Resection of Giant Mycotic Aneurysm in the Tibioperoneal Trunk by Posterior Approach in a Prone Position with Air Tourniquet.

Aneurysms of the tibioperoneal trunk (TPT) with peripheral arterial lesions are extremely rare. We present a case of a 68-year-old man who underwent surgical treatment for a mycotic aneurysm of the TPT. This report highlights the importance of en bloc surgical resection of the mycotic aneurysm and an appropriate approach with an air tourniquet for the prevention of injuries to the adherent tissues.

Recovery rate from conduction disorders in patients with permanent pacemaker implantation after transcatheter aortic valve implantation.

Backgrounds: Permanent pacemaker implantation (PPMI) is one of the greatest disadvantages of transcatheter aortic valve implantation (TAVI). To seek the predictors and clinical impacts of PPMI and investigate the recovery rate from conduction disorders.

Methods: We retrospectively analysed data from 745 consecutive patients who underwent TAVI for severe aortic stenosis from November 2013 to July 2022.

Self-expandable transcatheter valve is a potentially useful option for a failing small surgical aortic bioprosthetic valve.

Objective: Trans-catheter aortic valve implantation inside a failing surgical aortic valve bio-prosthesis has become an alternative for patients at high risk for redo surgical aortic valve replacement. However, the correlation between the size of the failing surgical aortic valve and the occurrence of prosthesis-patient mismatch after trans-catheter implantation is still controversial. The aim of this study is to analyze and report the results in Japanese patients.

Preceding Aortic Bare Stenting for Visceral and Limb Malperfusion before Proximal Surgical Repair of Stanford Type A Aortic Dissection.

Mesenteric malperfusion is a fatal complication of acute aortic dissection, which should rapidly be repaired. However, the optimal treatment strategy remains controversial in patients with type A aortic dissection. We report on a case with aortic bare stenting for visceral and lower limb malperfusion prior to the proximal repair.

Clinically Optimal Neuropsychological Tests for Postoperative Cognitive Dysfunction in Heart Valve Surgeries.

Background: Postoperative cognitive dysfunction (POCD) is widely recognized and reported, but the lack of a uniform definition makes it difficult to evaluate its clinical impact. The aim of this study is to establish the optimal neuropsychological tests and definition of POCD relevant to clinical outcomes in heart valve surgeries.

Methods and results: Between June 2015 and December 2019, 315 patients undergoing elective heart valve surgeries (age ≥65 years) were enrolled.

Mid-Term Outcomes of Late Open Conversion with Endograft Preservation for Sac Enlargement after Endovascular Abdominal Aortic Aneurysm Repair.

Background: Late open conversion has sometimes been required for sac enlargement after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm. Though the open repair with endograft preservation is considered less invasive compared to endograft removal, the mid-term outcomes are still unclear. The aim of this study is to evaluate the mid-term outcomes of late open conversion with endograft preservation after EVAR.

Flow adjusted transmitral pressure gradient as a modified indicator of functional mitral stenosis after repair for degenerative mitral regurgitation.

Background And Aim: After repair of degenerative mitral regurgitation (DMR), the focus is on functional mitral stenosis (FMS) when there is a decline of mitral hemodynamics. Yet, the clinical impacts and a standardized definition are still undecided. Since common mitral hemodynamic parameters are influenced by transmitral flow, the aim of this study is to seek the impact of flow adjusted transmitral pressure gradient (TMPG) by left ventricular stroke volume (LVSV) on the midterm outcomes.

Isolated endovascular repair of anomalous systemic arterial supply to the left basal lung.

Anomalous systemic arterial supply to the left basal lung is a rare congenital lung malformation, and its optimal treatment strategy is not well defined. We present a case of a 61-year-old man who underwent thoracic endovascular aortic repair (TEVAR) for anomalous systemic arterial supply to the left basal lung complicated with aneurysmal dilatation of the aberrant feeding artery. Computed tomography angiography after TEVAR revealed significant shrinkage of the aneurysmal portion as well as complete occlusion of the aberrant feeding artery.

Primary Minimally Invasive Repair with Atriopericardial Anastomosis Technique for Pulmonary Vein Stenosis after Catheter Ablation.

A pulmonary vein (PV) stenosis is a rare adverse event associated with catheter ablation for atrial fibrillation, which can potentially impair quality of life. Although percutaneous PV angioplasty is performed as the initial treatment of choice, the incidence of restenosis is reported to be considerably high. Herein, we describe a successful case of severe PV stenosis treated by primary surgical repair using the atriopericardial anastomosis technique via right minithoracotomy.

Clinical Impact of Flow Adjusted Transmitral Pressure Gradient After Surgical Annuloplasty for Functional Mitral Regurgitation.

Downsizing of mitral annulus due to mitral annuloplasty for ischemic functional mitral regurgitation (FMR) raises a new issue, functional mitral stenosis (FMS), defined as a decline of mitral hemodynamics. However, common mitral hemodynamic parameters are influenced by transmitral flow, therefore, the clinical impacts are still controversial. The aim of this study is to seek mitral hemodynamic indices (including transmitlra pressure gradient [TMPG] adjusted by left ventricular stroke volume [LVSV]) relevant to the mid-term outcomes after annuloplasty for ischemic functional mitral regurgitation (FMR).

A Better Predictor of Acute Kidney Injury After Cardiac Surgery: The Largest Area Under the Curve Below the Oxygen Delivery Threshold During Cardiopulmonary Bypass.

Background The aim of this study was to compare the predictive accuracy of acute kidney injury (AKI) after cardiac surgery using cardiopulmonary bypass for the largest area under the curve (AUC) below the oxygen delivery (DO) threshold and the cumulative AUC below the DO threshold. Methods and Results From March 2017 to October 2019, 202 patients who had undergone cardiac surgery with cardiopulmonary bypass were enrolled. The perfusion parameters were recorded every 20 seconds, and the DO (10×pump flow index [L/min per m]×[hemoglobin (g/dL)×1.

Impact of type and size of annuloplasty prosthesis on hemodynamic status after mitral valve repair for degenerative disease.

Objective: The aim of this study is to evaluate mitral valve hemodynamics after mitral valve repair for degenerative disease, and seek the impact of type/size of annuloplasty prosthesis on resting cardiac hemodynamics.

Methods: Between October 2012 and June 2019, 301 patients underwent isolated mitral valve repair for degenerative disease were enrolled. Correlation between postoperative mitral hemodynamics and type/size of annuloplasty prosthesis was evaluated.

Minimally invasive coronary artery bypass grafting: useful routine option for coronary revascularization in selected cases.

Objectives: The safety and feasibility of minimally invasive coronary artery bypass grafting (MICS CABG) were evaluated.

Methods: From December 2012 to March 2019, 122 consecutive patients underwent MICS CABG via a left mini-thoracotomy under direct vision. The internal thoracic artery (ITA) was harvested from all, while bilateral ITAs (BITAs) were used in 36 patients, with the second ITA as an in situ (n = 18) or free (n = 18) graft.

Correction to: Treatment outcomes for acute type A aortic dissection with patent false lumen in patients over the age of 80.

In the original publication of the article, Table 1 was published with errors. The correct Table 1 is given in this correction.

Characteristics and Surgical Results of Acute Type A Aortic Dissection in Patients Younger Than 50 Years of Age.

The aim of this study is to investigate the characteristics and surgical outcomes of acute type A aortic dissection (AAAD) in patients younger than 50 years of age. We retrospectively evaluated 307 patients who consecutively underwent surgical treatment for AAAD in our institute from January 2007 to June 2017. Patients were classified into two groups: the young group with 31 patients aged younger than 50 and the old group with 276 patients aged 50 years or older.

Preventive Strategy for Reexpansion Pulmonary Edema After Minimally Invasive Cardiac Surgery.

Reexpansion pulmonary edema is a serious complication of minimally invasive cardiac surgery through the right minithoracotomy. As reexpansion mechanical injury and ischemia reperfusion injury to the collapsed lung are possible mechanisms, we introduced a preventive protocol that consists of intermittent ventilation of the right lung, restoration of bilateral ventilation, administration of mannitol before unclamping the aorta, and institution of mild hypothermia. Among 469 patients who underwent minimally invasive cardiac surgery, we used this protocol in 379 patients.

Incidence and impact of silent brain lesions after coronary artery bypass grafting.

Objective: Silent brain lesions are known to occur after coronary artery bypass grafting (CABG). The aim of this study was to seek the incidence rate, the influence of procedures, and their impact on the postoperative course.

Methods: From July 2016 to April 2018, 104 consecutive patients undergoing elective and isolated first-time CABG (65 off-pump and 39 on-pump) were enrolled.

[Replacement of the Aortic Root with Stentless Bioprosthesis for Prosthetic Valve Endocarditis with Aortic Root Abscess;Report of a Case].

An 81-year-old man who had undergone aortic valve replacement was transferred to our hospital due to suspected prosthetic valve endocarditis(PVE) from the regional hospital. Transesophageal echocardiography findings showed severe aortic regurgitation with mobile vegetation on the right coronary cusp and annular abscess corresponding to left-none coronary cusps. Urgent operation was performed under the diagnosis of PVE with aortic root abscess.

Mitral annuloplasty for atrial functional mitral regurgitation in patients with chronic atrial fibrillation.

Background: Surgical ring annuloplasty is generally performed in patients with symptomatic atrial functional mitral regurgitation (MR) caused by long-standing atrial fibrillation (AF). However, its clinical results have not been well reported.

Methods: Twenty consecutive patients with atrial functional MR (mean age of 68 ± 9 years) and a left ventricular (LV) ejection fraction (EF) greater than 50% underwent mitral annuloplasty.

Treatment outcomes for acute type A aortic dissection with patent false lumen in patients over the age of 80.

Objectives: While reports which focus on the outcomes of conservative treatments for acute type A aortic dissection in patients over the age of 80 are worth considering, recently many studies have reported improved outcomes of surgical treatment. Accordingly, we analyzed the outcomes of surgical and conservative treatments for acute type A aortic dissection with patent false lumen in patients over the age of 80.

Methods: We retrospectively investigated 70 patients over 80 years in age out of 248 consecutive patients with acute type A aortic dissection between January, 2010, and May, 2015.

Transprosthetic Cuff Leakage of a Bovine Pericardial Aortic Bioprosthesis.

The Carpentier-Edwards PERIMOUNT Magna aortic heart valve is the most frequently implanted bioprosthesis. However, the existence of transvalvular cuff leakage necessitating a second cross clamp has been recently reported. The aim of this study is to seek the mechanism, occurrence rate, and influence of cuff leakage on the clinical course.

Exercise stress echocardiogram for the evaluation of change in the ventricular-arterial interaction after thoracic endovascular aortic repair.

Objectives: The aim of this study was to explore, with exercise echocardiography, the potential impact of thoracic endovascular aortic repair (TEVAR) on the ventricle-aorta coupling, based on the hypothesis that the interaction between the ventricle and aorta may be influenced by an increase in aortic stiffness due to the stent graft.

Methods: Of the patients who underwent isolated TEVAR for thoracic aortic diseases between April 2016 and December 2016, changes found in haemodynamic and echocardiographic parameters between the control (n = 17) and TEVAR (n = 30) groups were analysed by a stress echocardiogram.

Results: The end-systolic elastance significantly increased with stress in both groups [from 3.