Giant coronary artery aneurysm in the atrial septum.

A man in his 60s with paroxysmal atrial fibrillation was scheduled for a catheter ablation but was admitted to our department after contrast-enhanced CT showed a large homogeneous right atrial mass (52×52 mm) as well as a dilated right coronary artery (RCA). Coronary artery angiography showed a large fistula from the RCA to the mass in the right atrium. A giant coronary artery aneurysm was suspected and a surgical resection was performed.

[Surgical Treatment with Pulsed Lavage Irrigation for Infective Endocarditis].

Introduction: Pulsed lavage irrigation (PLI) is a procedure used to wash contaminated soft tissues and prevent infection in orthopedic surgery. We applicated PLI for surgical treatment of infective endocarditis( IE).

Subjects And Methods: From January 2017 to June 2021, 6 cases underwent surgical treatment IE using PLI.

Redo aortic valve replacement due to early structural valve deterioration in a trifecta valve: A case report.

Introduction And Importance: While the number of SAVR cases has been increasing for patients below their sixties due to the improvement of bioprosthetic valves, some early structural valve deterioration (SVD) in Trifecta valves has been reported.

Case Presentation: We present a case of a female who presented with sudden shortness of breath. Ultrasonography diagnosed SVD.

Total Debranching Plus Antegrade Thoracic Endovascular Aortic Repair without Side Clamping in a Patient with Arch Aneurysm and Ascending Aorta Calcification.

A high-risk patient with aortic arch aneurysm, associated with severe calcification of the ascending aorta and iliac arteries, was treated with total debranching and antegrade thoracic endovascular aortic repair (TEVAR) via the ascending aorta. Proximal anastomosis for a triple-branched graft to the ascending aorta was performed without side clamping using the "real chimney technique." After bypassing the supra-aortic branches, a TEVAR was performed in an antegrade fashion through the ascending aorta.

[Endoventricular Stepwise Plication for Left Ventricular Aneurysm].

A 69-year-old man was treated with oral anticoagulation for the left ventricular (LV) aneurysm. Echocardiography revealed dyskinetic apex with a mobile thrombus. The estimated LV end-diastolic and end-systolic volume index (LVEDVI, LVESVI) was 76 and 44 ml/m2, respectively.

Bioelectrical impedance analysis for perioperative water management in adult cardiovascular valve disease surgery.

Purpose: Bioelectrical impedance analysis (BIA) has been used recently to measure the body water of patients with acute heart failure. We used BIA in this study to better understand, and possibly identify a predictive marker for, perioperative water behavior in cardiac surgery patients.

Methods: We measured body water and studied its behavior in 44 patients undergoing surgery for cardiac valvular disease at our hospital.

Clinical significance of esophagogastroduodenoscopy in patients with esophageal motility disorders.

Objectives: The first aim of this study was to elucidate the detection rate of esophagogastroduodenoscopy (EGD) in patients complaining of dysphagia with esophageal motility disorders; the second was to clarify the useful parameters of EGD associated with esophageal motility disorders.

Methods: Participants included 380 patients who underwent EGD before high-resolution manometry (HRM) for dysphagia. EGD findings were investigated according to the following five parameters: resistance when passing through the esophagogastric junction (EGJ), residue in the esophageal lumen, esophageal dilation, and spastic and nonocclusive contractions.

Minimally Invasive Mitral Valve Repair Through Right Minithoracotomy - 11-Year Single Institute Experience.

Background: Although minimally invasive mitral valve repair (MIMVR) is increasingly being performed, only a few clinical studies from Japanese institutions have been reported.

Methods and results: From 2006 to 2017, 387 consecutive patients (135 females, mean age 56±13 years) underwent an initial isolated MIMVR through a right minithoracotomy. The mitral etiology was degenerative in 348, functional in 22, and endocarditis in 13 cases.

A case of ruptured infective coronary artery aneurysm.

Infective coronary artery aneurysm is extremely rare and ruptured aneurysm is life-threatening. We report a case of ruptured coronary artery aneurysm, which was successfully treated by the patch closure technique and coronary artery bypass grafting. Pathological examination revealed purulent inflammation in the aneurysmal wall.

Simple Interrupted Suturing for Redo Mitral Valve Replacement.

Background: An evaluation was made of the early clinical outcomes and efficacies of simple interrupted suturing (SIS) for redo mitral valve replacement (MVR).

Methods: Among 336 mitral valve surgery patients at the authors' institution between April 2000 and May 2014, a total of 21 redo MVR using SIS (12 women, nine men; mean age 67±11 years; range 32-80 years) participated in the study. Surgical indications for redo MVR were paravalvular leakage (PVL) in 10 patients, prosthetic valve endocarditis in five, mechanical valve thrombosis in three, and structural valve deterioration (SVD) of the bioprosthesis in three.

Long-Term Results of Obturator Bypass.

Objective: We evaluated the long-term outcomes of obturator bypass.

Material And Methods: A total of 16 patients (13 males and 3 females; 17 limbs) who underwent obturator bypass surgery at our department between April 1995 and March 2008 were included.

Results: Their ages ranged from 50 to 90 with a mean of 74 years.

Sternal closure by rigid plate fixation in off-pump coronary artery bypass grafting: a comparative study.

Sternal instability or dehiscence results in serious sternal wound infection. We sought to assess the early outcomes with such a plating system for sternal closure in comparison to the conventional wiring technique in off-pump coronary artery bypass grafting (CABG). Patients who underwent off-pump CABG were enrolled.

A Rare Case of Dacron Graft Rupture due to Friction against a Rib.

A 54-year-old man underwent aortic repair for the infected thoracoabdominal aneurysm with a woven Dacron graft (Vascutek, Renfrewshire, Scotland) treated with gentian violet. Four months later, he complained of sudden back pain, resulting in preshock status. Computed tomographic scans showed massive hematoma around the Dacron graft, suggesting graft rupture.

[Minimally Invasive Cardiac Surgery( MICS) through a Mini-right Thoracotomy].

Recently, the concept of minimally invasive surgery has been expanding in cardiothoracic surgery. Minimally invasive cadiac surgery( MICS) is characterized by the avoidance of full sternotomy and minimizing of surgical incision. The advantages of this approach include less postoperative discomfort and earlier mobilization and discharge.

Propensity score-matched analysis of minimally invasive aortic valve replacement.

Background: Right mini-thoracotomy and partial sternotomy are widely recognized as effective approaches in minimally invasive aortic valve replacement (AVR). The aim of this study was to evaluate the objective benefits of the respective approaches compared to the conventional approach. METHODS AND RESULTS: A retrospective analysis was performed in 282 consecutive patients who underwent isolated and initial AVR at a single cardiovascular institute between May 2007 and December 2012.

Propensity Score-Matched Analysis of Minimally Invasive Aortic Valve Replacement.

Background:Right mini-thoracotomy and partial sternotomy are widely recognized as effective approaches in minimally invasive aortic valve replacement (AVR). The aim of this study was to evaluate the objective benefits of the respective approaches compared to the conventional approach.Methods and Results:A retrospective analysis was performed in 282 consecutive patients who underwent isolated and initial AVR at a single cardiovascular institute between May 2007 and December 2012.

Successful treatment using percutaneous drainage for aortic arch prosthetic graft infection.

Prosthetic graft infection in the ascending aorta or aortic arch is a life-threatening complication. Redo graft replacement is also associated with high mortality and morbidity rates. Conservative treatments without graft removal recently developed as alternatives to conventional surgical approach have been reported with successful outcomes.

Initial large-dose administration of modified St. Thomas' solution.

Background: We introduced an initial large dose of modified St. Thomas' Hospital cardioplegic solution with the aim of providing both myocardial protection as well as a smooth intraoperative process.

Methods: In 90 cases of isolated aortic valve replacement, we used the modified technique of cardioplegia in 45 (group S) and conventional administration of glucose-insulin-potassium solution in 45 (group G).

Anterolateral approach for minimally invasive aortic valve replacement.

Objective: Right anterior thoracotomy is the most common approach of minimally invasive aortic valve replacement (MIAVR) via intercostal mini-thoracotomy. However, there are some disadvantages including sacrificing the right internal thoracic artery (RITA). The aim of the present study was to investigate the efficacy of anterolateral thoracotomy (ALT), which is similar to lateral thoracotomy used for minimally invasive mitral valve surgery, for MIAVR.

Open total aortic arch reconstruction for patients with advanced age in the era of endovascular repair.

Background: The aim of this study is to evaluate the influence of advanced age on the postoperative course in open aortic arch repair using hypothermic circulatory arrest and selective antegrade cerebral perfusion.

Methods: Of 158 consecutive patients who underwent open total arch repair between 2008 and 2012, we retrospectively compared outcomes between octogenarians (group E: mean age, 83.0 ± 3.

Infected cardiac myxoma.

A 66-year-old male presenting with low-grade fever and general fatigue was diagnosed as having infected myxoma of the left atrium. Blood cultures grew Streptococcus mitis. He underwent urgent resection and histological examination revealed tumor cells in a mucopolysaccharide matrix and bacterial colonies along with active inflammation.

Mitral valve reoperation under ventricular fibrillation through right mini-thoracotomy using three-dimensional videoscope.

Background: Conventional reoperative mitral valve surgery by median sternotomy has several difficulties. We performed mitral valve replacement (MVR) under ventricular fibrillation (VF) through right mini-thoracotomy with three-dimensional videoscope for avoiding the problems.

Methods: Between 2006 and 2011, we performed 257 cases of MVR, in which 125 cases underwent isolated MVR.

Difficulty in the management of anticoagulation with argatroban during off-pump coronary artery bypass grafting.

Heparin-induced thrombocytopenia (HIT) can often result in devastating thromboembolic outcomes. Argatroban is frequently administered as an alternative anticoagulant to heparin. We present a complicated case of HIT in which off-pump coronary artery bypass grafting was performed using anticoagulation with argatroban.

An elderly patient with severe aortic stenosis and myocardial infarction with a huge mobile thrombus as complication in the left ventricle.

An 86-year-old woman was admitted for emergency treatment of increasing dyspnea. Transthoracic echocardiography revealed decreased left ventricular systolic function with dyskinesis at the apex, and severe aortic stenosis. The apex of the left ventricle showed a huge mobile thrombus.