Balloon and Glue Technique: A Modification of Distal Reinforcement to Prevent Anastomotic New Entry, Reducing Replacement Range in Acute Type A Aortic Dissection.

In emergency surgery for acute type A aortic dissection, the creation of needle holes can cause various issues and complications. One persistent challenge is the prevention of distal anastomotic new entry tears, which frequently necessitate additional intervention. Modification of the distal reinforcement technique offers a straightforward solution by combining existing hemostatic agents with tools such as occlusion balloons.

A case of mitral regurgitation due to bilateral undifferentiated papillary muscles with detailed preoperative diagnosis of associated morphological abnormalities.

Incomplete differentiation of the mitral valve structures during fetal life results in the papillary muscles and tendon cords becoming hypoplastic, a condition termed undifferentiated papillary muscles (UDPM). This fetal abnormality causes a group of diseases that cause mitral valve dysfunction in adult life. Here, we report a case of UDPM centered on the medial posterior apex in which detailed morphological abnormalities were diagnosed preoperatively using echocardiography and three-dimensional computed tomography (3DCT) analysis, contributing to plastic surgery.

Spinal Cord Injury Risk in Open Repair for Descending Thoracic and Thoracoabdominal Aneurysm.

In open repair for descending thoracic aortic aneurysm (DTAA) or thoracoabdominal aortic aneurysm (TAAA), the influence of re-interventions on spinal cord injury (SCI) remains unclear. This study evaluated the relationships between re-interventions, atherosclerosis, and SCI. We retrospectively reviewed 78 patients who underwent open surgical repair for DTAA or TAAA between April 2011 and May 2023.

Repair of a right coronary artery rupture with perforated right ventricle following spontaneous pseudoaneurysm: a case report.

Background: Following the rupture of a coronary artery, a patient's condition usually deteriorates rapidly due to cardiac tamponade. A pseudoaneurysm due to a coronary artery rupture is rare; however, when a spontaneous coronary artery pseudoaneurysm occurs without tamponade, it creates a fistula in the right ventricle, often requiring surgical repair.

Case Presentation: This report describes the case of a 68-year-old man who presented with chest discomfort after a 12-day course of antibiotic treatment for bacteremia.

Relationship between false lumen morphology and entry tear in acute type A aortic dissection.

Objectives: This study aimed to investigate the relationship between false lumen morphology and the size, aortic segment and position of the entry tear for acute type A aortic dissection.

Methods: The records of patients who underwent emergency operation for acute type A aortic dissection in our institution between April 2011 and May 2022 were examined. Data regarding size, location and position of the entry tear and preoperative computed tomography findings were reviewed.

Benefits and Risks of Delayed Surgery for Ventricular Septal Rupture after Acute Myocardial Infarction.

The timing of surgery for ventricular septal rupture (VSR) after acute myocardial infarction (AMI) remains controversial. This study investigated the benefits and risks of delayed surgery for post-AMI VSR and examined differences in echocardiographic findings between early and delay groups.A total of 38 consecutive patients with post-AMI VSR who underwent surgery at our hospital between May 2003 and November 2020 were retrospectively analyzed.

Risk Factors for Sternal Wound Infection after Coronary Artery Bypass Grafting in Patients with and without Diabetes.

Diabetes mellitus (DM) is a well-known risk factor for sternal wound infections (SWIs). However, SWIs are also known to occur in patients without DM. This study aimed to examine the difference in risk factors for SWIs after coronary artery bypass grafting (CABG) between non-diabetic and diabetic patients.

Intensity Interference in a Coherent Spin-Polarized Electron Beam.

We investigate the intensity interference between pairs of electrons using a spin-polarized electron beam having a high polarization and a narrow energy width. We observe spin-dependent antibunching on the basis of coincident counts of electron pairs performed with a spin-polarized transmission electron microscope, which could control the spin-polarization without any changes in the electron optics. The experimental results show that the time correlation was only affected by the spin polarization, demonstrating that the antibunching is associated with fermionic statistics.

Secondary Aortoesophageal Fistula Treated by Covered Esophageal Stent and Muscle Wrapping.

Secondary aortoesophageal fistula is rare but is associated with serious complications and high mortality. We devised a treatment strategy involving a covered esophageal stent, instead of esophageal resection, and placing the latissimus dorsi muscle around the infected aorta without removing the aorta and the stent graft. A 72-year-old man with a history of total arch replacement with a frozen elephant trunk for a thoracic dissecting aneurysm developed aortoesophageal fistula and underwent surgical treatment using our strategy.

Surgical Treatment for Primary Mycotic Aneurysms Using Endovascular Therapy, Focusing on Patient Selection: Single-Center Experience.

Mycotic aneurysms (MAs) are relatively rare but life-threatening. Some recent reports have described the use of endovascular therapy for their treatment; however, this still is a controversial treatment, and a definite target population has not been determined. We performed surgery on 34 patients with MAs from March 2005 to March 2019.

Ruptured sinus of Valsalva aneurysm with ventricular septal defect complicated by preoperative cardiogenic shock, cardiac arrest, and multiple organ dysfunction: a rare survivor and review of contemporary literature.

Sinus of Valsalva aneurysm (SVA) is a relatively rare cardiac condition, in which the patient is usually asymptomatic. However, once this aneurysm ruptures, patients present with acute symptoms of heart failure. Timely surgical intervention is essential.

Influence of Luminal Communication on Aortic Enlargement after Hemiarch Replacement for Acute Type A Aortic Dissection.

Background: Aortic enlargement after hemiarch replacement (HAR) for acute type A aortic dissection (AAAD) is a serious problem. We reviewed our experience and analyzed the risk factors for aortic enlargement.

Methods: During April 2005 to December 2017, 364 patients underwent HAR for AAAD.

Distal Neo-Neck Formation for Chronic Type B Dissection: False Lumen Closure After TEVAR.

Objectives:: Patients with chronic aortic dissection often require repeat interventions due to enlargement of the pressurized false lumen or disseminated intravascular coagulation even after additional thoracic endovascular aortic repair (TEVAR) to occlude the entry tear. Residual false lumen flow can persist even after performing the candy-plug technique or branched stent-graft placement in some cases. We have devised a new method for false lumen closure.

Graft-Sparing Strategy for Thoracic Prosthetic Graft Infection.

Objective: Thoracic prosthetic graft infection is a rare but serious complication with no standard management. We reported our surgical experience on graft-sparing strategy for thoracic prosthetic graft infection.

Methods: This study included patients who underwent graft-sparing surgery for thoracic prosthetic graft infection at Matsubara Tokushukai Hospital in Japan from January 2000 to October 2017.

Strategy of delayed surgery for ventricular septal perforation after acute myocardial infarction.

Background: The timing of surgical repair for ventricular septal perforation (VSP) is important because patients are susceptible to bleeding from fragile myocardial tissue or residual shunt during the acute phase of acute myocardial infarction (AMI). This study aimed to assess the results of delayed surgery for VSP performed 2 weeks after AMI.

Methods: In total, 24 consecutive postinfarction patients with VSP (mean age: 72.

Resternotomy Plus Left Thoracotomy Surgery after Previous Acute Type A Aortic Dissection Repair.

Background: As the results of acute type A aortic dissection repair have improved, late reoperation for residual dissection has become increasingly important. We report our experience of graft replacement via extended approaches after a previous acute type A aortic dissection repair.

Methods: From April 2003 to September 2016, 17 patients underwent reoperation via extended (repeat median sternotomy plus left thoracotomy) approaches after a previous repair of an acute type A aortic dissection at the Matsubara Tokushukai Hospital in Japan and were included in the analyses (males, 16; mean age at surgery, 60.

Predictors of patent false lumen of the aortic arch after hemiarch replacement.

Background: Hemiarch replacement for acute type A aortic dissection is less invasive than total arch replacement but involves increased risk of late aortic arch dilation because of patent false lumen of the aortic arch. If we can predict this risk, it may be a valuable prognostic indicator for selecting surgical procedures for acute type A aortic dissection.

Methods: We reviewed our surgical experience to predict patent false lumen.

Emergency Pulmonary Embolectomy Using Minimally Invasive Cardiac Surgery.

A 78-year-old man who had undergone operation for acute type A aortic dissection presented with dyspnea and shock. Chest computed tomography revealed pulmonary embolism. Minimally invasive cardiac surgery was performed through a right fourth intercostal skin incision using cardiopulmonary bypass through the right femoral artery and vein.

Oblique venotomy with parallelogram anastomosis in sequential bypass grafting.

The proximal vein graft is incised obliquely and anastomosed to the coronary artery to ensure that the proximal rim of the vein incision is adjusted to the lateral side of the coronary artery incision adjacent to the proximal rim. So the vein graft can be placed perpendicular to the coronary artery without kinking, and the anastomosis orifice can be made wider than those made with diamond anastomosis. Oblique venotomy with parallelogram anastomosis provides sufficient anastomotic flow, allows long incisions, and prevents kinking.

Mitral and tricuspid valve surgery for Coffin-Lowry syndrome.

Coffin-Lowry syndrome is a rare X-linked disorder characterized by craniofacial and skeletal abnormalities, mental retardation, short stature, and hypotonia. An 18-year-old man with morphologic features characteristic of Coffin-Lowry syndrome was referred to our institution for valve disease surgery for worsening cardiac failure. Echocardiography showed severe mitral valve regurgitation associated with tricuspid valve regurgitation.

Congenital pericardial defect with ruptured acute type A aortic dissection.

We report 2 cases of congenital pericardial defect with ruptured acute type A aortic dissection. Case 1: An 83-year old man presented with sudden chest and back pain, and computed tomography (CT) showed acute aortic dissection with left pleural massive effusion. Because of his unstable haemodynamic condition with low blood pressure, an emergency operation was performed.

[Ruptured thoracic aortic aneurysm complicated by acute aortic dissection and aortic valve regurgitation; report of a case].

An 87-year-old man was found loss of consciousness after falling. He was found in a state of shock. Computed tomography showed rupture of aneurysm of the ascending aorta and aortic arch with acute aortic dissection.

[Mobile mass in the descending aorta with multiple embolism].

A 46-year-old man was referred to our hospital for abdominal pain. Computed tomography (CT) revealed mobile mass in the descending aorta and multiple systemic embolism. Emergent operation was indicated.