Syuichi Kozawa
Kobe University
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Featured researches published by Syuichi Kozawa.
The Annals of Thoracic Surgery | 1999
Tetsuya Higami; Syuichi Kozawa; Tatsuro Asada; Hidefumi Obo; Kunio Gan; Kazuhiko Iwahashi; Hideaki Nohara
BACKGROUND Time limits for neuroprotection by retrograde cerebral perfusion (RCP) and selective cerebral perfusion (SCP) in aortic arch aneurysm repair or dissection are undergoing definition. METHODS Using near-infrared optical spectroscopy, changes in regional cerebrovascular oxygen saturation (rSO2) were compared between the two perfusion methods. RESULTS Immediately before cardiopulmonary bypass, baseline rSO2 was 63.9%+/-6.9% for the RCP and 66.1%+/-5.3% for the SCP group (no significant difference). As patients were core-cooled to 20 degrees C, rSO2 increased to 73.1%+/-8.8% and 74.1%+/-7.9% in the RCP and SCP groups, respectively. With circulatory arrest, rSO2 suddenly decreased. After starting cerebral perfusion, rSO2 returned to prearrest values in the SCP group but continued decreasing steadily in the RCP group, to levels below baseline after about 25 minutes. At the end of perfusion, rSO2 was 57.4%+/-12.2% for the RCP group and 71.7%+/-6.9% for the SCP group, and the ratio of rSO2 to baseline value was 0.89 for RCP and 1.08 for SCP despite a shorter brain perfusion time for RCP (38.8+/-18.0 versus 103.3+/-43.3 minutes). Three of 5 patients whose ratios of rSO2 to baseline at the end of brain protection were 0.7 or less had neurologic deficits. CONCLUSIONS Although SCP showed no clinically important time limitation, rSO2 continued to decrease with time during RCP. An rSO2 ratio less than 0.7 could represent a critical lower limit.
The Annals of Thoracic Surgery | 2000
Tetsuya Higami; Syuichi Kozawa; Tatsuro Asada; Tsutomu Shida; Kyoichi Ogawa
A new method to skeletonize and harvest the internal thoracic artery using an ultrasonic scalpel is presented. The technique is simple, safe, and minimally invasive. It is possible to obtain sufficient vessel length for anastomosis to most coronary arteries for bypass grafting.
Surgery Today | 1998
Hidefumi Obo; Syuichi Kozawa; Tatsurou Asada; Nobuhiko Mukohara; Tetsuya Higami; Kunio Gan; Kazuhiko Iwahashi; Hideaki Nohara; Kyouichi Ogawa
We assessed the efficacy of emergency percutaneous cardiopulmonary bypass support (PCPS) in the treatment of patients with acute myocardial infarction complicated by cardiogenic shock. Emergency PCPS was instituted in 21 consecutive patients beginning in 1991. After the stabilization of the hemodynamics, coronary reperfusion was performed by means of coronary artery bypass grafting or percutaneous transluminal coronary angioplasty. Of the seven patients with acute myocardial infarction involving either the left main or two-vessel territories, five survived more than 1 month, but only one patient remained alive and well after 20 months. The main cause of death for this group was low output syndrome. Four of 12 patients with acute left main trunkal occlusion in the catheter laboratory survived and showed a preserved cardiac function (mean followup 28.5 months). The main cause of death for this group was brain damage. Two patients with single-vessel territory acute myocardial infarction underwent PCPS to treat refractory ventricular fibrillation. Both patients were still alive and well at a 12-month followup. Percutaneous cardiopulmonary bypass support successfully stabilized the hemodynamics, allowing time to perform revascularization for all three groups of patients with life-threatening acute myocardial infarction. Recanalization was nevertheless unable to salvage the damaged myocardium in cases of prolonged ischemic time.
The Japanese Journal of Thoracic and Cardiovascular Surgery | 1999
Tetsuya Higami; Syuichi Kozawa; Tatsuro Asada; Hidefumi Obo; Kunio Gan; Kazuhiko Iwahashi
Obstruction of the right coronary ostial anastomosis is a rare late complication after composite graft replacement of the ascending aorta and the aortic valve with separate Dacron coronary grafts (Cabrol method). Occlusion at the right coronary ostial anastomosis in a 36-year-old woman with aortitis syndrome who underwent a composite graft with a Dacron coronary graft is described. She underwent a third successful operation for right coronary reconstruction by minimally invasive direct coronary artery bypass grafting technique using the right gastroepiploic artery. This approach is likely to be extremely useful in avoiding resternotomy and cardiopulmonary bypass in patients requiring coronary reoperation.
Internal Medicine | 1999
Norio Yagi; Hiroyuki Akiyama; Naoya Igaki; Toru Oka; Fumihiko Tamada; Tetsuya Higami; Syuichi Kozawa; Tatsuro Asada; Takeo Goto
Annals of Thoracic and Cardiovascular Surgery | 2000
Tetsuya Higami; Syuichi Kozawa; Tatsuro Asada; Hidefumi Obo; Kazuhiko Iwahashi; Hideaki Nohara; Teruo Yamashita; Hidetaka Wakiyama; Tsutomu Shida; Kyoichi Ogawa
Nihon Gekakei Rengo Gakkaishi (journal of Japanese College of Surgeons) | 1999
Tatsuro Asada; Syuichi Kozawa; Tetsuya Higami; Hidehumi Obo
Japanese Journal of Cardiovascular Surgery | 1995
Hitoshi Matsuda; Toshiaki Ota; Syuichi Kozawa; Masayoshi Okada
Medical journal of Kobe University | 1990
Masao Okamura; Kazuo Nakamura; Syuichi Kozawa
Nihon Rinsho Geka Gakkai Zasshi (journal of Japan Surgical Association) | 1986
Tsutomu Shida; Hisao Yoshihara; Masami Nishiwaki; Toshiaki Ohta; Noboru Ishii; Syuichi Kozawa; Masayoshi Okada; Kazuo Nakamura; Syunsuke Yasuoka