X-ray phase contrast tomography and computed fluid dynamics for pulmonary vein stenosis

• Project/Area Number: 17K10725
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular surgery
• Research Institution: Niigata University
• Principal Investigator: SHIRAISHI Shuichi 新潟大学, 医歯学系, 准教授 (00422600)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2017: ¥2,600,000 (Direct Cost: ¥2,000,000、Indirect Cost: ¥600,000)
• Keywords: 肺静脈狭窄 / 免疫染色 / 位相差X線CT / 経食道心エコー / 血流解析 / CFD / 数値流体解析 / 先天性心臓血管外科学

Outline of Final Research Achievements

1. Main pahological finding of the pulmoanry vein stenosis was thickening of the intima of the pulmonary vein, mainly due to proliferation of myofibloblast, smooth muscle cell, and collagen fiber.
2. X-ray phase contrast tomography reveled no significant finding compared with immunostaining specimens at the junction of the pulmoanry vein and the left atrium.
3. Velocity time integral of the pulmoanry vein (PV-VTI) measured by intraoperative transesophageal echocardiography during palliative operation for congenital heart defect was useful for quantification of the pulmonary blood flow.

Academic Significance and Societal Importance of the Research Achievements

肺静脈狭窄病変(PVS)の病理組織学的変化の主体が肺静脈内膜における平滑筋細胞及び筋線維芽細胞、膠原線維であることが判明したため、今後はこれらの細胞増殖を抑える機序による新規の肺静脈狭窄症に対する治療法の開発が可能となる可能性がある。経食道心エコーを用いたVelocity Time Integral of Pulmonary Vein (PV-VTI)が肺血流の定量化に有用であることが判明したため、今後はこの指標を用いて術中に限らずスクリーニングなどでも肺血流量および血流パターンの評価を行うことにより、早期の肺静脈狭窄性病変の発見・治療の可能性がある。

Research Products

• [Journal Article] Swing-back and trap-door technique repair for interrupted aortic arch with right-sided descending aorta. (2019)
  • Author(s): Shuichi Shiraishi, Ai Sugimoto, Masanori Tsuchida
  • Journal Title: Interact Cardiovasc Thorac Surg Volume: 16 Issue: 5 Pages: 818-819
  • DOI: 10.1093/icvts/ivz175
  • Peer Reviewed
• [Journal Article] Impact of Characteristics at Stage-2-Palliation on Outcome Following Fontan Completion. (2019)
  • Author(s): Vitanova K, Shiraishi S, Mayr B, Beran E, Cleuziou J, Strbad M, Röhlig C, Hager A, Hörer J, Lange R, Ono M.
  • Journal Title: Pediatr Cardiol Volume: 24 Issue: 7 Pages: 1476-1487
  • DOI: 10.1007/s00246-019-02172-6
  • Peer Reviewed
• [Journal Article] A novel parameter for pulmonary blood flow during palliative procedures: velocity time integral of the pulmonary vein. (2018)
  • Author(s): Shuichi Shiraishi, Keiko Bamba, Ai Sugimoto, Masashi Takahashi, Masanori Tsuchida
  • Journal Title: Eur J Cardiothorac Surg Volume: 55 Issue: 5 Pages: 823-828
  • DOI: 10.1093/ejcts/ezy465
  • Peer Reviewed / Open Access
• [Journal Article] Impact of age at bidirectional cavopulmonary anastomosis on haemodynamics after Fontan operation. (2018)
  • Author(s): Shuichi Shiraishi, Toshide Nakano, Shinichiro Oda, Hideaki Kado.
  • Journal Title: Cardiol Young Volume: 28 Issue: 12 Pages: 1436-1443
  • DOI: 10.1017/s1047951118001543
  • Peer Reviewed / Open Access
• [Journal Article] Intact imaging of human heart structure using X-ray phase-contrast tomography (2017)
  • Author(s): Kaneko Y, Shinohara G, Hoshino M, Morishita H, Morita K, Oshima Y, Takahashi M, Yagi N, Okita Y, Tsukube T.
  • Journal Title: Pediatr Cardiol Volume: 38 Issue: 2 Pages: 390-393
  • DOI: 10.1007/s00246-016-1527-z
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Predictors of ventricular tachyarrhythmia occurring late after intracardiac repair of tetralogy of Fallot: combination of QRS duration change rate and tricuspid regurgitation pressure gradient. (2017)
  • Author(s): Shuichi Shiraishi, Masashi Takahashi, Ai Sugimoto, Masanori Tsuchida
  • Journal Title: J Thorac Dis Volume: 9 Issue: 12 Pages: 5112-5119
  • DOI: 10.21037/jtd.2017.11.53
  • Peer Reviewed / Open Access
• [Presentation] 右心バイパス手術時の経食道心エコーによる肺静脈血流量（PV-VTI）測定 (2019)
  • Author(s): 白石修一、杉本愛、佐藤哲彰、北原武尊、土田正則
  • Organizer: 第70回日本胸部外科学会定期学術集会
• [Presentation] Assessment of pulmonary blood flow with intra-operative transesophageal echocardiography during palliative procedure -Velocity Time Integral of pulmonary vein- (2018)
  • Author(s): Shiraishi Shuichi, Ai Sugimoto, Masashi Takahashi, Masanori Tsuchida
  • Organizer: 32nd Annual Meeting of European Association of Cardio-Thoracic Surgery (EACTS)
  • Int'l Joint Research
• [Presentation] 両方向性グレン手術時条件がFontan術後成績と運動耐容能に与える影響：体心室形態による比較 (2018)
  • Author(s): 白石修一、Keti Vitanova, Benedikt Mayr, Julie Cleuziou, Elisabeth Beran, Rudiger Lange, Masamichi Ono
  • Organizer: 第71回日本胸部外科学会定期学術集会
• [Presentation] Assessment of pulmonary venous blood flow by intra-operative transesophageal echocardiography at bilateral pulmonary artery banding -Velocity Time Integral of pulmonary vein (PV-VTI)- (2017)
  • Author(s): Shiraishi Shuichi, Ai Sugimoto, Ziyong Moon, Masashi Takahashi, Masanori Tsuchida
  • Organizer: 31st Annual Meeting of European Association of Cardio-Thoracic Surgery (EACTS)
  • Int'l Joint Research