Fatal airway obstruction due to a ball-valve clot with identical signs of tension pneumothorax.

Endo-tracheal tube obstruction due to an extensive blood clot is a recognized but very rare complication. A ball-valve obstruction in the airway could function as a check valve for the lung and thorax, resulting in tension pneumothorax-like abnormalities. A 47-year-old female patient had undergone implantation of a left ventricular assist device 3 weeks prior.

Bilateral versus single internal thoracic artery grafting in hemodialysis patients.

Background: The use of the bilateral internal thoracic arteries (BITAs) during myocardial revascularization reportedly provides a survival benefit over using a single internal thoracic artery (SITA). However, the advantages in chronic hemodialysis patients, who generally have multiple comorbidities, is unclear.

Methods: Outcomes of chronic hemodialysis patients who underwent isolated coronary artery bypass grafting (CABG) using a SITA with additional saphenous vein grafts (SVGs) (n = 33) or BITAs (n = 30) for left-side revascularization were retrospectively reviewed.

Spinal cord injury following aortic arch replacement.

Purpose: Postoperative spinal cord injury is a devastating complication after aortic arch replacement. The purpose of this study was to determine the predictors of this complication.

Methods: A group of 254 consecutive patients undergoing aortic arch replacement via median sternotomy, with (n = 78) or without (n = 176) extended replacement of the upper descending aorta, were included in a risk analysis.

Valve selection for the aortic position in dialysis patients.

Background: Prosthetic valve selection in dialysis patients remains controversial because of the limited data available. This study aimed to clarify late clinical outcomes and discuss strategies for optimal valve selection in dialysis patients.

Methods: We retrospectively analyzed the data obtained from 406 consecutive patients who underwent aortic valve replacement between 1995 and 2010.

Superior mesenteric artery plasty for type A acute aortic dissection with visceral ischemia.

Treatment of visceral ischemia complicated with acute type A aortic dissection is controversial. We had two cases of acute type A aortic dissection complicated by superior mesenteric artery (SMA) ischemia and successfully treated them with direct SMA perfusion during central aortic repair followed by SMA plasty. The presented procedures can be an option to treat visceral ischemia with a standard operative theater and equipment.

Recent risk factors for open surgical mortality in patients with ruptured abdominal aortic aneurysm.

Aim: We examined recent relevant prognostic factors for the outcome of open surgical treatment of ruptured abdominal aortic aneurysm.

Methods: Between 2006 and 2012, 35 patients received emergency open surgical treatment for ruptured abdominal aortic aneurysm at our institute. We reviewed ambulance activity logs and clinical records of 34 infrarenal ruptured abdominal aortic aneurysm patients retrospectively.

Effects of the side of arteriovenous fistula on outcomes after coronary artery bypass surgery in hemodialysis-dependent patients.

Objective: The aim of the study was to determine whether using the in situ internal thoracic artery (ITA) graft ipsilateral to the arteriovenous fistula adversely affects the outcomes after isolated coronary artery bypass grafting (CABG) in the dialysis-dependent patients to answer the concerns of a possible steal and consequent myocardial ischemia.

Methods: We categorized 155 dialysis patients undergoing isolated CABG between January 1993 and December 2011 into 108 patients (70%, ipsilateral group) whose left anterior descending artery (LAD) was revascularized with the ITA ipsilateral to the arteriovenous fistula and 47 patients (contralateral group) whose LAD was grafted with the ITA opposite to the fistula, to compare their early and late outcomes.

Results: While 94% of the ipsilateral group had left fistula, 55% of the contralateral group had left fistulas.

Clinical validation of coronary artery flow through an intracoronary shunt during off-pump coronary artery bypass grafting.

Objectives: Intracoronary shunts have been developed for a bloodless field and preserved forward flow preventing ischemia during off-pump coronary artery bypass (OPCAB) surgery. However, reports directly measuring the forward flow through the shunt in clinical settings are lacking.

Methods: Using a 7.

Predictors for early and late outcomes after coronary artery bypass grafting in hemodialysis patients.

Background: Markedly higher hospital and long-term mortality after coronary artery bypass grafting (CABG) have been reported in hemodialysis (HD)-dependent patients. We tried to identify the predictors for short-term and long-term outcomes after CABG, which have not been well studied.

Methods: Between 1993 and 2010, 152 patients undergoing HD (117 men; HD duration of 8.

Can we predict the site of entry tear by computed tomography in patients with acute type a aortic dissection?

Background: In patients with acute type A aortic dissection (AAD), localization of the primary entry tear to be excluded is of major importance for intervention.

Hypothesis: There are reliable indirect computed tomography (CT) findings to predict the entry site.

Methods: In 83 patients with type A AAD whose primary entry tears were identified surgically between 2003 and 2009, we retrospectively examined the diagnostic CT scans regarding pericardial effusion, the largest short-axial diameter of the aorta, widths of true and false lumens, and false lumen thrombosis at 6 levels of thoracic aorta from the aortic root to the descending aorta.

Long-term size follow-up of knitted Dacron grafts (Gelseal™) used in the ascending aorta.

There is limited information about the size change of a knitted Dacron graft (Gelseal™) used in the thoracic aorta. We evaluated the diameters of the Gelseal™ grafts at a long-term follow-up for 3.7 ± 1.

Simplified management of hemodialysis-dependent patients undergoing cardiac surgery.

Background: The mortality and morbidity rates are high after cardiac surgery in hemodialysis (HD)-dependent patients. To improve their outcomes, optimal perioperative managements should be discussed.

Methods: A retrospective analysis of 245 HD patients who underwent cardiac surgery between 1994 and 2007 was conducted.