A Case of High-Risk Myelodysplastic Syndrome Revealed After Emergent Aortic Surgery.

The outcomes of cardiac surgery in patients with hematologic disorders are significantly worse. However, details of the clinical course of each hematologic disease remain unclear. Myelodysplastic syndrome (MDS) presents with progressive pancytopenia that has the risk of infection, hemorrhage, and transformation to acute myelogenous leukemia.

Surgical Treatment of Simultaneous Common Femoral and Profunda Femoris Artery Aneurysms.

Profunda femoris artery aneurysms (PFAAs) are rare because of the histo-anatomical characteristics of the profunda femoris arteries. We present a case of simultaneous PFAA and common femoral artery aneurysm (CFAA) incidentally detected on computed tomography in a 58-year-old man with diverticular bleeding. Images revealed a 37-mm right PFAA and a 24-mm right CFAA.

Coil Embolization for a New Ulcer-Like Projection Near the Distal Anastomosis After a Hemiaortic Arch Replacement.

Ulcer-like projections (ULPs) with a tendency to enlarge are at risk of aortic events such as new dissection, aneurysmal formation, or rupture and require therapeutic intervention. However, what should be done after open chest surgery when standard thoracic endovascular aortic repair (TEVAR) cannot be performed is debatable. Here, we present a case of coil embolization of a newly enlarged ULP that was not amenable to TEVAR following a hemiarch aortic arch repair.

Giant Pheochromocytoma Resection Using Partial Cardiopulmonary Bypass and Blood Purification Therapy.

A 44-year-old man was diagnosed with a giant pheochromocytoma in the right retroperitoneal cavity following treatment for heart failure. Subsequent to improvement in cardiac function, the patient underwent a laparotomy to excise the tumor. Due to its considerable size, partial cardiopulmonary bypass and blood purification therapy were initiated to stabilize hemodynamics during the surgical intervention.

Right Parasternal Approach for Aortic Valve Replacement After Presternal Gastropexy.

Due to bicuspid aortic valve aortic stenosis, a 78-year-old man with a history of esophagectomy and presternal gastric tube reconstruction required aortic valve replacement (AVR). AVR with a bioprosthetic valve was performed through a right parasternal thoracotomy. Despite the unfavorable conditions for conventional median sternotomy, AVR was successfully performed through an alternate approach.

Bailout Procedure Utilizing Balloon Dilatation for a Percutaneous Micro-axial Flow Pump Entrapped Within a Significantly Calcified Subclavian Artery.

The IMPELLA 5.5 (Abiomed Inc., Danvers, Massachusetts, United States) is a catheter-based, micro-axial blood pump designed to enhance organ perfusion in patients with cardiogenic shock.

Cell Type-Specific Relationships Among Immune Cells in Human Aortic Dissection Tissue.

Background: Although recent studies have revealed the importance of inflammation in the pathogenesis of aortic dissection (AD), little is known about the relationships among inflammatory cells in human AD tissue.

Methods And Results: We assessed the relationships among various immune cell types, including neutrophils, macrophages (M1 and M2), B cells, and helper T cells (Th1, Th2, Th17, Treg and Tfh ) in human AD tissue. AD tissues displayed abundant infiltration of immune cells.

Delayed migration of a Sapien 3 Ultra Resilia following transcatheter aortic valve implantation after selection of a smaller-sized valve.

This report discusses a rare case of delayed migration of a Sapien 3 Ultra Resilia (S3UR) valve following transcatheter aortic valve implantation. An 81-year-old Japanese woman had a borderline aortic annular size of 20-23 mm according to the manufacturer's size chart. We chose to implant a smaller S3UR of 20 mm with an 80/20 depth ratio to allow for a second intervention, ensuring good hemodynamics and minimizing paravalvular leak.

Aortoesophageal fistula due to esophageal cancer: a case report of successful management.

Background: Aortoesophageal fistula (AEF) is a rare but potentially life-threatening condition. The best treatment for the AEF due to esophageal carcinoma is still unresolved. Here, we report a rare case of AEF caused by esophageal cancer, that was successfully treated with emergency thoracic endovascular aortic repair (TEVAR), followed by esophagectomy and gastric tube reconstruction.

Postoperative anticoagulation management using subcutaneous unfractionated heparin for a patient with nonbacterial thrombotic endocarditis: a case report.

Nonbacterial thrombotic endocarditis (NBTE) presents nonbacterial vegetation on cardiac valves. NBTE requires appropriate anticoagulant therapy to prevent recurrence after surgery. However, there has not yet been established evidence for anticoagulant therapy in NBTE, and low molecular weight heparin is not approved in Japan.

Early thrombus formation including hypo-attenuated leaflet thrombosis after surgical bioprosthetic aortic valve replacement.

Objective: To assess the occurrence, predictors, and outcomes of hypo-attenuated leaflet thickening (HALT) and thrombus outside the prosthetic valve following surgical aortic valve replacement.

Methods: A total of 118 patients underwent surgical aortic valve replacement with bioprosthetic valves between July 2020 and June 2022. Sixty-two (52.

Preoperative management using Impella support for acute aortic dissection with left coronary malperfusion: a case report.

Background: Acute aortic dissection (AAD) with impaired perfusion of the left coronary artery has a poor prognosis, even after urgent radical aortic surgery, due to extensive myocardial damage. Although Impella, a microaxial-flow catheter pump, is useful in managing acute myocardial infarction, it is generally contraindicated in patients with AAD because it is an intra-aortic device and the aortic structure is compromised in these cases. Here, we introduce a novel intervention that allowed a planned aortic repair after managing circulation using Impella and venoarterial extracorporeal membrane oxygenation in a case of AAD with left main trunk malperfusion.

A Case of Andexanet Alfa Induced Heparin Resistance in Emergent Aortic Surgery: Successful Anticoagulation Management Using Antithrombin Administration.

Andexanet alfa (AnAl) is utilized for the urgent reversal of direct oral anticoagulants (DOACs) in cases of severe bleeding. While the guidelines from the Society of Thoracic Surgeons recommend AnAl for urgent cardiac surgery in patients treated with DOACs, concerns persist regarding the potential of AnAl to induce heparin resistance. This report details the case of an 85-year-old woman diagnosed with acute type A aortic dissection, who received AnAl due to prior edoxaban use.

Large Thrombus Entrapped in a Patent Foramen Ovale during Inferior Vena Cava Filter Protection for Venous Thromboembolism.

. A large thrombus entrapped in the patent foramen ovale (PFO) is an extremely rare condition. Moreover, it is considered even rarer after temporary inferior vena cava filter (TIVCF) placement for the prevention of fatal pulmonary embolism due to venous thromboembolism (VTE).

Heyde-like syndrome occurring for the first time following aortic valve replacement with a bioprosthesis: a case report.

Background: Heyde's syndrome is known as a combination of gastrointestinal (GI) bleeding and aortic valve stenosis. However, there are no reports of an association between GI bleeding and bioprosthetic valve stenosis initially occurred after aortic valve replacement (AVR), even though there are several reports that GI bleeding due to native aortic valve stenosis disappeared after AVR, and GI bleeding recurred due to bioprosthetic valve stenosis or patient-prosthesis mismatch.

Case Presentation: An 80-year-old woman who was on hemodialysis for 13 years had undergone AVR with a bioprosthetic valve for aortic regurgitation 3 years prior.

Cusp overlap technique decreases paravalvular leakage in self-expandable transcatheter aortic valve replacement.

The cusp overlap technique allows greater visual separation between the basal annular plane and the conduction system and decreases the permanent pacemaker implantation rate. We assessed the impact of the cusp overlap technique on conduction disturbance and paravalvular leakage after transcatheter aortic valve replacement. A total of 97 patients underwent transfemoral transcatheter aortic valve replacement with self-expandable valves at our institution from November 2018 to January 2023.

Review of Implantable Left Ventricular Assist Devices.

Mechanical circulatory support has been an indispensable treatment for severe heart failure. While the development of a total artificial heart has failed, left ventricular assist devices (LVAD) have evolved from extracorporeal to implantable types. The first generation implantable LVAD (pulsatile device) was used as a bridge to transplantation, and demonstrated improvement in survival rate and activity of daily living.

Total arch replacement for the enhanced-fibrinolytic-type disseminated intravascular coagulation patient with endoleak after thoracic endovascular aortic repair for aortic dissection.

Background: Endoleaks after stent graft treatment can cause disseminated intravascular coagulation (DIC), leading to a bleeding tendency.

Case Presentation: A 69-year-old man received thoracic endovascular aortic repair (TEVAR) for acute type B aortic dissection. After that, he developed bleeding tendency, and the diameter of his distal aortic arch increased.