研究者詳細 - 黒子　洋介

論文 - 黒子　洋介

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Papillary-ventricular complex tugging for ischemic/functional mitral regurgitation. 国際誌

Masanori Hirota, Takanori Suezawa, Takuya Kawabata, Yosuke Kuroko, Yasuhiro Kotani, Fumi Yokohama, Yoichi Takaya, Hiroshi Ito, Shingo Kasahara

The Annals of thoracic surgery 113 ( 1 ) e71-e73 2021年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

DOI： 10.1016/j.athoracsur.2021.03.095

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Staged Repair of Tetralogy of Fallot: A Strategy for Optimizing Clinical and Functional Outcomes. 国際誌

Yasuyuki Kobayashi, Yasuhiro Kotani, Yosuke Kuroko, Takuya Kawabata, Shunji Sano, Shingo Kasahara

The Annals of thoracic surgery 113 ( 5 ) 1575 - 1581 2021年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

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

DOI： 10.1016/j.athoracsur.2021.01.087

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肥大したRVとは1.5または2心室修復が可能なくらい大きいのか? 岡山大学における純型肺動脈閉鎖症の段階的二心室治療戦略(How big RV is big enouh to go for biventricular repair or one and one half ventricular repair?)

笠原真悟, 小谷恭弘, 辻龍典, 木佐森永理, 小松弘明, 小林泰幸, 迫田直也, 横田豊, 堀尾直裕, 村岡玄弥, 小林純子, 川畑拓也, 黒子洋介, 末澤孝徳, 廣田正規

日本心臓血管外科学会学術総会抄録集 51回 PD2 - 2 2021年2月

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

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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Norwood procedure with right ventricle to pulmonary artery conduit: a single-centre 20-year experience. 国際誌

Yasuyuki Kobayashi, Yasuhiro Kotani, Yosuke Kuroko, Takuya Kawabata, Shunji Sano, Shingo Kasahara

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 58 ( 2 ) 230 - 236 2020年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVES: The aim of this study was to evaluate the long-term outcomes of the Norwood procedure with right ventricle-pulmonary artery (RV-PA) conduit for hypoplastic left heart complex. METHODS: A retrospective observational study was performed in 136 patients with hypoplastic left heart complex who underwent a Norwood procedure with RV-PA conduit between 1998 and 2017. The probabilities of survival, reintervention and Fontan completion were analysed. RESULTS: Stage 1 survival was 91.9% (125/136). Reintervention for PA stenosis was needed for 22% and 30% at stages 2 and 3, respectively, while 15% underwent reintervention for aortic arch recoarctation. Among 106 bidirectional Glenn survivors, 93 (68% of the total number of patients) had a Fontan completion, while 4 were not considered to be Fontan candidates. Risk factors for overall mortality included weighing <2.5 kg at the time of the Norwood procedure, intact atrium septum, total anomalous pulmonary vein connection and more than mild atrioventricular regurgitation at the time of the Norwood procedure. Overall survival was 80.9%, 72.3% and 62.8% at 1, 5 and 20 years, respectively. CONCLUSIONS: Probabilities of survival and Fontan completion were acceptable under the current surgical strategy incorporating RV-PA Norwood procedure as the first palliation. Incorporating a strategy to maintain PA growth and ventricular function through the staged repair is of prime importance. Further studies are necessary to observe changes in atrioventricular regurgitation as well as in right ventricular function, in patients who require atrioventricular valve interventions during the staged Fontan completion.

DOI： 10.1093/ejcts/ezaa041

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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

記述言語：英語掲載種別：研究論文（学術雑誌）

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

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

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

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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Congenital left ventricular aneurysm diagnosed with atrial septal defect. 国際誌

Yasuyuki Kobayashi, Yasuhiro Kotani, Yosuke Kuroko, Sadahiko Arai, Shingo Kasahara

Asian cardiovascular & thoracic annals 27 ( 5 ) 404 - 406 2019年6月

EVAR時代の開腹手術の現状

大澤晋, 藤井泰宏, 奥山倫弘, 黒子洋介, 小林泰幸, 村岡玄哉, 笠原真悟

日本血管外科学会雑誌 27 ( Suppl. ) P11 - 1 2018年6月

Homograft Replacement for Repeated Pseudoaneurysm after Aortic Valve Surgery in a Patient with Behçet Disease

Takuya Goto, Yosuke Kuroko, Takuya Kawabata, Koki Eto, Yasuyuki Kobayashi, Daiki Ousaka, Shingo Kasahara, Zenichi Masuda

Japanese Journal of Cardiovascular Surgery 47 ( 3 ) 133 - 137 2018年5月

[Subdural Hematoma after Open Heart Surgery for Infective Endocarditis Presenting with Pre-operative Intracranial Hemorrhage Infarction;Report of a Case].

Ryuta Tai, Yosuke Kuroko, Makoto Mohri, Masakazu Yamaoka

Kyobu geka. The Japanese journal of thoracic surgery 71 ( 5 ) 343 - 346 2018年5月

記述言語：日本語掲載種別：研究論文（学術雑誌）

A 47-year-old woman with a history of radiation enteritis and implantation of a central venous port was admitted to our intensive care unit(ICU) suffering from high fever. She was diagnosed with active infective endocarditis due to catheter-related blood stream infection. Although echocardiography showed a large vegetation on the mitral valve, surgical therapy was postponed for 5 weeks because of intracranial hemorrhage infarction. On the 3rd day after mitral valve repair, she developed consciousness disturbance and computed tomography(CT) revealed acute subdural hematoma of the posterior cranial fossa. Fortunately, she fully recovered from the neurological complication without surgical intervention.

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体格の小さな重症心不全患児に対する補助循環の現状

高寛, 堂口琢磨, 西村まどか, 宮本綾子, 高浪大地, 黒子洋介, 笠原真悟

体外循環技術 44 ( 3 ) 257 - 257 2017年9月

Fontan手術到達例から見たAsplenia syndromeの外科治療の成績査読

笠原真悟, 井上善紀, 川田幸子, 佐野俊和, 堀尾直裕, 小林純子, 石神修大, 藤井泰宏, 黒子洋介, 小谷恭弘, 新井禎彦

日本小児循環器学会雑誌 33 ( Suppl.1 ) s1 - 188 2017年7月

EVARにおける治療介入が必要であったtype 2エンドリークの検討 Dダイマーを中心に

大澤晋, 藤井泰宏, 増田善逸, 黒子洋介

日本血管外科学会雑誌 26 ( Suppl. ) O15 - 1 2017年6月

Decreased Serum Levels of High Mobility Group Box 1 (HMGB-1) after Graft Replacement or Stenting of Abdominal Aortic Aneurysm. 国際誌

Daiki Ousaka, Yasuhiro Fujii, Susumu Oozawa, Masahiro Nishibori, Yosuke Kuroko, Zenichi Masuda, Shunji Sano

Annals of vascular surgery 41 265 - 270 2017年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: High-mobility group box 1 (HMGB-1) is a key substance mediating inflammation and development of atherosclerotic lesions (ALs), including abdominal aortic aneurysms (AAA). Serum levels of HMGB-1 are increased in patients with AAA than those in normal controls because the ALs in AAAs secrete HMGB-1. We therefore postulate that the serum HMGB-1 level should decrease after endovascular aortic repair (EVAR) or open aortic repair (OAR). However, there is no evidence of this in the literature. The purpose of this study was to investigate the changes in HMGB-1 levels after surgical intervention for AAA. We also aimed to determine if the HMGB-1 levels varied between the two procedures. METHODS: Serum HMGB-1 levels were determined in 24 patients with AAA and 25 healthy controls. Twelve of the 24 AAA patients underwent EVAR, whereas the other half underwent OAR. The relationship between HMGB-1 levels and presence of AAA or influence of operative methods on the serum HMGB-1 level were prospectively investigated. RESULTS: Serum HMGB-1 levels in AAA patients were significantly higher than those in healthy controls (9.4 ± 5.7 vs. 4.1 ± 2.0 ng/mL, P < 0.01). The serum HMGB-1 levels in both the EVAR group and the OAR group were significantly decreased from baseline at both 3 mo and 1 y after surgery. CONCLUSIONS: Removal or isolation of AL via surgical intervention significantly decreases serum HMGB-1 levels. The significant postoperative reduction in HMGB-1 levels suggests that important endocrinological changes occur after surgical treatment of AAA.

DOI： 10.1016/j.avsg.2016.08.017

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EVARにおけるtype 2エンドリークの検討術前塞栓の必要性を中心に

大澤晋, 藤井康宏, 増田善逸, 黒子洋介, 藤原寛康, 生口俊浩, 松井裕輔, 平木隆夫, 郷原英夫, 金澤右

IVR: Interventional Radiology 32 ( Suppl. ) 248 - 248 2017年4月

Intracoronary Cardiac Progenitor Cells in Single Ventricle Physiology: The PERSEUS (Cardiac Progenitor Cell Infusion to Treat Univentricular Heart Disease) Randomized Phase 2 Trial. 国際誌

Shuta Ishigami, Shinichi Ohtsuki, Takahiro Eitoku, Daiki Ousaka, Maiko Kondo, Yoshihiko Kurita, Kenta Hirai, Yosuke Fukushima, Kenji Baba, Takuya Goto, Naohiro Horio, Junko Kobayashi, Yosuke Kuroko, Yasuhiro Kotani, Sadahiko Arai, Tatsuo Iwasaki, Shuhei Sato, Shingo Kasahara, Shunji Sano, Hidemasa Oh

Circulation research 120 ( 7 ) 1162 - 1173 2017年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

RATIONALE: Patients with single ventricle physiology are at high risk of mortality resulting from ventricular dysfunction. The preliminary results of the phase 1 trial showed that cardiosphere-derived cells (CDCs) may be effective against congenital heart failure. OBJECTIVE: To determine whether intracoronary delivery of autologous CDCs improves cardiac function in patients with single ventricle physiology. METHODS AND RESULTS: We conducted a phase 2 randomized controlled study to assign in a 1:1 ratio 41 patients who had single ventricle physiology undergoing stage 2 or 3 palliation to receive intracoronary infusion of CDCs 4 to 9 weeks after surgery or staged reconstruction alone (study A). The primary outcome measure was to assess improvement in cardiac function at 3-month follow-up. Four months after palliation, controls had an alternative option to receive late CDC infusion on request (study B). Secondary outcomes included ventricular function, heart failure status, somatic growth, and health-related quality of life after a 12-month observation. At 3 months, the absolute changes in ventricular function were significantly greater in the CDC-treated group than in the controls (+6.4% [SD, 5.5] versus +1.3% [SD, 3.7]; P=0.003). In study B, a late CDC infusion in 17 controls increased the ventricular function at 3 months compared with that at baseline (38.8% [SD, 7.7] versus 34.8% [SD, 7.4]; P<0.0001). At 1 year, overall CDC infusion was associated with improved ventricular function (41.4% [SD, 6.6] versus 35.0% [SD, 8.2]; P<0.0001) and volumes (P<0.001), somatic growth (P<0.0001) with increased trophic factors production, such as insulin-like growth factor-1 and hepatocyte growth factor, and quality of life, along with a reduced heart failure status (P<0.0001) and cardiac fibrosis (P=0.014) relative to baseline. CONCLUSIONS: Intracoronary infusion of CDCs after staged palliation favorably affected cardiac function by reverse remodeling in patients with single ventricle physiology. This impact may improve heart failure status, somatic growth, and quality of life in patients and reduce parenting stress for their families. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01829750.

DOI： 10.1161/CIRCRESAHA.116.310253

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小児大動脈弁疾患の外科治療戦略新生児・乳児期の先天性大動脈弁狭窄症に対する治療戦略と遠隔期成績

笠原真悟, 佐野俊和, 堀尾直裕, 後藤拓弥, 小林純子, 衛藤弘城, 石神修大, 藤井泰宏, 黒子洋介, 大澤晋, 小谷恭弘, 増田善逸, 新井禎彦, 佐野俊二

日本心臓血管外科学会学術総会抄録集 47回 474 - 474 2017年2月

EVARにおけるtype 2エンドリークの検討腰動脈塞栓の必要性を中心に

大澤晋, 藤井泰宏, 増田善逸, 黒子洋介, 佐野俊二

日本心臓血管外科学会学術総会抄録集 47回 676 - 676 2017年2月

[Delayed Diagnosis of Aortic Dissection Following Thrombolytic Therapy in a Patient with Acute Ischemic Stroke;Report of a Case].

Yosuke Miyamoto, Zenichi Masuda, Yasuhiro Kotani, Suguru Tarui, Yosuke Kuroko, Yasuhiro Fujii, Susumu Ozawa, Shunji Sano

Kyobu geka. The Japanese journal of thoracic surgery 69 ( 12 ) 1037 - 1040 2016年11月

記述言語：日本語掲載種別：研究論文（学術雑誌）

Diagnosis of aortic dissection complicating cerebral ischemic stroke is difficult. A 60-year-old patient presented at an emergency department of a hospital with a sudden development of left-sided weakness, but without chest pain. During administration of recombinant tissue plasminogen activator with diagnosis of cerebral infarction, he developed symptomatic hypotension and was transferred to our hospital. His chest computed tomography revealed Stanford type A aortic dissection. Replacement of the ascending aorta and aortic arch was successfully performed on the 4th day.

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