Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs, 2014
Continuous-flow left ventricular assist devices (LVADs) are becoming the standard of care for pat... more Continuous-flow left ventricular assist devices (LVADs) are becoming the standard of care for patients with refractory end-stage heart failure. We present the outcomes of patients enrolled in a prospective multicenter clinical study in Japan using the HeartMate II continuous-flow LVAD for bridge to transplantation. The study evaluated 6 inotrope-dependent heart failure patients failing on medical management (3 males and 3 females, age 44.7 ± 15.8 years, BSA 1.58 ± 0.17 m(2)) implanted with the HMII LVAD at 5 Japanese centers. Functional status, adverse events and outcomes were determined for the first 6 months with follow-up at 2 years. After implant, functional improvement was evident in 6-min walk distance which increased from 268 ± 92 m at baseline to 399 ± 105 m at 6 months, and 100% of patients were in NYHA class I or II at 6 months compared to 0% at baseline. Adverse events included localized non-device-related infection (4/6), arrhythmias (3/6) and percutaneous lead infection...
The use of minimally invasive and robotic operations has been increasing for coronary artery bypa... more The use of minimally invasive and robotic operations has been increasing for coronary artery bypass surgery; however, no suturing devices have been universally adopted for use in these procedures. We developed a new suturing device that enables omission of manual ligation after a running suture. Twenty-two rabbits were used in this study. In 22 rabbits, the right carotid artery was bypassed using an autologous jugular vein graft. Half of the animals were operated on using the new device and the other half using conventional suturing methods. Postoperative evaluations were performed at 1, 3, and 6 months. Suturing time was 15.6 ± 2.4 min in the device group and 16.6 ± 4.4 min in the control group (p = 0.34). Graft patency and blood flow measurements were not significantly different between the two groups. Histopathological examination of the anastomotic site showed common inflammatory responses in both groups. No particular histopathological change was seen related to the device. In conclusion, the safety of the new suturing device was confirmed, and its efficacy was equal to that of the conventional suturing technique.
Boron neutron-capture therapy (BNCT) has been used to inhibit the growth of various types of canc... more Boron neutron-capture therapy (BNCT) has been used to inhibit the growth of various types of cancers. In this study, we developed a (10)BSH-entrapped water-in-oil-in-water (WOW) emulsion, evaluated it as a selective boron carrier for the possible application of BNCT in hepatocellular carcinoma (HCC) treatment. We prepared the (10)BSH-entrapped WOW emulsion using double emulsification technique and then evaluated the delivery efficacy by performing biodistribution experiment on VX-2 rabbit hepatic tumour model with comparison to iodized poppy-seed oil (IPSO) mix conventional emulsion. Neutron irradiation was carried out at Kyoto University Research Reactor with an average thermal neutron fluence of 5 x 10(12) n/cm(2). Morphological and pathological analyses were performed on day-14 after neutron irradiation. Biodistribution results have revealed that (10)B atoms delivery with WOW emulsion was superior compared to those using IPSO conventional emulsion. There was no dissemination in a...
Few studies have examined HRQOL in pediatric Tx recipients' parents. This study investigated ... more Few studies have examined HRQOL in pediatric Tx recipients' parents. This study investigated HRQOL in these parents and relationships between HRQOL and perceived burden of nurturing, family functioning, and social support. Self-report anonymous questionnaires and a survey of medical records were completed between September and December 2013. The SF-36v2, which evaluates physical, psychological, and social health, was used to measure HRQOL. While values for physical and psychological health were higher than standard values (Cohen's d = 0.34 and 0.17, respectively), social health scores were lower (d = 0.21). "Parental consultation unrelated to donation" (standardized partial regression coefficient: β = -0.52) was associated with physical health. "Family functioning" and "Commuting time between home and primary follow-up hospital" (β = 0.57 and -0.31) were related to psychological health. "Total score for perceived burden of nurturing" (...
Dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) are genetically and phenotypic... more Dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) are genetically and phenotypically heterogeneous. Cardiac function is improved after treatment in some cardiomyopathy patients, but little is known about genetic predictors of long-term outcomes and myocardial recovery following medical treatment. To elucidate the genetic basis of cardiomyopathy in Japan and the genotypes involved in prognosis and left ventricular reverse remodeling (LVRR), we performed targeted sequencing on 120 DCM (70 sporadic and 50 familial) and 52 HCM (15 sporadic and 37 familial) patients and integrated their genotypes with clinical phenotypes. Among the 120 DCM patients, 20 (16.7%) had TTN truncating variants and 13 (10.8%) had LMNA variants. TTN truncating variants were the major cause of sporadic DCM (21.4% of sporadic cases) as with Caucasians, whereas LMNA variants, which include a novel recurrent LMNA E115M variant, were the most frequent in familial DCM (24.0% of familial cases) unlike ...
The immediate postoperative period of Fontan operation is frequently complicated by hemodynamic i... more The immediate postoperative period of Fontan operation is frequently complicated by hemodynamic instability, sometimes requiring fenestration of the conduit. Thrombosis of total cavo-pulmonary connection conduit warrants early intervention to prevent systemic and pulmonary embolism. We report a case of Fontan failure requiring fenestration; which was further complicated by thrombosis of total cavo-pulmonary connection conduit and managed with anticoagulants. Keywords: congenital heart disease; fontan procedure; thrombosis.
To assess the use of laparoscopic surgeries (LS) and the association between its performance and ... more To assess the use of laparoscopic surgeries (LS) and the association between its performance and hospitals' preference for LS over open surgeries. LS is increasingly used in many abdominal surgeries, albeit both with and without solid guideline recommendations. To date, the hospitals' preference (LS vs. open surgeries) and its association with in-hospital outcomes has not been evaluated. We enrolled patients undergoing 8 types of gastrointestinal surgeries in 2011-2013 in the Japanese National Clinical Database. We assessed the use of LS and the occurrences of surgery-related morbidity and mortality during the study period. Further, for 4 typical LS procedures, we assessed the hospitals' preference for LS by modeling the propensity to perform LS (over open surgeries) from patient-level factors, and estimating each institution's observed/expected (O/E) ratio for LS use. Institutions with O/E>2 were defined as LS-dominant. Using hierarchical logistic regression mode...
Negative pressure wound therapy (NPWT) is commonly used to accelerate wound healing, especially f... more Negative pressure wound therapy (NPWT) is commonly used to accelerate wound healing, especially following thoracic surgery; however, the mechanism remains elusive. Given the important role of vasculogenesis in wound healing, we evaluated whether NPWT might accelerate vasculogenesis in the wound area. Toward this end, we investigated the temporal expression of vascular endothelial growth factor receptors (VEGFRs) in an NPWT-wound healing rabbit model. Rabbits were divided into an NPWT group and a non-NPWT control group, and tissue samples were collected around wounds made in the skin of each rabbit at five time points: 0, 7, 14, 21, and 28 days after wound creation. Cryopreserved samples were then immunostained and subject to image analysis to evaluate the temporal changes in VEGFR1, VEGFR2, and VEGFR3 expression in the wound-healing process. Results of histological analysis of the temporal changes in VEGFR expression throughout the healing process showed that compared to the control...
Journal of the American Heart Association, Jan 19, 2015
We aimed to develop a simple structural model of aortic aneurysms using computer-assisted draftin... more We aimed to develop a simple structural model of aortic aneurysms using computer-assisted drafting (CAD) in order to create a basis of definition for saccular aortic aneurysms. We constructed a simple aortic aneurysm model with 2 components: a tube similar to an aorta and an ellipse analogous to a bulging aneurysm. Three parameters, including the vertical and horizontal diameters of the ellipse and the fillet radius, were altered in the model. Using structural analysis with the finite element method, we visualized the distribution of the maximum principal stress (MPS) in the aortic wall and identified the area(s) of prominent stress. We then selected patients with thoracic aortic aneurysms in whom the aneurysm expansion rates were followed up and applied the theoretical results to the raw imaging data. The maximum MPS drastically increased at areas where the aspect ratio (vertical/horizontal) was <1, indicating that "horizontally long" hypothetical ellipses should be de...
Interactive cardiovascular and thoracic surgery, 2011
Radial artery conduits have recently been used more often in coronary artery bypass grafting beca... more Radial artery conduits have recently been used more often in coronary artery bypass grafting because of their potentially better long-term patency than saphenous vein conduits. However, vasospasm of the radial artery conduit due to its nature as a muscular artery has always been of concern and a variety of vasodilators have empirically been used to reduce the risk of spasm. When a patient who was preoperatively taking antihypertensive agents undergoes coronary artery bypass using a radial artery graft, and if he/she is not hypertensive postoperatively, it is not always easy to decide what medication to start with. We report a case of a patient with a radial artery graft who did not receive vasodilators after surgery due to hypotension. The patient developed vasospasm of the radial artery conduit which did not respond to direct injection of vasodilators into the conduit but recovered after taking oral vasodilators for four weeks.
Interactive cardiovascular and thoracic surgery, 2006
Primary cardiac tumors located deep in the left ventricle present a surgical challenge. A mobile ... more Primary cardiac tumors located deep in the left ventricle present a surgical challenge. A mobile tumor located in the left ventricular apex was incidentally discovered on echocardiography in an 81-year-old female. The tumor was removed using a combined sternotomy and chest-port approach assisted by thoracoscopy. The use of an endoscopic sucker, instead of an endoscopic grasper, to retract the tumor helped keep the removal of the tumor en bloc uncomplicated. Detailed preoperative information about tumor location, size, and attachment to the endocardium facilitated the planning of the surgical approach and the instrumentation needed, which led to the successful removal of the deeply located left ventricular tumor. The surgical approach and instrumentation of previous case reports are reviewed.
We have developed a system to estimate velocity vector fields inside the cardiac ventricle by ech... more We have developed a system to estimate velocity vector fields inside the cardiac ventricle by echocardiography and to evaluate several flow dynamical parameters to assess the pathophysiology of cardiovascular diseases. A two-dimensional continuity equation was applied to color Doppler data using speckle tracking data as boundary conditions, and the velocity component perpendicular to the echo beam line was obtained. We determined the optimal smoothing method of the color Doppler data, and the 8-pixel standard deviation of the Gaussian filter provided vorticity without nonphysiological stripe shape noise. We also determined the weight function at the bilateral boundaries given by the speckle tracking data of the ventricle or vascular wall motion, and the weight function linear to the distance from the boundary provided accurate flow velocities not only inside the vortex flow but also around near-wall regions on the basis of the results of the validation of a digital phantom of a pipe...
Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs, 2014
Continuous-flow left ventricular assist devices (LVADs) are becoming the standard of care for pat... more Continuous-flow left ventricular assist devices (LVADs) are becoming the standard of care for patients with refractory end-stage heart failure. We present the outcomes of patients enrolled in a prospective multicenter clinical study in Japan using the HeartMate II continuous-flow LVAD for bridge to transplantation. The study evaluated 6 inotrope-dependent heart failure patients failing on medical management (3 males and 3 females, age 44.7 ± 15.8 years, BSA 1.58 ± 0.17 m(2)) implanted with the HMII LVAD at 5 Japanese centers. Functional status, adverse events and outcomes were determined for the first 6 months with follow-up at 2 years. After implant, functional improvement was evident in 6-min walk distance which increased from 268 ± 92 m at baseline to 399 ± 105 m at 6 months, and 100% of patients were in NYHA class I or II at 6 months compared to 0% at baseline. Adverse events included localized non-device-related infection (4/6), arrhythmias (3/6) and percutaneous lead infection...
The use of minimally invasive and robotic operations has been increasing for coronary artery bypa... more The use of minimally invasive and robotic operations has been increasing for coronary artery bypass surgery; however, no suturing devices have been universally adopted for use in these procedures. We developed a new suturing device that enables omission of manual ligation after a running suture. Twenty-two rabbits were used in this study. In 22 rabbits, the right carotid artery was bypassed using an autologous jugular vein graft. Half of the animals were operated on using the new device and the other half using conventional suturing methods. Postoperative evaluations were performed at 1, 3, and 6 months. Suturing time was 15.6 ± 2.4 min in the device group and 16.6 ± 4.4 min in the control group (p = 0.34). Graft patency and blood flow measurements were not significantly different between the two groups. Histopathological examination of the anastomotic site showed common inflammatory responses in both groups. No particular histopathological change was seen related to the device. In conclusion, the safety of the new suturing device was confirmed, and its efficacy was equal to that of the conventional suturing technique.
Boron neutron-capture therapy (BNCT) has been used to inhibit the growth of various types of canc... more Boron neutron-capture therapy (BNCT) has been used to inhibit the growth of various types of cancers. In this study, we developed a (10)BSH-entrapped water-in-oil-in-water (WOW) emulsion, evaluated it as a selective boron carrier for the possible application of BNCT in hepatocellular carcinoma (HCC) treatment. We prepared the (10)BSH-entrapped WOW emulsion using double emulsification technique and then evaluated the delivery efficacy by performing biodistribution experiment on VX-2 rabbit hepatic tumour model with comparison to iodized poppy-seed oil (IPSO) mix conventional emulsion. Neutron irradiation was carried out at Kyoto University Research Reactor with an average thermal neutron fluence of 5 x 10(12) n/cm(2). Morphological and pathological analyses were performed on day-14 after neutron irradiation. Biodistribution results have revealed that (10)B atoms delivery with WOW emulsion was superior compared to those using IPSO conventional emulsion. There was no dissemination in a...
Few studies have examined HRQOL in pediatric Tx recipients' parents. This study investigated ... more Few studies have examined HRQOL in pediatric Tx recipients' parents. This study investigated HRQOL in these parents and relationships between HRQOL and perceived burden of nurturing, family functioning, and social support. Self-report anonymous questionnaires and a survey of medical records were completed between September and December 2013. The SF-36v2, which evaluates physical, psychological, and social health, was used to measure HRQOL. While values for physical and psychological health were higher than standard values (Cohen's d = 0.34 and 0.17, respectively), social health scores were lower (d = 0.21). "Parental consultation unrelated to donation" (standardized partial regression coefficient: β = -0.52) was associated with physical health. "Family functioning" and "Commuting time between home and primary follow-up hospital" (β = 0.57 and -0.31) were related to psychological health. "Total score for perceived burden of nurturing" (...
Dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) are genetically and phenotypic... more Dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) are genetically and phenotypically heterogeneous. Cardiac function is improved after treatment in some cardiomyopathy patients, but little is known about genetic predictors of long-term outcomes and myocardial recovery following medical treatment. To elucidate the genetic basis of cardiomyopathy in Japan and the genotypes involved in prognosis and left ventricular reverse remodeling (LVRR), we performed targeted sequencing on 120 DCM (70 sporadic and 50 familial) and 52 HCM (15 sporadic and 37 familial) patients and integrated their genotypes with clinical phenotypes. Among the 120 DCM patients, 20 (16.7%) had TTN truncating variants and 13 (10.8%) had LMNA variants. TTN truncating variants were the major cause of sporadic DCM (21.4% of sporadic cases) as with Caucasians, whereas LMNA variants, which include a novel recurrent LMNA E115M variant, were the most frequent in familial DCM (24.0% of familial cases) unlike ...
The immediate postoperative period of Fontan operation is frequently complicated by hemodynamic i... more The immediate postoperative period of Fontan operation is frequently complicated by hemodynamic instability, sometimes requiring fenestration of the conduit. Thrombosis of total cavo-pulmonary connection conduit warrants early intervention to prevent systemic and pulmonary embolism. We report a case of Fontan failure requiring fenestration; which was further complicated by thrombosis of total cavo-pulmonary connection conduit and managed with anticoagulants. Keywords: congenital heart disease; fontan procedure; thrombosis.
To assess the use of laparoscopic surgeries (LS) and the association between its performance and ... more To assess the use of laparoscopic surgeries (LS) and the association between its performance and hospitals' preference for LS over open surgeries. LS is increasingly used in many abdominal surgeries, albeit both with and without solid guideline recommendations. To date, the hospitals' preference (LS vs. open surgeries) and its association with in-hospital outcomes has not been evaluated. We enrolled patients undergoing 8 types of gastrointestinal surgeries in 2011-2013 in the Japanese National Clinical Database. We assessed the use of LS and the occurrences of surgery-related morbidity and mortality during the study period. Further, for 4 typical LS procedures, we assessed the hospitals' preference for LS by modeling the propensity to perform LS (over open surgeries) from patient-level factors, and estimating each institution's observed/expected (O/E) ratio for LS use. Institutions with O/E>2 were defined as LS-dominant. Using hierarchical logistic regression mode...
Negative pressure wound therapy (NPWT) is commonly used to accelerate wound healing, especially f... more Negative pressure wound therapy (NPWT) is commonly used to accelerate wound healing, especially following thoracic surgery; however, the mechanism remains elusive. Given the important role of vasculogenesis in wound healing, we evaluated whether NPWT might accelerate vasculogenesis in the wound area. Toward this end, we investigated the temporal expression of vascular endothelial growth factor receptors (VEGFRs) in an NPWT-wound healing rabbit model. Rabbits were divided into an NPWT group and a non-NPWT control group, and tissue samples were collected around wounds made in the skin of each rabbit at five time points: 0, 7, 14, 21, and 28 days after wound creation. Cryopreserved samples were then immunostained and subject to image analysis to evaluate the temporal changes in VEGFR1, VEGFR2, and VEGFR3 expression in the wound-healing process. Results of histological analysis of the temporal changes in VEGFR expression throughout the healing process showed that compared to the control...
Journal of the American Heart Association, Jan 19, 2015
We aimed to develop a simple structural model of aortic aneurysms using computer-assisted draftin... more We aimed to develop a simple structural model of aortic aneurysms using computer-assisted drafting (CAD) in order to create a basis of definition for saccular aortic aneurysms. We constructed a simple aortic aneurysm model with 2 components: a tube similar to an aorta and an ellipse analogous to a bulging aneurysm. Three parameters, including the vertical and horizontal diameters of the ellipse and the fillet radius, were altered in the model. Using structural analysis with the finite element method, we visualized the distribution of the maximum principal stress (MPS) in the aortic wall and identified the area(s) of prominent stress. We then selected patients with thoracic aortic aneurysms in whom the aneurysm expansion rates were followed up and applied the theoretical results to the raw imaging data. The maximum MPS drastically increased at areas where the aspect ratio (vertical/horizontal) was <1, indicating that "horizontally long" hypothetical ellipses should be de...
Interactive cardiovascular and thoracic surgery, 2011
Radial artery conduits have recently been used more often in coronary artery bypass grafting beca... more Radial artery conduits have recently been used more often in coronary artery bypass grafting because of their potentially better long-term patency than saphenous vein conduits. However, vasospasm of the radial artery conduit due to its nature as a muscular artery has always been of concern and a variety of vasodilators have empirically been used to reduce the risk of spasm. When a patient who was preoperatively taking antihypertensive agents undergoes coronary artery bypass using a radial artery graft, and if he/she is not hypertensive postoperatively, it is not always easy to decide what medication to start with. We report a case of a patient with a radial artery graft who did not receive vasodilators after surgery due to hypotension. The patient developed vasospasm of the radial artery conduit which did not respond to direct injection of vasodilators into the conduit but recovered after taking oral vasodilators for four weeks.
Interactive cardiovascular and thoracic surgery, 2006
Primary cardiac tumors located deep in the left ventricle present a surgical challenge. A mobile ... more Primary cardiac tumors located deep in the left ventricle present a surgical challenge. A mobile tumor located in the left ventricular apex was incidentally discovered on echocardiography in an 81-year-old female. The tumor was removed using a combined sternotomy and chest-port approach assisted by thoracoscopy. The use of an endoscopic sucker, instead of an endoscopic grasper, to retract the tumor helped keep the removal of the tumor en bloc uncomplicated. Detailed preoperative information about tumor location, size, and attachment to the endocardium facilitated the planning of the surgical approach and the instrumentation needed, which led to the successful removal of the deeply located left ventricular tumor. The surgical approach and instrumentation of previous case reports are reviewed.
We have developed a system to estimate velocity vector fields inside the cardiac ventricle by ech... more We have developed a system to estimate velocity vector fields inside the cardiac ventricle by echocardiography and to evaluate several flow dynamical parameters to assess the pathophysiology of cardiovascular diseases. A two-dimensional continuity equation was applied to color Doppler data using speckle tracking data as boundary conditions, and the velocity component perpendicular to the echo beam line was obtained. We determined the optimal smoothing method of the color Doppler data, and the 8-pixel standard deviation of the Gaussian filter provided vorticity without nonphysiological stripe shape noise. We also determined the weight function at the bilateral boundaries given by the speckle tracking data of the ventricle or vascular wall motion, and the weight function linear to the distance from the boundary provided accurate flow velocities not only inside the vortex flow but also around near-wall regions on the basis of the results of the validation of a digital phantom of a pipe...
Uploads
Papers by Minoru Ono