|
所属 |
医学部 医学科 外科学講座心臓血管外科学分野 |
|
職名 |
教授 |
|
外部リンク |
|
|
関連SDGs |
|
論文 【 表示 ／ 非表示 】
-
The Role of Left Ventricular Reconstruction in Ischemic Cardiomyopathy 招待あり 査読あり
Furukawa Koji, Sakaguchi Shuhei, Mori Kousuke
Journal of Coronary Artery Disease 31 ( 3 ) 98 - 105 2025年9月
担当区分：筆頭著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：特定非営利活動法人 日本冠疾患学会
We review the relevant literature and our own experience to identify cases in which left ventricular reconstruction (LVR) has been successful, particularly for ischemic cardiomyopathy (ICM). Despite substantial advances in medical and device therapies, surgical treatment of ICM remains important. In this context, LVR for ICM is expected to play a complementary role between heart transplantation or ventricular assist device therapy and surgical treatments such as coronary artery bypass surgery. However, the number of LVRs performed has decreased. This may be because of the lack of well-established cases of successful LVR. Although a good outcome can be expected if the left ventricular (LV) volume is controlled after LVR, it is difficult to identify surgical responders based on preoperative LV volume. Here, we focused on the LV diastolic function, assessed by the echocardiographic mitral inflow waveform ratio (E/A ratio), as an index of the degree of progression of LV remodeling and examined the outcomes of LVR. The preserved LV diastolic function group (E/A ratio < 2) had significantly better outcomes than the impaired LV diastolic function group. The relationship between the degree of LV diastolic function and the efficacy of LVR has recently been investigated. Additionally, LVR has evolved from the resection of ventricular aneurysms to the isolation of the infarct area, reduction of LV volume, and restoration of the normal conical structure of the left ventricle, with promising results. Therefore, selective LVR is an option for HF treatment of heart failure.
DOI： 10.7793/jcad.31.006
-
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
担当区分：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：Springer Science and Business Media LLC
Background
The anomalous origin of the left circumflex coronary artery is rare and, when isolated, typically has minimal pathological significance. However, it can cause damage or compression of the coronary artery during aortic and mitral valve surgery.
Case presentation
The patient was a 34-year-old male diagnosed with severe aortic regurgitation due to a bicuspid aortic valve following infective endocarditis at the mitral valve. He was referred to our hospital owing to worsening heart failure. Preoperative evaluation revealed a mitral valve aneurysm and an anomalous left circumflex coronary artery originating from the right coronary artery and running posteriorly along the aortic valve annulus. During surgery, dissection of the anomalous left circumflex coronary artery was challenging. Mitral valve aneurysm repair and aortic valve replacement were performed. For the aortic valve replacement, a 23-mm St. Jude Medical Regent valve, one size smaller than optimal, was secured in the supra-annular position. Additionally, a coronary artery bypass graft was performed on the distal circumflex artery using a saphenous vein graft. The patient experienced no ischemic myocardial damage and was discharged in stable condition on postoperative day 14.
Conclusions
The anomalous origin of the left circumflex coronary artery should be recognized, and appropriate measures must be taken during valve surgery. Preemptive coronary artery bypass grafting is a reasonable option for patients undergoing aortic and mitral valve surgeries. -
Furukawa K, Iwasaki A, Ishii H, Shuhei S, Mori K, Hiromatsu S
General thoracic and cardiovascular surgery cases 4 ( 1 ) 11 2025年3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：Springer Science and Business Media LLC
Background
Mitral annular disjunction (MAD) is characterized by the detachment of the mitral valve-left atrial junction from the left ventricular myocardium. The association of MAD with Barlow’s disease and its relevance to treatment are increasingly recognized.
Case presentation
A 75-year-old male with a history of mitral regurgitation (MR) and ablation for paroxysmal atrial fibrillation was diagnosed with severe MR due to Barlow’s disease, as confirmed by echocardiography. Imaging revealed disjunction at the mitral valve’s posterior annulus. During surgery, the posterior leaflet was resected along the annulus with precise height adjustments. A 6-mm separation between the mitral valve–left atrial junction and the left ventricular myocardium was sutured using a four-stitch mattress technique. The procedure included leaflet repair, insertion of artificial chordae, and mitral annuloplasty. Postoperatively, the MAD was corrected successfully, eliminating the severe MR.
Conclusions
Confirming the presence of MAD before surgery is essential for patients with MR. Surgical correction of MAD is imperative when present to address the disjunction effectively. -
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.
-
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.
MISC 【 表示 ／ 非表示 】
-
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
-
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
-
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
-
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
-
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 】
-
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）
-
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
-
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）
-
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）
-
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 】
-
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
-
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
共同研究実施実績 【 表示 ／ 非表示 】
-
大動脈弁形成術普及を目指した大動脈リングの大学間共同開発研究
2025年07月 - 2026年03月
"学校法人慈恵大学 学校法人早稲田大学 国立大学法人鹿児島大学" 国内共同研究
古川 貢之、森 晃佑
担当区分：研究代表者 共同研究区分：国内共同研究
寄附金・講座・研究部門 【 表示 ／ 非表示 】
-
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
2025年01月
-
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
2024年12月
-
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
2024年11月
-
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
2024年10月
-
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
2024年10月