Papers - NAKAJIMA Tomohiro

Absent left circumflex artery detected by computed tomography-angiography.

Ryo Harada, Tomohiro Nakajima, Nobuyoshi Kawaharda

Asian cardiovascular & thoracic annals   25 ( 5 ) 401 - 401  2017.06  [International journal]

DOI PubMed

Histomorphologic superiority of internal thoracic arteries over right gastroepiploic arteries for coronary bypass.

Tomohiro Nakajima, Kazutoshi Tachibana, Nobuyuki Takagi, Toshiro Ito, Nobuyoshi Kawaharada

The Journal of thoracic and cardiovascular surgery   151 ( 6 ) 1704 - 8  2016.06  [International journal]

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OBJECTIVE: In this study, we compared the histologic and morphometric properties of both internal thoracic arteries and the right gastroepiploic artery (GEA) in patients undergoing coronary artery bypass grafting (CABG). METHODS: We microscopically examined transverse sections of segments of both internal thoracic arteries and the right GEA obtained from 83 consecutive patients who underwent CABG. RESULTS: There were no significant differences between the internal thoracic arteries. Significant differences were found between the left and right internal thoracic arteries and GEA in the intimal width (21.8, 21.5, and 71.7 μm, respectively; P < .01), intima-to-media ratio (0.286, 0.256, and 0.749, respectively; P < .01), and media width (148.5, 157.5, and 164.8 μm, respectively; P = .43). No atherosclerotic lesions, medial calcification, or intimal thickening were seen in the internal thoracic arteries; however, atherosclerotic lesions were seen in the GEA. The intima of the GEA was thicker than that of the internal thoracic arteries. Intimal thickening of the GEA, but not the internal thoracic arteries, was positively correlated with risk of arteriosclerosis. In patients with diabetes mellitus, dietary/drug therapy and insulin therapy were associated with GEA intimal thickness (P = .02 and .01, respectively). CONCLUSIONS: The internal thoracic arteries have equivalent histologic and morphometric properties that differ from those of the GEA only in intimal width. The former had no intimal thickening, and is thus preferable to the GEA for CABG.

DOI PubMed

Idiopathic bronchial hemorrhage: a rare but catastrophic complication in cardiac surgery.

Takeshi Uzuka, Masanori Nakamura, Tomohiro Nakajima, Shinichi Kusudoh, Hiroaki Usubuchi, Akihiko Tanaka, Noriyasu Watanabe

Journal of cardiothoracic surgery   11 ( 1 ) 78 - 78  2016.05  [International journal]

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BACKGROUND: Hemoptysis is a common complication in all kinds of surgery. However, it is rarely critical because it resolves with or without intervention. CASE PRESENTATION: Here the authors present what is believed to be an unprecedented report of a case involving a fatal idiopathic bronchial hemorrhage complication during cardiac surgery. Eighty-five-year-old female with severe aorticvalve stenosis had elective aortic valve replacement. Subsequently, she developed diffuse bilateral severe idiopathic bronchial hemorrhage which required maximum intervention such as external bronchial ligation, V-A ECMO, coil embolization of bronchial artery and internal airway blockage by spigot. CONCLUSIONS: Airway bleeding is not a rare complication in cardiac surgery, but this case should increase awareness of this potentially life threatening perioperative complication.

DOI PubMed

Acute dilatation of the ascending aorta and aortic valve regurgitation in Loeys-Dietz syndrome.

Tomohiro Nakajima, Kazutoshi Tachibana, Yasuko Miyaki, Nobuyuki Takagi, Takayuki Morisaki, Tetsuya Higami

The Annals of thoracic surgery   97 ( 6 ) 2188 - 90  2014.06  [International journal]

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Loeys-Dietz syndrome (LDS) is a recently recognized connective tissue disorder caused by mutations of the transforming growth factor (TGF)-β receptors. It is an autosomal dominant syndrome characterized by the triad of arterial tortuosity and aneurysms, hypertelorism, and bifid uvula or cleft palate. We treated an 18-year-old woman with a 100-mm-diameter aortic root aneurysm and severe aortic valve regurgitation. She underwent urgent aortic root replacement and bioprosthetic valve implantation. LDS was diagnosed by postoperative genetic screening results. Histopathologic examination of the aortic wall showed diffuse degeneration and elastin fragmentation in the media.

DOI PubMed

[Henoch-Schönlein Purpura with lung abscess].

Junji Nakazawa, Atsushi Watanabe, Tomohiro Nakajima, Taijiro Mishina, Masahiro Miyajima, Tetsuya Higami

Kyobu geka. The Japanese journal of thoracic surgery   66 ( 10 ) 886 - 9  2013.09  [Domestic journal]

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A 72-year-old man had underwent left lower lobectomy for squamous cell carcinoma in our hospital in 2008. Postoperative stage was I A (T1N0M0). In 2010, follow-up chest computed tomography (CT) images showed similar cavitary nodules in segments 2 and 8 of the right lung with positive uptake on fluorodeoxyglucose-positron emission tomography (FDG-PET) images. Physical examination, blood tests, and levels of serum tumor markers showed no abnormality. Transbronchial lung biopsy revealed the absence of malignant cells. Segment 8 of the right lower lobe with the nodule was partially resected, and pathological examination demonstrated lung abscess. He was discharged but was hospitalized in another hospital for purpuric rash, fever, and arthralgia. Microscopic albuminuria was noted, and renal biopsy revealed nephritis with immunoglobulin A( IgA)deposition. He was made a diagnosis of Henoch-Schönlein purpura. Oral steroid therapy( prednisolone 60 mg/d) was initiated, resulting in the improvement of symptoms and disapearance of the cavitary nodule in the right lung segment 2.

PubMed

[Aortic valve surgery in a patient with cold agglutinin disease; effectiveness of continuous retrograde cardioplegia].

Yasuko Miyaki, Nobuyuki Takagi, Takeo Hasegawa, Naomi Yasuda, Tomohiro Nakajima, Kazutoshi Tachibana, Tetsuya Higami

Kyobu geka. The Japanese journal of thoracic surgery   66 ( 3 ) 187 - 9  2013.03  [Domestic journal]

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A 76-year-old female was hospitalized because of congestive heart failure and anemia. A thorough examination led to a diagnosis of severe aortic stenosis and cold agglutinin disease. The critical temperature for hemagglutination was 27 °C, which caused particular problems with regard to the myocardial protection temperature during surgery. Aortic valve replacement was performed safely by increasing the normal myocardial protection temperature from 15 °C to 32 °C and using 3 times the normal volume of cardioplagic fluid. As a result of strict perioperative thermal management, the operation was completed without any complications.

PubMed

Transmanubrial approach with video-assisted thoracoscopic surgery for left superior sulcus tumour with dense adhesion after replacement of descending thoracic aorta.

Tomohiro Nakajima, Atsushi Watanabe, Jyunji Nakazawa, Tetsuya Higami

Interactive cardiovascular and thoracic surgery   14 ( 6 ) 906 - 8  2012.06  [International journal]

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There are various surgical approaches to superior sulcus tumours according to the location of the tumour. The chief difficulties in the operation are broadening of the operative field and adhesiolysis. This study presents the case of surgical treatment of superior sulcus tumour following chemoradiation therapy with dense pleural adhesion due to a history of graft replacement of the descending thoracic aorta. The patient underwent left upper lobectomy via a transmanubrial osteomuscular-sparing approach combined with video-assisted thoracoscopic surgery (VATS). Transmanubrial approach combined with VATS offered a good overview during local tumour dissection.

DOI PubMed

[Aneurysm of the aortic cusp; report of a case].

Shuichi Naraoka, Satomi Inoue, Tomohiro Nakajima, Yukihiro Niida

Kyobu geka. The Japanese journal of thoracic surgery   63 ( 13 ) 1164 - 7  2010.12  [Domestic journal]

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We performed surgical therapy to the rare case of the perforation of an aneurysm of the aortic cusp which had caused the congestive heart failure. 71-year-old man having developed coughing was diagnosed as a severe aortic regurgitation and came to our hospital for surgery. The non coronary cusp was dilated and perforated. The aortic valves were removed and replaced with a bioprosthetic valve. The pathological examination of the valves showed healed infective endocarditis. The patient discharged home uneventfully.

PubMed