Incidence of Cholecystitis After Endoscopic Biliary Drainage Using a Low Axial Force Covered Self-Expandable Metallic Stent in Patients With Malignant Distal Biliary Obstruction: A Multicenter Prospective Study.

Background And Aim: No prospective studies have verified the incidence of cholecystitis in patients using the covered self-expandable metallic stent. In this study, we aimed to investigate the incidence of cholecystitis and its risk factors after low axial force covered self-expandable metallic stent placement for malignant distal biliary obstruction.

Methods: This multicenter prospective study included patients diagnosed with unresectable distal biliary obstruction between November 2019 and October 2022 who underwent low axial force covered self-expandable metallic stent placement.

Midterm Performance of the Autologous Adventitial Overlay Method in Aortic Surgery.

Background: We developed an adventitial overlay method for reinforcing aortic anastomoses. This study evaluated the midterm morphologic and clinical outcomes of this method.

Methods: We harvested and prepared adventitia from a resected aneurysm or dissected aortic wall and performed aortic repair using the adventitial overlay method.

Comprehensive Pain Control Strategy in Minimally Invasive Mitral Valve Repair.

Purpose: The effect of our comprehensive strategy to reduce pain after minimally invasive mitral valve repair through a right mini-thoracotomy was assessed retrospectively.

Methods: Our comprehensive strategy constituted the following: planned rib cutting to avoid rib injury, sufficient intercostal muscle division to mobilize the cut rib, limiting the number of intercostal ports, avoiding nerve entrapment, continuous extra-pleural intercostal nerve block, and regular use of oral non-steroidal anti-inflammatory drugs. We compared patients treated with this comprehensive strategy (Group S, n = 13) and patients before this strategy was implemented (Group C, n = 13).

Utility of Ultrasonographic Assessment of Distal Femoral Arterial Flow during Minimally Invasive Valve Surgery.

Purpose: To evaluate the utility of ultrasonographic assessment of blood flow to the lower limb below the cannulation site in minimally invasive cardiac surgery (MICS).

Methods: Twenty-two patients who underwent ultrasonographic assessment in MICS were reviewed retrospectively. In all patients, the right femoral artery was used for arterial cannulation.

Cholecystitis after Placement of Covered Self-Expandable Metallic Stents in Patients with Distal Malignant Biliary Obstructions.

Background/aims: Cholecystitis can occur after the placement of covered self-expandable metallic stents for distal malignant biliary obstructions. We aimed to identify risk factors for cholecystitis following covered self-expandable metallic stent placement.

Methods: We investigated risk factors related to cholecystitis following covered self-expandable metallic stent placement in 118 patients with distal malignant biliary obstructions between January 1, 2015 and April 30, 2019.

Commissure enhancement technique in aortic valve repair.

Sinotubular junction enlargement is one of possible causes of aortic valve regurgitation. However, there is no appropriate technique for sinotubular junction diameter reduction in aortic valve repair in a patient without disease of the ascending aorta or sinus of Valsalva. Herein, we report a simple commissure enhancement technique comprising the placement a horizontal mattress suture buttressed with felt at the sinotubular junction level in the commissure area.

Endoscopic Balloon Dilation for Benign Bilioenteric Stricture: Outcomes and Factors Affecting Recurrence.

Background: Balloon dilation (BD) is a simple, effective procedure for postoperative benign bilioenteric strictures (BBESs). Factors associated with BBES recurrence after endoscopic BD have not been studied adequately. This study examined the outcomes and 1-year recurrence factors in patients with BBES who underwent endoscopic BD.

Segmental clamp and distal perfusion technique for reducing myocardial ischemia during coronary onlay grafting on a beating heart.

We present a segmental clamp with distal perfusion technique to reduce myocardial ischemia during onlay grafting, on a beating heart. After a proximal coronary arteriotomy for 2-3 cm, the distal artery is perfused through a cannula, with femoral arterial blood (distal perfusion with external shunt). During proximal and distal coronary snare clamping with distal perfusion, onlay anastomosis is performed, from the heel toward the point of cannula insertion.

Autologous adventitial overlay method reinforces anastomoses in aortic surgery.

In this study, we present an inexpensive and effective method for providing a secure and hemostatic anastomosis using autologous adventitia obtained from a dissected or aneurysmal wall. The resected aortic wall is separated between the adventitia and media, and a soft, 2 × 10-cm adventitial strip is overlaid to cover the anastomotic margin. A graft is sutured to the aortic stump.

Granulocyte colony-stimulating factor does not enhance recruitment of bone marrow-derived cells in rats with acute myocardial infarction.

Despite the potential benefit of granulocyte colony-stimulating factor (G-CSF) therapy in patients with acute myocardial infarction (MI), the efficacy of G-CSF in regenerating the heart after MI remains controversial. The authors hypothesize that the limited efficacy of G-CSF is related to its inhibitory effect on recruitment of bone marrow-derived cells (BMCs) to the infarcted tissue. MI was induced in rats with intrabone marrow-bone marrow transplantation from syngenic rats expressing green fluorescence protein to track BMCs.

The case of successful catheter ablation using only the approach from the upper part of the subject's body, with meandering aorta and implanted IVC filter.

A 79-year-old female had paroxysmal supraventricular tachycardia. However, she was implanted with an inferior vena cava filter and her descending aorta had significant meandering. It was thought that the insertion of the catheters would be difficult from the femoral vessels.

Retrograde fast pathway ablation with the EnSite NavX mapping system for slow-fast atrioventricular node reentrant tachycardia and a prolonged PR interval during sinus rhythm.

An 84-year-old male had experienced palpitations. He was transported to our hospital for treatment of palpitations. A 12-lead electrocardiogram (ECG) showed regular tachycardia with a wide QRS complex of 153 bpm, and the P wave was not clear.

Three surgical cases of isolated tricuspid valve infective endocarditis.

Tricuspid valve infective endocarditis (TVIE) is rare in Japan, though many reports of it in intravenous drug users are found in other countries. We experienced 3 surgical cases of isolated TVIE in 2 nonintravenous drug users and 1 intravenous user, and we presented successful results. The surgical options for TVIE are vegetectomy and valvulectomy, valve repair, and valve replacement, which are controversial in regard to hemodynamic consequences in right-sided low-pressure system and long-term prognosis.

Phenotypic modulation and turnover of bone marrow-derived cells after myocardial infarction in rats.

Background: Bone marrow-derived cells (BMCs) are critically involved in inflammation and regeneration after myocardial infarction (MI). However, the participation of BMCs in the reconstruction of infarcted myocardium remains unclear. In this study, we investigated phenotypic modulation of BMCs and their turnover in the heart following MI.

Complete removal of heart-compressing large mediastinal lipoma: a case report.

An 83-year-old man presented with worsening of respiratory discomfort and underwent close examination, which revealed a large mediastinal lipoma measuring 15 x 10 cm. The patient showed heart failure symptoms due to heart compression by tumor. The tumor was completely removed safely and reliably by cutting the ascending aorta, main pulmonary artery and superior vena cava.

Hemostatic effectiveness of a new application method for fibrin glue, the "rub-and-spray method", in emergency aortic surgery for acute aortic dissection.

Purpose: This study was performed to evaluate the clinical hemostatic effectiveness of a new application method for fibrin glue, the rub-and-spray method, in aortic surgery.

Methods: Twenty consecutive patients undergoing emergency ascending aorta or ascending-hemiarch replacement for Stanford type A acute aortic dissection were prospectively randomized into 2 groups, one with the rub-and-spray method (group G, 10 patients) and one without fibrin glue (group C, 10 patients). The rub-and-spray method consists of using a finger to rub the fibrinogen solution over needle holes, then spraying the fibrinogen solution and the thrombin solution simultaneously over the anastomosis, using an application nozzle.

Mitral valve stenosis caused by abnormal pannus extension over the prosthetic ring and leaflets after Duran ring mitral annuloplasty.

We treated a 61-year-old woman with mitral stenosis caused by pannus formation after Duran ring annuloplasty. Pannus overgrowth on the ring with extension onto both leaflets narrowed the mitral orifice and severely restricted the mobility of the valve leaflets. Mitral valve replacement with a St.

Surgical strategy for impending rupture of an infected anastomotic pseudoaneurysm of the aorta 9 years after a Bentall procedure: radical surgery involving en bloc resection of the infected sternum, pseudoaneurysm, and artificial vascular graft.

Infection of the sternum and anterior mediastinitis after open heart surgery are serious complications that are intractable with high case fatality rates. Frequently, infection spreads to an artificial foreign body in the mediastinum, causing difficulties with treatment. We report a case of infected pseudoaneurysm of the aorta at the anastomotic site of the artificial vascular graft.