[Metastatic Cardiac Tumor in the Left Atrium from Esophageal Cancer].

Metastatic cardiac lesions are clinically silent and are usually found a necropsy. The most common primary tumor resulting in cardiac metastases is carcinoma of the lung, with there being only a few reports of metastases from esophageal cancer. We report two cases of metastatic cardiac tumors in the left atrium from esophageal cancer and perform a review of the literature.

[Redo Valve Replacement of Wada-Cutter Prosthetic Valve at Tricuspid Valve Position 47 Years After Implantation;Report of a Case].

We experienced an explantation of Wada-Cutter prosthetic tilting disk valve of 47 years after implantation. The patient was 53 years old female who underwent the 1st operation for Ebstein's anomaly, which included tricuspid valve replacement (TVR), closure of atrial septal defect (ASD) and posterior annulorrhaphy when she was 6 years old. She was doing well after the 1st operation without symptom,but dyspnea and systemic edema worsened recently though increased admission of diuretics.

Long-term outcome in a case of translocated mitral valve replacement for massive mitral annular calcification.

Few reports have described long-term outcomes after translocated mitral valve replacement. We describe tips, potential pitfalls, and long-term outcome associated with the construction of a new mitral annulus and reinforcement of prosthesis attachment using a mitral prosthetic valve with an equine pericardial collar in a woman with extensive mitral valve calcification.

Outcomes of prosthetic valve replacement in women of child-bearing age.

Purpose: The outcomes of pregnancy are more favorable for women with bioprostheses than for those with mechanical prostheses. However, bioprostheses are associated with a high reoperation rate in young women and it remains unclear whether these young women can give birth without any complications. We analyzed the outcomes of prosthetic valve replacement and investigated the effectiveness and problems associated with bioprostheses in women of child-bearing age in Japan.

Aortic valve replacement in a patient with MPO-ANCA-positive Goodpasture disease.

Goodpasture disease (GD) is a rare autoimmune disorder characterized by the development of pathologic autoantibodies against both glomerular and alveolar basal membranes. Approximately one third of the patients with GD are also positive for anti-neutrophil cytoplasmic antibody (ANCA). In this case report, a 74-year-old woman was diagnosed as having myeloperoxidase (MPO)-ANCA-positive GD with severe aortic valve stenosis (AS).

Midterm results of left coronary artery reimplantation through the transverse sinus of the pericardium in adult Bland-White-Garland syndrome.

The anomalous origin of the left coronary artery from the pulmonary artery - known as Bland-White-Garland syndrome - is a rare congenital malformation that affects 1 in 300,000 live births. Most patients die in infancy without any surgical treatment. Some patients who survive past childhood often have varying symptoms such as myocardial ischemia, impaired left ventricular function, mitral regurgitation, and progressive heart failure, depending on the development collateral circulation.

Use of a Stent Graft for Patent Ductus Arteriosus in an Octogenarian Eliminates Ductus Flow.

Closure of a patent ductus arteriosus (PDA) in the elderly is a high-risk procedure because of tissue fragility and many possible complications. The patient in our case was an 81-year-old woman with a window-type PDA caused by cardiac failure. Based on the anatomy of the PDA and aorta and to minimize invasion, we used a stent graft to close the PDA.

[Ascending-descending Aortic Bypass and Aortic Valve Replacement for Aortic Coarctation with Bicuspid Aortic Valve and an Aberrant Right Subclavian Artery;Report of a Case].

A 53-year-old woman was developed congestive heart failure. She was diagnosed as having aortic coarctation, incompetent bicuspid aortic valve and an aberrant right subclavian artery by using echocardiography and enhanced computed tomography. Ankle brachial pressure index(ABI)in the right was 0.

Identification of Coronary Artery Orifice to Prevent Coronary Complications in Bioprosthetic and Transcatheter Aortic Valve Replacement.

Background: The aim of this study was to identify anatomical variations in coronary artery orifices among high-risk patients with a small aortic root undergoing bioprosthetic aortic valve replacement (BAVR) and transcatheter aortic valve replacement (TAVR) in order to prevent coronary orifice obstruction perioperatively.

Methods and results: Coronary orifice and root structure were identified in 400 patients using aortic multidetector-row computed tomography (MDCT). We measured the aortic root diameter; intercommissural distances; and distance from coronary orifice to valve annulus, commissure, and sinotubular junction.

Purulent pericardial effusion and mycotic pseudoaneurysm following insertion of a bare metal stent.

A 65-year-old male was diagnosed with purulent pericarditis, caused by Staphylococcus aureus five weeks after bare metal stenting for a 90% stenosis of the right coronary artery ostium. Subsequently, he developed a pseudoaneurysm in the right coronary sinus of Valsalva (CSV) requiring surgical intervention during the treatment of the pericarditis. Bacteremia after percutaneous coronary intervention (PCI) occurs in < 1% of patients and usually has insignificant clinical sequelae.

Usefulness of an enhanced recovery after surgery protocol for perioperative management following open repair of an abdominal aortic aneurysm.

Purpose: To achieve early recovery and early discharge from the hospital by applying an enhanced recovery after surgery (ERAS) protocol, which is mainly used with colonic surgery, for the perioperative management of open AAA surgery.

Method: One hundred twenty-seven open AAA surgery cases successfully carried out between 2003 and 2011 were included in this study. The ERAS protocol was used for the cases from April 2008 onward, and we performed a comparison of the conventionally treated cases with ERAS cases regarding the start of postoperative oral consumption, the postoperative hospital stay, and hospitalization medical costs.

Cardiac lipoma originating from the left ventricular apex diagnosed using the magnetic resonance imaging fat suppression technique: report of a case.

A 70-year-old male patient had a tumor in the left ventricular apex that was detected by transthoracic echocardiography. He had no clinical manifestations. A diagnosis of benign lipoma was made using the noninvasive fat suppression technique of cardiac magnetic resonance imaging (MRI).

Adult patent ductus arteriosus closure with a pedicled pulmonary arterial patch.

The vascular wall of patent ductus arteriosus in adults is usually fragile due to atherosclerosis with calcification. In adults, surgical treatment, such as direct or patch closure, is sometimes required for a wide, short, or calcified patent ductus arteriosus. We present a novel technique for patent ductus arteriosus closure with a pedicled patch created from the wall of a dilated pulmonary artery.

An alternative option for elderly patients with a small aortic annulus: the 16 mm ATS valve.

Background And Aim Of The Study: The optimal procedure and prosthesis remains debatable for aortic valve replacement (AVR) in high-risk elderly patients in whom the aortic annulus is too small to allow a standard AVR procedure with even the smallest sized bioprosthetic valve available. Herein are reported the early and mid-term results of standard AVR using a 16 mm ATS Advanced Performance (AP) mechanical heart valve.

Methods: The medical records of 10 patients (mean age 75 +/- 5 years; range: 64-79 years) in whom 16 mm ATS AP valves had been implanted in the supra-annular position were reviewed retrospectively.

Premeditated reoperation after mitral valve replacement with a Starr-Edwards ball valve for young women who desire to bear a child: report of two cases.

There are many difficulties for young women with a Starr-Edwards ball valve who want to attempt pregnancy. There is no consensus regarding whether they should maintain anticoagulation therapy throughout pregnancy with the risk of a thromboembolism or to undergo a reoperation with bioprosthetic heart valves, followed by a third operation when the valve deteriorates. This report presents two cases of young women who underwent mitral valve replacement (MVR) with Starr-Edwards ball valves (model 6120: 1M) during their childhood.

Prognosis after off-pump coronary artery bypass in patients receiving hemodialysis.

Purpose: This study was performed to evaluate the perioperative and long-term results of off-pump coronary artery bypass grafting (OPCAB) in hemodialysis (HD)-dependent patients.

Methods: We retrospectively analyzed the results of isolated OPCAB performed at Tokyo Women's University Medical Center East from February 27, 2000, to May 12, 2006. Perioperative data for patients receiving HD (group HD, n=39) were compared with data from patients not receiving HD (group noHD, n=60).

Clinical experience with Smart Care after off-pump coronary artery bypass for early extubation.

The purpose of this study was to compare the intubation time using Smart Care, a knowledge-based system for automated weaning, with that of conventional physician-controlled weaning after off-pump coronary artery bypass (OPCAB) and to determine the efficacy of Smart Care. During 2004, 53 sequential patients were scheduled for isolated coronary artery bypass grafting without cardiopulmonary bypass. Patients were divided into two groups: the Smart Care group (n = 10) and the control group (n = 35).