研究者詳細 - 木村　成卓

木村　成卓（キムラ　ナリタカ）

Kimura, Naritaka

写真a

所属（所属キャンパス）: 医学部外科学教室（心臓血管）（信濃町）

職名: 専任講師

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Stonehenge technique is associated with faster aortic clamp time in group of minimally invasive aortic valve replacement via right infra-axillary thoracotomy

Yamazaki M., Yoshitake A., Takahashi T., Ito T., Kimura N., Hirano A., Iida Y., Takanashi S., Shimizu H.

General Thoracic and Cardiovascular Surgery （General Thoracic and Cardiovascular Surgery） 66 （ 12 ） 700 - 706 2018年12月

ISSN 18636705

　概要を見る

© 2018, The Japanese Association for Thoracic Surgery. Background: Trans-right axillary aortic valve replacement (TAX-AVR) remains uncommon. We developed a special method to pull the heart closer to the right chest wall to make the surgery as easy and safe as aortic valve replacement via median sternotomy. Because the retraction sutures lifting the ascending aorta and aortic root are arranged circularly around the wound, we named this technique “Stonehenge technique”. Methods: We examined 47 patients who underwent aortic valve replacement through a small right infra-axillary thoracotomy as the initial surgical therapy. These patients were divided into two groups: the conventional TAX-AVR group that underwent AVR via the conventional small right axillary incision approach (n = 20) and the TAX-AVR with SH group that underwent AVR with the Stonehenge technique (n = 27). Results: The aortic cross-clamp and the extracorporeal circulation time were significantly shorter in the TAX-AVR with SH group than in the conventional TAX-AVR group (conventional TAX-AVR group: 125.5 ± 47.9; TAX-AVR with SH group: 96.0 ± 14.0, p = 0.004, and conventional TAX-AVR group: 163.8 ± 55.9; TAX-AVR with SH group: 140.0 ± 16.8, p = 0.04). Conclusion: The outcomes of this technique depend on the site of the retraction sutures in the opened pericardium, direction of pull, amount of force applied, and precautions taken. If performed correctly, the ascending aorta and the root can be pulled from the wound to within the surgeon’s fingers’ reach, thereby reducing aortic cross-clamp and extracorporeal circulation times in group of minimally invasive aortic valve replacement via right infra-axillary thoracotomy.
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Thoraco-abdominal aortic aneurysm rupture in a patient with Shprintzen-Goldberg syndrome

Kimura N., Inaba Y., Kameyama K., Shimizu H.

Interactive Cardiovascular and Thoracic Surgery （Interactive Cardiovascular and Thoracic Surgery） 26 （ 6 ） 1039 - 1040 2018年06月

ISSN 15699293

　概要を見る

© The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. Shprintzen-Goldberg syndrome is a rare systemic connective tissue disorder characterized by craniosynostosis, skeletal abnormalities, infantile hypotonia, mild-to-moderate intellectual disability and cardiovascular anomalies. To our knowledge, this is the first report of a Shprintzen-Goldberg syndrome patient who developed a thoraco-abdominal aortic aneurysm. The aneurysm grew rapidly necessitating emergent thoraco-abdominal aortic replacement. The postoperative course was uneventful, and a careful lifetime follow-up was planned.
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