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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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Tsuda Y, Arinaga K, Shuto T, Sonoda H, Matsumoto K, Sakaguchi S, Kuwahara G, Eto M, Takaki J, Inafuku H, Takamatsu M, Matsumaru I, Takagi K, Kawashima T, Ushijima T, Kanda H, Nakamura K, Teratani H, Yasutsune T, Yoshinaga T, Kise Y, Morokuma H, Eishi K, Miura T, Kamohara K, Furukawa K, Fukui T, Nishimura Y, Wada H, Furukawa K, Soga Y, Shiose A, Miyamoto S, Tayama E, Fujino Y, Otsuji Y, Kataoka M, ASPIRIN-Trial Investigators
Circulation journal : official journal of the Japanese Circulation Society advpub ( 0 ) 2026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：一般社団法人 日本循環器学会
<b><i>Background:</i></b> The benefits of adding aspirin to warfarin and warfarin treatment intensity for Japanese patients with mechanical valve replacement (MeVR) are unclear.<b><i>Methods and Results:</i></b> This multicenter non-randomized observational study recruited 158 Japanese patients who underwent MeVR in 11 university hospitals in Kyushu and Okinawa; 74 patients were allocated to the warfarin (W) group and 84 were allocated to the warfarin plus aspirin (W+A) group. Patients were followed for a mean (±SD) of 5.0±1.9 years. The primary and secondary endpoints were mainly atherosclerotic/thrombotic and bleeding events, respectively. There was no difference in the incidence of the primary endpoint between the W and W+A groups (14% vs. 22%, respectively; P=0.13). Univariate analysis revealed a higher incidence of the secondary endpoint in the W+A than W group (35% vs. 22%; P=0.032), but the difference was not significant in multivariate analysis. For the entire cohort, the postoperative mean international normalized ratio of prothrombin time (PT-INR) was relatively low (2.1±0.3). There were no differences in the incidence of events between PT-INR <2.0 and 2.0–3.0 (primary endpoint: 21% vs. 16%, respectively [P=0.41]; secondary endpoints: 33% vs. 26%, respectively [P=0.19]).<b><i>Conclusions:</i></b> Adding aspirin to warfarin treatment was not superior to warfarin alone, and relatively weak warfarin treatment (PT-INR <2.0) was not necessarily associated with an increased number of events (vs. PT-INR 2.0–3.0) in Japanese patients who underwent MeVR.
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Tsuda Y, Arinaga K, Shuto T, Sonoda H, Matsumoto K, Sakaguchi S, Kuwahara G, Eto M, Takaki J, Inafuku H, Takamatsu M, Matsumaru I, Takagi K, Kawashima T, Ushijima T, Kanda H, Nakamura K, Teratani H, Yasutsune T, Yoshinaga T, Kise Y, Morokuma H, Eishi K, Miura T, Kamohara K, Furukawa K, Fukui T, Nishimura Y, Wada H, Furukawa K, Soga Y, Shiose A, Miyamoto S, Tayama E, Fujino Y, Otsuji Y, Kataoka M, ASPIRIN-Trial Investigators
Circulation journal : official journal of the Japanese Circulation Society advpub ( 0 ) 2026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：一般社団法人 日本循環器学会
<b><i>Background:</i></b> The benefits of adding aspirin to warfarin and warfarin treatment intensity for Japanese patients with mechanical valve replacement (MeVR) are unclear.<b><i>Methods and Results:</i></b> This multicenter non-randomized observational study recruited 158 Japanese patients who underwent MeVR in 11 university hospitals in Kyushu and Okinawa; 74 patients were allocated to the warfarin (W) group and 84 were allocated to the warfarin plus aspirin (W+A) group. Patients were followed for a mean (±SD) of 5.0±1.9 years. The primary and secondary endpoints were mainly atherosclerotic/thrombotic and bleeding events, respectively. There was no difference in the incidence of the primary endpoint between the W and W+A groups (14% vs. 22%, respectively; P=0.13). Univariate analysis revealed a higher incidence of the secondary endpoint in the W+A than W group (35% vs. 22%; P=0.032), but the difference was not significant in multivariate analysis. For the entire cohort, the postoperative mean international normalized ratio of prothrombin time (PT-INR) was relatively low (2.1±0.3). There were no differences in the incidence of events between PT-INR <2.0 and 2.0–3.0 (primary endpoint: 21% vs. 16%, respectively [P=0.41]; secondary endpoints: 33% vs. 26%, respectively [P=0.19]).<b><i>Conclusions:</i></b> Adding aspirin to warfarin treatment was not superior to warfarin alone, and relatively weak warfarin treatment (PT-INR <2.0) was not necessarily associated with an increased number of events (vs. PT-INR 2.0–3.0) in Japanese patients who underwent MeVR.
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The Role of Left Ventricular Reconstruction in Ischemic Cardiomyopathy
Furukawa Koji, Sakaguchi Shuhei, Mori Kousuke
Journal of Coronary Artery Disease 31 ( 3 ) 98 - 105 2025年9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：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
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古川 貢之, 岩﨑 あや香, 阪口 修平, 石井 廣人
General thoracic and cardiovascular surgery cases 4 32 2025年7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：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. -
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
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Acute Stanford type B aortic dissection with rapid expansion associated with aortic coarctation and Turner syndrome: a case report 国際会議
Shuhei Sakaguchi
2024 STS-ASCVTS Aortic summit
開催年月日： 2024年11月14日 - 2024年11月16日
会議種別：口頭発表（一般）
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Formin相同タンパク質Fhod3が新生仔マウス心筋のサルコメア構築に果たす役割
阪口修平
第76回日本胸部外科学会定期学術集会 2023年10月21日
開催年月日： 2023年10月18日 - 2023年10月21日
記述言語：日本語 会議種別：口頭発表（一般）
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副僧帽弁組織 (AMVT) による左室流出路狭窄に対する手術例 英語演題名:
阪口修平
第53回日本心臓血管外科学会学術総会 2023年3月24日
開催年月日： 2023年3月23日 - 2023年3月25日
記述言語：日本語 会議種別：口頭発表（一般）
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思春期以降の大動脈縮窄症に対する手術成績
阪口修平
第75回日本胸部外科学会定期学術集会 2022年10月6日
開催年月日： 2022年10月5日 - 2022年10月8日
記述言語：日本語 会議種別：口頭発表（一般）
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脳卒中から見る若年者AVRの人工弁選択の検討
阪口 修平
第52回日本心臓血管外科学会学術集会 2022年3月
開催年月日： 2022年3月3日 - 2022年3月5日
記述言語：英語 会議種別：口頭発表（一般）
科研費（文科省・学振・厚労省）獲得実績 【 表示 ／ 非表示 】
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近赤外ハイパースペクトラルイメージングを用いた心臓刺激伝導系可視化技術の創出
研究課題/領域番号：25K11892 2025年04月 - 2028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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近赤外ボクセル分光による非染色三次元解剖構造描出法の創成
研究課題/領域番号：25K03501 2025年04月 - 2028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(B)
担当区分：研究分担者
研究・技術シーズ 【 表示 ／ 非表示 】
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先天性および後天性不全心筋における細胞骨格制御分子発現の生化学・組織学的検討
未熟心筋２核化の分子メカニズムの解明ホームページ： 宮崎大学医学部 外科学講座 心臓血管外科分野
技術相談に応じられる関連分野：心臓血管外科手術に関わる臨床データ収集、臨床サンプル収集
細胞骨格制御分子に関連したモデルマウス作成メッセージ：臨床と基礎の垣根を超えた研究を行なっております。ご興味のある方はぜひご連絡ください。