Long-term results of endovascular repair for distal arch and descending thoracic aortic aneurysms treated by custom-made endografts: usefulness of fenestrated endografts.

Objective: We evaluated early and long-term results of atherosclerotic aneurysm repair with custom-made endografts.

Materials And Methods: Eighty-one consecutive patients underwent thoracic endovascular aortic repair with custom-made endografts. Fenestrated grafts were used in 37 patients (45.

Factors influencing permanent neurologic dysfunction and mortality after total arch replacement with separate arch vessel grafting using selective cerebral perfusion.

Objectives: The present study was undertaken to identify risk factors for permanent neurological dysfunction (PND) and in-hospital mortality after total aortic arch replacement (TAR) with separate arch vessel grafting using selective cerebral perfusion (SCP) and hypothermic circulatory arrest.

Methods: Between 1998 and 2008, we preformed a TAR on 143 consecutive patients in two centers by identical methods. Of these, 19 (13.

Outcome after valve surgery in octogenarians and efficacy of early mobilization with early cardiac rehabilitation.

Purpose: This study aimed to compare postoperative complications and the surgical outcome in patients aged <80 years versus octogenarian patients. Another aim was to evaluate the safety and efficacy of early mobilization with early cardiac rehabilitation in octogenarians.

Methods: A retrospective analysis was performed in 138 consecutive patients (group Y comprised 118 patients <80 years, and group O comprised 20 octogenarians) who had undergone valve surgery at the authors' institution between July 2007 and December 2009.

Acute aortic regurgitation resulting from dehiscence of the aortic valve commissures.

A 62-year-old man with a history of hypertension complained of cough and dyspnea and was admitted to a family doctor. He was transferred to our hospital for further investigation and therapy, a result of his doctor's suspicions of aortic regurgitation (AR) with infective endocarditis. During the operation, acute AR was found to be caused by dehiscence of the aortic valve commissures, and the valve was replaced with a mechanical valve.

Clinical outcome of aortic valve replacement with 16-mm ATS-advanced performance valve for small aortic annulus.

Background: Various surgical techniques have been proposed to treat small aortic annulus. We have used small-diameter mechanical valves for small aortic annulus. The present study examined aortic valve replacement with small diameter mechanical valves to determine their effectiveness.

Adventitial mast cells contribute to pathogenesis in the progression of abdominal aortic aneurysm.

Abdominal aortic aneurysm (AAA) is histologically characterized by medial degeneration and various degrees of chronic adventitial inflammation, although the mechanisms for progression of aneurysm are poorly understood. In the present study, we carried out histological study of AAA tissues of patients, and interventional animal and cell culture experiments to investigate a role of mast cells in the pathogenesis of AAA. The number of mast cells was found to increase in the outer media or adventitia of human AAA, showing a positive correlation between the cell number and the AAA diameter.

Clinical analysis of acute type A intramural hematoma: comparison between two different pathophysiological types.

Background: Type A intramural hematoma (IMH) has two different etiologies, which are rupture of vasa vasorum and penetrating atherosclerotic ulcer (PAU); however, it is difficult to know which is the initiating event.

Methods: Between January 1993 and August 2004, 28 patients of acute type A IMH were treated in our department and were divided into two groups, 20 patients with IMH probably caused by rupture of vasa vasorum (non-PAU group) and 8 patients with IMH probably caused by PAU (PAU group), according to pathologic specimen and atherosclerotic findings on computed tomography. Background factors, radiographic findings, and prognosis were analyzed retrospectively.

Predictor of neurologic dysfunction after elective thoracic aorta repair using selective cerebral perfusion.

Objectives: This study was undertaken to determine the factors that influence postoperative neurological dysfunction after selective cerebral perfusion (SCP).

Design: From 1995 to August 2004, 60 patients were evaluated for the presence of cerebro-vascular disease (CVD), and then underwent thoracic aortic operations using SCP. Perioperative factors were evaluated by multivariate analyses.

Nitric oxide inhalation prompts weaning from the right ventricular assist device: evaluation under continuous-flow biventricular assistance.

Objective: The objective of this study was to investigate the effect of nitric oxide on the recovery of right heart function under global ischemia with a continuous-flow biventricular assist device support.

Methods: Fifteen piglets were divided into three groups: continuous-flow biventricular assist support only (control group), global ischemia with continuous-flow biventricular assist support (ischemia only group), and global ischemia with continuous-flow biventricular assist support plus nitric oxide inhalation (nitric oxide group). Two continuous-flow pumps were used as left and right ventricular assist devices.

A safe automatic driving method for a continuous flow ventricular assist device based on motor current pulsatility: in vitro evaluation.

We previously reported that detection of two specific points (the t-point and the s-point) in the relationship between pump speed and Motor Current Amplitude index (ICA) indicates the safe driving range for a continuous-flow ventricular assist device (CFVAD). During the first stage of the present experiment, the characteristic curves relating pump speed and ICA were determined by varying preload (left atrial pressure: -6 to 30 mm Hg), afterload (total circuit resistance: 890 to 3,180 dyne x sec x cm(-5)), and contractility of the left ventricle (total circuit flow: 0.5 to 2.