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Yasuhisa Fukada

Publications and source records attributed to Yasuhisa Fukada.

10 recordsLinked to original sources
PubMed2005

A new device for ensuring the correct length of artificial chordae in mitral valvuloplasty.

Mitral valvuloplasty using Gore-Tex as artificial chordae, especially for patients with anterior leaflet prolapse, is often associated with difficulties in determining the length of artificial chordae as well as in preventing knot slipping. We describe a simple technique of using a new device that enables surgeons to easily determine the accurate length of the artificial chordae and to tie the slippery knot without sliding and damaging it.

Cardiac Surgical Procedures↗
PubMed2005

Impact of papillary muscles approximation on the adequacy of mitral coaptation in functional mitral regurgitation due to dilated cardiomyopathy.

PURPOSE: We report early outcome of our modified papillary muscles approximation (PMA) as an adjunct to mitral annuloplasty (MAP) by analyzing the mitral coaptation zone echocardiographically and clinical outcome in three different procedures. METHODS: Mitral valve coaptation depth (MVCD) and tenting area were measured in patients with ischemic (n=8) or non-ischemic (n=22) dilated cardiomyopathy (ICM or non-ICM) undergoing either of following: Group I: isolated left ventricular volume reduction (LVVR) (n=11), Group II: PMA plus LVVR (n=14), Group III: isolated PMA (n=5). Clinical outcome including cardiac function were also investigated. RESULTS: Thirty-day mortality was 6.7%. Postoperative data in overall survivors showed significant improvement of ejection fraction (EF) (from 19+/-7 to 32+/-9%), left ventricular end-diastolic volume index (LVEDVI) (from 189+/-74 to 132+/-41 mL/m2), and left ventricular diastolic dimension (LVDd) (from 73+/-8 to 65+/-6 mm) (p<0.001). The overall preoperative MVCD (mm) and tenting area (cm2) was 10.4+/-2.8 and 2.4+/-0.6, respectively, which were both significantly reduced to 5.6+/-2.5 and 0.8+/-2.4 postoperatively (p<0.001). In comparison of the degree (%change) of improvement, Group II and III showed favorable effects on tethering force, compared with Group I. CONCLUSION: Our modified PMA is a relatively safe method to have the potential for improving tethering of the mitral valve and clinical outcome in evaluating mitral coaptation zone.

Cardiomyopathy, Dilated↗
PubMed2005

A case of mitral valve replacement with a collar-reinforced prosthetic valve for heavily calcified mitral annulus.

Mitral valve replacement in the presence of extensive calcification of the mitral annulus is a technical challenge. Dense calcification of the annulus can cause a great difficulty in the insertion of a prosthetic valve and later periprosthetic leakage. A radical calcium debridement may cause left circumflex coronary artery injury, atrioventricular rupture, and thromboembolic events. We report a case of a 65-year-old woman suffering from mitral regurgitation with a severely calcified mitral annulus. She underwent mitral valve replacement using a collar-reinforced prosthetic valve, which allowed the surgeon to safely insert a prosthetic valve, avoiding the calcification completely without any major complications. We recommend this method as a feasible technique for mitral valve replacement in the presence of heavily calcified or disrupted fragile mitral annulus.

Aged↗
PubMed2004

[Aberrant subclavian artery].

Aberrant subclavian artery (ASA) is the most frequently encountered congenital anomaly of aortic arch. The ASA aneurysms are rare but potentially lethal disease, it has been recognized that the presence of an aneurysm of an ASA itself is an indication for surgery. We experienced 4 cases with ASA during the past 23 years. All cases were male. Their ages ranged from 51 to 73 years old. Three patients had a right-sided aortic arch. Among the 4 patients, only 1 underwent total arch replacement, but the other 3 patients could be followed conservatively for 1, 7 and 23 years, respectively. We reviewed the problem of the diagnosis and treatment of the ASA including surgical indication.

Aged↗
PubMed2004

[Ischemic cardiomyopathy treated with overlapping ventriculoplasty].

A 58-year-old man was admitted due to congestive heart failure. Left ventriculography showed end-diastolic volume index (EDVI) of 172 ml/m2 and ejection fraction (EF) of 16%. Coronary angiography showed severe double vessel disease (the left anterior descending artery and the right coronary artery). Echocardiography showed dilated heart [left ventricular end-diastolic diameter (LVDd) of 74 mm] and severe mitral regurgitation due to tethering of the leaflets. The patient underwent our original left ventricular volume reduction operation, termed overlapping ventriculoplasty (OLVP) combined with mitral annuloplasty, papillary muscles plication (PMP) and coronary artery bypass grafting (CABG). The postoperative course was excellent. Postoperatively, the EDVI decreased to 96 ml/m2, the LVDd diminished to 67 mm, and the EF improved to 34%. This case implies the role of left ventricular remodeling procedure of OLVP and PMP in the ischemic cardiomyopathy with ischemic mitral regurgitation.

Cardiac Surgical Procedures↗
PubMed2003

Experimental study of a new operative procedure for nonischemic dilated cardiomyopathy: overlapping cardiac volume reduction operation.

PURPOSE: To assess a newly devised procedure for cardiac volume reduction without resecting any cardiac muscle and evaluate its effectiveness in an experimental settings. METHODS: Ten beagle dogs underwent a rapid pacing leading to heart failure for 3 weeks and then underwent left ventricular reduction by a procedure called the overlapping cardiac volume reduction operation (OLCVR), which consisted of a longitudinal incision in the left ventricular (LV) free wall, sutures from the left margin to the septal wall, and the right margin to the LV free wall. A slope of the linear preload recruitable stroke work relationship ( M(w)), with an X-intercept ( V(o)) were calculated as precise indicators of the LV systolic function. The constant of isovolumic pressure decay (Tau) and the peak filling rate (PFR) were also calculated as indicators of the LV diastolic function. RESULTS: The LV end-diastolic dimensions significantly decreased by OLCVR (43 +/- 2 to 25 +/- 1 mm). Fractional shortening significantly improved by OLCVR (11% +/- 2% to 30% +/- 4%). M(w) (erg. cm(-3). 10(3)) also significantly improved (21 +/- 2 to 33 +/- 3 ( P < 0.001)), whereas V(o), Tau, and PFR did not show any significant changes. CONCLUSION: The OLCVR significantly increased the early LV systolic function without any detrimental effects on the diastolic function. This procedure may therefore be a useful therapeutic option for end-stage cardiomyopathy.

Animals↗
PubMed2003

Combined cox maze procedure, septal myectomy, and mitral valve replacement for severe hypertrophic obstructive cardiomyopathy complicated by chronic atrial fibrillation.

Atrial fibrillation (AF) has been reported to be an important prognostic indicator for clinical deterioration particularly in patients with hypertrophic obstructive cardiomyopathy (HOCM). A 66-year-old female complained of severe exertional dyspnea and tachycardia, which were resistant to medical treatments. Doppler echocardiography demonstrated a peak left ventricular outflow tract (LVOT) gradient of 117 mmHg at rest. A catheter examination revealed left ventricular end diastolic pressure of 34 mmHg, a cardiac index of 1.94 L/minute/m(2), and a peak LVOT gradient of 70 mmHg at rest. A transaortic septal myotomy/myectomy was performed first, and Cox maze III procedure was performed through the right and left atrium followed by mitral valve replacement. The patient recovered dramatically except for temporary complete atrioventricular block. One year after operation, the patient is doing well with sinus rhythm and the echocardiogram revealed a peak LVOT pressure gradient of 7.6 mmHg at rest. This surgical approach might be recommended for the treatment of AF in HOCM. (Ann Thorac Cardiovasc Surg 2003; 9: 323-5)

Aged↗
PubMedDate not supplied

A surgical approach to severe congestive heart failure--overlapping ventriculoplasty.

BACKGROUND: Previously we developed a new procedure of overlapping cardiac volume reduction (OLCVR) surgery for patients with dilated cardiomyopathy refractory to medical treatment. Papillary muscle plication (PMP) when combined with OLCVR may achieve a better clinical outcome. PURPOSE: To investigate the early and intermediate results of OLCVR with or without PMP. METHODS: Twenty-five patients (21 males, 4 females, aged 60 +/- 13 years) with either ischemic (n = 7) or nonischemic (n = 18) dilated cardiomyopathy underwent either isolated OLCVR (n = 11; Original Group) or PMP combined with OLCVR (n = 14; Integrated Group). RESULTS: Early deaths occurred in two (8%) from a noncardiac cause and late deaths in six, two from a cardiac and four from a noncardiac cause. Postoperative data in survivors were significantly improved in terms of NYHA functional class (from 3.6 +/- 1.9 to 1.6 +/- 1.1), ejection fraction (from 18 +/- 6% to 31 +/- 8%), left ventricular diastolic dimension (from 73 +/- 9 to 65 +/- 6 mm), and left ventricular end-diastolic volume index (from 194 +/- 81 to 128 +/- 43 mL/m2) (p < 0.05) in selected comparative cases. One-year crude and cause-specific survivals were 70.9% and 83.1%, respectively, at a mean follow-up of 12.8 months. One-year crude survival of the Integrated and Original Group was 85.7% and 55.6%, respectively (p = 0.24). CONCLUSIONS: Although limitations exist in evaluating operative results, we consider OLCVR to be a relatively safe and effective procedure for selected patients with dilated cardiomyopathy. The addition of PMP to OLCVR may enhance the elliptic formation of left ventricle shape and improve mitral valve tethering, but further study is mandatory.

Aged↗