[Surgical Treatment of Acute Infective Endocarditis after Transcatheter Aortic Valve Replacement].

Infective endocarditis (IE) after transcatheter aortic valve replacement (TAVR) is a rare complication, but has a high mortality. An 86-year-old female with symptomatic severe aortic stenosis underwent TAVR at our hospital and she was discharged without complication after 10 days. She was readmitted with high fever and acute heart failure 1 month later.

In situ coronary-coronary bypass grafting for a huge left coronary aneurysm.

Surgical treatment for an atherosclerotic huge coronary aneurysm is very rare. We have reported 58 years old male who had a huge growing aneurysm in left circumflex coronary artery and underwent aneurysmectomy and coronary-coronary bypass grafting with saphenous vein.

Efficacy of left ventricular restoration with mitral valve surgery for endstage ischemic cardiomyopathy.

Patients with ischemic cardiomyopathy (ICM) are at an extremely high risk of death and ischemic events. This study aims to evaluate the impact of left ventricular restoration (LVR) and mitral valve surgery on the cardiac and clinical functional status of the patients with ICM. Twenty-six patients (46-80 years, mean: 64 years) with severely dilated heart (left ventricular end-systolic volume index: LVESVI > or = 100 ml/m2) who had coronary artery bypass grafting (2.

Left ventricle volume affects the result of mitral valve surgery for idiopathic dilated cardiomyopathy to treat congestive heart failure.

Background: Mitral valve surgery is a recommended treatment for congestive heart failure; however, its effect for idiopathic dilated cardiomyopathy (DCM) with an extremely enlarged left ventricle (LV) is not well documented. We examined our long-term results of mitral valve surgery for idiopathic dilated cardiomyopathy.

Methods: Fifty-five patients of idiopathic dilated cardiomyopathy have undergone mitral valve surgery to treat intractable congestive heart failure since 1998.

Septal anterior ventricular exclusion procedure for idiopathic dilated cardiomyopathy.

Background: Eight-year experience with the septal anterior ventricular exclusion procedure for congestive heart failure due to idiopathic dilated cardiomyopathy was evaluated.

Methods: In 36 patients (27 men and 9 women with a mean age of 60 years) with heart failure; New York Heart Association class III/IV (21/15); and mitral regurgitation 2+ or greater, the procedure was indicated when the diastolic dimension was 75 mm or greater, and the septum was akinetic. A long, narrow oval patch was sutured to form a downsized elliptical left ventricle by excluding the septum and anterior wall.

The "eaves" technique for distal anastomosis in aortic arch replacement.

We describe the "eaves" technique, a new method for distal anastomosis in aortic arch replacement. The 1-cm wide eaves were created at the site 3 to 4 cm distal to the graft end. The graft was bound with vessel tape from the eaves to the site proximal to the origin of the first branch to make a working space above the eaves and to facilitate graft handling.

Impact of ostial stenosis on the Doppler flow profiles in internal thoracic artery graft.

As ostial stenoses of internal thoracic artery (ITA) grafts rarely occur after coronary artery bypass grafting, little is known about their Doppler flow profile. This report describes changes in the Doppler flow of ITA grafts with ostial stenosis after surgical repair of the stenosis. A 54-year-old male underwent coronary artery bypass grafting (CABG) in which the left ITA was anastomosed to the left anterior descending coronary artery.

Rationale for the use of combination angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker therapy in heart failure.

Background: The present multicenter study investigated whether the combination of angiotensin-converting enzyme inhibitor (ACEI) and angiotensin II receptor blocker (ARB) is more beneficial for preventing left ventricular remodeling and suppressing neurohumoral factors than either ACEI or ARB alone.

Methods And Results: One hundred and six patients with mild-to-moderate congestive heart failure treated in 26 Japanese institutes were randomly assigned to the combination therapy or monotherapy. Changes in physical activity (New York Heart Association functional classes, Specific Activity Scale (SAS)), concentrations of neurohumoral factors (plasma renin activity, angiotensin II, aldosterone, and brain natriuretic peptide (BNP)), and cardiac function for 6 months were compared between the 2 groups.

Changes in left anterior descending coronary artery flow profiles after coronary artery bypass grafting examined by means of transthoracic Doppler echocardiography.

Objective: We sought to investigate the changes of velocity profiles in the left anterior descending coronary artery after coronary artery bypass grafting using transthoracic Doppler echocardiography.

Methods: Forty-five patients who received a bypass graft to the left anterior descending coronary artery were studied. Before coronary artery bypass grafting, Doppler velocity profiles of the distal left anterior descending coronary artery were recorded with transthoracic Doppler echocardiography.

Combined aortic valve replacement and coronary artery bypass grafting with in situ arterial grafts for porcelain aorta.

Patients with porcelain aorta carry a high risk of cerebral as well as systemic embolism during cardiac surgery. Here we describe a case of severe aortic stenosis and coronary artery disease combined with the circumferentially calcified aorta. The patient was a 77-year-old man who successfully received four coronary artery bypass grafts with in situ arterial grafts without clamping the aorta and aortic valve replacement.

Relationship between coagulation cascade, cytokine, adhesion molecule and aortic aneurysm.

Objectives: Patients with aortic aneurysm (AA) were in the chronic inflammatory condition and are often combined with disseminated intervascular coagulation. Recent studies demonstrated that atherosclerosis was inflammatory disease. AA and severe atherosclerosis with ulcer formation contain macrophages and T lymphocytes and accelerate the production of interleukin (IL)-2, which activates lymphocytes and lead to further adhesion of leukocytes.

Cost performance and efficacy of off-pump coronary artery bypass grafting.

Off-pump coronary artery bypass grafting (Off-Pump CABG) may provide an alternative form of surgical revascularization by avoiding the unwanted complications of cardiopulmonary bypass, particularly in high-risk patients. To clarify the efficacy and cost performance of Off-Pump CABG, we studied the postoperative course of Off-Pump CABG and compared it to On-pump coronary artery bypass grafting (On-Pump CABG). From Aug.

Acutely dissected aorta: a reliable and leak-proof technique.

When repairing an acutely dissected aorta, a primary concern is bleeding from the anastomotic site. To prevent a hemorrhagic complication, a unique variation of wall reinforcement with xenopericardium together with GRF glue was introduced to provide a leakproof seal for ascending and descending aortic grafts.