[Distal Stent Graft-induced New Entry after Total Arch Replacement for the Aortic Dissection:Report of a Case].

A 73-year-old man after total arch replacement with open stent graft (OSG) technique for Stanford type B aortic dissection was found to have expanding descending aortic aneurysm. Contrast-enhanced computed tomography (CT) showed distal stent graft-induced new entry (distal SINE). We successfully performed additional thoracic endovascular aortic repair (TEVAR).

[Postinfarction Ventricular Septal Perforation Treated with the Sandwich Method Using a Right Ventricular Approach;Report of a Case].

The patient was a 75-year-old man who presented to our hospital with complaints of palpitation and a cold sensation. Echocardiography revealed ventricular septal perforation(VSP) at the base of the posterior septum. As his hemodynamic condition was stable, patch closure of the VSP was performed on the 50th hospital day after fibrosis at the infarction site developed.

[Modified Warden Procedure for Correction of Partial Anomalous Pulmonary Venous Connection and Sinus Venosus Atrial Septal Defect in an Adult].

A 32-year-old woman was referred to our hospital for the surgical indication of sinus venosus-type atrial septal defect. Preoperative computed tomography scan revealed that the right upper pulmonary vein returned to the high superior vena cava. We performed a modified Warden procedure using a pedicle flap of the right atrial appendage along with a fresh autologous pericardium.

[A Single-knot Lock Procedure for Adjustment of Artificial Chordae in Mitral Valve Repair].

We describe a simple and reproducible technique for adjustment of neochordal length in mitral valve repair with a single-knot lock procedure. A small loop with polytetra fluoroethylene(CV-4)is secured on the papillary muscle as an anchor for the neochordae. A needle with CV-5 suture is passed through the anchor loop, and both ends of the suture are passed through the free edge of the prolapsed mitral leaflet.

[Technique to Reinforce Double-barreled Distal Aortic Anastomosis in the Repair of Aortic Dissection].

We describe a technique to reinforce a double-barreled aortic anastomosis in the repair of chronic aortic dissection. After distal aortic resection was carried out, an intimal flap was incised lineally 1 cm in width along with its margin. This intimal band was reapproximated to the adventitia which supported the false lumen.

[Novel Device for Creating Multiple Artificial Chordae Loops in Mitral Valve Repair].

A novel device to create multiple artificial chordae loops for mitral repair is developed. The device consists of a circular metal base with a removable central rod on one end, which can easily be attached or removed by screwing into a hole located on the base, and 51 fixed rods placed radially around the central rod at distances of 10~60 mm from the central rod. A needle with CV-4 e-polytetrafluoroethylene suture is passed through a pledget, and the suture is looped from the central rod around the fixed rod located at the desired loop length.

Effect of landiolol hydrochloride after off-pump coronary artery bypass.

Objectives: many studies have shown that oral beta blockers reduce the incidence of atrial fibrillation after coronary artery bypass. The goal of this study was to determine whether landiolol, an intravenous beta blocker, reduces the incidence of atrial fibrillation after off-pump coronary artery bypass.

Methods: 39 consecutive patients were given landiolol after coronary artery bypass, and 20 who were not given landiolol served as a control group.

Acute aortic regurgitation due to aortic dissection confined to the sinus of Valsalva.

A 34-year-old man with severe heart failure was diagnosed with acute aortic regurgitation (AR) by transthoracic echocardiography (TTE). However, this differential diagnosis was incomplete. Only transesophageal echocardiography (TEE) revealed an intimal flap, leading to a diagnosis of Stanford type A aortic dissection.

Diaphragmatic hernia following coronary artery bypass surgery with the right gastroepiploic artery: case report and literature review.

We report an unusual case of intrapericardial diaphragmatic hernia 2 years after coronary artery bypass surgery with the right gastroepiploic artery. Herniation through the orifice created for the right gastroepiploic artery caused small bowel strangulation and secondary volvulus requiring extensive small bowel resection due to acute mesenteric ischemia. This case highlights the importance of careful operative management of coronary artery bypass surgery with the right gastroepiploic artery and increases awareness of this rare but potentially fatal complication.

Injury to the tricuspid valve and membranous atrioventricular septum caused by huge calcified right ventricular myxoma: report of a case.

A 64-year-old female, admitted because of severe dyspnea on exertion and facial edema, showed echocardiographic findings of a large tumor in the right ventricle (RV). Echocardiography revealed a cardiac mass extending from the RV across the tricuspid valve into the right atrium, synchronized with the cardiac cycle, and severe tricuspid regurgitation was apparent. The mass was removed under cardiopulmonary bypass.

Pathogenetic significance of myxomatous degeneration in fenestration-related massive aortic regurgitation.

Background: Aortic valvular regurgitation has several mechanisms and the present study investigated its clinicopathological correlations with aortic valve fenestration.

Methods And Results: Six male patients with massive regurgitation and enlarged fenestrations or ruptured fenestrated fibrous cords underwent aortic valve replacement. The clinicopathological features showed many similarities.

Echocardiographic and surgical findings of spontaneous avulsion of the aortic valve commissure.

Spontaneous detachment of the aortic valve commissure (ie, avulsion of a commissure) is a rare cause of acute massive aortic regurgitation that follows a rapidly deteriorating clinical course. The aortic valve commissure between the non-coronary and right coronary cusps detached from the aortic wall in a 79-year old man with ascending aortic aneurysm. Emergency aortic valve replacement and aneurysmoplasty were successfully performed; histopathology of the aorta and aortic valve showed cystic medial necrosis and myxomatous degeneration, respectively.