Impact of the Cardioplegia Interval on Myocardial Protection Using the Modified St. Thomas Solution in Minimally Invasive Mitral Valve Surgery: A Double-Center Study.

It has been reported that a single-dose cardioplegia interval is useful, but the safe interval doses are not clear. We aimed to investigate the impact of the cardioplegia interval on myocardial protection using the modified St. Thomas solution.

Anomalous systemic arterial supply to the left basal lung with a calcified abnormal vessel: a case report.

Background: Anomalous systemic arterial supply to the normal basal segment of the left lower lobe is a congenital abnormality of the lung, frequently and is generally diagnosed at a young age. Surgery is generally recommended if symptoms such as blood sputum or fever are observed. Resection of the abnormal artery is often performed at an early age, with only few reports of surgery being performed at an older age.

Primary malignant pericardial mesothelioma presenting with cardiac tamponade.

Introduction: Primary malignant pericardial mesothelioma is a rare tumor that is very difficult to diagnose. Furthermore, it is a lethal disease, because patients usually have progressed at the time of referral.

Presentation Of The Case: We report a 44-year-old man with primary malignant pericardial mesothelioma.

Surgical treatment of a huge hepatic artery aneurysm without revascularization-Case Report.

Introduction: Hepatic artery aneurysms (HAA) are rare and life-threatening.

Presentation Of Case: We report a case of a 68-year-old man with a huge HAA diagnosed incidentally. Computed tomography showed a huge HAA (67-84 mm diameter).

Graft protective effect and induction of CD4Foxp3 cell by Thrombomodulin on allograft arteriosclerosis in mice.

Background: Thrombomodulin (TM) is a promising therapeutic natural anti-coagulant, which exerts the effects to control disseminated intravascular coagulation. However, little is known whether TM on micro-vessels could play an important role in the regulation of intimal hyperplasia. We investigated the vessel-protective effect of TM in the survival of fully major histocompatibility complex (MHC)-mismatched murine cardiac allograft transplantation.

Combination of paeoniae radix and cnidii rhizoma prolonged survival of fully mismatched cardiac allografts and generated regulatory cells in mice.

In previous studies, we have demonstrated that Tokishakuyakusan (TJ-23) can prolong the survival of allogeneic cardiac grafts and induce regulatory T cells. In this study we investigated the effects of Paeoniae radix and Cnidii rhizoma, two components of TJ-23, on alloimmune responses in a murine cardiac transplantation model and whether the two agents have synergistic effect. CBA mice underwent transplantation of a C57BL/6 heart and received oral administration of 2 g/kg/day of Paeoniae radix, Cnidii rhizoma, or the mixture of two agents from the day of transplantation until 7 days afterward.

Outcomes of contemporary emergency open surgery for type A acute aortic dissection in elderly patients.

Objectives: We sought to evaluate surgical outcomes of type A acute aortic dissection in elderly patients.

Methods: Between January 2004 and July 2011, 422 patients underwent emergency open surgery for type A acute aortic dissection at our institution. Of those, 124 patients who were ≥75 years (mean age, 78.

[Mitral valve replacement in dextrocardia and situs inversus].

Cardiac surgery for acquired valvular diseases in patients with dextrocardia is extremely rare. We report a surgical case of mitral valve replacement and tricuspid annuloplasty in a patient with dextrocardia and situs inversus. A 74-year-old man with dextrocardia and situs inversus, who had undergone patch closure of atrial septal defect 25 years before, was referred for surgical treatment of severe mitral and tricuspid valve regurgitation.

Prior cardiac and thoracic aortic surgery as a complication risk factor for abdominal aortic aneurysm repair.

Background: Patients with both cardiothoracic lesions and abdominal aortic aneurysm (AAA) are increasing in Japan. The objective of this study was to clarify the effect of 2-staged surgery on complication rates.

Methods And Results: Three hundred and forty-six patients who underwent elective surgery for infrarenal AAA were entered.

Graft selection in elderly patients undergoing coronary artery bypass grafting.

Purpose: This study aimed to assess the clinical and angiographic outcomes after coronary artery bypass grafting (CABG) in elderly patients (≥75 years).

Methods: We reviewed the records of 1021 patients who underwent CABG between September 2004 and December 2009. We divided these patients into two groups: ≥75 years (group E, n = 292) versus <75 years (group N, n = 729).

Outcomes of total arch replacement with stepwise distal anastomosis technique and modified perfusion strategy.

Objective: Total arch replacement has been reported to present high morbidity and mortality. We have introduced a stepwise distal anastomosis technique and modified perfusion strategy, including selective antegrade cerebral perfusion, moderate hypothermia, and separate lower-body perfusion, to minimize organ ischemia and secondary morbidities. We report the operative outcomes of total arch replacement with our modified perfusion strategy.

Mechanisms of recurrent regurgitation after valve repair for prolapsed mitral valve disease.

Background: We assessed mitral valve (MV) function using serial echocardiography as an indicator of the durability of MV repair. The aim of this study was to analyze the mechanisms of recurrent regurgitation after MV repair for degenerative disease.

Methods: From 1991 to 2007, 736 patients had valve repair for mitral regurgitation caused by leaflet prolapse: 346 patients had posterior and 390 had anterior leaflet prolapse.

Impact of proximal anastomosis procedures on stroke in off-pump coronary artery bypass grafting.

Background: There are many options for proximal anastomosis during off-pump coronary artery bypass grafting (CABG), but the efficacies of these procedures have not been well clarified. Therefore, we examined the clinical impact of our strategy to modify the proximal anastomosis procedure for aortic atherosclerosis.

Methods: We retrospectively reviewed 535 consecutive patients undergoing off-pump CABG between 2004 and 2007.

Early tracheal extubation after on-pump coronary artery bypass grafting.

Objective: A fast-track recovery in cardiac surgery yields many benefits, and early tracheal extubation is important as the first step. The purpose of this study is to evaluate the status of early tracheal extubation after on-pump coronary artery bypass grafting (CABG) and to find key factors for successful early tracheal extubation.

Methods: From September 1996 to February 2005, isolated on-pump CABG was performed on 485 patients, and an early tracheal extubation protocol was employed on all.

Long-term outcome of mitral valve repair for infective endocarditis.

Background: In patients with mitral endocarditis, reconstruction of the damaged mitral valve (MV) is still challenging, and its durability remains unknown. We evaluated the long-term outcomes of MV repair for mitral regurgitation (MR) in patients with infective endocarditis.

Methods: From 1991 to 2006, 633 patients had MV repair for MR caused by leaflet prolapse: 78 had endocarditis (active in 14, healed in 64) and 555 had degenerative disease.

Intermediate-term patency of saphenous vein graft with a clampless hand-sewn proximal anastomosis device after off-pump coronary bypass grafting.

Background: To avoid complications related to aortic manipulation, devices were developed to perform clampless anastomosis. However, there are few studies concerning the late patency of the graft. The aims of this study were to investigate the patency rate of saphenous vein (SV) graft after off-pump coronary artery bypass grafting (OPCAB) and to evaluate the influence of a clampless hand-sewn proximal anastomosis on late graft patency.

Emergent mitral valvuloplasty with an autologous pericardial patch in an octogenarian with active infective endocarditis.

An 83-year-old woman with suppurative spondylitis was referred to our hospital due to active infective endocarditis with an expanding mobile vegetation and a high echoic mass on the posterior mitral leaflet. During the operation, the high echoic mass was found to be a chronically organized abscess, which was located at the base of the vegetation on the posterior leaflet and extended toward the annulus. The patient underwent a successfully emergent resection of the vegetation and mass, and valvuloplasty using an autologous pericardial patch with an excellent outcome.

Characteristic changes in cerebral perfusion during on-pump and off-pump coronary artery surgery.

Objective: We investigated the cerebral perfusion status during on-pump or off-pump coronary artery bypass grafting (CABG).

Methods: We monitored somatosensory evoked potential (SEP) and regional cerebral oxygen saturation (rSO2) as parameters of cerebral perfusion in an on-pump group (n=10) and an off-pump group (n=16). The percent changes from control values were calculated before, during, and after aortic clamping, and after weaning from cardiopulmonary bypass, in the on-pump group.