A Case of Transapical Thoracic Endovascular Repair for Thoracic Aortic Aneurysm with a Complicated Access Route.

Thoracic endovascular aortic repair (TEVAR) for thoracic aortic aneurysms (TAAs) is an alternative treatment option for high-risk patients. While conventionally performed via a transfemoral approach, it is sometimes difficult due to poor access routes. We report the case of a 90-year-old man who was incidentally diagnosed with a descending TAA while undergoing computed tomography for esophageal cancer.

Pulmonary artery reconstruction using a pulmonary vein conduit in case having an imbalanced dissection length during double-sleeve lobectomy.

Background: Among the types of lung resection procedures, pneumonectomy carries the highest risk for mortality. In recent years, bronchovascular double-sleeve lobectomy has been performed for centrally located non-small cell lung cancer involving both the bronchus and the pulmonary artery (PA) in order to avoid pneumonectomy. The use of an autologous pulmonary vein (PV) conduit for PA reconstruction during lung-sparing resections had first been reported in 2009.

[Bentall Operation for Pregnant Women with Marfan's Syndrome].

A 35-years-old pregnant woman with Marfan's syndrome visited the emergent department. She had sudden severe back pain. She was at the 20th week of gestation.

[Hybrid Treatment for Thoracoabdominal Aortic Aneurysm by Combined Graft Replacement and Stent-graft].

Graft replacement for thoracoabdominal aortic aneurysm(TAAA) is still an important technique, yet it has high risks of mortality, spinal cord ischemia, and pulmonary complications. In our hospital, thoracoabdominal aneurysm repair with grafting and endovascular treatment (TARGET) method was performed in patients with severe chronic obstructive pulmonary disease( COPD), severe pulmonary adhesions after descending aortic replacement, or those considered high risk from general condition to undergo a wide range replacement. In this method, thoracoabdominal aortic replacement near the diaphragm was followed by stent graft treatment of the residual proximal or distal lesions.

[Mediastinal Bronchial Artery Aneurysm Resected together with the Descending Aorta under the Partial Extracorporeal Circulation;Report of a Case].

Bronchial artery aneurysm(BAA) is quite rare, but its rupture is often lethal. Once it is found, treatments should be aggressively considered. A 67-year-old woman was diagnosed to have a 26 mm mediastinal BAA on computed tomography (CT) which was performed for screening.

Compressed Amplatzer Vascular Plug II Embolization of the Left Subclavian Artery for Thoracic Endovascular Aortic Repair is Efficient and Safety Method Comparable to Conventional Coil Embolization.

Background: Left subclavian artery (LSA) embolization is occasionally required to prevent type II endoleak in the thoracic endovascular aortic repair (TEVAR) procedure. This is a retrospective study comparing compressed Amplatzer Vascular Plug II embolization (CAE) and conventional coil embolization (CCE) in preventing retrograde flow into the aneurysmal sac through the LSA after TEVAR.

Methods: We retrospectively reviewed the records of patients who underwent CAE or CCE of the LSA during TEVAR from June 2013 to March 2016 in our hospital.

[Hybrid Treatment for Aortic Arch Aneurysm Concomitant with Right Subclavian Artery Aneurysm].

A 78-year-old man was hospitalized for aortic arch aneurysm concomitant with right subclavian artery aneurysm. Maximum diameter of each aneurysm was 65 mm and 40 mm, respectively. Both aneurysms clearly needed to be treated.

Spinal cord protection during thoracoabdominal aortic replacement: spinal cord perfusion maintenance.

Objectives: Spinal cord protection during thoracoabdominal aortic surgery is challenging for surgeons. We performed thoracoabdominal replacement using a strategy for maintaining spinal cord perfusion pressure. Here, we report our experience with this procedure and the surgical outcomes.

Innominate artery cannulation for arterial perfusion during aortic arch surgery.

Objective: Antegrade cerebral perfusion during aortic arch surgery plays an important role in improving postoperative neurological outcomes. We report our experience using innominate artery cannulation for arterial perfusion during aortic arch surgery.

Methods: From January 2008 to December 2015, 159 patients underwent aortic arch surgery using innominate artery perfusion and were included in the study analysis (mean age, 71.

Operative results of the anterolateral thoracotomy with partial sternotomy approach for chronic-type B aortic dissection involving the aortic arch.

Objectives: There are various treatment strategies for chronic-type B aortic dissection involving the aortic arch. Our aim was to review our surgical experience in the anterolateral thoracotomy with the partial sternotomy approach for chronic-type B aortic dissection involving the aortic arch.

Methods: From January 2000 to October 2015, 39 patients underwent the single-stage open surgery for chronic-type B aortic dissection involving the aortic arch using the anterolateral thoracotomy with partial sternotomy approach.

[Closure of Ascending Aortic Entry by Debranching Endovascular Management in an Elderly Patient with Acute Stanford Type A Dissection].

An 85-year-old woman was hospitalized by emergency for an acute Stanford type A aortic dissection. Computed tomography showed a primary entry on the ascending aorta and pericardial effusion. Although her hemodynamics was unstable due to cardiac shock, her family wished no open surgery considering her age and frailty.

Outcomes of Anterolateral Thoracotomy With or Without Partial Sternotomy for Kommerell Diverticulum.

Background: Kommerell diverticulum is a rare aortic arch anomaly. The indications for operative intervention and surgical strategy are still controversial. The standard surgical procedure at our institution is total aortic arch plus descending aortic replacement using anterolateral thoracotomy with partial sternotomy.

Outlet strut fracture and leaflet escape of Bjork-Shiley convexo-concave valve.

Prosthetic valve fracture is a serious complication and may arise in patient post-valve replacement. We experienced an outlet strut fracture and leaflet escape of a Bjork-Shiley convexo-concave valve. We performed an emergency redo mitral valve replacement and successfully retrieved the fractured strut and escaped leaflet from superficial femoral artery and the abdominal aorta.

Aortogastric Fistula Caused by a Foreign Body in a Hiatal Hernia.

Foreign body ingestion is more common in children than in adults, and sharp foreign body ingestion is extremely rare. We report a 93-year-old woman who was unaware of foreign body ingestion and who presented with sudden hematemesis and circulatory collapse. Computed tomography showed a hiatus hernia and part of the stomach herniating in the posterior mediastinum.

Two cases of thoracic aortic aneurysm with right aortic arch: comparison of two operative strategies for hybrid thoracic endovascular repair.

Hybrid TEVAR was performed in 2 patients with right aortic arch accompanied by Kommerell's diverticulum and aortic aneurysm. In patient 1, total debranch + TEVAR was performed with 1-stage median sternotomy. In patient 2, total arch replacement and insertion of a peripheral elephant trunk were performed first, followed by TEVAR.

Single-Stage Endovascular Treatment Performed on Multiple Aortic Aneurysms in a Patient with Behçet's Disease-Report of a Case.

A 50-year-old male diagnosed with Behçet's disease was referred to our department for stent graft treatment because of thoracic, abdominal, and right common iliac artery (CIA) aneurysms. He had a superior mesenteric artery aneurysm in 2005 that was treated with resection and bypass surgery through the radial artery. He later underwent four abdominal surgical procedures for conditions such as intestinal perforation and ileus.

Missing leaflet: a rare cause of structural deterioration of a bovine pericardial aortic bioprosthesis-report of a case.

We experienced a rare cause of aortic bioprosthesis deterioration in which one of the leaflets disappeared 8.7 years after primary aortic valve replacement (AVR) in a male octogenarian. Successful redo AVR with a 23-mm Magna EASE (Carpentier-Edwards, Irvine, CA) was performed.

Optimal timing of aortic valve replacement in elderly patients with severe aortic stenosis.

Purpose: The elderly population with severe aortic stenosis (AS) requiring aortic valve replacement (AVR) is increasing. The optimal timing of AVR in these patients has been under discussion.

Methods: We retrospectively reviewed the data from severe AS patients (n = 84) who underwent AVR with/without concomitant procedures from 2005 to 2010.

Acute aortic dissection at 33 weeks of gestation with fetal distress syndrome.

The present report describes a female patient, 33 weeks pregnant, who demonstrated complicated abnormal placenta formation and fetal distress, and who presented with an acute type A aortic dissection. The patient underwent an immediate cesarean section and hysterectomy followed by a successful emergency surgical aortic repair, thereby obtaining a favorable outcome for both mother and baby.

Saphenous vein graft aneurysm after coronary artery bypass grafting.

Saphenous vein graft (SVG) aneurysms are an unusual but potentially fatal complication after coronary artery bypass grafting (CABG). We report a case of multiple SVG aneurysms 23 years following CABG. Although the patient was on dialysis and had a poor left ventricular function, the aneurysms were successfully excised, and the ascending aorta was uneventfully replaced to be possible for percutaneous coronary intervention in the near future.

[Mediastinal abdominal wall fistula due to ePTFE membrane].

A 78-year-old woman who had undergone double valve replacement 13 years before was referred to our department because of postoperative wound dehiscence and exudate. Although the result of exudate culture was negative, the wound was disinfected continuously for 4 weeks and showed a transient remission. However, the exudate was observed again 3 weeks later.

Chronic contained rupture of an abdominal aortic aneurysm with vertebral erosion: report of a case.

A 73-year-old man had lumbago of unknown cause for several months prior to presentation. At examination prior to surgery for gastric cancer, an abdominal aortic aneurysm (AAA) of 6 cm in maximum diameter, retroperitoneal hematoma and vertebral erosion were found on abdominal computed tomography (CT). Hematological examination revealed mild anemia and stable hemodynamics.

Resection of a cardiac tumor extending into the inferior vena cava presenting as Budd-Chiari syndrome.

This report describes the successful treatment of a case of cardiac adenocarcinoma with the clinical presentation as Budd-Chiari syndrome. Complete surgical excision of the atriocaval mass was successfully achieved under deep hypothermic circulatory arrest. Histopathological diagnosis of this tumor was tubular adenocarcinoma with positive immunostaining by carcinoembrionic antigen.

Mycotic abdominal aortic pseudoaneurysm caused by a penetrating atherosclerotic ulcer: report of a case.

We report a case of mycotic abdominal aortic pseudoaneurysm caused by a penetrating atherosclerotic ulcer (PAU). An 81-year-old woman was admitted to a local hospital with fever and abdominal pain, and when her symptoms were not improved by antibiotics, she was referred to our department. Computed tomography (CT) and angiography showed a saccular aneurysm below the renal arteries, and an emergency laparotomy was performed because we suspected a mycotic abdominal aortic pseudoaneurysm.