Successful hybrid repair of a giant coronary artery aneurysm after previous coronary artery bypass grafting.

Unlabelled: A 64-year-old woman had undergone coronary artery bypass grafting (CABG) for right coronary occlusion and the Dor procedure for a left ventricular apex aneurysm 10 years previously. A follow-up computed tomography scan showed the evolution of a giant coronary artery aneurysm (CAA) located on the proximal left circumflex artery (CX). It also revealed a previous saphenous vein graft (SVG) that was patent and located on the midline.

[Open Surgery after Zone 0 Debranch Thoracic Endovascular Aortic Repair with Fenestrated Stent Graft:Report of a Case].

Thoracic endovascular aortic repair (TEVAR) has been widely used in recent years as a treatment for thoracic aortic aneurysm, but open surgery may be required for various complications that cannot be controlled by endovascular treatment alone. It is often a more challenging operation. A 78-year-old man underwent two debranch TEVAR (zone 1) for thoracic aortic aneurysm eight years before, and he received TEVAR (zone 0) again with the Najuta stent graft for re-expansion of aneurysm due to typeⅠa endoleak two years before.

Recurrent nonbacterial thrombotic endocarditis the day after mitral valve replacement.

Nonbacterial thrombotic endocarditis (NBTE) is relatively rare, with an identification rate of 1.6% at autopsy, and is associated with malignancy and systemic lupus erythematosus. Further, bioprosthetic valve NBTE is extremely rare, with only a few reports in the literature.

I-BMIPP/Tl dual myocardial SPECT proves the efficacy of surgical treatment for an adult with Bland-White-Garland syndrome.

Bland-White-Garland (BWG) syndrome is a rare congenital heart disease in which the left coronary artery originates from the pulmonary artery (PA). Surgical treatment to rebuild a dual coronary system is recommended at the time of the diagnosis. However, no effective operative procedure has been established for adult-type BWG patients because of the paucity of such cases.

[Huge Left Thrombosis after Mitral Valvuloplasty and Maze Procedure;Report of a Case].

Generally, anticoagulation therapy is not essential for patients who maintain sinus rhythm after mitral valvuloplasty. A 66-year-old woman who had undergone mitral valvuloplasty and maze procedure for treatment of mitral valve regurgitation and atrial fibrillation 4 years ago was diagnosed as having left atrial thrombosis despite maintenance of sinus rhythm on electrocardiography. Echocardiography showed narrow mitral valvular area(1.

Redefinition of tricuspid valve structures for successful ring annuloplasty.

Background: Although numerous reports have described suturing techniques for tricuspid annuloplasty, most studies were not based on a detailed anatomy of the tricuspid annulus. Thus, the definition of the tricuspid commissures remains unclear. This study aimed to clearly define the commissures and leaflets of the tricuspid valve and subvalvular structures, and to define a standard method for tricuspid annuloplasty.

[Unplanned Ascending Aortic Graft Replacement at Valvuler Surgery in a Patient with Systemic Lupus Erythematosus;Report of a Case].

A 65-year-old woman with severe mitral stenosis was admitted to our hospital. She had been previously diagnosed with systemic lupus erythematosus (SLE) and had been taking prednisolone (5 mg/day) for 19 years. As SLE patients with prolonged steroid use are known to be at risk of an aortic dissection and aneurysm, femoral artery was chosen for arterial perfusion to reduce the risk of a dissection of the ascending aorta.

Technique of managing periprosthetic leakage due to mitral prosthetic valve endocarditis: report of a case.

A patient with multiple leaks caused by active mitral prosthetic valve endocarditis with an annular abscess underwent repeat mitral valve replacement. To secure the new mitral prosthesis, sutures were placed through the healthy interatrial septal wall from right to left at the posteromedial region and then to the new prosthetic valve sewing cuff. In the anterolateral region, sutures were placed through the reconstructed annulus after debridement of the abscess and then reinforced with a pericardial xenograft patch.

The conduction system in heterotaxy.

Cardiac malformations associated with the syndrome of atriovisceral heterotaxy are among the most complex forms of congenital heart disease. Accordingly, the disposition of the specialized conduction tissue (the conduction system) is also variable and complex in these particular anomalies. The location of the conduction system and the degree of abnormalities of the conduction system correlate with the severity and location of the associated structural cardiac anomalies.

Reconsideration of patient-prosthesis mismatch definition from the valve indexed effective orifice area.

Background: The objective of this study was to reassess the validity of defining patient-prosthesis mismatch (PPM) in the aortic position on the basis of an indexed effective orifice area (iEOA) less than 0.85 cm(2)/m(2).

Methods: From June 1996 to March 2008, 342 patients underwent aortic valve replacement with a Carpentier-Edwards Perimount valve.

Validity of identifying patient-prosthesis mismatch from the indexed effective orifice area.

The main problem that arises from patient-prosthesis mismatch after aortic valve replacement is a residual high transvalvular pressure gradient, resulting in left ventricular overload. It was demonstrated by Pibarot and Dumesnil that the indexed effective orifice area should be larger than 0.85-0.

Mitral valve reconstruction: long-term results of triangular resection for degenerative prolapse.

Objectives: Surgical treatment of a prolapsed anterior leaflet of the mitral valve is relatively difficult and controversial compared with management of a prolapsed posterior leaflet. The aim of this study was to assess the long-term results of mitral valve repair, focusing on triangular resection of the anterior leaflet.

Methods: Between October 1991 and December 2006, surgical treatment for a prolapsed anterior leaflet was performed in 57 patients with degenerative mitral valve disease, including 49 patients who had anterior leaflet resection.

[Modified Komeda-David operation for postinfarction ventricular septal perforation].

The infarct exclusion technique with a xeno-pericardial patch which Komeda and associates firstly reported in 1990 is one of the best procedure to close ventricular septal perforation. A large patch can protect the perforation and the surrounding weak tissue from the internal left ventricular pressure. However, suturing this large patch to the left ventricular wall through the small incision is not technically easy because of the patch design in the ventricle.

Extracardiac rerouting of the persistent left superior vena cava in the left isomerism heart.

The left isomerism heart is common to have various forms of the systemic and pulmonary venous connections, for which numerous reparative methods have been proposed. This report describes a successful extracardiac rerouting of the persistent left superior vena cava of a 6-year-old girl patient having the isomerism heart, bilateral superior vena cava, partial anomalous pulmonary venous connection, and partial form of the atrioventricular septal defect. Intraatrial rerouting of the left superior vena cava was found unfeasible, since this procedure had a potential hazard to obstruct the systemic and/or pulmonary venous drainage.