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Article ; Online: Optimal patient selection for maze procedure in patients undergoing mitral valve disease.

Masuda, Tomoaki / Aoki, Atsushi / Omoto, Tadashi / Maruta, Kazuto

2024 Volume 19, Issue 1, Page(s) 190

Abstract: Objectives: Although risk factors for unsuccessful Maze procedure have been demonstrated, an appropriate patient selection is still controversial. In our institute, Maze procedure is indicated for those whom normal sinus rhythm (NSR) was reestablished ... ...

Abstract	Objectives: Although risk factors for unsuccessful Maze procedure have been demonstrated, an appropriate patient selection is still controversial. In our institute, Maze procedure is indicated for those whom normal sinus rhythm (NSR) was reestablished by intraoperative direct cardioversion (DC) after ventricular unloading by total cardiopulmonary bypass. The purpose of this study was to evaluate the effectiveness of our indication criteria for Maze procedure in patients with mitral valve disease. Methods: Between October 2012 and October 2021, MAZE was indicated in 55 patients in whom normal sinus rhythm (NSR) was reestablished by intraoperative direct current cardioversion (DC). Three endpoints and predictors were examined: disappearance of atrial fibrillation (AF), NSR, and A-wave detection. Results: Restoration of NSR by intraoperative DC was confirmed in 43 patients, and these patients underwent MAZE. AF disappeared in 39 patients (90.7%), and F-wave ≥ 0.1 mV was a significant predictive factor (odds ratio (OR) 20.99, 95% CI 1.22-1079.06). NSR was reestablished in 36 patients (83.7%), and F-wave ≥ 0.1 mV (odds ratio 15.62, 95% CI 1.62-359.86) + AF history ≤ 3 years (OR 8.30, 95% CI 1.09-177.04) were significant predictors. A-wave detection was confirmed in 26 patients (60.5%), and left atrial diameter ≤ 55 mm was a significant predictor (OR 5.22, 95% CI 1.28-24.79). Conclusions: Intraoperative DC after ventricular unloading resulted effective patient selection for concomitant Maze procedure. F-wave and AF history were predictive factor of electrical restoration of AF, and left atrial diameter was predictive factor of restoration of atrial function.
MeSH term(s)	Humans ; Mitral Valve/surgery ; Maze Procedure ; Mitral Valve Insufficiency ; Patient Selection ; Mitral Valve Stenosis/surgery ; Treatment Outcome ; Heart Valve Diseases/complications ; Atrial Fibrillation/diagnosis ; Catheter Ablation/methods
Language	English
Publishing date	2024-04-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2227224-0
ISSN	1749-8090 ; 1749-8090
ISSN (online)	1749-8090
ISSN	1749-8090
DOI	10.1186/s13019-024-02766-z
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Article: Factors Influencing on the Aneurysm Sac Shrinkage after Endovascular Abdominal Aortic Aneurysm Repair by the Analysis of the Patients with the Aneurysm Sac Shrinkage and Expansion.

Aoki, Atsushi / Maruta, Kazuto / Masuda, Tomoaki / Omoto, Tadashi

Annals of vascular diseases

2023 Volume 16, Issue 4, Page(s) 245–252

Abstract: Objectives: ...

Abstract	Objectives:
Language	English
Publishing date	2023-09-28
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2394256-3
ISSN	1881-6428 ; 1881-641X
ISSN (online)	1881-6428
ISSN	1881-641X
DOI	10.3400/avd.oa.23-00065
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Article: Procedure and Aortic Remodeling Effects of Entry Closure with Stentgraft for Type B Aortic Dissection: Comparison between the Patients with Narrow True Lumen and Those with Aneurysmal Dilated False Lumen.

Aoki, Atsushi / Maruta, Kazuto / Masuda, Tomoaki / Omoto, Tadashi

Annals of vascular diseases

2022 Volume 15, Issue 3, Page(s) 175–185

Abstract: ... ...

Abstract	Objectives
Language	English
Publishing date	2022-07-13
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2394256-3
ISSN	1881-6428 ; 1881-641X
ISSN (online)	1881-6428
ISSN	1881-641X
DOI	10.3400/avd.oa.22-00089
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Article ; Online: Operative Timing and Feasibility of Mitral Valve Repair in Active Infective Endocarditis.

Omoto, Tadashi / Aoki, Atsushi / Maruta, Kazuto / Masuda, Tomoaki

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

2022 Volume 29, Issue 1, Page(s) 23–28

Abstract: Purpose: We studied the association between operative timing and the feasibility of mitral valve (MV) repair in active infective endocarditis (IE).: Methods: Forty-nine active IE patients who underwent MV operation were classified according to ... ...

Abstract	Purpose: We studied the association between operative timing and the feasibility of mitral valve (MV) repair in active infective endocarditis (IE). Methods: Forty-nine active IE patients who underwent MV operation were classified according to operative timing: within 48 hours (Term I: n = 7), between 3 and 14 days (Term II: n = 22), and ≥15 days (Term III: n = 20). Patient profiles, operative outcomes, and feasibility of MV repair were evaluated. Complexity score and severity score were used to define the feasibility of MV repair depending on the extent of infected lesion and technical difficulties. Results: There were no differences in basic profile in the three groups. Rate of major complications was higher in Term I (86%) than II (41%, p = 0.031) and III (25%, p = 0.005). In-hospital mortality was also higher in Term I (43%) than II (9%, p = 0.039) and III (5%, p = 0.015). The three groups did not differ by feasibility of MV repair calculated by the two-score system or by frequency of MV repair (I: 57%, II: 59%, and III: 55%). Conclusions: Morbidity and mortality were high in urgent cases. Feasibility of MV repair is associated with the extent of infected lesion and technical difficulties, and not with operative timing.
MeSH term(s)	Humans ; Mitral Valve/diagnostic imaging ; Mitral Valve/surgery ; Feasibility Studies ; Heart Valve Prosthesis Implantation/adverse effects ; Treatment Outcome ; Endocarditis, Bacterial/complications ; Endocarditis/diagnostic imaging ; Endocarditis/surgery ; Mitral Valve Insufficiency/diagnostic imaging ; Mitral Valve Insufficiency/surgery ; Mitral Valve Insufficiency/etiology
Language	English
Publishing date	2022-11-03
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2019756-1
ISSN	2186-1005 ; 1341-1098
ISSN (online)	2186-1005
ISSN	1341-1098
DOI	10.5761/atcs.oa.22-00135
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Zs.A 5253: Show issues

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Article ; Online: Clinical impact of the right ventricular impairment in patients following transcatheter aortic valve replacement.

Higuchi, Satoshi / Mochizuki, Yasuhide / Omoto, Tadashi / Matsumoto, Hidenari / Masuda, Tomoaki / Maruta, Kazuto / Aoki, Atsushi / Shinke, Toshiro

Scientific reports

2024 Volume 14, Issue 1, Page(s) 1776

Abstract: The right ventricular (RV) impairment can predict clinical adverse events in patients following transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS). Limited reports have compared impact of the left ventricular (LV) and RV ... ...

Abstract	The right ventricular (RV) impairment can predict clinical adverse events in patients following transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS). Limited reports have compared impact of the left ventricular (LV) and RV disorders. This retrospective study evaluated two-year major adverse cardiac and cerebrovascular events (MACCE) in patients following TAVR for severe AS. RV sphericity index was calculated as the ratio between RV mid-ventricular and longitudinal diameters during the end-diastolic phase. Of 239 patients, 2-year MACCE were observed in 34 (14%). LV ejection fraction was 58 ± 11%. Tricuspid annular plane systolic excursion (TAPSE) and RV sphericity index were 20 ± 3 mm and 0.36 (0.31-0.39). Although the univariate Cox regression analysis demonstrated that both LV and RV parameters predicted the outcomes, LV parameters no longer predicted them after adjustment. Lower TAPSE (adjusted hazard ratio per 1 mm, 0.84; 95% confidence interval, 0.75-0.93) and higher RV sphericity index (adjusted hazard ratio per 0.1, 1.94; 95% confidence interval, 1.17-3.22) were adverse clinical predictors. In conclusion, the RV structural and functional disorders predict two-year MACCE, whereas the LV parameters do not. Impact of LV impairment can be attenuated after development of RV disorders.
MeSH term(s)	Humans ; Transcatheter Aortic Valve Replacement/adverse effects ; Retrospective Studies ; Ventricular Function, Left ; Stroke Volume ; Ventricular Dysfunction, Left/etiology ; Aortic Valve Stenosis
Language	English
Publishing date	2024-01-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-52242-w
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Article ; Online: Midterm Outcomes of Endovascular Abdominal Aortic Aneurysm Repair with Prevention of type 2 Endoleak by Intraoperative Aortic Side Branch Coil Embolization.

Aoki, Atsushi / Maruta, Kazuto / Omoto, Tadashi / Masuda, Tomoaki

Annals of vascular surgery

2021 Volume 78, Page(s) 180–189

Abstract: Objective: The midterm results of endovascular abdominal aortic aneurysm repair (EVAR) with aortic side branch coil embolization during EVAR was evaluated.: Methods: Our center began coil embolization for all patent inferior mesenteric artery (IMA) ... ...

Abstract	Objective: The midterm results of endovascular abdominal aortic aneurysm repair (EVAR) with aortic side branch coil embolization during EVAR was evaluated. Methods: Our center began coil embolization for all patent inferior mesenteric artery (IMA) and lumbar artery (LA) with an inner diameter more than 2.0 mm during EVAR since June 2015. When four or more LA were patent, coil embolization for LA with inner diameter 2.0 mm or less was done. EVAR without aortic side branches coil embolization was performed for 59 patients prior to June 2015 (control group) and 79 patients underwent EVAR with coil embolization during EVAR (coil group). The success rate of coil embolization for IMA and LA was evaluated in coil group. The frequency of type 2 endoleak (T2EL), freedom from aneurysm sac expansion (5 mm or more) rate and the rate of the aneurysm sac shrinkage (10 mm or more) were compared between the coil and control groups. Additionally, multiple logistic regression analysis for all patients was conducted to analyze whether IMA patency and the number of patent lumbar artery at the end of EVAR were the risk factors of the aneurysm sac expansion of 5 mm or more. Results: The success rate of IMA coil embolization was 96.4% and that of LA was 74.5%. Compared to the control group, the frequency of T2EL was significantly lower in coil group at 7 days (1.3% vs. 60.4%, P <0.0001) and at 6 months (2.1% vs 38.2%, P <0.0001) after EVAR. The freedom from aneurysm sac expansion rate was significantly better in the coil group at 5 years (100% in coil group and 65.2% in control group, P = 0.002). The rate of aneurysm sac shrinkage was significantly better in coil group (15.5% vs. 2.0% at 1 year, 42.8% vs. 6.3% at 2 years and 53.4% vs. 17.8% at 3 years, p = 0.0007). The risk of aneurysm sac expansion of 5 mm or more was estimated to be 11 times greater when the IMA was patent, and 4.9 times greater when 3 or more LAs were patent at the end of EVAR. Conclusion: When IMA was occluded and the number of patent LA became 2 or less by aortic side branch coil embolization during EVAR, favorable mid-term results were safely obtained and good long-term result could be expected with EVAR.
MeSH term(s)	Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/physiopathology ; Aortic Aneurysm, Abdominal/surgery ; Blood Vessel Prosthesis Implantation/adverse effects ; Case-Control Studies ; Embolization, Therapeutic/adverse effects ; Embolization, Therapeutic/instrumentation ; Endoleak/diagnostic imaging ; Endoleak/etiology ; Endoleak/prevention & control ; Endovascular Procedures/adverse effects ; Female ; Humans ; Lumbar Vertebrae/blood supply ; Male ; Mesenteric Artery, Inferior/diagnostic imaging ; Mesenteric Artery, Inferior/physiopathology ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2021-09-17
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2021.06.037
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Zs.A 2882: Show issues

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Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Infective endocarditis secondary to

Maruo, Hiroko / Ohsugi, Koichi / Maruta, Kazuto / Kotani, Toru

BMJ case reports

2021 Volume 14, Issue 8

Abstract: Klebsiella ... ...

Abstract	Klebsiella pneumoniae
MeSH term(s)	Aged, 80 and over ; Cystitis/complications ; Cystitis/diagnostic imaging ; Endocarditis ; Endocarditis, Bacterial/diagnosis ; Endocarditis, Bacterial/diagnostic imaging ; Humans ; Klebsiella pneumoniae ; Male ; Mitral Valve
Language	English
Publishing date	2021-08-19
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2021-243497
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Article ; Online: Influence of transcatheter aortic valve replacement on patients with severe aortic stenosis undergoing non-cardiac surgery.

Omoto, Tadashi / Aoki, Atsushi / Maruta, Kazuto / Masuda, Tomoaki / Horikawa, Yui

Journal of cardiothoracic surgery

2020 Volume 15, Issue 1, Page(s) 198

Abstract: Objectives: The purpose of this study was to clarify the influence of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS) undergoing non-cardiac surgery.: Methods: Thirty-four patients with severe AS diagnosed by ... ...

Abstract	Objectives: The purpose of this study was to clarify the influence of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS) undergoing non-cardiac surgery. Methods: Thirty-four patients with severe AS diagnosed by preoperative evaluation for non-cardiac surgery were reviewed and compared in two categories. First, patient profiles and surgical risk were compared before (pre-TAVR group; n = 10) and after (post-TAVR group; n = 24) the introduction of TAVR. Second, the completion rate of non-cardiac surgery and interval between the two cardiac and non-cardiac operations were compared between surgical aortic valve replacement (AVR) patients before the introduction of TAVR (pre-AVR group (n = 10)), in AVR patients after the introduction of TAVR (post-AVR (n = 12)), and in TAVR patients (TAVR group (n = 12)). Results: Age and Japan score were higher in the post-TAVR group than in the pre-TAVR group. Malignancy was the most common non-cardiac disease (80%) in the pre-TAVR group, whereas orthopedic disease was the most common (50%) in the post-TAVR group. Completion rate of non-cardiac operation in the pre-AVR, post-AVR and TAVR groups was 70, 33, and 75% (post-AVR vs. TAVR: p = 0.010), and the interval between the two operations was 129 ± 98 days, 87 ± 40 days and 27 ± 15 days, respectively (pre AVR vs. TAVR: p = 0.034 and post AVR vs. TAVR: p = 0.025). In the post-TAVR group, AVR was selected because of a lack of fitness for TAVR in 5 of 12 patients. Conclusions: After the introduction of TAVR, more senile and high-risk patients became candidates for a two-stage operation, and orthopedic conditions became the most common non-cardiac disease. Innovation in transcatheter valvular interventions and expansion of indications for patients currently evaluated as "unfit for TAVR" might be crucial issues for non-cardiac surgery with severe AS.
MeSH term(s)	Aged ; Aged, 80 and over ; Aortic Valve Stenosis/surgery ; Digestive System Diseases/surgery ; Female ; Heart Valve Prosthesis Implantation ; Humans ; Japan ; Male ; Musculoskeletal Diseases/surgery ; Neoplasms/surgery ; Orthopedic Procedures/statistics & numerical data ; Preoperative Care/statistics & numerical data ; Retrospective Studies ; Risk Factors ; Surgical Procedures, Operative/statistics & numerical data ; Transcatheter Aortic Valve Replacement ; Treatment Outcome
Language	English
Publishing date	2020-07-29
Publishing country	England
Document type	Journal Article
ISSN	1749-8090
ISSN (online)	1749-8090
DOI	10.1186/s13019-020-01237-5
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Article: [Mitral Valve Plasty in Active Infective Endocarditis].

Omoto, Tadashi / Aoki, Atsushi / Maruta, Kazuto / Masuda, Tomoaki / Horikawa, Yui

Kyobu geka. The Japanese journal of thoracic surgery

2020 Volume 73, Issue 1, Page(s) 4–8

Abstract: According to the current guideline, early surgery is recommended in patients with infective endocarditis (IE). On the other hand, mitral valve plasty (MVP) became the preferred surgical option in patients with IE, because of its benefits in the ... ...

Abstract	According to the current guideline, early surgery is recommended in patients with infective endocarditis (IE). On the other hand, mitral valve plasty (MVP) became the preferred surgical option in patients with IE, because of its benefits in the preservation of left ventricular function and prevention of recurrence of infection. Feasibility of MVP is an important issue in surgical strategy, however, it might be associated with the timing of the operation:feasibility of MVP might be higher in healed IE than active IE, although there had been no clear evidence in previous studies. In order to develop scoring system to predict feasibility of MVP in patients with active IE, we have introduced "severity score".Severity score defined as the sum of valvular score which evaluates the extensiveness of the valvular destruction, and technical score which evaluates the complexity and durability of the repair. Probability of feasible MVP was high in severity score≤7 points and low in severity score≥9 points. MVP is basically selected in patients with severity score of 8 points, taking the benefit of patients and risks of longterm durability into consideration. We believe that severity score is valuable and reproducible scoring system in surgical decision making.
MeSH term(s)	Endocarditis, Bacterial/surgery ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Prolapse
Language	Japanese
Publishing date	2020-01-11
Publishing country	Japan
Document type	Journal Article
ZDB-ID	603899-2
ISSN	0021-5252
ISSN	0021-5252
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Zs.B 11: Show issues

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Article: Clinical Implications of Determining Individualized Positive End-Expiratory Pressure Using Electrical Impedance Tomography in Post-Cardiac Surgery Patients: A Prospective, Non-Randomized Interventional Study.

Bito, Kiyoko / Shono, Atsuko / Kimura, Shinya / Maruta, Kazuto / Omoto, Tadashi / Aoki, Atsushi / Oe, Katsunori / Kotani, Toru

Journal of clinical medicine

2022 Volume 11, Issue 11

Abstract: Optimal positive end-expiratory pressure (PEEP) can induce sustained lung function improvement. This prospective, non-randomized interventional study aimed to investigate the effect of individualized PEEP determined using electrical impedance tomography ( ...

Abstract	Optimal positive end-expiratory pressure (PEEP) can induce sustained lung function improvement. This prospective, non-randomized interventional study aimed to investigate the effect of individualized PEEP determined using electrical impedance tomography (EIT) in post-cardiac surgery patients (n = 35). Decremental PEEP trials were performed from 20 to 4 cmH2O in steps of 2 cmH2O, guided by EIT. PEEP levels preventing ventilation loss in dependent lung regions (PEEPONLINE) were set. Ventilation distributions and oxygenation before the PEEP trial, and 5 min and 1 h after the PEEPONLINE setting were examined. Furthermore, we analyzed the saved impedance data offline to determine the PEEP levels that provided the best compromise between overdistended and collapsed lung (PEEPODCL). Ventilation distributions of dependent regions increased at 5 min after the PEEPONLINE setting compared with those before the PEEP trial (mean ± standard deviation, 41.3 ± 8.5% vs. 49.1 ± 9.3%; p < 0.001), and were maintained at 1 h thereafter (48.7 ± 9.4%, p < 0.001). Oxygenation also showed sustained improvement. Rescue oxygen therapy (high-flow nasal cannula, noninvasive ventilation) after extubation was less frequent in patients with PEEPONLINE ≥ PEEPODCL than in those with PEEPONLINE < PEEPODCL (1/19 vs. 6/16; p = 0.018). EIT-guided individualized PEEP stabilized the improvement in ventilation distribution and oxygenation. Individual PEEP varies with EIT measures, and may differentially affect oxygenation after cardiac surgery.
Language	English
Publishing date	2022-05-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11113022
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