Publications by authors named "Mio Shinshi"

A 75-year-old man was admitted for cerebral infarction. Magnetic resonance imaging revealed parietal lobe cerebral infarction. Transesophageal echo and contrast-enhanced computed tomography indicated mobile and speckled mass arising from left atrium.

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A 71-year-old woman was admitted for cardiac tamponade due to left ventricular free wall rupture after acute myocardial infarction. Sutureless repair was performed for bleeding from the inferior wall. Fifteen days later, computed tomography demonstrated enlargement of a left ventricular pseudoaneurysm.

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A 67-year-old woman had sudden loss of consciousness and chest and back pain. She was transported by ambulance about two hours later. Computed tomography (CT) showed dissection of the aorta, the brachiocephalic artery and the right common carotid artery (RCCA).

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An 87-year-old male was referred to our hospital for surgery of saccular aortic arch aneurysm. As he had a history of thoracoplasty on his left side due to pulmonary tuberculosis, his aortic arch adhered to the apex of the left thorax. Total arch replacement(TAR) via median sternotomy was considered difficult, and anterolateral thoracotomy with partial sternotomy (ALPS) was performed.

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A 76-year-old female was referred to our hospital for fever and chillness. She was diagnosed with pneumonia and sepsis, and methicillin-resistant Staphylococcus aureus (MRSA)was detected by the sputum culture. Echocardiography showed mobile vegetation and left ventricular pseudoaneurysm at the apex.

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Article Synopsis
  • Median sternotomy is the standard method for coronary artery bypass grafting, but in some high-risk cases, alternative approaches may be necessary.
  • The authors describe a case of off-pump coronary artery bypass grafting performed through left anterior thoracotomy in a patient with unstable angina and a complicated medical history, specifically total laryngectomy and tracheostoma.
  • By modifying the surgical technique to extend the incision and resect certain ribs, they successfully accessed the heart without converting to median sternotomy, suggesting this approach could be a viable option for similar patients at risk for surgical complications.
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Approximately 40% of the patients with aortic aneurysm have coronary artery disease(CAD), which is an important factor contributing to early mortality associated with aneurysm surgery. Combined coronary artery bypass grafting (CABG)and aortic aneurysm repair of the ascending aorta to the aortic arch is often performed through a median sternotomy due to a good surgical exposure. However, treatment strategy of thoraco-abdominal aortic aneurysm(TAAA) combined with CAD is often controversial.

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