Yoshikazu Ono

All Publications

• Effect of graft sizing in valve-sparing aortic root replacement for bicuspid aortic valve: The Goldilocks ratio. JTCVS techniques Choi, P. S., Sharir, A., Ono, Y., Shibata, M., Kaiser, A. D., Zhu, Y., Marsden, A. L., Woo, Y. J., Ma, M. R., Kim, J. B. 2024; 25: 1-7

  Abstract

  To investigate the effect of graft sizing on valve performance in valve-sparing aortic root replacement for bicuspid aortic valve.In addition to a diseased control model, 3 representative groups-free-edge length to aortic/graft diameter (FELAD) ratio <1.3, 1.5 to 1.64, and >1.7-were replicated in explanted porcine aortic roots (n = 3) using straight grafts sized respective to the native free-edge length. They were run on a validated ex vivo univentricular system under physiological parameters for 20 cycles. All groups were tested within the same aortic root to minimize inter-root differences. Outcomes included transvalvular gradient, regurgitation fraction, and orifice area. Linear mixed effects model and pairwise comparisons were employed to compare outcomes across groups.The diseased control had mean transvalvular gradient 10.9 ± 6.30 mm Hg, regurgitation fraction 32.5 ± 4.91%, and orifice area 1.52 ± 0.12 cm2. In ex vivo analysis, all repair groups had improved regurgitation compared with control (P < .001). FELAD <1.3 had the greatest amount of regurgitation among the repair groups (P < .001) and 1.5-1.64 the least (P < .001). FELAD <1.3 and >1.7 exhibited greater mean gradient compared with both control and 1.5 to 1.64 (P < .001). Among the repair groups, 1.5 to 1.64 had the largest orifice area, and >1.7 the smallest (P < .001).For a symmetric bicuspid aortic valve, performance after valve-sparing aortic root replacement shows a bimodal distribution across graft size. As the FELAD ratio departs from 1.5 to 1.64 in either direction, significant increases in transvalvular gradient are observed. FELAD <1.3 may also result in suboptimal improvement of baseline regurgitation.

  View details for DOI 10.1016/j.xjtc.2024.03.025

  View details for PubMedID 38899072

  View details for PubMedCentralID PMC11184666

• Novel strategy to preserve valve morphology for 3-dimensional analysis of rat pulmonary valves JTCVS Structural and Endovascular Ono, Y., Shibata, M., Ma, X., Gil-Antunano, M., Sewell, H. L., Hanley, F., Riemer, R. K., Abilez, O. J. 2024; 1-2

  View details for DOI 10.1016/j.xjse.2024.100010

• Death, reoperation, and late cardiopulmonary function after truncus repair. JTCVS open Hoashi, T., Imai, K., Okuda, N., Komori, M., Ono, Y., Kurosaki, K., Ichikawa, H. 2023; 14: 407-416

  Abstract

  To identify the late surgical outcomes of truncus arteriosus.Fifty consecutive patients with truncus arteriosus who underwent surgery between 1978 and 2020 at our institute were enrolled in this retrospective, single institutional cohort study. The primary outcome was death and reoperation. The secondary outcome was late clinical status, including exercise capacity. The peak oxygen uptake was measured by a ramp-like progressive exercise test on a treadmill.Nine patients underwent palliative surgery, which resulted in 2 deaths. Forty-eight patients went on to truncus arteriosus repair, including 17 neonates (35.4%). The median age and body weight at repair were 92.5 days (interquartile range, 10-272 days) and 3.85 kg (interquartile range, 2.9-6.5 kg), respectively. The survival rate at 30 years was 68.5%. Significant truncal valve regurgitation (P = .030) was a risk factor for survival. Survival rates were similar between in the early 25 and late 25 patients (P = .452). The freedom from death or reoperation rate at 15 years was 35.8%. Significant truncal valve regurgitation was a risk factor (P = .001). The mean follow-up period in hospital survivors was 15.4 ± 12 years (maximum, 43 years). The peak oxygen uptake, which was performed in 12 long-term survivors at a median duration from repair of 19.7 years (interquartile range, 16.8-30.9 years), was 70.2% of predicted normal (interquartile range, 64.5%-80.4%).Truncal valve regurgitation was a risk factor for both survival and reoperation, thus improvement of truncal valve surgery is essential for better life prognosis and quality of life. Slightly reduced exercise tolerance was common in long-term survivors.

  View details for DOI 10.1016/j.xjon.2023.02.010

  View details for PubMedID 37425460

  View details for PubMedCentralID PMC10328806

• Comparison of long-term outcomes of atrial switch with Rastelli and physiological repair using left ventricle-to-pulmonary artery conduit for levo-transposition of the great arteries. The Journal of thoracic and cardiovascular surgery Ono, Y., Hoashi, T., Imai, K., Okuda, N., Komori, M., Tanimoto, K., Kurosaki, K., Ichikawa, H. 2022

  Abstract

  The objectives of this study was to compare the long-term outcomes of anatomic repair using atrial switch with the Rastelli procedure versus physiological repair with left ventricle-to-pulmonary artery conduit for patients with levo-transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction.Of patients with levo-transposition of the great arteries who underwent biventricular repair between 1978 and 2001, 31 hospital survivors after anatomic repair of atrial switch and the Rastelli (anatomic group) and 14 hospital survivors after physiological repair with left ventricle-to-pulmonary artery conduit (physiological group) were enrolled. Survival rates, reoperation rates, and most recent conditions were compared.The overall survival rate at 20 years was 79.7% (95% CI, 66.4%-95.6%) in the anatomic group and 85.1% (95% CI, 68.0%-100%) in the physiological group (P = .87). The reoperation rate at 10 years was 19.8% (95% CI, 5.6%-34.0%) in the anatomic group and 52.0% (95% CI, 25.0%-79.1%) in the physiological group (P = .067). Only patients in the physiological group underwent systemic tricuspid valve replacement. The anatomic group showed a better cardiac index at catheterization (2.79 ± 0.75 L/min/m2 vs 2.30 ± 0.54 L/min/m2; P = .035), lower serum brain natriuretic peptide (73 ± 86 pg/mL vs 163 ± 171 pg/mL; P = .024), and better maximal oxygen uptake in the treadmill test (64.1 ± 16.5% vs 52.7 ± 17.8% of predicted normal; P = .036), although the period until most recent catheterization, blood inspection, and treadmill testing were earlier in the anatomic group.Preservation of the left ventricle as the systemic ventricle using anatomic repair contributes to better cardiopulmonary condition compared with physiological repair.

  View details for DOI 10.1016/j.jtcvs.2022.08.018

  View details for PubMedID 36241450

• Early Outcomes of Intuity Rapid Deployment Aortic Valve Replacement Compared With Conventional Biological Valves in Japanese Patients. Circulation journal : official journal of the Japanese Circulation Society Ono, Y., Yajima, S., Kainuma, S., Kawamoto, N., Tadokoro, N., Kakuta, T., Koga-Ikuta, A., Fujita, T., Fukushima, S. 2022

  Abstract

  This study aimed to elucidate the short-term surgical outcomes and hemodynamics of the Intuity valve compared to the standard bioprosthesis in Japanese patients.Methods and Results: Among the 307 consecutive patients who underwent aortic valve replacement (AVR) between February 2019 and March 2021, the Intuity valve was implanted in 95 patients (Intuity group) and a conventional stented bioprosthesis was implanted in 193 patients (conventional group). After propensity score matching, there was no significant difference in in-hospital mortality between the Intuity (n=2, 3%) and conventional groups (n=0, P=0.490). Operation, cardiopulmonary bypass, and aortic cross-clamping times were significantly shorter in the Intuity group. Although the effective orifice area index, trans-prosthetic mean pressure gradient, and peak velocity were similar between the 2 groups at 1 week postoperatively, the Intuity group showed a better mean pressure gradient and peak velocity at 1 year postoperatively. Complete atrioventricular block requiring permanent pacemaker implantation developed in 2 patients (3%) in the Intuity group and none in the conventional group (P=0.476). Mild or greater paravalvular leakage was present in 8 patients (13%) in the Intuity group and 2 patients (3%) in the conventional group (P=0.095).AVR using the Intuity valve in Japanese patients is satisfactory, with a better valve performance and a low incidence of complete atrioventricular block at 1 year postoperatively.

  View details for DOI 10.1253/circj.CJ-21-0959

  View details for PubMedID 35569971

• Impact of right ventriculotomy for tetralogy of Fallot repair with a pulmonary valve-sparing procedure. JTCVS open Ono, Y., Hoashi, T., Imai, K., Okuda, N., Komori, M., Kurosaki, K., Ichikawa, H. 2022; 9: 191-205

  Abstract

  The study objectives were to reconfirm the superiority of the pulmonary valve-sparing procedure versus the transannular patch procedure for repair of tetralogy of Fallot and to evaluate the influence of a right ventriculotomy in the pulmonary valve-sparing procedure.Between 1978 and 2003, 440 patients (aged <10 years) underwent tetralogy of Fallot repair. Of these patients, 242 (55.0%) underwent the transannular patch procedure, 106 (24.1%) underwent the pulmonary valve-sparing procedure without right ventriculotomy, and 92 (20.9%) underwent the pulmonary valve-sparing procedure with right ventriculotomy. End points focused on adverse events and included all-cause mortality, reoperation, catheter intervention, and symptomatic arrhythmias. To compare the outcomes of pulmonary valve sparing with and without right ventriculotomy, inverse probability weighting was applied to adjust for potential confounding factors.The median follow-up period was 20.3 years (interquartile range, 10.7-27.6). In all cohorts, the pulmonary valve-sparing procedure was the independent factor that reduced adverse events after tetralogy of Fallot repair (hazard ratio, 0.47; 95% confidence interval, 0.23-0.94; P = .033). After weighting, there was no difference in overall survival or event-free survival in the pulmonary valve-sparing with and without right ventriculotomy group. However, the pulmonary valve-sparing with right ventriculotomy group exhibited a larger cardiothoracic ratio (beta: 6.01; 95% confidence interval, 2.36-9.66; P = .001), lower medication-free rate (odds ratio, 0.29; 95% confidence interval, 0.098-0.79; P = .019), and higher New York Heart Association functional classification (odds ratio, 2.99; 95% confidence interval, 1.36-6.80; P = .007) at the latest follow-up.Right ventriculotomy for tetralogy of Fallot repair with pulmonary valve-sparing did not increase major adverse events. However, negative impacts on current status cannot be ignored.

  View details for DOI 10.1016/j.xjon.2021.10.061

  View details for PubMedID 36003424

  View details for PubMedCentralID PMC9390402

• Successful Staged Repair for Truncus Arteriosus With Anomalous Arch Vessels and Left Coronary Artery WORLD JOURNAL FOR PEDIATRIC AND CONGENITAL HEART SURGERY Ono, Y., Hoashi, T., Kurosaki, K., Ichikawa, H. 2019; 10 (5): 643-644

  Abstract

  A patient was born with truncus arteriosus type 2, left aortic arch, anomalous origin of arch vessels, left coronary artery from the right common carotid artery, and multiple extracardiac anomalies. Surgery involving translocation of the left coronary artery to the truncal root, division of branch pulmonary arteries from the truncal artery, and right ventricle-to-branch pulmonary arteries conduit placement was performed at the age of four months. Closure of the ventricular septal defect using a one-way fenestrated patch and conduit upsizing was performed successfully when the patient reached four years of age.

  View details for DOI 10.1177/2150135119857705

  View details for Web of Science ID 000490595000020

  View details for PubMedID 31496398