Impact of Atrial Fibrillation on Fontan Circulation: Fontan Computational Model.

Background: Patients with Fontan circulation may have heart failure resulting in atrial fibrillation during the late phase. Inotropic effects to ameliorate hemodynamics on the Fontan circulation are not well understood, especially when in atrial fibrillation. This study was performed to determine whether dobutamine therapy in patients with Fontan circulation has limited effects on improving hemodynamics.

Aortic root replacement in a patient with unoperated tricuspid atresia.

A 42-year-old man was referred to our hospital with heart failure and unoperated tricuspid atresia with pulmonary valve stenosis. His condition was initially managed with medical therapy; however, he required repeat hospitalisations for congestive heart failure. We diagnosed the chief cause of his heart failure as aortic valve regurgitation secondary to aortic root dilatation.

A Case of Thoracic Endovascular Aortic Repair Using Carotid Access with Axillary-Carotid Bypass for Descending Aortic Aneurysm in a Patient with Aortoiliac Occlusive Disease.

The authors report a 71-year-old male with descending thoracic aortic aneurysm and multiple risk factors (aortoiliac occlusive disease, obesity, ascending aorta dilatation, and history of left ventriculoperitoneal shunt for hydrocephalus) who was treated with thoracic endovascular aortic repair (TEVAR) via left common carotid artery (LCCA) access and left axillary-carotid artery (Ax-CA) bypass; this approach shortened the LCCA clamp time during the procedure. The patient was discharged without any complications. TEVAR via LCCA access with left Ax-CA bypass is a useful and safe procedure for patients in whom conventional femoral artery access is not feasible.

Surgical treatment for adult congenital heart disease: consideration for indications and procedures.

The number of the adult patients with congenital heart diseases (ACHD) continues to grow owing to improvement of surgical results and medical management. Corrective surgery for complex CHD does not always mean complete cure. It is not rare that the patients will visit the cardiology institutes because of secondary lesions due to residua or sequela in adults.

Surgical angioplasty for ostial atresia of left main coronary artery in child.

Ostial atresia of the left main coronary artery (LMCA) in children without any primary disease is extremely rare. We present here a case of occlusion of the LMCA in a 9-year-old girl. Myocardial scintigraphy showed poor perfusion in both domains of the left anterior descending artery (LAD) and left circumflex artery (LCx).

Fontan completions over 10 years after Glenn procedures.

Objective: Despite the broadened indications for Fontan procedure, there are patients who could not proceed to Fontan procedure because of the strict Fontan criteria during the early period. Some patients suffer from post-Glenn complications such as hypoxia, arrhythmia, or fatigue with exertion long after the Glenn procedure. We explored the possibility of Fontan completion for those patients.

Assessment of functional tricuspid regurgitation using 320-detector-row multislice computed tomography: risk factor analysis for recurrent regurgitation after tricuspid annuloplasty.

Objective: Functional tricuspid regurgitation (TR) often develops secondary to left heart disease. Tricuspid annuloplasty (TAP) is usually the treatment of choice for significant TRs, but recurrence of TR after surgery can occur. Previous studies have not clearly demonstrated the cause of the recurrent TR after TAP.