Type A Aortic Dissection After Thoracic Endovascular Aortic Repair.

Background: Type A aortic dissection (TAAD) is a rare complication associated with thoracic endovascular aortic repair (TEVAR). Although TAAD can result in catastrophic outcomes, the pathology of the condition has not been thoroughly clarified yet.

Methods: We retrospectively reviewed details from the medical records of 546 patients with diseases of the thoracic aorta (thoracic aortic aneurysm, n = 362; aortic dissection, n = 178; and fistula between the descending thoracic aorta and esophagus, n = 6) who underwent TEVAR in five hospitals from May 1997 through February 2015 to identify patients in whom TAAD developed during or after TEVAR.

Upside down use of Gore Excluder or Cook Zenith legs.

Purpose: Endovascular aneurysm repair is becoming increasingly popular. This technical note describes the usefulness of the upside-down technique of Gore Excluder or Cook Zenith legs.

Methods: Four patients with iliac or abdominal aortic aneurysms were treated.

Improve morbidity and mortality in coronary artery bypass graft surgery for severe atherosclerosis.

Objectives: Atherosclerosis has been identified as a risk factor for both morbidity and mortality in patients undergoing coronary artery bypass grafting (CABG). To investigate outcomes following CABG for severe atherosclerosis, and to determine whether different surgical techniques can reduce the risk of neurologic events in these patients.

Methods: We studied 225 consecutive patients who underwent elective isolated CABG.

Aortic valve destruction and pseudoaneurysm of the sinus of Valsalva associated with infective endocarditis.

We report the successful surgical treatment of a case of aortic valve destruction and pseudoaneurysm of the sinus of Valsalva associated with infective endocarditis (IE) in an 80-year-old woman. Multidetector-row computed tomography revealed an abnormal cavity in the left posterior aortic root. We had made the diagnosis of the aortic valve destruction and saccular pseudoaneurysm of the sinus of Valsalva associated with IE.

Surgical removal of a left ventricular thrombus associated with cardiac sarcoidosis.

We report successful surgical management of a 31-year-old man with a left ventricular thrombus following heart failure due to cardiac sarcoidosis. Preoperative echocardiography showed diffuse hypokinesis and a mobile ball-like thrombus in the left ventricle. Computed tomography revealed a left ventricular tumor and bilateral hilar lymphadenopathy, while MRI of the brain showed small infarctions in the occipital lobe.

Report of takotsubo cardiomyopathy occurring during cardiopulmonary bypass.

On weaning from cardiopulmonary bypass, a 59-year-old Japanese woman with mitral valve plasty suddenly showed a greatly increased heart rate, and an electrocardiogram revealed elevated ST-segments. There was also abnormal wall motion in the inferior region and apical ballooning of the left ventricle. We diagnosed the condition as takotsubo cardiomyopathy (acute left ventricle apical ballooning syndrome), possibly caused by catecholamine release and regional stress-induced ischemia.

New intraluminal coronary shunt tube for off-pump coronary artery bypass grafting.

Purpose: In cooperation with JMS Co., Ltd. (Hiroshima, Japan), we have developed a new intraluminal coronary shunt tube to allow easier, safer, and more accurate off-pump coronary artery bypass grafting (OPCABG).

Usefulness of preoperative intraaortic balloon pump therapy during off-pump coronary artery bypass grafting in high-risk patients.

Background: In off-pump coronary artery bypass grafting (OPCABG) surgery, the most critical complication is hemodynamic deterioration, which can occur during displacement of the heart to expose the target vessels. Preoperative intraaortic balloon pump (IABP) therapy improves cardiac performance and facilitates access to the target coronary artery while maintaining hemodynamic stability, especially in high-risk patients.

Methods: One hundred thirty-three consecutive patients who underwent OPCABG through sternotomy between April 2000 and July 2003 were studied.

Our experiences for off-pump coronary artery bypass grafting to the circumflex system.

Background: Complete revascularization has been difficult in off-pump coronary artery bypass grafting (OPCAB). Hemodynamic deterioration often prevents access to the circumflex territory. This study presents instrumentation for accessing the circumflex territory, and our clinical experience.