1.Mid-term Results of Endovascular Treatment for Type B Aortic Dissection
Munehiro Saiki ; Yoshinobu Nakamura ; Suguru Shiraya ; Shingo Harada ; Yuichiro Kishimoto ; Takeshi Ohnohara ; Tomohiro Kurashiki ; Satoru Kishimoto ; Hiromu Horie ; Motonobu Nishimura
Japanese Journal of Cardiovascular Surgery 2016;45(3):101-106
Background : Endovascular treatment of the thoracic aorta (TEVAR) for type B aortic dissection is reported to be effective if the interval between the onset and the procedure is relatively short. However, the optimal timing for TEVAR is still controversial. Method : From December 2008 to April 2015, we experienced 46 TEVARs for type B aortic dissection. The interval between onset and TEVAR was within 3 months in 15 cases (Group A), from 3 months to 1 year in 10 cases (Group B), and more than 1 year in 21 cases (Group C). Result : Primary success was obtained in all cases, and no new intimal tear was formed during the procedure. There was no hospital death. At the time of discharge, disappearance of ULP or thrombosed thoracic false lumen occurred significantly more frequently in Group A (93%) than in Group B (50%) and Group C (43%) (p<0.05). At 6 months, the rate of the patients with reduced aneurysm diameter more than 5 mm was significantly higher in Group A (87%) and Group B (70%) than in Group C (19%) (p<0.05). Three cases of Group C had enlargement of the aneurysm despite of TEVAR, and graft replacement of thoracoabdominal aorta was performed in one of the cases. Conclusion : For type B aortic dissection, TEVAR is more effective if performed within 3 months from the onset.
2.A Case of Successful Hybrid Treatment for Chronic Type B Dissection in a Patient with Bilateral Occlusion of Iliac Arteries
Yuichiro Kishimoto ; Munehiro Saiki ; Yoshinobu Nakamura ; Yoshikazu Fujiwara ; Suguru Shiraya ; Takeshi Oonohara ; Yuki Ohtsuki ; Satoru Kishimoto ; Motonobu Nishimura
Japanese Journal of Cardiovascular Surgery 2012;41(6):323-326
Hybrid techniques to enable endovascular treatment of complex aortic pathology have been previously described. A staged endograft repair of a complex, chronic Stanford type B aortic dissection with atherosclerotic occlusion of bilateral iliac arteries is reported in a 66-year-old man. The patient also had chronic obstructive lung disease as well as chronic renal dysfunction. The aneurysmal portion of the dissection extended from the distal arch to the entire thoracic aorta. Bilateral femoral arteries were bypassed from the abdominal aorta using open techniques. Then, total arch replacement with a frozen elephant trunk was performed through median sternotomy. Finally, the aneurysmal portion was completely covered with an endograft from the frozen elephant trunk to the upper abdominal aorta, just proximal to the celiac trunk. The patient had no neurologic complications. This case report illustrates the feasibility of the hybrid technique in selected high-risk patients when confronted with complex aortic pathology.
3.How to Develop Human Resources in Cardiovascular Surgery : Investigation about the Gap between Ideal and Reality No.12
Koki ETO ; Yuichiro KISHIMOTO ; Hiromi WADA ; Hiromi ARASE ; Hiroyuki KURAZUMI ; Yuzi KODAMA ; Sayako NAKAGAWA ; Taisuke NAKAYAMA
Japanese Journal of Cardiovascular Surgery 2019;48(4):4-U1-4-U3
We investigated the training system of a young cardiovascular surgeon in Japan. We presented the result of surveillance at the 49th Annual Meeting of the Japanese Society for Cardiovascular Surgery 2019, and report here the summary.
4.1.How Can We Promote Work Style Reforms of Cardiovascular Surgeons ?
Hiromi WADA ; Hiroki ARASE ; Yoshinori INOUE ; Koki ETO ; Yuichiro KISHIMOTO ; Yusuke KINUGASA ; Hiroshi KURAZUMI ; Hiroshi KODAMA ; Sayako NAKAGAWA ; Taisuke NAKAYAMA ; Kenji NAMIGUCHI ; Akira FUJITA ; Hiromu HORIE
Japanese Journal of Cardiovascular Surgery 2020;49(1):1-U1-1-U4
The work style of doctors gets attention within the Work Style Reforms that have been fully implemented since 2019. Now, we conducted a questionnaire survey at 10 institutions in Chugoku and Shikoku region and reviewed the latest work style of cardiovascular surgeons in comparison with other departments.