[Thoracic Endovascular Aortic Repair for Traumatic Aortic Injury with Internal Iliac Approach;Report of a Case].

A 40-year-old female was injured in a car accident while driving. Computed tomography confirmed a dissection localized to the distal aortic arch and hematoma around the area. Severe liver damage with surrounding extravasation was also confirmed.

[Surgical Repair for Blunt Cardiac Rupture].

Blunt cardiac injury is a life-threatening condition. We report 3 successful cases in which we performed surgery for blunt cardiac injury. Three individuals were injured, 2 in traffic accidents and the other being caught between a crane and a steel frame.

[Pulmonary Benign Metastasizing Leiomyoma Resected Six Times during Twenty Years;Report of a Case].

Benign metastasizing leiomyoma (BML) is a rare condition in which a benign uterine leiomyoma causes metastasis, mainly to the lungs. The patient was a 72-year-old woman who had undergone hysterectomy for an uterine leiomyoma at 37 years of age. Between the ages of 52 and 68 years, she had undergone 5 metastatectomies for 10 BMLs.

[Solitary pulmonary lesion developed after the resection of primary lung cancer].

The purpose of this study was to evaluate the characteristics of solitary pulmonary lesion developed after the resection of primary lung cancer and the outcome. Between 1990 and 2011, 1,004 patients underwent complete resection for primary lung cancer in our hospital and we retrospectively analyzed 53 patients with a history of primary lung cancer resection who had a solitary pulmonary lesion. Pulmonary resections were performed in 43 patients.

[Off-pump coronary artery bypass grafting with large cerebral infarction; report of a case].

A 48-year-old male was consulted to our hospital on the next day when he was developed acute myocardial infarction (AMI). He developed cerebral infarction 26 years ago, and had left hemiparesis. Coronary angiogram revealed left main trunk and 2 vessels disease which was not amenable to catheter intervention, and brain computed tomography (CT) showed a very large infarction in right cerebrum.

Pseudocoarctation of the aorta complicated by thoracic aortic aneurysm.

Pseudocoarctation is a rare anomaly involving kinking or buckling of the aorta without a pressure gradient across the lesion, considered to be a benign entity warranting no specific intervention. An uncommon case of pseudocoarctation associated with aortic aneurysm formation in 21-year-old woman is described. Pathological findings suggested that the etiology was anomalous development of the aorta in association with pseudocoarctation; therefore, careful follow-up of patients affected by pseudocoarctation is mandatory.

[Robot assisted tumor resection of an asymptomatic right atrial intracardiac lipoma; report of a case].

Primary cardiac tumors are relatively rare. No therapeutic guidelines have been established for the surgical indications of such cases. This creates therapeutic dilemmas, especially when the patient is asymptomatic.

Simple active air evacuation procedure for right ventricular failure caused by intracoronary air embolism.

In cardiac surgical cases such as valve replacement, right ventricular failure caused by intracoronary air embolism sometimes occurs after aortic declamping and during weaning from cardiopulmonary bypass (CPB). The details are reported of a de-airing method which involves simply rotating the arterial cannula towards the base of the heart, with no need for a particular circuit. This method was used in ten patients who, following open-heart surgery, suffered postoperative right ventricular failure due to air embolism in the right coronary artery that did not respond to other de-airing methods.

Awake coronary artery bypass grafting under thoracic epidural anesthesia: great impact on off-pump coronary revascularization and fast-track recovery.

Objective: The ultimate goal of minimally invasive coronary artery bypass grafting (CABG) is day surgery. We evaluated the potential of a new awake CABG protocol using only epidural anesthesia in realizing day surgery.

Methods: Seventy-two patients who underwent awake off-pump CABG (OPCAB) in our institute from March 2003 were studied.

Tepid hypothermic (32° C) circulatory arrest for total aortic arch replacement: a paradigm shift from profound hypothermic surgery.

In total aortic arch replacement (TARCH) using hypothermic circulatory arrest (HCA) and selective cerebral perfusion (SCP), postoperative cerebral complications, including metabolic abnormalities, are by no means rare. Furthermore, there is a lack of international guidelines for the optimal perfusion temperature and flow for SCP. Starting in 2008, TARCH was performed using tepid HCA at 32 °C.

Potassium-induced cardiac resetting technique for persistent ventricular tachycardia and fibrillation after aortic declamping.

We report a technique of injecting a high concentration of potassium chloride into the aorta root to resolve refractory ventricular tachycardia after aortic declamping, which occurs occasionally in open heart surgeries. Using this technique, normal sinus rhythm can be restored without the need for defibrillation and aortic clamping.

Multivessel awake off-pump coronary bypass grafting using median approach: technical considerations.

Objective: : Several reports of awake off-pump coronary artery bypass grafting (AOCAB) under high thoracic epidural anesthesia (TEA) for single-vessel grafts have been published, but few have described its application in multiple bypass procedures. We report the procedures and safety of AOCAB for multivessel disease.

Methods: : Fifty-five multivessel AOCAB (52 men, 3 women; aged 68 ± 9.

Inferior vena cava occluder for remote access perfusion in robotic cardiac surgery.

Robotic cardiac surgery requires remote access perfusion. We have developed an inferior vena cava (IVC) occluder that can safely and conveniently drain blood from the IVC. This device has been clinically applied in one patient, as described herein.

Multivisceral fibromuscular dysplasia: an unusual case of renal and superior mesenteric involvement.

Fibromuscular dysplasia (FMD), a disease process which leads to arterial stenosis and aneurysm formation, has been reported to occur in almost every arterial bed in the body. However, multivisceral FMD is rare, and we report a 43-year-old woman with hypertension who had incidental finding of FMD of both renal arteries and the superior mesenteric artery (SMA). The left renal aneurysms and right renal stenosis were successfully treated by aneurysm resection and aortorenal bypass and percutaneous transluminal angioplasty, respectively.

[On/off-pump beating coronary artery bypass grafting after thoracoplasty].

Off-pump coronary artery bypass grafting (CABG) [OPCAB] or on-pump beating CABG (conventional CABG) was performed in 3 post-thoracoplasty patients. Considering their poor respiratory function after thoracoplasty, OPCAB is considered more suitable than conventional CABG with cardio-pulmonary bypass in such cases with severe coronary lesions. However, because the sternum inclines or the pleural cavity may be polluted in these patients, special care is necessary for the operation.

Thoracic epidural anesthesia for coronary bypass surgery affects autonomic neural function and arrhythmias.

Background: : In recent years, the invasiveness of coronary reconstruction has been markedly reduced. Awake off-pump coronary artery bypass (AOCAB), coronary bypass surgery with thoracic epidural anesthesia (TEA) without general anesthesia and cardiopulmonary bypass), has been reported in the literature. Because the details of this technique are still unclear, we evaluated its usefulness by examining the autonomic neural state and the incidence of arrhythmia.