慶應義塾研究者情報データベース

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• A Safe Incision Line in Commando Surgery for Prosthetic Valve Infective Endocarditis with Dense Adhesions: A Case Report

  Kaneyama H., Koizumi K., Ikebata K., Waga M., Hashizume K., Shimizu H.

  SN Comprehensive Clinical Medicine 8 （ 1 ）  2026年12月

  　概要を見る

  Introduction: Commando surgery carries a substantial risk of bleeding owing to its multiple operative steps, prolonged cardiac arrest time, and the need for many sutures to the fragile tissues of the heart. Prosthetic valve infective endocarditis, especially after multiple valve replacements, can be difficult to treat surgically because of the high degree of adhesions. Case Presentation: We report a 66-year-old man who underwent a Commando procedure for recurrent prosthetic valve endocarditis, following two previous double valve replacement surgeries. Adequate exposure was achieved without injury to surrounding structures by selecting an incision line that avoided extensive dissection of dense adhesions. Bleeding was further minimized by reconstructing the aortic, left atrial, and right atrial walls while preserving adherent tissue as much as possible. Conclusion: The route of incision and reconstruction we have shown in this study may allows for reproducible Commando surgery even in the presence of strong adhesions.

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• Visceral segment interrupted constraining suture in physician-modified endografts for dissecting thoracoabdominal aortic aneurysms

  Hashizume K., Mori M., Yamazaki M., Yagami T., Haida H., Shimizu H.

  Journal of Vascular Surgery Cases Innovations and Techniques 12 （ 3 ）  2026年06月

  　概要を見る

  Severe true lumen narrowing in chronic dissecting thoracoabdominal aortic aneurysms (dTAAAs) can compromise accurate fenestration alignment and hinder reliable bridging of the renovisceral branches. We evaluated the safety and feasibility of fenestrated endovascular aortic repair using a physician-modified endograft incorporating a visceral segment interrupted constraining suture. This permanent diameter-constraining modification is intended to stabilize the endograft within a narrowed true lumen and improve target vessel access. Sixteen patients with chronic dTAAA underwent elective repair using a low-profile Zenith Alpha Thoracic device. All 60 renovisceral branches were successfully bridged, resulting in 100% intraoperative technical success, defined as completion of the planned procedure with aneurysm sac sealing, with no 30-day mortality. Three patients required early reintervention for endoleak (1 type IC; 2 type IIIC). Follow-up imaging through 12 months demonstrated durable aneurysm exclusion and sustained branch patency. In this early experience, a visceral segment interrupted constraining suture provided reproducible diameter control and facilitated target vessel access in complex dTAAA treated by physician-modified endograft-based fenestrated endovascular aortic repair.

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• Standardization for Minimally Invasive Combined Aortic and Mitral Valve Surgery via a Right Minithoracotomy

  Yamazaki M., Takahashi T., Matsumoto Y., Haida H., Kimura N., Hashizume K., Ito T., Shimizu H.

  Annals of Thoracic Surgery Short Reports 4 （ 1 ） 123 - 126 2026年03月

  　概要を見る

  Surgeons have been reluctant to adopt minimally invasive combined aortic and mitral valve surgery through a minithoracotomy because of its complexity and prolonged cardiopulmonary bypass and aortic cross-clamping times. Our technique was designed to provide a close and frontal surgical visual field without the need for long-shafted specialized surgical instruments, thereby allowing a standardized and well-visualized surgical visual field in many cases. Here we describe the implementation of our minimally invasive combined aortic and mitral valve surgical procedure through a right minithoracotomy facilitated by the superior septal approach for mitral valve access.

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• Direct aorta implantation technique of microaxial blood pump using a coronary artery bypass grafting anastomosis assist device

  Harada D., Aoyagi Y., Kasai M., Mori M., Hashizume K., Shimizu H.

  Jtcvs Techniques 35 2026年02月

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• Branched stented anastomosis frozen elephant trunk repair reduces operative time and transfusion requirements in acute type A aortic dissection

  Hashizume K., Mori M., Matsuoka T., Koizumi K., Yamazaki M., Kimura N., Iida Y., Matsumoto Y., Haida H., Kasai M., Kaneyama H., Harada D., Shimizu H., Oki N., Aoyagi Y., Shimizu H.

  Jtcvs Open 2026年

  　概要を見る

  Background In acute type A aortic dissection (AADA) patients, total arch replacement (TAR) using the frozen elephant trunk (FET) technique has been adopted in emergencies to promote distal false lumen (FL) thrombosis. However, TAR is technically demanding and is associated with prolonged operative time and increased intraoperative blood transfusion. We previously reported the branched stented anastomosis frozen elephant trunk repair (B-SAFER) technique. Comparative data versus conventional TAR (cTAR) adjusted for disease severity remain limited. Here we compared the early surgical outcomes of TAR using B-SAFER versus cTAR in AADA. Methods This retrospective, multicenter, nonrandomized study included patients with AADA and a patent FL who underwent emergency TAR using B-SAFER (n = 63) and cTAR (n = 75). Propensity score matching based on EuroSCORE and JapanSCORE identified 48 matched pairs. After matching, 16 patients (33%) in the comparator group underwent conventional TAR without an FET device because of institutional practice patterns or device-related constraints. Results The 30-day mortality was 7.3% overall (7/96), with no significant difference between the groups (6.2% for B-SAFER vs 8.3% for cTAR; P > .999). Spinal cord ischemia occurred in 0% versus 4.2% ( P = .153). All operative time metrics were significantly shorter with B-SAFER (all P ≤ .024). Transfusion requirements for red blood cells, fresh frozen plasma, and platelets were all significantly lower (all P < .001). Conclusions In propensity score–matched patients with AADA, TAR using B-SAFER was safe and reproducible, with reduced operative times and transfusion requirements compared to cTAR.

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• Percutaneous coronary intervention with orbital atherectomy after transcatheter aortic valve replacement

  Yashima F., Sato M., Matsumura H., Yoshijima N., Hashizume K., Shimoji K.

  Cardiovascular Intervention and Therapeutics 40 （ 1 ） 189 - 190 2025年01月

  ISSN  18684300

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• Reply: Hybrid aortic arch replacement as innovative treatment option for acute type A aortic dissection

  Hashizume K., Matsuoka T., Mori M., Takaki H., Koizumi K., Kaneyama H., Funaishi K., Kuroo K., Shimizu H.

  Jtcvs Techniques 18   24 - 25 2023年04月

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• Staged repairの限界とPrimary repairにおける工夫

  饗庭了，加藤木利行，橋詰賢一，飯野与志美，古泉潔，安西兼丈，井上慎也，保土田健太郎，吉武明弘，又吉秀樹，四津良平

  [国内会議]  第55回日本胸部外科学会総会, 

  2002年10月

  , 

  口頭発表（一般）

• 成長期における左側房室弁置換後の至適再弁置換時期

  飯野与志美，加藤木利行，饗庭了，橋詰賢一，古泉潔，安西兼丈，井上慎也，保土田健太郎，又吉秀樹，吉武明弘，志水秀行，四津良平

  [国内会議]  第55回日本胸部外科学会総会, 

  2002年10月

  , 

  口頭発表（一般）

• 一過性大動脈虚血モデルを用いたラジカル消去薬MCI－186の脊髄障害に対する保護効果の実験的検討

  橋詰賢一，上田敏彦，志水秀行，四津良平

  [国内会議]  第55回日本胸部外科学会総会, 

  2002年10月

  , 

  口頭発表（一般）

• pull-through法を用いた弓部下行置換例

  古泉潔，上田敏彦，志水秀行，保土田健太郎，飯野与志美，橋詰賢一，安西兼丈，井上慎也，又吉秀樹，吉武明弘，四津良平

  [国内会議]  第123回日本胸部外科学会関東甲信越地方会, 

  2002年09月

  , 

  口頭発表（一般）

• 術前VT/VFを認めたDor手術の一例

  又吉秀樹，申範圭，橋詰賢一，森光晴，吉武明弘，岡本一真，鈴木亮，安西兼丈，四津良平

  [国内会議]  第123回日本胸部外科学会関東甲信越地方会, 

  2002年09月

  , 

  口頭発表（一般）

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• 心臓血管外科学臨床実習

  2026年度

• 外科学講義

  2026年度