[Multi-stage Operations to Thrombose a False Lumen for Chronic Aortic Dissection:Report of a Case].

A 72 years old man underwent hemiarch replacement for acute aortic dissection of Stanford type A at the age of 62 years. Entry remained at the aortic arch, and the false lumen was patent to the terminal aorta. After 10 years, his aortic aneurysm was enlarged to 55 mm.

[Emergency Operation for Impending Rupture of Syphilitic Aortic Aneurysm with Left Coronary Ostial Stenosis:Report of a Case].

Syphilis is known as a cause of syphilitic aortitis. Chronic inflammation leads to formation of syphilitic aneurysm which often is found at the ascending aorta. If the inflammation spreads to the aortic root, stenosis of coronary ostium or aortic valve regurgitation are caused.

Comparative study of Japanese frozen elephant trunk device for open aortic arch repairs.

Objective: We performed a multicenter prospective comparative study to determine the impact of a Japanese frozen elephant trunk device on total arch replacement compared with conventional repair without it.

Methods: Between 2016 and 2019, a total of 684 patients (frozen elephant trunk procedure; n = 369; conventional repair, n = 315) from 41 institutions were enrolled. The 2 procedures were selected according to each center's strategy.

Surgical Treatment for Primary Mycotic Aneurysms Using Endovascular Therapy, Focusing on Patient Selection: Single-Center Experience.

Mycotic aneurysms (MAs) are relatively rare but life-threatening. Some recent reports have described the use of endovascular therapy for their treatment; however, this still is a controversial treatment, and a definite target population has not been determined. We performed surgery on 34 patients with MAs from March 2005 to March 2019.

Endovascular repair for three-channelled aortic dissection.

Surgical repair of extensive thoracic aortic disease induced by repeated aortic dissection is challenging due to its invasive nature in some cases. We report a rare case of successful endovascular repair of a dissected 3-channelled thoracic aortic aneurysm using the PETTICOAT (provisional extension to induce complete attachment) technique and false-lumen embolization (the candy-plug technique). The PETTICOAT technique improved visceral flow, and the false lumen of the aneurysm was completely thrombosed by the candy-plug technique.

Stented balloon fenestration before entry repair using the frozen elephant trunk technique for chronic aortic dissection.

Endovascular fenestration on the abdominal aorta is effective for preventing visceral malperfusion in aortic dissection. We report a case of stented balloon fenestration before residual entry repair using the frozen elephant trunk technique for chronic aneurysmal dissection after ascending aortic replacement for DeBakey I aortic dissection. We recognized poor communication between the true lumen and false lumen in the abdominal aorta, and visceral perfusion depended almost entirely on the proximal large entry.

Early- and mid-term aortic remodelling after the frozen elephant trunk technique for retrograde type A acute aortic dissection using the new Japanese J Graft open stent graft.

Objectives: We previously performed the frozen elephant trunk (FET) technique for acute type A aortic dissection to try to improve the long-term prognosis. In this study, we report the mid-term results of the FET technique for treating retrograde type A acute aortic dissection using a new device, the J Graft open stent graft (JOSG).

Methods: Between January 2008 and December 2015, 24 patients (mean age: 59.

Management of cerebral malperfusion in surgical repair of acute type A aortic dissection.

Objectives: Cerebral malperfusion for patients with acute type A aortic dissection (AAAD) remains an unsolved problem. The present study aimed to evaluate our management of cerebral perfusion and identify predictors of perioperative cerebral malperfusion in patients undergoing surgical repair of AAAD.

Methods: Between January 2004 and December 2015, 137 consecutive patients with AAAD underwent aortic replacement at Tsuchiya General Hospital.

Successful endovascular repair of spontaneous aortic rupture early postpartum.

Endovascular repair of pregnancy-associated aortic disease is controversial because the long-term result is still unclear. We report a rare case of early postpartum spontaneous aortic rupture that was successfully treated by endovascular repair, with a good midterm result. Multiangle thin-slice images of contrast-enhanced computed tomography revealed a very small rupture point.

A pitfall of false lumen embolization in chronic aortic dissection: intimal injury caused by the embolization device edge.

We report a case of intimal injury caused by the occluder device in the false lumen (FL) after treatment of refractory chronic aortic dissection with FL embolization. We speculate that the intimal injury was due to the disproportionate stress from the FL. We covered the new entry by an additional stent graft in the true lumen.

Impact of the size mismatch between saphenous vein graft and coronary artery on graft patency.

Background: The saphenous vein graft (SVG) is widely used in coronary artery bypass grafting because of its availability and ease of use. However, the patency rate of the SVG grafted to the right coronary artery (RCA) is poor. Diameter mismatch between the coronary artery and SVG is an important cause of graft occlusion.

[Stent Grafting for Aortic Dissection].

The purpose of stent graft for aortic dissection is to terminate antegrade blood flow into the false lumen through primary entry. Early intervention for primary entry makes excellent aortic remodeling and emergent stent grafting for complicated acute type B aortic dissection is supported as a class I. On the other hand stent grafting for chronic aortic dissection is controversial.

Endovascular Repair by Graft-to-Graft Bridging in a Patient with Marfan Syndrome.

We report a case of chronic aortic dissection in a patient with Marfan syndrome in which we performed thoracic endovascular repair after aortic root replacement, total arch replacement with open stent grafting and thoracoabdominal aortic repair. We consider that endovascular repair of the dissected descending aorta in a patient with Marfan syndrome can be effective when graft-to-graft bridging is performed as the "finishing procedure".

A new device as an open stent graft for extended aortic repair: a multicentre early experience in Japan.

Objectives: Open stent grafting for extended aortic repair has been widely carried out around their world. We reported the effectiveness of a new device as an open stent graft for extended aortic repair.

Methods: A new device was used as an open stent graft in this study.

Postoperative atrial fibrillation after thoracic aortic surgery.

Background: Postoperative atrial fibrillation (POAF) increases considerably the chances of morbidity and mortality after cardiac surgery. The objective of this study was to identify the major risk factors responsible for POAF after thoracic aortic surgery in order to define preventive measures.

Methods: We analyzed 12,260 records (between January 1, 2004, and December 31, 2008) obtained from the Japan Adult Cardiovascular Surgery Database.

[Aortoplasty with autologous pulmonary patch for the ascending aortic stenosis after interrupted aortic arch repair].

We experienced a case of ascending aortic stenosis after interrupted aortic arch repair. At the first operation in the neonatal period, diameter of the aortic annulus was 4.8 mm and no subvalvular stenosis was presented.

Multiple factors predict the risk of spinal cord injury after the frozen elephant trunk technique for extended thoracic aortic disease.

Objectives: Spinal cord injury (SCI) after the frozen elephant trunk (FET) technique is more frequent than after endovascular aneurysm repair. This study aimed to identify risk factors of SCI after the FET technique.

Methods: We performed the FET technique for extended thoracic aortic disease in 224 patients (mean age, 72.

Delayed surgery for type A aortic dissection caused by blunt trauma.

We describe a rare case of delayed surgery for blunt ascending aortic injury. A 77-year-old man was injured in a traffic accident. He lost consciousness and suffered severe blunt trauma to the chest.

The frozen elephant trunk technique for acute type A aortic dissection: results from 15 years of experience†.

Objectives: We aimed to evaluate the long-term prognosis of prophylactic repair of the descending aorta using the frozen elephant trunk (FET) technique for acute type A aortic dissection (AAAD).

Methods: Between 1997 and 2012, 120 consecutive patients (mean age: 64.4 ± 10.

How to prevent spinal cord injury during endovascular repair of thoracic aortic disease.

The incidence of spinal cord injury in thoracic endovascular aortic repair (TEVAR) has been 3-5 % from recent major papers where sacrifice of the critical intercostal arteries is inevitable by a stent graft. Hemodynamic stability, which depends on a network of blood vessels around the cord is most important not only during but also after stent-graft deployment. High risk factors of spinal cord injury during endovascular aortic repair are (1) coverage of the left subclavian artery, (2) extensive coverage of long segments of the thoracic aorta, (3) prior downstream aortic repair, (4) compromising important intercostal (T8-L1), vertebral, pelvic and hypogastric collaterals, and (5) shaggy aorta.

Real-time graft flow assessment using epigraftic ultrasonography during coronary artery bypass grafting.

Objectives: Real-time graft flow assessment in the operative field has been performed to ascertain the patency in coronary artery bypass grafting (CABG). This study aims to evaluate the efficacy of graft flow assessment by epigraftic ultrasonography.

Methods: CABG was performed in 135 patients from January 2010 to December 2012.