Publications by authors named "Shinji Fukuhara"

7 Publications

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[Cavernous Hemangioma Originating in the Left Atrial Appendage:Report of a Case].

Kyobu Geka 2021 Mar;74(3):237-240

Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, Takatsuki, Japan.

A 66-year-old male with hypertension was referred for evaluation of abnormal find chest X-ray. A computed tomography (CT) scan revealed a solitary pericardial mass with a diameter of 5 cm, located in the left atrioventricular groove. It showed solid but unevenly enhanced contents suggesting a well vascularized tumor originating in either a part of the left heart or the pericardium. As magnetic resonance imaging showed a clear boundary between the tumor and the pericardium, cardiac origin was suspected. Surgical removal of the tumor was performed via median sternotomy. The tumor originated from the lateral aspect of the left atrial appendage, having a base of 10 mm in diameter. The tumor was fully excised with an associated left atrial cuff under cardiopulmonary bypass. The postoperative course was uneventful. The tumor was histopathologically diagnosed as cavernous hemangioma originating in the left atrial wall. There has been no sign of recurrence for four years following surgery.
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March 2021

A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture.

Surg Case Rep 2018 Mar 27;4(1):27. Epub 2018 Mar 27.

Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.

Background: The rupture of the posterior ventricular septum after acute inferior myocardial infarction is more challenging to repair than ruptures in other sites since it is less accessible and anatomically restricted. We described a modification of Daggett's original technique of multi-patch repair of ruptured posterior septum.

Case Presentation: The technique was employed in the operation of a 67-year-old male who presented with severe heart failure at the 10th day after he developed inferior myocardial infarction. His ventricular septum had ruptured at the level between the posteromedial papillary muscle and the mitral annulus. A large endoventricular patch covered separately over the locally patched septal defect and the ventriculotomy defect which was going to be roofed eventually with an external patch. Both defects were then individually closed in double layers, holding a single continuous patch in common. The common use of a single patch expedited multilayered closure of the left ventricular defects and could minimize geometric remodeling of the covered area. The patches on both the endocardial and the epicardial sides avoided potentially fatal bleeding from the ventriculotomy site. The transmural mattress sutures incorporating ventriculotomy patches required minimal bites toward the posteromedial papillary muscle and mitral annulus, thereby preserving the mitral valve function.

Conclusions: Thus, the technique enhances the advantage of the left ventriculotomy in the repair of posterior septal rupture and avoids ventriculotomy-related morbidity.
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http://dx.doi.org/10.1186/s40792-018-0426-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871608PMC
March 2018

Repair of a Kommerell's diverticulum with an absent left subclavian artery and a right aortic arch.

J Card Surg 2018 Mar 1;33(3):149-150. Epub 2018 Mar 1.

Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, Takatsuki, Osaka, Japan.

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http://dx.doi.org/10.1111/jocs.13549DOI Listing
March 2018

Pseudoaneurysm of the external iliac artery is a rare late complication after total hip arthroplasty.

J Vasc Surg Cases Innov Tech 2017 Sep 18;3(3):149-151. Epub 2017 Jul 18.

Department of Thoracic and Cardiovascular Surgery, Osaka Medical College Hospital, Osaka, Japan.

Vascular injury as a delayed complication of total hip arthroplasty (THA) is rare. We present a case of pseudoaneurysm of the external iliac artery due to chronic irritation from a prominent bone spicule occurring 2 years after revision THA. We successfully managed the patient with open repair, and there has been no sign of recurrence in the 2 years since the previous surgery. This report suggests that patients who have undergone THA should be followed up carefully and assessed for vascular injuries even after a substantial time.
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http://dx.doi.org/10.1016/j.jvscit.2017.04.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764856PMC
September 2017

[Three Surgical Cases of Quadricuspid Aortic Valve].

Kyobu Geka 2017 Sep;70(10):811-815

Department of Cardiovascular Surgery, Osaka Medical College, Takatsuki, Japan.

Quadricuspid aortic valve is a rare congenital disease. We experienced 3 surgical cases of quadricuspid aortic valve. Patient 1 was a 72-year-old man who was noted to have a quadricuspid aortic valve associated with aortic regurgitation and an ascending aortic aneurysm(51 mm in diameter). He underwent replacement of the aortic valve and the ascending aorta. Patient 2 was a 71-year-old man with severe aortic stenosis, regurgitation, and coronary triple vessel disease. He underwent aortic valve replacement and coronary artery bypass grafting. Preoperative echocardiography revealed no abnormalities in the number of valve leaflets, but quadricuspid aortic valve was identified during surgery. Patient 3 was a 79-year-old man with severe aortic regurgitation, who underwent aortic valve replacement. In all patients, the 4 valve cusps were approximately of the same size. Multi-detector computed tomography is useful for evaluation of valve morphology. Indication of prophylactic ascending aorta replacement in patients with aortic dilatation requires further study.
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September 2017

Changes in coronary resistance related to the stages of the female life cycle.

Circ J 2006 Apr;70(4):478-81

School of Medicine, University of Tsukuba, Tenoudai, Japan.

Background: Estrogen is known to dilate the coronary vascular system mainly through nitric oxide (NO) release. However, it has not been determined whether or not this effect occurs equally throughout all stages of the female life cycle. We examined the changes in coronary flow properties in adolescent, adult and ovariectomized (OVX) female rats using the endothelial NO synthetase blocker, L-N (omega) nitroarginine (L-NNA).

Methods And Results: Female rats were divided into 3 groups: adolescent (13 weeks, n=6), adult (19 weeks, n=8) and OVX (20 weeks, n=7, 12 weeks after oophorectomy). Coronary effluent was measured using the Langendorff non-working heart model before and 15 min after the use of L-NNA. In OVX rats, coronary effluent was significantly decreased in comparison with adolescent and adult rats (adolescent vs OVX: p<0.001; adult vs OVX: p<0.05). After treatment with L-NNA, coronary effluent was significantly higher in the adolescent group compared with the adult and OVX groups (adolescent vs adult: p<0.01; adolescent vs OVX: p<0.0005).

Conclusions: Oophorectomy brought about an increase in coronary vascular resistance. L-NNA exacerbated coronary vascular resistance in relation to maturation. It is suggested that the effect of estrogen on vascular dilatation in adolescents is largely dependent on a non-NO pathway, whereas adults are largely dependent on an NO pathway.
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http://dx.doi.org/10.1253/circj.70.478DOI Listing
April 2006

Evaluation of clinical efficacy of Maeda's nomogram for vancomycin dosage adjustment in adult Japanese MRSA pneumonia patients.

Drug Metab Pharmacokinet 2006 Feb;21(1):54-60

Department of Pharmacy, Okayama Rousai General Hospital, Japan.

The clinical efficacy of Maeda's nomogram for vancomycin dosage adjustment was evaluated by comparison with a standard dosage regimen (package insert information: vancomycin dose reduced in elderly patients and patients with renal dysfunction, with Moellering's nomogram used for renal-dysfunction patients) in adult Japanese MRSA pneumonia patients. Using Maeda's nomogram, the vancomycin dose is fixed at 1,000 mg while the dosing interval is varied in accordance with individual creatinine clearance. Using a standard dosage regimen, 5 patients out of 27 (18.5%) achieved target plasma levels of vancomycin (25-40 microg/mL for peak and 5-15 microg/mL for trough) within 2-6 days. Using Maeda's nomogram, 38 patients out of 53 (71.7%) achieved target levels in that time. A higher clinical response (complete resolution of all signs and symptoms of MRSA infection) to vancomycin therapy was also obtained with Maeda's nomogram when evaluated approximately 2-weeks after discontinuation of vancomycin therapy (43.4% versus 18.5% for the standard regimen). In conclusion, the Maeda's nomogram regimen with a 1,000 mg vancomycin dose was shown to achieve target plasma levels of vancomycin at a higher rate and provide higher clinical efficacy in vancomycin therapy of MRSA pneumonia patients, as compared with the currently available standard dosage regimen.
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http://dx.doi.org/10.2133/dmpk.21.54DOI Listing
February 2006