Satoshi Unosawa

Seiwa Hospital

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Akira Sezai

Nihon University

Tetsuya Niino

National Disaster Medical Center

Mitsumasa Hata

Nihon University

Isamu Yoshitake

Yamaguchi University

Kazutomo Minami

Fukuyama Cardiovascular Hospital

Shunji Osaka

Nihon University

Masashi Tanaka

Nihon University

Shinji Wakui

Nihon University

Motomi Shiono

Nihon University

Nobuyuki Furukawa

Heart and Diabetes Center North Rhine-Westphalia

Cooperative Institutions

Nihon University

Nihon University Itabashi Hospital

Surugadai Nihon University Hospital

Heart and Diabetes Center North Rhine-Westphalia

Osaka University

National Cerebral and Cardiovascular Center

National Disaster Medical Center

The University of Tokyo

Society of Thoracic Surgeons

Komagino Hospital

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Long-term outcomes of patients undergoing extracorporeal membrane oxygenation for refractory postcardiotomy cardiogenic shock

Surgery Today (2012)

Satoshi Unosawa Akira Sezai Mitsumasa Hata Kin‐ichi Nakata Isamu Yoshitake

Refractory (planetary science)

10.1007/s00595-012-0322-6

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Citations (61)

Pulmonary Embolism with Myomatous Erythrocytosis Syndrome and Extreme Obesity

The Thoracic and Cardiovascular Surgeon (2009)

Satoshi Unosawa Masatoshi Hata Akira Sezai Tetsuya Niino Isamu Yoshitake

We here report a case of a 53-year-old woman requiring pulmonary embolectomy for acute massive pulmonary embolism caused by a huge uterine myoma compressing veins in the pelvis and extreme obesity. She was also diagnosed as having myomatous erythrocytosis syndrome, a rare disease associated with secondary polycythemia. The polycythemia improved after a hysterectomy which was performed after pulmonary embolectomy.

Embolectomy

10.1055/s-2008-1038880

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Citations (6)

Ruptured Valsalva Sinus Aneurysm with Ventricular Septal Defect and Double-Chambered Right Ventricle without Heart Failure: A Case Report

The Heart Surgery Forum (2019)

Keito Suzuki Akira Sezai Rei Hinoura Satoshi Unosawa Masashi Tanaka

Valsalva sinus aneurysm and double-chambered right ventricle are both rare congenital cardiac anomalies. Ventricular septal defect may be present in approximately 50%-60% of patients with Valsalva sinus aneurysm or approximately 70%-80% of patients with double-chambered right ventricle. However, Valsalva sinus aneurysm, double-chambered right ventricle, and ventricular septal defect rarely coexist in the same patient. As these diseases progress, patients often complain of symptoms of heart failure, due to the shunt flow. The case of a patient with Valsalva sinus aneurysm, double-chambered right ventricle, and ventricular septal defect without symptoms of heart failure had never been reported until now.

Sinus (botany)

10.1532/hsf.2463

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Citations (1)

Cardiac Angiosarcoma with Cardiac Tamponade Diagnosed as a Ruptured Aneurysm of the Sinus Valsalva

Japanese Journal of Clinical Oncology (2009)

Isamu Yoshitake Masahiro Hata Akira Sezai Tetsuya Niino Satoshi Unosawa

Primary cardiac angiosarcoma is a rare, diagnostically elusive disease with a poor prognosis. In this report, we describe the case of a 56-year-old woman with a right atrial angiosarcoma. The patient presented with impending cardiac tamponade caused by right atrial perforation, but was misdiagnosed as a ruptured aneurysm of the sinus valsalva based on findings of a continuous murmur and an aorta to right atrium shunt by echocardiography. In the emergent operation that ensued, we found a right atrial perforation and a right coronary artery fistula to the right atrium. Coronary artery fistula is a rare complication of primary cardiac angiosarcoma, and a continuous murmur is also extremely rare as a clinical finding of angiosarcoma. We report the case and review the literature.

Hemangiosarcoma

10.1093/jjco/hyp044

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Citations (17)

Prognosis for Patients With Type B Acute Aortic Dissection Risk Analysis of Early Death and Requirement for Elective Surgery

Circulation Journal (2007)

Mitsumasa Hata Akira Sezai Tetsuya Niino Masataka Yoda Shinji Wakui

Background The long-term outcome of medical treatment in patients with type B acute aortic dissection (BAD) was assessed and predictors of early in-hospital death were investigated, as well as the need for surgical intervention. Methods and Results In the past 11 years, 180 patients were admitted to hospital and medically treated at the time of onset. If the maximum diameter of the dissected aorta exceeded 60 mm, or rapid enlargement or vital organ ischemia were identified, early or elective surgery was performed. Emergency operation was required in 7 patients. Elective surgery was required for 31 patients (19.1%). The operation-free rate was 76.0% at 10 years. Actuarial survival rate was 89.4% at 5 years and 71.8% at 10 years. Multivariate analysis indicated that refractory hypertension (odds ratio (OR), 4.08, 95% confidence interval (CI), 3.06-21.44, p=0.0434) and rupture (OR 5.87, 95% CI, 2.21-9.12, p=0.0154) were predictors of early hospital mortality. The only significant predictor for elective surgery was a maximum diameter exceeding 40 mm at the time of onset (OR 13.4, 95% CI, 1.93-6.89, p=0.0003). Conclusions Medical treatment for BAD produced good results. Strict control of blood pressure is important for patients with a dissected aortic diameter exceeding 40 mm at the time of onset. (Circ J 2007; 71: 1279 - 1282)

Elective surgery

10.1253/circj.71.1279

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Citations (69)

Efficacy of Neutrophil Elastase Inhibitor on Type A Acute Aortic Dissection

The Thoracic and Cardiovascular Surgeon (2010)

Tetsuya Niino Mitsumasa Hata Akira Sezai Isamu Yoshitake Satoshi Unosawa

Background: Surgery for type A acute aortic dissection (AAD) is associated with a high mortality and incidence of postoperative complications, including acute respiratory failure and coagulopathy. Aim of the study was to investigate the effects of sivelestat on pulmonary function and coagulopathy in patients undergoing surgery for AAD. Methods: Sixty patients undergoing emergency ascending replacement for AAD were divided into two groups. Group I was administered sivelestat intravenously from the beginning of surgery until extubation. Group II was not treated with sivelestat. The platelet count, antithrombin III (AT III) level, leukocyte count, C-reactive protein (CRP) level, prothrombin time (PT), activated partial thrombin time (APTT), and prothrombin time-international normalized ratio (PT‐INR) were measured. Results: The postoperative decrease of AT III and the platelet count on admission to the intensive care unit (ICU) and 3 hours later were significantly less in group I. The leukocyte count and the values of CRP, PT, APTT, and PT‐INR did not differ significantly between the groups. The duration of mechanical ventilation after surgery tended to be shorter in group I. Conclusions: Sivelestat significantly reduced the postoperative decreases in AT III and platelet count in patients undergoing emergency surgery for AAD.

Neutrophil elastase

Proteinase inhibitor

10.1055/s-0029-1240846

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Citations (3)

Myocardial Protective Effect of Human Atrial Natriuretic Peptide in Cardiac Surgery - "hANP Shot" in Clinical Safety Trial -

Circulation Journal (2011)

Akira Sezai Shinji Wakui Kenji Akiyama Mitsumasa Hata Isamu Yoshitake

Background: We studied low-dose human atrial natriuretic peptide (hANP) infusion therapy during cardiac surgery and reported the cardiac and renal protective effects. The efficacy of a bolus injection of hANP (the "hANP shot") simultaneously with induction of cardioplegia has been proven in animal experiments. In the present study the clinical effects of this "hANP shot" were examined. Methods and Results: The subjects were 67 patients undergoing Coronary artery bypass grafting. At the time of inducing cardioplegia, 1 group received a simultaneous bolus injection of 100μg of hANP (hANP group) and the other group received an injection of physiological saline (placebo group). The primary endpoints were (1) operative mortality and complications, and (2) the creatine kinase isoenzyme MB (CPK-MB), troponin-I, and human heart fatty acid binding protein (H-FABP) levels. The secondary endpoints were (1) the incidence of arrhythmia, and levels of (2) atrial and B-type natriuretic peptides, and cyclic guanosine monophosphate (cGMP), and (3) renin, angiotensin II, and aldosterone. Postoperative CPK-MB, troponin-I, and H-FABP levels were significantly lower in the hANP group than in the placebo group. Postoperative arrhythmia was significantly less frequent in the hANP group than in the placebo group. Conclusions: It is possible to achieve cardioprotective effects based on the safety of the "hANP shot", as well as from biomarkers of ischemia and results related to arrhythmia. The "hANP shot" should also be evaluated as a safer and new cardioprotective method for cardiac surgery. (Circ J 2011; 75: 2144-2150)

Atrial natriuretic peptide

10.1253/circj.cj-11-0185

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Citations (13)

Optimal treatment strategy and prognosis for the patients with type B acute aortic dissection

The Thoracic and Cardiovascular Surgeon (2008)

Masahiro Hata Akira Sezai Tetsuya Niino Masataka Yoda Satoshi Unosawa

Objective: The aim of this study is to assess the long-term outcome of the patients with type B dissection (BAD) who received medical treatment and determine the independent risk of requiring the surgery during follow-up.

Medical treatment

10.1055/s-2008-1038047

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Citations (0)

A Rare Surgical Case of Isolated Double-Chambered Right Ventricle Without Cardiac Malformations in an Older Female Patient.

PubMed (2024)

Yuki Hayashi Shunji Osaka Satoshi Unosawa M. Tanaka

Double-chambered right ventricle (DCRV) is a congenital heart disease. Most cases of DCRV are complicated by another congenital cardiac anomaly. Mostly, a ventricular septal defect (VSD) is the usual comorbidity. The flow turbulence by VSD has been suggested to be associated with DCRV, which occurs in many patients during childhood, but very rarely in later years of life. Although there are some cases of DCRV in older adults, there is almost no literature on patients over 70 years of age. We report the surgical case of a 72-year-old female patient with isolated DCRV who visited the hospital due to fatigue. Transthoracic echocardiography (TTE) revealed severe right heart overload, severe tricuspid valve regurgitation, and right ventriculography, leading to a diagnosis of DCRV. We resected anomalous muscle bundles caused by right ventricular outflow tract (RVOT) stenosis via the transventricular approach, closed RVOT using a bovine pericardium patch, and performed tricuspid annuloplasty. Intraoperative findings showed no VSD. After surgery, right ventricular pressure decreased significantly, the patient was discharged on postoperative day 20. DCRV is one of the pathological conditions of which prognosis can be improved with appropriate surgical intervention even in advanced age.

10.7759/cureus.74051

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Citations (0)

A persistent sciatic artery aneurysm containing a free-floating thrombus: report of a case

Surgery Today (2014)

Satoshi Unosawa Yusuke Ishii Tetsuya Niino

Popliteal artery

Vascular anomaly

10.1007/s00595-014-0981-6

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Citations (4)