Aortic valve repair with sinus plication for a regurgitant bicuspid aortic valve: a case report.

Background: Repair of the regurgitant bicuspid aortic valve is an attractive alternative to valve replacement. Although good long-term outcomes have been reported, postoperative aortic stenosis remains a major late cause of repair failure in bicuspid aortic valves. Sinus plication is effective for creating a more symmetrical commissural angle, leading to a decrease in the mean transvalvular pressure gradient.

Exploratory Study of the Measurement of Geometric Height in 3D Transesophageal Echocardiography as a Predictor of Valve-Sparing Root Replacement for Aortic Regurgitation.

: Valve-sparing root replacement surgery is an alternative strategy for patients with aortic regurgitation with or without aortic root enlargement. A detailed understanding of the mechanisms of regurgitation and the morphology of the aortic root would be beneficial for predicting the feasibility and success of valve-sparing surgery. This is an exploratory study of the measurement of geometric height in 3D transesophageal echocardiography as a predictor of valve-sparing root replacement for aortic regurgitation.

Haemodynamic Assessment and Outcomes of Aortic Valvuloplasty for Aortic Regurgitation in Patients with Bicuspid Aortic Valve.

Aortic valvuloplasty for bicuspid aortic valve carries a risk of postoperative stenosis. We evaluated the haemodynamic differences between aortic valvuloplasty for bicuspid aortic valve, tricuspid aortic valve, and aortic valve replacement by echocardiography. We also assessed whether a higher postoperative pressure gradient affects the outcomes of aortic valvuloplasty for bicuspid aortic valve.

Interpapillary muscle distance independently predicts recurrent mitral regurgitation.

Objective: Ischaemic secondary mitral regurgitation (ISMR) after surgery is due to the displacement of papillary muscles resulting from progressive enlargement of the left ventricle end-diastolic diameter (LVEDD). Our aim was to prove that if the interpapillary muscle distance (IPMD) is surgically stabilized, an increase in LVEDD will not lead to a recurrence of ischaemic mitral regurgitation (MR).

Methods: Ninety-six patients with ISMR, who underwent surgical revascularisation and annuloplasty, were randomly assigned in a 1:1 ratio to undergo papillary muscle approximation (PMA).

Loeys-Dietz syndrome with a novel in-frame SMAD3 deletion diagnosed as a result of postpartum aortic dissection: A case report.

Objective: Loeys-Dietz syndrome (LDS) is a rare, autosomal dominant connective tissue disorder which can aggressively affect the aortic vasculature. Limited information is available regarding its impact on pregnancy and postpartum outcomes.

Case Report: A pregnant 38-year-old nulliparous woman with mild aortic regurgitation and family history of aortic aneurysms presented with an aortic root measuring 49 mm.

Clinical Features of 544 Patients With Ruptured Aortic Aneurysm - A Report From the Tokyo Acute Aortic Super Network Database.

Background: Epidemiological data on ruptured aortic aneurysms from large-scale studies are scarce. The aims of this study were to: clarify the clinical course of ruptured aortic aneurysms; identify aneurysm site-specific therapies and outcomes; and determine the clinical course of patients receiving conservative therapy.

Methods And Results: Using the Tokyo Acute Aortic Super Network database, we retrospectively analyzed 544 patients (mean [±SD] age 78±10 years; 70% male) with ruptured non-dissecting aortic aneurysms (AAs) after excluding those with impending rupture.

Incidence and trend of antiresorptive agent-related osteonecrosis of the jaw from 2016 to 2020 in Kure, Japan.

Unlabelled: We investigated the incidence/trend of osteonecrosis of the jaw by antiresorptive agent dose over a 5-year period in Kure city, Japan. The incidence was 24 times higher among osteoporosis patients with low-dose agents and 421 times higher among cancer patients with high-dose agents than in the population without agents.

Purpose: We launched the registry system of osteonecrosis of the jaw (ONJ) cases in 2015 to investigate the trend in ONJ incidence.

Blood flow characteristics of the bilateral internal thoracic artery: implications of optimal graft configuration for coronary artery bypass grafting to maximize blood supply.

Purpose: There is controversy regarding which internal thoracic artery (ITA) should be anastomosed to the left anterior descending artery (LAD). Here, we propose an optimal graft design based on measurement of blood flow in the ITA.

Methods: Sixty-one patients (53 men, median age 68 [62-75] years) undergoing first elective coronary artery bypass grafting were enrolled.

Outcomes of type A acute aortic dissection with cardiopulmonary arrest: Tokyo Acute Aortic Super-network Registry.

Objectives: Preventing loss of life in patients with type A acute aortic dissection (AAD) who present with cardiopulmonary arrest (CPA) can be extremely difficult. Thus, we investigated the early outcomes in these patients.

Methods: Patients with type A AAD who were transported to hospitals belonging to the Tokyo Acute Aortic Super-network between January 2015 and December 2019 were considered for this study.

Impact of Steroid on Macrophage Migration Inhibitory Factor During and After Cardiopulmonary Bypass.

Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine released in response to glucocorticoids, which counter-regulates the effects of glucocorticoids. This study was performed to determine the impact of steroids on the expression of MIF and other pro- and anti-inflammatory cytokines during and after cardiopulmonary bypass (CPB). Twenty adult patients (10 men, 64 ± 8 years old) who underwent elective cardiac surgery by CPB were given either 2000 mg (group-H, n = 10) or 500 mg of methylprednisolone (group-L, n = 10) during CPB.

Right-to-left shunt via iatrogenic atrial septal defect requiring emergency surgical repair following cryoballoon atrial fibrillation ablation in a patient with arrhythmogenic right ventricular cardiomyopathy.

Unlabelled: An 81-year-old woman with arrhythmogenic right ventricular cardiomyopathy underwent catheter ablation for atrial fibrillation and atrial flutter. Hypoxemia refractory to the administration of oxygen was seen after transseptal puncture. Transthoracic echocardiography revealed right to left shunt via an iatrogenic atrial septal defect (IASD) that was increased by tricuspid regurgitation flow.

Comparison of hemodynamics and root configurations between remodeling and reimplantation methods for valve-sparing aortic root replacement: a pulsatile flow study.

Purpose: To compare the characteristics of reimplantation (RI) using grafts with sinuses and remodeling (RM) with/without external suture annuloplasty using a pulsatile flow simulator.

Methods: Porcine aortic roots were obtained from an abattoir, and six models of RM and RI with sinuses were prepared. External suture annuloplasty (ESA) was performed in the RM models to decrease the root diameter to 22 mm (RM-AP22) and 18 mm (RM-AP18).

Changes in Internal Thoracic Artery Blood Flow According to the Degree of Stenosis of the Anterior Descending Branch of the Left Coronary Artery.

Purpose: Computational fluid dynamics has enabled the evaluation of coronary flow reserve. The purpose of this study was to clarify the hemodynamic variation and reserve potential of the left internal thoracic artery (LITA).

Methods: Four patients were selected on the basis of various native coronary stenosis patterns and graft design.

In-Hospital Mortality of Patients With Acute Type A Aortic Dissection Hospitalized on Weekends Versus Weekdays.

Background: In acute aortic dissection, weekend admissions are reported to be associated with increased mortality compared with weekday admissions.

Objective: This study aimed to determine whether patients with acute type A aortic dissection (ATAAD) admitted on weekends had higher in-hospital mortality than those admitted on weekdays in the Tokyo metropolitan area, where we developed a patient-transfer system for aortic dissection.

Methods: Data were collected during the first year after our transfer system began (cohort I) and in the subsequent years from 2013 to 2015 (cohort II).

Current controversies in aortic valve-preserving surgery.

The clinical outcome of severe aortic regurgitation (AR) remains suboptimal, but surgery has been shown to have survival benefit over medical therapy. Postoperative survival is inferior in patients with reduced left ventricular function, and therefore early surgical intervention is recommended. Aortic valvuloplasty (AVP) is an attractive option to avoid the major drawbacks of prosthetic valves but has not been widely adopted.

Optimal threshold score of aortic valve calcification for identification of significant aortic stenosis on non-electrocardiographic-gated computed tomography.

Objectives: This study evaluated the association between aortic valve calcification (AVC) and aortic stenosis (AS) by scoring the AVC to determine the threshold scores for significant AS on non-electrocardiographic (ECG)-gated computed tomography (CT).

Methods: We retrospectively analyzed the AVC scores of 5385 patients on non-contrast non-ECG-gated CT, who underwent transthoracic echocardiography (TTE) from March 1, 2013, to December 26, 2019, at our institution. Multivariable logistic regression models were used to identify potential risk factors for significant AS.

Giant aneurysm of left circumflex artery branch with fistula to the coronary sinus: a case report.

Background: Aneurysm of a coronary artery branch with a fistula is extremely rare. Here, we present a case of giant aneurysm of the left circumflex artery branch with a fistula to the coronary sinus treated successfully with aneurysmectomy.

Case Presentation: A 58-year-old woman was referred to our hospital due to an abnormal pericardial mass found by multidetector computed tomography.

[Intraoperative Pulmonary Artery Rupture Induced by a Pulmonary Artery Catheter].

We herein present a case of massive intratracheal hemorrhage due to pulmonary artery catheter (PAC) use during triple valve surgery. A 75-year-old woman underwent biological aortic valve replacement along with mitral and tricuspid valve annuloplasty. Operative procedures were uneventful.