[Intraoperative Subsegmental Pulmonary Artery Embolization for Catheter Induced Pulmonary Pseudoaneurysm].

An 82-year-old female patient with severe aortic stenosis underwent aortic valve replacement. After weaning from cardiopulmonary bypass, it was noticed that Swan-Ganz( SG) catheter tip was located 50 cm distally to the right neck. After the catheter was pulled back, massive hemoptysis occurred.

Parallel placement of Excluder legs for treatment of type IIIb endoleaks caused by fabric tear after endovascular aneurysm repair.

A total of 576 patients underwent endovascular aneurysm repair using main body devices for treatment of abdominal aortic aneurysms or iliac artery aneurysms. During follow-up, type IIIb endoleaks caused by fabric tear occurred in six patients (1.0% [6/576]).

Associations of residual left ventricular and left atrial remodeling with clinical outcomes in patients after aortic valve replacement for severe aortic stenosis.

Background: Aortic valve replacement (AVR) is currently the standard therapy for severe aortic stenosis (AS), and regression of left ventricular (LV) hypertrophy after AVR has been reported. However, data regarding a temporal relation between LV mass and left atrial (LA) volume are limited, and their prognostic impacts have not been fully elucidated. We aimed to clarify the temporal patterns of LA and LV reverse remodeling and their associations with clinical outcomes.

Late results of mitral valve repair with glutaraldehyde-treated autologous pericardium.

Background: Mitral valve repair is an established surgical procedure for treating severe organic mitral regurgitation. The mechanisms of mitral regurgitation due to infective endocarditis include rheumatic disease and congenital diseases such as a lack of leaflet tissue, and thus additional material is required to create a functional coaptation surface. We review our experience with 139 patients who underwent mitral valve repair with glutaraldehyde-treated autologous pericardium to treat organic mitral regurgitation between March 1992 and November 2011.

Reversal of acute monoparesis following thoracoabdominal aortic aneurysm repair.

A 67-year-old man underwent surgical repair for a Crawford extent V thoracoabdominal aortic aneurysm under cerebrospinal fluid drainage and motor evoked potential monitor on distal aortic perfusion. Postoperatively, weakness of right-sided leg graded 2/5 and bladder disorder were recognized. Magnetic resonance imaging revealed hyperintensity between Th11 and L1 on T2-weighted image.

Tricuspid leaflet augmentation with an autologous pericardial patch for recurrent severe tricuspid regurgitation that occurred after suture annuloplasty.

We, herein, report the use of tricuspid leaflet augmentation with an autologous pericardial patch to treat a patient with severe tricuspid regurgitation (TR) that occurred after suture annuloplasty. The patient underwent mitral valve replacement for rheumatic mitral disease and tricuspid suture annuloplasty for moderate TR 23 years ago. She developed right-sided heart failure associated with severe TR.

Clinical outcomes of open heart surgery in patients with atopic dermatitis.

Atopic dermatitis is a skin condition often complicated by colonization with Staphylococcus aureus, which increases the risk of infective endocarditis, skin cellulitis and osteomyelitis. Positive cultures for Staphylococcus aureus are obtained from 70% to 80% of wounds in patients with mediastinitis. Thus sternotomy carries increased risk of mediastinitis in patients with atopic dermatitis.

Impact of diabetes mellitus on outcomes in Japanese patients undergoing coronary artery bypass grafting.

Background And Purpose: There have been no large-scale studies on the impact of diabetes mellitus (DM) on outcomes in Japanese patients undergoing coronary artery bypass grafting (CABG).

Methods And Subjects: A multi-institutional retrospective cohort study was conducted in 14 Japanese centers. All adult patients who underwent isolated CABG from 2007 to 2008 were included (n=1522, mean age: 68.

Aortic valve-sparing operation after correction of heart displacement due to pectus excavatum using Nuss procedure in a Marfan syndrome patient.

Cardiovascular surgery in the setting of chest wall deformities is a clinical challenge. Pectus excavatum, for example, can cause heart displacement to the left thoracic cavity, following the poor operative field. This report highlights a case in which a successful aortic valve-sparing operation via conventional median sternotomy after correction of the heart displacement due to pectus excavatum using Nuss procedure in Marfan syndrome.

Successful treatment for infected aortic aneurysm using endovascular aneurysm repairs as a bridge to delayed open surgery.

Management of infected aortic aneurysms, which can be life-threatening, remains challenging. Open surgical treatments, including debridement of the infected aorta and the surrounding tissue and either in situ reconstruction or extra-anatomic bypass covering with omentum or muscle flap, are the mainstay of therapy. However, increasing advances in technology have made endovascular treatment of infected aneurysms feasible.

Dissecting aneurysm in a patient with autosomal dominant polycystic kidney disease.

Autosomal dominant polycystic kidney disease (ADPKD) is primarily associated with renal failure, but it also causes systemic diseases, including cysts of other systemic organs and cerebral or visceral aneurysm. To make matters worse, life-threatening aortic diseases are associated with ADPKD in some cases. However, only a few reports of ADPKD-associated with thoracic aortic dissection have been published.

[Coronary artery bypass grafting in a patient with systemic lupus erythematosus, scleroderma and secondary antiphospholipid syndrome].

A 71-year-old patient with systemic lupus erythematosus, scleroderma and secondary antiphospholipid syndrome underwent coronary artery bypass grafting using cardiopulmonary bypass for angina pectoris. Postoperatively, new onset of thrombotic complications including neurological deficits was not recognized. She was discharged without any complications.

Delayed perforation of the right ventricular wall by a single standard-caliber implantable cardioverter-defibrillator lead detected by multidetector computed tomography.

We present an unusual case of a delayed right ventricular perforation by a single standard-caliber implantable cardioverter-defibrillator lead, which manifested 14 days after implantation. Multidetector computed tomography could clearly display the lead perforation, and allow for identification of the associated sequelae such as pericardial effusion and planning the lead extraction strategy.

Outcomes of mitral valve repair for bileaflet prolapse.

Objective: Repair of bileaflet prolapse has been considered to be technically demanding and challenging. To assess the reliability and durability of mitral valve repair for bileaflet prolapse, the present study compared the outcomes of mitral valve repair for bileaflet prolapse with those for posterior prolapse.

Methods: From January 1991 to April 2010, 191 consecutive patients with bileaflet prolapse (group B) underwent mitral valve repair using a combination procedure of expanded polytetrafluoroethylene chordal reconstruction for anterior prolapse, resection suture technique with/without sliding technique for posterior prolapse, and ring annuloplasty.

Chylous ascites as a rare complication after abdominal aortic aneurysm surgery.

Chylous ascites is a rare complication, and the treatment, which includes conservative and surgical strategies, is controversial. We describe two cases of chylous ascites that occurred after abdominal aortic aneurysm surgery. The first patient died of underlying diseases despite conservative treatment, while in the second patient, chylous ascites resolved with conservative treatment.

Clinical characteristics and outcomes of Japanese women undergoing coronary revascularization therapy.

Background: Limited data are available for gender-based differences in patients undergoing coronary revascularization. This study aimed to identify gender-based differences in risk factor profiles and outcomes among Japanese patients undergoing coronary revascularization.

Methods And Results: The subjects consisted of 2,845 women and 6,843 men who underwent first percutaneous coronary intervention or coronary artery bypass grafting in 2000-2002.

[Successful surgical treatment for Stanford type A acute aortic dissection complicating a loss of consciousness; report of a case].

An 88-year-old man was transfered to our hospital due to loss of consciousness. Intravenous dopamine was initiated for a shock status and endotracheal intubation was performed. Computed tomography with contrast medium showed Stanford type A acute aortic dissection complicating cardiac tamponade.

Aortic pseudoaneurysm detected on external jugular venous distention following a Bentall procedure 10 years previously.

An asymptomatic 49-year-old woman was admitted for the purpose of surgery for aortic pseudoaneurysm. She had Marfan syndrome and had undergone an emergent Bentall procedure 10 years previously. About six months previously, she could palpate distended bilateral external jugular veins, which became distended only in a supine position and without any other symptoms.

Mitral valve replacement via right thoracotomy approach for prevention of mediastinitis in a female patient with long-term uncontrolled diabetes mellitus: a case report.

A 76-year-old woman with a history of percutaneous transvenous mitral commissurotomy and repeated hospital admissions due to heart failure was referred for an operation for severe mitral valve stenosis. She presented with hypertension, hyperlipidemia and cerebral infarction with stenosis of right internal carotid artery, retinopathy, neuropathy and nephropathy caused by long-term uncontrolled diabetes mellitus, hemoglobin A1c of 9.4%, and New York Heart Association (NYHA) functional classification of 3/4.

Clinical outcomes of medical therapy and timely operation in initially diagnosed type a aortic intramural hematoma: a 20-year experience.

Background: The management of aortic intramural hematoma (IMH) involving the ascending aorta (type A) has not been well-established. The purpose of this study was to clarify the long-term clinical outcomes of patients with type A IMH who were treated with medical therapy and timely operation.

Methods And Results: Clinical data including operative mortality, IMH-related events, and long-term survival were retrospectively reviewed in 66 patients with type A IMH, who were admitted to our institution from 1986 to 2006.

Two surgical cases of acute aortic dissection in pregnancy with marfan syndrome.

We describe 2 surgical cases of acute aortic type A dissection during pregnancy in women with Marfan syndrome. Both of them underwent emergency aortic root replacement under deep hypothermia; one patient was in her 21(st) week of pregnancy and the other was treated 1 day after a normal delivery. The patients experienced fair postoperative courses, but intrauterine fetus death was confirmed in the first case.

Reoperation for early failure of a freestyle bioprosthesis using a full root technique.

The case is reported of a 65-year-old male who required reoperation for early failure of a Freestyle stentless valve aortic root bioprosthesis implanted using the full root technique. The bioprosthesis had been implanted to treat annuloaortic ectasia associated with severe aortic regurgitation (AR). At 18 months postoperatively, a new diastolic murmur developed, though without complaint by the patient.