Retrieving a lost needle in the descending aorta during hemi-arch replacement.

A 73-year-old man diagnosed with moderate aortic insufficiency and dilatation of the aortic root and ascending aorta underwent a modified Bentall procedure and hemi-arch aortic replacement. During open distal anastomosis of the ascending aorta, the surgical needle was lost. Because of circulatory arrest, the operation was continued; before closing the chest, radiography and a transesophageal echo were located in the needle in the descending aorta.

[Mitral Valve Surgery for a Patient with Mediastinal Shift after Left Pneumonectomy:Report of a Case].

A 70-year-old patient who survived about 40 years after left pneumonectomy for tuberculosis visited emergency hospital, because of dyspnea. She received suitable medical therapy for atirial fibrillation and severe mitral regurgitation and hesitated heart surgery because of anxiety for surgical risk. The computed-tomography showed mediastinal shift to left and right lung compensatory expansion.

Do meteorological factors influence the occurrence of acute aortic dissection? A 10-year retrospective institutional study.

Objective: This study aimed to clarify the relationship between meteorological factors and the occurrence of aortic dissection.

Methods: The study included 282 consecutive patients who were admitted to our institute with acute aortic dissection over a 10-year period. The local meteorological data over the same period were analyzed.

Clostridium septicum-infected Stanford type A acute aortic dissection: a case report.

Background: Thoracic aortitis caused by Clostridium septicum is a rare infection with a strong association with malignancy and high mortality rate when left untreated. We report a case of surgical treatment for Stanford type A acute aortic dissection in a patient with C. septicum sepsis and thoracic aortitis.

The role of angiographic follow-up after percutaneous coronary intervention.

In the early days of coronary angioplasty, follow-up coronary angiography was often performed to assess restenosis. Angiographic restenosis has been shown to be associated with worse clinical outcomes, though the exact causality has yet to be determined. Numerous studies have repeatedly demonstrated that routine follow-up coronary angiography increases the incidence of target lesion revascularization without a clear reduction in mortality or myocardial infarction.

[Coronary Artery Bypass Grafting for In-stent Restenosis Probably Caused by Allergic Response;Report of a Case].

A 58-year-old female presented to our hospital with recurrence of chest pain. She had undergone coronary intervention using biolimus-eluting-stent for total occlusion of the left anterior descending artery(LAD) 3 years before. Since then in-stent restenosis had repeated 4 times in 3 years.

En-bloc free gastroepiploic artery graft provides a good long-term patency rate.

For coronary artery bypass grafting, the use of free gastroepiploic artery is unpopular because of its tendency to vasospasm. We assessed the en-bloc free gastroepiploic artery graft, which has the gastroepiploic vein anastomosed to the right atrial appendage to prevent graft spasm, and compared it to the skeletonized free gastroepiploic artery graft. A retrospective review was conducted in 57 patients who received en-bloc grafts and 29 who had skeletonized grafts.

[Method of proximal anastomosis with a new assist device].

Various devices have been invented for proximal anastomosis performed during coronary bypass surgery. Enclose II allows a handling of the needle to be similar to a single cross clamp proximal anastomosis with almost no blood loss. However, when creating the anastomotic hole, it is difficult to determine whether an incision into the aortic wall will extend to the intima, and in some instances there is a risk that the hemostatic membrane may be injured.

Transplantation of the free gastroepiploic artery graft for myocardial revascularization: long-term clinical and angiographic results.

Background: Use of the free gastroepiploic artery (GEA) graft for coronary revascularization is not very popular because of its tendency to vasospasm. We hypothesize that the cause of free GEA spasm is graft damage caused by an interruption of venous drainage from the graft. To overcome this problem, we anastomosed the accompanied gastroepiploic vein to the right atrial appendage simultaneously with the GEA grafting in the aortocoronary position.

Spontaneous restoration of patency in the free gastroepiploic artery graft: the living transplanted vascular system for coronary revascularization.

We report an incidence of coronary revascularization with the gastroepiploic artery in which angiography demonstrated patency at 1 month, severe narrowing at 1 year, and restoration of patency associated with progression of proximal coronary disease at 8 years. This report documents the reversibility of the free gastroepiploic artery.

On-pump beating-heart coronary artery bypass: a propensity matched analysis.

Background: It remains unclear how cardioplegic arrest affects surgical results after coronary artery bypass grafting surgery (CABG). This study compares early outcomes after on-pump beating-heart CABG and conventional CABG.

Methods: From 2002 to 2005, 114 patients underwent on-pump beating-heart CABG.

Aortic valve replacement with a 16-mm CarboMedics valve in adult patients.

Management of the small aortic root is a significant problem for the surgeon with regard to operative technique and selection of the prosthesis. We report on four adults with a small aortic root who underwent aortic valve replacement with a 16-mm CarboMedics bileaflet valve. All patients now lead normal lives.