Kyobu geka. The Japanese journal of thoracic surgery最新文献

[Current Status of Implantable Ventricular Assist Device]. 植入式心室辅助装置的现状

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-04-01

Yangsin Lee, Masahiko Ando, Minoru Ono

引用次数: 0

[Long-term Outpatient Management and Shared Care Practices to Prevent Rehospitalization and Improve Quality of Life in Patients with Implantable Ventricular Assist Device]. [长期门诊管理和共享护理实践预防再住院和提高植入式心室辅助装置患者的生活质量]。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-04-01

Yuichiro Kishimoto, Yasushi Yoshikawa

引用次数: 0

[Driveline Infection of Implantable Left Ventricular Assist Devices]. [植入式左心室辅助装置传动系统感染]。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-04-01

Haruki Tanaka, Tatsuichiro Seto

引用次数: 0

[Long-term Management of Implantable Left Ventricular Assist Device for Maintaining Quality of Life]. [植入式左心室辅助装置维持生活质量的长期管理]。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-04-01

Hitoshi Inafuku

{"title":"[Long-term Management of Implantable Left Ventricular Assist Device for Maintaining Quality of Life].","authors":"Hitoshi Inafuku","doi":"","DOIUrl":"","url":null,"abstract":"The outcomes of implantable left ventricular assist device( iVAD) treatment in Japan are favorable; however, the high rate of re-hospitalization due to complications remains a significant issue. This report details the procedures for iVAD treatment conducted at our hospital. Specifically, we focus on:1. driveline( DL) infection, 2. stroke, and 3. right heart failure. 1. As part of DL infection control, the DL was assumed to enter through the upper umbilicus, and an incision was made from the right side, passing through the left rectus abdominis muscle to the left side. All patients are treated with a simple omental covering, and a new disinfectant, Prontosan, which contains both a surfactant and an antibacterial agent, is used to manage exit site infections involving biofilm. 2. To prevent stroke, all patients are provided with a CoaguChek XS device at discharge, which is adjusted to extend the time required to reach target prothrombin time-international normalized ratio (PT-INR) values. 3. As an innovative approach to treating right heart failure, we have developed a simple or unidirectional valved anastomosis between the superior vena cava and the right pulmonary artery, allowing blood to flow into the pulmonary artery under elevated venous pressure. This procedure is part of a collaborative research project with the School of Science and Engineering at Waseda University( TWIns).","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"78 4","pages":"312-317"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Outcomes of Implantable Left Ventricular Assist Device for Treating Advanced Heart Faire in Our Institute and Outlook for Long-term Use]. [植入式左心室辅助装置在我院治疗晚期心衰的疗效及长期应用前景]。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-04-01

Masahiko Ezure

{"title":"[Outcomes of Implantable Left Ventricular Assist Device for Treating Advanced Heart Faire in Our Institute and Outlook for Long-term Use].","authors":"Masahiko Ezure","doi":"","DOIUrl":"","url":null,"abstract":"From 2011, 13 patients with implantable ventricular assist device (VAD) have followed in our institute, 11 as a bridge to transplant (BTT), and two as destination therapy (DT). All patients were implanted left VAD (LVAD) in INTERMACS profile level 2 to 4, except two as a bridge to bridge (BTB) cases. The EVAHEART LVAD was selected in four, Jarvic2000 was in four, and HeartMate3 was in five patients. There were no major complications in perioperative period. Outpatient cares were provided by VAD team members every week. Of the 13 patients, six underwent transplant, two died during support and five are ongoing. Support averaged 38 months( three cases over 60 months). Eight patients required rehospitalization for more than one time. First three patients had cerebral hemorrhages in four, 10 and 25 months. One patient suffered severe right heart faire, and was repeatedly hospitalized( 22 times). There was no driveline infection, and no aortic regurgitation over moderate level. Several patients have continued cardiac rehabilitation, and improved physical strength and ventilatory power. Complications caused implantable VAD have been decreasing due to progressions of the device and appropriate managements for outpatient care. The current implantable LVAD can be used safely in advanced heart failure patients not only as BTT but also as DT. We can look forward to improve the technology of implantable VAD system in the future too. However, aging changes will be considered for long term follow-up of the DT patients.","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"78 4","pages":"307-311"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Prevention of Driveline Infection in the HeartMate 3 Era]. [心脏伴侣3时代传动系统感染的预防]。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-04-01

Tomo Yoshizumi, Masato Mutsuga

引用次数: 0

[Current State of Right Heart Failure after Implantable Ventricular Assist Device]. [植入式心室辅助装置后右心衰的现状]。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-04-01

Naoki Eguchi, Akira Sezai, Masashi Tanaka

{"title":"[Current State of Right Heart Failure after Implantable Ventricular Assist Device].","authors":"Naoki Eguchi, Akira Sezai, Masashi Tanaka","doi":"","DOIUrl":"","url":null,"abstract":"Japanese registry for Mechanically Assisted Circulatory Support (J-MACS) reports on the results of implantable ventricular assist devices (VADs) in Japan show that the survival rates have stabilized at 93% at one year, 90% at two years and 81% at four years. However, the incidence of neurological dysfunction, hemorrhage and infection, the three major complications, has not been resolved, although it has decreased. Right heart failure has also been improved by implantable left VAD (iLVAD) in patients with preoperative biventricular failure. The J-MACS reported right heart failure free rates of 95% at 90 days, 92% at one year, 90% at two years and 84% at four years. Most cases are in the acute phase after iLVAD and often improve with nitric oxide( NO), drugs or a temporary right VAD( RVAD). In Japan, the waiting period for heart transplantation is long due to the shortage of donors, and the period of RVAD support is much longer than in the West. Right heart failure is sometimes observed in the remote period after iLVAD. Severe cases requiring RVAD and biventricular assist device( BiVAD) are treated with early cardiac transplantation in Europe and the United States of America (USA), while cases requiring long-term BiVAD therapy are extremely rare. Therefore, there are currently no clear standards for the indications and management of RVAD. In this report, we discuss domestic and foreign reports on right heart failure after left VAD (LVAD) and report a valuable case in which RVAD was performed three and a half years after iLVAD in our department, and BiVAD management was required for more than one year for heart transplantation.","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"78 4","pages":"293-299"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Durable Left Ventricular Assist Device Therapy for Patients with a Prior MitraClip or Impella Intervention]. 既往有MitraClip或Impella介入的患者的持久左心室辅助装置治疗。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-04-01

Tomoki Ushijima, Takeo Fujino, Shogo Matsunaga, Satoshi Kimura, Hiromichi Sonoda, Akira Shiose

{"title":"[Durable Left Ventricular Assist Device Therapy for Patients with a Prior MitraClip or Impella Intervention].","authors":"Tomoki Ushijima, Takeo Fujino, Shogo Matsunaga, Satoshi Kimura, Hiromichi Sonoda, Akira Shiose","doi":"","DOIUrl":"","url":null,"abstract":"Some patients have undergone implantation of a durable left ventricular assist device( LVAD) following heart failure treatment with Impella( Abiomed) or MitraClip( Abbott). Impella may carry a potential risk of de novo aortic insufficiency (AI), while MitraClip may pose hemodynamic issues under LVAD circulation. In this report, we present the outcomes of durable LVAD therapy in patients with these prior treatments. Seventeen patients had previously received Impella support, and five had undergone MitraClip implantation. Among the 17 post-Impella patients, seven underwent aortic valvuloplasty during LVAD implantation, and one required surgical intervention due to AI progression 10 months postoperatively. Of the nine non-interventional patients, one with moderate AI underwent heart transplantation without intervention five years after the LVAD implantation, while the remaining eight patients had mild or less AI. Four of the five post-MitraClip patients underwent mitral valve replace ment with a bioprosthetic valve during LVAD implantation. The remaining non-interventional patient experienced no hemodynamic problems. The number of LVAD therapies for patients with a prior Impella or MitraClip intervention is expected to increase in the future. It is essential to establish an appropriate therapeutic strategy based on detailed and careful evaluations of individual cases.","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"78 4","pages":"249-254"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Treatment Strategy for Implantable Ventricular Assist Device Infections:Is Omental Flap Useful?] 植入式心室辅助装置感染的治疗策略：网膜瓣有用吗？］

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-04-01

Masaomi Fukuzumi

引用次数: 0

[How to Avoid Reoperation for Complications Associated with Durable Mechanical Circulatory Support Therapy]. 如何避免持久机械循环支持治疗相关并发症的再手术。

Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2025-04-01

Tomonori Ooka, Taro Minamida, Hiroshi Sugiki, Yasushige Shingu, Satoru Wakasa

{"title":"[How to Avoid Reoperation for Complications Associated with Durable Mechanical Circulatory Support Therapy].","authors":"Tomonori Ooka, Taro Minamida, Hiroshi Sugiki, Yasushige Shingu, Satoru Wakasa","doi":"","DOIUrl":"","url":null,"abstract":"Since April 2011, durable mechanical circulatory support (DMCS) has been used for bridge to transplant (BTT-DMCS) in Japan, with its success leading to insurance coverage for destination therapy (DT-DMCS) in 2021. Despite advancements, managing DMCS-related complications remains challenging, with high readmission rates impacting patients' quality of life and healthcare facilities' workloads. Key complications include de novo aortic insufficiency (dnAI), driveline infections (DLI), and external outflow graft obstruction( EOGO). dnAI contributes significantly to chronic right heart failure, with no consensus on optimal intervention timing. Techniques such as bioprosthetic aortic valve replacement (bioAVR) and central aortic valve closure( CAVC) are employed, each with distinct benefits and limitations. DLI, often caused by mechicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant bacteria, or Mycobacterium abscessus, necessitates advanced wound management, driveline translocation, and prolonged antibiotic therapy. Imaging modalities like 18-FDG PET/CT are crucial for accurate diagnosis and treatment planning. EOGO, frequently caused by seroma compression, can lead to circulatory failure and often requires surgical intervention or catheter-based treatments. Preventing reoperations, optimizing intervention timing, and ensuring multidisciplinary collaboration are essential strategies for improving patient outcomes and enhancing the long-term effectiveness of DMCS therapy.","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":"78 4","pages":"318-323"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0