[Infective Endocarditis Caused by Abiotrophia defectiva Required Double-valve Replacement Using the Manouguian Procedure].

A 39-year-old man was presented with infective endocarditis caused by Abiotrophia defectiva. Transesophageal echocardiography revealed extensive vegetation and destruction extending from the aortic valve to the aortic-mitral curtain and mitral valve accompanied by severe regurgitation of the aortic and mitral valves. After removal of vegetation, double-valve replacement were performed with double patch and mechanical prosthesis using the manouguian procedure.

Emphysematous aortic arch aneurysm infected with : A case report.

Infected aortic aneurysm is a relatively rare disease that is extremely difficult to manage, resulting in a poor prognosis. We rescued a patient with Salmonella-infected aortic arch aneurysm surrounded with a specific and massive emphysema, despite experiencing aortic rupture, including delayed esophageal perforation after surgery.

Blunt cardiac rupture due to kicking on the lateral side of the right chest.

Blunt cardiac rupture can be caused by an indirect blow to the heart during sports. Clinicians should consider the possibility of cardiac injury regardless of the severity of trauma. Confirming the diagnosis and reaching a decision to operate as soon as possible is the only way to rescue the patient.

Combined treatment for a large primary cardiac sarcoma: a case report.

Background: Undifferentiated pleomorphic sarcoma (UPS) as a primary cardiac tumor is rare, with extremely poor prognosis owing to high recurrence and invasion. We encountered a patient who presented with a primary cardiac tumor incarcerating the mitral valve and who was in a shock state.

Case Presentation: A 41-year-old man was transported emergently to our hospital owing to acute respiratory distress and hemoptysis.

[Severe aortic valve stenosis combined with a large brain tumor; report of a case].

We report a case of severe aortic valve stenosis with a large benign brain tumor (meningioma), which was successfully treated with simple replacement with a mechanical valve under extracorporeal circulation (ECC). A large meningioma is considered as a risk in an operation under ECC because it may increase intracranial pressure and cause bleeding. In this case we chose a simple method of aortic valve replacement for the purpose of shortening the ECC time.

[Three cases of cardiac tumor; an approach to excise a large tumor in the left atrium].

Tumors originated from the heart are very rare disease and their clinicopathological state has not been fully recognized. Cardiac tumors are most frequently found in the left atrium. An initial treatment is a surgical excision of tumors entirely including their pedicles.

Life-threatening acute heart failure due to primary cardiac undifferentiated pleomorphic sarcoma.

A 41-year-old man was admitted with acute heart failure and shock status. An echocardiogram showed a mobile tumor obstructing blood flow through the mitral valve with a stalk on the posterior left atrium (LA) wall. Emergent open-heart surgery was performed to resect the tumor (77×36×30 mm).

Troponin elevation after radiofrequency catheter ablation of atrial fibrillation: relevance to AF substrate, procedural outcomes, and reverse structural remodeling.

Background: Although radiofrequency ablation creates myocardial necrosis leading to troponin T (TnT) release into the systemic circulation, the significance of TnT elevation after atrial fibrillation (AF) ablation is unknown.

Objective: To demonstrate a possible mechanism of reverse structural remodeling in the left atrium (LA) by evaluating postprocedural TnT elevation.

Methods: This study included 106 patients with an enlarged LA (paroxysmal AF, n = 43; persistent AF, n = 63).

Sex difference in peripheral arterial response to cold exposure.

Background: In Japan, there is a symptom commonly referred to as "Hie-sho", which is a feeling of coldness or chill in a particular part of the body, and it can sometimes be unendurable. This phenomenon is known to occur more frequently in women. The present study used synchrotron radiation micro-angiography (SRMA) to examine the hypothesis that this feeling is derived from a sex difference in the vascular response to coldness.

Cigarette-smoke-induced vasoconstriction of peripheral arteries: evaluation by synchrotron radiation microangiography.

Background: Although cigarette smoking is thought to constrict peripheral vessels, details have not been clarified because of the limitation of spatial resolution in conventional X-ray angiography systems. Synchrotron radiation microangiography can identify small arteries down to 50 microm in diameter.

Method And Results: Male Wistar rats (n=9) were made to smoke a cigarette using the modified Griffith snout exposure system.

A GIS-based zoning of illegal dumping potential for efficient surveillance.

To assist in the efficient surveillance against illegal dumping, this study examined and evaluated two methods to illustrate the illegal dumping potential of sites using GIS (Geographic Information System) data. One approach focused on the occurrence of illegal dumping sites; the other on the size of the illegal dumping. Both approaches to zoning were implemented for the Kanto region of Japan, utilizing seven or eight major geographical attributes most closely related to illegal dumping.

[Stickler syndrome with rapidly progressive mitral valve regurgitation: report of a case].

A 36-year-old man with Stickler syndrome who underwent mitral valve replacement for rapidly progressive mitral regurgitation due to prolapse of an anterior leaflet. Stickler syndrome is a relatively rare condition caused by a defective collagen gene and characterized by high myopia, sensorineural-hearing deficit and flattened facial features. The prevalence of mitral valve prolapse in Stickler syndrome is reported to be much higher than in the general population because of its connective tissue dysplasia.

Complex intimal flaps in acute aortic dissection.

A 43-year-old man was emergently admitted and diagnosed as acute aortic dissection (Stanford type A). While being prepared for emergent operation he fell into hemodynamic hazard with repeated ventricular fibrillation and loss of consciousness. Massive aortic regurgitation and coronary disturbance due to a back-and-forth movement of an intimal flap through the aortic valve were the causes of the cardiogenic catastrophy.

Aortic dissection in an elderly patient with atrial septal defect.

We report a case of acute aortic dissection that occurred in the late course of surgically untreated atrial septal defect. A 60-year-old man with acute aortic dissection and atrial septal defect was operated on successfully, and we discuss the causal relationship between these two unusual conditions.

[A case of CABG under the cardiac arrest induced by a short acting beta-blocker without clamping the aorta].

A seventy one year old woman had a coronary artery bypass grafting. No touch technique to her ascending aorta was applied due to the severely atherosclerotic aorta. Cardiac arrest was induced by a large dose of short acting beta-blocker (Esmolol) without cross-clamping the aorta under the normothermic cardio-pulmonary bypass.

[Two cases of annulo-aortic ectasia with type A aortic dissection reconstructed by reimplantation of the aortic valve].

We performed aortic valve sparing operation in two cases of annulo-aortic ectasia combined with Type A aortic dissection. Marfan syndrome was found in one case and the dissection was acutely evolving in another case. The aortic valves were observed as normal configuration in both cases and then reimplanted within the synthetic grafts along with the David's procedure.

[A successful repair of ventricular septal defect and patient ductus arteriosus associated with pulmonary hypertension in an infant with left lung agenesis].

We report the first case of successful repair of ventricular septal defect (VSD) and patent ductus arteriosus (PDA) associated with pulmonary hypertension in an infant with left lung agenesis. A 70-days-old infant was referred to our hospital with the diagnosis of congenital heart disease and abnormalities of the left lung. Two-dimensional echocardiogram showed ventricular septal defect and patent ductus arteriosus associated with pulmonary hypertension.

[Subdural hematoma complicated after open heart surgery: a report of two cases with successful treatment].

Two cases of subdural hematoma complicated after open heart surgery were successfully treated during thirty years history of the department. A 45 year-old woman underwent tricuspid valve replacement due to isolated congenital tricuspid insufficiency. On the 27th postoperative day, she was suddenly attacked by headache, and disturbance of consciousness was recognized with gradual deterioration.

[Pseudoaneurysm of the left ventricle after mitral valve replacement: report of two cases without surgical repair].

We report two non-surgical cases of pseudoaneurysm of the left ventricle after mitral valve replacement. Two patients underwent uncomplicated mitral valve replacement with Ionescu-Shiley and Carpentier-Edwards bioprosthesis respectively, and both had good early postoperative course with no symptoms. Left ventriculogram one month after operation showed subvalvular pseudoaneurysm of the left ventricle in both patients.

[A case report of poststernotomy mediastinitis treated with the pectoralis major muscle flap after protracted wound irrigation].

A 8-year-old boy developed mediastinitis after direct closure of atrial septal defect. Methicillin-resistant Staphylococcus aureus (MRSA) was detected from the wound. Intermittent wound irrigation with povidone-iodine solution and vancomycin solution was protracted for two months.

[A case of acute postinfarction mitral insufficiency and cardiogenic shock caused by total rupture of a papillary muscle].

A 61-year-old male in cardiogenic shock was transferred to our hospital with an intra-aortic balloon pumping (IABP). He had had acute posterior myocardial infarction previous day. He had developed progressively increasing dyspnea and physical signs of severe congestive failure.

[Fatal delayed hemolytic transfusion reaction in a postoperative case of traumatic aortic rupture].

A 52-year-old woman with traumatic rupture of the thoracic descending aorta had a history of previous blood transfusion 23 years ago. This time, she received 4,600 ml of blood transfusion during the replacement procedure of thoracic aorta. On the 12th postoperative day, she had acutely progressive severe jaundice, anemia and hepatosplenomegaly.