Report on Iki Adachi, MD - Fontan Prize Winner 2006
By Dr. S. Yen Ho, Head of Cardiac Morphology, National Heart & Lung Institute, Imperial College London and Royal Brompton & Harefield Hospitals, London, UK
Dr Adachi arrived at the Cardiac Morphology Unit, Royal Brompton Hospital, London, in October 2006. He has settled in very well and began his stay by completing manuscripts based on his previous work in Japan. During this time he had 6 accepted by peer reviewed journals (see list below). He also participated in writing a review article with members of the Cardiac Morphology team. This has also been accepted for publication.
Following ethical approval in 2007, Dr Adachi has carried out a research project on the finer details of morphology of hearts with atrioventricular septal defect. The results are currently under analysis and writing up. He has also begun laboratory work his main project which received ethical approval a few months ago. Tissue collection is progressing well. Histological sections have been prepared from the initial cases and we anticipate completing the series over the next two months. We have planned another study, on Ebstein anomaly and will be submitting the study for ethical consideration in September. By October, Dr Adachi will have completed his year under the Fontan fellowship award. He will be staying on as a researcher in the Cardiac Morphology Unit for another year in order to complete the study on his main project.
Ongoing studies
1. Histopathology of the atria relevant to arrhythmogenic substrates
Whereas atrial tissue degeneration has been nominated as key substrate for arrhythmia development in the normally structured heart, very little is known about atrial remodelling in congenital heart disease. Atrial tissues removed from patients undergoing congenital heart surgery will be investigated to seek any underlying mechanisms leading to arrhythmic generation.
2. Morphologic investigation of hearts with Ebstein’s anomaly
Plication of the “atrialised” right ventricle is a procedure of choice in adolescent and adult patients with Ebstein’s anomaly. This procedure is likely to restore right ventricular function, however its influence on the left ventricle is not well known. To provide insight about this issue, morphologic investigation will be done.
Accepted manuscripts since October 2006
Original articles
Adachi I, Yagihara T, Kagisaki K, Hagino I, Ishizaka T, Kobayashi J, Kitamura S, and Uemura H. Preoperative small pulmonary artery did not affect the midterm results of Fontan operation. Eur J Cardiothorac Surg. 2007;32:156-62
*This paper was presented at the EACTS meeting in Stockholm 2006.
Uemura H, Kagisaki K, Adachi I, Takeda K, Hagino I, Yagihara T, Kitamura S. Aortic valvar involvement in patients undergoing closure of ventricular septal defect via the pulmonary trunk. Int J Cardiol. 2007 in press
Case reports
Adachi I, Ishibashi-Ueda H, Yagihara T, Kagisaki K, Hagino I, Ishizaka T, Uemura H. Immunohistology of pedicled autologous pericardium 9 years after implantation for an extracardiac conduit in Fontan pathway -comparison with in-situ pericardium and pulmonary arterial tissue from the same patient-. J Thorac Cardiovasc Surg. 2007;133:1101-3
Adachi I, Kagisaki K, Yagihara T, Hagino I, Ishizaka T, Kobayashi J, Kitamura S. Unroofing aortic intramural left coronary artery arising from right pulmonary artery. Ann Thorac Surg. 2007 in press
Uemura H, Adachi I, Kagisaki K, Shikata F, and Yagihara T. Intermediate results after a modified Yasui procedure with the Lecompte maneuver. Ann Thorac Surg. 2007;84:284-6
Uemura H, Yagihara T, Adachi I, Kagisaki K, and Shikata F. Conversion to total cavopulmonary connection after failed one and one-half ventricular repair. Ann Thorac Surg. 2007;84:666-8
Editorials
Matsui H, Adachi I, Uemura H, Gardiner H, Ho Y. Anatomy of coarctation, hypoplastic, and interrupted aortic arch: relevance to interventional/surgical treatment. Expert Rev Cardiovasc Ther. 2007 in press
Manuscripts in preparation/submission
Original articles
Adachi I, Ho SY, McCarthy K, Uemura H. Morphologic investigation of the hearts specimens with atrioventricular septal defect -comparison among hearts with different levels of intracardiac shunting- (tentative title).
Uemura H, Ho SY, Adachi I, Yagihara T. Morphologic spectrum of ventriculo-arterial connections in hearts with double inlet left ventricle: implications for surgical procedures.
Uemura H, Ho SY, Adachi I, Yagihara T. Is the morphologically mitral valve in discordant atrioventricular connections always normal?
Qualifications obtained
United States Medical License Examination: Step 1 (Basic medicine)
passed in June 2007 with 2-digit score of 94 (greater than 90 percentile)
