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医学部 附属病院 心臓血管外科 |
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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
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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Mitral valve repair in severe mitral regurgitation due to Barlow's disease with concomitant mitral annular disjunction: a case report. 査読あり
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
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Managing uncontrolled bleeding in elective surgery: The role of damage control techniques 査読あり
Nanashima A., Wada T., Kawano F., Hamada K., Taniguchi T., Furukawa K.
International Journal of Surgery Case Reports 128 111040 2025年3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：International Journal of Surgery Case Reports
Introduction: The main text introduction expands on the initial introduction by providing a more detailed discussion of massive bleeding in elective surgeries and its challenges. It describes how traditional hemostatic procedures are essential but may not always be sufficient, especially in uncontrolled coagulopathy despite aggressive transfusion. It then introduces DCS as a well-established approach in trauma surgery, emphasizing its role in stabilizing patients with hemorrhagic shock, coagulopathy, hypothermia, and acidosis. It highlights that DCS can be a lifesaving intervention when unexpected massive bleeding occurs and justifies its use in patients with unstable vital signs or increased intra-abdominal pressure by our two experienced cases presentation. Case 1. A 76-year-old obese male diagnosed with advanced transverse colon cancer with regional balky lymph node metastasis was identified at the root of the regional colic vein trunk. A robotic surgical approach was changed to open laparotomy because of bleeding tendency due to fatty mesentery. During the balky node dissection, the root of the vein was injured and induced massive bleeding during the compressive hemostatic procedure. As the hypotensive control rapidly became quite tricky, DCS by gauze packing and covered by the commercial dressing kit with open abdominal management (OAM). The second look operation, by supporting the Restrictive Endovascular Balloon Occlusion of the Aorta, repaired the superior mesenteric vein's injured parts. He survived for nine months. Case 2. The 72-year-old male patient was diagnosed as solitary 3 cm of hepatocellular carcinoma at S6 with alcoholic liver cirrhosis. The laparoscopic limited hepatic resection was changed to the open laparotomy due to the bleeding tendency at the transected parenchyma. After accomplishing limited resection, massive hepatic venous bleeding occurred; DCS was decided due to continuing hypotension, oozed hemorrhage, and low platelet level with metabolic acidosis by peri-hepatic gauze packing around the right liver. The second look operation for remnant hemostasis and the de-packing with abdominal closure could be achieved without severe events. The postoperative course showed no hepatic failure, and they recovered during a hospital stay. Discussion: It describes how conventional hemostatic procedures are essential but may not always be sufficient, especially in uncontrolled coagulopathy despite aggressive transfusion. DCS is a well-established approach in trauma surgery, emphasizing its role in stabilizing patients with hemorrhagic shock, coagulopathy, hypothermia, and acidosis. The role of DCS is well known even in elective surgery in unforeseen emergency situations such as hemodynamic instability, severe coagulopathy, and prolonged surgery over 24 h. It highlights that DCS can be a lifesaving intervention when unexpected massive bleeding occurs and justifies its use in patients with unstable vital signs or increased intra-abdominal pressure, where prolonged surgery is not feasible. It reinforces that DCS was successfully utilized in the reported cases, leading to favorable second-look operations. Conclusion: The main text introduction is a more comprehensive and structured expansion of the initial introduction. While the initial version introduces the problem concisely, the revised introduction elaborates on the challenges of massive bleeding, the principles of DCS, and its potential role in elective surgeries before transitioning into the case reports.
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Harada K., Kawagoe K., Matsuura Y., Kawano M., Suiko Y., Tanaka H., Moribayashi K., Ishii H., Ideguchi T., Furukawa K., Kaikita K.
Journal of Cardiology Cases 31 ( 3 ) 76 - 79 2025年3月
掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Cardiology Cases
We report a case of Salmonella cardiovascular infection presenting with acute pericarditis as a precursor to the rapid progression of aortic aneurysm. An 81-year-old man presented with persistent fever and chest pain worsened with inspiration and was admitted to a nearby hospital with a diagnosis of bacterial pericarditis. However, hoarseness emerged two days later, and the patient was transferred to our hospital because of concerns about extracardiac inflammatory foci. Computed tomography (CT) revealed a periaortic exudate and aortic arch aneurysm. After transfer, blood cultures confirmed Salmonella infection. Ampicillin (ABPC) was initiated for long-term treatment of Salmonella infection, and pericarditis was treated with ibuprofen and colchicine for approximately one month. The associated symptoms and inflammatory blood data significantly improved, but five weeks later, follow-up CT revealed enlargement of the arch aneurysm. Due to the patient's age and nutritional status, thoracic endovascular aortic repair (TEVAR) was performed along with continued ABPC. Postoperatively, the infection was well-controlled, and follow-up CT revealed a size reduction in the treated aneurysm. No recurrent Salmonella-related vascular events were observed for two years after TEVAR. Learning objective: Acute pericarditis can present as a precursor to life-threatening vascular lesions associated with Salmonella infection and requires timely and appropriate diagnosis of the etiology behind the manifestation. Patients with aortic aneurysms caused by Salmonella often do not tolerate invasive surgical treatment when diagnosed, and the lesions progress rapidly. Therefore, endovascular treatment combined with long-term antibiotic therapy may be a practical option.
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Kawagoe K., Furukawa K., Ishi H., Sakaguchi S., Taniguchi T., Meiri R., Yamamura Y.
Journal of Cardiology Cases 2025年
担当区分：責任著者 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Cardiology Cases
Anomalous papillary muscles (PMs), in which the PMs are directly attached to the anterior mitral valve (MV) leaflet, can cause obstruction of the left ventricular outflow tract (LVOT). Accurately diagnosing of anomalous PMs, understanding their pathology, and performing appropriate surgery are essential for relieving LVOT obstruction effectively. A 71-year-old man with hypertrophic obstructive cardiomyopathy was referred to our hospital. Transthoracic echocardiography revealed LVOT obstruction with a peak outflow pressure gradient of 63 mm Hg at rest and 96 mm Hg during the Valsalva maneuver. Furthermore, an anomalous PM was suspected to be the cause of LVOT obstruction. Three- and four-dimensional cardiac computed tomography (CT) images clearly demonstrated that an anomalous PM from the anterior PMs was directly attached to the body of the anterior MV leaflet and that the anomalous PM, together with the thickened ventricular septum, caused a dynamic obstruction of the LVOT. We resected the anomalous PM from the anterior PMs and the subaortic ventricular septum using a transaortic approach. In this case, preoperative three-dimensional and four-dimensional cardiac CT images were effective at revealing the presence of an anomalous PM and its pathology in patient with LVOT obstruction, leading to accurate and smooth surgical procedures and improved patient outcomes. Learning objective: • Anomalous PMs are classified by their attachment patterns and appropriate surgical methods are recommended for each type, providing valuable insights for clinical decision-making. • This report emphasizes the significance of 3D and 4D cardiac CT in identifying the causes of LVOTO. This imaging technique provides important information regarding the location of the anomalous PM and dynamic impact, leading to a successful surgical outcome.
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