Multidisciplinary surgical approach for renal cell carcinoma with inferior vena cava tumor thrombus.

Purposes: The optimal surgical management of renal cell carcinoma with tumor thrombus within the inferior vena cava (IVC) remains to be clarified.

Methods: Sixteen consecutive cases were reviewed. Incision, the IVC clamping position, and the venous drainage procedure were modified according to the tumor thrombus extension level: level I or II (below the hepatic vein, n = 8), level III (above the hepatic vein but below the right atrium, n = 5), and level IV (extending into the right atrium, n = 3).

[Intractable Atrial Arrhythmia after Maze Procedure].

Maze procedure has achieved high cure rates and become the surgical golden standard for the treatment of atrial fibrillation. But, atrial arrhythmia after maze procedure is often persistent and drug-resistant. In these cases, diagnosis by electrophysiological study (EPS) and treatment by catheter ablation (ABL) are useful.

[Severe Coronary Artery Spasm after Coronary Artery Bypass Grafting;Report of a Case].

Coronary artery spasm after coronary artery bypass grafting(CABG) is rare and often fatal. There is no established treatment for perioperative coronary spasm because of the rare and not fully understood complications. We report a 67-year-old male, who experienced perioperative spasm of native coronary arteries and the left thoracic artery graft following CABG.

Spinal cord injury following aortic arch replacement.

Purpose: Postoperative spinal cord injury is a devastating complication after aortic arch replacement. The purpose of this study was to determine the predictors of this complication.

Methods: A group of 254 consecutive patients undergoing aortic arch replacement via median sternotomy, with (n = 78) or without (n = 176) extended replacement of the upper descending aorta, were included in a risk analysis.

[Fifteen-year Follow-up of a Patient with Aortitis, Treated by Sino-tubular Junction Plication Using a Prosthetic Tube Graft for Aortic Regurgitation;Report of a Case].

A 43-year-old woman was diagnosed with aortitis associated with mild aortic regurgitation (AR) at the age of 25, which advanced to a severe grade requiring surgical treatment at age 28. Dilation of the sinotubular junction (STJ) was treated with ascending aortic replacement (Hemashield Gold 24 mm), which reduced AR from severe to mild. The patient conceived 9 years later and delivered a baby by cesarean section at 38 weeks of gestation.

[Incomplete Surgical Resection of a Right Ventricular Hemangioma with Asymptomatic Gradual Enlargement for more than a Decade;Report of a Case].

We encountered a case of a cardiac hemangioma protruding into the inner cavity of the right ventricle from the right ventricular free wall. The tumor gradually enlarged over 11 years (from 35 mm to 78mm) without presenting any symptoms. However, when it extended to the right ventricular outflow tract, non-sustained ventricular tachycardia occurred, and emergency surgery was required.

[Aortic Valve Replacement of Quadricuspid Valve with Regurgitation].

Congenital quadricuspid aortic valve is a very rare malformation. In most cases it has been found incidentally at aortic valve surgery or at autopsy. It frequently causes aortic regurgitation, which may become manifest in adulthood and require surgical treatment.

A case of floating thrombus in the ascending aorta that caused recurrent peripheral arterial embolic events.

We report the case of a 62-year-old man with recurrent arterial embolisms to his arms caused by a thrombosis of the ascending aorta. He had developed a left brachial artery embolism 8 years previously, but presented with a right brachial artery embolus on this occasion. A clot-like mass was seen in the ascending aorta on computed tomography without significant atherosclerosis.

Risk-adjusted mortality rate cumulative sum analysis based on the Japan SCORE represents a learning curve in mitral valve reparative surgery.

Purpose: We calculated the cumulative sum analysis of an individual surgical learning curve for mitral valve reconstructive surgery to monitor quality control.

Methods: Between April 2003 and March 2009, 25 consecutive patients underwent mitral valve reconstructive surgery for mitral regurgitation (MR). All operations were performed by a single surgeon.

Long-term results of tissue-engineered small-caliber vascular grafts in a rat carotid arterial replacement model.

The concept of tissue engineered small-caliber vascular grafts (TE-SCVGs) is theoretically ideal. In this study, we evaluated the long-term (more than 1 year) course of TE-SCVGs using a rat carotid arterial replacement model. We fabricated a TE-SCVG scaffold (0.

Collagen type IV-specific tripeptides for selective adhesion of endothelial and smooth muscle cells.

Controlling the balance of endothelial cells (ECs) and smooth muscle cells (SMCs) in blood vessels is critically important to minimize the risk associated with vascular implants. Extracellular matrix (ECM) plays a key role in controlling the cellular balance, suggesting a promising source of cell-selective peptides. To obtain EC- or SMC-selective peptides, we start by highlighting sequence differences found among ECM molecules as enriched targets for cell-selective peptides.

Novel small-caliber vascular grafts with trimeric Peptide for acceleration of endothelialization.

Background: Both rapid endothelialization and the prevention of intimal hyperplasia are essential to improve the patency of small-caliber vascular grafts (SCVGs). Using the peptide array based screening system, we identified the peptide CAG (cysteine-alanine-glycine), which has a high affinity for endothelial cells and a low adhesive property for smooth muscle cells (SMCs). In this article, we report an in vivo analysis of novel vascular grafts that were constructed with a biodegradable polymer (poly-ε-caprolactone [PCL]) containing CAG peptide.

Pathogenesis of paravalvular leakage as a complication occurring in the late phase after surgery.

Paravalvular leakage (PVL) remains an unavoidable late complication after valve surgery. We indicate surgery only cases with progressive congestive heart failure and/or hemolytic anemia. We review our clinical experiences of PVL surgery.

[Primary cardiac angiosarcoma in the left atrium with adrenal metastasis; report of a case].

We encountered a 61-year-old woman with primary cardiac angiosarcoma in the left atrium. On echocardiography, the tumor extended into the atrial septum and mitral valve, and mitral valve stenosis and regurgitation were significant. We resected the tumor protruding into left atrium, and affecting mitral valve.