[Aortic Valve Papillary Fibroelastoma Stated for Preoperative Twelve Years without Any Symptom: Report of a Case].

We experienced a case of papillary fibroelastoma of aortic valve, which had been located for preoperative 12 years without any symptom. We could assess tumor growth rate of 0.17 mm/year.

A modified technique for supra-annular implantation of prosthetic tricuspid valve.

In conventional tricuspid valve replacement, there is a risk of valve detachment because stitches are placed on relatively fragile tissues. In the supra-annular implantation technique, stitches are placed lateral to the triangle of Koch and the coronary sinus instead of the anterior and septal leaflets as in conventional tricuspid valve replacement. This procedure relieves stress at the antero-septal commissural area, as well as avoids injury to the conduction system.

Early cardiac surgery for infective endocarditis with acute extensive cerebral infarction.

Early cardiac surgery was successfully performed on a patient with infective endocarditis and extensive cerebral infarction due to septic embolus, following mechanical embolectomy for proximal middle cerebral artery occlusion. Mechanical embolectomy may be useful for the success of early cardiac surgery in these patients.

[Mitral Valve Infective Endocarditis Complicated with Meningitis in a Patient with Atopic Dermatitis;Report of a Case].

Meningitis has not been described to the same extent as other neurological complications of infective endocarditis(IE). The appropriate selection and dosing of antibiotics for patients with IE and meningitis do not exist. Herein, we described an instructive surgical case of mitral valve endocarditis and meningitis caused in a patient with atopic dermatitis, that was successfully treated using a multi-disciplinary approach.

[Unilateral Pulmonary Edema during Aortic Valve Replacement through Median Sternotomy].

Unilateral pulmonary edema (UPE) has been reported as a re-expansion pulmonary edema that occurs following rapid re-expansion of a collapsed lung in a patient with pneumothorax or large volume of pleural fluid. Recently, UPE after minimally invasive cardiac surgery through right-sided thoracotomy has received considerable attention because of its increasing morbidity and mortality. However, development of UPE in patients undergoing cardiac surgery through median sternotomy has not generally been recognized.

Primary cardiac angiosarcoma resection and reconstruction with pedicled autologous pericardium: A case report.

Introduction: Primary cardiac angiosarcoma is rare, and its prognosis remains poor. Complete surgical resection is the first choice among the available treatments, to ensure prolonged patient survival.

Presentation Of Case: We report the case of a 72-year-old man with right atrial angiosarcoma who presented with bloody pericardial effusion due to tumor hemorrhaging.

Hypereosinophilia and Multisite Vasculopathy of Fibromuscular Dysplasia: A Case Report.

The impact of blood disorders on fibromuscular dysplasia is unknown, and cardiovascular surgery results are also unclear. Furthermore, there are only a few case reports about the association between fibromuscular dysplasia and blood disorders. We report a case of a coronary bypass surgery and an aortic root replacement for a patient who is hypereosinophilic with multisite vasculopathy of fibromuscular dysplasia, including that of the coronary artery and saphenous vein, which was diagnosed by a histopathologic examination after an autopsy was performed 5 months after surgery.

[Adult Cor Triatriatum Found by Chance at the Onset of Myocardial Infarction].

Cor triatriatum sinister is a rare congenital heart disease in which the left atrium is divided into 2 chambers by a membrane, causing resistance to the blood flow to the left ventricle. The onset of symptoms depends upon the effective size of the orifice in the membrane and the associated heart disease. Our case is a 67-year-old woman with cor triatriatum found by chance at the onset of myocardial infarction.

[Traumatic Cardiac Injury due to Striking at Epigastric Fossa;Report of a Case].

Blunt chest trauma can cause life-threatening condition. We performed prompt drainage and operative repair for traumatic cardiac injury caused by striking at epigastric fossa. Close monitoring should be needed even for blunt chest trauma due to assault.

Direct oral anticoagulant therapy as an alternative to surgery for the treatment of a patient with a floating thrombus in the ascending aorta and pulmonary embolism.

A floating thrombus in the ascending aorta was incidentally discovered in a patient with a descending thoracic aortic aneurysm and a history of alcoholism. The patient developed deep venous thrombosis and pulmonary embolism. However, he refused to undergo surgical excision of the thrombus in the ascending aorta.

[Coronary Artery Bypass Surgery for the Patient with a History of Anaphylaxis due to Neuromuscular Blocking Agent ; Report of a Case].

We present herein a patient with rocuronium anaphylaxis, which had been identified using skin test, underwent conventional coronary artery bypass surgery without any neuromuscular blocking agent. Immobility was achieved with sedatives and analgesics.

[Effective Anticoagulation Therapy Prior to Surgical Excision of an Aortic Valve Papillary Fibroelastoma Diagnosed after a Transient Cerebral Ischemic Attack;Report of a Case].

Cardiac papillary fibroelastoma is reported to be the 2nd most common cardiac tumor following myxoma. Owing to the risk of embolism, early surgical excision is the treatment of choice. We report a case of effective anticoagulation therapy prior to surgical excision of an aortic valve papillary fibroelastoma.

Saphenous Vein Graft Aneurysm Repaired with Radial Artery Graft Pre-Sewn Vascular Prosthesis Patch.

Saphenous vein graft aneurysms are rare but are potentially fatal and their optimal management is not clearly established. Herein, we report a case of a saphenous vein graft aneurysm that was successfully treated with surgical intervention, including aneurysmal resection and re-grafting. The aneurysm, detected 36 years after coronary artery bypass grafting, was located at the proximal part of the saphenous vein graft to the posterolateral branch; the flow of the left anterior descending coronary artery was limited due to compression of the left internal thoracic artery by the adjacent aneurysm.

Implementation of bundled interventions greatly decreases deep sternal wound infection following cardiovascular surgery.

Objective: Surgical site infection (SSI), particularly deep sternal wound infection (DSWI), is a serious complication after cardiovascular surgery because of its high mortality rate. We evaluated the effectiveness of an SSI bundle to reduce DSWI and identify the risk factors for DSWI.

Methods: During the period January 2004 to February 2012, 1374 consecutive patients undergoing cardiovascular surgery via sternotomy were included.

Retrograde cardioplegia revisited: open technique for long aortic cross clamping.

Background: The efficacy of retrograde cardioplegia for myocardial protection is still controversial. In our institution, we exclusively use intermittent administration of tepid, undiluted blood supplemented with potassium and magnesium for the cases with aortic insufficiency, requiring aortotomy, or undergoing mitral valve repair. In using this retrograde technique, we make a point of cannulating a retrograde perfusion catheter under direct vision following right atriotomy.

Novel technique of retrograde cerebral perfusion for descending aortic repair: direct cannulation into left internal jugular vein.

We performed descending thoracic aortic repair via posterolateral thoracotomy using retrograde cerebral perfusion with direct cannulation into the left internal jugular vein. No postoperative neurological dysfunction was observed. This patient was discharged without any adverse events.

Safety of mild hypothermic circulatory arrest with selective cerebral perfusion.

Although hypothermic circulatory arrest with antegrade selective cerebral perfusion is used for cerebral protection, optimal perfusion characteristics are still unclear. Between May 2006 and March 2008, 26 patients (mean age, 68.9 years; 14 males) underwent thoracic aortic repair with mild hypothermic circulatory arrest (34.

Emergency total aortic arch replacement for a renal transplant recipient by mild hypothermia with selective cerebral perfusion.

Hypothermia and immunosuppressive drugs may promote surgical wound infection. We successfully performed an emergency total arch replacement with mild hypothermia and selective cerebral perfusion for a renal transplant recipient. The postoperative course was almost uneventful without any surgical site infection.

Combined coronary artery re-operation and pulmonary resection for hemoptysis.

We present a 59-year-old woman who underwent combined pulmonary resection for bronchiectasis with massive, recurrent hemoptysis and redo coronary artery bypass. She had previously been hospitalized four times for massive hemoptysis. She had also undergone coronary artery bypass and had symptomatic severe graft disease.

Mitral valve surgery for dilated cardiomyopathy with mitral regurgitation.

Outcomes of surgery for non-ischemic non-valvular dilated cardiomyopathy with associated mitral regurgitation were assessed in 8 consecutive patients who underwent 9 mitral valve operations between 2001 and 2004. Mitral valve replacement was performed when the coaptation depth exceeded 10 mm. Two patients initially underwent mitral valvuloplasty, and 6 underwent valve replacement.

A vascular tube for intercostal artery reimplantation.

Paraplegia and paraparesis are major concerns in descending and thoracoabdominal aortic repair. A shorter period of spinal cord ischemia is preferred for protection. We have developed a new technique in which plural intercostal arteries are reattached in a short time.

Early clinical results of St. Jude Medical Symmetry aortic connector.

An automated anastomosis device named St. Jude Medical symmetry aortic connector has been used worldwide for off-pump coronary artery bypass grafting. However, early graft obstruction was recently reported, and its predictors should be clarified.

Natural history of a dilated ascending aorta after aortic valve replacement.

Background: Little information is available regarding the incidence of aortic dissection or rupture in patients with a dilated ascending aorta after aortic valve replacement (AVR). The present clinical study aimed to demonstrate the incidence of aortic complications after AVR in patients with a dilated ascending aorta and to clarify those risk factors associated with the progression of a dilated ascending aorta or late aortic events.

Methods And Results: A total of 35 patients with a dilated ascending aorta at the time of AVR were enrolled.

Thoracic aneurysm rupture due to graft perforation after endovascular stent-grafting via median sternotomy.

We performed emergency repeat surgery for aneurismal rupture due to graft perforation with mechanical stress of the Z stent in a kinking graft after frozen elephant trunk procedure. Graft kinking occurred due to cranial migration of the Z stent. It is important to prevent stent dislodgement in order to achieve long-term durability and reliability in the frozen elephant trunk procedure.

Beating mitral valve replacement for a patient with porcelain aorta.

Beating mitral valve replacement was performed for mitral valve stenosis in a patient with a porcelain aorta after aortic valve replacement. The 77-year-old patient had developed heart failure several times. A chest computed tomographic scan revealed severe calcification on the ascending aorta and aortic arch.