We conducted a high-risk redo mitral valve replacement through a right mini-thoracotomy without rib spreading (redo-MICS MVR) under systemic hyperkalemia combined with circulatory arrest to circumvent complications associated with cardioplegia delivery. The patient, a 75-year-old man, had a predicted mortality rate of 20%. Initial antegrade cardioplegia successfully induced cardiac arrest, which was administered every 30 min.
View Article and Find Full Text PDFSevere pulmonary vasoconstriction induced by protamine is a rare complication. We report a case of a 77-year-old male patient with a history of mitral valve plasty (MVP). He underwent redo MVP via right thoracotomy under the totally endoscopic procedure (MICS redo-MVP).
View Article and Find Full Text PDFThe surgical management of prosthetic valvular endocarditis (PVE) can be challenging. We report a case of a 46-year-old female patient who had a history of four cardiac operations. We chose a mitral valve replacement via right thoracotomy to enable optimal exposure of the mitral valve (MV).
View Article and Find Full Text PDFChronic limb-threatening ischemia (CLTI) is associated with a short-term risk of limb loss. Multidisciplinary teams are often involved in CLTI treatment; however, in Asian countries, multidisciplinary teams that include podiatrists specializing in foot wounds and vascular surgeons who can perform distal bypass surgery are lacking. We investigated predictive factors for limb salvage and foot ulcer recurrence in patients with CLTI treated by a Japanese single-center intensive multidisciplinary team over 6 years.
View Article and Find Full Text PDFWe herein report a unique case of aortic rupture due to co-localization of aortic intimal myofibroblastic sarcoma (IMFS) and urothelial carcinoma (UC). A 76-year-old man who was being followed up after surgery for UC 5 years earlier developed aortic rupture and underwent emergency surgery. Intraoperatively, a tumorous mass on the luminal side of the aortic arch was found near the rupture.
View Article and Find Full Text PDFTo prevent graft injury at the thoracic surgery after coronary artery bypass grafting (CABG), thymus is often used to cover the grafts. We report a thymoma that developed 12 years after CABG in a 65-year-old woman. The patient had undergone percutaneous coronary intervention (PCI) with stenting of the left anterior descending( LAD) artery, 13 years ago, and a 4-vessel CABG, 12 years ago.
View Article and Find Full Text PDFObjective: The midterm outcomes and aortic remodeling after thoracic endovascular aortic repair (TEVAR) for uncomplicated type B aortic dissection (TBAD) were evaluated.
Methods: Forty-seven patients (mean age 66 ± 12 years) who underwent TEVAR for uncomplicated TBAD with double-barrel type from January 2012 to December 2017 were retrospectively analyzed. The indication for TEVAR for entry closure was a maximum aortic diameter > 40 mm with a patent false lumen.
An analysis of rabbit cryopreserved aortic allografts excised on postoperative days (POD) 2, 5, 11, 60, 210, 360, and 720, as well as controls that were untransplanted native aortas and cryopreserved aortas, was performed. On POD2, the number of medial smooth muscle cells in the allografts was reduced to approximately 50%. Ki-67 analysis revealed that medial smooth muscle cells in the allografts proliferated from the 2nd day.
View Article and Find Full Text PDFThis report documents the sudden onset of aortic regurgitation (AR) by an exceptional cause. A 68-year-old woman suddenly experienced general fatigue, and AR was diagnosed. One year later, we performed aortic valve replacement.
View Article and Find Full Text PDFA 73-year-old woman with a 10-year history of myelodysplastic syndrome (MDS) had severe aortic regurgitation (AR) and an ascending thoracic aortic aneurysm (TAA) with a maximum diameter of 55 mm. By retrograde cerebral perfusion (RCP) in the patient under deep hypothermic circulatory arrest (DHCA), we replaced the ascending aorta graft and aortic valve. After surgery, we periodically administered granulocyte colony-stimulating factor (GCSF) with platelet aggregation.
View Article and Find Full Text PDFGen Thorac Cardiovasc Surg
May 2011
A 72-year-old woman complaining of dyspnea on effort was diagnosed as having mitral regurgitation (MR). Asymptomatic jaundice had initially been noticed during primary school, and an examination had shown hyperbilirubinemia. After the diagnosis of constitutional jaundice, she had remained well without further examination or medical treatment.
View Article and Find Full Text PDFA-79-year-old woman underwent percutaneous coronary intervention (PCI) to the right coronary artery (RCA) for effort angina, followed by intravascular ultrasonography (IVUS) to ascertain stent expansion. The IVUS catheter became entangled in the stent and could not be withdrawn from the outside. The patient was transferred to our hospital for its surgical removal.
View Article and Find Full Text PDFThree patients had severe abdominal pain of sudden onset. Computed tomography showed localized dissection in the superior mesenteric artery in two patients and in the celiac artery in one. With conservative therapy abdominal symptoms were self-remitted.
View Article and Find Full Text PDFInteract Cardiovasc Thorac Surg
January 2010
A 76-year-old female had suffered from distal arch aortic aneurysm and chronic DeBakey IIIB type dissecting aneurysm. The patient underwent thoracic endovascular aortic repair (TEVAR). After TEVAR the patient had a motor and proprioceptive loss on the left side and a pain and body temperature loss on the right side below the level of T7.
View Article and Find Full Text PDFEur J Cardiothorac Surg
June 2009
A 58-year-old female was referred to our hospital with an abnormal shadow on her chest X-ray. Further examination revealed the left anterior descending coronary artery to pulmonary artery fistula with aneurysms. The patient was successfully repaired with operation and had no residual fistulas and aneurysms.
View Article and Find Full Text PDFInteract Cardiovasc Thorac Surg
February 2009
A 67-year-old female had suffered from fatigue and palpitation. Cardiac examination revealed coronary sinus atrial septal defect, moderate mitral and tricuspid regurgitation, coronary artery disease, and supraventricular tachycardia with paroxysmal atrial fibrillation. Surgical repair of the anomaly, regurgitant valves, and arrhythmia associated with coronary revascularization was successfully performed and the patient has been doing well in normal sinus rhythm.
View Article and Find Full Text PDFAsian Cardiovasc Thorac Ann
October 2008
In total aortic arch replacement, distal aortic anastomosis is often remarkably difficult because of the deep operative field. Once bleeding from the anastomotic area occurs, it is intractable not only because of technical problems but also decreased coagulability due to deep hypothermia and the fragility of the aortic wall. We describe a simple but reliable strategy for distal anastomosis, which is unique with regard to the approach to the anastomotic area and the anastomotic method.
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