[The Result of Aortic Valve Plasty with Autologous Pericardium Using Sawazaki's Template].

The autologous pericardial aortic valve repair technique developed by Ozaki et al., using glutaraldehyde-treated autologous pericardium, has demonstrated superior durability to bioprosthetic valves. However, this technique has certain limitations, including excessive cusp height and cusp fluttering due to leaflet redunduncy.

[Mid-ventricular Hypertrophic Obstructive Cardiomyopathy in a Patient Whose Hemodynamics Were Exacerbated by Forward Shift of the Posterior Leaflet Caused by Mitral Annular Calcification].

A 82-year-old woman came to our hospital because of orthopnea and cardiac cachexia. Echocardiography revealed a pressure gradient of 50 mmHg at the left ventricular outflow tract and that of 78 mmHg at the mid-ventricle. Systolic anterior motion of the mitral leaflet caused by mitral annular calcification and severe mitral regurgitation( MR) were observed.

[Mitral Valve Plasty for Complicated Lesions with Barlow-like Anterior Leaflet].

A 66 year-old male was admitted to our clinic suffering from dyspnea on effort. Cardio thoracic ratio (CTR) was 62%. Electrocardiogram showed atrial fibrillation.

[How to Repair the Bicuspid Aortic Valve Accompanying Regurgitation?].

We repaired the bicuspid aoric valve( BAV) with aortic regurgitation( AR) by bicuspidization. However, repaired fused cusp does not open full, and shows doming. Between 1997 and 2023 we repaired 30 BAV with AR.

Transmitral thrombectomy to treat a patient with Takotsubo cardiomyopathy.

A 68-year-old woman with a history of bipolar disorder was admitted to another hospital with a gastric ulcer. On admission, Takotsubo cardiomyopathy was suspected because her electrocardiogram was abnormal and the characteristic left ventricular wall motion was apparent. On hospital day 11, echocardiography revealed a thrombus in the apex of the left ventricle.

A nationwide survey of aortic valve surgery in Japan: current status of valve preservation in cases with aortic regurgitation.

Objective: Although aortic valve-sparing operations are performed throughout Japan, the indications, specific repair techniques, and outcomes have not been reported in full. Thus, we conducted the first nationwide survey of aortic valve-sparing surgery.

Methods: We mailed a questionnaire to 508 institutions across Japan to obtain information on elective aortic valve and aortic root surgeries performed in 2014.

Interrupted commissural band annuloplasty prevents mitral stenosis.

Background: Mitral annuloplasty is an important component of the treatment of degenerative mitral valve disease. However, postoperative echocardiography reveals elevated mitral gradients in some patients. We developed a technique that we termed interrupted commissural band annuloplasty (iCBA), which does not shorten either the anterior or posterior annulus and is not associated with the development of a mitral gradient.

Total endoscopic repair of unroofed coronary sinus syndrome via right mini-thoracotomy.

Unroofed coronary sinus syndrome (URCS) is a rare congenital cardiac anomaly. Recently, cardiac surgery using a minimally invasive approach has become the preferred treatment, affording better cosmetic results and a more rapid post-operative recovery than the traditional method. We report the case of a 54-year-old male in whom partial URCS was treated via a totally endoscopic repair technique featuring right mini-thoracotomy.

An improved isolation technique for shaggy brachiocephalic artery and aortic arch replacement.

A mobile plaque in the ascending and transverse aorta increases the risk of cerebral infarction during treatment of an arch aneurysm. A previous report described an isolation technique for replacing the ascending and transverse aorta with a mobile atheroma by selective hypothermic antegrade cerebral perfusion (Shiiya et al., Ann Thorac Surg 72:1401-1402, 2001).

Controversy in mitral valve repair, resection or chordal replacement?

Mitral valve plasty has superseded valve replacement as the standard technique for treating degenerative mitral valve prolapse. Quadrangular resection is considered the gold standard for posterior leaflet prolapse. Chordal replacement was first developed to treat the anterior leaflet and subsequently became widely used for the posterior leaflet, after which a new version of posterior leaflet resection was developed that did not involve local annular plication.

Interrupted commissural band annuloplasty for degenerative mitral valve disease.

Background: Mitral annuloplasty is useful for treating degenerative mitral valve disease. Although the incidence of complications is low, prosthetic ring-related complications can occur. Hemolysis and mitral stenosis are serious complications requiring reoperation.

Aggressive atrial volume reduction for bilateral giant atria improves respiratory function.

Giant bilateral atria with mitral and tricuspid regurgitation can cause postoperative respiratory dysfunction. In this article, we describe a case of giant atria with poor respiratory function that was improved by atrial volume reduction. A 79-year-old woman was referred to our institution for valve surgery.

Hourglass-shaped resection technique for repair of tall mitral valve posterior leaflet prolapse.

Objective: We developed a repair technique for an excessively high posterior leaflet of the mitral valve. This is an improvement of the folding plasty.

Methods: The resection shape is that of an hourglass rather than a quadrangle.

Double triangular resection for a widely prolapsed posterior mitral leaflet.

A wide and redundant prolapse of the posterior mitral leaflet in active infective endocarditis cannot be easily repaired. A sliding plasty can be attempted, but the range of annular plication is often too large. Chordal replacement is another option, but is prone to long-term degeneration because the redundant leaflet still exists.

[New concept of mitral valve repair for posterior leaflet prolapse].

Background: Conventional repair of posterior mitral valve prolapse involves quadrangular resection and sliding plasty. However, these 2 methods require annular plication and useful leaflet tissue is sacrificed.

Methods: Our concept is to make an ideally shaped posterior leaflet without annular plication.

Giant sinus of valsalva aneurysm with severe aortic incompetence treated with a valve-sparing operation.

Typically, a sinus of Valsalva aneurysm with severe aortic incompetence is repaired with patch closure and aortic valve replacement. Here, we describe a very rare case of a giant nonruptured right Valsalva aneurysm, combined with severe aortic incompetence, treated with a valve-sparing aortic root replacement. During surgery we noted that the lengths of the free margin of the cusps and annuli were not uniform.

A single papillary muscle with chordal rupture in an adult.

A single papillary muscle (SPM) is a rare anomaly in normal adults. It is sometimes associated with a complete common atrioventricular canal. Chordal rupture combined with a single papillary muscle in an adult has not been reported.

Chordal replacement for leaflet prolapse in a posterior mitral valve with a calcified mitral annulus.

Mitral annular calcification (MAC) is sometimes associated with Carpentier type 2 mitral valve regurgitation and is a challenge to repair. Complete annular decalcification and mitral valve reconstruction is considered the ideal treatment. This report demonstrates the success of chordal replacement and band annuloplasty without resection of the leaflet and MAC.

[The formula of the aortic valve repair for bicuspid aortic valve].

Background: The treatment of aortic regurgitation( AR) with bicuspid aortic valve( BAV) repair is still uncommon as the reproducibility of the repair is low and the 5-year durability is poor. In this study, we examined a method of cusp suspension after triangular resection. In addition, the relationship between the length of the cusp margin and diameter of the sino-tubular( ST) junction was evaluated.

[How to repair a mitral valve prolapse;an assessment of operative techniques dependent on late results].

Background: In this study, we assessed the repair techniques employed for mitral valve prolapse.

Patients And Methods: Between 1992 and 2011, we repaired 173 consecutive patients with mitral valve prolapse. The mean age of the patients was 60.

Development of a new data entry system suitable for the Japan Adult Cardiovascular Surgery Database.

Purpose: Patient data related to cardiovascular surgery are usually managed separately by surgeons and clinical engineers in their respective data files. Recently, with our participation in the Japan Adult Cardiovascular Surgery Database (JACVSD), we newly prepared JACVSD-ready cardiovascular surgery data files by combining two data entry systems.

Methods: We constructed a cardiovascular surgery database system using FileMaker Pro and FileMaker Server.