Bypass Grafting to Circumflex: Left Internal Thoracic Artery versus Saphenous Vein.

Background: This study aimed to compare the short- and long-term outcomes of saphenous vein grafts (SVGs) and in situ left internal thoracic artery (LITA) grafts to the left circumflex artery (LCX) territory.

Methods: This study included 678 patients who underwent LITA-left anterior descending (LAD) + SVG-LCX grafts and 286 patients who underwent right internal thoracic artery (RITA)-LAD + in situ LITA-LCX grafts from January 2002 to December 2020. Short-term and long-term clinical outcomes were compared using inverse probability of treatment weighting adjustment to reduce selection bias.

Very-long-term outcomes of mechanical valves in mitral position focusing on valve-related complications.

Objectives: This study aimed to examine very-long-term outcomes of a mechanical valve at the mitral position.

Methods: This study included all patients who underwent mitral valve replacement (MVR) using a mechanical valve including urgent operation at the Department of Cardiovascular Surgery, Hyogo Brain and Heart Center, Himeji, from January 1987 to December 2015.

Results: Five hundred and eighty-three patients (277 men [47.

Distal Stent Graft-Induced New Entry after Total Arch Replacement with Frozen Elephant Trunk for Aortic Dissection.

Distal stent graft-induced new entry (dSINE), defined as a new tear caused by a stent graft, has been increasingly observed following total arch replacement using frozen elephant trunk (FET) for aortic dissection. We aimed to investigate the incidence and treatment of dSINE after the use of FET. This retrospective study evaluated 70 patients who underwent total arch replacement using FET for aortic dissection between August 2014 and March 2020.

Modes of the bioprosthetic valve failure of the porcine and pericardial valves in the mitral position.

Objectives: This study was conducted to examine the incidence and modes of the bioprosthetic valve failure of the porcine valve in the mitral position and compare them with those of the pericardial valve.

Methods: This study included 240 patients (116 men [48.3%]; mean age, 74.

Dynamic changes in insulin requirements with post-operative time using bedside artificial pancreas to maintain normoglycemia without hypoglycemia after cardiac surgery.

It is difficult to manage postoperative blood glucose levels without hyperglycemia and hypoglycemia in cardiac surgery patients even if continuous intravenous insulin infusion is used. Therefore, the insulin requirements for maintaining normoglycemia may be difficult to evaluate and need to be elucidated. In this single-center retrospective study, 30 adult patients (age 71.

Recurrent Pulmonary Embolism Caused by Superficial Femoral Vein Aneurysm.

Venous aneurysms (VA), particularly superficial femoral VAs (SFVAs), are rare vascular lesions. A 65-year-old woman with a history of pulmonary embolism (PE), treated with tissue plasminogen activator and oral anticoagulation, was admitted to hospital for dyspnea. Enhanced computed tomography showed recurrent PE and right SFVA with a mural thrombus.

Utility of bedside artificial pancreas for postoperative glycemic control in cardiac surgery.

Unlabelled: Perioperative hyperglycemia, hypoglycemia, and high glycemic variability are independent risk factors for mortality in critically ill patients. After cardiac surgery, intensive glycemic control without hypoglycemia may help to reduce the number of adverse events; however, postoperative glycemic control is difficult in many cases. In this study, we investigated whether the bedside artificial pancreas STG-55 is useful for postoperative glycemic control in cardiac surgery.

Efficacy of left atrial plication for atrial functional mitral regurgitation.

Objective: Atrial functional mitral regurgitation (AFMR) is caused by atrial fibrillation and left atrial enlargement. Our study aimed to evaluate the efficacy of left atrial plication (LAP) for AFMR.

Methods: Of 1164 mitral valve surgery patients at our hospital from January 2000 to May 2019, 22 patients underwent surgery for AFMR.

Hybrid Repair of Kommerell's Diverticulum with Embolization of Aberrant Left Subclavian Artery.

An asymptomatic 70-year-old man presented with Kommerell's diverticulum (KD) and an aberrant left subclavian artery. Computed tomography revealed a KD diameter of 53 mm, severe aortic arch angulation, and no landing zone for thoracic endovascular aortic repair from the arch vessels to the diverticulum. We performed single-stage hybrid repair of KD of the right aortic arch, left carotid-left subclavian artery bypass, and embolization of the subclavian artery, followed by replacement of the descending aorta through deep hypothermic circulatory arrest via right thoracotomy.

Organ Protection for Radical Debridement to Prevent Recurrence of Infection after Zone 1 Thoracic Endovascular Aortic Aneurysm Repair: A Case Report.

We present the case of a 73-year-old man with stent graft infection, who had undergone thoracic endovascular aortic aneurysm repair with a supra-aortic bypass from the right axillary to the left common carotid and axillary arteries. The procedure included total stent graft removal, radical debridement, and in situ graft replacement via left anterolateral thoracotomy. Cerebral perfusion from the left axillary artery and cardioplegia using an occlusion balloon with moderate hypothermia were performed to reinforce organ protection.

Outcomes of Late Open Conversion after Endovascular Abdominal Aneurysm Repair.

: To review our experience with a late open conversion as a final option for an endograft infection and aneurysm expansion after endovascular aneurysm repair (EVAR), especially in endoleaks for which radiological intervention is impossible. : In this retrospective study, 13 late open conversions out of 513 consecutive patients treated by EVAR were analyzed. Indications for an open conversion were aneurysm enlargement, including all endoleaks, endograft migration, and endograft infection.

Preventing brain embolism by using a modified isolation technique in transcatheter aortic valve implantation for a patient with shaggy and porcelain aorta.

Transcatheter aortic valve implantation (TAVI) has become a useful and effective treatment for surgical high-risk patients with severe aortic valve stenosis (AS). Stroke is one of the most frequent complications associated with TAVI. Shaggy and porcelain aortas are a risk factor for procedure-related strokes.

Randomized clinical trial of an elastomeric sealant for hemostasis in thoracic aortic surgery.

Objectives: This study aimed to demonstrate the efficacy and safety of a newly developed elastomeric sealant, which does not require any blood coagulation system to exert its effect, during thoracic aortic surgery.

Methods: This is a multicenter, randomized study conducted in six hospitals in Japan. A total of 81 patients undergoing replacement surgery of a thoracic aortic aneurysm using cardiopulmonary bypass were randomized with a ratio of 2-:1 for those patients designated to receive the sealant (Group S, 54 patients) or those without the usage of the sealant (Group C, 27 patients).

Secondary Aorto-enteric Fistula and Type II Endoleak Five Years after Endovascular Abdominal Aortic Aneurysm Repair.

Introduction: Secondary aorto-enteric fistula (AEF) after endovascular abdominal aortic aneurysm repair (EVAR) is a rare but potentially fatal disease. The aetiology and mechanisms are unclear. This study presents a patient who developed secondary AEF and type II endoleak five years after EVAR.

Midterm outcomes of thoracic endovascular repair for uncomplicated type B aortic dissection with double-barrel type.

Objective: The midterm outcomes and aortic remodeling after thoracic endovascular aortic repair (TEVAR) for uncomplicated type B aortic dissection (TBAD) were evaluated.

Methods: Forty-seven patients (mean age 66 ± 12 years) who underwent TEVAR for uncomplicated TBAD with double-barrel type from January 2012 to December 2017 were retrospectively analyzed. The indication for TEVAR for entry closure was a maximum aortic diameter > 40 mm with a patent false lumen.

Outcomes of valve replacement with mechanical prosthesis versus bioprosthesis in dialysis patients: A 16-year multicenter experience.

Objective: To evaluate the long-term outcomes of heart valve replacement with mechanical prosthesis (MP) versus bioprosthesis (BP) in patients on dialysis.

Methods: A retrospective review was performed at 7 hospitals. Patients on dialysis who underwent valve replacement were included.

Fatal Complications of New-Onset Complicated Type B Aortic Dissection After Endovascular Abdominal Aortic Aneurysm Repair: Report of 2 Cases and Literature Review.

New-onset antegrade Stanford type B aortic dissection (TBAD) after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) is rare. The extension of aortic dissection leads to various symptoms and affects the stent graft. Moreover, various symptoms may arise owing to a stent graft being present.

Severe Obstructive Calcification of the Descending Aorta: A Case Report of "Coral Reef Aorta".

An 82-year-old man suffering from lower back pain and dyspnea presented to our institute in a state of shock. Computed tomography showed subtotal occlusion of the descending aorta with massive atherosclerotic calcification. As the proximal portion of the superior mesenteric artery was obstructed, emergency bypass from the right axillary artery to the bilateral external iliac arteries was performed, but the patient died 2 days later.

[Disruption of Matsui-Kitamura Stent-graft Six Years after Treatment for Rupture of Thoracic Aortic Aneurysm].

Matsui-Kitamura stent-graft (MKSG) is a home-made device for thoracic endovascular aortic repair (TEVAR) developed in Japan. A 76-year-old man who had been treated by TEVAR (zone 3) with a MKSG for ruptured thoracic aortic aneurysm was diagnosed as having type Ia endoleak caused by suture disruption and aneurysmal sac expansion 6 years later. He underwent TEVAR (zone 1) with debranching and type Ia endoleak disappeared.

Surgical management without resection of the oesophagus for aorto-oesophageal fistula secondary to aortic arch aneurysm rupture.

A 79-year-old moderately frail man with a history of graft replacement for descending thoracic aortic aneurysm and chronic kidney disease presented with the onset of haemoptysis. Computed tomography demonstrated aorto-oesophageal fistula secondary to aortic arch aneurysm rupture. Emergency surgery was performed through a median sternotomy.

Early and Late Outcomes of Operation for Acute Type A Aortic Dissection in Patients Aged 80 Years and Older.

Background: The number of elderly patients undergoing emergency operation for acute type A aortic dissection is increasing in the aging society. We examined the early and late outcomes of operation for acute type A aortic dissection in elderly patients (≥80 years old).

Methods: From January 2001 to December 2015, 345 consecutive patients underwent surgical treatment for acute type A aortic dissection at our institution.

[Early and Long Term Outcomes of Surgery for Acute Type A Aortic Dissection Complicated with Organ Malperfusion].

Objective: The purpose of this study was to evaluate early and long term outcomes of surgery for acute type A aortic dissection complicated with organ malperfusion.

Method: From January 2001 to October 2015, 336 consecutive patients (mean age 68.6±12.