2025/08/30 更新

写真a

シバタ　ツヨシ
柴田　豪
所属
医学部 外科学講座心臓血管外科学講座 講師
職名
講師
ORCID ID
0000-0002-4105-2937
外部リンク

論文

  • Editor's Choice – Comparative Analysis of Three Year Results of Two Paclitaxel Related Stents for the Management of Femoropopliteal Disease in a Real World Setting

    T. Shibata, Y. Iba, M. Shingaki, O. Yamashita, Y. Tsubakimoto, F. Kimura, A. Hatada, F. Kasashima, K. Ueno, N. Kawaharada

    Journal of Vascular Surgery   2025年8月

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.1016/j.jvs.2025.05.128

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  • Endovascular Repair of a Subclavian Artery Aneurysm With Re-purposed Aorto-Iliac Stent Graft Components

    Tomohiro Nakajima, Tsuyoshi Shibata, Yutaka Iba, Nobuyoshi Kawaharada

    EJVES Vascular Forum   2025年5月

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.1016/j.ejvsvf.2025.05.001

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  • Isolated occlusion of the common femoral artery with suspected fibromuscular dysplasia

    Hiroki Uchiyama, Tsuyoshi Shibata, Jiro Ogino, Hirosato Doi

    Journal of Vascular Surgery   2025年4月

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.1016/j.jvs.2025.04.018

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  • Unraveling Novel Subsets of Lymphocytes Involved in Sac Expansion in the Tertiary Lymphoid Structure Within an Abdominal Aortic Aneurysm. 国際誌

    Itaru Hosaka, Ippei Ikegami, Takuma Mikami, Tatsuya Sato, Toshifumi Ogawa, Kei Mukawa, Marenao Tanaka, Keisuke Endo, Yukinori Akiyama, Akihito Ohkawa, Junji Nakazawa, Tsuyoshi Shibata, Tomohiro Nakajima, Yutaka Iba, Chikara Shiiku, Satoshi Sumino, Ryuji Koshima, Kenichi Takano, Shingo Ichimiya, Nobuyoshi Kawaharada, Masato Furuhashi

    Journal of the American Heart Association   e040279   2025年2月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    BACKGROUND: Chronic inflammation is involved in the development of abdominal aortic aneurysm (AAA). A tertiary lymphoid structure (TLS) within vascular lesions has recently been focused on for its role in modulation of inflammation in local tissues. We aimed to elucidate the relationships between TLS and pathophysiology of AAA. METHODS: Abdominal aortic samples obtained from 37 patients with AAA (men/women: 34/3, age: 72.8±9.9 years) and 15 autopsied patients who died from non-aortic events (men/women: 11/4, age: 65.5±9.8 years) were investigated. RESULTS: TLSs in AAA lesions were confirmed by focal infiltration of CD3-positive cells surrounding germinal center-like structures containing CD20-positive cells between the tunica adventitia and tunica media layers. The formation of a TLS was significantly more prevalent in AAA patients than in autopsied patients. The number of TLSs in AAA lesions was positively correlated with sac diameter (r=0.357, P=0.035) and the amount of intraluminal thrombosis (r=0.466, P=0.005). T cells and B cells were predominant cellular populations among CD45+ cells in AAA lesions. There was a significantly positive correlation between the proportions of interfollicular T follicular helper (CD3+CD4+CD45RA-CXCR5+PD-1+) cells and double negative B (CD3-CD19+IgD-CD27-) cells, and they were positively correlated with sac diameter, intraluminal thrombosis, and serum lipids. Deposited single-cell RNA-sequencing data for AAA showed that T follicular helper cells and double negative B cells were associated with lipid metabolism, T cell activation/proliferation and inflammation. CONCLUSIONS: The formation of a TLS in AAA lesions is associated with sac diameter and intraluminal thrombosis in connection with interfollicular T follicular helper cells and double negative B cells, which may contribute to the pathophysiology of AAA and might be novel therapeutic targets for the development of AAA.

    DOI： 10.1161/JAHA.124.040279

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  • Physician-modified inner-branched endovascular repair with re-intervention

    Shingo Tsushima, Tsuyoshi Shibata, Nobuyoshi Kawaharada

    Vascular   2025年2月

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.1177/17085381241236569

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  • Challenging diagnosis of endoleak after physician-modified fenestrated/inner-branched endovascular repair using four-dimensional computed tomography

    Kenta Yoshikawa, Tsuyoshi Shibata, Yutaka Iba, Keishi Ogura, Taiki Chono, Nobuyoshi Kawaharada

    Journal of Vascular Surgery   2025年2月

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.1016/j.jvs.2025.02.009

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  • Importance of Successful Revascularization in Acute Limb Ischemia: Sub‐Analysis From the RESCUE ALI Trial

    Takuya Haraguchi, Michinao Tan, Daiki Uchida, Yutaka Dannoura, Tsuyoshi Shibata, Shuko Iwata, Nobuyoshi Azuma

    Catheterization and Cardiovascular Interventions   2025年1月

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.1002/ccd.31319

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  • Open Aortic Repair After Thoracic Endovascular Aortic Repair: Strategic Insights From a Single Centre Surgical Experience

    Yutaka Iba, Tomohiro Nakajima, Junji Nakazawa, Tsuyoshi Shibata, Shuhei Miura, Nobuyoshi Kawaharada

    EJVES Vascular Forum   2025年

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.1016/j.ejvsvf.2024.12.001

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  • Initial Outcomes of Physician-Modified Inner-Branched Endovascular Repair for Distal Aortic Arch Aneurysm

    Shingo Tsushima, Tsuyoshi Shibata, Yutaka Iba, Tomohiro Nakajima, Junji Nakazawa, Shuhei Miura, Ayaka Arihara, Kei Mukawa, Yu Iwashiro, Nobuyoshi Kawaharada

    Journal of Clinical Medicine   2024年12月

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.3390/jcm14010039

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  • Long-Term Outcomes and Late Complications of Thoracic Endovascular Aortic Repair Using the GORE TAG or Conformable GORE TAG

    Shingo Tsushima, Tsuyoshi Shibata, Yutaka Iba, Taku Sakurada, Satoshi Muraki, Toshiyuki Maeda, Tomohiro Nakajima, Junji Nakazawa, Shuhei Miura, Ayaka Arihara, Keitaro Nakanishi, Takakimi Mizuno, Kei Mukawa, Nobuyoshi Kawaharada

    Journal of Endovascular Therapy   2024年12月

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.1177/15266028241305960

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  • Clinical Frailty Scale Predicts Outcomes After Elective Thoracic Endovascular Aortic Repair: A Single-Center Retrospective Cohort Study

    Shingo Tsushima, Tsuyoshi Shibata, Yutaka Iba, Tomohiro Nakajima, Junji Nakazawa, Shuhei Miura, Ayaka Arihara, Keitaro Nakanishi, Takakimi Mizuno, Kei Mukawa, Nobuyoshi Kawaharada

    Journal of Endovascular Therapy   2024年12月

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.1177/15266028241302658

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  • Midterm outcomes of surgical strategy for secondary aorto-enteric fistula

    Shuhei Miura, Ayaka Arihara, Yutaka Iba, Tomohiro Nakajima, Junji Nakazawa, Tsuyoshi Shibata, Yu Iwashiro, Kei Mukawa, Nobuyoshi Kawaharada

    Annals of Vascular Surgery - Brief Reports and Innovations   2024年12月

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.1016/j.avsurg.2024.100346

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  • Multicentre retrospective analysis of physician-modified fenestrated/inner-branched endovascular repair for complex aortic aneurysms

    Tsuyoshi Shibata, Yutaka Iba, Kiyomitsu Yasuhara, Noriaki Kuwada, Yoshiaki Katada, Hitoki Hashiguchi, Takeshi Uzuka, Itaru Hosaka, Tomohiro Nakajima, Nobuyoshi Kawaharada

    European Journal of Cardio-Thoracic Surgery   2024年11月

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.1093/ejcts/ezae404

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  • 腹部大動脈瘤拡大因子としての瘤壁三次リンパ組織形成および濾胞関連新規リンパ球サブセットの解明

    保坂 到, 池上 一平, 三上 拓真, 佐藤 達也, 小川 俊文, 武川 慶, 田中 希尚, 遠藤 圭佑, 秋山 幸功, 大川 陽史, 仲澤 順二, 柴田 豪, 中島 智博, 伊庭 裕, 高野 賢一, 一宮 慎吾, 川原田 修義, 古橋 眞人

    脈管学   64 ( Suppl. )   S149 - S150   2024年10月

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    記述言語：日本語   出版者・発行元：(一社)日本脈管学会  

    医中誌

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  • 脈管分野において人工知能が果たす役割 Graph based clusteringを用いた腹部大動脈瘤拡大因子としての濾胞関連新規リンパ球サブセットの同定と機能的意義の解明

    保坂 到, 池上 一平, 三上 拓真, 佐藤 達也, 小川 俊文, 田中 希尚, 遠藤 圭佑, 秋山 幸功, 大川 陽史, 仲澤 順二, 柴田 豪, 中島 智博, 伊庭 裕, 高野 賢一, 一宮 慎吾, 川原田 修義, 古橋 眞人

    脈管学   64 ( Suppl. )   S114 - S114   2024年10月

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    記述言語：日本語   出版者・発行元：(一社)日本脈管学会  

    医中誌

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  • Successful endovascular treatment for acute type A aortic dissection in a Jehovah's Witness patient

    Kei Mukawa, Tsuyoshi Shibata, Yutaka Iba, Ayaka Arihara, Kenta Yoshikawa, Nobuyoshi Kawaharada

    Journal of Vascular Surgery   2024年10月

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.1016/j.jvs.2024.10.023

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  • Intraoperative evaluation for endoleaks using the SCORPION procedure during endovascular aortic repair

    Itaru Hosaka, Takeshi Uzuka, Kyousuke Miki, Tsuyoshi Shibata, Akihiko Sasaki, Nobuyoshi Kawaharada

    Vascular   2024年6月

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    掲載種別：研究論文（学術雑誌）   出版者・発行元：SAGE Publications  

    Objectives

    Endoleaks are important complications of endovascular aortic repair. Usually, endoleaks are judged indirectly by aortography or postoperative computed tomography. However, findings from these modalities are difficult to distinguish because of the divergency of endoleaks. Few studies have reported direct visualization of endoleaks. Herein, we introduce a direct procedure for intraoperatively evaluating endoleaks using angioscopy.

    Methods

    From April 2023, consecutive patients with an abdominal aortic aneurysm, except emergency cases and those of narrow access, seen at Sunagawa City Medical Center were enrolled in our study. Endoleaks were detected by intraoperative angioscopy using a novel endovascular procedure.

    Results

    Seven patients underwent endovascular aortic repair of an abdominal aortic aneurysm with intraoperative angioscopy. None of the enrolled patients experienced complications. The procedure revealed types 2, 3a, and 4 endoleaks.

    Conclusions

    This is the first study to demonstrate intraoperative visualization of endoleaks using angioscopy. Direct findings observed by this novel procedure might provide information on the velocity and volume of the endoleak, providing comprehensive insights into the intra-sac hemodynamics after the endovascular aortic repair.

    その他リンク： https://journals.sagepub.com/doi/full-xml/10.1177/17085381241264719

    DOI： 10.1177/17085381241264719

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  • Early Clinical Results From the Japanese Prospective Multicenter Study to Evaluate Zenith Alpha Abdominal Stent Graft for Abdominal Aortic Aneurysm (JUSTICE) Registry Demonstrate Acceptable Limb Patency at 12 Months

    Naoki Fujimura, Shigeo Ichihashi, Tsuyoshi Shibata, Hitoshi Matsumura, Michiko Watanabe, Noriyasu Morikage, Yoshihiko Kurimoto, Hiroshi Banno, Hidetoshi Uchiyama, Hideaki Obara

    Journal of Endovascular Therapy   2024年4月

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.1177/15266028241248311

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  • Mid-term outcomes of physician-modified endograft therapy for complex aortic aneurysms

    Tsuyoshi Shibata, Hiroshi Mitsuoka, Yutaka Iba, Kenichi Hashizume, Norio Hongo, Kiyomitsu Yasuhara, Noriaki Kuwada, Yoshiaki Katada, Hitoki Hashiguchi, Takeshi Uzuka, Yuta Murai, Tomohiro Nakajima, Junji Nakazawa, Nobuyoshi Kawaharada

    Interdisciplinary CardioVascular and Thoracic Surgery   2024年3月

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    掲載種別：研究論文（学術雑誌）  

    DOI： 10.1093/icvts/ivae044

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  • SFA領域のEVTにおけるDevice選択 再狭窄形態からDESをどう選ぶべきか REALDES study preliminary dateより

    柴田 豪, 伊庭 裕, 新垣 正美, 中西 敬太郎, 山下 修, 椿本 恵則, 木村 文昭, 畑田 充俊, 笠島 史成, 植野 恭平, 中島 智博, 仲澤 順二, 三浦 修平, 在原 綾香, 川原田 修義

    日本血管外科学会雑誌   33 ( Suppl. )   PD2 - 3   2024年

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    記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

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  • Ten-year follow-up study of a young woman with loeys-dietz syndrome: a case report. 国際誌

    Tomohiro Nakajima, Yutaka Iba, Tsuyoshi Shibata, Itaru Hosaka, Jyunji Nakazawa, Nobuyoshi Kawaharada

    Journal of cardiothoracic surgery   18 ( 1 )   209 - 209   2023年7月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    We herein report the 10-year surgical course of a 27-year-old woman who underwent two surgeries after being diagnosed with Loeys-Dietz syndrome. As described in previous cases, this patient developed ectopic arterial enlargement. We followed her temporal changes over a 10-year period, including the changes in computed tomography, pathology, and surgery.

    DOI： 10.1186/s13019-023-02322-1

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  • One Year Outcomes of Zilver PTX Versus Eluvia for Femoropopliteal Disease in Real-World Practice: REALDES Study. 国際誌

    Tsuyoshi Shibata, Yutaka Iba, Masami Shingaki, Osamu Yamashita, Yoshinori Tsubakimoto, Fumiaki Kimura, Atsutoshi Hatada, Fuminori Kasashima, Kyohei Ueno, Keitaro Nakanishi, Kiyofumi Morishita, Tomohiro Nakajima, Junji Nakazawa, Akihito Ohkawa, Itaru Hosaka, Ayaka Arihara, Shingo Tsushima, Nobuyoshi Kawaharada

    Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists   15266028231179861 - 15266028231179861   2023年6月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    PURPOSE: This multicenter, prospective, observational study aimed to compare Zilver PTX and Eluvia stents in real-world settings for treating femoropopliteal lesions as the differences in the 1-year outcomes of these stents have not been elucidated. MATERIALS AND METHODS: Overall, 200 limbs with native femoropopliteal artery disease were treated with Zilver PTX (96 limbs) or Eluvia (104 limbs) at 8 Japanese hospitals between February 2019 and September 2020. The primary outcome measure of this study was primary patency at 12 months, defined as a peak systolic velocity ratio of ≤2.4, without clinically-driven target lesion revascularization (TLR) or stenosis ≤50% based on angiographic findings. RESULTS: The baseline clinical and lesion characteristics of Zilver PTX and Eluvia groups were roughly comparable (of all limbs analyzed, approximately 30% presented with critical limb-threatening ischemia, approximately 60% presented with Trans-Atlantic Inter-Society Consensus II C-D, and approximately half had total occlusion), except for the longer lesion lengths in the Zilver PTX group (185.7±92.0 mm vs 160.0±98.5 mm, p=0.030). The Kaplan-Meier estimates of primary patency at 12 months were 84.9% and 88.1% for Zilver PTX and Eluvia, respectively (log-rank p=0.417). Freedom from clinically-driven TLR rates were 88.8% and 90.9% for Zilver PTX and Eluvia, respectively (log-rank p=0.812). CONCLUSIONS: The results of the Zilver PTX and Eluvia stents were not different regarding primary patency and freedom from clinically-driven TLR at 12 months after treating patients with femoropopliteal peripheral artery disease in real-world settings. CLINICAL IMPACT: This is the first study to reveal that the Zilver PTX and Eluvia have similar results in real-world practice when the proper vessel preparation is performed. However, the type of restenosis in the Eluvia stent may differ from that in the Zilver PTX stent. Therefore, the results of this study may influence the selection of DES for femoropopliteal lesions in routine clinical practice.

    DOI： 10.1177/15266028231179861

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  • Initial Outcomes of Physician-Modified Inner Branched Endovascular Repair in High-Surgical-Risk Patients. 国際誌

    Tsuyoshi Shibata, Yutaka Iba, Tomohiro Nakajima, Junji Nakazawa, Akihito Ohkawa, Itaru Hosaka, Ayaka Arihara, Shingo Tsushima, Keishi Ogura, Kenta Yoshikawa, Nobuyoshi Kawaharada

    Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists   15266028231169183 - 15266028231169183   2023年4月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    PURPOSE: To report the initial outcomes of physician-modified inner branched endovascular repair (PMiBEVAR) for pararenal aneurysms (PRAs), thoracoabdominal aortic aneurysms (TAAAs), and aortic arch aneurysms in high-surgical-risk patients. MATERIALS AND METHODS: A total of 10 patients (6 men; median age, 83.0 years) treated using PMiBEVAR were enrolled in this retrospective, single-center study. All patients were at high surgical risk because of severe comorbidities (American Society of Anesthesiologists physical status score≥3 or emergency repair). End points were defined as technical success per patient and per vessel (successful deployment), clinical success (no endoleaks postoperatively), in-hospital death, and major adverse events. RESULTS: There were 3 PRAs, 4 TAAAs, and 3 aortic arch aneurysms with 12 renal-mesenteric arteries and 3 left subclavian arteries incorporated by inner branches. The technical success rate was 90.0% (9/10) per patient and 93.3% (14/15) per vessel. The clinical success rate was 90% (9/10). There were 2 in-hospital deaths, unrelated to aneurysms. Paraplegia and shower emboli occurred separately in 2 patients. Three patients experienced prolonged ventilation for 3 days after surgery. Aneurysm sac shrinkage occurred in 4 patients, and aneurysm size stabilized in 1 patient during follow-up, more than 6 months later. None of the patients required intervention. CONCLUSION: PMiBEVAR is a feasible approach for treating complex aneurysms in high-surgical-risk patients. This technology may complement the existing technology in terms of improved anatomical adaptability, no time delay and practicability in many countries. However, long-term durability remains undetermined. Further large-scale and long-term studies are needed. CLINICAL IMPACT: This is the first clinical study to investigate outcomes of physician-modified inner branched endovascular repair (PMiBEVAR). PMiBEVAR for treating pararenal aneurysm, thoracoabdominal aortic aneurysm, or aortic arch aneurysm is a feasible procedure. This technology is likely to complement existing technology in terms of improved anatomical adaptability (compared to off-the-shelf devices), no time delay (compared to custom-made devices), and the potential to be performed in many countries. On the other hand, surgery time varied greatly depending on the case, suggesting a learning curve and the need for technological innovation to perform more consistent surgeries.

    DOI： 10.1177/15266028231169183

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  • 手術ハイリスク患者のComplex aortic aneurysmに対するPhysician modified inner branched endovascular repairの早期成績

    柴田 豪, 伊庭 裕, 中島 智博, 仲澤 順二, 大川 陽史, 保坂 到, 在原 綾香, 對馬 慎吾, 川原田 修義

    日本外科学会定期学術集会抄録集   123回   SF - 5   2023年4月

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    記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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  • Analysis of the Relationship between Blood Flow, Function, and CHA2D2-VASc Score in the LAA and LA Using 4D Flow MRI(タイトル和訳中)

    大川 陽史, 伊庭 裕, 中島 智博, 柴田 豪, 保坂 到, 在原 綾香, 對馬 慎吾, 川原田 修義

    日本循環器学会学術集会抄録集   87回   PJ020 - 3   2023年3月

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    記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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  • Temperature analysis of aortic repair with hypothermic circulatory arrest to quantify the injury by cooling. 国際誌

    Hiroshi Sato, Yutaka Iba, Nobuyoshi Kawaharada, Joji Fukada, Yuu Iwashiro, Shingo Tsushima, Itaru Hosaka, Akihito Okawa, Tsuyoshi Shibata, Jyunji Nakazawa, Tomohiro Nakajima, Takeo Hasegawa, Yukihiko Tamiya

    Interdisciplinary cardiovascular and thoracic surgery   36 ( 1 )   2023年1月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    OBJECTIVES: We analyzed the temperature in proximal aortic repair with moderate hypothermic circulatory arrest (HCA) and evaluated the effect of the cooling status on postoperative outcomes. METHODS: A total of 340 patients who underwent elective ascending aortic replacement or total arch replacement with moderate HCA from December 2006 to January 2021 were studied. The change in body temperature trends recorded during surgery was shown graphically. Several parameters, such as the nadir temperature, cooling speed and the degree of cooling (cooling area), which was the area under curve of inverted temperature trends from cooling to rewarming as calculated by the integral method, were analyzed. The relationships between these variables and a major adverse outcome (MAO) postoperatively defined as prolonged ventilation (>72 h), acute renal failure, stroke, reoperation for bleeding, deep sternal wound infection or in-hospital death were evaluated. RESULTS: An MAO was observed in 68 patients (20%). The cooling area was larger in the MAO group than in the non-MAO group (1668.7 vs 1383.2°C min; P < 0.0001). A multivariate logistic model showed that old myocardial infarction, peripheral vascular disease, chronic renal dysfunction, cardiopulmonary bypass time and the cooling area were independent risk factors for an MAO (odds ratio = 1.1 per 100°C min; P < 0.001). CONCLUSIONS: The cooling area, which indicates the degree of cooling, shows a significant relationship with an MAO after aortic repair. This finding indicates that the cooling status with HCA can affect clinical outcomes.

    DOI： 10.1093/icvts/ivac282

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  • REALDES studyZilver PTXとEluviaの実臨床における多施設前向き研究の一年次結果

    柴田 豪, 伊庭 裕, 新垣 正美, 中西 敬太郎, 山下 修, 椿本 恵則, 木村 文昭, 畑田 充俊, 笠島 史成, 植野 恭平, 中島 智博, 仲澤 順二, 大川 陽史, 保坂 到, 川原田 修義

    日本血管外科学会雑誌   32 ( Suppl. )   EA - 4   2023年

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    記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

    医中誌

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  • Abscess Formation Requiring Extraluminal Arterial Graft Explantation and Bypass Surgery.

    Itaru Hosaka, Tsuyoshi Shibata, Yutaka Iba, Nobuyoshi Kawaharada

    Circulation journal : official journal of the Japanese Circulation Society   87 ( 1 )   153 - 153   2022年12月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    DOI： 10.1253/circj.CJ-22-0550

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  • Pararenal aortic aneurysm repair using a physician-modified stent-graft with inner branches. 国際誌

    Tsuyoshi Shibata, Yutaka Iba, Tomohiro Nakajima, Itaru Hosaka, Nobuyoshi Kawaharada

    Journal of vascular surgery cases and innovative techniques   8 ( 3 )   356 - 357   2022年9月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    DOI： 10.1016/j.jvscit.2022.04.016

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  • Improvement of predicted hematocrit values after the initiation of cardiopulmonary bypass in cardiovascular surgery.

    Takeo Hasegawa, Yutaka Iba, Shuichi Naraoka, Tomohiro Nakajima, Syuichi Hashimoto, Takao Murohashi, Riko Umeta, Itaru Hosaka, Akihito Ohkawa, Naomi Yasuda, Tsuyoshi Shibata, Nobuyoshi Kawaharada

    Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs   25 ( 2 )   117 - 124   2022年6月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    Hematocrit (Hct) values after the initiation of cardiopulmonary bypass (CPB) must be maintained appropriately to avoid perioperative complications. Therefore, an accurate prediction is required. However, the standard prediction equation often results in actual values that are lower than the predicted values. This study aimed to clarify the limits of agreement (LOA) and bias of the prediction equations and investigate better the prediction equations. A retrospective study was performed on adult patients between April 2015 and December 2020. Study 1 included 158 patients, and Study 2 included 55 patients. The primary outcomes were the LOA and bias between the predicted and measured Hct values after the initiation of CPB, and two studies were conducted. In Study 1, total blood volume (TBV) was estimated, and the new blood volume index (BVI) was calculated. BVI was also evaluated for the overall value and gender differences. Therefore, the patient's background was compared by gender differences. In, Study 2 the conventional predicted equation (Eq. 1), the predicted equation using the new BVI (Eq. 2), and the predicted equation using the new BVI including physiological factors in the TBV equation (Eq. 3) were compared. In Study 1, BVI was 53 (44-67) mL/kg. In Study 2, bias ± LOA was - 2.5 ± 6.8% for Eq. 1, 0.1 ± 6.6% for Eq. 2, and 0.4 ± 6.2% for Eq. 3. The new equation is expected to predict the Hct value after the initiation of CPB with better LOA and bias than the conventional equation.

    DOI： 10.1007/s10047-021-01295-z

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  • Scattered Media Elastic Fibers from the Aortic Root to the Ascending Aorta in a 30-Year-Old Marfan Syndrome Patient.

    Tomohiro Nakajima, Yutaka Iba, Syuichi Naraoka, Tsuyoshi Shibata, Shintaro Sugita, Nobuyoshi Kawaharada

    Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia   2022年5月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    We present a case report of a 30-year-old Marfan syndrome patient who underwent a David procedure for severe aortic valve insufficiency and Valsalva aneurysm. Harvested aortic walls were examined by pathologists. Although the tunica media of the ascending aorta contained aligned elastic fibers, the aortic root media lacked aligned elastic fibers.

    DOI： 10.5761/atcs.cr.22-00044

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  • Physician-modified stent graft with inner branches for treating ruptured thoracoabdominal aortic aneurysm. 国際誌

    Tsuyoshi Shibata, Nobuyoshi Kawaharada, Kiyomitsu Yasuhara, Syuichi Naraoka

    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery   61 ( 4 )   952 - 954   2022年3月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    Thoracoabdominal aortic aneurysm (TAAA) repair remains challenging in patients with high surgical risk. We report a case of TAAA in an 84-year-old woman with type Ib endoleak after thoracic endovascular aortic repair with coeliac artery coverage due to impending ruptured TAAA. A stent graft was assembled to create 3 fenestrations and sew 3 inner grafts for the superior mesenteric artery (SMA) and bilateral renal arteries. This stent graft system was inserted into the thoraco-abdominal aorta and partially unsheathed until the first inner branch endograft fully expanded. The wire was used to catheterize the stent graft, inner branch, and SMA from the left upper limb, and a bridge stent was deployed from the inner branch to the SMA. A similar procedure was performed for bilateral renal arteries. The stent graft system was fully unsheathed. Postoperative computed tomography angiography revealed no endoleak and good flow of the visceral artery. The use of the physician-modified inner branched endograft system described is feasible and can make TAAA endovascular repair simpler and safer.

    DOI： 10.1093/ejcts/ezab543

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  • 腹部大動脈瘤治療をマスターする:Short neckに対する治療戦略 Short neckに対するphysician modified inner branchの有用性

    柴田 豪, 梅田 璃子, 保坂 到, 大川 陽史, 安田 尚美, 中島 智博, 伊庭 裕, 川原田 修義

    日本心臓血管外科学会学術総会抄録集   52回   PD9 - 5   2022年3月

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    記述言語：日本語   出版者・発行元：(NPO)日本心臓血管外科学会  

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  • Estimation Model for Hypothermic Circulatory Arrest Time to Predict Risk in Total Arch Replacement. 国際誌

    Hiroshi Sato, Nobuyoshi Kawaharada, Joji Fukada, Keitaro Nakanishi, Takuma Mikami, Tsuyoshi Shibata, Ryo Harada, Syuichi Naraoka, Takeshi Kamada, Yukihiko Tamiya

    The Annals of thoracic surgery   113 ( 1 )   256 - 263   2022年1月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    BACKGROUND: We created an estimation model for hypothermic circulatory arrest time and analyzed the risk factors for major adverse outcomes in total arch replacement. METHODS: This study involved 272 patients who underwent total arch replacement. The estimation model for hypothermic circulatory arrest time was established using multiple linear regression analysis, and the predicted hypothermic circulatory arrest time from this model was analyzed to detect risk factors. RESULTS: Atrial fibrillation, rupture, malperfusion, saccular aneurysm, cardiopulmonary bypass time, and hypothermic circulatory arrest time were identified as independent risk factors associated with major adverse outcomes. The estimation model for hypothermic circulatory arrest time was established as follows: hypothermic circulatory arrest time = 99.3 - 0.19 × age + 0.65 × body mass index + 6.19 × previous cardiac operation + 11.7 × acute dissection + 8.9 × rupture + 0.19 × aortic angulation + 0.15 × length to the distal anastomosis site - 6.17 × total arch replacement surgeon case volume - 3.06 × surgery year. The predicted hypothermic circulatory arrest time calculated by this estimation model was evaluated using multivariate logistic analysis, which identified atrial fibrillation, rupture, malperfusion, saccular aneurysm, and predicted hypothermic circulatory arrest time as risk factors. CONCLUSIONS: As with the actual hypothermic circulatory arrest time, the predicted hypothermic circulatory arrest time using our model detected significant factors associated with major adverse outcomes. These results indicated that this prediction model for hypothermic circulatory arrest time may be effective.

    DOI： 10.1016/j.athoracsur.2020.12.060

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  • A case of a giant pulmonary artery aneurysm due to an atrial septal defect with left main coronary artery occlusion.

    Takuma Mikami, Syuichi Naraoka, Akiyoshi Hashimoto, Hirosato Doi, Keitaro Nakanishi, Tsuyoshi Shibata, Tomohiro Nakajima, Ryo Harada, Takeshi Kamada, Nobuyoshi Kawaharada

    General thoracic and cardiovascular surgery   69 ( 9 )   1338 - 1343   2021年9月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    Cases of coronary artery occlusion due to the exclusion of pulmonary artery aneurysm are extremely rare, and there are few reports of surgical treatment. A 60-year-old woman with pulmonary hypertension due to an atrial septal defect and obstruction of the left main coronary trunk due to the exclusion of a giant pulmonary artery aneurysm underwent surgery. The surgery included atrial septal defect closure, tricuspid annulus plasty, pulmonary artery aneurysmorrhaphy, and coronary artery bypass grafting. One and a half years after the surgery, no re-expansion of the pulmonary artery was observed, and the symptoms of heart failure had improved. There are no reports of improvement in pulmonary valve regurgitation by aneurysmorrhaphy in pulmonary artery aneurysm. Surgery for pulmonary artery aneurysm with the exclusion of other organs was effective, and aneurysmorrhaphy for pulmonary artery aneurysm was acceptable.

    DOI： 10.1007/s11748-021-01653-x

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  • Descending thoracic aorta-abdominal aortic bypass and bilateral renal arterial blood circulation reconstruction are effective in atypical coarctation of the aorta with heart failure: a case report. 国際誌

    Takuma Mikami, Takeshi Kamada, Toshiyuki Yano, Tomohiro Nakajima, Naomi Yasuda, Tsuyoshi Shibata, Keitaro Nakanishi, Ryo Harada, Syuichi Naraoka, Kojiro Toda, Nobutaka Nagano, Atsuko Muranaka, Nobuyoshi Kawaharada

    Journal of cardiothoracic surgery   16 ( 1 )   219 - 219   2021年8月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    BACKGROUND: There are a lot of reports of the renal failure and heart failure due to coarctation of the aorta. However, there are no case reports in which revascularization dramatically improved left ventricular function in patients with progressive decline in left ventricular function. Herein, we present a rare case in which the left ventricular function was dramatically improved by surgical treatment for progressive left ventricular dysfunction due to atypical coarctation of the aorta. CASE PRESENTATION: A 58-year-old man underwent left axillary artery-bilateral femoral artery bypass at another hospital for atypical coarctation of the aorta due to Takayasu's arteritis. Approximately 10 years later, he was re-hospitalized for heart failure, and the left ventricular ejection fraction gradually decreased to 28%. Computed tomography showed severe calcification and stenosis at the same site from the peripheral thoracic descending aorta to the lower abdominal aorta of the renal artery, and aortography showed delayed bilateral renal artery blood flow. An increase in plasma renin activity was also observed. Despite the administration of multiple antihypertensive drugs, blood pressure control was insufficient. We decided to perform surgical treatment to improve progressive cardiac dysfunction due to increased afterload and activated plasma renin activity. Descending thoracic aorta-abdominal aorta bypass and revascularization of the bilateral renal arteries via the great saphenous vein grafts were performed. Postoperative blood pressure control was improved, and the dose of antihypertensive drugs could be reduced. Plasma renin activity decreased, and transthoracic echocardiography 1.5 years later showed an improvement in contractility with a left ventricular ejection fraction of 58%. CONCLUSION: In atypical coarctation of the aorta in patients with decreased bilateral renal blood flow, heart failure due to renal hypertension, and progressive decrease in left ventricular contractility, descending thoracic aorta-abdominal aortic bypass and bilateral renal artery recirculation can be extremely effective.

    DOI： 10.1186/s13019-021-01598-5

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  • Images in Vascular Medicine: Heart-shaped saphenous vein graft pseudoaneurysm - Endovascular repair with covered stent. 国際誌

    Tsuyoshi Shibata, Kiyofumi Morishita, Masami Shingaki, Kazunori Ishikawa, Toru Mawatari, Miho Okawa, Nobuyoshi Kawaharada

    Vascular medicine (London, England)   26 ( 4 )   462 - 463   2021年8月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    DOI： 10.1177/1358863X21995573

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  • Postoperative spinal cord ischaemia: magnetic resonance imaging and clinical features. 国際誌

    Naomi Yasuda, Yosuke Kuroda, Toshiro Ito, Masanori Sasaki, Shinichi Oka, Ryo Ukai, Keitaro Nakanishi, Takuma Mikami, Tsuyoshi Shibata, Ryo Harada, Shuichi Naraoka, Takeshi Kamada, Nobuyoshi Kawaharada

    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery   60 ( 1 )   164 - 174   2021年7月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    OBJECTIVES: Ischaemic spinal cord injury (SCI) is one of the most serious complications of aortic surgery. Ischaemic SCIs occur due to various aetiologies, and prediction of the risk is difficult. Magnetic resonance imaging (MRI) is useful to detect the details of spinal cord infarction. There are few studies about MRI for evaluating ischaemic SCI after cardiovascular surgery and aortic events. We report 9 cases of postoperative ischaemic SCI and analyse their MRI features. METHODS: T2-weighted MRI scans of 9 patients who developed ischaemic SCI due to cardiovascular surgery and aortic events between 2012 and 2017 were evaluated. RESULTS: In all patients, high-intensity areas were observed on T2-weighted magnetic resonance images. The site of infarction was the thoracic spinal cord level (9 cases) and additionally at the lumbar spinal cord level (5 cases). The area of infarction area was categorized based on the arterial territory: anterior spinal artery territory (3 cases), posterior spinal artery territory (2 cases), spinal sulcal artery territory (1 case) and artery of Adamkiewicz territory (3 cases). CONCLUSIONS: MRI revealed the infarction sites in all cases and the differences in the infarction patterns in each case. MRI could thus be useful for investigating the aetiology of ischaemic SCI following aortic surgeries and events.

    DOI： 10.1093/ejcts/ezaa476

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  • Changes in Skin Perfusion Pressure After Endovascular Treatment for Chronic Limb-Threatening Ischemia. 国際誌

    Shigeo Ichihashi, Mitsuyoshi Takahara, Naoki Fujimura, Tsuyoshi Shibata, Miki Fujii, Taku Kato, Yoshinori Tsubakimoto, Shinichi Iwakoshi, Kenji Obayashi, Kimihiko Kichikawa

    Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists   28 ( 2 )   208 - 214   2021年4月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    PURPOSE: To assess skin perfusion pressure (SPP) changes after endovascular treatment (EVT) of patients with chronic limb-threatening ischemia (CLTI) and to explore preoperative factors that affect SPP changes. MATERIALS AND METHODS: This prospective, multicenter study recruited 147 patients (mean age 74 years; 99 men) with ischemic wounds at 6 vascular centers in Japan between July 2017 and December 2018. Over half of the patients (92, 63%) were diabetic, and 76 (52%) required dialysis. Sixty-four patients (43%) had WIfI (wound, ischemia, foot infection) wound grades of 2 or 3; 59 (40%) had foot infections. SPP was measured before and 1, 2, 7, and 30 days after EVT to establish inline flow to the ischemic foot based on the angiosome concept when feasible. The anterior and posterior tibial arteries and the peroneal artery were revascularized in 66 (45%), 50 (34%), and 30 (21%) patients, respectively. RESULTS: Both the dorsal and plantar SPPs at 1 or 2 days post-EVT were significantly higher than those at baseline (p<0.001), and both SPPs increased further at 1 month compared with those at 1 (p=0.001) or 2 days (p=0.006) post-EVT. SPP increases occurred on the dorsal and plantar surfaces of the foot regardless of the vessel revascularized. The SPP increase at 1 month after EVT was significantly lower in patients with foot infections than that in those without foot infections (p=0.003). Age, sex, diabetes, dialysis, wound severity, and direct revascularization did not affect the pattern of SPP change. CONCLUSION: The SPP increased continuously up to 1 month after EVT, though the increase was smaller in patients with wound infections. The SPP on the dorsal and plantar surfaces increased, regardless of the vessel revascularized, which could justify indirect revascularization when direct revascularization is technically challenging.

    DOI： 10.1177/1526602820963932

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  • Surgeon-modified endovascular grafts for treating ruptured arch aneurysm due to proximal endograft failure after thoracic endovascular aneurysm repair combined with total debranching.

    Tsuyoshi Shibata, Masami Shingaki, Kiyofumi Morishita

    General thoracic and cardiovascular surgery   69 ( 1 )   118 - 121   2021年1月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    Generally, proximal endograft failure after total arch debranching and thoracic endovascular repair (TEVAR) is one of the most difficult problems because re-sternotomy poses extremely high risks to patients with high surgical risk. Herein, we report an endovascular technique using surgeon-modified endovascular grafts for a patient with ruptured arch aneurysm caused by type Ia endoleak following total arch debranching and TEVAR.

    DOI： 10.1007/s11748-020-01414-2

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  • Two-Year Results of a Multicenter Prospective Observational Study of the Zenith Spiral-Z Limb Deployed in the External Iliac Artery During Endovascular Aneurysm Repair.

    Naoki Fujimura, Tomohiro Imazuru, Hitoshi Matsumura, Tsuyoshi Shibata, Tadashi Furuyama, Kenjiro Kaneko, Hidetoshi Uchiyama, Noriyasu Morikage, Takayuki Uchida, Eiichi Teshima, Terutoshi Yamaoka, Hiroshi Masuhara, Hideki Ueda, Mamoru Arakawa, Togo Norimatsu, Hideaki Obara, Seiji Onitsuka

    Circulation journal : official journal of the Japanese Circulation Society   84 ( 10 )   1764 - 1770   2020年9月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    BACKGROUND: Limited data is available on the use of a polyester graft limb with a helical stent configuration deployed in the external iliac artery (EIA) during endovascular aneurysm repair (EVAR), so we prospectively analyzed the efficacy of the Zenith Spiral-Z limb deployed in the EIA.Methods and Results:Patients undergoing EVAR using a Zenith stent-graft and Spiral-Z limb deployed in the EIA were prospectively registered in 24 Japanese institutions from June 2017 to November 2017. In total, 65 patients (74 limbs) (mean age: 77.1±8.0 years, 87.7% men, mean abdominal aortic aneurysm (AAA) diameter: 51.9±7.2 mm, mean iliac artery aneurysm (IAA) diameter: 38.3±10.0 mm) were registered and followed up. The most common reason for deployment in the EIA was a common IAA (43 limbs, 58.1%), and 8 limbs (10.8%) had a bare nitinol stent placed at the Spiral-Z limb. A total of 61 patients (70 limbs) completed a 24-month follow-up. There were 2 Spiral-Z limb stenoses and 1 occlusion, leading to a primary patency of 95.5% and a secondary patency of 100%, at 24 months. Buttock claudication occurred in 24.3% of the limbs treated at 1 month but decreased to 4.3% at 24 months. CONCLUSIONS: Our multicenter prospective study showed that Spiral-Z limb deployed in the EIA was associated with satisfactory results and seems to be a durable option, even in the era of iliac branch devices.

    DOI： 10.1253/circj.CJ-20-0195

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  • Vessel Calcification as a Risk Factor for In-Stent Restenosis in Complex Femoropopliteal Lesions After Zilver PTX Paclitaxel-Coated Stent Placement. 国際誌

    Shigeo Ichihashi, Tsuyoshi Shibata, Naoki Fujimura, Satoru Nagatomi, Hiroshi Yamamoto, Ryoichi Kyuragi, Akira Adachi, Shinichi Iwakoshi, Francesco Bolstad, Keigo Saeki, Kenji Obayashi, Kimihiko Kichikawa

    Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists   26 ( 5 )   613 - 620   2019年10月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    Purpose: To evaluate the effect of vessel calcification on in-stent restenosis (ISR) after drug-coated stent (DCS) placement in the femoropopliteal segment. Materials and Methods: A retrospective multicenter study was undertaken involving 220 consecutive symptomatic patients (mean age 73.1±8.3 years; 175 men) with femoropopliteal lesions in 230 limbs treated with the Zilver PTX DCS and having duplex surveillance after the endovascular procedures. Mean lesion length was 16.4±9.8 cm (range 2-40); there were 104 (45.2%) total occlusions and 68 (29.6%) in-stent restenoses (ISR). Twenty (8.7%) vessels had no runoff. The majority of lesions (148, 64.3%) were calcified according to the peripheral arterial calcium scoring system (PACSS). Primary patency was evaluated by duplex. Lesions were classified as either PACSS 0-2 (none or unilateral wall calcification) or PACSS 3 and 4 (bilateral wall calcification). Multivariate analysis was performed to identify variables associated with ISR; the results are given as the hazard ratio (HR) and 95% confidence interval (CI). Results: The 1-, 2-, and 5-year primary patency and freedom from clinically-driven target lesion revascularization estimates were 75.9%, 63.6%, and 45.0%, and 84.7%, 73.7%, and 54.2%, respectively. Major amputations were performed on 4 limbs during follow-up. In multivariate analysis, vessel calcification (adjusted HR 1.718, 95% CI 1.035 to 2.851, p=0.036) was significantly correlated with the occurrence of ISR, along with lesion length (adjusted HR 1.041, 95% CI 1.013 to 1.070, p=0.003), and cilostazol administration (adjusted HR 0.476, 95% CI 0.259 to 0.876, p=0.017). Conclusion: This study suggested that bilateral vessel wall calcification was an independent risk factor for ISR in complex femoropopliteal lesions after Zilver PTX DCS placement, along with lesion length; cilostazol administration had a protective effect.

    DOI： 10.1177/1526602819860124

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  • [Surgery for Flail Chest with Titanium Plates after Cardiopulmonary Resuscitation;Report of a Case].

    Kohdai Tsuruta, Tohru Mawatari, Kouhei Narayama, Tsuyoshi Shibata, Masami Shingaki, Toshio Baba, Kiyofumi Morishita, Suguru Ishizaka, Atsushi Watanabe

    Kyobu geka. The Japanese journal of thoracic surgery   72 ( 4 )   318 - 320   2019年4月

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    記述言語：日本語   掲載種別：研究論文（学術雑誌）  

    A 74-year-old woman was admitted for the management of nausea with hyponatremia. On the 19th day of hospitalization, the patient developed cardiac arrest and needed cardiopulmonary resuscitation (CPR). CPR was successful but the patient developed multiple rib fractures with flail chest by CPR. Because of persistent dyspnea, surgery for fixing of the fractured ribs was performed using 4 titanium plates, with prompt improvement of the flail chest after the operation.

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  • Predictive Factors for Abdominal Aortic Aneurysm Shrinkage One Year after Successful Endovascular Aneurysm Repair. 国際誌

    Masami Shingaki, Kiyofumi Morishita, Toshio Baba, Tsuyoshi Shibata, Kohei Narayama

    Annals of vascular surgery   53   92 - 96   2018年11月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    BACKGROUND: Often, we experience cases of aneurysm shrinkage and no aneurysm shrinkage after successful endovascular aortic aneurysm repair, without postoperative endoleaks. We studied these cases to ascertain the predictive factors for aneurysm shrinkage. METHODS: From 2007 to 2014, we selected 255 cases that comprised aneurysm shrinkage (>4 mm) and no-shrinkage cases (shrinkage from 0 to 4 mm). Excluding 36 cases of endoleaks, 43 cases without 1-year follow-up computed tomography scan, and 3 cases of aortic dissection, we assessed 93 cases of aneurysm shrinkage (S group) and 80 cases of no aneurysm shrinkage (N group) at 1-year follow-up. RESULTS: No significant differences were found in sex, comorbidities (diabetes mellitus, chronic kidney disease, hemodialysis, and malignancy), and medications (antiplatelet drugs, anticoagulant drugs, steroids, and statins). Advanced age was a strong negative predictive factor for aneurysm shrinkage (N: 75.0 ± 1.0 vs. S: 72.1 ± 0.9 years; P = 0.023), and intraoperative endoleaks were more frequent in the N group (N: 31.3 vs. S: 9.7%; P = 0.001). Neck thrombus was more likely in the N group (N: 17.5 vs. S: 7.5%; P = 0.045), but it had a strong correlation with intraoperative endoleaks (P = 0.008). In the multivariate analysis, patient age and intraoperative endoleaks were predictive factors for aneurysm shrinkage. CONCLUSIONS: Advanced age and intraoperative endoleaks were negative predictive factors for aneurysm shrinkage at 1-year follow-up after successful endovascular treatment without postoperative endoleaks.

    DOI： 10.1016/j.avsg.2018.04.032

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  • Anatomical repair for Kommerell diverticulum with deep site in-situ fenestration. 国際誌

    Masami Shingaki, Yoshihiko Kurimoto, Kiyofumi Morishita, Toshio Baba, Tsuyoshi Shibata, Kohei Narayama

    Asian cardiovascular & thoracic annals   26 ( 6 )   467 - 469   2018年7月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    An 83-year-old woman with a Kommerell diverticulum was treated by anatomical endovascular repair with a deep site in-situ fenestration instead of complex debranching techniques. The main component of the thoracic stent-graft was deployed just distal to the third cervical branch to completely exclude the Kommerell diverticulum. A deep site in-situ fenestration was made on the main component using a radiofrequency needle through the left subclavian artery, and a stent-graft was deployed to bridge the main component to the left subclavian artery. Six months postoperatively, the Kommerell diverticulum was completely excluded with excellent left subclavian artery patency.

    DOI： 10.1177/0218492318785250

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  • [Infectious Endocarditis due to Methicillin-sensitive Bovine Staphylococcus aureus;Report of a Case].

    Toshio Baba, Kiyofumi Morishita, Tooru Mawatari, Masami Shingaki, Tsuyoshi Shibata, Kouhei Narayama, Koudai Tsuruta

    Kyobu geka. The Japanese journal of thoracic surgery   71 ( 2 )   103 - 106   2018年2月

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    記述言語：日本語   掲載種別：研究論文（学術雑誌）  

    A 19-year-old male patient was admitted to our hospital after developing infectious endocarditis associated with methicillin-sensitive bovine Staphylococcus aureus septicemia. Brain magnetic resonance imaging confirmed occipital lobe cerebral bleeding. An echocardiogram showed severe mitral regurgitation with vegetation on the posterior mitral leaflet. We performed mitral valve replacement. However, a hepatic artery aneurysm and a ruptured splenic artery aneurysm was found on the 5th postoperative day and coil embolization was accordingly performed. The patient suffered repeated cerebral bleeding and received external decompression. He was discharged on the 92nd day after the valve replacement. Our case is rare in that methicillin-sensitive bovine Staphylococcus aureus isolated from human is extremely unusual especially complicated by multiple peripheral aneurysms. This is the 1st reported case of methicillin-sensitive bovine Staphylococcus aureus isolated from human in the Japanese literature.

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  • Physician-Modified Thoracic Stent-Grafts for the Treatment of Aortic Arch Lesions. 国際誌

    Ludovic Canaud, Toshio Baba, Thomas Gandet, Kouhei Narayama, Baris Ata Ozdemir, Tsuyoshi Shibata, Pierre Alric, Kiyofumi Morishita

    Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists   24 ( 4 )   542 - 548   2017年8月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    PURPOSE: To evaluate outcomes of physician-modified thoracic stent-grafts for the treatment of aortic arch aneurysms. METHODS: A retrospective dual-center analysis was performed involving 36 patients (mean age 74.7±9 years, range 58-91; 27 men) with an aortic arch lesion who were treated between November 2013 and June 2016 using physician-modified thoracic stent-grafts. Half of the patients had a degenerative aneurysm; the remainder had type B dissection (n=9), traumatic transection (n=3), type Ia endoleak after previous endografting (n=5), or aortoesophageal fistula (n=1). All patients were considered to be at high surgical risk. Patients were treated using an aortic arch stent-graft with a single fenestration (n=24) or a proximal scallop (n=12); zone 0 was involved in 16 patients, zone 1 in 9, and zone 2 in 11. The modified thoracic stent-graft was deployed after supra-aortic branch revascularization in 24 (67%) patients. RESULTS: Mean time required for stent-graft modifications was 18 minutes (range 14-21). Technical success was obtained in all cases with no type I endoleak. One (3%) patient had a stroke without permanent sequelae. The 30-day mortality was 6%. During a mean follow-up of 11.4±6 months (range 2-36), there were no conversions to open repair. The overall mortality was 14%; aorta-related mortality was 6%. CONCLUSION: Our experience suggests that physician-modified thoracic stent-grafts are feasible for aortic arch lesions and provide encouraging results in the short term. Durability concerns will need to be assessed.

    DOI： 10.1177/1526602817714206

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  • [Echographic Examination for Leg Vein Thromboembolism in Thoracic Surgery].

    Tohru Mawatari, Kouhei Narayama, Tsuyoshi Shibata, Toshifumi Saga, Toshio Baba, Kiyofumi Morishita, Jun Niwa, Yuusuke Watanabe, Tatsushi Yamashita, Natsuko Hirakata, Atsushi Watanabe

    Kyobu geka. The Japanese journal of thoracic surgery   69 ( 7 )   491 - 4   2016年7月

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    記述言語：日本語   掲載種別：研究論文（学術雑誌）  

    Echographic examination for leg vein thromboembolism was carried out in 123 patients scheduled for thoracic surgery. Preventive measures for thromboembolism were conducted after the risk assessment. Echography was done after surgery in 72 cases, most of which were cases of lung malignant tumors, and thromboembolism was detected in 4 cases. Thus, the incidence rate of venous thromboembolism was 5.6%( 4/72). There was no patients who developed pulmonary thromboembolism during the examination period, suggesting reasonable risk assessment and preventive measures in our procedure.

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  • [Examination of the postoperative change of pedicled pericardial fat pad for reinforcement of bronchial sutures by computed tomography].

    Tohru Mawatari, Tsuyoshi Shibata, Toshifumi Saga, Kohsuke Ujihira, Shunsuke Ohori, Toshio Baba, Kiyofumi Morishita, Atsushi Watanabe

    Kyobu geka. The Japanese journal of thoracic surgery   66 ( 13 )   1128 - 31   2013年12月

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    記述言語：日本語   掲載種別：研究論文（学術雑誌）  

    A pedicled pericardial fat pad (PPFP) is often used in pulmonary resection to reinforce bronchial sutures. Here, we assessed the significance of PPFP by serial chest computed tomography (CT). Ten cases in which bronchial stump were covered with a PPFP in the past 6 years were reviewed. The procedures were pneumonectomy (3), lobectomy (6), and a segmentectomy. According to the CT value evaluated serially PPFP was recognized as fat tissue until 1~2 postoperative months. No cases of bronchopleural fistulae was encountered in this series. The coverage of the sutures with the PPFP was thought to contribute to the prevention of bronchial fistula by staying around bronchial stump for at least 1 to 2 months.

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  • [Total debranching through mini-sternotomy].

    Kosuke Ujihira, Kiyofumi Morishita, Tsuyoshi Shibata, Toshifumi Saga, Toshio Baba, Toru Mawatari

    Kyobu geka. The Japanese journal of thoracic surgery   66 ( 11 )   990 - 5   2013年10月

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    記述言語：日本語   掲載種別：研究論文（学術雑誌）  

    Aneurysms of the aortic arch are technically challenging to repair with thoracic endovascular aneurysm repair (TEVAR). Various optional techniques such as debranching or hybrid TEVAR enable landing zones to extend, however, there is still room for improvement. We have performed total debranching to facilitate TEVAR with adequate central neck length more than 2.5 cm. In summary our procedure has 3 features:mini-thoracotomy to minimize its surgical stress which might cause post-operative respiratory failure, side-to-side anastomosis of trifurcated graft with ascending aorta to avoid its kinking after chest closure, and the usage of Pruitt-Inahara shunt tube during anastomoses of the carotid artery.

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