Publications by authors named "Yoshikazu Motohashi"

6 Publications

  • Page 1 of 1

[Repeated Hemoptysis after Thoracic Endovascular Aortic Repair for Ruptured Thoracic Aortic Aneurysm with Hemoptysis;Report of a Case].

Kyobu Geka 2020 Sep;73(9):695-699

Department of Cardiovascular Surgery, Kyoto-Katsura Hospital, Kyoto, Japan.

In recent years, re-rupture due to endoleaks after thoracic endovascular aortic repair (TEVAR) for ruptured thoracic aortic aneurysms has become a problem. Hemoptysis has been reported in patients after pneumocentesis. We report a patient who developed delayed hemoptysis not related to endoleak after TEVAR. An 80-year-old male underwent emergent TEVAR due to a ruptured thoracic aortic aneurysm accompanying sudden hemoptysis. Eleven days after the operation, recurrent hemoptysis was noted, but contrast-enhanced computed tomography (CT) revealed no endoleak or re-rupture. Bronchoscopy demonstrated hemorrhage from the left upper lobe. As hemostasis was difficult by conservative treatment, left upper lobectomy was performed. The aortic rupture hole exhibited thrombus, and there was no hemorrhage. On histopathological examination of the resected lung, formation accompanied by severe intra-alveolar fibrosis and cholesterin clefts, and marked foreign body reactions in the interstitium and small blood vessels of the lung were observed. Cholesterol embolism is associated with not only organ ischemia due to microembolism, but also immunological mechanisms. Thus, cholesterol embolism due to aorta-derived cholesterin may have led to the delayed pulmonary hemorrhage. Differentiation from re-rupture due to endoleaks is important.
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September 2020

Correction to: Development of a simple device enabling percutaneous flow regulation for a small vascular graft for a Blalock-Taussig shunt capable of flow regulation: complete translation of an original article originally published in Pediatric Cardiology and Cardiac Surgery (154-159, 2016: vol. 32).

Gen Thorac Cardiovasc Surg 2018 09;66(9):556

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

In the original publication of the article, the title was incorrectly published.
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http://dx.doi.org/10.1007/s11748-018-0958-2DOI Listing
September 2018

Development of a simple device enabling percutaneous flow regulation for a small vascular graft for a Blalock–Taussig shunt capable of flow regulation: complete translation of an original article originally published in Pediatric Cardiology and Cardiac Surgery (154–159, 2016: vol. 32).

Gen Thorac Cardiovasc Surg 2018 03 9;66(3):145-149. Epub 2017 Nov 9.

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

Objectives: The Blalock-Taussig shunt (BTS) operation is a cornerstone as initial palliative surgery for congenital heart disease with severely reduced pulmonary blood flow (PBF). The ideal PBF provided by BTS is crucial for an uneventful postoperative course, since excess PBF results in acute distress of the systemic circulation and insufficient PBF requires another BTS surgery. Therefore, the goal of this study was to develop a simple device to control the shunt graft flow percutaneously using a constrictor balloon connected to a subcutaneous port.

Methods: The device consists of a cylindrical balloon and an anti-bending structure extension connected to the balloon center. A PTFE vascular graft wrapped by the device was connected to a simulated closed circuit to measure the relationship between pressure and blood flow while changing the inner volume of the balloon. In a beagle model of replacement of the right carotid artery, blood flow velocity was measured in the carotid artery after saline injection into the balloon. The blood flow velocity before and after balloon inflation was compared immediately after implantation of the device and at 3 months after implantation.

Results: The device provided good flow control by inflating and deflating the balloon ex vivo and in vivo for up to 3 months in a canine model with a small graft wrapped with the device.

Conclusions: The simple device developed in this study may enable regulation of PBF through a small vascular graft and help to prevent severe morbidity and mortality in the clinical setting of BTS.
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http://dx.doi.org/10.1007/s11748-017-0860-3DOI Listing
March 2018

[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

[Concomitant Operations for Thoracic Aortic Aneurysm and Myasthenia Gravis;Report of a Case].

Kyobu Geka 2017 Aug;70(9):791-793

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

A 77-year-old man, who had been under medical treatment for myasthenia gravis without thymoma, was diagnosed with aortic arch aneurysm. He underwent total aortic arch replacement and total resection of the thymus through median sternotomy. His symptoms relating to myasthenia gravis dramatically disappeared after the surgery. The serum anti-acetyl chorine receptor antibody decreased from 2.7 to 0.7 nmol/l (N<0.2) with the reduction of oral predonisolone from 12.5 to 5 mg/day at 4 years after the surgery. The concomitant operations significantly improved his quality of life.
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August 2017

[Arterial switch operation for transposition of the great arteries with situs inversus and mirror image dextrocardia].

Kyobu Geka 2012 Sep;65(10):872-5

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

We report a successful arterial switch operation for complete transposition of great arteries with atrial and visceral situs inversus totalis and mirror image dextrocardia in a 12-day-old infant girl. The aorta was located left side-by-side to the pulmonary trunk with a single coronary artery (mirror image of 1RLCx). After French maneuver, the posterior circumference of the neo-aorta was reconstructed. Then the coronary button was transplanted into the neo-aorta with a trap door technique carefully avoiding any twist and over-stretch. The neo-pulmonary trunk was reconstructed with an autologous pericardial patch and sutured to the longitudinal incision made into the left central pulmonary artery. The baby was discharged from hospital and has been doing well without any morbidity relating myocardial ischemia.
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September 2012