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13 results on '"Otsuki, Shin-ichi"'

1. Predictors of liver cirrhosis and hepatocellular carcinoma among perioperative survivors of the Fontan operation

Author

Inuzuka, Ryo, primary, Nii, Masaki, additional, Inai, Kei, additional, Shimada, Eriko, additional, Shinohara, Tokuko, additional, Kogiso, Tomomi, additional, Ono, Hiroshi, additional, Otsuki, Shin-ichi, additional, Kurita, Yoshihiko, additional, Takeda, Atsuhito, additional, Hirono, Keiichi, additional, Takei, Kota, additional, Yasukohchi, Satoshi, additional, Yoshikawa, Tadahiro, additional, Furutani, Yoshiyuki, additional, Shinozaki, Tomohiro, additional, Matsuyama, Yutaka, additional, Senzaki, Hideaki, additional, Tokushige, Katsutoshi, additional, and Nakanishi, Toshio, additional

Published
2022
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2. Outcomes of Patients with Pulmonary Atresia with Intact Ventricular Septum Reaching Adulthood

Author

Toh, Norihisa, Kotani, Yasuhiro, Akagi, Teiji, Kuroko, Yosuke, Baba, Kenji, Otsuki, Shin-ichi, Kasahara, Shingo, and Ito, Hiroshi

Subjects
parasitic diseases, Pulmonary atresia with intact ventricular septum, adult congenital heart disease, outcome
Abstract

Background: There is limited information on outcomes of adult patients with pulmonary atresia with intact ventricular septum (PA-IVS) due to the low incidence of disease and the large variation of surgical histories. Methods: Among 58 patients with repaired PA-IVS, a total of 32 patients aged ≥16 years and who were followed at our institution between January 2003 and December 2018 were reviewed. Surgical history, clinical outcomes, and laboratory, echocardiographic and electrocardiographic data were obtained by chart review. Results: Follow-up was from the age of 16 years and the median age at the latest follow-up was 23.7 years. Twenty-four patients had undergone biventricular repair (BVR), 3 had undergone one-and-a half ventricular repair (1.5VR), and 5 had undergone univentricular repair. Over a median follow-up period of 7.7 years (interquartile range: 4.1–11.0 years), 1 BVR patient died suddenly and 7 patients had heart failure. Arrhythmias were present in 5 patients. Ten patients underwent surgical re-interventions, including 4 BVR take-downs with conversion to 1.5VR and 3 Fontan conversions. Overall survival, heart failure-free, arrhythmia-free, and surgical re-intervention-free rates at 5 years and 10 years from the age of 16 years were 96.2% (95% confidence interval [CI], 77.2–99.4) and 96.2% (95% CI, 77.2– 99.4), 81.4% (95% CI, 62.1–92.1) and 74.6% (95%CI, 52.3–88.7), 88.7% (95% CI, 70.1–96.3) and 75.9% (95% CI, 51.7–90.2), and 80.7% (95% CI, 60.8–91.8) and 70.8% (95% CI, 49.7–85.7), respectively. Conclusion: Adults with PA-IVS have preserved long-term survival regardless of the early operative strategy, while they are at risk for heart failure, arrhythmia, and surgical re-intervention. Thus, detailed and continued follow-up is mandatory for all PA-IVS patients from childhood to adulthood.

Published
2020

3. Predictors of liver cirrhosis and hepatocellular carcinoma among perioperative survivors of the Fontan operation

Author

Inuzuka, Ryo, Nii, Masaki, Inai, Kei, Shimada, Eriko, Shinohara, Tokuko, Kogiso, Tomomi, Ono, Hiroshi, Otsuki, Shin-ichi, Kurita, Yoshihiko, Takeda, Atsuhito, Hirono, Keiichi, Takei, Kota, Yasukohchi, Satoshi, Yoshikawa, Tadahiro, Furutani, Yoshiyuki, Shinozaki, Tomohiro, Matsuyama, Yutaka, Senzaki, Hideaki, Tokushige, Katsutoshi, and Nakanishi, Toshio

Abstract

ObjectiveFontan-associated liver disease (FALD) is widely recognised as a common complication in patients long after the Fontan operation. However, data on the predictors of FALD that can guide its screening and management are lacking. The present study aimed to identify the predictors of liver cirrhosis (LC) and hepatocellular carcinoma (HCC) in post-Fontan patients.MethodsThis was a multi-institutional retrospective cohort study. Clinical data of all perioperative survivors of Fontan operation before 2011 who underwent postoperative catheterisation were collected through a retrospective chart review.ResultsA total of 1117 patients (538 women, 48.2%) underwent their first Fontan operation at a median age of 3.4 years. Postoperative cardiac catheterisation was conducted at a median of 1.0 year. During a median follow-up period of 10.3 years, 67 patients (6.0%) died; 181 (16.2%) were diagnosed with liver fibrosis, 67 (6.0%) with LC, 54 (4.8%) with focal nodular hyperplasia and 7 (0.6%) with HCC. On multivariable analysis, high central venous pressure (CVP) (HR, 1.28 (95% CI 1.01 to 1.63) per 3 mm Hg; p=0.042) and severe atrioventricular valve regurgitation (HR, 6.02 (95% CI 1.53 to 23.77); p=0.010) at the postoperative catheterisation were identified as independent predictors of LC/HCC.ConclusionsPatients with high CVP and/or severe atrioventricular valve regurgitation approximately 1 year after the Fontan operation are at increased risk of developing advanced liver disease in the long term. Whether therapeutic interventions to reduce CVP and atrioventricular valve regurgitation decrease the incidence of advanced liver disease requires further elucidation.

Published
2023
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13. A staged decompression of right ventricle allows growth of right ventricle and subsequent biventricular repair in patients with pulmonary atresia and intact ventricular septum.

Author

Kotani Y, Kasahara S, Fujii Y, Eitoku T, Baba K, Otsuki S, Kuroko Y, Arai S, and Sano S

Subjects
Echocardiography, Female, Follow-Up Studies, Heart Defects, Congenital diagnosis, Heart Ventricles diagnostic imaging, Humans, Infant, Infant, Newborn, Male, Pulmonary Atresia diagnosis, Retrospective Studies, Treatment Outcome, Ventricular Septum diagnostic imaging, Blalock-Taussig Procedure methods, Decompression, Surgical methods, Heart Defects, Congenital surgery, Heart Ventricles surgery, Pulmonary Atresia surgery, Ventricular Septum surgery
Abstract

Objectives: To achieve the growth of right-sided heart structures, our choice of the first palliation for patients with pulmonary atresia and intact ventricular septum (PA-IVS) includes a modified Blalock-Taussig shunt (BTS) with pulmonary valvotomy. We sought to analyse the impact of the first palliation on the growth of right-sided heart structures and factors associated with a choice of definitive surgical procedure., Methods: Fifty patients with PA-IVS who underwent a staged surgical approach from 1991 to 2012 were retrospectively reviewed., Results: Right ventricular (RV)-coronary artery fistulas were seen in 42% of patients at the time of birth. All 50 patients had a modified BTS with pulmonary valvotomy. Six patients died after the first palliation or inter-stage. Thirty patients achieved a biventricular repair (BVR group), 6 patients had a 1 + 1/2 ventricular repair (1 + 1/2V group) and 5 patients had a Fontan completion (Fontan group). After modified BTS with pulmonary valvotomy, tricuspid valve z-score did not increase in any of the group (BVR: pre -2.79 vs post -2.24, 1 + 1/2V: pre -5.25 vs post -6.69, Fontan: pre -6.82 vs post -7.94). Normalized RV end-diastolic volume increased only in BVR group after modified BTS with pulmonary valvotomy (BVR: pre 32% vs post 64%, 1 + 1/2V: pre 43% vs post 42%, Fontan: pre 29% vs post 32%). Major RV-coronary artery fistula was a strong factor with proceeding single-ventricle palliation [BVR: 4/30 (13%) patients, 1 + 1/2V: 1/6 (17%) and Fontan: 4/5 (80%)]., Conclusions: Tricuspid valve growth was not obtained by modified BTS with pulmonary valvotomy; therefore, tricuspid valve size at birth appeared to be a predictor for achieving BVR. Proportionate RV growth was seen only in patients who achieved BVR. However, RV growth was not seen in patients having 1 + 1/2 ventricular repair. Major RV-coronary artery fistula was a strong predictor for proceeding single-ventricle palliation., (© The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Published
2016
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