Removal of a left ventricular thrombus complicated by cardiac sarcoidosis using a 3D microscope system.

A woman in her 60s was brought to the previous hospital with respiratory distress. She was referred for the treatment of severe cardiac dysfunction and a mobile mass in the left ventricle. Echocardiography revealed the mass to be of 20×11 mm in size, mobile and slightly attached to the left ventricle by a stalk.

[Ruptured Thoracic Aortic Aneurysm Treated with Total Arch Replacement and Direct Transaortic Thoracic Endovascular Aortic Repair].

Open stent grafting is an effective technique in surgery for treating-ruptured aortic aneurysms in the distal aortic arch, but it is not always applied as it depends on the shape of the aneurysm. In this case, the aneurysm was long in the distal aortic arch and sharply angulated into the descending aorta;thus, it was anticipated that an off-the-shelf open stent graft would not cover the ruptured area. Therefore, we used a stent graft device for thoracic endovascular aortic repair as an open stent and succeeded in saving the patient's life.

Superficial femoral artery-anterior tibial artery bypass with great saphenous vein grafting via the lateral femoropopliteal route for infection after Viabahn placement.

We report a case involving an elderly man who successfully underwent superficial femoral artery-anterior tibial artery bypass via the lateral femoropopliteal route following development of a stent infection after placement of a small-diameter covered stent for a ruptured superficial femoral artery pseudoaneurysm. This report suggests that appropriate treatment strategies for device infection subsequent to device removal are paramount for the prevention of reinfection and preservation of the affected extremity.

[Distal Anastomosis with Pleural Flap Wrap for Ruptured Acute Aortic Dissection].

A 69-year-old woman developed back pain was brought to our hospital. She was diagnosed with acute Stanford type B aortic dissection, and had a history of ascending aortic replacement for acute Stanford type A aortic dissection at another hospital 10 years before. In three days after admission, enhanced computer tomography (CT) revealed ruptured aortic dissection at the distal arch.

Arteriovenous malformation with pseudoaneurysm on the left upper limb.

A 61-year-old woman developed a pulsatile mass on the left upper limb and was diagnosed with arteriovenous malformation with pseudoaneurysm. A two-stage operation including ligation and resection of the aberrant branches and subsequent resection of the mass with revascularization was performed. Histological analysis suggested arteriovenous malformation and pseudoaneurysm.

Successful one-stage operation for type B acute intramural hematoma with descending aortic rupture.

A 76-year-old man who complained of back pain was referred to our hospital. Computed tomography revealed an intramural hematoma with a descending aortic rupture. Total arch replacement with the frozen elephant trunk technique and thoracic endovascular aortic repair was performed emergently in one stage.

[Florida Sleeve Technique Concomitant with Total Aortic Arch Replacement].

A 73-year-old man with chest pain was brought to our hospital. He was diagnosed with acute myocardial infraction (AMI) by coronary arteriogram and underwent emergent intervention. Enhanced computer tomography( CT) revealed thoracic aortic aneurysm extending from sinus of Valsalva to proximal aortic arch.

Concomitant decalcification of the anterior mitral leaflet via the aortic annulus during aortic valve replacement for significant aortic and mitral stenoses.

An 82-year-old man undergoing regular hemodialysis with substantial aortic and mitral valve stenoses underwent aortic valve replacement with concomitant mitral decalcification via the aortic annulus. Postoperative transthoracic echocardiography showed reduced mitral stenosis. The patient was discharged on the 14th postoperative day uneventfully.

[The Mid-term Results of Transapical Transcatheter Aortic Valve Implantation for Aortic Stenosis].

We aimed to evaluate the results of transapical transcatheter aortic valve implantation (TAVI) for aortic stenosis. Thirty patients who had aortic stenosis and underwent transapical TAVI between 2016 and 2020 were enrolled. Medical records were reviewed, and the following data were retrieved and analyzed:basic demographic data, and intraoperative data and postoperative outcomes.

[Giant Left Atrial Myxoma Complicated with Hemorrhagic Cerebral Infarction].

A 48-year-old woman developed paralysis of the left upper limb and dysarthria. Two days later, she was admitted to a local hospital due to no improvement of symptoms. Brain magnetic resonance imaging showed acute hemorrhagic cerebral infarction in the left nucleus basalis.

[Missing Floating Mass in the Ascending Aorta;Report of a Case].

A 65-year-old man, with a history of hypertension, presented with dizziness and emesis and was admitted to a local hospital. He was a moderate smoker, but he did not take any hormone-based medication. Magnetic resonance imaging showed scattered cerebral infarction in the bilateral cerebral hemisphere and right cerebellar hemisphere.

Aggressiveness is associated with excitement on the five-factor model of the positive and negative syndrome scale and prefrontal function in patients with stable schizophrenia.

Aggressiveness is a clinical concern in the stable phase of schizophrenia, as well as in the acute phase. The factors that affect aggressiveness during the stable phase remain unclear. This study investigated factors associated with aggressiveness in patients with stable schizophrenia.

[Rapid Expansion of Distal Aortic Arch Aneurysm with the Short Elephant Trunk;Report of a Case].

A 78-year-old female patient was introduced to our hospital with chief complaint of massive hemoptysis. She had a history of total arch replacement using a short elephant trunk for acute Stanford type A aortic dissection 3 years before. A contrast-enhanced computed tomography (CT) revealed kinking of the short elephant trunk and distal aortic arch aneurysm which caused aortobronchial fistula.

[Surgical Results for Left Ventricular Thrombus Formation after Myocardial Infarction].

We aimed to review the surgical results of left ventricular restoration for left ventricular thrombus after myocardial infarction. A retrospective study was conducted on 5 patients who underwent thrombus removal and left ventricular restoration for left ventricular thrombus after myocardial infarction. Two patients were in an acute phase of myocardial infarction, and 3 in a chronic phase.

The interference with transapical transcatheter aortic valve implantation by the anterior chordae tendineae preserved at previous mitral valve replacement.

Preserved anterior chordae tendineae is a possible risk factor for disturbing delivery of a transcatheter heart valve. Inserting a sheath just below the aortic valve for delivery of the transcatheter heart valve might be proposed as an alternative to avoid the chordae tendineae.

[Mediastinal Hematoma after Intravenous Thrombolytic Therapy for Cerebral Infarction in a Patient with a History of Total Aortic Arch Replacement].

An 80-year-old male patient with a history of total arch replacement for thoracic aortic aneurysm 5 years before was introduced to our hospital with a chief complaint of chest pain. Tissue plasminogen activator (t-PA) had been administrated because of acute brain infarction. A contrast-enhanced computed tomography (CT) scan demonstrated a large hematoma in the posterior mediastinum extending from the level of distal aortic arch to the descending aorta together with left pleural effusion.

Valve-sparing partial root repair for aortic dissection limited to the right coronary sinus of Valsalva.

Background And Aim Of The Study: To reveal a technical feasibility and safety of valve-sparing partial aortic root repair for spontaneous aortic dissection limited to the right coronary sinus of Valsalva.

Methods: A 68-year-old woman presented with chest pain. Twelve-lead electrocardiogram revealed atrioventricular dissociation and ST-segment elevation on II, III, and aVF.

[Acute Aortic Insufficiency due to the Avulsion of Aortic Valve Commissure;Report of a Case].

A 61-year-old man with a history of hypertension and cerebral infarction, presented to a clinic with sudden dyspnea at rest. He was diagnosed with heart failure and referred to our hospital. Echocardiography and three-dimensional computed tomography showed acute heart failure and aortic insufficiency due to avulsion of the aortic valve commissure between the right coronary cusp and the non-coronary cusp.

Adventitial Wrap Technique for Acute Type A Aortic Dissection.

We describe a simple and reproducible technique to achieve complete and immediate hemostasis of the distal anastomosis in total arch replacement with the frozen elephant trunk technique. The adventitia was left seamlessly 1.0 cm longer than the level of the suture line.

Impact of the size mismatch between saphenous vein graft and coronary artery on graft patency.

Background: The saphenous vein graft (SVG) is widely used in coronary artery bypass grafting because of its availability and ease of use. However, the patency rate of the SVG grafted to the right coronary artery (RCA) is poor. Diameter mismatch between the coronary artery and SVG is an important cause of graft occlusion.

Right Atrial Calcified Ball Thrombus Mimicking a Myxoma.

An 80-year-old woman was admitted to our hospital because of congestive heart failure. Transthoracic echocardiography revealed severe aortic valve stenosis, and a mobile calcified mass was attached to the interatrial septum in the right atrium. We suspected that the mass was cardiac myxoma.

Patch Repair for a Subepicardial Aneurysm With an Approach From Inside the Heart.

We present a case of subepicardial aneurysm that developed as a complication of acute myocardial infarction. Although the patient had stable hemodynamics, the diameter of the aneurysm tended to increase over time; thus, an operation was performed. We thought that approaching the aneurysm from outside the heart would injure the papillary muscle or distort the left ventricle and exacerbate mitral regurgitation.

Single-Stage Repair of Thoracic Aortic Aneurysm through a Median Sternotomy in a Patient with Pseudocoarctation of the Aorta and Severe Aortic Valve Stenosis.

Pseudocoarctation of the aorta is a rare anomaly and considered a benign condition. Pseudocoarctation of the aorta has been associated with aneurysm formation in the thoracic aorta, which may cause sudden rupture or dissection. Thus, the presence of an aneurysm in combination with pseudocoarctation of the aorta is thought to be an indication for surgery.

Ascending aortic false aneurysm formation associated with rupture of acute type a aortic dissection.

A 63-year-old man with ruptured acute type A aortic dissection was referred to our hospital. Computed tomography showed a false aneurysm arising from the false lumen located beside the ascending aorta. His hemodynamic status was stable inspite of the ruptured acute aortic dissection.