[Right Atrial Approach for the Surgical Repair of Delayed Ventricular Septal Rupture].

Ventricular septal rupture(VSR) after acute myocardial infarction(AMI) is a rare and serious complication that is associated with extremely high mortality. Delayed VSR is particularly uncommon and is difficult to diagnose and treat. A 68-year-old man presented with dyspnea on effort.

Pyogenic granuloma originating in the pulmonary artery.

We herein report an unreported case of pyogenic granuloma that originated in the pulmonary artery. A 38-year-old man was urgently hospitalized with dyspnea and back pain. He had been on hemodialysis for 2 years due to chronic renal failure.

Aorto-renal bypass surgery normalized blood pressure without antihypertensive medications in a young female patient with renal artery occlusion.

We described a 19 year old female case with renovascular hypertension, whose blood pressure was high taking antihypertensive medications. The right renal artery was completely occluded at its ostium, and percutaneous transluminal renal angioplasty was unsuccessful. After aortorenal bypass surgery, blood pressure was normalized without administration of antihypertensive medication.

Successful treatment of myocardial infarction by aortic sinus thrombosis.

This case report concerns a 59-year-old man with acute myocardial infarction associated with a giant organized thrombus occupying the right sinus of Valsalva that developed into chest pain and bradycardia. Magnetic resonance imaging showed low intensity in both T1-weighted and T2-weighted images, indicating that the mass was a thrombus. A direct approach involving grafting effectively resolved the embolization and myocardial ischemia, even during the subacute period.

Impact of non-di-(2-ethylhexyl)phthalate cardiopulmonary bypass tubes on inflammatory cytokines and coagulation-fibrinolysis systems during cardiopulmonary bypass.

Di-(2-ethylhexyl)phthalate (DEHP), an excellent plasticizer for poly(vinyl chloride) (PVC), is a known endocrine-disrupting chemical. This study was designed to investigate whether a new non-DEHP bilayer tube reduced the release of DEHP, suppressed inflammatory cytokines, and altered coagulation-fibrinolysis systems. Sixteen patients undergoing coronary artery bypass grafting (CABG) were randomly assigned to the non-DEHP bilayer group (group B, n = 8), or the noncoated PVC group (group N, n = 8).

Which valve and which size should we use in the valve-on-valve technique for re-do mitral valve surgery?

The valve-on-valve (VOV) technique is that a mechanical valve is implanted on the sewing cuff of the previous bioprosthesis after removing degenerated leaflets. We conducted an in vitro study to determine the size-match of the valves for VOV technique. The Carpentier-Edwards pericardial (CEP) valve and Mosaic valve were used.

Mitral valve replacement for extensive calcification: half and half technique.

A 50-year-old woman who had been undergoing hemodialysis for 18 years underwent mitral valve replacement because of mitral valve stenosis. Her mitral valve leaflet and annulus were highly calcified, and it was impossible to remove the posterior leaflet from the ventricular wall. At the time of surgery, noneverted horizontal mattress sutures were placed from the left ventricle to the left atrium on the anterior half of the mitral annulus and everted horizontal mattress sutures on the left atrial wall close to the calcified posterior annulus.

Modification of the Bentall operation using the proximal double sewing technique without excision of leaflets.

We present a report on reinforcement of the proximal anastomosis during the Bentall operation. The aortic wall was excised with a 5-mm remnant, and aortic valve leaflets were preserved. Interrupted horizontal mattress sutures (2-0 Polyestel) reinforced with pledgets were placed.

Exposure of the mitral valve using flexible self-retaining retractors and an atrial hook.

We hereby present our technique for using the self-retaining flexible arm retractor and its attachments for mitral valve exposure. The Aortic Valve Assistant, which was developed for aortic valve exposure, is also very useful for exposure of the inferior wall of the left atrium. Our modified atrial hook provides excellent exposure of the anterior mitral annulus.

Immunolocalization of platelet glycoprotein IIb/IIIa and P-selectin, and neutrophil-platelet interaction in human coronary unstable plaques.

Platelet aggregation at the site of plaque rupture or erosion is a dominant feature in the pathophysiology of plaque destabilization. To elucidate the role of glycoprotein (GP) IIb/IIIa in coronary plaque destabilization, we immunohistochemically studied the presence of GP IIb/IIIa in coronary atherectomy specimens obtained from patients with stable angina (SAP) and unstable angina pectoris (UAP). Moreover, we immunohistochemically investigated the presence of P-selectin, which is known to be a marker of platelet activation, in these specimens.

A new poly-2-methoxyethylacrylate-coated cardiopulmonary bypass circuit possesses superior platelet preservation and inflammatory suppression efficacy.

Background: Poly-2-methoxyethylacrylate (PMEA) is a new coating material, and several studies have revealed that PMEA-coated cardiopulmonary bypass (CPB) circuits have good biocompatibility. This study sought to compare this biocompatibility with those of heparin-coated and noncoated circuits.

Methods: Forty-five patients undergoing coronary artery bypass grafting were randomly assigned to PMEA-coated (group P, n = 15), heparin-coated (group H, n = 15), or noncoated (group N, n = 15) circuit groups.

Orally administered benidipine and manidipine prevent ischemia-reperfusion injury in the rat heart.

Background: The present study was designed to investigate whether orally administered benidipine and manidipine protect the myocardium from ischemia - reperfusion injury.

Methods And Results: Each drug (1, 3 or 10 mg/kg) was administered orally once daily for 1 week. The isolated rat heart model (Langendorff perfusion) was used, and each heart was subjected to global ischemia at 37 degrees C for 40 min followed by reperfusion.

Small-intestinal bleeding from angiodysplasia after aortic valve replacement.

An association between aortic stenosis and angiodysplasia of the gut has been reported, though this is unproven. In many instances, recurrent gastrointestinal bleeding originating from angiodysplasia has ceased following aortic valve replacement (AVR). A case is reported of massive bleeding from a small-intestinal angiodysplasia after AVR.

Mallory - weiss tear complicating intraoperative transesophageal echocardiography.

A Mallory - Weiss tear occurred as a complication of intraoperative transesophageal echocardiography carried out in a 62-year-old man who underwent coronary artery bypass grafting. Left ventricular function was monitored in the transgastric short-axis view. Postoperative esophagogastroscopy revealed a Mallory - Weiss tear at the gastroesophageal junction and erosions in the cardia, presumably secondary to contact pressure by the echoprobe and ultrasonic thermal injury.