Stanford type B aortic dissection is more frequently associated with coronary artery atherosclerosis than type A.

Background: The relationship between aortic dissection and coronary artery disease is not clear. The purpose of this study was to clarify the difference in the rate of coronary artery atherosclerosis between Stanford type A and type B aortic dissection by reviewing our institutional database.

Methods: One hundred and forty-five patients (78 males, 67 females; mean age: 60 ± 12 years) admitted to our hospital with acute aortic dissection who underwent coronary angiography during hospitalization from 2000 through 2002 were enrolled in this study.

Successful coronary transfer for transposition of the great arteries with bilateral intramural coronary arteries from a single aortic sinus.

We experienced an arterial switch operation in a patient with d-transposition of the great arteries associated with bilateral intramural coronary arteries from a single coronary ostium. In performing the coronary transfer, intramural course of bilateral coronary arteries was unroofed and coronary ostium was separated into two coronary buttons. The two coronary buttons were translocated to the neo-aorta using modified trap-door technique.

The AB Portable Driver Generates Higher Drive-Line Pressures Possibly Leading to Accelerated Hemolysis.

The AB5000 Circulatory Support System is paracorporeal pulsatile ventricular assist device. The AB Portable Driver is a portable console for this system. We experienced two cases with accelerated hemolysis while receiving support by the AB Portable Driver.

Total arch replacement for coarctation of the aorta in an adolescent.

A 16-year-old boy suffered a subarachnoid hemorrhage and underwent open head surgery. He was subsequently diagnosed with coarctation of the aorta and referred to our hospital. The coarctation was at the distal transverse arch, just at the site of branching of the subclavian artery.

Bisphosphonate-related enamel hypoplasia in a child with idiopathic arterial calcification of infancy.

We report bisphosphonate-related enamel hypoplasia as a rare side effect in a child with idiopathic arterial calcification of infancy.

In situ graft replacement and rectus abdominis muscle flap transfer for infected thoracoabdominal aortic aneurysm after gastrectomy.

An infected thoracoabdominal aneurysm is a rare, life-threatening condition with high mortality. We performed an in situ graft replacement and applied a rectus abdominis muscle flap transfer technique in a case of infected thoracoabdominal aortic aneurysm after distal gastrectomy. A rectus abdominis muscle flap transfer might be a good alternative when the omental flap technique is not feasible.

[Aortic and mitral valve replacement for calcified valvular annulus in a dialysis patient; report of a case].

A 77-year-old man on hemodialysis was admitted to our hospital due to heart failure. Echocardiography showed aortic valve stenosis and regurgitation, mitral valve stenosis and regurgitaion, and tricuspid valve regurgitation. Catheter examination revealed severe calcification at aortic valve and mitral valve including their annulus.

Anatomical tricuspid valve replacement in a patient with corrected transposition of the great arteries and situs inversus with 90° clockwise rotation of the heart through right thoracotomy.

The patient was a 34-year-old man with corrected transposition of the great arteries and situs inversus who was admitted with dyspnea. He had undergone ventricular septal defect closure and pulmonary valve commissurotomy at the age of 15. Preoperative examinations revealed severe tricuspid (systemic atrioventricular valve) insufficiency associated with dysfunction of the systemic (anatomical right) ventricle.

[Usefulness of photo dynamic eye system for detection of graft spasm in off-pump coronary artery bypass grafting].

A 54-year-old-man on hemodialysis was admitted to the hospital because of effort angina. A coronary angiography revealed multiple stenoses including 90% stenosis in the left main trunk. Coronary artery bypass grafting (CABG) was performed with Y-composite grafts constructed by the right internal thoracic artery (RITA) and the free gastroepiploic artery (GEA) which were anastomosed to left anterior descending artery (LAD) and the diagonal branch (D1) using the off-pump technique.

[Preoperative respiratory training for a patient with chronic obstructive pulmonary disease undergoing redo mitral valve replacement].

The patient is a 76-year-old woman. She had undergone double valve replacement for rheumatic mitral and aortic valve regurgitation at the age of 64. She was diagnosed with chronic obstructive pulmonary disease (COPD) at 73 years old (Hugh-Jones class IV) .

Total arch replacement for incomplete double aortic arch associated with patent ductus arteriosus in an adult.

The patient was a 52-year-old man. A plain chest radiograph showed widening of the superior mediastinum. Three-dimensional computed tomography revealed a thoracic aortic aneurysm involving an incomplete double aortic arch (Stewart's IB type 4) with a patent ductus arteriosus.

Conversion to total cavopulmonary connection 9 years after closure of a large ventricular septal defect.

We performed an extracardiac total cavopulmonary connection (TCPC) operation using tissue-engineered graft for a patient with elevated central venous pressure due to severe tricuspid valve insufficiency 9 years after closure of a large ventricular septal defect. Before the TCPC, this patient had a right atrial thrombus and pulmonary embolism for which thrombolytic therapy was ineffective. The patient has been receiving anticoagulation therapy with both warfarin sodium and aspirin for 10 months after TCPC operation to avoid thrombotic complications.

Modified Myers and coronary artery bypass grafting using free internal thoracic artery graft for complicated supravalvular aortic stenosis.

The left main trunk stenosis with Williams syndrome and supravalvular stenosis is a cause of sudden death and a serious disease. We performed modified Myers procedure with patch aortoplasty concomitant with coronary artery bypass grafting (CABG) using a free right internal thoracic artery (ITA) graft for a 2-year-old patient with this disease. The proximal cuff of the free right ITA graft was implanted in the posterior wall of the reconstructed aorta.

Establishing right ventricle-pulmonary artery continuity by autologous tissue: an alternative approach for prosthetic conduit repair.

Background: In conventional conduit operations, longevity has been essentially limited by the inevitable need for conduit replacement. This study was undertaken to compare long-term results of the use of equine pericardial conduits, autologous pericardial conduits, and direct anastomosis repair.

Methods: Between 1982 and 2001, 366 patients underwent primary establishment of right ventricle-pulmonary artery continuity at our institution.

The influence of pH strategy on cerebral and collateral circulation during hypothermic cardiopulmonary bypass in cyanotic patients with heart disease: results of a randomized trial and real-time monitoring.

Objective: The optimal pH strategy during hypothermic cardiopulmonary bypass remains controversial. Systemic pulmonary collateral circulation may develop in patients with cyanotic anomalies. The purpose of this study was to evaluate the effect of pH strategies on cerebral oxygenation and systemic pulmonary collateral circulation during hypothermic cardiopulmonary bypass in cyanotic patients with heart disease.

Persistent fifth aortic arch and fourth arch interruption in a 28-year-old woman.

A 28-year-old woman having persistent fifth aortic arch and aortic coarctation associated with the fourth arch interruption, without other cardiac malformation, underwent graft interposition, 20 mm in diameter, between the fourth arch including the left subclavian artery and the descending aorta.

Extracardiac total cavopulmonary connection using a tissue-engineered graft.

Objective: Extracardiac and lateral tunnel total cavopulmonary connection are currently 2 major options for patients with a single ventricle physiology. However, each procedure has some disadvantages over the other. We developed a new technique of extracardiac total cavopulmonary connection using a tissue-engineered graft to overcome some of the disadvantages previously associated with both the extracardiac and lateral tunnel procedures.

Surgery for unilateral absence of pulmonary artery using autologous tissue.

A 7-year-old girl with unilateral absence of the pulmonary artery underwent autologous tissue limited reconstructive surgery. The proximal portion of the artery was reconstructed by rotating a reverse U-shaped cut opposite the pulmonary arterial wall and covering the anterior surface with autologous pericardium. Follow-up catheterization at 5.

Role of microtubules versus myosin heavy chain isoforms in contractile dysfunction of hypertrophied murine cardiocytes.

In large mammals there is a correlation between microtubule network densification and contractile dysfunction in severe pressure-overload hypertrophy. In small mammals there is a similar correlation for the shift to beta-myosin heavy chain (MHC), a MHC isoform having a slower ATPase Vmax. In this study, murine left ventricular (LV) pressure overload invoked both mechanisms: microtubule network densification and beta-MHC expression.

Cardiac-specific expression and hypertrophic upregulation of the feline Na(+)-Ca(2+) exchanger gene H1-promoter in a transgenic mouse model.

The NCX1 gene contains three promoters (H1, K1, and Br1), and as a result of alternative promoter usage and alternative splicing, there are multiple tissue-specific variants of the Na(+)-Ca(2+) exchanger. We have proposed that for NCX1, the H1 promoter regulates expression in the heart, the K1 promoter regulates expression in the kidney, and the Br1 promoter regulates expression in the brain as well as low-level ubiquitous expression. Here, using a transgenic mouse model, we test the role of the DNA region including -1831 to 67 bp of intron 1, encompassing exon H1 of the feline NCX1 gene (NCX1H1).

Coarctation of the aorta and ventricular septal defect: should we perform a single-stage repair?

Background: Optimal management for coarctation of the aorta and ventricular septal defect remains controversial. The current study was undertaken to determine outcome, including recoarctation after 2-stage repair, at our institution.

Methods: Between 1984 and 1998, 79 patients younger than 3 months with coarctation and ventricular septal defect underwent 2-stage repair at our institution.

Predicting blood transfusion factors in coronary artery bypass surgery.

Objective: Blood conservation has become one of the most important issues in cardiac surgery. We clarified preoperative predictors of the need for blood transfusions during coronary artery bypass graft surgery.

Methods: Subjects were 89 patients--66 men (74%) and 23 women (26%) 40 to 84 years old (mean: 66.

Surgical intervention for anomalous origin of the left coronary artery from the pulmonary artery: the Tokyo experience.

Background: Few studies after surgical repair of the anomalous origin of the left coronary artery have reported the importance of the mitral annuloplasty or the long-term results.

Methods: Between January 1982 and March 2000, 29 patients with anomalous origin underwent surgical intervention at our institution (direct aortic reimplantation in 19 and Takeuchi procedure in 10). Age at the time of operation ranged from 2 months to 24 years (median, 29.