312   2010年1月

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    記述言語:日本語  

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  • Diagnosis-Based Differences in Response of Global Ventricular Performance to Modified Ultrafiltration in Children

    Osami Honjo, Satoru Osaki, Yasuhiro Kotani, Teiji Akagi, Shunji Sano

    CIRCULATION JOURNAL   74 ( 1 )   86 - 92   2010年1月

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    記述言語:英語   出版者・発行元:JAPANESE CIRCULATION SOC  

    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&lt;0.05). MUF resulted in an improvement in MPI in all groups (P&lt;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&lt;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)

    DOI: 10.1253/circj.CJ-09-0248

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  • PICS~AICS2010に参加して

    赤木禎治

    JPIC News Letter   2219 - 2222   2010年

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  • 企画にあたって 特集「弁膜症と先天性心疾患の非外科的治療」

    赤木禎治

    Heart View   12   6 - 7   2010年

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  • 症例に基づいた非外科治療の進め方「成人期の心房中隔欠損症に対するカテーテル治療」

    中川晃志, 赤木禎治

    Heart View   12   76 - 83   2010年

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  • 経カテーテル的心房中隔欠損閉鎖術の術前評価における経胸壁心エコー図による多孔型症例診断についての検討

    逢坂大樹, 谷口学, 赤木禎治, 渡辺修久, 田辺康治, 武本梨佳, 佐野俊二

    日本心エコー図学会学術集会抄録集   21st   2010年

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  • 経カテーテル的閉鎖術前の心房中隔欠損形態評価における右側胸壁アプローチの有用性

    渡辺修久, 谷口学, 赤木禎治, 田辺康治, 逢坂大樹, 武本梨佳, 杜徳尚, 草野研吾, 伊藤浩, 小出典男, 佐野俊二

    日本心エコー図学会学術集会抄録集   21st   2010年

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  • Application of Real-Time Three-Dimensional Transesophageal Echocardiography Using a Matrix Array Probe for Transcatheter Closure of Atrial Septal Defect

    Manabu Taniguchi, Teiji Akagi, Nobuhisa Watanabe, Yoshio Okamoto, Koji Nakagawa, Yasufumi Kijima, Norihisa Toh, Shinichi Ohtsuki, Kengo Kusano, Shunji Sano

    JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY   22 ( 10 )   1114 - 1120   2009年10月

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元:MOSBY-ELSEVIER  

    Background: The aim of this study was to demonstrate the utility of real-time three-dimensional (3D) transesophageal echocardiography (RT3D-TEE) using a matrix array 3D transesophageal echocardiographic probe for morphologic evaluation and guidance of transcatheter closure of atrial septal defects (ASDs).
    Methods: Forty-eight consecutive patients scheduled for the intervention were included. Two-dimensional (2D) transesophageal echocardiography (2D-TEE) and RT3D-TEE were performed before and during the procedures. Measurements of maximal ASD diameter and surrounding rims obtained on RT3D-TEE were compared with those obtained on 2D-TEE.
    Results: In 46 patients (96%), optimal 3D images for the morphologic evaluation of ASDs were obtained. RT3D-TEE facilitated the evaluation of ASD morphology and surrounding rims and was able to provide intra-procedural information clearly. A Bland-Altman plot showed a mean maximal diameter difference of -0.12 mm between the means (95% limits of agreement, -2.2 to 2.5 mm).
    Conclusion: RT3D-TEE is a clinically useful, complementary option to 2D-TEE for evaluation of ASD morphology and for interventional guidance. (J Am Soc Echocardiogr 2009; 22: 1114-20.)

    DOI: 10.1016/j.echo.2009.06.008

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  • Biventricular repairに到達したright isomerismの1例

    櫻井茂, 笠原真悟, 井上陽一, 高垣昌巳, 新井禎彦, 赤木禎治, 佐野俊二

    日本小児循環器学会雑誌   25 ( 5 )   713   2009年9月

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    記述言語:日本語  

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  • 右側胸壁アプローチを含めた経胸壁心エコー図による心房中隔欠損の形態評価

    渡辺 修久, 谷口 学, 赤木 禎治, 田辺 康治, 杜 徳尚, 草野 研吾, 小出 典男, 伊藤 浩, 佐野 俊二

    日本心臓病学会誌   4 ( Suppl.I )   431 - 431   2009年8月

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    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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  • Large atrial septal defect visualized by real-time three-dimensional echocardiography

    Nobuhisa Watanabe, Manabu Taniguchi, Teiji Akagi, Takeshi Maruo, Yasuharu Tanabe, Shingo Kasahara, Kengo Kusano, Norio Koide, Shunji Sano

    Journal of Echocardiography   7 ( 2 )   39 - 40   2009年6月

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  • 単心室患者における体循環流出路狭窄のmanagement―予防的Damns‐Kaye‐Stansel吻合は有用か?―

    藤井泰宏, 井上陽一, 高垣昌巳, 新井禎彦, 笠原真悟, 赤木禎治, 小谷恭弘, 大野直幹, 岡本吉生, 大月審一, 佐野俊二

    日本小児循環器学会雑誌   25 ( 3 )   421   2009年5月

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  • 右室-冠動脈瘻を伴った純型肺動脈閉鎖症に対する新術式 右室減圧を伴ったFontan手術

    川畑 拓也, 笠原 真悟, 新井 禎彦, 赤木 禎治, 宮原 義典, 小谷 恭弘, 佐野 俊二

    日本小児循環器学会雑誌   25 ( 3 )   557 - 557   2009年5月

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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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  • 15歳未満小児ASD症例に対するカテーテル治療の限界

    岡本 吉生, 大月 審一, 大野 直幹, 近藤 麻衣子, 栗田 佳彦, 栄徳 隆裕, 森島 恒雄, 赤木 禎治, 谷口 学, 佐野 俊二, 岩崎 達雄

    日本小児循環器学会雑誌   25 ( 3 )   395 - 395   2009年5月

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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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  • 多発性心房中隔欠損症に対するカテーテル閉鎖術 デバイス選択と閉鎖手技に関する検討

    赤木 禎治, 谷口 学, 大月 審一, 岡本 吉生, 笠原 真悟, 藤井 泰宏, 川畑 拓也, 富井 奉子, 岩崎 達雄, 戸田 雄一郎, 佐野 俊二

    日本小児循環器学会雑誌   25 ( 3 )   395 - 395   2009年5月

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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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  • 奇異な臨床経過をたどった腹部大動脈腫瘍(MFH)の一例:過去の報告例の検討

    櫻井茂, 三井秀也, 井上陽一, 高垣昌巳, 新井禎彦, 笠原真悟, 赤木禎治, 佐野俊二

    日本血管外科学会雑誌   18 ( 2 )   375   2009年4月

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  • Continuous Epoprostenol Therapy and Septal Defect Closure in a Patient With Severe Pulmonary Hypertension

    Aki Hirabayashi, Katsumasa Miyaji, Teiji Akagi

    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS   73 ( 5 )   688 - 691   2009年4月

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    記述言語:英語   出版者・発行元:WILEY-LISS  

    A 31-year-old woman with exertional dyspnea diagnosed as having atrial septal defect (ASD) with severe pulmonary hypertension (PH). Intravenous epoprostenol therapy was started to improve PH. Although pulmonary arterial pressure decreased, her symptoms remained in class III of WHO functional class, probably because of exacerbation of the left-to-right shunt caused by the reduction of pulmonary vascular resistance (PVR). Transcatheter atrial septal closure was therefore performed. Soon after the procedure, additional reduction in pulmonary arterial pressure was achieved. Her symptoms improved and oxygen inhalation was discontinued. One year after the procedure, although intravenous epoprostenol was still required, her symptoms had improved to class I of WHO functional class without exacerbation of PH. Transcatheter atrial septal closure after lowering PVR by intravenous epoprostenol would be a novel therapy for patients with ASD accompanied by PH. (C) 2009 Wiley-Liss, Inc.

    DOI: 10.1002/ccd.21877

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  • Transcatheter Closure of Atrial Septal Defect in Elderly Patients With Permanent Atrial Fibrillation

    Manabu Taniguchi, Teiji Akagi, Shinichi Ohtsuki, Yoshio Okamoto, Yasuharu Tanabe, Nobuhisa Watanabe, Koji Nakagawa, Norihisa Toh, Kengo Kusano, Shunji Sano

    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS   73 ( 5 )   682 - 686   2009年4月

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    記述言語:英語   出版者・発行元:WILEY-LISS  

    Objectives: The aim of this study is to evaluate the feasibility and efficacy of device closure of atrial septal defect (ASD) in elderly patients with permanent atrial fibrillation. Background: Little is known about the feasibility of device closure of ASD in those patients. Methods: Nine consecutive patients (mean age 68.1 years) with permanent atrial fibrillation (&gt;1 year persistent) underwent catheter closure using the Amplatzer septal occluder. Transthoracic echocardiography and plasma B-type natriuretic peptide (BNP) level were assessed before and at 24 hours; and 1, 3, and &gt;6 months after the closure. Before the procedure, appropriate dose of warfarin was used in all, diuretics was used in 8/9. Same amount of medications were continued after the procedure. Results: ASD could be closed in all (mean device size 27.3 mm) without hemodynamic and thromboembolic complications. New York Heart Association (NYHA) functional classification was significantly improved in all patients after device closure. No hemodynamic and thromboembolic complications were observed during the follow-up period (mean 10.6 months). Although permanent atrial fibrillation did not change in all after the procedure, resting heart rate decreased from 76.2 +/- 16.0 to 68.3 +/- 13.2 beats/min (P = 0.015). There was statistically significant improvement in right ventricular/left ventricular diameter ratio (1.08 +/- 0.16 to 0.73 +/- 0.10, P = 0.008) and plasma BNP level (183.7 +/- 90.5 to 94.6 +/- 47.4 pg/mL, P = 0.008) after &gt;6 months device closure. Conclusions: Even in the patients complicated with permanent fibrillation, transcatheter closure of ASD can contribute to symptomatic improvement as well as cardiac geometric remodeling. (C) 2009 Wiley-Liss, Inc.

    DOI: 10.1002/ccd.21870

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  • 肺動脈の圧排により左冠動脈主幹部に高度の狭窄を認めた心房中隔欠損症、肺高血圧症の1例

    尾上 豪, 柚木 佳, 福家 聡一郎, 西井 伸洋, 永瀬 聡, 幡 芳樹, 中村 一文, 森田 宏, 草野 研吾, 赤木 禎治, 立野 博也

    Circulation Journal   73 ( Suppl.II )   975 - 975   2009年4月

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  • 心臓病合併妊娠に対するリスク評価-循環動態の変化と心疾患の関連.

    赤木禎治

    心臓   41 ( 4 )   378 - 382   2009年

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    記述言語:日本語   出版者・発行元:Japan Heart Foundation  

    DOI: 10.11281/shinzo.41.378

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  • PICS, AICS2009ライブデモンストレーションを実施して.

    赤木禎治

    JPIC News Letter   17   16 - 18   2009年

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  • Midterm to Long-term Outcome of Total Cavopulmonary Connection in High-Risk Adult Candidates.

    Fujii Y, Sano S, Kotani Y, Yoshizumi K, Kasahara S, Ishino K, Akagi T

    Annals of Thoracic Surgery   87 ( 2 )   562 - 570   2009年

  • Clinical outcome of the Fontan operation in patients with impaired ventricular function.

    Kotani Y, Kasahara S, Fujii Y, Yoshizumi K, Oshima Y, Otsuki S, Akagi T, Sano S

    European Journal of Cardio-Thoracic Surgery   36 ( 4 )   683 - 687   2009年

  • 7歳未満の乳幼児僧帽弁閉鎖不全症に対する僧帽弁形成術の検討.

    大島 祐, 笠原真悟, 吉積 功, 赤木禎治, 大野直幹, 岡本吉生, 大月審一, 佐野俊二

    日本小児循環器学会雑誌   25 ( 6 )   44 - 49   2009年

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  • 周囲縁欠損例に対する経カテーテル的心房中隔欠損閉鎖術についての検討

    谷口学, 赤木禎治, 中川晃志, 木島康文, 草野研吾, 伊藤浩, 佐野俊二

    日本循環器学会中国地方会(Web)   95th   2009年

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  • 59) 三心房心の3症例(第92回日本循環器学会中国・四国合同地方会)

    森下 陽子, 谷口 学, 杜 徳尚, 赤木 禎治, 草野 研吾, 大江 透, 田辺 康治, 渡辺 修久

    Circulation journal : official journal of the Japanese Circulation Society   72 ( Suppl.III )   1035 - 1035   2008年10月

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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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  • Clinical outcome of Fontan operation in the patients with impaired cardiac function

    Yasuhiro Kotani, Shingo Kasahara, Yasuhiro Fujii, Ko Yoshizumi, Yu Oshima, Shin-Ichi Otsuki, Teiji Akagi, Shunji Sano

    JOURNAL OF CARDIAC FAILURE   14 ( 7 )   S151 - S151   2008年9月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS  

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  • 成人における経カテーテルASD閉鎖術の術前心エコー図評価における技師の役割

    渡辺 修久, 谷口 学, 赤木 禎治, 田辺 康治, 杜 徳尚, 草野 研吾, 小出 典男, 佐野 俊二, 大江 透

    日本心臓病学会誌   2 ( Suppl.I )   198 - 198   2008年8月

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    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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  • 成人期に診断された左房性三心房心の6症例

    森下 陽子, 谷口 学, 杜 徳尚, 渡辺 修久, 田辺 康治, 赤木 禎治, 草野 研吾, 大江 透

    日本心臓病学会誌   2 ( Suppl.I )   557 - 557   2008年8月

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    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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  • 小児重症患者のスコアリングシステムの小児先天性心疾患患者でのvalidation PIM,PRISM,PELODを用いて

    戸田 雄一郎, 岩崎 達雄, 清水 一好, 金澤 伴幸, 森田 潔, 鈴木 聡, 赤木 禎治, 佐野 俊二, 笠原 真悟, 大月 審一, 岡本 吉生

    日本小児循環器学会雑誌   24 ( 3 )   293 - 293   2008年5月

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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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  • ファロー四徴症根治術において、肺動脈弁輪はどこまで温存可能か? 肺動脈弁輪温存術式の適応と遠隔成績

    小谷 恭弘, 笠原 真悟, 藤井 泰宏, 大島 祐, 吉積 功, 大月 審一, 赤木 禎治, 佐野 俊二

    日本小児循環器学会雑誌   24 ( 3 )   329 - 329   2008年5月

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  • Blunt cardiac rupture in a patient with a history of total correction of tetralogy of Fallot

    Yasuhiro Fujii, Teiji Akagi, Shingo Kasahara, Hideya Mitsui, Kozo Ishino, Shunji Sano

    General Thoracic and Cardiovascular Surgery   56 ( 3 )   134 - 136   2008年3月

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    記述言語:英語  

    A 35-year-old man with a history of total correction of tetralogy of Fallot (TOF) fell down while riding a bike and experienced blunt cardiac rupture. His vital signs were stable because the bleeding was limited by an adhesion caused by the previous operation. Chest computed tomography clearly displayed the ruptured points, and an emergency operation was performed. Because a pneumothorax was suspected, a cardiopulmonary bypass was established with a femorofemoral bypass while the patient was conscious before artificial ventilation was initiated. Two ruptured points were detected on the anterior wall of the right ventricle and were repaired by suturing. The patient recovered and was discharged without any major complications 40 days after the operation. This is the first published case of blunt cardiac rupture after total correction of TOF. © 2008 The Japanese Association for Thoracic Surgery.

    DOI: 10.1007/s11748-007-0206-7

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  • Difference of cardiac remodeling after transcatheter closure of atrial septal defect between pediatric and adult patients

    Teiji Akagi, Manabu Taniguchi, Shin-ich Otsuki, Yoshio Okamoto, Yoshio Okamoto, Kengo Kusano, Shunji Sano

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   51 ( 10 )   B22 - B22   2008年3月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • 四肢のみかた.心血管疾患診療のエクセレンス.

    赤木禎治

    日本医師会雑誌   137   44 - 45   2008年

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  • 動脈スイッチ術後肺動脈狭窄に対するカテーテル治療の問題点:術者が認識しておくべきことは?.

    赤木禎治

    日本小児循環器学会雑誌   24   145 - 146   2008年

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  • 川崎病心臓血管後遺症の診断と治療に関するガイドライン(2008 年改訂版)

    小川俊一, 赤木禎治, 石井正浩, 唐澤賢祐, 佐地 勉, 鈴木淳子, 薗部友良, 馬場 清, 濵岡建城, 藤原久義, 鮎沢 衛, 岡田知雄, 荻野 廣太郎, 西垣和彦, 深澤隆治

    Circulation Journal   電子版   2008年

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  • 慢性心房細動を合併する心房中隔欠損症における経カテーテル的閉鎖術前後の形態的変化

    谷口学, 赤木禎治, 田辺康治, 渡辺修久, 杜徳尚, 大月審一, 岡本吉生, 草野研吾, 佐野俊二, 大江透

    Circulation Journal   72 ( Supplement 2 )   2008年

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  • 奇異性脳塞栓症再発予防を目的とした心房レベル右左短絡に対するカテーテル閉鎖術の初期成績

    中川晃志, 谷口学, 赤木禎治, 草野研吾, 大月審一, 岡本吉生, 佐野俊二, 大江透

    Circulation Journal   72 ( Supplement 3 )   2008年

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  • 経カテーテル的心房中隔欠損閉鎖術におけるReal-time 3D経食道心エコー図の役割

    谷口学, 赤木禎治, 岡本吉生, 大月審一, 草野研吾, 佐野俊二, 大江透

    日本心臓病学会誌   2 ( Supplement 1 )   2008年

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  • Clinical implication of early ventricular volume reduction for hypoplastic left heart syndrome with significant tricuspid valve regurgitation

    Yasuhiro Kotani, Teiji Akagi, Shingo Kasahara, Ko Yoshizumi, Yu Ohshima, Shunji Sano

    INTERNATIONAL JOURNAL OF CARDIOLOGY   122   73 - 73   2007年12月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER IRELAND LTD  

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  • 先天性心疾患術後遠隔期の管理・侵襲的治療に関するガイドライン(ダイジェスト版,循環器病の診断と治療に関するガイドライン(2005-2006年度合同研究班報告))

    越後 茂之, 角 秀秋, 富田 英, 中澤 誠, 丹羽 公一郎, 松田 暉, 村上 新, 八木原 俊克, 市川 肇, 大内 秀雄, 黒嵜 健一, 白石 修一, 立野 滋, 竹内 功, 中村 真, 山田 修, 山村 英司, 赤木 禎治, 原田 研介, 安井 久喬, 山口 徹

    Circulation journal : official journal of the Japanese Circulation Society   71   1191 - 1203   2007年11月

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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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  • 96)中年成人心房中隔欠損症における経カテーテル的閉鎖術後の経時的リモデリングについての検討(第90回日本循環器学会中国・四国合同地方会)

    谷口 学, 赤木 禎治, 丸尾 健, 田辺 康治, 渡辺 修久, 草野 研吾, 佐野 俊二, 大江 透

    Circulation journal : official journal of the Japanese Circulation Society   71 ( Suppl.III )   967 - 967   2007年10月

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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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  • Predictive factors for long-term prognosis in adults with cyanotic congenital heart disease – Japanese multi-center study.

    Sakazaki H, Niwa K, Echigo S, Akagi T, Nakazawa M

    Int J Cardiol   120 ( 1 )   72 - 78   2007年8月

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  • 経カテーテル的心房中隔欠損閉鎖術後におけるBNP上昇の予測 Wave intensityによる検討

    谷口 学, 丸尾 健, 赤木 禎治, 渡辺 修久, 田辺 康治, 草野 研吾, 佐野 俊二, 大江 透

    Journal of Cardiology   50 ( Suppl.I )   379 - 379   2007年8月

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    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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  • Differences in right and left ventricular remodeling after transcatheter closure of atrial septal defect among adults

    En-Ting Wu, Teiji Akagi, Manabu Taniguchi, Takeshi Maruo, Satoru Sakuragi, Shinichi Otsuki, Yoshio Okamoto, Shunji Sano

    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS   69 ( 6 )   866 - 871   2007年5月

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    記述言語:英語   出版者・発行元:WILEY-LISS  

    Objectives: To evaluate acute cardiac remodeling after transcatheter closure of atrial septal defect (ASD) in adult patients.
    Background: In adult patients with ASD, longer periods of cardiac adaptation should be expected after the procedure due to long-standing RV volume overload and subsequent changes in the pulmonary vasculature. There are limited reports about this remodeling in adult patients.
    Methods: We prospectively enrolled 17 adults (mean age 58.4 +/- 17.3 years) who underwent successful transcatheter closure of their ASDs from August 2005 to July 2006. We performed routine transthoracic echocardiographic studies, including LV and RV myocardial performance indices, or Tei indices, and plasma brain natriuretic peptide (BNP) sampling before closure of the ASD, and I day, I month, and 3 months after closure.
    Results: We found (1) LV end diastolic diameter increased, and RVEDD decreased markedly after the closure; (2) differences existed in LV and RV adaptation. While LV Tei index improved soon after the procedure, RV Tei index worsened until 1 month after the procedure, then recovered by the 3 month follow-up visit; and (3) BNP elevated 1 day after closure of the ASD and declined by the 1-month follow-up visit.
    Conclusion: '' Shrinkage '' of the RV and '' expansion '' of the LV occurred soon after the procedure, even in elderly patients. Device closure of ASDs caused rapid improvement of LV function, but RV function underwent transient deterioration, probably due to delayed changes in RV ventricular mass in the face of acute volume reduction in this aged cohort. (c) 2006 Wiley-Liss, Inc.

    DOI: 10.1002/ccd.21075

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  • 経右房-経肺動脈アプローチによるファロー四徴症根治術の遠隔成績

    小谷 恭弘, 笠原 真悟, 石野 幸三, 吉積 功, 大月 審一, 赤木 禎治, 佐野 俊二

    日本小児循環器学会雑誌   23 ( 3 )   262 - 262   2007年5月

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  • Left ventricular retraining and anatomic correction in teenage patient with congenitally corrected transposition of the great arteries

    Osami Honjo, Masaaki Kawada, Teiji Akagi, Yasuhiro Kotani, Kozo Ishino, Shunji Sano

    CIRCULATION JOURNAL   71 ( 4 )   613 - 616   2007年4月

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    記述言語:英語   出版者・発行元:JAPANESE CIRCULATION SOCIETY  

    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 (33/4mm 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.

    DOI: 10.1253/circj.71.613

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  • Ventricular wall motion abnormality after right ventricle to pulmonary artery shunt does not cause hemodynamic impairment in patients with hypoplastic left heart syndrome

    Shinichi Otsuki, Teiji Akagi, Yoshio Okamoto, Kouzou Ishino, Shingo Kasahara, Shunji Sano

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   49 ( 9 )   270A - 270A   2007年3月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • 心室-大血管の再建術 左心低形成症候群 Norwood手術による大動脈弓部再建術の検討

    吉積 功, 笠原 真悟, 小谷 恭弘, 石野 幸三, 泉本 浩史, 三井 秀也, 岡本 吉生, 大月 審一, 赤木 禎治, 佐野 俊二

    日本心臓血管外科学会雑誌   36 ( Suppl. )   151 - 151   2007年1月

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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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  • 心房中隔欠損症に対するカテーテル治療.

    赤木禎治, 大月審一, 岡本吉生

    小児内科   2007;39:901-903   2007年

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  • 心房中隔欠損症に対するカテーテル治療:海外における成績と問題点.

    赤木禎治

    小児科診療   2007;70:231-237   2007年

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  • 成人期に達した川崎病:循環器内科医が知っておくべきこと(editorial comment).

    赤木禎治

    心臓   2007;39:475-476   2007年

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  • 心房中隔欠損症に対するカテーテル治療.

    赤木禎治, 大月審一, 岡本吉生

    小児内科   2007;39:901-903   2007年

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  • 先天性心疾患術後遠隔期の管理・侵襲的治療に関するガイドライン

    越後茂之, 角 秀秋, 富田 英, 中澤 誠, 丹羽公一郎, 松田 暉, 八木原俊克, 赤木禎治

    Circulation Journal   71suppl IV   1115 - 1204   2007年

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  • 心房中隔欠損症に対するカテーテル治療:海外における成績と問題点.

    赤木禎治

    小児科診療   2007;70:231-237   2007年

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  • 成人期に達した川崎病:循環器内科医が知っておくべきこと(editorial comment).

    赤木禎治

    心臓   2007;39:475-476   2007年

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  • 再発性心原性脳梗塞に対し経カテーテル的閉鎖術を施行した一例

    赤木達, 谷口学, 赤木禎治, 丸尾健, 大月審一, 岡本吉生, 草野研吾, 佐野俊二, 大江透

    Circulation Journal   71 ( Supplement 3 )   2007年

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  • 心房中隔欠損症に対するAmplatzer Septal Occluderによる経カテーテル的閉鎖術の治療成績

    谷口学, 赤木禎治, 大月審一, 岡本吉生, 丸尾健, 田辺康治, 渡辺修久, 草野研吾, 佐野俊二, 大江透

    Circulation Journal   71 ( Supplement 3 )   2007年

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  • Discrepancy between intraoperative transesophageal echocardiography and postoperative transthoracic echocardiography in assessing congenital valve surgery

    Osami Honjo, Yasuhiro Kotani, Satoru Osaki, Yasufumi Fujita, Takanori Suezawa, Atsushi Tateishi, Kozo Ishino, Masaaki Kawada, Teiji Akagi, Shunji Sano

    ANNALS OF THORACIC SURGERY   82 ( 6 )   2240 - 2246   2006年12月

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

    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 &lt; 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 &lt; 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 &lt; 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.

    DOI: 10.1016/j.athoracsur.2006.06.073

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  • An 84-year-old patient with an atrial septal defect rescued using the Amplatzer septal occluder device

    Tetsuya Sato, Toru Hioka, Teiji Akagi

    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS   68 ( 5 )   758 - 762   2006年11月

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    記述言語:英語   出版者・発行元:WILEY-LISS  

    We report the case of a rescued 84-year-old patient with atrial septal defect (ASD) who was emergently admitted to our intensive care unit with progressive dyspnea requiring mechanical ventilation for severe anoxia and respiratory arrest. She had no history of congenital heart diseases. EGG and chest X-ray revealed overload of the right atrium and ventricle, and severe increase in pulmonary vascular markings. Transesophageal echocardiography showed a moderately large size ASD (18 x 23 mm(2)). Hemodynamic evaluation documented an increase in PA pressure of 37/16 mm Hg and Q(p)/Q(s) of 2.33. Her systemic condition did not improve following diuretics, cathecholamine, and afterload-reducing substances. She required mechanical ventilation for severe hypoxia. She underwent successful closure of the ASD using an Amplatzer septal occluder on day 17. Hemodynamics and findings on chest X-ray dramatically improved after this procedure. She was discharged from the hospital on foot. (C) 2006 Wiley-Liss, Inc.

    DOI: 10.1002/ccd.20822

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  • 機能的単心室に伴う三尖弁逆流の経時的変化 弁形成術回避の治療戦略としての早期BDG手術

    小谷 恭弘, 笠原 真悟, 石野 幸三, 吉積 功, 赤木 禎治, 大月 審一, 日置 里織, 河田 政明, 佐野 俊二

    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY   54 ( Suppl. )   337 - 337   2006年9月

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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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  • 経カテーテル的心房中隔欠損閉鎖術前後におけるWave intensityの変化

    谷口 学, 丸尾 健, 赤木 禎治, 田辺 康治, 渡辺 修久, 桜木 悟, 草野 研吾, 佐野 俊二, 大江 透

    Journal of Cardiology   48 ( Suppl.I )   608 - 608   2006年9月

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    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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  • 成人心房中隔欠損症に対するAmplatzer septal occluderによる治療前後のBNP変化 経胸壁心エコー図との比較

    谷口 学, 赤木 禎治, 丸尾 健, 田辺 康治, 渡辺 修久, 桜木 悟, 草野 研吾, 佐野 俊二, 大江 透

    Journal of Cardiology   48 ( Suppl.I )   344 - 344   2006年9月

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    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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  • Late outcome after repair of aortico-left ventricular tunnel - 10-year follow-up

    O Honjo, K Ishino, M Kawada, S Ohtsuki, T Akagi, S Sano

    CIRCULATION JOURNAL   70 ( 7 )   939 - 941   2006年7月

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    記述言語:英語   出版者・発行元:JAPANESE CIRCULATION SOCIETY  

    Despite successful surgical repair, patients with congenital aortico-left ventricular tunnel (ALVT) are at risk of developing aortic incompetence in the late postoperative period. Two cases of ALVT were followed for 10 years with special reference to aortic incompetence and geometry of the aortic root. The patients underwent repair of ALVT, one at 4 years of age and the other at 4 months of age. The first patient had a slit-like tunnel (type 1) and the aortic orifice was closed with a pericardial patch. The second patient had a large tunnel with an extracardiac aneurysm (type H) and was closed with a pericardial patch at the aortic orifice and a Dacron patch at the left ventricular orifice, thereby completely obliterating the tunnel. The last echocardiographic evaluation showed no residual flow in the tunnel and no aortic incompetence in case 1, but there was mild aortic valvular regurgitation with deformity of the right sinus in case 2. Careful long-term follow-up is necessary because patients with ALVT have some inherent structural abnormalities from the left ventricular outflow tract to the aortic root.

    DOI: 10.1253/circj.70.939

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  • Repair of a dysplastic tricuspid valve using artificial chordae: Case report

    O Honjo, K Ishino, K Yoshizumi, M Kawada, S Ohtsuki, T Akagi, S Sano

    JOURNAL OF HEART VALVE DISEASE   15 ( 3 )   392 - 393   2006年5月

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    記述言語:英語   出版者・発行元:I C R PUBLISHERS  

    Atrioventricular valve repair with artificial chordal replacement has been widely used for congenital and acquired mitral valve abnormalities, but not for tricuspid valve abnormalities. A case is presented of dysplastic tricuspid valve that was successfully repaired using artificial chordae. A 2-year-old female presented with poor weight gain. Echocardiography revealed severe tricuspid regurgitation due to dysplastic tricuspid valve, poor coaptation by prolapse of the anterior leaflet, and tethering of the septal leaflet by short chordae. The prolapsed anterior leaflet was repaired with three pairs of 6-0 expanded polytetrafluoroethylene sutures. The short chordae of the septal leaflet were detached, and the septal and posterior leaflets were sutured together. Trivial tricuspid regurgitation was noted postoperatively. There was no tricuspid regurgitation during the follow up period of three years. The present case provides further evidence that artificial chordal replacement is a useful technique even for small children with congenitally abnormal tricuspid valves.

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  • 成人Fallot四徴症の遠隔期心室機能とclinical status 再手術の与えた因子とは

    小谷 恭弘, 赤木 禎治, 本浄 修己, 板垣 晶子, 笠原 真悟, 石野 幸三, 河田 政明, 佐野 俊二

    日本小児循環器学会雑誌   22 ( 3 )   279 - 279   2006年5月

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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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  • Eisenmenger症候群に対する肺移植術後の、心臓の形態的及び機能的変化

    高橋 研, 笠原 真悟, 小谷 恭弘, 吉積 功, 三井 秀也, 神吉 和重, 石野 幸三, 赤木 禎治, 泉本 浩史, 河田 政明, 伊達 洋至, 佐野 俊二

    日本心臓血管外科学会雑誌   35 ( Suppl. )   234 - 234   2006年3月

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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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  • 心室細動にて発症し救命しえた川崎病の1例

    原岡 佳代, 伴場 主一, 中村 一文, 草野 研吾, 大江 透, 赤木 禎治, 佐野 俊二

    Progress in Medicine   26 ( 1 )   239 - 240   2006年1月

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    記述言語:日本語   出版者・発行元:(株)ライフ・サイエンス  

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  • 心房中隔欠損症,動脈管開存症

    赤木禎治, 大月審一

    Cardiovascular Med-Surg   8,9-13?   2006年

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  • チアノーゼ型先天性心疾患にみられる腎疾患の頻度,成因解析と診断,治療法の策定

    長嶋正實, 丹羽公一郎, 赤木禎治, 佐々木彰人, 篠原徳子, 越後茂之, 塚野慎也, 石澤 瞭, 寺井 勝, 長田道夫, 服部元史, 和田尚弘, 波多江 健, 飯島一誠, 上村 治, 牛鴬克己

    日本小児循環器学会雑誌   22 ( 2 )   130 - 133   2006年

  • 小児科クリニカルクラークシップにおけるクリニック実習・プライマリケア実習の教育効果

    赤木禎治, 吉田一郎, 藤野 浩, 石井正浩, 松石豊次郎

    日本小児科学会雑誌   2006年

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  • 成人の心室中隔欠損症

    赤木禎治

    日本医事新報   4308,93-95   2006年

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  • 心房中隔欠損症のカテーテル治療とは?

    赤木禎治

    季刊クリニック   536,16-17   2006年

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  • 心疾患患者の妊娠・出産の適応,管理に関するガイドライン.

    中澤 誠, 青見茂之, 赤木禎治, 笠貫 宏, 千葉喜英, 丹羽公一郎, 松岡瑠美子, 松田義雄, 宮武邦夫, 山口 厳

    Circulation Journal   69,suppl IV:1267-1328 ( 5 )   425 - 438   2006年

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  • 先天性心疾患の妊娠と出産

    赤木禎治

    小児の治療指針 小児科診療増刊号   69,suppl.352-354   2006年

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  • 先天性心疾患に対するカテーテル治療

    赤木禎治

    胸部外科   59,681-687   2006年

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  • 川崎病冠動脈病変に対するカテーテル治療の長期予後(第86回日本循環器学会中国地方会)

    赤木 禎治, 石野 幸三, 佐野 俊二

    Circulation journal : official journal of the Japanese Circulation Society   69   918 - 918   2005年10月

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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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  • Interventions in Kawasaki disease

    T Akagi

    PEDIATRIC CARDIOLOGY   26 ( 2 )   206 - 212   2005年3月

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    記述言語:英語   出版者・発行元:SPRINGER  

    During the past 10 years, the clinical experience of catheter interventional treatment in Kawasaki disease has gradually increased. These treatments include balloon angioplasty, stent implantation, rotational ablation, and transluminal coronary revascularization. Because coronary artery stenosis in Kawasaki disease commonly involves severe calcification, in contrast with adult atherosclerotic coronary artery lesions, the indication or technique of catheter intervention for adult patients cannot be directly determined. Satisfactory acute results for coronary balloon angioplasty were obtained in patients in a relatively short interval from the onset of disease, especially within 6 years. However, the incidence of restenosis after angioplasty was still high. Rotational ablation may be the most appropriate catheter intervention for Kawasaki disease. The advantage of rotational ablation is the high success rate, even in patients with calcified coronary artery stenosis. Stent implantation requires larger arterial access and is not possible in younger children. Care should be paid to the detection of new aneurysm formation because this was associated with the use of additional balloon angioplasty using high-pressure balloon inflation. Anticoagulation or antiplatelet regimens are essential for long-term management.

    DOI: 10.1007/s00246-004-0964-2

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  • 心房中隔欠損症

    赤木禎治, 大月審一

    循環器科   58,124-130   2005年

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  • 末梢肺動脈狭窄に対するステント留置術の到達点とは

    赤木禎治

    日本小児循環器学会雑誌   2005年

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  • 肺高血圧のために手術不能と判断された先天性心疾患-成人期の問題と管理-

    姫野和家子, 赤木禎治, 日高淑恵, 江上公康, 前野泰樹, 石井正浩, 松石豊次郎

    日本小児循環器学会雑誌   21 ( 1 )   2 - 7   2005年

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  • Long-term issues of coronary artery sequelae in Kawasaki disease

    Akagi T

    Congenital Heart Disease Today   6,1-4   2005年

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  • 小児の形態の年齢別変化(循環器領域)

    日置里織, 大月審一, 赤木禎治

    小児看護   28,415-421 ( 4 )   415 - 421   2005年

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    記述言語:日本語   出版者・発行元:へるす出版  

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    その他リンク: http://search.jamas.or.jp/link/ui/2005135449

  • 心疾患患者の妊娠・出産の適応,管理に関するガイドライン

    中澤 誠, 青見茂之, 赤木禎治, 笠貫 宏, 千葉喜英, 丹羽公一郎, 松岡瑠美子, 松田 義, 宮武邦夫, 山口 厳

    Circulation Journal   69,Suppl IV:1267-1328   1274 - 1278   2005年

  • ミトコンドリア脳筋症(MELAS)における血管内皮機能―flow mediatedvasodilatation(FMD)による検討―

    古井潤, 石井正浩, 牟田広実, 菅原洋子, 赤木禎治, 古賀靖敏

    日本小児循環器学会雑誌   20 ( 3 )   302   2004年5月

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    記述言語:日本語  

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  • OE-279 Coil Occlusion for Patent Ductus Arteriosus : Japanese Multicenter Experience from 2000 though 2002(Congenital Heart Disease/Kawasaki's Disease 1 (M) : OE35)(Oral Presentation (English))

    Akagi Teiji, Echigo Shigeyuki, Tomita Hideshi, Kobayashi Toshiki, Satomi Gengi, Ishizawa Akira, Nakanishi Toshio

    Circulation journal : official journal of the Japanese Circulation Society   68   208 - 208   2004年3月

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    記述言語:英語   出版者・発行元:社団法人日本循環器学会  

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  • Transcatheter coil embolization of a high-flow coronary artery fistula using 0.052-inch Gianturco coils - A case report

    E Tayama, T Akagi, T Shojima, H Tomoeda, T Takaseya, S Fukunaga, N Hayashida, S Aoyagi

    CIRCULATION JOURNAL   67 ( 12 )   1059 - 1060   2003年12月

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    記述言語:英語   出版者・発行元:BLACKWELL PUBLISHING ASIA  

    A giant, high-flow coronary fistula is usually difficult to treat by transcatheter coil embolization, but the 0.052-inch Gianturco coil, which is larger and has a stronger shape memory than conventional coils, is now available. Using this device and additional conventional coils, a high-flow coronary artery fistula in a healthy 31-year-old man was successfully embolized. The new Gianturco coil widens the indication for the transcatheter embolization of coronary artery fistulas.

    DOI: 10.1253/circj.67.1059

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  • Arrhythmia and conduction disturbances in patients with congenital heart disease during pregnancy - Multicenter study

    S Tateno, K Niwa, M Nakazawa, T Akagi, T Shinohara, T Yasuda

    CIRCULATION JOURNAL   67 ( 12 )   992 - 997   2003年12月

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    記述言語:英語   出版者・発行元:BLACKWELL PUBLISHING ASIA  

    The incidence, manifestation and management of arrhythmia in congenital heart disease (CHD) during pregnancy were evaluated in a multicenter study. Of 126 pregnancies in patients with CHD in 17 institutions from January 1991 to December 2000, 29 cases of pregnancy in 27 patients after cardiac repair (mean age, 29 +/- 4.9 years) were identified with arrhythmias (supraventricular tachyarrhythmia (SVT) in 15, ventricular tachycardia (VT) in 9, high-grade atrioventricular block in 4 and sick sinus syndrome in 3) (group A) and 29 control pregnancies from 29 patients with repaired CHD and no arrhythmias (group B). SVT tended to require anti-arrhythmic medication more than VT (10/15 vs 2/9, p=0.04). Nine different types of anti-arrhythmic agents were successfully administered without maternal complications. There were no maternal deaths in either group. In the comparison of group A with group B, there was lower cardiac functional class (8/29, p=0.04), higher incidence of polysplenia (4/29, p=0.04), and higher incidence of low-birthweight infant (7/29, p=0.02) in the former. It appears that there is a high prevalence of arrhythmias during pregnancy in patients with repaired CHD. Patients with CHD and low cardiac functional class and/or polysplenia could have arrhythmia during pregnancy that results in a low-birthweight infant. Meticulous care for these patients during pregnancy is recommended.

    DOI: 10.1253/circj.67.992

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  • Transcatheter coil embolization of a high-flow coronary artery fistula using 0.052-inch Gianturco coils - A case report

    E Tayama, T Akagi, T Shojima, H Tomoeda, T Takaseya, S Fukunaga, N Hayashida, S Aoyagi

    CIRCULATION JOURNAL   67 ( 12 )   1059 - 1060   2003年12月

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    記述言語:英語   出版者・発行元:BLACKWELL PUBLISHING ASIA  

    A giant, high-flow coronary fistula is usually difficult to treat by transcatheter coil embolization, but the 0.052-inch Gianturco coil, which is larger and has a stronger shape memory than conventional coils, is now available. Using this device and additional conventional coils, a high-flow coronary artery fistula in a healthy 31-year-old man was successfully embolized. The new Gianturco coil widens the indication for the transcatheter embolization of coronary artery fistulas.

    DOI: 10.1253/circj.67.1059

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  • Left ventricular performance during pregnancy in patients with repaired tetralogy of Fallot - Prospective evaluation using the Tei index

    Y Hidaka, T Akagi, W Himeno, M Ishii, T Matsuishi

    CIRCULATION JOURNAL   67 ( 8 )   682 - 686   2003年8月

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    記述言語:英語   出版者・発行元:BLACKWELL PUBLISHING ASIA  

    Little is known about the influence of hemodynamic changes on ventricular performance during pregnancy in patients with congenital heart disease. A prospective evaluation was made of 17 pregnancies in I I women with repaired tetralogy of Fallot (ToF). Twenty age-matched non-pregnant women and 41 stable pregnant women without heart disease were studied as controls. Blood pressure (BP), heart rate (HR), left ventricular end-diastolic dimension (LVEDD) and ejection fraction (LVEF), and the Tei index were measured before pregnancy; during the 1st, 2nd, and 3rd trimesters; and after delivery. BP and HR gradually increased during the pregnancy in both groups. The LVEDD in the controls increased throughout the gestation period, then decreased after delivery. In contrast, the LVEDD in the ToF was significantly smaller than that of the controls, and no such increase was observed. The LVEF did not change throughout pregnancy or after the delivery in either group. Although the Tei index of the controls did not change throughout the pregnancy, in the ToF group it was significantly increased in the 2nd and 3rd trimester and then decreased after delivery. These findings suggest that subclinical left ventricular intolerance for volume overload, probably because of the smaller LVEDD, may exist during pregnancy inpatients with a repaired ToF.

    DOI: 10.1253/circj.67.682

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  • Efficacy and safety of thermal vasodilation therapy by sauna in infants with severe congestive heart failure secondary to ventricular septal defect

    Y Sugahara, M Ishii, H Muta, K Egami, T Akagi, T Matsuishi

    AMERICAN JOURNAL OF CARDIOLOGY   92 ( 1 )   109 - 113   2003年7月

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    記述言語:英語   出版者・発行元:EXCERPTA MEDICA INC  

    DOI: 10.1016/S0002-9149(03)00483-1

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  • Role of angiotensin Ⅱ type 1 receptor in tumor angiogenesis and growth.

    Egami K, Murohara T, Shimada T, Sasaki K, Shintani S, Sugaya T, Ishii M, Akagi T, Ikeda H, Matsuishi T, Imaizumi T

    J Clin Invest   112 ( 1 )   67 - 75   2003年7月

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  • Efficacy and safety of thermal vasodilation therapy by sauna in infants with severe congestive heart failure secondary to ventricular septal defect

    Y Sugahara, M Ishii, H Muta, K Egami, T Akagi, T Matsuishi

    AMERICAN JOURNAL OF CARDIOLOGY   92 ( 1 )   109 - 113   2003年7月

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    記述言語:英語   出版者・発行元:EXCERPTA MEDICA INC  

    DOI: 10.1016/S0002-9149(03)00483-1

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  • Increased angiogenic growth factor in cyanotic congenital heart disease

    W Himeno, T Akagi, J Furui, Y Maeno, M Ishii, K Kosai, T Murohara, H Kato

    PEDIATRIC CARDIOLOGY   24 ( 2 )   127 - 132   2003年3月

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    記述言語:英語   出版者・発行元:SPRINGER-VERLAG  

    To examine the relationship between the plasma levels of angiogenic growth factors and the severity of cyanosis, 80 patients with cyanotic heart disease (CHD) and 81 healthy controls were studied. Median age and mean arterial blood oxygen saturation respectively were 4.2 years and 81% in CHD subjects and 4.8 years and 98% in controls. Vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) were measured in plasma using enzyme-linked immunoassay. Plasma VEGF levels in controls depended negatively on age (p &lt; 0.0001) until 3 months, when VEGF was no longer elevated. No such age dependence was found for HGF. Although VEGF levels did not differ between CHD and control subjects up to the age of 3 months, VEGF was significantly elevated in CHD patients older than 3 months compared to controls of similar age (149 +/- 106 vs 65 +/- 23 pg/ml, p &lt; 0.0001). Moreover, the VEGF levels were negatively correlated with oxygen saturation (p = 0.03) and positively correlated with hemoglobin (p = 0.004) in CHD patients aged between 3 months and 10 years. Although the physiologic elevation of VEGF in the neonatal period decreases rapidly if oxygen saturation is normal, VEGF elevations persist if systemic hypoxia is present.

    DOI: 10.1007/s00246-002-0266-5

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  • Incidence and clinical features of asymptomatic atrial septal defect in school children diagnosed by heart disease screening

    H Muta, T Akagi, K Egami, J Furui, Y Sugahara, M Ishii, T Matsuishi

    CIRCULATION JOURNAL   67 ( 2 )   112 - 115   2003年2月

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    記述言語:英語   出版者・発行元:BLACKWELL PUBLISHING ASIA  

    The purpose of this study was to investigate the incidence and clinical features of atrial septal defect (ASD) in school children in Japan who were diagnosed by heart disease screening. From 1989 to 1998, a questionnaire, electrocardiography (ECG) and phonocardiogram were obtained from school children when they entered their first year of elementary school (n=86,142) or junior high school (n=80,632). In this program, 33 asymptomatic ASD patients were newly diagnosed (0.020%). The ECG findings showed incomplete fight bundle-branch block (79%), right axis deviation (55%), and fight ventricular hypertrophy (9%). An ejection systolic murmur was audible in 30 patients (94%) and mid-diastolic murmur in 10 patients (30%). Thirty patients (90%) showed fixed split of second heart sound. Using echocardiography or catheter observation, 31 patients (94%) were judged to require closure of the ASD. Although the medical care is widely available in Japan, undetected ASD patients were not rare and importantly, most of them required closure of the defect even if they were asymptomatic.

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  • Incidence and clinical features of asymptomatic atrial septal defect in school children diagnosed by heart disease screening

    H Muta, T Akagi, K Egami, J Furui, Y Sugahara, M Ishii, T Matsuishi

    CIRCULATION JOURNAL   67 ( 2 )   112 - 115   2003年2月

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    記述言語:英語   出版者・発行元:BLACKWELL PUBLISHING ASIA  

    The purpose of this study was to investigate the incidence and clinical features of atrial septal defect (ASD) in school children in Japan who were diagnosed by heart disease screening. From 1989 to 1998, a questionnaire, electrocardiography (ECG) and phonocardiogram were obtained from school children when they entered their first year of elementary school (n=86,142) or junior high school (n=80,632). In this program, 33 asymptomatic ASD patients were newly diagnosed (0.020%). The ECG findings showed incomplete fight bundle-branch block (79%), right axis deviation (55%), and fight ventricular hypertrophy (9%). An ejection systolic murmur was audible in 30 patients (94%) and mid-diastolic murmur in 10 patients (30%). Thirty patients (90%) showed fixed split of second heart sound. Using echocardiography or catheter observation, 31 patients (94%) were judged to require closure of the ASD. Although the medical care is widely available in Japan, undetected ASD patients were not rare and importantly, most of them required closure of the defect even if they were asymptomatic.

    DOI: 10.1253/circj.67.112

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  • 第6回Pediatric Interventional Cardiac Symposium (PICS-VI)に出席して.

    赤木禎治

    JPIC News Letter   7:19-21   2003年

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  • 川崎病心臓血管後遺症の診断と治療に関するガイドライン(循環器病の診断と治療に関するガイドライン(2001-2002年度合同研究班報告)

    原田研介, 加藤裕久, 赤木禎治, 唐澤賢祐, 北村惣一郎, 佐地 勉, 鈴木淳子, 馬場 清, 藤原久義, 鮎澤 衛, 岡田知雄, 小川俊一, 萩野廣太郎, 西垣和彦, 遠藤真弘, 尾内善四郎, 中澤 誠, 山口 徹

    Circulation Journal   67 suppl.Ⅳ,:1153-1173   1111 - 1173   2003年

  • 動脈管開存症に対するカテーテル治療-これからの課題-

    赤木禎治

    心臓   2003年

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  • 成人先天性心疾患患者の社会的自立の現況と問題点:自立を妨げる要因 -結婚と妊娠(男女の違い)-.

    赤木禎治, 日高淑恵, 姫野和家子, 加藤裕久

    日本小児循環器学会雑誌   19   72 - 74   2003年

  • 喀血を伴う成人体肺短絡血管に対するコイル閉鎖術.

    姫野和家子, 赤木禎治, 江上公康, 水元淑恵, 菅原洋子, 家村素史, 前野泰樹, 石井正浩, 松石豊次郎

    心臓   35   295 - 299   2003年

  • 3ヵ月未満に発症した川崎病の臨床像に関する検討.

    姫野和家子, 赤木禎治, 石井正浩, 前野泰樹, 浦部大策, 大部敬三, 加藤裕久, 松石豊次郎

    日本小児科学会雑誌   2003年

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  • 小児科クリニカルクラークシップにおける実習:学生に対する教育効果と意義.

    赤木禎治, 吉田一郎, 武谷 茂, 日吉保彦, 本間真一, 吉永陽一郎, 田中地平, 井上謙吉, 松石豊次郎

    福岡県小児科医会   2003年

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  • 動脈管開存症に対するカテーテル治療-これからの課題-.

    赤木禎治

    心臓   2003年

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  • 基本的臨床技能習得のためのスキルスラボの導入とその有用性.

    上野隆登, 吉田一郎, 林 明宏, 高城喜典, 渡邉誠之, 黒木岳人, 吉村浩一, 牛島公生, 末安禎子, 松尾和彦, 鳥島拓司, 安陪等思, 宮崎 洋, 香野修介, 赤木禎治, 中島 裕, 佐田通夫

    医学教育   34 ( 2 )   81 - 87   2003年

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    記述言語:日本語   出版者・発行元:Japan Society for Medical Education  

    久留米大学医学部4年生を対象に基本的臨床技能実習を実施し, その間学生の基本的臨床技能の向上を目的としたスキルスラボを利用し, その効果を検討した.4年生113名を対象とした.方法は10グループに分け各グループが2か月にわたりラボを利用した.ラボには救急蘇生モデル, 生体シミュレーター "イチロー", ワイヤレス聴診器, 医学教育用ビデオなどを準備した.実習終了後, 使用体験に関するアンケート調査を行った.その結果, 半数以上の学生から基本的臨床技能の習得にスキルスラボが有用であったとの評価を得た.しかし, 教材の有効な使用法が十分に理解できずその結果, 有用でなかったと答えた一部の学生もいた.今後, 各種シミュレーターを導入し, 学生の基本的臨床技能の習得をさらに向上させるためスキルスラボの充実が重要であると考えられる.

    DOI: 10.11307/mededjapan1970.34.81

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  • 成人となった小児心疾患.川崎病冠動脈合併症の成人後経過,治療,予後.

    菅原洋子, 石井正浩, 赤木禎治

    小児科診療   66:1221-1226 ( 7 )   1221 - 1226   2003年

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    記述言語:日本語   出版者・発行元:診断と治療社  

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  • 先天性心疾患.

    姫野和家子, 赤木禎治

    小児科   44:1482-1488   2003年

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  • 先天性心疾患の内科的治療と患者管理.

    菅原洋子, 赤木禎治

    小児看護   26:1357-1362   2003年

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  • 先天性短絡疾患に対するカテーテル治療.

    小泉博彦, 赤木禎治

    成人病と生活習慣   33:969-974   2003年

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  • 小さな動脈管に対する閉鎖術:より安全に,より確実に.

    赤木禎治

    心臓   35:683-684 ( 10 )   683 - 684   2003年

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    記述言語:日本語   出版者・発行元:公益財団法人 日本心臓財団  

    DOI: 10.11281/shinzo1969.35.10_683

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  • 早期に冠動脈の著しい変化を認めた川崎病例の長期予後について教えてください.

    江上公康, 石井正浩, 赤木禎治

    小児内科   35:1604-1605   2003年

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  • 川崎病と虚血性心疾患の関係について考えてください.

    赤木禎治, 家村素史, 石井正浩, 加藤裕久

    小児内科   35:1432-1434   2003年

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  • 川崎病急性期を過ぎてみられる弁膜病変の特徴について考えてください.

    小泉博彦, 赤木禎治

    小児内科   35:1606-1607   2003年

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  • 川崎病急性期治療のガイドライン.

    佐地 勉, 薗部友良, 上村 茂, 赤木禎治, 鮎澤 衛, 加藤裕久, 原田研介, 長嶋正実, 浅井利夫

    日本小児科学会雑誌   107:1713-1716   2003年

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  • Two novel frameshift mutations in NKX2.5 result in novel features including visceral inversus and sinus venosus type ASD

    Y Watanabe, DW Benson, S Yano, T Akagi, M Yoshino, JC Murray

    JOURNAL OF MEDICAL GENETICS   39 ( 11 )   807 - 811   2002年11月

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    記述言語:英語   出版者・発行元:BRITISH MED JOURNAL PUBL GROUP  

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  • Mortality and risk factors for late deaths in tetralogy of Fallot: the Japanese Nationwide Multicentric Survey

    K Niwa, H Hamada, M Nakazawa, M Terai, S Tateno, S Sugimoto, H Watanabe, A Murakami, M Ohta, A Ishizawa, T Katoki, K Mori, S Yasui, Y Kawahira, T Akagi, N Haraguchi, MA Gatzoulis

    CARDIOLOGY IN THE YOUNG   12 ( 5 )   453 - 460   2002年10月

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    記述言語:英語   出版者・発行元:GREENWICH MEDICAL MEDIA LTD  

    Objectives: We have compared mortality and risk factors for late deaths in patients with tetralogy of Fallot undergoing surgical repair in 1972 and 1982 in a Japanese multicentric study, examining in particular the impact of time of repair. Background: There is limited information on the effect that time of repair, and our constantly changing approach to it, has on late outcome in repaired tetralogy of Fallot. Methods: We analysed the Japanese registry of deaths occurring after surgical repair of tetralogy of Fallot. We studied two postoperative 1-year cohorts of survivors of surgery performed in 12 centers. Of the patients, 122, aged 29 12 years, had undergone repair in 1972, their age at repair being 9.6 years. An additional 186 patients, aged 23 8.7 years, had been repaired in 1982 at the age of 7.7 years. Results: Annual mortality, as judged per 100,000 population of patients with tetralogy of Fallot, declined from 0.387 in 1972 to 0.196 in 1982. Significant differences were deaths following surgery (27% vs. 13%, p &lt; 0.001), patching of the subpulmonary outflow tract (48% vs. 89%, p &lt; 0.001), and transjunctional patching (13% vs. 63%, p &lt; 0.001). Late death was observed in 6 vs. 3 patients (9/308, 2.9%). The actuarial rate of survival calculated over 14 years was 97% vs. 98%. Reoperation was performed in 5 vs. 9 patients (14/308, 4.5%). Risk factors for late death were age at repair (p = 0.01), and history of reoperation (p &lt; 0.001). Transjunctional patching (p = 0.01) proved to be associated with late mortality only in patients repaired in 1972. Conclusions: Late survival was excellent, with a low incidence of reoperations in both groups of patients. The era of repair has a big influence on total and operative mortality, but has only a small impact on late mortality: Ongoing analysis of follow-up will possibly reveal subsequent changes with time.

    DOI: 10.1017/S104795110200077X

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  • Transcatheter closure of atrial septal defect with Amplatzer septal occluder –A Japanese clinical trial-.

    Oho S, Ishizawa A, Akagi T, Kato H

    Circ J   66 ( 9 )   791 - 794   2002年9月

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  • Sequential follow-up results of catheter intervention for coronary artery lesions after Kawasaki disease - Quantitative coronary artery angiography and intravascular ultrasound imaging study

    M Ishii, T Ueno, H Ikeda, M Iemura, T Sugimura, J Furui, Y Sugahara, H Muta, T Akagi, Y Nomura, T Homma, H Yokoi, M Nobuyoshi, T Matsuishi, H Kato

    CIRCULATION   105 ( 25 )   3004 - 3010   2002年6月

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

    Background-The purpose of this study was to assess the sequential follow-up results of catheter intervention in Kawasaki disease by use of quantitative coronary angiography (QCA) and intravascular ultrasound imaging.
    Methods and Results-Catheter intervention was performed on 23 stenotic lesions in 22 patients (aged 2 to 24 years). Percutaneous balloon angioplasty (PBA) was performed in 4 patients, stent implantation in 7, percutaneous transluminal coronary rotational ablation (PTCRA) in 10, and a combination of PTCRA with stent implantation in 2. A total of 21 lesions (91%) were successfully dilated by catheter intervention without major or minor complications. One patient immediately underwent coronary artery bypass grafting (CABG) surgery because stent implantation failed to resolve his lesion. At 4 to 6 months after catheter intervention, 2 restenotic lesions (9%) were detected by QCA in 2 patients who had undergone PBA, and these patients subsequently underwent CABG surgery. In 6 months to 3 years after catheter intervention, no patients showed evidence of ischemic findings. At 3 to 4 years after catheter intervention, QCA and intravascular ultrasound studies were performed on 15 lesions in 14 patients. Two restenotic lesions (13%) were detected by QCA in 2 patients. One of the 2 had stent implantation and underwent CABG surgery, and the other had undergone PTCRA and underwent re-PTCRA. Thirteen patients demonstrated no ischemic findings at 3 to 8 years after catheter intervention.
    Conclusion-Catheter intervention for Kawasaki disease can be accomplished and can be effective in the short term, but the long-term efficacy should be verified by further study.

    DOI: 10.1161/01.CIR.0000019733.56556.D8

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  • Assessment of the ability of myocardial contrast echocardiography with harmonic power Doppler imaging to identify perfusion abnormalities in patients with Kawasaki disease at rest and during dipyridamole stress

    M Ishii, W Himeno, M Sawa, M Iemura, J Furui, H Muta, Y Sugahara, K Egami, T Akagi, M Ishibashi, H Kato

    PEDIATRIC CARDIOLOGY   23 ( 2 )   192 - 199   2002年3月

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    記述言語:英語   出版者・発行元:SPRINGER-VERLAG  

    The aim of our study was to assess the ability of myocardial contrast echocardiography (MCE) with harmonic power Doppler imaging (HPDI) to identify perfusion abnormalities in patients with Kawasaki disease at rest and during pharmacological stress imaging with dipyridamole. Results were compared with those of Tc-99m-tetro-fosmin single-photon emission computed tomography (SPECT) imaging as the clinical reference standard. MCE with HPDI was performed on 20 patients with a history of Kawasaki disease. Images were obtained at baseline and during dipyridamole infusion (0.56 mg kg(-1)) in the apical two- and four-chamber views. Myocardial opacification suitable for the analysis was obtained in all patients. Nine patients with stenotic lesions had a reversible defect after dipyridamole infusion detected by both MCE with HPDI and SPECT, and 3 patients with a history of myocardial infarction had a partially or completely irreversible defect detected by both methods. Three patients with coronary aneurysm without stenotic lesion, 4 patients with regressed coronary aneurysm, and 2 patients with normal coronary artery in acute phase also had normal perfusion at rest and after pharmacological stress by both methods. A 96% concordance (kappa = 0.87) was obtained when comparing the respective segmental perfusion scores using the two methods at baseline, and an 86% concordance (kappa = 0.81) was obtained at postdipyridamole infusion. After combining baseline and postdipyridamole images, each segment was labeled as having normal perfusion, irreversible defects, or reversible defects. Using these classifications, concordance for the two methods was 92% (kappa = 0.87). MCE with HPDI is a safe and feasible method by which to detect asymptomatic ischemia due to severe stenotic lesion, and it may be an important addition to the modalities used to identify patients at risk for myocardial infarction as a complication of Kawasaki disease.

    DOI: 10.1007/s00246-001-0046-7

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  • Assessment of the ability of myocardial contrast echocardiography with harmonic power Doppler imaging to identify perfusion abnormalities in patients with Kawasaki disease at rest and during dipyridamole stress

    M Ishii, W Himeno, M Sawa, M Iemura, J Furui, H Muta, Y Sugahara, K Egami, T Akagi, M Ishibashi, H Kato

    PEDIATRIC CARDIOLOGY   23 ( 2 )   192 - 199   2002年3月

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    記述言語:英語   出版者・発行元:SPRINGER-VERLAG  

    The aim of our study was to assess the ability of myocardial contrast echocardiography (MCE) with harmonic power Doppler imaging (HPDI) to identify perfusion abnormalities in patients with Kawasaki disease at rest and during pharmacological stress imaging with dipyridamole. Results were compared with those of Tc-99m-tetro-fosmin single-photon emission computed tomography (SPECT) imaging as the clinical reference standard. MCE with HPDI was performed on 20 patients with a history of Kawasaki disease. Images were obtained at baseline and during dipyridamole infusion (0.56 mg kg(-1)) in the apical two- and four-chamber views. Myocardial opacification suitable for the analysis was obtained in all patients. Nine patients with stenotic lesions had a reversible defect after dipyridamole infusion detected by both MCE with HPDI and SPECT, and 3 patients with a history of myocardial infarction had a partially or completely irreversible defect detected by both methods. Three patients with coronary aneurysm without stenotic lesion, 4 patients with regressed coronary aneurysm, and 2 patients with normal coronary artery in acute phase also had normal perfusion at rest and after pharmacological stress by both methods. A 96% concordance (kappa = 0.87) was obtained when comparing the respective segmental perfusion scores using the two methods at baseline, and an 86% concordance (kappa = 0.81) was obtained at postdipyridamole infusion. After combining baseline and postdipyridamole images, each segment was labeled as having normal perfusion, irreversible defects, or reversible defects. Using these classifications, concordance for the two methods was 92% (kappa = 0.87). MCE with HPDI is a safe and feasible method by which to detect asymptomatic ischemia due to severe stenotic lesion, and it may be an important addition to the modalities used to identify patients at risk for myocardial infarction as a complication of Kawasaki disease.

    DOI: 10.1007/s00246-001-0046-7

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  • 川崎病心血管合併症.

    家村素史, 赤木禎治

    小児科診療   65(suppl)299-301.   2002年

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  • Quantitative evaluation of the changes in plasma concentrations of cardiac natriuretic peptide before and after transcatheter closure of atrial septal defect

    H Muta, M Ishii, Y Maeno, T Akagi, H Kato

    ACTA PAEDIATRICA   91 ( 6 )   649 - 652   2002年

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    記述言語:英語   出版者・発行元:TAYLOR & FRANCIS AS  

    The purpose of this study was to investigate the changes in plasma concentrations of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in patients with atrial septal defect (ASD) during transcatheter closure of defects. The plasma concentrations of ANP and BNP were obtained from 14 patients with ASD at before closure. and at 5 min. 24 h 1 mo and 3 mo after transcatheter ASD closure using an Amplatzer septal occluder. Ten healthy children aged 6-18 y were studied as controls. All ASDs were successfully closed. Compared with control (mean +/- SD 17 +/- 6 .8 ng l(-1)), ANP concentrations before Closure were significantly elevated (24 +/- 9.8 ng l(-1) p &lt; 0.05). ANP concentrations increased significantly at 5 min after Closure (34 18 ng I p &lt; 0.05) compared with preclosure concentrations. At 24 h after Closure, the concentrations decreased to, values not different front control values (19 +/- 11 ng l(-1). p = ns). BNP levels before closure (19 +/- 9.9 ng l(-1)) were also elevated significantly compared with control values (12 +/- 4.9 ng l(-1) p &lt; 0.05). BNP concentrations increased significantly at 5 min after Closure (23 +/- 14 ng l(-1) p &lt; 0.05) compared with preclosure concentrations, ANP values at 24 h were lower than at 5 min after closure, whereas BNP values were higher (32 +/- 11 ng l(-1), p &lt; 0.05). As with ANP, the concentrations gradually decreased to values not different from control values at 3 mo after the procedure (12 +/- 6.3 ng l(-1), p = ns).
    Conclusion: Plasma concentrations of ANP and BNP may become effective markers for evaluating changes in cardiac load after transcatheter ASD closure.

    DOI: 10.1080/080352502760069043

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  • Soluble forms of the selectin family in children with Kawasaki disease: prediction for coronary artery lesions

    J Furui, M Ishii, H Ikeda, H Muta, K Egami, Y Sugahara, W Himeno, T Akagi, H Kato, T Matsuishi

    ACTA PAEDIATRICA   91 ( 11 )   1183 - 1188   2002年

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    記述言語:英語   出版者・発行元:TAYLOR & FRANCIS AS  

    Aim: To investigate the relationship between the plasma levels of soluble forms of the selectin family and the incidence of coronary artery lesions (CALs) in patients with Kawasaki disease (KD). Methods: Thirty-three patients with KD, including group A patients (n = 22) who had no CALs and group B patients (n = 11) who had CALs, as well as age-matched febrile (n = 10) and afebrile controls (n = 11), were studied. Results: Peak plasma E-selectin levels (172.0 +/- 58.6 ng ml(-1)) occurred during the acute phase of KD, while peak plasma P-selectin levels (260.3 +/- 43.2 ng ml(-1)) occurred during the subacute phase of the illness (p &lt; 0.05). Plasma L-selectin levels (1757.3 &PLUSMN; 244.3 ng ml(-1)) during the convalescent phase tended to be higher than in either the acute or the subacute phase (not significant). Before intravenous immunoglobulin treatment, the plasma levels of E- (225.1 &PLUSMN; 46.8 ng ml(-1)) and P-selectin (259.4 &PLUSMN; 76.2 ng ml(-1)) of patients with CALs (n = 11) were significantly higher than those of patients (n = 22) with no CALs (E- selectin, 131.6 &PLUSMN; 36.9 ng ml(-1); P-selectin, 184.9 &PLUSMN; 84.6 ng ml(-1); p &lt; 0.05). When a plasma E- selectin value before immunoglobulin treatment of &gt;184.7 ng ml(-1) was used as the cut-off point, the sensitivity and specificity for the incidence of CALs were 81.8% and 90.9%, respectively. These findings demonstrate the relationship between plasma levels of selectins and disease severity of Kawasaki vasculitis.
    Conclusion: Higher plasma levels of E- selectin may have potential as a predictor of the incidence of coronary artery lesions in Kawasaki disease patients.

    DOI: 10.1080/080352502320777414

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  • 川崎病ガンマグロブリン療法における製剤間での治療効果の比較.

    牟田広実, 石井正浩, 廣瀬彰子, 古井 潤, 菅原洋子, 姫野和家子, 赤木禎治, 加藤裕久

    日本小児科学会雑誌   2002年

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  • 大動脈弁病変を伴う心室中隔欠損症の長期予後.

    牟田広実, 石井正浩, 古井 潤, 江上公康, 姫野和家子, 菅原洋子, 赤木禎治, 加藤裕久, 松石豊次郎

    日本小児循環器学会雑誌   2002年

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  • 川崎病冠状動脈後遺症のカテーテル治療に関する指針

    加藤裕久, 馬場清, 原田研介, 浜岡建城, 賀藤均, 津田悦子, 上村茂, 佐地勉, 赤木禎治, 石井正浩, 小川俊一, 越後茂之, 山口徹, 上野高史

    心臓   2002年

  • 3ヶ月未満川崎病の臨床像に関する検討.

    姫野和家子, 浦部大策, 大部敬三, 古井 潤, 長井幸二郎, 樋口恵美, 石井正浩, 前野泰樹, 赤木禎治, 加藤裕久, 松石豊次郎

    筑後小児科医会会報   10;14:15-20   2002年

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  • 手術不適応先天性心疾患患児の管理.

    姫野和家子, 赤木禎治

    小児科   43:357-363. ( 3 )   357 - 363   2002年

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    記述言語:日本語   出版者・発行元:金原出版  

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    その他リンク: http://search.jamas.or.jp/link/ui/2002200457

  • 成人で見られる川崎病後遺症.

    菅原洋子, 石井正浩, 赤木禎治

    Medicina   39:1534-1536.   2002年

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  • 成人先天性心疾患患者の妊娠と出産.

    水元淑恵, 赤木禎治

    小児科   43: 633-640 ( 5 )   633 - 640   2002年

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    記述言語:日本語   出版者・発行元:金原出版  

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    その他リンク: http://search.jamas.or.jp/link/ui/2002272507

  • 心筋炎・心筋症 (特大号 小児救急医療の実際--重症化の予知とその対策) -- (おもな救急疾患)

    水元 淑恵, 赤木 禎治

    小児科診療   64 ( 11 )   1846 - 1850   2001年11月

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    記述言語:日本語   出版者・発行元:診断と治療社  

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  • Guidelines for catheter intervention in coronary artery lesion in Kawasaki disease

    M Ishii, T Ueno, T Akagi, K Baba, K Harada, K Hamaoka, H Kato, E Tsuda, S Uemura, T Saji, S Ogawa, S Echigo, T Yamaguchi, H Kato

    PEDIATRICS INTERNATIONAL   43 ( 5 )   558 - 562   2001年10月

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    記述言語:英語   出版者・発行元:WILEY-BLACKWELL  

    The Research Committee of Ministry of Health, Labour and Welfare &apos;Study of treatment and long-term management in Kawasaki disease&apos; reported the guidelines for catheter intervention in coronary artery lesion in Kawasaki disease in this paper. The contents include: (i) background and natural history of coronary artery lesion in Kawasaki disease: (ii) indication of catheter intervention; (iii) types of procedure, and their indication and care, (iv) institute and backup system; (v) the management after procedure, evaluation and follow up, and (vi) prospects, especially in relation to bypass surgery.

    DOI: 10.1046/j.1442-200X.2001.01464.x

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  • Catheter closure of moderate to large sized patent ductus arteriosus using the simultaneous double or triple coil technique

    T Akagi, Y Mizumoto, M Iemura, Y Tananari, M Ishii, Y Maeno, H Kato

    PEDIATRICS INTERNATIONAL   43 ( 5 )   536 - 541   2001年10月

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    記述言語:英語   出版者・発行元:BLACKWELL PUBLISHING ASIA  

    Background: Although the clinical experience with transcatheter closure of the patent ductus arteriosus using the coils has grown rapidly, one important complication of this procedure using the conventional Gianturco coil was the migration of coils into peripheral vessels. This is especially for patients with a relatively larger size ductus and the risk for such complications could be increased, In this situation. the detachable coil may have some technical benefits to perform coil occlusion and reduce the incidence of complications.
    Methods: We describe the clinical efficacy of a simultaneous double or triple coil Occlusion technique using the Cook detachable coil or bioptome delivered 0.052 inch Gianturco coil to close the ductus arteriosus. This was performed in patients whose ductus diameter was greater than 3.0 mm.
    Results: From February 1995 to December 2000, 118 patients with patent ductus arteriosus were treated by coil occlusion using Cook detachable coils, of whom 58 patients whose minimum diameter of ductus greater than or equal to 3.0 mm were reviewed. All patients had successful placement of coils. According to the evaluation by color flow mapping, a trivial shunt was observed in 17 patients (29%) within 24 h after the procedure. In 11 out of 17 patients, a residual shunt was not detected 1 month after the procedure. At 6 months after the procedure, the residual shunt was detected only in three patients.
    Conclusions: Although this study did not calculate the statistical significance between detachable and nondetachable coils in term of occlusion rate, our institutional experience Suggests that the simultaneous double or triple coil technique using the detachable or 0.052 inch Gianturco coils can reduce the prevalence of coil migration or complications.

    DOI: 10.1046/j.1442-200X.2001.01460.x

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  • Balloon aortic valvuloplasty in children - A multicenter study in Japan

    H Tomita, S Echigo, K Kimura, T Kobayashi, T Nakanishi, R Ishizawa, T Akagi, T Ino, Y Harada, H Kado, T Yagihara

    JAPANESE CIRCULATION JOURNAL-ENGLISH EDITION   65 ( 7 )   599 - 602   2001年7月

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    記述言語:英語   出版者・発行元:BLACKWELL SCIENCE ASIA  

    A questionnaire was used to survey the experience of 8 Japanese institutions with percutaneous transluminal aortic valvuloplasty (PTAV) in children. Among 99 procedures reported in 88 patients, sufficient data for analysis was obtained from 76 procedures in 72 patients. In those 76 procedures the pressure gradient decreased significantly from 68 +/- 25 (20-140) to 33 +/- 22(0-100) mmHg (p&lt;0.01), whereas aortic regurgitation (AR) increased at least one grade in 26 cases (34%). None of the parameters analyzed in this study were predictors of an increase in AR. The reduction in pressure gradient was judged as good in 44 of the 76 procedures (58%). A larger ring diameter, larger balloon diameter and larger ratio balloon diameter/the normal predicted diameter of the aortic valve ring significantly contributed to an effective reduction of pressure gradient. Follow up data (mean interval, 4 years) was available for 26 of 39 clinically effective procedures. AR progressed at least 1 grade in 11 (42%), and the pressure gradient re-developed to more than 50 mmHg in 2 cases (8%). In Japan, PTAV has been accepted as a useful procedure for valvular aortic stenosis in children, but progressive AR or re-development of the pressure gradient is not uncommon even after clinically effective PTAV.

    DOI: 10.1253/jcj.65.599

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  • Re-treatment for immune globulin-resistant Kawasaki disease: A comparative study of additional immune globulin and steroid pulse therapy

    M Ishii, K Hashino, M Iemura, T Akagi, H Kato

    PEDIATRICS INTERNATIONAL   43 ( 3 )   211 - 217   2001年6月

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    記述言語:英語   出版者・発行元:BLACKWELL PUBLISHING ASIA  

    Background: We compared the efficacy and safety of additional intravenous immune globulin (IVIG) therapy with steroid pulse therapy in patients with IVIG-resistant Kawasaki disease.
    Methods: Two-hundred and sixty-two consecutive patients had been treated with a single dose of IVIG (2 g/kg) and aspirin (30 mg/kg per day). Thirty-five patients (13.4%) were not clinical responders to the initial IVIG treatment. They received an additional IVIG treatment (1 g/kg) within 48 h after the initial treatment. Seventeen patients (6.5%) did not respond to the additional IVIG treatment. We randomly divided these patients into two groups: group 1 consisted of eight patients who were treated with a single additional dose of IVIG (1 g/kg), while group 2 consisted of nine patients who were treated with steroid pulse therapy.
    Results: The IVIG-resistant patients had a high incidence of coronary artery lesions (CAL; 48.6%). Five patients (62.5%) in group 1 had CAL, including two patients who each had a giant aneurysm and three patients who each had a small aneurysm. Seven patients (77.8%) in group 2 had CAL, including two patients who each had a giant aneurysm, two patients who each had a small coronary aneurysm and three patients who each showed transient dilatation during steroid pulse therapy. There was no significant difference in the incidence of CAL between the two groups. The duration of high fever in group 2 (1.4+/-0.7 days) was significantly shorter than in group 1 (4.8+/-3.4 days; P&lt;0.05). The medical costs for the treatment of patients in group 2 ($113 012+/-22 084) were significantly lower than those for group 1 ($144 194+/-12 914; P&lt;0.05).
    Conclusions: Steroid pulse therapy may be useful in the treatment of patients with IVIG-resistant Kawasaki disease who experience prolonged fever. However, transient dilatation of the coronary artery is observed during steroid pulse therapy, so careful echocardiographic examination should be performed for those patients receiving steroid pulse therapy for the sake of early detection of coronary artery abnormalities.

    DOI: 10.1046/j.1442-200x.2001.01373.x

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  • Torn-off balloon tip of Z-5 atrial septostomy catheter

    T Akagi, Y Tananari, YV Maeno, W Himeno, J Furui, M Ishii, H Kato

    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS   52 ( 4 )   500 - 503   2001年4月

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    記述言語:英語   出版者・発行元:WILEY-LISS  

    Creation of atrial communication was performed in a newborn with critical aortic stenosis. After the success of the initial creation, balloon atrial septostomy using Z-5 catheter was performed, When catheter was pulled back, the tip of the balloon was tom oft. This experience could be considered as noteworthy when using this catheter in patients with unusually thick atrial septum. (C) 2001 Wiley-Liss, Inc.

    DOI: 10.1002/ccd.1112

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  • Quantitative assessment of severity of ventricular septal defect by three-dimensional reconstruction of color Doppler-Imaged vena contracta and flow convergence region

    M Ishii, K Hashino, G Eto, T Tsutsumi, W Himeno, Y Sugahara, H Muta, J Furui, T Akagi, Y Ito, H Kato

    CIRCULATION   103 ( 5 )   664 - 669   2001年2月

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

    Background-The aim of the present study was to investigate the feasibility and potential value of the computer-controlled, 3D, echocardiographic reconstruction of the color Doppler-imaged vena contracta (CDVC) and the flow convergence (FC) region as a means of accurately and quantitatively estimating the severity of a ventricular septal defect (VSD).
    Methods and Results-We performed a 3D reconstruction of the CDVC and the FC region in 19 patients with an isolated VSD using an ultrasound system interfaced with a Tomtec computer. The variable asymmetric geometry of the CDVC and the FC region could be 3D-visualized in all patients. The 3D-measured areas of CDVC correlated well with volumetric measurements of the severity of VSD (r=0.97, P&lt;0.001). Regression analysis between the shunt flow rate (calculated from the product of the area of CDVC and the continuous Doppler-derived velocity time integral) and the corresponding reference results (calculated by cardiac catheterization) demonstrated a close correlation (r=0.95, P&lt;0.001). There was also a good correlation between shunt flow rates calculated using the conventional 2D, 1-axis measurement of the FC isovelocity surface area with the hemispheric assumption (r=0.95, P&lt;0.001); shunt flow rates calculated using 3D, 3-axis measurements of the FC region (r=0.97, P&lt;0.01); and reference results by cardiac catheterization. However, the 2D method substantially underestimated the actual shunt flow rate.
    Conclusions-The 3D reconstruction of the CDVC and the FC region may aid in quantifying the severity of VSD.

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  • Simultaneous double or triple coil technique for closure of moderate sized (≥ 3.0 mm) patent ductus arteriosus

    Teiji Akagi, Motofumi Iemura, Yoshifumi Tananari, Masahiro Ishii, Shiho Yoshizawa, Hirohisa Kato

    Journal of Interventional Cardiology   14 ( 1 )   91 - 96   2001年

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    記述言語:英語   出版者・発行元:Futura Publishing Company Inc.  

    One important complication of coil occlusion of patent ductus arteriosus using the conventional Gianturco coil is migration of coils into peripheral vessels. Especially in patients having relatively larger size ductus, the risk for such complication could be increased. In this regard, a detachable coil may have some technical benefits in performing coil c occlusion and reducing the incidence of complications such as migration of coil. Based on our clinical experiences, we describe the clinical efficacy of a simultaneous double or triple coil occlusion technique using the Cook detachable coil system to close the ductus arteriosus, especially in patients whose ductus diameter more than 3.0 mm.

    DOI: 10.1111/j.1540-8183.2001.tb00718.x

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  • 臨床医学の展望「小児科学」循環器病・川崎病

    赤木禎治, 石井正浩

    日本医事新報.   4009:22-24   2001年

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  • 手術不適応例の管理.

    姫野和家子, 赤木禎治, 廣瀬彰子, 水元淑恵, 菅原洋子, 前野泰樹, 石井正浩, 加藤裕久

    小児内科   33:612-615   2001年

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  • 心筋炎・心筋症.

    水元淑恵, 赤木禎治

    小児科診療   64:1846-1850   2001年

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  • 先天性心疾患のカテーテル治療.

    赤木禎治, 家村素史, 棚成嘉文, 加藤裕久

    小児科   42:2053-2059   2001年

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  • 僧房弁逸脱症候群.

    菅原洋子, 赤木禎治

    小児科診療   64:167   2001年

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  • 成人先天性心疾患診療における小児循環器医の役割.

    赤木禎治, 丹羽公一郎, 石澤 瞭

    日本小児科学会雑誌   2001年

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  • 小児循環器診療の最前線 成人に達した先天性心疾患患者の諸問題.

    赤木禎治

    若年者心疾患対策協議会誌   2001年

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  • 急性期を過ぎた後に生じる病変への対応.―川崎病―冠動脈瘤をつくらぬ診断と治療のコツはあるのか.

    赤木禎治

    State of the art in Immunology, Hematology & Infection   2:14-15.   2001年

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  • 大人になった川崎病既往者の問題.

    赤木禎治, 家村素史, 石井正浩, 加藤裕久

    小児科   42:856-864. ( 5 )   856 - 864   2001年

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    記述言語:日本語   出版者・発行元:金原出版  

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    その他リンク: http://search.jamas.or.jp/link/ui/2001239194

  • Sequential evaluation of left ventricular myocardial performance in children after anthracycline therapy

    M Ishii, T Tsutsumi, W Himeno, G Eto, J Furui, K Hashino, Y Sugahara, H Muta, T Akagi, A Ando, H Eguchi, H Kato

    AMERICAN JOURNAL OF CARDIOLOGY   86 ( 11 )   1279 - +   2000年12月

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    記述言語:英語   出版者・発行元:EXCERPTA MEDICA INC  

    This study prospectively assessed subclinical cardiotoxicity in patients undergoing chemotherapy by using the Tei index combining systolic and diastolic time intervals. A significant difference in the Tei index was observed between patients who received a low dose and those who received a moderate to high dose of anthracycline antibiotic drugs. The Tei index is a sensitive, accurate, and easy approach for detecting subclinical anthracycline cardiotoxicity.

    DOI: 10.1016/S0002-9149(00)01222-4

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  • Quantitation of the global right ventricular function in children with normal heart and congenital heart disease: A right ventricular myocardial performance index

    M Ishii, G Eto, C Tei, T Tsutsumi, K Hashino, Y Sugahara, W Himeno, H Muta, J Furui, T Akagi, R Fukiyama, O Toyoda, H Kato

    PEDIATRIC CARDIOLOGY   21 ( 5 )   416 - 421   2000年9月

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    記述言語:英語   出版者・発行元:SPRINGER  

    Although the assessment of right ventricular (RV) function is important in the clinical management of children with congenital heart disease, available imaging techniques have been limited because of the complex geometry of the right ventricle. A new Doppler index combining systolic and diastolic time intervals (the Tei index) has been reported to be useful for the assessment of global RV function in adults. However, normal values in children, age-related changes, and the clinical utility of the Tei index with regard to congenital heart disease have not been demonstrated. The purpose of this study was to prospectively assess RV function in children with normal heart and congenital heart disease using the Tei index. The subjects included 150 healthy children and 43 patients with congenital heart disease (35 patient?; with atrial septal defects and 8 patients who had had a Senning operation). The index was defined as the sum of isovolumetric contraction time and isovolumetric relaxation time divided by ejection time and was measured from conventional RV outflow and inflow Doppler velocity profiles. The Tei index was not affected by age in healthy children (0.24 +/- 0.04). There was a significant difference in index rating between patients who had had a Senning operation (0.58 +/- 0.09) and healthy children (p &lt; 0.01), but there was no significant difference between children with atrial septal defect (0.25 +/- 0.13) and healthy children. The Tei index is a feasible approach to use when assessing global RV function in children with congential heart disease.

    DOI: 10.1007/s002460010100

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  • Catheter interventional treatment in Kawasaki disease: a report from the Japanese Pediatric Interventional Cardiology Investigation Group

    T Akagi, S Ogawa, T Ino, M Iwasa, S Echigo, K Kishida, K Baba, M Matsushima, K Hamaoka, H Tomita, M Ishii, H Kato

    JOURNAL OF PEDIATRICS   137 ( 2 )   181 - 186   2000年8月

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    記述言語:英語   出版者・発行元:MOSBY-ELSEVIER  

    Objective: To assess the current status of catheter intervention in Kawasaki disease and to evaluate its efficacy and outcome.
    Study design: A questionnaire was sent to 55 major institutions in Japan.
    Results: A total of 58 procedures in 57 patients were reported. The median age at the time of intervention was 12.1 years. The procedures included percutaneous transluminal coronary angioplasty (PTCA; n = 34), percutaneous transluminal coronary rotational ablation (PTCRA; n = 13), directional coronary atherectomy (DCA; n = 4), and stent implantation (n = 7). The immediate success rate was 74% for PTCA, 100% for PTCRA, 100% for DCA, and 86% for stents. The interval from the onset of disease to intervention in successful PTCA (n = 25) was significantly shorter than that in unsuccessful PTCA (n = 9). Restenosis after PTCA was observed in 24%. Development of new coronary aneurysms was reported in 3 patients for PTCA, 2 for PTCRA, 3 for DCA, and 1 for stents. Except for the DCA, all new aneurysms were associated with the use of high-pressure balloon inflation. Two deaths were reported as acute complications.
    Conclusions: Catheter intervention is a promising therapeutic strategy in the management of coronary stenosis caused by Kawasaki disease. Care should be paid to avoid acute coronary arterial complications and the development of new coronary aneurysms.

    DOI: 10.1067/mpd.2000.107164

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  • Long-term consequences of regressed coronary aneurysms after Kawasaki disease: Wall morphology and vascular function

    M Iemura, M Ishii, T Sugimura, T Tsutsumi, T Akagi, H Kato

    PEDIATRIC RESEARCH   47 ( 4 )   557 - 557   2000年4月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:INT PEDIATRIC RESEARCH FOUNDATION, INC  

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  • 胎児,新生時期の難治性発作性上室頻拍症における塩酸sotalolの有効性.

    姫野和家子, 前野泰樹, 古井 潤, 神田 洋, 藤野 浩, 棚成嘉文, 橋野かの子, 石井正浩, 赤木禎治, 加藤裕久

    日小循誌   2000年

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  • 成人に達した先天性心疾患患者の管理と問題点.

    赤木禎治, 加藤裕久

    小児科   41:96-102   2000年

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  • 先天性心疾患のカテーテル治療:Current topics.

    赤木禎治

    JMS Cardiology News   2:1-13   2000年

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  • 先天性心疾患のカテーテル治療:最新の進歩.

    赤木禎治

    福岡県小児科医報   38:76-79   2000年

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  • 大人になった川崎病の問題.

    赤木禎治

    はばたき(川崎病友の会報)   65:1-7.   2000年

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  • 成人先天性心疾患診療ガイドライン.

    門間和夫, 石澤瞭, 加藤裕久, 石光敏行, 松田暉, 黒沢博身, 千葉喜英, 中林正雄, 宮武邦夫, 大川真一郎, 瀬口正史, 松島正気, 赤木禎治, 柳川幸重

    Japanese Circulation Journal   64   1167 - 1204   2000年

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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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  • 先天性心疾患(動脈管開存症,心房中隔欠損症)および川崎病のカテーテル治療.

    赤木禎治, 石井正浩, 加藤裕久

    循環器専門医   2000年

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  • 学校心臓検診で発見された心房中隔欠損症.

    牟田広実, 赤木禎治, 石井正浩, 姫野和家子, 古井 潤, 菅原洋子, 橋野かの子, 前野泰樹, 棚成嘉文, 家村素史, 加藤裕久

    筑後小児科医会会報   13: 15-18   2000年

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  • 血管内エコー図.

    姫野和家子, 古井 潤, 石井正浩, 赤木禎治

    小児科診療   63:96-101.   2000年

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  • Assessment of global left ventricular function in normal children and in children with dilated cardiomyopathy

    GY Eto, M Ishii, CW Tei, T Tsutsumi, T Akagi, H Kato

    JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY   12 ( 12 )   1058 - 1064   1999年12月

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    記述言語:英語   出版者・発行元:MOSBY-ELSEVIER  

    A Doppler index combining systolic and diastolic time intervals (Tei index) has been reported to be useful for assessing global left ventricular (LV) function and predicting clinical outcome in adult patients with LV dysfunction. However, normal values in children and age-related changes in the index have not yet been clarified. The aim of this study was to prospectively determine normal values of the Tei index and the effect of aging on the index in children and to assess the global cardiac function in patients with dilated cardiomyopathy with this index. The subjects included 161 consecutive normal children aged 30 days to 18 years and 5 patients with dilated cardiomyopathy, The Tei index was defined as the sum of the isovolumetric contraction time and the isovolumetric relaxation time divided by the ejection time and was measured from conventional LV outflow and inflow Doppler velocity profiles. The Tei index correlated significantly with the logarithm of age (r = 0.51, P &lt; .001). The index decreased with aging until 3 years and then did not change after age 3 years. The Tei index in children under age 3 years (0.40 +/- 0.09, n = 80) was significantly higher than that in children ranging in age from 3 to 18 years old (0.33 +/- 0.02, n = 81). The index in patients with dilated cardiomyopathy (0.78 +/- 0.28) was markedly increased compared with that in normal subjects. Age-related changes in the Tei index may reflect maturational or developmental alterations in the LV properties in infants. The data in this study give basic information for further quantitative assessment of global cardiac function in children with congenital or acquired heart disease.

    DOI: 10.1016/S0894-7317(99)70102-1

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  • Coil occlusion of aortopulmonary collateral arteries in an infant with scimitar syndrome

    H Muta, T Akagi, M Iemura, H Kato

    JAPANESE CIRCULATION JOURNAL-ENGLISH EDITION   63 ( 9 )   729 - 731   1999年9月

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    記述言語:英語   出版者・発行元:BLACKWELL SCIENCE ASIA  

    Scimitar syndrome in infancy is a rare condition, presenting with severe congestive heart failure and pulmonary hypertension. The presence of large systemic-pulmonary collateral arteries may play a role in the cause of heart failure and pulmonary hypertension. A 4-month-old infant underwent coil occlusion of large anomalous systemic arteries supplying the right lower pulmonary lobe. Symptoms of severe congestive heart failure and pulmonary hypertension improved dramatically with coil occlusion, and surgical correction was performed 3 months later without any complications. Coil occlusion of anomalous systemic arteries can improve symptoms of heart failure and pulmonary hypertension in infants and may bring about a good surgical result for this disease.

    DOI: 10.1253/jcj.63.729

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  • Clinical features of isolated noncompaction of the ventricular myocardium - Long-term clinical course, hemodynamic properties, and genetic background

    F Ichida, Y Hamamichi, T Miyawaki, Y Ono, T Kamiya, T Akagi, H Hamada, O Hirose, T Isobe, K Yamada, S Kurotobi, H Mito, T Miyake, Y Murakami, T Nishi, M Shinohara, M Seguchi, S Tashiro, H Tomimatsu

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   34 ( 1 )   233 - 240   1999年7月

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

    OBJECTIVES A nationwide survey was conducted to clarify the clinical features of isolated noncompaction of the ventricular myocardium (INVM) in Japanese children in comparison with features previously described in patients with INVM.
    BACKGROUND Isolated noncompaction of the ventricular myocardium is a rare disorder characterized by an excessively prominent trabecular meshwork. It is accompanied by depressed ventricular function, systemic embolism and ventricular arrhythmia.
    METHODS A questionnaire specifically designed for this study was sent to 150 hospitals in Japan where a pediatric cardiology division exists.
    RESULTS Twenty-seven patients were diagnosed by two-dimensional echocardiography, their ages ranging from one week to 15 years at presentation, with follow-up lasting as long as 17 years. The gross anatomical appearance and the extension of noncompacted myocardium predominantly at the apex observed on two-dimensional echocardiograms were similar to observations reported previously. Dissimilarities included a greater number of asymptomatic patients at initial presentation, a longer clinical course with gradually depressed left ventricular function, no systemic embolism, and rare ventricular tachycardia in the Japanese children. Cardiac catheterization disclosed normal left ventricular end-diastolic volume and increased left ventricular end-diastolic pressure in most cases, consistent with restrictive hemodynamics. A higher incidence of Wolff-Parkinson-White syndrome was found in the children, whereas left bundle branch block was rarer than reported in adults. Familial recurrence was high (44%) and included many women.
    CONCLUSION In Japanese children, INVM can be found by screening examinations at asymptomatic stage, and it might have a longer clinical course with gradually depressed left ventricular function and restrictive hemodynamics. The pattern of familial recurrence we observed implies that INVM is a distinctive clinical entity with a heterogeneous genetic background. (C) 1999 by the American College of Cardiology.

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  • Selective high dose gamma-globulin treatment in Kawasaki disease: Assessment of clinical aspects and cost effectiveness

    N Sato, T Sugimura, T Akagi, R Yamakawa, K Hashino, G Eto, M Iemura, M Ishii, H Kato

    PEDIATRICS INTERNATIONAL   41 ( 1 )   1 - 7   1999年2月

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    記述言語:英語   出版者・発行元:BLACKWELL SCIENCE ASIA  

    Background: High-dose intravenous gamma-globulin (IVGG) plus aspirin (ASA) treatment is effective in preventing coronary artery complications in acute Kawasaki disease (KD). However, gamma-globulin is very expensive, especially in Japan. Furthermore the indication for IVGG treatment and the optimal dose of gamma-globulin remain controversial.
    Objectives: To examine these two issues, we used Harada's scoring system to investigate whether a single 2 g/kg dose therapy has any advantage over the 5 day 400 mg/kg per day therapy.
    Methods: We studied 203 patients with KD who had no coronary artery complications on admission. Of these, 145 patients scored 4 or more on Harada score within the first 9 days of illness and were treated with IVGG treatment. Using a random number table, 72 patients were selected to receive a single 2 g/kg dose (2 g group), while the remaining 73 patients were treated with 400 mg/kg; per day for 5 consecutive days (400 mg group). Those who had a Harada score of three or less received no IVGG (non-IVGG group) treatment (58 patients).
    Results: The incidence rate of coronary artery complications in the 2 g group was significantly lower than in the 400 mg group. The duration of high fever, positive duration of C-reactive protein and the number of hospital days in the 2 g group were each significantly shorter than in the 400 mg group. The total medical expense in the 2 g group was significantly lower than in the 400 mg group. There were no coronary artery complications in the non-IVGG group.
    Conclusions: It was found to be clinically more effective and more cost effective to select a patient by Harada's scoring system and, where a score of four or more was obtained, to administer a single 2 g/kg intravenous dose of gamma-globulin for acute KD.

    DOI: 10.1046/j.1442-200X.1999.01014.x

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    前野泰樹, 棚成嘉文, 石井正浩, 赤木禎治, 加藤裕久

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