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Article: [Preliminary Results with Implantation of Extracorporeal Ventricular Assist System without Sternotomy Incision].

Akiyama, Masatoshi / Saiki, Yoshikatsu

Kyobu geka. The Japanese journal of thoracic surgery

2018 Volume 71, Issue 7, Page(s) 519–523

Abstract: Temporary mechanical circulatory support device has been highly advocated for severe cardiogenic shock patient. However, standard ventricular assist device (VAD) implantation is invasive procedure for these sick patients. Less-invasive cardiac procedures ...

Abstract	Temporary mechanical circulatory support device has been highly advocated for severe cardiogenic shock patient. However, standard ventricular assist device (VAD) implantation is invasive procedure for these sick patients. Less-invasive cardiac procedures are known to be generally associated with many beneficial effects such as reduction of trauma, blood loss and risk of infection, and relatively short intensive care unit stay. Here we describe an alternative technique for less invasive extracorporeal VAD implantation.
MeSH term(s)	Heart-Assist Devices ; Humans ; Prosthesis Implantation/methods ; Shock, Cardiogenic/surgery ; Sternotomy ; Treatment Outcome
Language	Japanese
Publishing date	2018-06-19
Publishing country	Japan
Document type	Journal Article
ZDB-ID	603899-2
ISSN	0021-5252
ISSN	0021-5252
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Article ; Online: Fenestrated Fontan-like circulation under durable left-ventricular assist device support in fulminant myocarditis.

Tokunaga, Chiho / Iguchi, Atsushi / Nakajima, Hiroyuki / Hayashi, Jun / Takazawa, Akitoshi / Akiyama, Masatoshi / Yoshitake, Akihiro

Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs

2022 Volume 26, Issue 3, Page(s) 233–236

Abstract: Fulminant myocarditis is a fatal development from profound biventricular heart failure and often requires both right- and left-ventricular assistance to maintain hemodynamics, even at the risk of increased mortality and morbidity. Here, we present a 42- ... ...

Abstract	Fulminant myocarditis is a fatal development from profound biventricular heart failure and often requires both right- and left-ventricular assistance to maintain hemodynamics, even at the risk of increased mortality and morbidity. Here, we present a 42-year-old female with profound biventricular failure due to fulminant myocarditis, resolved by an isolated durable left-ventricular assist device support under a fenestrated, Fontan-like circulation and managed low-pulmonary vascular resistance.
MeSH term(s)	Female ; Humans ; Adult ; Myocarditis/complications ; Myocarditis/surgery ; Heart-Assist Devices ; Treatment Outcome ; Heart Failure/surgery ; Hemodynamics ; Shock, Cardiogenic
Language	English
Publishing date	2022-08-24
Publishing country	Japan
Document type	Case Reports ; Journal Article
ZDB-ID	1463555-0
ISSN	1619-0904 ; 1434-7229
ISSN (online)	1619-0904
ISSN	1434-7229
DOI	10.1007/s10047-022-01357-w
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Article ; Online: Individual Variability in von Willebrand Factor Fragility in Response to Shear Stress: A Possible Clue for Predicting Bleeding Risk.

Sakatsume, Ko / Akiyama, Masatoshi / Sakota, Daisuke / Hijikata, Wataru / Horiuchi, Hisanori / Maruyama, Osamu / Saiki, Yoshikatsu

ASAIO journal (American Society for Artificial Internal Organs : 1992)

2021 Volume 68, Issue 9, Page(s) 1128–1134

Abstract: Acquired von Willebrand syndrome (AVWS), characterized by reduced von Willebrand factor (VWF) large multimers, has recently been implicated as the principal mechanism underlying bleeding in patients implanted with left ventricular assist devices (LVADs). ...

Abstract	Acquired von Willebrand syndrome (AVWS), characterized by reduced von Willebrand factor (VWF) large multimers, has recently been implicated as the principal mechanism underlying bleeding in patients implanted with left ventricular assist devices (LVADs). Hematological severity of AVWS varies among patients, even if an identical device is implanted. We investigated whether this diversity in hematological severity is due to individual variability in VWF fragility, according to responses to incremental shear stress. Whole-blood samples were sheared at 20,000-40,000 s -1 shear rate, an index of shear stress, using a custom-made shear stressor that could generate shear stress compatible with that produced by an LVAD. The degree of VWF large multimers degradation was evaluated using the VWF large multimer index. A significant inverse correlation was observed between the VWF large multimer index and LVAD-compatible magnitudes of shear stress: the VWF large multimer indices were 68.5 ± 18.3, 48.0 ± 13.9, 33.9 ± 12.1, 23.7 ± 7.9, and 18.7% ± 8.7% at 20,000, 25,000, 30,000, 35,000, and 40,000 s -1 of shear rates, respectively ( P < 0.0001). Furthermore, experimental VWF large multimer index values were compatible with those derived from patients with implanted LVADs (median; 28.9%). Finally, reduction in the VWF large multimer index corresponding to shear stress showed individual variation. We demonstrated that the combined use of a novel high shear stress loading device and quantitative evaluation of VWF large multimers may predict risk of bleeding before LVAD implantation.
MeSH term(s)	Heart-Assist Devices/adverse effects ; Hemorrhage/etiology ; Humans ; Stress, Mechanical ; von Willebrand Diseases/etiology ; von Willebrand Factor/metabolism
Chemical Substances	von Willebrand Factor
Language	English
Publishing date	2021-12-28
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	759982-1
ISSN	1538-943X ; 0162-1432 ; 1058-2916
ISSN (online)	1538-943X
ISSN	0162-1432 ; 1058-2916
DOI	10.1097/MAT.0000000000001623
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Article ; Online: Changes in the Quality of Life of Patients with Left Ventricular Assist Device and their Caregivers in Japan: Retrospective Observational Study.

Suzuki, Fumika / Sato, Hiroe / Akiyama, Masatoshi / Akiba, Miki / Adachi, Osamu / Harada, Taku / Saiki, Yoshikatsu / Kohzuki, Masahiro

The Tohoku journal of experimental medicine

2022 Volume 257, Issue 1, Page(s) 45–55

Abstract: Left ventricular assist devices (LVAD) improve quality of life (QOL) in many patients with end-stage severe heart failure, but not in some patients. In addition, the burden on caregivers is expected to increase after LVAD patients are discharged. Our ... ...

Abstract	Left ventricular assist devices (LVAD) improve quality of life (QOL) in many patients with end-stage severe heart failure, but not in some patients. In addition, the burden on caregivers is expected to increase after LVAD patients are discharged. Our study aimed to investigate the impact of LVAD on the QOL of patients and caregivers. Thirty-two LVAD patients were assessed for changes in QOL, mental status, and activity level using the Euro QOL (EQ-5D-5L), Short Form 12 (SF-12), Minnesota Living with Heart Failure Questionnaire, Hospital Anxiety and Depression Scale (HADS), and Frenchay Activities Index. Twenty-four caregivers were assessed for changes in QOL, mental status, and burden of care using the EQ-5D-5L, SF-12, HADS, and Burden Index of Caregiver (BIC-11). The LVAD patients and caregivers responded contemporaneously regarding two points: pre-and post-LVAD. Patients' physical and mental QOL was significantly improved, but not social QOL and activity level. Caregivers' QOL and burden of care did not change, and anxiety was reduced (p = 0.028). The patients were divided into two groups based on whether EQ-5D-5L was improved: twelve patients in the unimproved group (UG) and twenty patients in the improved group (IG). In the UG, 50% had LVAD-related strokes (p = 0.001, IG: 0%), and their social QOL decreased (p = 0.023). The activity levels improved in the IG. Multi-dimensional analyses on the QOL in LVAD patients yielded mixed results. Anticipated benefits derived from LVAD therapy may be limited by LVAD-related complications such as stroke that negatively impacts on the QOL.
MeSH term(s)	Caregivers ; Heart Failure/surgery ; Heart-Assist Devices ; Humans ; Japan ; Quality of Life
Language	English
Publishing date	2022-03-31
Publishing country	Japan
Document type	Journal Article ; Observational Study
ZDB-ID	123477-8
ISSN	1349-3329 ; 0040-8727
ISSN (online)	1349-3329
ISSN	0040-8727
DOI	10.1620/tjem.2022.J016
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Article ; Online: Nanobubble technology to treat spinal cord ischemic injury.

Naganuma, Masaaki / Saiki, Yuriko / Kanda, Keisuke / Akiyama, Masatoshi / Adachi, Osamu / Horii, Akira / Saiki, Yoshikatsu

JTCVS open

2020 Volume 3, Page(s) 1–11

Abstract: Background: Spinal cord ischemic injury is a severe complication of aortic surgery. We hypothesized that cerebrospinal fluid (CSF) oxygenation with nanobubbles after reperfusion could ameliorate spinal cord ischemic injury.: Methods: Twenty white ... ...

Abstract	Background: Spinal cord ischemic injury is a severe complication of aortic surgery. We hypothesized that cerebrospinal fluid (CSF) oxygenation with nanobubbles after reperfusion could ameliorate spinal cord ischemic injury. Methods: Twenty white Japanese rabbits were categorized into 4 groups of 5 rabbits each: sham group, with balloon catheter insertion into the aorta; ischemia group, with spinal cord ischemic injury by abdominal aortic occlusion; nonoxygenated group, with nonoxygenated artificial CSF irrigation after spinal cord ischemic injury; and oxygenated group, with oxygenated artificial CSF irrigation after spinal cord ischemic injury. At 48 hours after spinal cord ischemic injury, the modified Tarlov score to reflect hind limb movement was evaluated. The spinal cord was histopathologically examined by counting anterior horn cells, and microarray and quantitative reverse-transcription polymerase chain reaction (qRT-PCR) analyses were performed. Results: The oxygenated group showed improved neurologic function compared with the ischemia and nonoxygenated groups ( Conclusions: CSF oxygenation with nanobubbles after reperfusion can ameliorate spinal cord ischemic injury and suppress inflammatory responses in the spinal cord.
Language	English
Publishing date	2020-07-23
Publishing country	Netherlands
Document type	Journal Article
ISSN	2666-2736
ISSN (online)	2666-2736
DOI	10.1016/j.xjon.2020.07.005
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Article ; Online: A Case of an Increase in Prothrombin Time-International Normalized Ratio by Interaction Between Warfarin and Baloxavir Marboxil in a Patient on Implantable Ventricular Assist Device.

Kurosawa, Keiko / Takasaki, Shinya / Suzuki, Hisaki / Sato, Yuji / Akiyama, Masatoshi / Akiba, Miki / Saiki, Yoshikatsu / Mano, Nariyasu

Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques

2021 Volume 24, Page(s) 37–40

Abstract: Background: Baloxavir marboxil (BM) is a novel drug with a cap-dependent endonuclease inhibitory action for influenza A or B; it is highly safe and requires just a single oral dose. Patients with severe heart failure use implantable ventricular assist ... ...

Abstract	Background: Baloxavir marboxil (BM) is a novel drug with a cap-dependent endonuclease inhibitory action for influenza A or B; it is highly safe and requires just a single oral dose. Patients with severe heart failure use implantable ventricular assist device (iVAD) until transplantation, but they have an increased risk of thrombosis development. Their warfarin is administered based on point-of-care testing (POCT) with a strict control of prothrombin time-international normalized ratio (PT-INR). Case report: Here, we report a case of a patient with iVAD whose PT-INR was significantly increased from the target range after BM administration. The patient was a 45-year-old man and transplanted with iVAD; warfarin treatment was started when his PT-INR target range was 3.0-3.5. At home, he frequently self-measured PT-INR by POCT and precisely controlled the warfarin dose. He had a fever, was diagnosed with influenza A and was administered BM 40 mg. Thereafter, his PT-INR continued to increase, reaching 4.8 on day 12 of BM administration, exceeding his target range; warfarin was skipped for 1 day. In this case, based on the history of BM administration and clinical course, the increase in PT-INR could be due to BM. Considering the interaction between warfarin and BM, we suspected a possibility of competition for protein-binding sites. Increased PT-INR in the patient was detected early by POCT and thus severe bleeding was avoided. Conclusion: Strict monitoring of PT-INR when using BM in patients taking warfarin is of clinical importance.
MeSH term(s)	Anticoagulants/administration & dosage ; Anticoagulants/therapeutic use ; Dibenzothiepins/administration & dosage ; Dibenzothiepins/therapeutic use ; Heart Failure/therapy ; Heart-Assist Devices/adverse effects ; Humans ; International Normalized Ratio ; Male ; Middle Aged ; Morpholines/administration & dosage ; Morpholines/therapeutic use ; Prothrombin Time ; Pyridones/administration & dosage ; Pyridones/therapeutic use ; Triazines/administration & dosage ; Triazines/therapeutic use ; Warfarin/administration & dosage ; Warfarin/therapeutic use
Chemical Substances	Anticoagulants ; Dibenzothiepins ; Morpholines ; Pyridones ; Triazines ; baloxavir (4G86Y4JT3F) ; Warfarin (5Q7ZVV76EI)
Language	English
Publishing date	2021-03-09
Publishing country	Canada
Document type	Case Reports ; Journal Article
ZDB-ID	1422972-9
ISSN	1482-1826 ; 1482-1826
ISSN (online)	1482-1826
ISSN	1482-1826
DOI	10.18433/jpps31375
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Article ; Online: Aortic Insufficiency Causes Symptomatic Heart Failure during Left Ventricular Assist Device Support.

Naganuma, Masaaki / Akiyama, Masatoshi / Sasaki, Konosuke / Maeda, Kay / Ito, Koki / Suzuki, Tomoyuki / Katahira, Shintaro / Suzuki, Yusuke / Saiki, Yoshikatsu

The Tohoku journal of experimental medicine

2021 Volume 255, Issue 3, Page(s) 229–237

Abstract: De novo aortic insufficiency is often documented during long-term left ventricular assist device (LVAD) support, despite the absence of aortic insufficiency at the time of LVAD implantation. However, whether aortic insufficiency affects long-term ... ...

Abstract	De novo aortic insufficiency is often documented during long-term left ventricular assist device (LVAD) support, despite the absence of aortic insufficiency at the time of LVAD implantation. However, whether aortic insufficiency affects long-term mortality and symptomatic heart failure in LVAD-supported patients remains controversial. We aimed to examine whether aortic insufficiency development influenced mortality and symptomatic heart failure following LVAD implantation. Fifty-three patients who underwent durable LVAD implantation between January 1, 2008 and April 31, 2017 were retrospectively examined in a single center institute. After discharge, we performed the echocardiographic examination in accordance with the Japanese registry for the mechanically assisted circulatory support protocol. Aortic insufficiency was graded on an interval scale (severe = 4, moderate = 3, mild = 2, trivial or none = 1). Kaplan-Meier estimates for long-term mortality at the follow-up were generated. We used a logistic regression model to identify risk factors for symptomatic heart failure. The overall median duration of LVAD support was 856.3 ± 430.8 days (range, 12-1,744 days). We did not observe a significant difference in long-term mortality in patients with aortic insufficiency ≥ 3 grade compared with patients with aortic insufficiency < 3 grade (P = 0.767; log-rank). Aortic insufficiency was associated with an increased risk for heart failure event after discharge (odds ratio, 4.12; confidence interval, 1.48-16.93; P = 0.005). Aortic insufficiency was an independent risk factor for symptomatic heart failure and was not associated with long-term mortality. Aortic insufficiency progression was associated with symptomatic heart failure.
MeSH term(s)	Aortic Valve Insufficiency ; Echocardiography ; Heart Failure/etiology ; Heart-Assist Devices/adverse effects ; Humans ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-11-18
Publishing country	Japan
Document type	Journal Article
ZDB-ID	123477-8
ISSN	1349-3329 ; 0040-8727
ISSN (online)	1349-3329
ISSN	0040-8727
DOI	10.1620/tjem.255.229
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Article: [Effects of Olmesartan Medoxomil on Patients with Thoracic and Thoracoabdominal Aortic Aneurysm;Evaluation of Anti-hypertensive Effect and Possible Suppression of Aneurysmal Dilation( OLM 40 Study)].

Sasaki, Konosuke / Sato, Mitsuru / Sugawara, Yumi / Kumagai, Kiichiro / Motoyoshi, Naotaka / Akiyama, Masatoshi / Adachi, Osamu / Saiki, Yoshikatsu

Kyobu geka. The Japanese journal of thoracic surgery

2020 Volume 73, Issue 9, Page(s) 652–661

Abstract: We evaluated the blood pressure( BP) lowering effect and possible suppression of aortic enlargement by olmesartan (OLM) in patients with thoracic and thoracoabdominal aortic aneurysm. In this single center prospective, forced titration study, 50 patients ...

Abstract	We evaluated the blood pressure( BP) lowering effect and possible suppression of aortic enlargement by olmesartan (OLM) in patients with thoracic and thoracoabdominal aortic aneurysm. In this single center prospective, forced titration study, 50 patients were registered between 2008 and 2011. After all patients received any of OLM 10, 20, and 40 mg/day as an initial dose, the dosage of OLM was titrated up to 40 mg as needed during follow-up period. Home BP (HBPs), aortic aneurysm size assessed by computed tomography (CT) scan, indices of renal function were recorded at 3- and 6-months follow-up. Depending on whether 40 mg/day of prescription was continued for more than 4 months or not, the patients were divided into 2 groups:less than 40 mg (<40 mg) and 40 mg groups. Morning HBPs tended to decrease in both groups, and the percent changes in BPs were essentially the same regardless of dosage. The absolute value of aortic diameter tended to slightly enlarge only in <40 mg group. Also in the <40 mg group, the absolute differences in aortic diameter between those at the time of study registration and each follow-up were 0.5±1.8 mm at 3-month and 1.2±2.3 mm at 6-month (p=0.047),whereas the percent changes were 0.9±3.3% and 2.2±4.5% at 3 and 6 months, respectively( p=0.058). As for 40 mg group, the absolute differences and percent changes did not reach statistically significant increase during the follow-up period. No severe renal dysfunction related to OLM 40 mg prescription was observed. Our results imply that OLM 40 mg may suppress aortic aneurysmal dilation independently of blood pressure lowering effect. Further study with larger number of sample size is warranted to assure this observation.
MeSH term(s)	Antihypertensive Agents/therapeutic use ; Aortic Aneurysm, Thoracic ; Dilatation ; Humans ; Hypertension ; Imidazoles ; Olmesartan Medoxomil ; Prospective Studies ; Tetrazoles
Chemical Substances	Antihypertensive Agents ; Imidazoles ; Tetrazoles ; Olmesartan Medoxomil (6M97XTV3HD) ; olmesartan (8W1IQP3U10)
Language	Japanese
Publishing date	2020-08-31
Publishing country	Japan
Document type	Journal Article
ZDB-ID	603899-2
ISSN	0021-5252
ISSN	0021-5252
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Article ; Online: Selective Cerebral Perfusion with the Open Proximal Technique during Descending Thoracic or Thoracoabdominal Aortic Repair: An Option of Choice to Reduce Neurologic Complications.

Hosoyama, Katsuhiro / Kawamoto, Shunsuke / Kumagai, Kiichiro / Akiyama, Masatoshi / Adachi, Osamu / Kawatsu, Satoshi / Saiki, Yoshikatsu

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia

2018 Volume 24, Issue 2, Page(s) 89–96

Abstract: Purpose: Selective cerebral perfusion with the open proximal technique for thoracoabdominal aortic repair has not been conclusively validated because of its procedural complexity and unreliability. We report the clinical outcomes, particularly the ... ...

Abstract	Purpose: Selective cerebral perfusion with the open proximal technique for thoracoabdominal aortic repair has not been conclusively validated because of its procedural complexity and unreliability. We report the clinical outcomes, particularly the cerebroneurological complications, of an open proximal procedure using selective cerebral perfusion. Methods: A retrospective chart review identified 30 patients between 2007 and 2015 who underwent aortic repair through left lateral thoracotomy with selective cerebral perfusion, established through endoluminal brachiocephalic and left carotid artery and retrograde left axillary artery. Results: The mean durations of the open proximal procedure and cerebral ischemia (the duration of the open proximal procedure minus the duration of selective cerebral perfusion) were 110.3 ± 40.1 min and 24.8 ± 13.0 min, respectively. There were two cases (7%) of permanent neurologic dysfunction (PND) but no in-hospital deaths. Multivariate analysis identified the duration of cerebral ischemia as an independent risk factor for neurologic complications including temporary neurologic dysfunction (TND; odds ratio (OR): 1.13; p = 0.007), but no correlation was found between selective cerebral perfusion duration and neurologic complications. Conclusion: Despite the relatively long duration of the open proximal procedure, selective cerebral perfusion has a potential to protect against cerebral complications during thoracic aortic repair through a left lateral thoracotomy.
MeSH term(s)	Aged ; Aortic Aneurysm, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/physiopathology ; Aortic Aneurysm, Thoracic/surgery ; Axillary Artery/physiopathology ; Axillary Artery/surgery ; Blood Vessel Prosthesis Implantation/adverse effects ; Blood Vessel Prosthesis Implantation/methods ; Brachiocephalic Trunk/physiopathology ; Brachiocephalic Trunk/surgery ; Carotid Artery, Common/physiopathology ; Carotid Artery, Common/surgery ; Cerebrovascular Circulation ; Chi-Square Distribution ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Nervous System Diseases/diagnosis ; Nervous System Diseases/etiology ; Nervous System Diseases/physiopathology ; Nervous System Diseases/prevention & control ; Odds Ratio ; Operative Time ; Perfusion/adverse effects ; Perfusion/methods ; Protective Factors ; Retrospective Studies ; Risk Factors ; Thoracotomy/adverse effects ; Thoracotomy/methods ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2018-01-26
Publishing country	Japan
Document type	Journal Article ; Observational Study
ZDB-ID	2019756-1
ISSN	2186-1005 ; 1341-1098
ISSN (online)	2186-1005
ISSN	1341-1098
DOI	10.5761/atcs.oa.17-00138
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Article ; Online: Continuous flow left ventricular assist device implantation concomitant with aortic arch replacement and aortic valve closure in a patient with end-stage heart failure associated with bicuspid aortic valve.

Akiyama, Masatoshi / Hosoyama, Katsuhiro / Kumagai, Kiichiro / Kawamoto, Shunsuke / Saiki, Yoshikatsu

Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs

2015 Volume 18, Issue 4, Page(s) 365–369

Abstract: Left ventricular assist device (LVAD) implantation has become an established treatment for patients with end-stage heart failure as a bridge to cardiac transplantation. During LVAD implantation, some patients require concomitant surgeries, including ... ...

Abstract	Left ventricular assist device (LVAD) implantation has become an established treatment for patients with end-stage heart failure as a bridge to cardiac transplantation. During LVAD implantation, some patients require concomitant surgeries, including tricuspid valve repair, aortic valve repair or replacement, and patent foramen ovale closure. However, concomitant aortic surgeries are rare in patients requiring LVAD implantation. We successfully performed total arch replacement with an open distal technique, aortic valve closure, and continuous flow LVAD implantation simultaneously.
MeSH term(s)	Aorta, Thoracic/surgery ; Aortic Valve/abnormalities ; Aortic Valve/surgery ; Bicuspid Aortic Valve Disease ; Heart Failure/etiology ; Heart Failure/surgery ; Heart Transplantation ; Heart Valve Diseases/surgery ; Heart-Assist Devices ; Humans ; Male ; Middle Aged ; Treatment Outcome
Language	English
Publishing date	2015-05-10
Publishing country	Japan
Document type	Case Reports ; Journal Article
ZDB-ID	1463555-0
ISSN	1619-0904 ; 1434-7229
ISSN (online)	1619-0904
ISSN	1434-7229
DOI	10.1007/s10047-015-0840-2
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