Long-Term Survival in a Case of Primary Leiomyosarcoma of the Inferior Vena Cava in Which PET-CT Follow-up Was Useful.

Leiomyosarcoma of the inferior vena cava (IVC) is a rare malignancy, but has been found more frequently with recent advances in diagnostic imaging. Local recurrence and metastases are frequent with this pathology, and prognosis is poor. We report a case of a patient with leiomyosarcoma of the IVC surviving for >10 years after the first resection despite local recurrence and two metastatic recurrences to the pancreas and liver, with successful excisions following early detection on positron emission tomography-computed tomography.

[Intravenous Ablation for Lower Extremity Varices to Prevent Recurrent Pulmonary Embolism in Klippel-Trenaunay Syndrome;Report of a Case].

Klippel-Trenaunay syndrome( KTS) is a complex congenital anomaly characterized by lower extremity varix and venous malformations, port-wine stains, and soft tissue and bone hypertrophy. We present a case of a 35-year-old man of KTS with pulmonary embolism (PE). The patient was referred to our hospital complaining of the leg pain and sudden onset of dyspnea.

Coronary artery spasm following off-pump coronary artery bypass surgery.

Coronary artery spasm after coronary artery bypass surgery may result in life-threatening arrhythmias, circulatory collapse, or death. We report two cases of coronary artery spasm after coronary artery bypass surgery, one of which developed ventricular fibrillation requiring extracorporeal membrane oxygenation support. Both patients were discharged in good condition and are currently followed as outpatients.

Large aneurysm in saphenous vein coronary artery graft with fistula: case report and review.

Aneurysms developing in a saphenous vein graft (SVG) after coronary artery bypass grafting (CABG) are an unusual complication and fistulae forming between an SVG aneurysm and a cardiac chamber are even rarer. A 71-year-old man had undergone a triple CABG with the left internal thoracic artery and double SVGs. Twenty years later, he was admitted with repeated congestive heart failure.

Repeated mitral valve replacement in a patient with extensive annular calcification.

Background: Mitral valve replacement in the presence of severe annular calcification is a technical challenge.

Case Report: A 47-year-old lady who had undergone mitral and aortic valve replacement for rheumatic disease 27 years before presented with dyspnea. At reoperation, extensive mitral annular calcification was hindering the disc motion of the Starr-Edwards mitral prosthesis.

Long term results with the Cabrol aortic root replacement.

Cabrol aortic root replacement is rarely performed in recent years because of potential coronary complications. The purpose of this study was to investigate its early and late results, including coronary complications, by evaluating our experience thus far. A retrospective lookup of patients who underwent Cabrol aortic root replacement between 1988 and 2001 found a total of 36 patients (24 men and 12 women) with a mean age of 45 years.

[Acute forearm compartment syndrome after total arch replacement].

A 61-year-old female presented with shortness of breath and was found to have moderate aortic regurgitation with annulo-aortic ectasia and an aneurysm involving the aortic arch. She underwent Bentall operation and total arch replacement with a branched prosthesis. The patient developed hypesthesia and paresis of the left forearm one day after the surgery.

Arteriovenous access closure in hemodialysis patients with refractory heart failure: a single center experience.

Arteriovenous dialysis access may impose a burden on the cardiac system. The objective of this study is to examine the usefulness of access closure in hemodialysis patients with refractory heart failure and to identify possible factors associated with symptomatic improvements. The study population comprised 33 hemodialysis patients with symptomatic heart failure (New York Heart Association [NYHA] class ≥ II), who underwent arteriovenous access closure (30 fistulas and three grafts) between 1991 and 2008.

[Heparin-induced thrombocytopenia after on-pump coronary artery bypass grafting].

We report herein a case of a patient who suffered heparin-induced thrombocytopenia (HIT) after on-pump coronary bypass grafting (CABG). A 62-year-old woman had received coronary angiography with heparin 4 months before CABG. She had been given heparin for 7 days before CABG, and underwent the operation under cardiopulmonary bypass uneventfully.

Mid-term results of a closed biatrial procedure using bipolar radiofrequency ablation concomitantly performed with non-mitral cardiac operations.

The long-term success rate of the Cox maze III procedure is excellent, although it has not been widely adopted because of the need for extensive incisions of the atria. In this study, we report our experience with a closed biatrial procedure using bipolar radiofrequency (RF) ablation for treating atrial fibrillation (AF) during non-mitral cardiac operations. Beginning in December 2004, a total of 19 patients underwent a closed biatrial procedure with bipolar RF energy.

Concomitant aortic valve-sparing operation and closed biatrial radiofrequency ablation for annuloaortic ectasia and paroxysmal atrial fibrillation.

A 53-year-old woman was admitted for annuloaortic ectasia with moderate aortic valve insufficiency (AI) and paroxysmal atrial fibrillation. Concomitant aortic root replacement with a valve-sparing technique and closed biatrial procedure using bipolar radiofrequency ablation was performed successfully. Postoperative echocardiography showed trivial AI with regular sinus rhythm, which meant she could avoid anticoagulation therapy.

Off-pump coronary artery bypass grafting in a patient with Werner's syndrome.

Werner's syndrome is a rare hereditary disorder that is characterized by premature aging. We report a case of off-pump coronary artery bypass grafting (OPCAB) in a 56-year-old man with Werner's syndrome. We used an endoscopic vessel-harvesting system to harvest great saphenous vein grafts (SVGs) because this system helps minimize surgical wounds.

Papillary fibroelastoma of the left ventricle: report of two cases.

Papillary fibroelastoma is a relatively rare cardiac tumor. We report two cases of papillary fibroelastoma. The first case involved a 45-year-old woman who presented with rheumatic valves and three tumors developing from the papillary muscle and left ventricle.

Evaluation of coronary artery bypass grafts and native coronary arteries using 64-slice multidetector computed tomography.

Background: The conventional use of 16-slice multidetector computed tomography (MDCT) remains somewhat limited for evaluating stenoses in vein graft distal anastomotic sites and in coronary arteries. We investigated the diagnostic accuracy of 64-slice MDCT for assessment of both grafts and coronary arteries in patients with coronary artery bypass grafts.

Method: The study group included 54 consecutive patients.

Rapid diagnosis and management of intraoperative myocardial infarction during valvular surgery: using intraoperative transesophageal echocardiography followed by emergency coronary artery bypass grafting without coronary angiography.

A 68-year-old man was admitted to undergo elective mitral valve surgery. Although the preoperative coronary angiography was normal, the patient suffered a myocardial infarction that resulted in untreatable collapsed hemodynamics. After inferring the responsible occluded coronary artery from the segmental wall motion abnormality detected in intraoperative transesophageal echocardiography, together with the anatomy found in preoperative coronary angiography, we performed an emergency coronary artery bypass graft surgery without a new angiography.