Infectious Thoracoabdominal Aortic Aneurysm Repair in a Patient with Myasthenia Gravis: A Case Report.

Myasthenia gravis (MG) is an autoimmune neuromuscular junction disorder that rarely coexists with infectious thoracoabdominal aortic aneurysms (TAAA) requiring open repair. A 57-year-old patient with MG underwent elective thoracoabdominal aortic replacement. He was diagnosed with MG (Osserman classification II A).

[Intractable Hyperglycemia and Hyperlactatemia with Severe Circulatory Failure after Coronary Artery Bypass Grafting;Report of a Case].

The patient a 75-year-old man who was treated for diabetes and angina pectoris. He relapsed with an angina attack. Coronary angiography revealed three-vessel disease.

Single lung retrieval from a donor supported by a left ventricular assist device.

The number of patients who need cardiac support with a left ventricular assist device (LVAD) has increased over the last decade. However, the number of reports of organ retrieval from donors with an LVAD is still small. Successful lung retrieval for single lung transplantation was performed from a donor on LVAD support.

Valve-sparing aortic root re-implantation for commissural detachment with fibrous strand.

Both aortic valve commissural detachment and commissural fenestration are rare causes of aortic regurgitation. In general, aortic valve replacement is the mainstay treatment for aortic regurgitation caused by commissural detachment or commissural fenestration. We herein describe valve-sparing aortic root re-implantation and aortic valve repair for aortic regurgitation and aortic root dilatation in an extremely rare case accompanied by both commissural detachment and commissural fibrous strand of fenestrated cusp.

Afebrile Pannus-Induced Blood Culture-Negative Mechanical Valve Endocarditis.

The diagnosis of prosthetic valve endocarditis may be challenging in patients with an atypical clinical presentation. Virtually all infections associated with mechanical prosthetic valves are localized to the prosthesis-tissue junction at the sewing ring and are accompanied by tissue destruction around the prosthesis. Because the orifice of the mechanical prosthetic valve is made of metal and pyrolytic carbon, which do not enable the adherence of microorganisms, any vegetation originating from the interior of the valve orifice is usually rare.

Long-Term Quality of Life after Cardiac and Thoracic Aortic Surgery for Very Elderly Patients 85 Years or Older.

Purpose: We evaluated the outcomes of open heart surgery and long-term quality of life for patients 85 years and older.

Methods: We enrolled 46 patients 85 years and older who underwent cardiac and thoracic aortic surgery between May 1999 and November 2012. Long-term assessment was performed for 43 patients; three patients who died in the hospital were excluded.

[Native Valve Endocarditis due to Corynebacterium Striatum; Report of a Case].

We recently encountered a case of native valve endocarditis caused by Corynebacterium striatum (C. striatum) in the absence of immunosuppression and a prosthetic valve. A 49-year-old woman was urgently admitted for disturbance of consciousness and nosebleeds.

[Surgical Procedure Using the Elephant Trunk Technique at All Anastomotic Sites for Acute Type A Aortic Dissection].

Objective: We report the use of the elephant trunk technique at all anastomotic sites in acute type A aortic dissection surgery.

Methods: Artificial graft carrying a 2-mm short elephant trunk were prepared for both distal and proximal anastomotic sites. Subjects were 82 patients with acute type A aortic dissection who underwent surgery using this procedure between March 2009 and August 2015.

Imaging-Based Predictors of Persistent Type II Endoleak After Endovascular Abdominal Aortic Aneurysm Repair.

Objective: The purpose of this study is to determine the imaging-based parameters associated with the occurrence of persistent type II endoleaks after endovascular abdominal aortic aneurysm repair.

Materials And Methods: We reviewed the imaging and clinical data for 47 patients with early-onset type II endoleak after endovascular repair. Various predictors of persistent type II endoleaks were analyzed on the basis of preoperative CT findings.

Swinging Calcified Amorphous Tumors With Related Mitral Annular Calcification.

Among cardiac calcified amorphous tumors, the mitral annular calcification-related calcified amorphous tumor is extremely rare. We herein describe 3 surgical cases of swinging calcified amorphous tumor with related mitral annular calcification. The clinical, echocardiographic, and pathophysiologic features are reported here together with a brief review of the literature.

A right thoracotomy approach for mitral and tricuspid valve surgery in patients with previous standard sternotomy: comparison with a re-sternotomy approach.

Background: To compare the outcomes of mitral and/or tricuspid valve surgery in patients with previous sternotomy between those who underwent a right thoracotomy and those who underwent re-sternotomy.

Methods: Between October 2009 and May 2015, eighteen patients underwent a right thoracotomy (R group) and 28 underwent re-sternotomy (re-S group). The right thoracotomy was prioritized for previous coronary artery bypass grafting.

Surgical repair of pulmonary artery dissection in a patient with 10-year history of Takayasu's arteritis.

Pulmonary artery (PA) dissection is a rare but life-threatening event, predisposing to sudden cardiac death and cardiogenic shock, and generally occurs in patients with underlying pulmonary hypertension. We report a case of surgical repair of PA dissection in a patient with 10-year history of Takayasu's arteritis and with no diagnosis of pulmonary hypertension.

A modified Bentall procedure in a patient with a displaced left coronary ostium.

We encountered a 63-year-old female in whom the left coronary ostium was located close to the commissure between the right and left coronary cusps, and performed aortic root replacement leaving the left coronary artery and surrounding the sinus of Valsalva. The sinus of Valsalva, prosthetic valve cuff, and prosthetic vessel were sutured together when the region other than the left coronary artery-containing sinus of Valsalva was sutured. The hemostatic effect of our procedure, which is for cases in which preparation of a coronary button is difficult, was favorable and antegrade coronary arterial blood flow could be maintained.

[Repair of Cardiac and Pulmonary Damage caused by Stabbing with a Kitchen Knife;Report of a Case].

A 51-year-old woman was stabbed in the chest with a kitchen knife. Twenty minutes after arrival at our hospital by ambulance, she was transferred to the operating room, and a cardiopulmonary bypass was established from the right femoral artery and vein, and a median sternotomy was performed. The knife had damaged the surface of the heart and penetrated the lingular segment of the left lung.

Technical aspects of mitral valve repair in Barlow's valve with prolapse of both leaflets: triangular resection for excess tissue, sophisticated chordal replacement, and their combination (the restoration technique).

Background: Histological degeneration in Barlow's valve mainly starts in the rough zone, frequently expands toward the chordae, and advances to the clear zone, resulting in a saccular aneurysm-like morphology in the prolapsed region. On this basis, we have repaired the prolapsed segment by triangular resection, chordal replacement and the combination (the restoration technique). The aim of this study was to report our initial findings and evaluate the efficacy of our technique.

[Annuloplasty ring and band for valve repair].

Annulus dilatation is present in almost all patients with mitral regurgitation, tricuspid regurgitation. Therefore annuloplasty is required to obtain normal leaflet coaptation. Annuloplasty ring or band offers more stability in valve repair, improving long-term outcome.

Free-floating left atrial ball thrombus after mitral valve replacement with patent coronary artery bypass grafts: successful removal by a right minithoracotomy approach without aortic cross-clamp.

A free-floating thrombus in the left atrium without attachment to either the atrial wall or the mitral valve is extremely rare. We describe a case in a 79-year-old woman with chronic atrial fibrillation and a recent stroke who had undergone mitral valve replacement 25 years previously and coronary artery bypass grafting 5 years previously. Redo cardiac surgery represents a clinical challenge due to a higher rate of peri-operative morbidity and mortality.

Asymptomatic and isolated accessory mitral valve tissue in an adult.

Accessory mitral valve (AMV) tissue is a congenital anomaly that occurs in association with other congenital anomalies, and is an uncommon cause of left ventricular outflow tract obstruction. It is usually detected in early childhood when accompanied by symptoms of obstruction of the left ventricular outflow tract, and is rarely diagnosed in adults. We present a case of a 53-year-old man who was referred to our institution for evaluation of a systolic heart murmur.

Right infarction response to coronary artery bypass and the Abiomed BVS 5000.

A 57-year-old man presented with acute right ventricular infarction. A percutaneous coronary intervention was undertaken, but he developed shock and required extracorporeal membrane oxygenator support. Coronary artery bypass was performed, and a Abiomed BVS 5000 was implanted as a right ventricular assist device.

A cardiac hemangioma treated by a right minithoracotomy approach with thoracoscopic assistance.

Cardiac hemangiomas are extremely rare tumors, accounting for only 2.5% of all cardiac tumors. Most of these develop in the ventricles, and obtaining a good field of view is, therefore, the key to successful operation.