• Search Research Projects
  • Search Researchers
  • How to Use
  1. Back to previous page

血栓塞栓症予防法としての心房細動へのmaze手術の意義(術前後の血液凝固線溶系と活性化血小板接着分子測定による検討)

Research Project

Project/Area Number 09771000
Research Category

Grant-in-Aid for Encouragement of Young Scientists (A)

Allocation TypeSingle-year Grants
Research Field Thoracic surgery
Research InstitutionIwate Medical University

Principal Investigator

鎌田 潤也  岩手医科大学, 医学部, 助手 (10254765)

Project Period (FY) 1997 – 1998
Project Status Completed (Fiscal Year 1998)
Budget Amount *help
¥1,500,000 (Direct Cost: ¥1,500,000)
Fiscal Year 1998: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 1997: ¥800,000 (Direct Cost: ¥800,000)
Keywords慢性心房細動 / 僧帽弁閉鎖不全症 / 僧帽弁狭窄症 / 血栓塞栓症 / Maze手術 / 心房細動 / 活性化血小板接着分子 / セレクチン / 僧帽弁膜症
Research Abstract

1. 慢性心房細動症例104例に対し,基礎心疾患手術にMaze手術を併せて行った.病院死亡は4例であったが,いずれの死因もMaze手術との因果関係はなく,また術後出血のための再開胸を2例に要した以外,重篤な合併症は認めていない.
2. 手術生存100例の遠隔期(平均5年)における基本調律の内訳は,洞調律68%,心房細動24%,洞機能不全8%と,昨年度の報告より洞調律維持率が減少していた.
3. Maze手術後に回復した洞調律例で,ホルター心電図により心拍変動を検討すると,術後早期では口内変動が消失していたが約1年後には改善傾向を示し,さらに約2年後には有意に改善をみた.症候限界性の運動負荷によっても,術後早期には心拍応答の著しい低下をきたすが経時的に改善傾向を示した.
4. 心エコー図上,調律回復後には多くの症例で心房収縮能が観察され,さらに術後経時的に改善傾向を示した.
5. Maze手術前後の血液凝固系の推移の検討で、手術後早期にはD-ダイマー,アンチトロンビンIII複合体が増加傾向にあるものの,約1年後には減少傾向を示し,さらに約2年後には有意に減少をみた,また,活性化血小板接着分子P-Selectinは,手術前後に有意な変化を示さなかった.
6. 生活の質(QOL)に関するアンケート調査で,約1年後には向上する傾向を示し,さらに約2年後には有意に向上していた.
7. 今年度までの遠隔期の血栓塞栓症は,洞調律群で1例(1.5%),心房細動群で2例(8,3%)であった.しかしながら,心房細動群の2例では,抗凝固療法が不十分であった可能性があり,人工弁関連の合併症と思われた.引き続き,長期の遠隔成績の追跡調査を行う必要がある.

Report

(2 results)
  • 1998 Annual Research Report
  • 1997 Annual Research Report
  • Research Products

    (12 results)

All Other

All Publications (12 results)

  • [Publications] Junya Kamata: "Electrocardiographic nature of restored sinus rhythm after Cox Maze procedure in patients with chrcitic atrial fibrillation who also had other cardiac surgery." Heart. 77(1). 50-55 (1997)

    • Related Report
      1998 Annual Research Report
  • [Publications] 鎌田 潤也: "Maze手術の光と影" カレントテラピー. 16(2). 126-130 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] Junya Kamata: "Predictors of sinus rhythm restoration after Cox Maze procedure concomitant with other cardiac operations." Ann Thorac Surg. 64(2). 394-398 (1997)

    • Related Report
      1998 Annual Research Report
  • [Publications] Hiroshi Izumoto: "Operative results after the Cox/Maze procedure combined with mitral valve operation" Ann Thorac Surg. 66. 800-804 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] Hiroshi Izumoto: "Can the Maze procedure be combined safely with mitral valve repair?" J Heart valve Dis. 6. 166-170 (1997)

    • Related Report
      1998 Annual Research Report
  • [Publications] Hideki Yamanishi: "Clinical experience of surgical repair for mitral regurgitation secondary to papillary muscle ruptule complicating acute myocardial infarction." Ann Thorac Cardiovasc Surg. 4. 83-86 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] Junya,Kamata: "Electrocardiographic nature of restored sinus rhythm after Cox maze procedure in patients with chronic atrial fibrillation atrial fibrillation." Heart. 77. 50-55 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] Kenji,Ueshima: "Recovery of atrial function after combined treatment with surgica repair for organic heart disease and mazeprocedure for atrial fibrillation" J.Thorac Cardiovasc Surg. 113. 214-215 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] Hiroshi,Izumoto: "Can the maze procedure be combined safely with mitral ralve repair?" J Heart Valve Dis. 6. 166-170 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] Junya,Kamata: "Predictors of sinus rhythm restoration after Cox maze procedure concomitant with other cardiac surgery." Ann Thorac Surg. 64. 394-398 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] Hideki,Yamanishi: "Combined surgery for chronic constrictive pericarditis and atrial fibrillation." Ann Thorac Cardiovas Surg. 3. 351-353 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] 川副,浩平: "Maze手術の光と影" カレントテラピー. 16(2). 126-130 (1998)

    • Related Report
      1997 Annual Research Report

URL: 

Published: 1997-04-01   Modified: 2016-04-21  

Information User Guide FAQ News Terms of Use Attribution of KAKENHI

Powered by NII kakenhi