[Debranching Endovascular Repair for Impending Rupture of Aortic Arch Aneurysm in an Eldery Patient;Report of a Case].

Recently, thoracic endovascular aortic repair( TEVAR) has emerged as an alternative to open repair. We reported a case of a 92-year-old woman who underwent successful TEVAR for impending rupture of aortic arch aneurysm. The patient presented with back pain.

Successful bicuspid aortic valve repair using external aortic annuloplasty.

A 33-year-old man presented with severe aortic insufficiency due to a prolapsed bicuspid aortic valve. The ventriculoaortic junction was dilated to 29 mm without root dilatation, and external ring annuloplasty was performed using a Gelweave (Terumo, Tokyo, Japan) graft to reduce the size to 22 mm. The leaflets were repaired by dividing and suturing a raphe between the right and left cusps.

Mid-term results of tricuspid annuloplasty using the MC3 ring for secondary tricuspid valve regurgitation.

We investigated mid-term outcomes after ring annuloplasty with the MC3 ring and aimed to identify factors associated with recurrent tricuspid regurgitation (TR). From October 2006 to October 2010, 136 patients (male:female 80:56, with a mean age 64.7±11.

Left ventriculoplasty for dilated cardiomyopathy in Fukuyama-type muscular dystrophy.

A 29-year-old man was hospitalized because of heart failure causing dilated cardiomyopathy (DCM). On admission, he had elevated creatinine kinase levels (hyper CKemia) (4283IUl⁻) and false enlargement of bilateral calves. By a muscular biopsy, he was diagnosed as Fukuyama-type muscular dystrophy.

Alternative technique for implanting an epicardial cardioverter defibrillation patch during a tricuspid valve replacement for arrhythmogenic right ventricular cardiomyopathy.

Transvenous endocardial cardioverter defibrillator lead implantation is contraindicated in patients with prosthetic tricuspid valves (TVs). A 61-year-old male was hospitalized due to right heart failure, severe TV regurgitation, and non-sustained ventricular tachycardia (VT), which required Sotalol. The patient received an implantable cardioverter defibrillator (ICD) using an epicardial cardioverter defibrillation patch during a TV replacement (TVR) for VT and severe TV regurgitation because of arrhythmogenic right ventricular cardiomyopathy.

Surgical outcome of simultaneous carotid and cardiac surgery.

Purpose: The surgical outcome of a simultaneous carotid endarterectomy and cardiac surgery has not been clarified. This study retrospectively reviewed short- and mid-term outcomes after a carotid endarterectomy combined with valvular surgery or coronary artery bypass grafting (CABG).

Methods: Fifteen patients (12 males and 3 females, mean age 68.

Multiple papillary fibroelastomas in rare locations of aortic valve and left ventricular outflow tract: a case report.

Papillary fibroelastoma (PFE) is the third most common primary neoplasm of the heart. The lesions generally appear singly, but multiple PFEs may rarely occur. The case is reported of multiple PFEs in a woman initially admitted for acute cerebral infarction.

A case report of central extracorporeal membrane oxygenation after implantation of a left ventricular assist system: femoral vein and left atrium cannulation for ECMO.

Purpose: The left ventricular assist system (LVAS) is often used for end-stage heart failure. However, in severe lung disorder, the patient needs extracorporeal membrane oxygenation (ECMO) because oxygenation using only a ventricular assist system (VAS) is insufficient. We report a successful case of combining the use of LVAS and right VAS (RVAS) with ECMO.

First clinical application of the DuraHeart centrifugal ventricular assist device for a Japanese patient.

The DuraHeart ventricular assist device (VAD) is a third-generation implantable centrifugal pump with a magnetically levitated impeller. Since February 2007, the device has been clinically applied with excellent results as a bridge to heart transplantation in Europe. As of this writing, however, the device has yet to be approved by the Ministry of Health, Labour and Welfare for clinical use in Japan.

Reconstructive surgery for an akinetic anterior ventricular wall in ischemic cardiomyopathy.

Background: The purpose of this prospective study is to analyze the postoperative outcome after only left ventricular reconstruction (LVR) versus LVR combined with coronary artery bypass grafting (CABG) and/or mitral valve (MV) procedure in ischemic cardiomyopathy (ICM) as a result of an akinetic anterior ventricular wall.

Methods And Results: Nineteen patients underwent only LVR, and 37 underwent a concomitant LVR procedure. In both groups, New York Heart Association (NYHA) classification improved significantly from 3.

The CardioWest total artificial heart for chronic heart transplant rejection.

Mechanical circulatory support has been used to treat graft failure after heart transplantation, but in patients who needed mechanical circulatory support because of chronic rejection, we have suffered from the treatment because its outcome was catastrophic. Multiple organ failure was often caused by the addition of or increase in immunosuppressive medications, and it is known as a cause of the poor outcomes. The CardioWest total artificial heart was implanted for a case of chronic heart transplant rejection to enable complete withdrawal of immunosuppressive medication.

Mechanical circulatory support for fulminant myocarditis.

Purpose: Fulminant myocarditis is potentially fatal because it progresses rapidly into cardiogenic shock; thus, immediate and appropriate treatment is essential. Mechanical circulatory support (MCS) is an important part of treatment for fulminant myocarditis. We review our experience of treating fulminant myocarditis with MCS.

First report of Bartonella quintana endocarditis in Japan.

Bartonella (Rochalimaea) species are increasingly recognized as a cause of endocarditis, but the total number of cases remains low. Especially, Bartonella quintana endocarditis is very rare and there have been no reports in Japan. A 66-year-old man was hospitalized because of dyspnea and fever.

Long-term survival after cardiac retransplantation: a single-center experience.

Cardiac retransplantation is controversial therapy because of a chronic shortage of donor hearts. We retrospectively reviewed short- and long-term outcomes after cardiac retransplantation. Between February 1989 and December 2004, 28 cases of cardiac retransplantation were performed.

Should emergency surgical intervention be performed for an octogenarian with type A acute aortic dissection?

Objective: The number of octogenarians undergoing emergency surgery is increasing and may negate the impact of the beneficial advances. The aim of this study was to review octogenarians with type A acute aortic dissection and assess the prognosis.

Methods: Fifty-eight patients with acute aortic dissection, whose average age was 83.

A simple and safe operation method for brachiocephalic artery aneurysms.

A 64-year-old man was referred to our hospital due to dyspnea and fever. The chest computed tomogram revealed a 60-mm aneurysm of the brachiocephalic artery with mural thrombus. The aneurysm of the brachiocephalic artery and the right subclavian artery were exposed through only median sternotomy.

Reoperation for aortic valve stenosis due to severe calcification of the bioprosthetic valve after modified Bentall operation in Takayasu arteritis.

Takayasu arteritis is an inflammatory disease that affects the aorta and its main branches. The dilation of the aortic root would cause aortic regurgitation (AR). We would demonstrate the dramatic change of the bioprosthesis implanted in the young woman with Takayasu arteritis, which has not been reported previously, and we believe that bioprosthesis should not be implanted easily in Takayasu arteritis.

Successful treatment of fulminant myocarditis with mechanical circulatory support.

A 66-year-old man with acute fulminant myocarditis was supported by a left ventricular assist device (LVAD) for 22 days, and successfully recovered from severe heart failure. Prior to this, he was treated using percutaneous cardiopulmonary support (PCPS) for five days. However, cardiac function was not recovered, so we conducted implantation of the LVAD.

Vascular protecting effect of angiotensin receptor blocker (ARB) on the radial artery graft.

Purpose: We hypothesized that the vascular protecting effect of an angiotensin receptor blocker (ARB) reduced endothelial damage of the radial artery (RA) after coronary bypass and conducted a comparative study.

Patients And Methods: One hundred and sixty four patients were divided into the following two groups, Group C: 92 subjects who were orally administered Candesartan 8 mg/day, Group I: 72 subjects who were administered Imidapril at 5 mg/day. Graft angiography was performed one year after surgery and the RA intima was evaluated using an angioscope.

First case report in Japan of left ventricular pacing via a coronary vein in a patient with a mechanical tricuspid valve.

Transvenous endocardial pacemaker implantation is contraindicated in patients after prosthetic tricuspid valve replacement. A 65-year-old woman underwent both replacement of the mitral and tricuspid valves and pacemaker implantation with epicardial lead for bradycardia with chronic atrial fibrillation. At 2 years after this operation, the pacemaker's battery became low, and she was admitted for a battery exchange.

Surgical treatment of an aortoesophageal fistula caused by stent implantation for esophageal stenosis: report of a case.

An aortoesophageal fistula is uncommon, but almost always fatal. We report a case of an aortoesophageal fistula that developed after stent dilation for an esophageal stricture caused by benign esophagitis. As soon as esophageal hemorrhaging was identified by endoscopy, the patient was transferred to the operating theater; however, the uncontrollable and massive bleeding resulted in pulseless shock.

Prophylactic reoperation after mitral valve replacement with the Starr-Edwards ball valve: a report of four cases.

Purpose: The Starr-Edwards ball valve was first applied clinically in 1960. In our hospital, this valve has been used since 1963, and some patients have been followed up for 30 years or more. Based on our experience, therapeutic strategies included revalve replacement as a preventive procedure in the absence of valve-related complications.

Coronary sinus dissection during left ventricular pacing electrode implantation.

Coronary sinus (CS) dissection during biventricular pacing electrode implantation is a complication that rarely develops. A 71-year-old female with recurrent ventricular tachycardia, heart decompensation, and poor left ventricular function because of dilated cardiomyopathy was admitted for the implantation of a cardioverter-defibrillator for biventricular pacing. During the operation, we experienced a CS dissection with hematoma in the left ventricle wall while introducing the guidance catheter into the CS.

Prognosis for patients with type B acute aortic dissection: risk analysis of early death and requirement for elective surgery.

Background: The long-term outcome of medical treatment in patients with type B acute aortic dissection (BAD) was assessed and predictors of early in-hospital death were investigated, as well as the need for surgical intervention.

Methods And Results: In the past 11 years, 180 patients were admitted to hospital and medically treated at the time of onset. If the maximum diameter of the dissected aorta exceeded 60 mm, or rapid enlargement or vital organ ischemia were identified, early or elective surgery was performed.

A surgical case of left ventricular pseudoaneurysm complicating myocardial infarction in a diabetic patient on dialysis.

A 57-year-old man was hospitalized with dyspnea and heart failure. We performed an electrocardiogram, coronary angiogram, echocardiogram, and magnetic resonance imaging. He was diagnosed with a left ventricular pseudoaneurysm (i.