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医学部 附属病院 心臓血管外科 |
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教授 |
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論文 【 表示 ／ 非表示 】
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Furukawa K, Yano M, Ishii H, Sakaguchi S, Mori K, Nishimura M, Nakamura K
Heart and vessels 36 ( 7 ) 1064 - 1071 2021年1月
担当区分：筆頭著者, 責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Heart and Vessels
Objectives: The objective of this study was to analyze our surgical experiences with mitral valve plasty (MVP) combined with subvalvular procedures (SVPs) for functional mitral regurgitation (FMR) and to determine which preoperative factors affected clinical outcomes. Methods: This study retrospectively analyzed 33 patients who underwent MVP combined with SVPs for FMR with a left ventricular ejection fraction lower than 40% and advanced remodeled left ventricles. The mean follow-up period was 49 ± 33 months. Results: The preoperative mean right ventricular fractional area change (RVFAC) used to quantify right ventricular (RV) systolic function was 26 ± 11%. Sixteen patients (48%) had an RVFAC < 26%. One patient died during hospital stay, and nine more patients died of cardiac causes during follow-up. The 3- and 5-year rates of freedom from cardiac-related mortality were 78% and 68%, respectively. RVFAC was the significant predictor of cardiac-related mortality in a univariate analysis (risk ratio [RR] = 0.92, 95% confidence interval [CI] 0.85–0.99, p = 0.03) and demonstrated a non-significant tendency to predict cardiac-related mortality in the Cox multivariate analysis (RR = 0.94, 95% CI 0.86–1.003, p = 0.08). Continued reverse left ventricular remodeling was associated with an RVFAC ≥ 26%. At 3 years, there was also a significant difference in survival rates of cardiac-related mortality between patients with an RVFAC ≥ 26% and < 26% (94% vs. 61%; p = 0.03). Conclusions: Preoperative RV function affected left ventricular remodeling and cardiac-related mortality after MV surgery. MVP combined with SVPs for FMR provided promising results for patients without severe RV dysfunction.
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Furukawa K., Yano M., Nishimura M., Nakamura E., Watanabe N., Nishino S., Nakamura K.
General Thoracic and Cardiovascular Surgery 67 ( 11 ) 925 - 933 2019年11月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：General Thoracic and Cardiovascular Surgery
© 2019, The Japanese Association for Thoracic Surgery. Objectives: To analyze our surgical experiences with surgical ventricular restoration (SVR) for dilated ischemic cardiomyopathy (ICM) and to determine the significance of preoperative right ventricular (RV) function on outcomes. Methods and results: This study retrospectively analyzed 19 patients who underwent SVR between April 2010 and May 2016. Their mean age and New York Heart Association functional class were 62 ± 11 years and 2.9 ± 0.8, respectively. The preoperative mean left ventricular (LV) end-systolic volume index and LV ejection fraction (LVEF) were 134 ± 56 mL/m2 and 24 ± 7%, respectively. The preoperative mean RV fractional area change (RVFAC) to quantify RV systolic function was 33 ± 13%, as assessed by transthoracic echocardiography. The mean follow-up period was 47 ± 20 months. Three patients died of cardiac causes during the follow-up, with the 3-year and 5-year freedoms from cardiac-related death of 89% and 79%, respectively. Major adverse cardiac events (MACEs) occurred in ten patients, with the 3-year and 5-year MACE-free survival rates of 58% and 41%, respectively. RVFAC (risk ratio [RR] = 0.92, 95% confidence interval [CI] 0.86–0.98, p = 0.01) and LVEF (RR = 0.83, 95% CI 0.68–0.97, p = 0.02) were significant predictors of MACEs in the multivariate analysis. Patients with RVFAC of < 35% had significantly poorer MACE-free survival rates (33% at 3 years) than those with RVFAC of ≥ 35% (80% at 3 years). Conclusion: SVR for ICM provided acceptable freedom from cardiac-related death; however, MACEs commonly occurred and was associated with RV dysfunction.
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Furukawa K., Yano M., Nakamura E., Nishimura M., Nakamura K.
General Thoracic and Cardiovascular Surgery 66 ( 12 ) 707 - 715 2018年12月
担当区分：筆頭著者, 責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：General Thoracic and Cardiovascular Surgery
© 2018, The Japanese Association for Thoracic Surgery. Objectives: Mitral annuloplasty (MAP) for ischemic mitral regurgitation (IMR) with advanced remodeling is often associated with recurrent mitral regurgitation (MR). We performed surgeries adjusted according to the degree of remodeling; i.e., for advanced remodeling cases, we added subvalvular repair (SVR) to MAP. This study aimed to evaluate our experience with patients with IMR. Methods and results: Thirty patients with IMR (MR grade ≥ 2) were retrospectively analyzed. We performed MAP with SVR for 13 patients (MAP + SVR group) and MAP alone for 17 patients (MAP group). The MAP + SVR group had significantly larger left ventricular dimension and tenting height than the MAP group. Four patients (two in each group) experienced recurrence of MR (MR grade ≥ 2), and the 3-year and 5-year freedom from recurrence of MR rates were 97% and 83%, respectively. Six patients (two in the MAP group and four in the MAP + SVR group) died of cardiac causes during follow-up, and the 3-year and 5-year freedom from cardiac-related death rates were 81% and 74%, respectively. There was no difference between the 2 groups regarding freedom from recurrent MR (p = 0.6) and freedom from cardiac-related death (p = 0.1). The preoperative left ventricular end-systolic dimension was a significant predictor of cardiac death in the multivariate analysis. Conclusion: Mitral valve repair adjusted according to the degree of remodeling progression provided durable mitral competence; however, it remains unclear if such a strategy is related to a high probability of freedom from cardiac-related death.
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Furukawa K., Yano M., Nakamura E., Matsuyama M., Nishimura M., Kawagoe K., Nakamura K.
General Thoracic and Cardiovascular Surgery 65 ( 7 ) 381 - 387 2017年7月
担当区分：筆頭著者, 責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：General Thoracic and Cardiovascular Surgery
© 2017, The Japanese Association for Thoracic Surgery. Objectives: The impact of surgical ventricular restoration (SVR) on survival and major adverse cardiac events (MACEs) is still controversial. The purposes of this study were to analyze our surgical experience with SVR for ischemic cardiomyopathy and to determine the effect of preoperative left ventricular diastolic dysfunction on mid-term outcomes after SVR. Methods and results: Between April 2010 and May 2016, 19 patients underwent SVR. The mean age was 60 ± 11 years and the mean New York Heart Association functional class was 2.9 ± 0.8. Preoperative mean left ventricular end systolic volume index (LVESVI) and ejection fraction (LVEF) were 134 ± 56 mL/m 2 and 24 ± 7%, respectively. The early-to-late mitral valve flow ratio (E/A) on echocardiogram was 2.4 ± 1.8 and 9 patients had E/A ≥2, excluding 2 patients with atrial fibrillation. The mean follow-up period was 29 ± 16 months. One patient died of heart failure at 6 months postoperative; the overall survival rate at 3 years was 95%. MACEs requiring hospitalization occurred in 10 patients; E/A ≥2, or restrictive filling pattern, was the only significant predictor of MACE in multivariate analysis. Reverse remodeling was associated with E/A <2, but not E/A ≥2. There was also a significant difference between patients with E/A <2 vs. ≥2 with respect to MACE-free survival rates at 3 years (100 vs. 10%; p = 0.001). Conclusion: The degree of preoperative diastolic dysfunction can influence the outcome after SVR. Patients with E/A ≥2 may not be good candidates for SVR.
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Surgical management of a patient with anomalous origin of the left circumflex coronary artery undergoing aortic and mitral valve surgery. 査読あり
Kojima R, Furukawa K, Hiromatsu S, Mori K, Iwasaki A, Shuhei S, Ishii H
General thoracic and cardiovascular surgery cases 4 ( 1 ) 32 2025年7月
MISC 【 表示 ／ 非表示 】
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Nishino S., Watanabe N., Furukawa K., Shibata Y.
European Journal of Cardio-thoracic Surgery 53 ( 5 ) 1096 2018年5月
記述言語：英語 掲載種別：記事・総説・解説・論説等（学術雑誌） 出版者・発行元：European Journal of Cardio-thoracic Surgery
DOI： 10.1093/ejcts/ezx435
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心室中隔心筋切除術とlow-profile生体弁による僧帽弁置換術を行った閉塞性肥大型心筋症の1例
古川貢之, 阪口修平，中村栄作，矢野光洋
胸部外科 2015年6月
記述言語：日本語 掲載種別：記事・総説・解説・論説等（商業誌、新聞、ウェブメディア） 出版者・発行元：南江堂
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A型大動脈解離術後に遅発性対麻痺を発症した1例
古川貢之, 阪口修平，川越勝也，松山正和，矢野光洋
日本心臓血管外科学会雑誌 2015年1月
記述言語：日本語 掲載種別：研究発表ペーパー・要旨（全国大会，その他学術会議） 出版者・発行元：日本心臓血管外科学会
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心筋梗塞後後乳頭筋部分断裂に僧帽弁形成を行った1例
古川貢之, 阪口修平, 早瀬崇洋, 矢野光洋
胸部外科 2014年6月
記述言語：日本語 掲載種別：記事・総説・解説・論説等（商業誌、新聞、ウェブメディア） 出版者・発行元：南江堂
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Mitral valve replacement and septal myectomy for hypertrophic obstructive cardiomyopathy
Kouji Furukawa, Takahiro Hayase, Mitsuhiro Yano
Gen Thorac Cardiovasc Surg 2014年3月
記述言語：英語 掲載種別：研究発表ペーパー・要旨（全国大会，その他学術会議） 出版者・発行元：The Japanese association for thoracic surgery
講演・口頭発表等 【 表示 ／ 非表示 】
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FMRへの僧帽弁形成術の効果と限界
古川貢之, 矢野光洋, 中村都英
第33回日本冠疾患学会学術集会
開催年月日： 2019年12月13日 - 2019年12月14日
記述言語：日本語 会議種別：シンポジウム・ワークショップ パネル（公募）
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EF40％未満の低左心機能に伴うFMRの外科治療成績
古川貢之、矢野光洋、石井廣人、白崎幸枝、森晃佑、中村栄作、中村都英
第72回日本胸部外科学会定期学術集会
開催年月日： 2019年10月30日 - 2019年11月2日
記述言語：日本語 会議種別：ポスター発表
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右室機能の左室形成術治療成績に及ぼす影響
古川貢之、矢野光洋、渡邉 望、西野 峻、中村栄作、中村都英
第24回日本冠動脈外科学会学術大会
開催年月日： 2019年7月11日 - 2019年7月12日
記述言語：日本語 会議種別：口頭発表（一般）
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胸腹部大動脈瘤手術における脊椎保護の変遷と手術成績の検討
古川貢之、中村栄作、石井廣人、白崎幸枝、市来伸彦、樋口和宏、中村都英
第49回日本心臓血管外科学会定期学術総会
開催年月日： 2019年2月11日 - 2019年2月13日
記述言語：日本語 会議種別：口頭発表（一般）
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中期遠隔期予後からみた透析患者での大動脈弁位人工弁選択に関する考察
古川貢之、中村栄作、石井廣人、白崎幸枝、市来伸彦、樋口和宏、中村都英
第49回日本心臓血管外科学会定期学術総会
開催年月日： 2019年2月11日 - 2019年2月13日
記述言語：日本語 会議種別：ポスター発表
科研費（文科省・学振・厚労省）獲得実績 【 表示 ／ 非表示 】
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FMR治療における病理、遺伝子発現機構からの検証に基づいた左房機能評価の意義の確立
研究課題/領域番号：23K08239 2023年04月 - 2027年03月
独立行政法人日本学術振興会 科学研究費基金 基盤研究(C)
担当区分：研究代表者
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インド地下水汚染地域における妊娠、出産および小児の発育・発達に関する研究
研究課題/領域番号：20KK0222 2020年04月 - 2025年03月
独立行政法人日本学術振興会 科学研究費補助金 国際共同研究加速基金(国際共同研究強化(B))
マドゥエスタ ハリシャクマール、
担当区分：研究分担者
寄附金・講座・研究部門 【 表示 ／ 非表示 】
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外科学講座心臓血管外科学・呼吸器、乳腺外科学分野研究奨学金
寄附者名称：公益社団法人宮崎市郡医師会 2024年01月
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外科学講座心臓血管外科学・呼吸器、乳腺外科学分野研究奨学金
寄附者名称：泉工医科工業株式会社 2023年12月
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外科学講座心臓血管外科学・呼吸器、乳腺外科学分野研究奨学金
寄附者名称：KMﾊﾞｲｵﾛｼﾞｸｽ株式会社 2023年11月
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外科学講座心臓血管外科学・呼吸器、乳腺外科学分野研究奨学金
寄附者名称：日本ﾗｲﾌﾗｲﾝ株式会社 2023年09月
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外科学講座心臓血管外科学・呼吸器、乳腺外科学分野研究奨学金
寄附者名称：日本血液製剤機構 2023年07月