SURGERY (Section 2)

1. Congenital Heart Disease(CHD)
Surgical treatment for complex CHD on infants and neonates has been investigated and improved in patients with corrective repairs(1,2). Also, aggressive surgical trials for adult CHD(3), and various new and modified operations have been applied to complex cardiac anomalies(4). Long-term follow-up studies after surgical repairs for CHD revealed good postoperative quality of life in patients with CHD(5,6).

2. Acquired Heart Disease(AHD)
Surgical results for AHD in recent decade have been much improved by applying myocardial protection(7). Surgical treatment for mitral valvular disease has recently been directed to repair or reconstruction of original valve instead of valve replacement(8) and stable long-term results obtained with no anticoagulants and no incidences of thromboembolism(9), but there are still problems in patients with active native or prosthetic valve endocarditis(10). Coronary bypass surgery and redo operations have been safely carried out with improved myocardial protective solutions(11).

3. Vascular Disease
Surgery for vascular diseases has recently been increasing and thoracic aneurysms have been safely treated surgically by use of selective cerebral perfusion(12). Our research (12,13) has concentrated upon prevention of to cerebral damage by measuring optimal cerebral blood flow and electrophysiological evaluations .

4. Thoracic Surgery
Surgical treatment for lung cancer is directed towards to aggressive resection of lymph node and invaded surrounding tissues. A new surgical approach to apical thorax by dislocation of the sterno-claviacular joint to remove apical lung cancer invading the chest wall resulted in satisfactory operative area and curative procedure(14). Surgical reconstruction of esophageal cancer include super-extensive lymph node resection and intra-thoracic anastomosis(15).

5. Experimental Research Activities
Myocardial protection during open heart surgery has extensively been investigating clinically(16) and experimentally(17) from the aspects of myocardial function, morphology and metabolism and these studies have provided and produced excellent surgical results postoperatively. Also, experimental and clinical worpppks of selective cerebral perfusion on cerebral protection during aoric arch reconstrnction have been performed and established as a safety and beneficial method(12,13). Research works for biventricular assist device on cardiac function in left or right heart failure has been studied(18,19). The efficiency of FK506 on a rat heterotopic cardiac transplantation model and also on an accelerated rejection model following donor specific transfusion has been investigated(20). Furthermore, the possibility of adhesion molecule-1(ICAM-1) and lymphocyte function-associated antigen-1(LFA-1) on a rat heterotopic cardiac transplantation model has been investigated.

List of Main Publications from 1990 to 1993

1) Baba,M., Ajiki,H., Nakamura,M., Nakakura,Y., Abe,T., Komatsu,S. : Effects and problems after central palliation for extreme tetralogy of Fallot and pulmonary atresia with ventricular septal defect. Jap. J. Cardiovasc. Surg. 20(6), 11949-6(1991) (in Japanease)

2) Ajiki,H., Baba,M., Asai,Y. and Komatsu,S. : Surgical treatment for congenital heart diseases with pulmonary hypertension　- Long-term follow-up study -　　Surg. Therapy. 64(2), 140-46(1991) (in Japanese)

3) Abe,T. : Recent advances for surgical treatment for congenital heart diseases.　　Nippon Iji Shinppo. 3566, 9-14(1992) (in Japanese)

4) Abe,T., Tsukamoto,M., Ajiki,H., Komatsu,S. : Surgical indication and postoperative problems of modified Fontan operation. Jap.J. Ca rdiovasc. Surg. 20(8), 1382-856(1991) (in Japanese)

5) Abe,T., Komatsu,S. : Long-term follow-up studies in 211 patients with tetralogy of Fallot after corrective surgery over 10 years.　　Jap. J. Thoracic. Surg. 43(8), 598-604(1990) (in Japanese)

6) Abe,T., Hamaya,H., Asai,Y., Watanabe,N. and Komatsu,S. : Ebstein's anomaly　-Clinical study of 23 patients.　　Jap. J. Pediatric. Surg. 28(5), 947-54(1992) (in Japanese)

7) Kimura,N., Abe,T., and Komatsu,S. : Myocardial protection of valve re-replacement surgery ; Analysis of antegrade cold blood cardioplegia with topical cooling.　　Jap. Ann. Thorac. Surg. 11(1), 53-58(1991) (in Japanese)

8) Yamada,O., Kazui,T., Inoue,N., Tanaka,A., Ito,T., Watanabe,N., Yamaguchi,T., Yamamoto,N., Abe,T. and Komatsu,S. : Have the results of mitral valve replacement improved?　　J. Jap. Assoc. Thracic. Surg. 38(11),61-67(1990) (in Japanese)

9) Abe,T., Komatsu,S. : Reconstructive surgery of mitral valve incompetence　- Long-term results of different surgical techniques -.　　 Jap. Ann. Thorac. Surg. 12(1), 17-22(1992) (in Japanese)

10) Abe,T., Tsukamoto,M. and Komatsu,S. : Surgical treatment of active infective endocarditis　- Early and late results of active native and prosthetic valve endocarditis -.　　Jap Circulation J. (in Press)

11) Tanaka,T., Kazui,T., Sugimoto,T., Komatsu,K., Sasaki,A., Inoue,N., Yokoyama,H., Abe,T. and Komatsu,S. : Clinical evaluation of blood- diltiazem-nitroglycerin cardioplegia in coronary artery bypass grafting.　Jap. Ann. Thorac. Surg. 10(suppl), 15-18(1990) (in Japanese)

12) Kazui,T., Inoue,N., Yamada,O. and Komatsu,S. : Selective cerebral perfusion during operation for aneurysms of the aortic arch ; A reassessment.　　Ann Thorace Surg. 53, 109-14(1992)

13) Tanaka,H. : Experimental studies on cerebral protection during aortic arch reconstruction-optimal cerebral perfusion flow and electrophysiological evaluation of brain function during selective cerebral perfusion.　　Sapporo Med. J. 61, 325-336(1992) (in Japanese )

14) Kusajima,K., Inaoka,M., Yamaguchi,T., Mishina,H. and Komatsu,S. : Recent advances of surgical treatment for lung cancer.　　J. Jap. Assoc. Thorac. Surg. 50th Hokkaido Memorial J. 41-46(1991) (in Japanese)

15) Watanabe,A., Kusajima,K., Kawaharada,N., Komatsu,K., Sugimoto,S., Doi,M., Tanaka,A., Takada,H., Mishina,H. and Komatsu,S. : The management of extra vascular lung water using a thermal-sodium double indicator dilution technique in patients undergoing surgery for esophageal cancer.　　J. Jap. Assoc. Thrac. Surg. 38(11), 47-54( 1990) (in Japanese)

16) Yokoyama,H., Kimura,N., Tanaka,T., Kazui,T., Abe,T. and Komatsu,S. : Recent advances im myocardial protection.　　J. Jap. Assoc. Thorac. Surg. 50th. Hokkaido Memorial J. 112-120(1991) (in Japanese)

17) Sugimoto,T. : The effect of superoxide dismutase on reperfusion injury during open heart surgery with blood cardioplegia.　　Sapporo Med. J. 59(3), 251-262(1990) (in Japanese)

18) Tanaka,T. : The effect of bi-ventricular assist device on profound cardiac failure.　　Sapporo Med. J. 61(4), 247-256(1992) (in Japanese)

19) Kimura,N. ; Right ventricular assist for experimental acute right ventricular failure in dogs.　　J. Jap. Assoc. Thrac. Surg. 41(4), 17-28(1993) (in Japanese)

20) Komatsu,K. : The effect of FK506 on aceclerated rejection due to donor specific transfusion　-Experimental studies on rat heterotopic heart transplantation model- .　　Sapporo Med. J. 59(4), 323-333 (1990) (in Japanese)

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SURGERY (Section 2)

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Introduction