Publications by authors named "Hiroyuki Kamiya"

302 Publications

A word of caution: bilateral axillofemoral bypass could not provide sufficient blood flow in a patient who underwent aortic resection for aortoesophageal fistula: a case report.

J Surg Case Rep 2021 Oct 25;2021(10):rjab356. Epub 2021 Oct 25.

Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.

An 81-year-old man was transferred to our hospital for a ruptured infected descending aortic aneurysm. An emergency thoracic endovascular aortic repair was performed, but a computed tomography scan 7 days later revealed an aortoesophageal fistula. The establishment of extracorporeal circulation using the femoral artery and utilization of the omentum was considered difficult. We performed bilateral axillofemoral bypass followed by descending aortic resection and esophagectomy. However, the patient's circulatory insufficiency worsened, and he died on the 18th postoperative day. In the treatment of aortoesophageal fistula, bilateral axillofemoral bypass is not recommended as an alternative to descending aortic replacement.
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http://dx.doi.org/10.1093/jscr/rjab356DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8557330PMC
October 2021

COVID-19 mRNA Vaccine-induced Pneumonitis: A Case Report.

Intern Med 2021 Oct 26. Epub 2021 Oct 26.

Department of Internal Medicine, Tatebayashi Kosei General Hospital, Japan.

A 65-year-old man experienced cough and shortness of breath 3 days after receiving the first dose of the Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine. Chest X-ray revealed bilateral infiltrates, and the desaturation deteriorated rapidly. The symptoms and radiographic abnormalities rapidly improved after the initiation of corticosteroid therapy. Intradermal testing of the Pfizer-BioNTech COVID-19 vaccine showed a delayed positive reaction. Based on these findings, the patient was diagnosed with COVID-19 vaccine-induced pneumonitis. The timing of the onset of pneumonitis after vaccination and the results of intradermal testing suggest that Type IV hypersensitivity against COVID-19 vaccine may have been responsible for this clinical condition.
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http://dx.doi.org/10.2169/internalmedicine.8310-21DOI Listing
October 2021

Investigations into the Potential of Using Open Source CFD to Analyze the Differences in Hemodynamic Parameters for Aortic Dissections (Healthy versus Stanford Type A and B).

Ann Vasc Surg 2021 Oct 12. Epub 2021 Oct 12.

Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.

Background: The objective of this study was to develop a method to evaluate the effects of an aortic dissection on hemodynamic parameters by conducting a comparison with that of a healthy (nondissected) aorta. Open-source software will be implemented, no proprietary software/application will be used to ensure accessorily and repeatability, in all the data analysis and processing. Computed tomography (CT) images of aortic dissection are used for the model geometry segmentation. Boundary conditions from literature are implemented to computational fluid dynamics (CFD) to analyze the hemodynamic parameters.

Methods: A numerical simulation model was created by obtaining accurate 3-dimensional geometries of aortae from CT images. In this study, CT images of 8 cases of aortic dissection (Stanford type-A and type-B) and 3 cases of healthy aortae are used for the actual aorta model geometry segmentation. These models were exported into an open-source CFD software, OpenFOAM, where a simplified pulsating flow was simulated by controlling the flow pressure. Ten cycles of the pulsatile flow (0.50 sec/cycle) conditions, totaling 5 sec, were calculated.

Results: The pressure distribution, wall shear stress (WSS) and flow velocity streamlines within the aorta and the false lumen were calculated and visualized. It was found that the flow velocity and WSS had a high correlation in high WSS areas of the intermittent layer between the true and false lumen. Most of the Stanford type-A dissections in the study showed high WSS, over 38 Pa, at the systole phase. This indicates that the arterial walls in type-A dissections are more likely to be damaged with pulsatile flow.

Conclusions: Using CFD to estimate localized high WSS areas may help in deciding to treat a type-A or B dissection with a stent graft to prevent a potential rupture.
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http://dx.doi.org/10.1016/j.avsg.2021.08.007DOI Listing
October 2021

Use of laboratory testing for prediction of postoperative bleeding volume in cardiovascular surgery.

Thromb J 2021 Oct 9;19(1):70. Epub 2021 Oct 9.

Department of Medical Laboratory and Blood Center, Asahikawa Medical University Hospital, Midorigaoka-Higashi 2-1-1-1, Asahikawa, 078-8510, Japan.

Background: Coagulopathy and following massive bleeding are complications of cardiovascular surgery, particularly occurring after procedures requiring prolonged cardiopulmonary bypass (CPB). Reliable and rapid tests for coagulopathy are desirable for guiding transfusion. Measuring multiple coagulation parameters may prove useful. The purpose of this study is to determine the laboratory parameters predicting massive bleeding.

Methods: In a prospectively collected cohort of 48 patients undergoing cardiovascular surgery, markers of coagulation and fibrinolysis were measured using automated analyzer and their correlations with bleeding volume were determined.

Results: Operation time was 318 (107-654) min. CPB time was 181 (58-501) min. Bleeding volume during surgery was 2269 (174-10,607) ml. Number of transfusion units during surgery were packed red blood cells 12 (0-30) units, fresh frozen plasma 12 (0-44) units, platelets 20 (0-60) units and intraoperative autologous blood collection 669 (0-4439) ml. Post-surgery activities of coagulation factors II (FII), FV, FVII, FVIII, FIX, FX, FXI and FXII were decreased. Values of fibrinogen, antithrombin, α2 plasmin inhibitor (α2PI) and FXIII were also decreased. Values of thrombin-antithrombin complex (TAT) were increased. Values of FII, FIX, FXI and α2PI before surgery were negatively correlated with bleeding volume (FII, r = - 0.506: FIX, r = - 0.504: FXI, r = - 0.580; α2PI, r = - 0.418). Level of FIX after surgery was negatively correlated with bleeding volume (r = - 0.445) and level of TAT after surgery was positively correlated with bleeding volume (r = 0.443).

Conclusions: These results suggest that several clinical and routine laboratory parameters of coagulation were individually associated with bleeding volume during cardiovascular surgery. Determining the patterns of coagulopathy may potentially help guide transfusion during cardiovascular surgery.
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http://dx.doi.org/10.1186/s12959-021-00324-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501637PMC
October 2021

Feasibility of the AtriClip Pro Left Atrium Appendage Elimination Device via the Transverse Sinus in Minimally Invasive Mitral Valve Surgery.

J Chest Surg 2021 Oct;54(5):383-388

Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.

Background: Achieving external access to and manual occlusion of the left atrial appendage (LAA) during minimally invasive mitral valve surgery (MIMVS) through a small right thoracotomy is difficult. Occlusion of the LAA using an epicardial closure device seems quite useful compared to other surgical techniques.

Methods: Fourteen patients with atrial fibrillation underwent MIMVS with concomitant surgical occlusion of the LAA using double-layered endocardial closure stitches (n=6, endocardial suture group) or the AtriClip Pro closure device (n=8, AtriClip group) at our institution. The primary safety endpoint was any device-related adverse event, and the primary efficacy endpoint was successful complete occlusion of blood flow into the LAA as assessed by transthoracic echocardiography at hospital discharge. The primary efficacy endpoint for stroke reduction was the occurrence of ischemic or hemorrhagic neurologic events.

Results: All patients underwent LAA occlusion as scheduled. The cardiopulmonary bypass and aortic cross-clamp times in the endocardial suture group and the AtriClip group were 202±39 and 128±41 minutes, and 213±53 and 136±44 minutes, respectively (p=0.68, p=0.73). No patients in either group experienced any device-related serious adverse events, incomplete LAA occlusion, early postoperative stroke, or neurologic complication.

Conclusion: Epicardial LAA occlusion using the AtriClip Pro during MIMVS in patients with mitral valve disease and atrial fibrillation is a simple, safe, and effective adjunctive procedure.
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http://dx.doi.org/10.5090/jcs.21.048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8548185PMC
October 2021

Gene correction by 5'-tailed duplexes with short editor oligodeoxyribonucleotides.

J Biosci Bioeng 2021 Dec 10;132(6):552-559. Epub 2021 Sep 10.

Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan. Electronic address:

Various diseases, including cancer, are caused by genetic mutations. A 5'-tailed duplex (TD) DNA, consisting of a long single-stranded (ss) editor DNA and a short (∼35-base) ss assistant oligodeoxyribonucleotide, can introduce a base-substitution in living cells and thus correct mutated genes. Previously, several hundred-base DNAs were employed as the editor DNAs. In this study, 5'-TDs were prepared from various editor DNAs with different lengths and examined for their gene correction abilities, using plasmid DNA bearing a mutated copepod green fluorescent protein (copGFP) gene, in human cells. High-throughput analysis was performed by the reactivated fluorescence of the wild-type protein encoded by the corrected gene as the indicator. The analysis revealed that 5'-TDs with ∼100-base ss editor DNAs enabled gene editing at least as efficiently as those with longer editor DNAs. Moreover, the antisense strand was more effective as the editor than the sense strand, in contrast to the 5'-TDs with longer editor strands. These results indicated that the 5'-TD fragments with shorter editor strands than those used in previous studies are useful nucleic acids for gene correction.
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http://dx.doi.org/10.1016/j.jbiosc.2021.08.012DOI Listing
December 2021

Transapical thoracic endovascular aortic repair with a frozen elephant trunk for thoracic aortic aneurysm with shaggy aorta.

JTCVS Tech 2021 Aug 1;8:33-36. Epub 2021 Apr 1.

Division of Cardiac Surgery, Department of Surgery, Asahikawa Medical University, Asahikawa, Japan.

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http://dx.doi.org/10.1016/j.xjtc.2021.03.030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8350784PMC
August 2021

Impact of the axillary approach on epicardial pacing lead durability in children.

Ann Thorac Surg 2021 Aug 4. Epub 2021 Aug 4.

Department of Cardiovascular Surgery, Kanagawa Children's Medical Center, Yokohama, Japan.

Background: To avoid lead failure and pocket infection in neonates/infants requiring pacemakers, we used the axillary approach of placing the generator in the axilla and the leads in the intrathoracic space. We describe the technical details of the axillary approach and evaluate the efficacy of this method.

Methods: We assessed 21 patients (7 males) weighing ≤8.0 kg who underwent epicardial pacemaker implantation with the axillary approach between 2004 and 2018. The axillary approach entails (1) positioning the pacemaker generator in the axilla to avoid local skin/pocket complications due to tissue compression by the generator and (2) making a double loop in the pleural space to reduce stress on the pacemaker leads caused by somatic growth. This approach can be combined with median sternotomy for simultaneous intracardiac repair.

Results: The patients' median age at pacemaker implantation was 6.0 months; 16 (76%) patients were aged <12 months. The median body weight was 4.5 kg (interquartile range: 3.0-7.0). In all five patients requiring simultaneous cardiac repair, a median sternotomy was performed to access the heart. Sixteen patients required only pacemaker implantation: left thoracotomy was performed in 10 patients, right thoracotomy in 5, and subxiphoid approach in 1. The 5- and 10-year freedom from pacemaker-related adverse events was 89.4% and 79.5%, respectively.

Conclusions: The axillary approach using intrathoracic double-loop routing of leads to position the generator in the axilla for pacemaker implantation can be a valuable alternative for neonates/infants weighing ≤8 kg with or without complex congenital heart disease.
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http://dx.doi.org/10.1016/j.athoracsur.2021.06.079DOI Listing
August 2021

Comparing Conscious Sedation With Regional Anesthesia Versus General Anesthesia in Minimally Invasive Mitral Valve Surgery With Right-Sided Minithoracotomy: A Retrospective Study.

J Cardiothorac Vasc Anesth 2021 Jul 8. Epub 2021 Jul 8.

Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.

Objectives: The aims of the present study were to evaluate and compare the safety and feasibility, including hospitalization, intensive care unit (ICU) stay, frequency of conversion to general anesthesia (GA), pH, PaCO, and PaO, of selected patients who underwent minimally invasive mitral valve surgery (MIMVS) via a right minithoracotomy under conscious sedation (CS) to avoid GA. The authors also aimed to evaluate the perioperative management of spontaneous breathing.

Design: A retrospective, observational study.

Setting: Single-center.

Participants: This study enrolled 101 patients who underwent MIMVS under CS or GA.

Interventions: The patients who underwent MIMVS were managed under CS or GA according to indication criteria.

Measurements And Main Results: ICU stay (p = 0.010), postoperative time until first fluid intake (p < 0.0001), and duration of mechanical ventilation (p = 0.004) were shorter in the CS group than in the GA group. No patients converted to GA from CS. PaCO during cardiopulmonary bypass (CPB) in the CS group was significantly lower than that in the GA group. However, PaCO at the termination of CPB in the CS group was significantly higher than that in the GA group.

Conclusions: In the CS group, advanced-age patients with comorbidities underwent mitral surgery without postoperative complications. The authors' findings suggested that MIMVS under CS could be a potentially less-invasive method, providing a quicker recovery than MIMVS under GA.
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http://dx.doi.org/10.1053/j.jvca.2021.07.005DOI Listing
July 2021

Action-at-a-distance mutations at 5'-GpA-3' sites induced by oxidised guanine in WRN-knockdown cells.

Mutagenesis 2021 Oct;36(5):349-357

Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan.

G:C sites distant from 8-oxo-7,8-dihydroguanine (GO, 8-hydroxyguanine) are frequently mutated when the lesion-bearing plasmid DNA is replicated in human cells with reduced Werner syndrome (WRN) protein. To detect the untargeted mutations preferentially, the oxidised guanine base was placed downstream of the reporter supF gene and the plasmid DNA was introduced into WRN-knockdown cells. The total mutant frequency seemed higher in the WRN-knockdown cells as compared to the control cells. Mutation analyses revealed that substitution mutations occurred at the G:C pairs of 5'-GpA-3'/5'-TpC-3' sites, the preferred sequence for the apolipoprotein B mRNA-editing enzyme, catalytic polypeptide-like 3 (APOBEC3)-family cytosine deaminases, in the supF gene in both control and knockdown cells. These mutations were observed more frequently at G sites than C sites on the DNA strand where the GO base was originally located. This tendency was promoted by the knockdown of the WRN protein. The present results imply the possible involvement of APOBEC3-family cytosine deaminases in the action-at-a-distance (untargeted) mutations at G:C (or G) sites induced by GO and in cancer initiation by oxidative stress.
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http://dx.doi.org/10.1093/mutage/geab027DOI Listing
October 2021

Edge-to-edge repair of the systolic anterior motion of mitral valve and cardiac myectomy of the abnormally positioned papillary muscles in an infant with mutation.

J Surg Case Rep 2021 Jun 25;2021(6):rjab240. Epub 2021 Jun 25.

Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa 078-8510, Japan.

Surgical treatment is challenging in pediatric patients with left ventricular outflow tract (LVOT) stenosis (LVOTS). We herein present the case of a 2-year-old male patient with porencephaly who was diagnosed with LVOTS accompanied by moderate mitral valve regurgitation (MR) with systolic anterior motion (SAM). Edge-to-edge mitral valve reconstruction and myectomy of the abnormal cardiac muscle were performed, with an uneventful postoperative course. LVOT myectomy and edge-to-edge mitral valve repair may be considered as a safe and acceptable approach with good clinical outcomes in pediatric patients with LVOTS accompanied by MR with SAM.
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http://dx.doi.org/10.1093/jscr/rjab240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8238399PMC
June 2021

Similar frequency and signature of untargeted substitutions induced by abasic site analog under reduced human APE1 conditions.

J Toxicol Sci 2021 ;46(6):283-288

Graduate School of Biomedical and Health Sciences, Hiroshima University.

Abasic sites are formed in cells by various factors including environmental mutagens and considered to be involved in cancer initiation, promotion, and progression. A chemically stable abasic site analog (tetrahydrofuran-type analog, THF) induces untargeted base substitutions as well as targeted substitution and large deletion mutations in human cells. The untargeted substitutions may be initiated by the cleavage of the DNA strand bearing THF by the human apurinic/apyrimidinic endonuclease 1 (APE1) protein, the major repair enzyme for THF and abasic sites. To examine the effects of lower APE1 levels, the protein was knocked down by siRNA in human U2OS cells. A plasmid containing a single THF modification outside the supF gene was introduced into the knockdown cells, and the untargeted substitution mutations in the reporter gene were analyzed. Unexpectedly, the knockdown had no evident impact on their frequency and spectrum. The G bases of 5'-GpA-3' dinucleotides on the modified strand were quite frequently substituted, with and without the APE1 knockdown. These results suggested that the DNA strand cleavage by APE1 is not essential for the THF-induced untargeted base substitutions.
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http://dx.doi.org/10.2131/jts.46.283DOI Listing
November 2021

Simultaneous aortic and pulmonary valve replacement in a young patient after intracardiac repair for tetralogy of Fallot: mechanical or biological valve? A case report.

J Surg Case Rep 2021 May 17;2021(5):rjab170. Epub 2021 May 17.

Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.

Pulmonary valve stenosis and regurgitation can occur in the distant stages after intracardiac repair of tetralogy of Fallot (TOF). Aortic regurgitation (AR) can also occur, although it is rare in postoperative patients. However, there are few reports of simultaneous replacement of the pulmonary and aortic valves in young patients after intracardiac repair of TOF, and there are no clear guidelines for selecting a valve prosthesis in such patients. We report a case of severe pulmonary valve stenosis and regurgitation with severe AR 38 years after the TOF operation, in which urgent double valve replacement and right ventricular outflow tract patching were performed with a mechanical valve in the aortic valve position and a bioprosthetic valve in the pulmonary valve position, with a successful outcome.
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http://dx.doi.org/10.1093/jscr/rjab170DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130639PMC
May 2021

A systematic review of the incidence, risk factors and prognosis of acute exacerbation of systemic autoimmune disease-associated interstitial lung disease.

BMC Pulm Med 2021 May 5;21(1):150. Epub 2021 May 5.

Department of Intensive Care Medicine, Northern Hospital, Melbourne, Australia.

Introduction: Acute exacerbation (AE) is a devastating phenomenon and reported to be complicated with systemic autoimmune disease-associated interstitial lung disease (ILD). The aim of this study was to investigate the incidence and prognosis of AE of systemic autoimmune disease-ILD and clarify relevant clinical information predictive of these outcomes.

Method: This study was designed as a systematic review and meta-analysis. A primary study except for a case report, which reported the incidence and/or prognosis of AE of systemic autoimmune disease-ILD, was eligible for the review. Electronic databases such as Medline and EMBASE were searched from 2002 through 23 February 2020. Two reviewers independently selected eligible reports and extracted relevant data. Risk of bias of individual studies was assessed similarly. The incidence and prognosis of the disease were analysed qualitatively. Univariate results of risk and prognostic factors were combined if feasible.

Results: Out of a total of 2662 records, 24 studies were eligible. A total of 420 subjects with 45.7% of men developed AE of systemic autoimmune disease-ILD and the two major underlying systemic autoimmune diseases were rheumatoid arthritis (34.2%) and polymyositis/dermatomyositis (31.9%). The frequency ranged from 4.3 to 32.9% with the incident rate being 3.19 and 5.77 per 100 patient-years and all-cause mortality was between 30.0 and 58.3% at 90 days. Age at initial presentation was significantly associated with the development of AE of systemic autoimmune disease-ILD with an HR of 1.22 (95%CI 1.05-1.50) while a percentage of predicted diffusing capacity of the lung for carbon monoxide (%DLCO) was also significantly associated with the development of the disease with an HR of 0.95 (95%CI 0.90-1.00) and an OR of 0.97 (95%CI 0.95-0.99). Partial pressure of arterial oxygen/fraction of inspired oxygen ratio (PaO/FiO) at AE was significantly associated with all-cause mortality of AE of systemic autoimmune disease-ILD with an HR of 0.99 (95%CI 0.98-0.99).

Conclusion: AE of systemic autoimmune disease-ILD was not uncommon and demonstrated dismal prognosis. Age at initial presentation and %DLCO were deemed as risk factors while PaO/FiO at AE was considered as a prognostic factor of the disease. Registration CRD42019138941.
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http://dx.doi.org/10.1186/s12890-021-01502-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8101129PMC
May 2021

Micra leadless pacemaker for bridge use after explantation of infected permanent pacemaker system: a case report.

J Surg Case Rep 2021 Apr 14;2021(4):rjab094. Epub 2021 Apr 14.

Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.

The extraction of a pacemaker (PM) lead may cause tricuspid regurgitation; however, in cases of device infection, surgical intervention or immediate PM system replacement is undesirable in the short term to prevent reinfection. We describe a case where Micra leadless PM was used as a bridge procedure to ensure an adequate period for antibacterial therapy and later replaced with a permanent PM system in the setting of PM pocket infection.
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http://dx.doi.org/10.1093/jscr/rjab094DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8053411PMC
April 2021

A simplified isolation technique for atherosclerotic aortic arch aneurysms surgery.

J Surg Case Rep 2021 Apr 19;2021(4):rjab082. Epub 2021 Apr 19.

Department of Cardiovascular Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.

The isolation technique is a useful adjunct that prevents atherosclerotic embolism in the brain when the aneurysm is filled with a massive hematoma or 'shaggy aorta'. But the technique is not widespread because of the difficulty in performing the cannulation. We modified this technique by simplifying the cannulation procedure using a puncture method with aortic root cannulas.
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http://dx.doi.org/10.1093/jscr/rjab082DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8055174PMC
April 2021

Systematic review and meta-analysis of the risk of rheumatoid arthritis-associated interstitial lung disease related to anti-cyclic citrullinated peptide (CCP) antibody.

BMJ Open 2021 03 31;11(3):e040465. Epub 2021 Mar 31.

Department of Intensive Care Medicine, Northern Hospital, Epping, Victoria, Australia.

Objective: To clarify the risk of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) related to anti-cyclic citrullinated peptide (CCP) antibody.

Eligibility Criteria: Patients with RA with and without ILD were eligible. The primary outcome was the prevalence or incidence of ILD. Primary studies of any design aside from a case report were eligible.

Information Sources: Medline, EMBASE, Science Citation Index Expanded and Cochrane Central Register of Controlled Trials were searched from the inception through 12 November 2019.

Data Extraction And Risk Of Bias: Two reviewers independently selected eligible reports, extracted relevant data and assessed risk of bias using a modified Quality in Prognostic Studies tool.

Data Synthesis: Meta-analysis was conducted using a random-effects model.

Quality Of Evidence: The Grades of Recommendation, Assessment, Development and Evaluation system was applied.

Results: Among 29 out of 827 records retrieved through electronic databases and four additional reports identified from other sources, 29 studies were focused for the review. A total of 10158 subjects were included and the mean age at inclusion was between 45.8 and 63.9 years. The mean RA duration was between 4.3 and 14.9 years. The positivity of anti-CCP antibody ranged from 50.7% to 95.8%. All studies except for two were deemed as high risk of bias. A pooled analysis of univariate results demonstrated that the presence of anti-CCP antibody was significantly associated with RA-ILD with an OR of 2.10 (95% CI: 1.59 to 2.78). Similarly, the titre of anti-CCP antibody was significantly higher for RA-ILD with a standardised mean difference of 0.42 (95% CI: 0.20 to 0.65). These results were confirmed by multivariate analysis in the majority of studies and consistent by any subgroup and sensitivity analyses.

Conclusion: The presence and higher titres of anti-CCP antibody were suggested to be significantly associated with an increased risk of RA-ILD. However, the quality of evidence was rated as low or very low.
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http://dx.doi.org/10.1136/bmjopen-2020-040465DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016072PMC
March 2021

Undeliverable Sapien 3 prosthesis in transaortic transcatheter aortic valve implantation.

J Surg Case Rep 2021 Feb 18;2021(2):rjab001. Epub 2021 Feb 18.

Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.

In transaortic (TAo) trasncatheter aortic valve implantation (TAVI), direct transmission of forces to the stenotic aortic valve is possible. Therefore, the need of balloon aortic valvoplasty in TAo-TAVI may be very limited regarding the deliverability of TAVI prosthesis. However, if the TAVI prosthesis becomes undeliverable, it becomes seriously problematic. Herein, we present a case of TAo-TAVI in which the TAVI prosthesis was undeliverable, and it was forcefully pushed together with the introducer system into the aortic valve as a bailout technique.
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http://dx.doi.org/10.1093/jscr/rjab001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7888976PMC
February 2021

Non-pledget commissural suture technique to avoid atrioventricular block.

Gen Thorac Cardiovasc Surg 2021 May 19;69(5):906-908. Epub 2021 Feb 19.

Department of Cardiothoracic Surgery, Excela Health Westmoreland Hospital, Greensburg, PA, USA.

Here, we report our unique "non-pledget commissural suture technique" to avoid complete atrioventricular block during surgical aortic valve replacement, whereby all commissural stiches are made in a figure-of-eight fashion without a pledget. Then, standard stiches in a non-everting fashion are made using pledget sutures and a prosthetic valve is implanted at the supra-annular position. Among 152 evaluated patients, only five patients experienced complications, including three left bundle branch blocks, one postoperative pacemaker implantation, and one moderate paravalvular leak. Based on the high success rate, our technique may be a reasonable alternative for surgical aortic valve replacement.
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http://dx.doi.org/10.1007/s11748-021-01605-5DOI Listing
May 2021

Descending aortic transection for recurrence of a pseudoaneurysm previously treated with a stent graft after extra-anatomical bypass for aortic coarctation: a case report.

Surg Case Rep 2021 Feb 16;7(1):50. Epub 2021 Feb 16.

Department of Cardiac Surgery, Asahikawa Medical University, Midorigaoka Higashi 2-1-1-1, Asahikawa, 078-8510, Japan.

Background: In adult patients with primary or recurrent coarctation of the aorta (CoA), extra-anatomic bypass grafting (EABG) has been widely used as a surgical treatment option. However, there have been few reports on pseudoaneurysms (PAs) of the distal anastomotic sites after extra-anatomic bypass for CoA.

Case Presentation: A 51-year-old man with hemoptysis was transferred to our hospital. Twenty years ago, he had undergone EABG from the ascending to the descending aorta (ascending-to-descending EABG) for CoA with right aortic arch. Eight years ago, he underwent thoracic endovascular aortic repair (TEVAR) for the ruptured PA on the distal anastomotic site of the EABG. Contrast-enhanced computed tomography scans revealed recurrent ruptured PA on the distal anastomotic site of the EABG. Therefore, we decided to replace the descending aorta, followed by end-to-side anastomosis of the EABG to the replaced descending aorta. However, due to massive adhesion of the lung to the EABG and PA, we performed transection of the descending aorta to decompress the PA. The postoperative course was uneventful, and the patient is doing well 5 months after surgery.

Conclusions: Aortic transection between the CoA and the distal anastomosis site may be a useful additional procedure in patients previously treated with TEVAR for PAs in the distal anastomosis site after EABG.
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http://dx.doi.org/10.1186/s40792-021-01136-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7886949PMC
February 2021

Vascular Tissue Engineering: Polymers and Methodologies for Small Caliber Vascular Grafts.

Front Cardiovasc Med 2020 11;7:592361. Epub 2021 Jan 11.

Hematology and Stem Cell Laboratory, Faculty of Pharmacy, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.

Cardiovascular disease is the most common cause of death in the world. In severe cases, replacement or revascularization using vascular grafts are the treatment options. While several synthetic vascular grafts are clinically used with common approval for medium to large-caliber vessels, autologous vascular grafts are the only options clinically approved for small-caliber revascularizations. Autologous grafts have, however, some limitations in quantity and quality, and cause an invasiveness to patients when harvested. Therefore, the development of small-caliber synthetic vascular grafts (<5 mm) has been urged. Since small-caliber synthetic grafts made from the same materials as middle and large-caliber grafts have poor patency rates due to thrombus formation and intimal hyperplasia within the graft, newly innovative methodologies with vascular tissue engineering such as electrospinning, decellularization, lyophilization, and 3D printing, and novel polymers have been developed. This review article represents topics on the methodologies used in the development of scaffold-based vascular grafts and the polymers used and .
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http://dx.doi.org/10.3389/fcvm.2020.592361DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7873993PMC
January 2021

Awake Surgical Mitral Valve Repair after Transcatheter Aortic Valve Replacement.

Thorac Cardiovasc Surg Rep 2021 Jan 20;10(1):e15-e17. Epub 2021 Jan 20.

Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.

Transcatheter aortic valve replacement has become a popular choice for cases with severe aortic stenosis. However, when severe mitral regurgitation is comorbid in high-risk patients with severe aortic stenosis, therapeutic options must be weighed for each case. Here we present a very frail 88-year-old patient with severe aortic stenosis and severe mitral valve regurgitation who underwent a successful awake minimally invasive mitral valve repair after transcatheter aortic valve replacement.
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http://dx.doi.org/10.1055/s-0040-1718774DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817333PMC
January 2021

Anomalous Origin of the Left Anterior Descending Coronary Artery in an Adult.

Thorac Cardiovasc Surg Rep 2021 Jan 19;10(1):e9-e10. Epub 2021 Jan 19.

Department of cardiovascular surgery, National Obihiro Hospital, Obihiro, Hokkaido, Japan.

An anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease. Among the variants, an anomalous origin of the left anterior descending coronary artery from the pulmonary artery (ALADPA) is extremely rare. Here, we report a case of ALADPA in an adult that was treated with coronary artery bypass grafting using the left internal thoracic artery.
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http://dx.doi.org/10.1055/s-0040-1721470DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815332PMC
January 2021

Surgical Management of Aortoenteric Erosion Due to Pulsatile Stress After Aneurysm Repair: A Case Report.

Ann Vasc Dis 2020 Sep;13(3):355-357

Department of Cardiac Surgery, Asahikawa Medical University.

Secondary aortoenteric fistula or erosion (SAEFE), an abnormal connection between the aorta and gastrointestinal tract, is a rare but critical complication after abdominal aortic aneurysm repair. Most SAEFEs occur between the aorta or proximal graft anastomosis and the duodenum, and occurrence between the iliac graft and small intestine is rare. Standard SAEFE management involves graft removal and extra-anatomical bypass. However, this is extremely invasive and has a high mortality rate. We encountered a rare case of SAEFE with no sign of infection, which was successfully treated by ligating the iliac graft to reduce mechanical pulsatile stress and bleeding following the retroperitoneal approach.
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http://dx.doi.org/10.3400/avd.cr.20-00094DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7751083PMC
September 2020

Tyrosyl-DNA phosphodiesterases are involved in mutagenic events at a ribonucleotide embedded into DNA in human cells.

PLoS One 2020 31;15(12):e0244790. Epub 2020 Dec 31.

Department of Biology, Graduate School of Science, Chiba University, Chiba, Japan.

Ribonucleoside triphosphates are often incorporated into genomic DNA during DNA replication. The accumulation of unrepaired ribonucleotides is associated with genomic instability, which is mediated by DNA topoisomerase 1 (Top1) processing of embedded ribonucleotides. The cleavage initiated by Top1 at the site of a ribonucleotide leads to the formation of a Top1-DNA cleavage complex (Top1cc), occasionally resulting in a DNA double-strand break (DSB). In humans, tyrosyl-DNA phosphodiesterases (TDPs) are essential repair enzymes that resolve the trapped Top1cc followed by downstream repair factors. However, there is limited cellular evidence of the involvement of TDPs in the processing of incorporated ribonucleotides in mammals. We assessed the role of TDPs in mutagenesis induced by a single ribonucleotide embedded into DNA. A supF shuttle vector site-specifically containing a single riboguanosine (rG) was introduced into the human lymphoblastoid TK6 cell line and its TDP1-, TDP2-, and TDP1/TDP2-deficient derivatives. TDP1 and TDP2 insufficiency remarkably decreased the mutant frequency caused by an embedded rG. The ratio of large deletion mutations induced by rG was also substantially lower in TDP1/TDP2-deficient cells than wild-type cells. Furthermore, the disruption of TDPs reduced the length of rG-mediated large deletion mutations. The recovery ratio of the propagated plasmid was also increased in TDP1/TDP2-deficient cells after the transfection of the shuttle vector containing rG. The results suggest that TDPs-mediated ribonucleotide processing cascade leads to unfavorable consequences, whereas in the absence of these repair factors, a more error-free processing pathway might function to suppress the ribonucleotide-induced mutagenesis. Furthermore, base substitution mutations at sites outside the position of rG were detected in the supF gene via a TDPs-independent mechanism. Overall, we provide new insights into the mechanism of mutagenesis induced by an embedded ribonucleotide in mammalian cells, which may lead to the fatal phenotype in the ribonucleotide excision repair deficiency.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0244790PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775084PMC
March 2021

The analysis of left ventricular ejection fraction after minimally invasive surgery for primary mitral valve regurgitation.

J Card Surg 2021 Feb 18;36(2):661-669. Epub 2020 Dec 18.

Department of Cardiac Surgery and Research Group for Experimental Surgery, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.

Background: Although minimally invasive mitral valve surgery (MIMVS) has become the first choice for primary mitral regurgitation (MR) in recent years, clinical evidence in this field is yet limited. The main focus of this study was the analysis of preoperative (Pre), postoperative (Post), and 1-year follow-up (Fu) data in our series of MIMVS to identify factors that have an impact on the left ventricular ejection fraction (LVEF) evolution after MIMVS.

Methods: We reviewed the perioperative and 1-year follow-up data from 436 patients with primary MR (338 isolated MIMVS und 98 MIMVS combined with tricuspid valve repair) to analyze patients' baseline characteristics, the change of LV size, the postoperative evolution of LVEF and its factors, and the clinical outcomes.

Results: The overall mean value of ejection fraction (EF) slightly decreased at 1-year follow-up (mean change of LVEF: -2.63 ± 9.00%). A significant correlation was observed for preoperative EF (PreEF) und EF evolution, the higher PreEF the more pronounced decreased EF evolution (in all 436 patients; r = -.54, p < .001, in isolated MIMVS; r = -.54, p < .001, in combined MIMVS; r = -.53, p < .001). Statistically significant differences for negative EF evolution were evident in patients with mild or greater tricuspid valve regurgitation (TR) (in all patients; p < .05, odds ratio [OR] = 1.64, in isolated MIMVS; p < .01, OR = 1.93, respectively). Overall clinical outcome in New York Heart Association classification at 1 year was remarkably improved.

Conclusions: Our results suggest an excellent clinical outcome at 1 year, although mean LVEF slightly declined over time. TR could be a predictor of worsened follow-up LVEF in patients undergoing MIMVS.
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http://dx.doi.org/10.1111/jocs.15256DOI Listing
February 2021

Aorto-Right Atrial Fistula after Minimally Invasive Tricuspid Valve Repair: A Report of Two Cases.

Thorac Cardiovasc Surg Rep 2020 Jan 13;9(1):e55-e57. Epub 2020 Dec 13.

Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.

We experienced two cases of postoperative iatrogenic aorto-right atrial fistula (ARAF) after tricuspid valve repair (TVR) using minimally invasive cardiac surgery (MICS) technique. In both the cases, the flow of ARAF passed through the sinus of Valsalva near the noncoronary cusp (NCC)/right coronary cusp (RCC) commissure or NCC to right atrium. The quality of the fine needle used in the MICS technique may be inferior to that used in conventional surgery; ARAF after TVR could be a unique pitfall with the MICS technique.
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http://dx.doi.org/10.1055/s-0040-1718552DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733707PMC
January 2020

New indicator strain for rapid and accurate detection of mutations.

Genes Environ 2020 22;42:28. Epub 2020 Sep 22.

Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553 Japan.

Background: The gene of is useful for forward mutation analysis in bacterial and mammalian cells used in mutagenesis and DNA repair studies. Indicator strains, such as KS40/pOF105, have been used to analyze mutations. However, KS40/pOF105 is not enough to select mutants on nutrient-rich agar plates. Therefore, in this study, a new indicator strain for rapid and accurate detection of mutations was developed.

Results: The and genes with an amber mutation were integrated into the chromosomal DNA of KS40 to produce a new indicator strain, RF01. RF01 cells transformed by the wild-type gene were sensitive to nalidixic acid and streptomycin on LB agar plates. mutant frequencies and mutation spectra in RF01 were similar to those in KS40/pOF105. In addition, some mutations in were only detected in RF01.

Conclusion: RF01 is a new and useful indicator strain for analyzing mutations.
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http://dx.doi.org/10.1186/s41021-020-00167-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510118PMC
September 2020

A rare form of cardiac myxoma: interatrial septum tumor.

J Surg Case Rep 2020 Sep 17;2020(9):rjaa333. Epub 2020 Sep 17.

Department of Cardiothoracic Surgery, Excela Health Westmoreland Hospital, Greensburg, PA, USA.

A myxoma is one of the most common tumors in cardiac surgery, with most of them originating from the left or right atrial walls and causing embolic complications. An 84-year-old woman was referred to our institution after echocardiography showed an interatrial septum tumor that was presumed to be a thrombus; however, postoperative pathological examination revealed it to be a cardiac myxoma. This atypical myxoma was covered with a solid capsule containing connective tissue and substantial calcifications, which had made it difficult to establish a diagnosis of myxoma.
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http://dx.doi.org/10.1093/jscr/rjaa333DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7497063PMC
September 2020

Rupture of aneurysmal coronary-to-pulmonary artery fistula in a 96-year-old female; report of a case.

Gen Thorac Cardiovasc Surg 2021 Mar 16;69(3):601-604. Epub 2020 Sep 16.

Department of Cardiac Surgery, Asahikawa Medical University, Midorigaoka Higashi 2-1-1-1, Asahikawa, 078-8510, Japan.

Coronary artery fistula (CAF) is a relatively rare congenital abnormality of the coronary arteries; typically, patients who undergo surgery for CAFs are relatively young because it is a congenital disease. Here we present a case of an aneurysmal coronary-to-pulmonary artery fistula rupture in a 96-year-old female. Considering her extreme high age and missing preoperative diagnostics, only local hemostasis without anatomical repair was performed but the patient is still doing well 1 year after the operation.
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http://dx.doi.org/10.1007/s11748-020-01488-yDOI Listing
March 2021
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