Refractory heart failure and intermittent claudication secondary to supra-renal coral reef aorta.

Coral reef aorta (CRA), a rare disease, is characterized by severe calcification of the juxta-renal and suprarenal aorta that grows into the lumen and leads to severe stenosis. A 70-year-old woman with refractory hypertension and lower limb claudication presented with hypertension and congestive heart failure. Treatment with vasodilators and diuresis led to oliguria and exacerbated kidney function, while her congestion remained.

Emergency thoracic endovascular aortic repair with celiac artery coverage in hereditary hemorrhagic telangiectasia.

Celiac artery (CA) coverage during thoracic endovascular aortic repair has been demonstrated to be a feasible and effective strategy for selected cases. However, there is a potential risk of ischemic complications due to CA coverage in patients with certain types of hereditary hemorrhagic telangiectasia (HHT). Herein, we report a case of thoracoabdominal aortic rupture in a patient with HHT that was successfully treated with emergency thoracic endovascular aortic repair covering the CA preceded by hepatic artery bypass.

Outcomes of Totally Endoscopic Atrial Septal Defect Closure Using a Glutaraldehyde-Treated Autologous Pericardial Patch.

Background: We evaluated the outcomes of totally endoscopic minimally invasive surgery for atrial septal defect (ASD) using a glutaraldehyde-treated autologous pericardial patch in the transcatheter interventional era.

Methods and results: We retrospectively reviewed 37 consecutive patients who underwent totally endoscopic ASD closure with a glutaraldehyde-treated autologous pericardial patch between June 2011 and April 2015. All patients had been deferred from catheter-based intervention for clinical or anatomical reasons.

Use of the Rigid Table Mount System During Transcatheter Aortic Valve Replacement With the Direct Aortic Approach.

Although the direct aortic approach is one option in performing transcatheter aortic valve replacement, it is essential to keep a sheath manually in the same position during the procedure. Holding the sheath by hand is not ideal because of the relatively high dose of radiation to the person who holds the sheath. We here describe a unique way to keep the sheath firm with a table mount system.

A Novel Approach for Emergency Repair of Intraoperative Type A Aortic Dissection Through a Left Thoracotomy.

We observed a case of intraoperative type A dissection during open descending and thoracoabdominal aortic replacement. It is difficult to obtain optimal access to the ascending aorta and aortic root through a left thoracotomy. Transection of the pulmonary trunk provided excellent exposure of the ascending aorta and aortic root, and we successfully managed this devastating adverse event.

A Simple Nonresectional Technique for Degenerative Mitral Regurgitation With a Very Large Posterior Leaflet: Chordal Foldoplasty.

Leaflet resection with sliding valvuloplasty or additional chordal replacement is a standard technique for very large posterior leaflet prolapse. Regular chordal replacement without resection is simpler than those techniques. However, it may not reduce the leaflet height enough to avoid systolic anterior motion.

A Simple, Effective, and Inexpensive Technique for Exposure of Papillary Muscles in Minimally Invasive Mitral Valve Repair: Wakka Technique.

Obtaining excellent exposure of the papillary muscles is challenging in minimally invasive mitral valve repair. We have developed a simple and effective technique using a sterile paper ruler. The ruler is cut to the proper length (8 to 12 cm) depending on the valve size, then rolled and sutured.

A case of right ventricular diastolic dysfunction due to a large hematoma posterior to the left ventricle.

We report a case of right ventricular (RV) diastolic dysfunction due to a large hematoma posterior to the left ventricle (LV) after cardiac surgery. An 80-year-old woman underwent cardiac surgery. After surgery, her physical findings revealed right heart failure.