Postoperative Changes in Pulmonary Function after Valve Surgery: Oxygenation Index Early after Cardiopulmonary Is a Predictor of Postoperative Course.

Objective: To determine pulmonary functional changes that predict early clinical outcomes in valve surgery requiring long cardiopulmonary bypass (CPB).

Methods: This retrospective study included 225 consecutive non-emergency valve surgeries with fast-track cardiac anesthesia between January 2014 and March 2020. Blood gas analyses before and 0, 2, 4, 8, and 14 h after CPB were investigated.

[Overwhelming Postsplenectomy Infection after Cardiac Surgery in a Patient with Immune Thrombocytopenia;Report of a Case].

Splenectomy for immune thrombocytopenia (ITP) can increase the number of platelets. However, patients without functioning spleen become vulnerable to bacteria. Overwhelming post-splenectomy infection( OPSI), its most fulminant form, is rapidly progressive and is highly fatal.

Early extubation in current valve surgery requiring long cardiopulmonary bypass: Benefits and predictive value of preoperative spirometry.

Background: Early extubation (EEx) after cardiac surgery has been essentially studied in patients with short cardiopulmonary bypass (CPB). Whether preoperative spirometry can predict EEx remains controversial.

Objectives: To investigate whether EEx can be a goal and predicted by preoperative spirometry in valve surgery requiring long CPB.

Saphenous vein characteristics evaluated using three-dimensional contrastless computed tomography before coronary artery bypass grafting.

Objective: Saphenous vein (SV) grafts are occasionally unsuitable for grafting owing to anatomic variants. However, there is some concern regarding preoperative SV evaluation. We used contrastless 3D-CT to investigate the anatomical SV characteristics before CABG.

Differences in pharmacological property between combined therapy of the vasopressin V2-receptor antagonist tolvaptan plus furosemide and monotherapy of furosemide in patients with hospitalized heart failure.

Background: Tolvaptan has been shown to improve congestion in heart failure patients. The purpose of this study was to evaluate the pharmacology and clinical efficacy of combined tolvaptan and furosemide therapy.

Methods: This study included 40 patients with systemic volume overload who were hospitalized for heart failure.

Clinical significance of arterial stiffness as a factor for hospitalization of heart failure with preserved left ventricular ejection fraction: a retrospective matched case-control study.

Background: Previous studies have been conducted to identify characteristics of patients with heart failure with preserved ejection fraction (HFpEF), but the risk factors of HFpEF remain unclear. We investigated the associations between arterial stiffness and the risk of hospitalization for HFpEF patients.

Methods: For the case group, we enrolled patients with preserved EF who had been hospitalized for HF from April 2013 to March 2015 and examined the cardio-ankle vascular index (CAVI).

Long-term outcomes of endovascular aortic aneurysm repair with the Zenith AAA endovascular graft: a single-center study.

Purpose: To present long-term results obtained with endovascular abdominal aortic aneurysm (AAA) repair (EVAR) using the Zenith AAA endovascular graft from a single institution.

Materials And Methods: Between 2007 and 2013, 95 consecutive patients (median age 77 years) underwent EVAR using Zenith. Data were prospectively collected and retrospectively analyzed until 2019.

Long-term impact of critical silent cerebrovascular disease in patients undergoing coronary artery bypass surgery: a propensity score and multivariate analyses.

Background: Cerebrovascular disease (CVD) with brain hypoperfusion is a strong risk factor for stroke. However, how this pathology influences long-term outcomes after coronary artery bypass graft (CABG) surgery is not known.

Methods: Magnetic resonance imaging/angiography (MRI/A) of the neck and brain was performed in 318 out of 575 consecutive CABG patients between May 2005 and April 2018.

Coronary artery bypass surgery in patients with chronic brain hypoperfusion.

Background: Cerebrovascular disease (CVD) is a risk factor of stroke and cerebral hypoperfusion is one of the underlying mechanisms. We hypothesized that coronary artery bypass grafting (CABG) can be performed at an acceptable risk for such patients without concomitant surgery for CVD.

Methods: Carotid echo was carried out for 538 consecutive patients undergoing isolated CABG between 2005 and 2016.

Effects of tolvaptan on urine output in hospitalized heart failure patients with hypoalbuminemia or proteinuria.

Hypoalbuminemia is an independent prognostic factor in hospitalization for heart failure (HHF). Hypoalbuminemia or proteinuria is related to resistance to loop diuretics. Tolvaptan is an oral non-peptide, competitive antagonist of vasopressin receptor-2.

Restoration of sinus rhythm and atrial transport function after the maze procedure: U lesion set versus box lesion set.

Objective: In a U lesion set, the left atrium (LA) roof between the right and left superior pulmonary veins is not ablated, to allow activation to propagate across the posterior LA and to recruit this segment as a contractile atrial component. In contrast, the box lesion set isolates the entire posterior LA.

Methods: To compare the two lesion sets, postoperative freedom from atrial fibrillation (AF) and LA transport function were examined in 402 patients who underwent surgery for AF with a U lesion (n = 329) or box lesion (n = 73) set.

Propofol protects the immature rabbit heart against ischemia and reperfusion injury: impact on functional recovery and histopathological changes.

The general anesthetic propofol protects the adult heart against ischemia and reperfusion injury; however, its efficacy has not been investigated in the immature heart. This work, for the first time, investigates the cardioprotective efficacy of propofol at clinically relevant concentrations in the immature heart. Langendorff perfused rabbit hearts (7-12 days old) were exposed to 30 minutes' global normothermic ischemia followed by 40 minutes' reperfusion.

[Left apical tumor extirpation via left ventriculotomy with the aid of epicardial echocardiography].

We reported a rare case of cardiac lipoma in the left ventricular apex. A 67-year-old woman who was diagnosed with cardiac tumor in the left ventricular apex was underwent the extirpation of the tumor via left ventriculotomy with the aid of intraoperative epicardiac ultra-sound. An intraoperative epicardiac ultra-sound is a very useful tool to document a location of the tumor, and a left ventriculotomy approach for the extirpation of the tumor provides a good operative field.

Preoperative evaluation of the saphenous vein by 3-D contrastless computed tomography.

Volume-rendering computed tomography (CT) without contrast medium has clearly demonstrated the 3-D mapping of the saphenous vein (SV). Contrastless volume-rendering CT was used to preoperatively evaluate the SV anatomy before coronary artery bypass grafting (CABG). This technique was useful for atypical anatomical variations, such as partial duplication of SV (Case 1) or varicose veins (Case 2).

Haemolytic anaemia due to stenosed double-reinforced grafts after surgical repaired aortic dissection.

Haemolytic anaemia due to a stenosed graft is a rare complication after surgery for aortic dissection. We present the case of a patient with haemolytic anaemia and heart failure, who had undergone emergent ascending aorta replacement for type A acute aortic dissection 5 years earlier. Chest computed tomography revealed severe graft stenosis of the proximal anastomosis and transthoracic echocardiography showed severe aortic regurgitation.

Controlled hyperkalemic reperfusion with magnesium rescues ischemic juvenile hearts by reducing calcium loading.

Objectives: Our objectives were (1) to determine whether elevated Mg(2+) in controlled hyperkalemic reperfusate without intervention during ischemia protects the juvenile heart against reperfusion injury; and (2) to identify the mechanism(s) underlying any protective effect of Mg(2+).

Methods: Langendorff-perfused hearts from juvenile (11- to 14-day-old) guinea pigs were subjected to mild (30-minute) or severe (45-minute) normothermic global ischemia and 35-minute reperfusion. Hearts were subjected to controlled hyperkalemic reperfusion without or with various concentrations of Mg(2+) (5, 10, 16, 23 mM).

Two-patch repair for atrioventricular septal defect with mitral aneurysm.

We experienced an unusual case of partial atrioventricular septal defect in an elderly patient. A preoperative ultrasonic cardiogram revealed the mitral leaflet pouching toward the right atrium and suggested the presence of a ventricular septal defect underneath the atrioventricular valve. The mitral aneurysm was diagnosed as a septal aneurysm on preoperative ultrasonic cardiogram.

Pulmonary injury after cardiopulmonary bypass: beneficial effects of low-frequency mechanical ventilation.

Objective: Pulmonary dysfunction is a frequent postoperative complication after cardiac surgery with cardiopulmonary bypass, and atelectasis is thought to be one of the main causes. The aim of this study was to evaluate whether low-frequency ventilation and continuous positive airway pressure during cardiopulmonary bypass reduce postcardiopulmonary bypass lung injury.

Methods: Eighteen Yorkshire pigs were subjected to 120 minutes of cardiopulmonary bypass (1 hour of cardioplegic arrest) followed by 90 minutes of recovery before being sacrificed.

Nonocclusive mesenteric ischemia after aortic surgery in a hemodialysis patient.

We report a case of nonocclusive mesenteric ischemia (NOMI), which developed after grafting for a descending thoracic aortic aneurysm in a hemodialysis patient. On postoperative day 5, acute increases in serum enzyme levels developed. Emergency angiography revealed severe vasoconstriction in the superior mesenteric artery (SMA) and other splanchnic arteries.

Cardioprotection of neonatal heart using normothermic hyperkalaemia: the importance of delivery and terminal cardioplegia.

Cardioprotection of immature hearts remains controversial and largely based on the use of hypothermic cardioplegia. Recent clinical trials in pediatric open-heart surgery suggest that normothermic cardioplegic arrest is also cardioprotective. However, the advantages of using normothermic cardioplegia delivered as single- or multi-dose with or without terminal cardioplegia are unknown.

Repair of an abdominal aortic aneurysm with a remarkably dilated meandering artery: Report of a case.

A 73-year-old man on dialysis for chronic renal dysfunction was referred to our hospital for surgical treatment of an abdominal aortic aneurysm (AAA). Preoperative angiography showed a remarkably developed meandering artery branching from the inferior mesenteric artery (IMA). The superior mesenteric and celiac arteries were occluded at the origin, and all blood flow to the abdominal organs was apparently supplied by collateral circulation from the IMA.

Intraoperative mapping of the right atrial free wall during sinus rhythm: variety of activation patterns and incidence of postoperative atrial fibrillation.

Objective: The atrial conduction properties associated with cardiac disease are speculated as the background of postoperative atrial fibrillation (POAF). We examined the atrial conduction patterns and conduction properties during sinus rhythm (SR) in patients that had undergone cardiac operations and evaluated the incidence of POAF in all patients.

Methods: Fifty-two patients with stable SR who underwent cardiac surgery, with a diagnosis of valvular disease in 25, ischemic heart disease in 24, and others in 3, were enrolled in this study.

Surgical experience of subacute pulmonary thromboembolism with severe pulmonary hypertension.

Surgical treatment for subacute pulmonary arterial thromboembolism has previously been considered to be inappropriate. We undertook a pulmonary arterial thrombectomy and removal of a floating right heart thrombus in a patient who had been symptomatic for over a month. The pulmonary arterial pressure, which had been equal to the systemic pressure preoperatively, decreased gradually and almost normalized one month postoperatively.