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Mitsugu Ogawa

Publications and source records attributed to Mitsugu Ogawa.

6 recordsLinked to original sources
PubMed2006

Pulmonary artery augmentation using autologous vena cava in right heart bypass operations.

We obtained good results in the right heart bypass operation concomitant with the pulmonary arterial augmentation using the vena cava in 7 patients. We report the techniques used in 2 representative patients. The techniques used were a hemi-Fontan procedure with large superior vena caval patches and a bidirectional cavopulmonary shunt with superior vena caval interposition. These techniques have advantages in that the augmented pulmonary arteries have growth potential and low thrombogenicity because the procedures can be performed without the use of prosthetic materials or xenografts, especially in cases in which it is impossible to use the autologous pericardium.

Cardiopulmonary Bypass↗
PubMed2005

Does off-pump coronary artery bypass grafting beneficially affect renal function?

BACKGROUND: Off-pump coronary artery bypass grafting (CABG) has been reported to beneficially affect renal function, but this remains to be confirmed. The purpose of the present paper was to study the effects of off-pump CABG on renal function and analyse predictors of postoperative renal impairment in patients who received off-pump CABG. METHODS: A total of 451 patients who underwent isolated CABG between January 1999 and August 2003 were retrospectively studied. No patient was receiving dialysis. A total of 300 patients (228 men) underwent off-pump CABG (off-pump group) and 151 patients (104 men) underwent on-pump CABG (on-pump group). Perioperative serum creatinine levels and creatinine ratios (peak postoperative creatinine level/preoperative creatinine level) were compared between the groups. RESULTS: Renal impairment (serum creatinine >1.5 mg/dL) developed postoperatively in 12.7% of the off-pump group and 18.5% of the on-pump group (P = 0.1). The creatinine ratio was significantly lower in the off-pump group (1.2 +/- 0.4) than in the on-pump group (1.4 +/- 0.7, P = 0.003). Logistic regression analysis demonstrated that the strongest predictors of postoperative renal impairment in off-pump CABG were left ventricular dysfunction (odds ratio 10.8) and multivessel grafting (odds ratio 4.3). CONCLUSIONS: Off-pump CABG provides better renal protection than on-pump CABG. However, perioperative renal function should be closely monitored in patients who have left ventricular dysfunction or who undergo multivessel grafting, even when off-pump CABG is performed.

Aged↗
PubMed2005

[Clinical evaluation of hydrocolloidal dressing in 147 patients undergoing cardiovascular surgery].

Recent evidence has suggested that a moist environment plays an important role in wound healing. Karayahesive, one type of hydrocolloidal dressing, contains natural karaya gum as a hydrophilic gel. We applied hydrocolloidal dressing to operative wounds in 147 patients who underwent cardiovascular surgery from April 2001 through August 2002 to evaluate its clinical usefulness. The dressing was kept on the wounds for 7 days after operation, but was immediately switched to conventional dressing with gauze if there was any problem. A total of 144 patients (98%) had no wound chest infections. Good wound healing was obtained with only 1 dressing, removed 7 days after operation, in 128 patients (87%). In 19 patients (13%), the hydrocolloidal dressing was switched to conventional dressing. In 13 of these patients the hydrocolloidal dressing dissolved naturally or exudation occurred; clinically, there were no local problems; however, 3 patients had infection, 2 had fat necrosis, and 1 had burn injury caused by electrocautery. No patients had skin problems caused by this dressing. We conclude that hydrocolloidal dressing can be used safely and effectively in patients undergoing cardiovascular surgery and reduce the workload of healthcare workers.

Adult↗
PubMed2004

Which patients can be weaned from inotropic support within 24 hours after cardiac surgery?

Inotropic support after cardiac surgery is sometimes employed for a long period without any definite criteria to wean patients from it. There are few reports describing factors influencing the inotropic support period. This study was undertaken to clarify the proper inotropic support period, especially to judge which patients can be weaned from it within 24 h. From January 2000 to December 2001, 151 patients, 88 (58.2%) with ischemic heart disease, 51 (33.8%) with valvular disease, 7 (4.6%) with congenital heart disease, and 5 (3.4%) with other heart disease, underwent cardiac surgery. The mean age was 66.2 +/- 10.1 years (range 30-95); 98 patients (65%) were male. The data were analyzed retrospectively. Eighty patients (53%) were weaned from inotropic support within 24 h after cardiac surgery. Univariate analysis showed that intra-aortic balloon pumping, blood transfusion, operation time, cardiopulmonary bypass time, and aortic cross-clamping time significantly influenced the inotropic support period. Multivariate analysis indicated that intra-aortic balloon pumping, blood transfusion, and cardiopulmonary bypass time significantly influenced the inotropic support period. Intra-aortic balloon pumping, blood transfusion, and cardiopulmonary bypass time might determine the inotropic support period. Appropriate surgical procedure and methods both reducing cardiopulmonary bypass time (<75 min) and minimizing blood loss are the keys to weaning patients from inotropic support within 24 h.

Adult↗
PubMedDate not supplied

Hemodiafiltration during cardiac surgery in patients on chronic hemodialysis.

BACKGROUND: We have developed a hemodiafiltration (HDF) protocol used during cardiac surgery to preserve fluid and electrolyte balance and prevent postoperative bleeding in patients on chronic hemodialysis. This retrospective study examined the operative results associated with our new protocol. METHODS: The study included 33 consecutive patients on long-term hemodialysis who underwent cardiac surgery at our hospital between January 2001 and April 2005, including off-pump coronary artery bypass grafting (CABG) in 19 patients. Vascular access was achieved via a 12-French double-lumen catheter inserted into the left femoral vein under general anesthesia, and HDF begun when the operation was started. After completion of cardiopulmonary bypass or, in patients who underwent off-pump CABG, after the distal anastomoses were completed, HDF was continued until target hematocrit between 30% and 35%, central venous pressure between 3 and 5 mmHg, and serum potassium concentration between 3.0 and 3.5 mEq/L were reached. The chest was closed after confirmation of hemostasis. RESULTS: There was no in-hospital death. Three patients were extubated in the operating room. There were no postoperative wound infection, mediastinitis, respiratory tract infection, or hemorrhage. The patients were discharged at a mean of 15.6 days after operation. CONCLUSIONS: These results suggest that intraoperative HDF lowers postoperative morbidity and mortality in chronic dialysis patients. Other advantages include early extubation and ambulation, and a shortened hospitalization.

Adult↗