The prognostic impact of the controlling nutritional status (CONUT) score in patients undergoing cardiovascular surgery.

Background: Various postoperative predictive markers following cardiovascular surgery have been examined for use in the current aging population. The controlling nutritional status (CONUT) score, which is advocated not only as a screening tool for poor nutritional status, but also as an immunonutritional assessment, has started to attract attention in several clinical settings, such as in cancer and heart failure patients. The aim of this study was to evaluate the value of the CONUT score as a postoperative prognostic marker in patients who underwent cardiovascular surgery.

A Clinical Association between an Increasing Renal Resistive Index and the Atherosclerotic Burden in Patients with a Preserved Renal Function.

Objective A positive correlation is observed between the progression of renal impairment and the increasing risk of cardiovascular disease. Our aim was to examine the relationship between the renal resistive index (RRI) assessed by duplex sonography and the extent of atherosclerosis in patients without renal impairment undergoing vascular imaging studies. Methods The RRI was evaluated pre-procedurally among 106 outpatients with an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.

Endovascular Treatment for Kommerell's Diverticulum with a Right-Sided Aortic Arch.

We report a rare case of type A dissection involving a right-sided aortic arch with an aberrant left subclavian artery originating from Kommerell's diverticulum in a 76-year-old woman. Endovascular treatment for Kommerell's diverticulum including intimal tear of the dissection was performed. At the 5-year follow-up, the patient was doing well, with no endoleak or dilatation of the Kommerell's diverticulum.

Addition of a renin-angiotensin-aldosterone system inhibitor to a calcium channel blocker ameliorates arterial stiffness.

Background: The aim of controlling hypertension is to protect against arteriosclerosis. Calcium channel blockers (CCBs) and renin-angiotensin-aldosterone system (RAAS) inhibitors have been reported to have antihypertensive effects, but their effect on the progression of arteriosclerosis is not fully understood. The cardio-ankle vascular index (CAVI) was developed to estimate arterial stiffness, which reflects arteriosclerosis.

A Case of an Aortic Abscess around the Elephant Trunk.

A 52-year-old male patient with a history of total arch replacement using the elephant trunk technique for acute aortic dissection 4 years before visited our hospital with the chief complaint of persistent fever. Chest computed tomography (CT) suggested prosthetic vascular graft infection, which was treated surgically after chemotherapy. The first surgery consisted of debridement of an abscess around the vascular graft and in the aorta around the elephant trunk, and thoracic descending aorta replacement and vacuum-assisted closure (VAC) in view of the risk of bleeding from the peripheral region of the elephant trunk.

[Surgical Repair of Coarctation of the Aorta in an Adult;Report of a Case].

We present a case of 30-year-old man with successful bypass grafting for coarctation of the aorta. Hypertension was identified during a health examination. Blood pressure difference between the upper and lower limbs was about 60 mmHg.

Morphological Evaluation of Proximal Anastomosis by PAS-Port(®) System in Patients with Long-Term Patent Grafts.

Purpose: We examined grafts employing for morphological analysis of early and long-term results on proximal anastomosis with the PAS-Port(®).

Methods: One hundred and four patients treated by OPCAB with PAS-Port(®) were performed postoperative MDCT. Morphological evaluation of the proximal anastomotic region was classified into three groups (A; graft was anastomosed almost perpendicularly to the aortic wall, B; graft was same type A, but subsequently curved to form an acute angle with the aortic wall, C; graft take off acute angle with the aortic wall) evaluated on planar and sagittal sections.

Usefulness of perioperative blood glucose control in patients undergoing off-pump coronary artery bypass grafting.

Objective: We investigated the usefulness of perioperative blood glucose control in patients undergoing coronary artery bypass grafting (CABG).

Methods: DM patients were aggressively treated with intensive insulin therapy to achieve a preoperative fasting blood glucose level of 140 mg/dl and a postoperative level of 200 mg/dl. For comparison, patients were divided as follows: (1) DM group vs.

Evaluation of bioprosthetic valve for small aortic root in elderly patients.

The hemodynamics of stentless bioprostheses are superior to those of mechanical valves, especially for patients with a small aortic root. Between March 1999 and July 2001, we implanted 18 Freestyle stentless porcine valves using our technique of repeated division of the space by halving the distance. Seven patients received 19-21-mm valves and 11 received 23-25-mm valves.

Limitations of retrograde continuous tepid blood cardioplegia for myocardial remodeling.

Objective: We assessed potential limitations of retrograde continuous tepid blood cardioplegia (RCTBC) for myocardial remodeling, represented by hypertrophied and/or dilated myocardium in patients with severe cardiomyopathy following single aortic valve replacement.

Methods: The study was conducted on 91 patients who underwent initial single aortic valve replacement with tepid cardiopulmonary bypass (CPB) and RCTBC. Based on the postoperative maximum creatine phosphokinase (max CPK)-MB level, the patients were allocated to Group H (>/=100 IU/mL) with severe cardiomyopathy or Group L (<100 IU/mL) to make intergroup comparisons of preoperative, intraoperative, and postoperative parameter values.

Assessment of on-pump beating coronary artery bypass surgery performed after introduction of off-pump approach.

Objective: To clarify the position of on-pump beating coronary artery bypass (CAB) and to define preoperative indicators of intentional conversion to the procedure in the era of advancement of off-pump CAB (OPCAB), we assessed on-pump beating CAB performed after the introduction of OPCAB.

Subjects And Methods: We assessed 130 patients who underwent single CAB [117 (90%) with OPCAB and 13 (10%) with on-pump beating CAB] between August 1999 (when OPCAB was selected as the first-line surgical procedure) and December 2004.

Results: No significant differences were seen between the groups in the number of coronary lesions or the prevalence of left main trunk (LMT) lesion.

A case report of emergency off-pump CABG in an aged patient with ACS renewing ventricular fibrillation.

An emergency off-pump coronary artery bypass (OPCAB) was performed successfully in an aged patient with acute coronary syndrome (ACS). The patient, an 80-year-old woman residing in a nursing home, suddenly lost consciousness during lunch. The electrocardiogram (ECG) showed ventricular fibrillation (Vf) but defibrillation successfully recovered the sinus rhythm.

Intravascular ultrasound imaging for detection of pseudoaneurysm with aortobronchopulmonary fistula after graft replacement of descending aorta.

A 63-year-old man had undergone graft replacement of the descending aorta due to dissection of aortic aneurysm nine years before and closure of an aortobronchopulmonary fistula two years before. He was admitted to our hospital because of massive hemoptysis. Angiography and chest computed tomography (CT) revealed a pseudoaneurysm on the proximal end caused by graft detachment.

L-arginine protects human heart cells from low-volume anoxia and reoxygenation.

Protective effects of L-arginine were evaluated in a human ventricular heart cell model of low-volume anoxia and reoxygenation independent of alternate cell types. Cell cultures were subjected to 90 min of low-volume anoxia and 30 min of reoxygenation. L-Arginine (0-5.