Thoracic Endovascular Aortic Repair Without Subclavian Revascularization of a Ruptured Kommerell Diverticulum.

A ruptured Kommerell diverticulum is extremely rare. This is the first report of thoracic endovascular aortic repair without subclavian revascularization of a ruptured Kommerell diverticulum with a right-sided aortic arch. However, decisions regarding subclavian revascularization should be individualized based on the patient's anatomy and clinical presentation.

Strategy for acute DeBakey type I aortic dissection considering midterm results: a retrospective cohort study comparing ascending aortic replacement and total arch replacement with frozen elephant trunk technique.

Background: Acute type A aortic dissection is treated with an emergency procedure that uses ascending aortic replacement (AAR). However, to avoid a residual dissected aorta with a false lumen, total arch replacement (TAR) is required. The frozen elephant trunk (FET) technique is a promising surgical approach that promotes false lumen obliteration in a single step.

Concomitant surgery of minimally invasive direct coronary artery bypass with left atrium appendage closure.

Surgical approaches of minimally invasive direct coronary artery bypass and left atrial appendage exclusion are different, and issues may arise in cases of concomitant surgery. Moreover, the safety of concomitant procedures has not been established. A man in his 80s with a history of stroke required minimally invasive coronary artery bypass grafting and left atrial appendage closure for the stenosis of the left anterior descending artery and atrial fibrillation.

A Partial Clamp During Off-Pump Coronary Artery Bypass Grafting Can be Safely Used When Utilizing the Calcium Score with Computed Tomography For Evaluating The Ascending Aorta.

Background: No previous study has shown that the volume of calcium score is useful for evaluating the aorta when performing a partial clamp (PC). The purpose of this study was to examine the effect of different clamping strategies during off-pump coronary artery bypass grafting (OPCAB), in terms of the incidence of postoperative stroke using the calcium score of the ascending aorta.

Methods: We retrospectively reviewed 339 patients, who underwent isolated OPCAB between August 2013 and March 2021.

Combination of endoscopic internal thoracic artery harvest and proximal anastomoses on the descending aorta in minimally invasive coronary artery bypass grafting.

Minimally invasive coronary artery bypass grafting is less invasive. Proximal anastomoses at the ascending aorta, in contrast, are technically difficult to perform because of the limited field of view. A man in his 60s undergoing haemodialysis required minimally invasive coronary artery bypass grafting for left anterior descending artery and circumflex arterial restenosis.

Revascularization for controlling hypertension and improving cardiorenal failure in Leriche syndrome.

Leriche syndrome usually occurs when atherosclerotic obstructions result in luminal narrowing of the abdominal aorta or iliac arteries and leads to thrombosis; it rarely causes heart or renal failure. We report the case of a 58-year-old Asian man with heart and renal failure as the dominant clinical manifestations of renovascular hypertension caused by Leriche syndrome. We performed an aorto-bifemoral bypass and unilateral renal artery stenting.

Endoscopic Internal Thoracic Artery Harvesting with Changes in Scope Position.

Although minimally invasive direct coronary artery bypass (MIDCAB) is a less invasive procedure, internal thoracic artery (ITA) harvesting is difficult. A 65-year-old woman was advised to undergo MIDCAB for recurrent in-stent restenosis. We harvested the ITA using three-dimensional endoscopy without robotics and determined the scope position using enhanced computed tomography.

Stent graft in abdominal aortic aneurysm collapsed suddenly after thoracic endovascular aortic repair.

Stent graft collapse due to aortic dissection is an extremely rare event. Although endovascular aneurysm repair (EVAR) and thoracic endovascular aortic repair (TEVAR) are increasingly being performed, various complications can occur. We report a case of collapse of a stent graft, which was used to repair an abdominal aortic aneurysm (AAA) after TEVAR for thoracic aortic aneurysm (TAA).

Late-onset total anomalous pulmonary venous connection in a 70-year-old woman.

Total anomalous pulmonary venous connection (TAPVC) is a rare congenital cardiac anomaly. There are a few reports of untreated TAPVC diagnosed in patients older than 60 years. Herein, we report the successful surgical treatment of TAPVC in a 70-year-old woman.

Mild Systemic Hypothermic Circulatory Arrest Using a Frozen Elephant Trunk Graft with Endo-Balloon Occlusion for Total Arch Replacement.

Background: Stroke and paraplegia are serious complications of total aortic arch replacement (TAR). Hypothermic circulatory arrest and cerebral perfusion reduce the risk of neurologic complications, but longer circulatory arrest time remains a risk factor for such complications. We utilized a frozen elephant trunk (FET) with endo-balloon occlusion under mild systemic hypothermia, which allowed us to shorten circulatory arrest time.

Three-port totally endoscopic repair vs conventional median sternotomy for atrial septal defect.

Purposes: We assessed the validity of three-port totally endoscopic repair (3PTER) for atrial septal defect (ASD).

Methods: Between February, 2000 and November, 2017, 151 patients underwent surgery for ASD. Forty-seven patients underwent 3PTER as minimally invasive cardiac surgery (MICS) and 104 patients underwent conventional median sternotomy (CMS).

Long-term patency of on- and off-pump coronary artery bypass grafting with bilateral internal thoracic arteries: the significance of late string sign development in the off-pump technique.

Objectives: This study aimed to examine the effect of off-pump coronary artery bypass grafting (CABG) in patients who underwent revascularization with bilateral internal thoracic arteries (ITAs).

Methods: Between January 2000 and December 2014, 499 patients underwent isolated CABG with bilateral ITAs for complete revascularization of the left coronary system at our institution. On-pump CABG was performed in 137 patients, and off-pump CABG was performed in 362 patients.

Trans-right axillary aortic valve replacement: propensity-matched comparison with standard sternotomy approach.

Objectives: We developed trans-right axillary aortic valve replacement (TAX-AVR) as a more cosmetically superior approach to minimally invasive AVR. We herein retrospectively compared the safety and invasiveness between TAX-AVR and conventional AVR (C-AVR).

Methods: TAX-AVR was performed under femorofemoral cardiopulmonary bypass.

Three-port (one incision plus two-port) endoscopic mitral valve surgery without robotic assistance.

Objectives: Totally endoscopic minimally invasive mitral valve surgery (MIMVS) is technically demanding and often performed with robotic assistance. We hypothesized that three-port video-assisted thoracic surgery (VATS) would facilitate endoscopic MIMVS and evaluated its feasibility and safety.

Methods: From October 2010 to June 2016, we performed first-time MIMVS in 250 consecutive patients (122 male), with median age of 65 years (54-73 years, 25-75 percentile).

Effect of modified proximal anastomosis of the free right internal thoracic artery: piggyback and foldback techniques.

Objectives: Few studies have reported the free right internal thoracic artery (RITA) being used in an aorto-coronary fashion. This study aimed to evaluate the free RITA with modified proximal anastomosis in an aorto-coronary fashion.

Methods: Between January 2000 and December 2012, 282 patients underwent coronary artery bypass grafting with bilateral internal thoracic arteries for complete revascularization of the left coronary system at our institution.

Outcomes of video-assisted minimally invasive approach through right mini-thoracotomy for resection of benign cardiac masses; compared with median sternotomy.

Background: We performed a retrospective study of patients who underwent a video-assisted minimally invasive right mini-thoracotomy approach for cardiac benign tumor resection compared with median sternotomy.

Methods: Of 23 patients who underwent isolated benign cardiac mass resection at the Japanese Red Cross Nagoya Daiichi Hospital from 2001 to 2014, 16 patients were treated through median sternotomy and seven were operated through right mini-thoracotomy.

Results: No hospital deaths occurred.

[Reoperative cardiac surgery after previous coronary artery bypass grafting].

Reoperative cardiac surgery after coronary artery bypass grafting( CABG) has been increasing. We reviewed 25 cases of reoperative cardiac surgery after CABG. Re-CABG was not included in this study.

Seamless reconstruction of mitral leaflet and chordae with one piece of pericardium.

Objectives: Mitral valve repair is challenging when enough pliable mitral leaflets and chordae are not left intact because of extensive infective endocarditis or chronic sclerotic degeneration. For those cases, we developed a simple method to reconstruct defective leaflets and chordae en bloc with a piece of pericardium, and the mid-term results were evaluated.

Methods: From January 2009 to November 2013, 25 patients with the mean age of 63 (range 20-88) years underwent this operation.

[Ascending aorta replacement late after aortic valve replacement].

Replacement of the asceding aorta is indicated in patients undergoing aortic valve replacement( AVR), if the diameter of the ascending aorta is greater than 5.0 cm. If the diameter of the asceding aorta is from 4.