[Pulmonary metastasis from colorectal cancer with hepatic metastasis].

We have investigated cases where pulmonary metastasis from colorectal cancer was resected during the last 15 years, comparing a group with liver metastasis [LM (+)] to a group without liver metastasis [LM (-)]. The following are the characteristics of the LM (+) versus LM (-) groups. Gender: male 6, female 5 versus male 9, female 11, age: 61.

[Esophageal rupture just after the graft replacement of thoracoabdominal aorta for chronic aortic dissection].

A 51-year-old man with thoracoabdominal aortic aneurysm (DeBakey IIIb type chronic aortic dissection) first underwent the graft replacement of thoracic aorta with elephant trunk technique. Postoperatively, the residual false lumen just distal to the inserted graft as an elephant trunk enlarged in a short period, and it compressed the esophagus. He underwent the second graft replacement of thoracoabdominal aorta 2 months after the first surgery.

Total aortic replacement for aortitis syndrome: report of a case.

We report herein the case of a 35-year-old woman who was administered steroid therapy based on a diagnosis of aortitis syndrome. Despite this treatment, the symptoms of cardiac failure gradually progressed, and she was referred to our hospital to undergo surgery. Preoperative evaluations revealed a large aneurysm extending from the ascending aorta to the thoracoabdominal aorta.

Impending rupture of the descending aorta by enlargement of the false lumen after graft replacement with the elephant trunk technique: report of a case.

We report herein a case of an impending rupture of the descending aorta caused by an enlargement of the false lumen after a graft replacement using the elephant trunk technique. The patient was a 51-year-old woman who had received a graft replacement of the ascending aorta for an acute Stanford type A aortic dissection 6 years previously. An enhanced computed tomographic scan and digital subtraction angiography revealed pseudoaneurysms at the proximal and distal anastomotic site, and a residual dissection of the aortic arch.

A single-stage operation for bicuspid aortic valve, annulo-aortic ectasia, hypoplastic aortic arch, and coarctation of the aorta: A case report.

The patient was an 18-year-old man who had been diagnosed as having a bicuspid aortic valve and dilatation of the ascending aorta six years previously. As he grew up, aneurysmal change of the ascending aorta and hypertension in the upper body gradually progressed. Preoperative evaluation showed annulo-aortic ectasia and the following congenital abnormalities: bicuspid aortic valve, hypoplastic aortic arch, and coarctation of the aorta.

[Axillary artery perfusion for the extensive arterial vascular disease].

Usefulness of axillar artery perfusion for the cases with severe systematic atherosclerosis was reported. It is generally accepted that the femoral artery is a common arterial cannulation site when performing the surgery of ascending aorta and total aortic arch. However, atheroembolism is one of the most severe complication for the patients with extensive arterial vascular disease by using femoral arterial perfusion.

[A case of Stanford type A acute aortic dissection associated with a distal aortic arch atherosclerotic aneurysm].

We report a rare case of Stanford type A acute aortic dissection associated with a distal aortic arch atherosclerotic aneurysm. A 71-year-old female was referred to us with the diagnosis of thrombosed Stanford type A acute aortic dissection, however on the next day transesophageal echocardiography revealed the false lumen has been recanalized. In the operation, there was a distal aortic arch atherosclerotic aneurysm which was unidentified at the preoperation.

Occlusion of the abdominal aorta caused by enlargement of the false lumen after graft replacement for a DeBakey type IIIb dissecting aneurysm: report of a case.

We report herein a case of abdominal aorta occlusion caused by enlargement of the false lumen after a graft replacement. The patient was a 70-year-old man who underwent a graft replacement of the descending thoracic aorta for a DeBakey type IIIb dissecting aneurysm. Digital subtraction angiography performed on postoperative day 18 revealed an abdominal aorta occlusion caused by enlargement of the false lumen.

[Successful surgical treatment for severe mitral valve annulus enlargement and mitral regurgitation 5 years after aortic root replacement in Marfan syndrome: a case report].

Major cardiovascular lesions associated with Marfan syndrome include aortic diseases such as aortic root dilatation and mitral disease. If untreated, cardiovascular manifestations of the Marfan syndrome cause death in one half of patients during the first four decades of life. Although aortic diseases in the Marfan syndrome are responsible for most of serious morbidity and mortality, 60-80% of patients with Marfan syndrome have mitral valve dysfunction.

[Minimally invasive direct coronary artery bypass grafting (MIDCAB) for re-operation in a 85 year-old patient].

An 85-year-old male, who had undergone aorto-coronary bypass grafting to left anterior descending coronary artery (LAD) using saphenous vein graft (SVG) seventeen years before, was operated with minimally invasive direct coronary artery bypass grafting (MIDCAB) without cardiopulmonary bypass. LAD was anastomosed with the in situ left internal thoracic artery through a limited anterior thoracotomy. The postoperative angiography showed patent graft, and the patient has been doing well without any complications.

[The early results of the minimally invasive direct coronary artery bypass (MIDCAB)].

The clinical experiences of 29 consecutive MIDCAB procedures performed at our institution between October, 1996, and October, 1997, were analyzed. Preoperative patient's characteristics were as follows; LAD single vessel disease: 25, double vessel disease: 1, triple vessel disease: 1, RC single vessel disease: 1, LMT lesion: 1, concomitant procedures: 2 (ASO: 1, AAA: 1). LITA harvesting was performed using the video-assisted thoracoscopy in initial 4 patients, and in last 10 patients we used the specially designed retractor THORALIFT (Autosuture Co.

[A case of graft replacement of the ascending aorta to the aortic arch and the partial descending aorta in a single stage for thrombosed aortic dissection (DeBakey type II + IIIb)].

We report here a case of graft replacement of the ascending aorta to the aortic arch and the middle portion of the descending aorta in a single stage for thrombosed aortic dissection. The patient was a 53-year-old male who was transferred to our hospital with a diagnosis of thrombosed aortic dissection. Conservative therapy was continued but three weeks after the onset, chest enhanced CT scan and digital subtraction angiography revealed an opacified false lumen in the ascending aorta and a ulcer like projection in the middle portion of the descending aorta.

[A case of painless Standford type A acute aortic dissection complicating acute occlusion of the right subclavian artery].

We reported about a rare case of painless Stanford type A acute aortic dissection with the only complaints being numbness and paleness in the right arm. A 68-year-old male who hed been treated in another hospital under the diagnosis of acute occlusion of the right subclavian artery was referred to our hospital because of severe heart failure and shock. After being admitted to our hospital, the patient was diagnosed as Standford type A acute aortic dissection with transesophageal echocardiography and underwent an emergency graft replacement of the ascending aorta and total aortic arch.

[A case report of ruptured pseudoaneurysm into the left lung after graft replacement of the descending thoracic aorta].

We report a successful case of total aortic arch replacement using selective cerebral perfusion for ruptured pseudoaneurysm into the left lung after graft replacement of the descending thoracic aorta. A 74-year-old female who had graft replacement of the descending thoracic aorta for ruptured acute type B dissecting aneurysm into the left pleural cavity was admitted with a complaint of severe hemoptysis. Preoperative enhanced computed tomography revealed a large pseudoaneurysm of the aortic arch and massive hematoma around it.

[Minimally invasive direct coronary artery bypass grafting (MIDCAB) for multivessel disease in a 86 year-old patient].

An 86-year-old male underwent minimally invasive direct coronary artery bypass grafting (MIDCAB) without cardiopulmonary bypass, for severe triple-vessel coronary disease. Left descending coronary artery was anastomosed with the in situ left internal thoracic artery through a limited anterior thoracotomy, and right coronary artery was anastomosed with the in situ right gastroepiploic artery through a small upper laparotomy. The postoperative angiography showed patent grafts, and the patient has been doing well without any complications.

[Total aortic arch replacement for distal aortic arch aneurysms].

Between January 1991 to April 1997, 13 consecutive patients underwent the total aortic arch replacement for distal aortic arch aneurysms. The operation was performed through the median sternotomy and the cardiopulmonary bypass was instituted with the cannulation of ascending aorta for arterial perfusion and of right atrium for venous return. Then the aortic arch was totally replaced with four limbed artificial graft with the aid of selective cerebral perfusion and open distal anastomosis of the distal end of the aneurysm.

[A case of paraplegia after graft replacement of the ascending aorta and the total aortic arch for the DeBakey type I acute aortic dissection].

A rare case of paraplegia after an emergency operation for DeBakey type I acute aortic dissection was reported. The patient was a 52-year-old female who complained of severe chest and back pain. She underwent graft replacement of the ascending aorta and the total aortic arch.

[Clinical evaluation of heparin concentration and activated clotting time monitoring (HEPCON HMS) system].

The HEPCON HMS system provides both activated clotting time (ACT) and accurate whole blood heparin concentration measurements. We evaluated the impact of heparin and protamine administration using this system on the incidence and treatment of bleeding after performing a cardiopulmonary bypass. Patients were randomly divided into two groups.

[Surgical strategy for Stanford type A aortic dissection with Marfan syndrome].

Between January 1979 and May 1996, 23 Marfan patients underwent surgeries for type A aortic dissection; 8 patients with localized type dissection and 15 with extensive type. All of the 23 patients suffered from annuloaortic ectasia (AAE) which was treated by composite graft replacement, 10 of these patients had a concomitant replacement of the aortic arch. The operative mortality rate was 8.

[A case report of ruptured distal aortic arch aneurysm into pericardial space].

We report a case of successful total aortic arch replacement using selected cerebral perfusion for ruptured distal aortic arch aneurysm (DAAA) into the pericardial space. A 75 year-old man who had preoperative episode of severe chest pain and tachycardia was transferred to our hospital. Computed tomography showed saccular DAAA and pericardial effusion, so the patient was diagnosed as ruptured DAAA into pericardial space.