[Mitral valve replacement after previous coronary artrey bypass grafting( CABG) with functioning left internal thoracic artery( LITA) grafts in an elderly patient; report of a case].

An 85-year-old woman had a history of coronary artery bypass grafting (CABG) performed 7 years ago, and dyspnea on effort had been worsening recently. Since echocardiography showed severe mitral valve regurgitation( MR), mitral valve repair was suggested. Preoperative enhanced computed tomography (CT) showed the patent functioning left internal thoracic artery (LITA) graft.

[Initial clinical experience of early cardiac rehabilitation for very elderly patients over 85 years old following open heart surgery].

In this study, we evaluated the initial clinical experience of early cardiac rehabilitation( CR) for very elderly patients over 85 years old after open heart surgery. From September 2007 to January 2011, 7 consecutive patients (85~90 years, mean 85.9 years, male:female=4:3) who underwent cardiac surgery in our institute were selected.

[Open heart surgery in a patient with a history of Takotsubo cardiomyopathy].

An 81-year-old man had a history of Takotsubo cardiomyopathy induced by general fatigue after travel and acute gastritis 2 years previously. Recently, dyspnea on effort had been worsening. Since preoperative echocardiography showed severe aortic valve regurgitation (AR) with left ventricular (LV) dilatation, aortic valve replacement (AVR) by the standard procedure was indicated.

Relationship between epicardial fat measured by 64-multidetector computed tomography and coronary artery disease.

Background: Epicardial fat (EF) is the visceral fat of the heart deposited under the visceral layer of the pericardium and has the same origin as abdominal visceral fat, which is shown to be strongly related to the development of coronary artery disease (CAD). We measured the volume of EF (EFV) by 64-multidetector computed tomography (MDCT) and studied the relationship between EFV and the severity of CAD.

Hypothesis: Epicardial fat volume increases steeply in patients with significant coronary artery stenosis and in those with severe coronary artery calcification.

Prevalence of subclinical atherosclerosis in asymptomatic patients with low-to-intermediate risk by 64-slice computed tomography.

Background: Recent research has shown that cardiovascular risk scoring significantly underestimates or misclassifies risk in key subsets of the population. There is a growing need for a noninvasive imaging to detect a subclinical atherosclerosis. Thus we hypothesized that 64-slice computed tomography (CT) could effectively detect subclinical atherosclerosis in asymptomatic patients with low-to-intermediate risk.

[Clinical experience with intravenous administration of nifekalant hydrochloride for ventricular tachycardia in a hemodialysis patient after open heart surgery].

A 78-year-old man with chronic renal failure (CRF) on hemodialysis (HD) was diagnosed as having severe aortic regurgitation with left ventricular dysfunction. Aortic valve replacement with a 21 mm ATS mechanical bileaflet prosthesis was performed without intraoperative complications. Sustained ventricular tachycardia suddenly occurred 1 day after surgery, then intravenous administration of nifekalant hydrochloride (NIF) was started at a dose of 0.

Prevalence of non-calcified coronary plaque on 64-slice computed tomography in asymptomatic patients with zero and low coronary artery calcium.

Objectives: To study the prevalence of noncalcified plaque in asymptomatic low-risk patients with no or mild coronary artery calcium (CAC).

Methods: From 502 patients with coronary risk factors who underwent 64-slice computed tomography, 224 asymptomatic patients were identified with no CAC (n=117) or mild CAC (n=107; defined as patients with Agatston scores from 1 to 100).

Results: Patients with no CAC were younger and had diabetes less often.

Distribution of coronary atherosclerosis in patients with coronary artery disease.

The distribution of coronary atherosclerosis has not been fully clarified. We measured coronary artery calcium score (CACS) in 624 consecutive patients for the right coronary artery (RCA), left main trunk (LMT), left anterior descending coronary artery (LAD), and left circumflex coronary artery (LCx), then calculated total CACS. Coronary artery calcium score was measured using the Agatston method.

Prevention of coronary slow flow/no reflow during percutaneous coronary intervention by the use of embolic protection device, 'Filtrap'.

A 68 year-old man underwent percutaneous coronary intervention (PCI). A 64 multi-slice computed tomography (MSCT) demonstrated a non-calcified plaque with positive remodeling. Intravascular ultrasound showed severe attenuation which suggested high risk of coronary no reflow during PCI.

Prevalence of subclinical atherosclerosis in asymptomatic diabetic patients by 64-slice computed tomography.

Objectives: Patients with diabetes have a 2-fold to 4-fold higher risk of a cardiovascular event than nondiabetic patients. Thus there is a need to identify patients with diabetes who are at risk of cardiovascular events before the onset of symptoms. We studied the prevalence of coronary artery disease in asymptomatic diabetic patients compared with asymptomatic nondiabetic patients by 64-slice computed tomography (CT).