Surgical treatment of chronic aortic dissection with liver dysfunction due to constrictive pericarditis caused by IgG4-related disease: a case report.

Background: Severe liver failure with ascites may be associated with cardiac disease and may be the primary manifestation of constrictive pericarditis or aortic dissection. We report a case of a patient with a chief complaint of ascites for whom close examination revealed that the liver injury was attributed to constrictive pericarditis and chronic aortic dissection, with immunoglobulin G4 (IgG4)-related disease (IgG4-RD) as the primary cause.

Case Summary: A 72-year-old man presented to the emergency department with scrotal oedema and ascites.

Acute endocarditis complicated by left ventricular pseudoaneurysm with acute bloody pericardial effusion: A case report.

Rationale: Delay in seeking medical attention for high fever and inadequate diagnosis can lead to rapid progression of inflammation and spread to surrounding tissues and organs. Staphylococcus aureus is a common cause of systemic infections, and infectious endocarditis can swiftly become severe; therefore, careful management is required.

Patient Concerns: A 54-year-old woman was admitted to our hospital with high fever and progressive loss of consciousness.

Sternal closure with sandwiched three-piece bioresorbable mesh reduces postoperative hemorrhage: a retrospective study.

Background: Median sternotomy is the most performed procedure in cardiac surgery; however, sternal displacement and bleeding remains a problem. This study aimed to investigate whether sternal reconstruction using a sandwiched three-piece bioresorbable mesh plate can prevent postoperative sternal displacement and bleeding more than a bioresorbable pin.

Methods: Patients (n = 218) who underwent median sternotomy were classified according to whether a sandwiched three-piece bioresorbable mesh plate and wire cerclage (group M, n = 109) or a bioresorbable pin and wire cerclage (group P, n = 109) were used during sternal reconstruction.

Management of cardiovascular surgery in patients with systemic lupus erythematosus including thromboembolism and multiple organ failure prevention: A retrospective observational study.

Systemic lupus erythematosus is a chronic autoimmune disease that affects most tissues. Cardiovascular events are critical, life-threatening, long-term complications of systemic lupus erythematosus (SLE). We report our single-center experience of performing cardiovascular surgery in patients with SLE while avoiding postoperative complications.

Endovascular repair for iliac artery aneurysms.

Introduction: This study aimed to retrospectively determine the association between aortic dilatation and common iliac artery neck size.

Methods: Consecutive patients who had undergone elective endovascular aneurysm repair for iliac artery aneurysms (IAAs) from January 2009 to December 2017 were evaluated.

Results: Aneurysm dilatations >3 mm were observed in five cases; two cases were LAND+ and three cases were LAND-.

Thoracic Endovascular Aortic Repair After Salvage Coronary Artery Bypass Graft for Type A Dissection.

Acute aortic dissection (AAD) is a life-threatening condition. It has a high death rate, especially in malperfusion. An 84-year-old man diagnosed with AAD with complete right coronary artery occlusion underwent bypass of only 1 branch of the coronary artery; the chest was closed without treating the AAD.

Two-stage aortic surgery for distal aortic arch and descending aorta aneurysms: A case report.

Rationale: Although surgical treatment strategies for patients with extensive thoracic aortic disease involving the aortic arch have improved considerably, the impact of stent graft length and placement site on aortic remodeling at long-term follow-up is not fully understood, and the protection of the Adamkiewicz artery (AKA) using the frozen elephant trunk (FET) method is also unclear.

Patient Concerns: The patient was a 69-year-old man with diabetic nephropathy who became increasingly fatigued and started maintenance hemodialysis 6 months prior to admission. At 64 years, he underwent clipping of a right cerebellar artery aneurysm.

Coronary Artery Bypass Grafting in Patients with Chronic Kidney Disease: Chronic Kidney Disease Has an Independent Adverse Effect on the Long-Term Outcome of Coronary Artery Bypass Grafting.

We examined short- and long-term outcomes of coronary artery bypass grafting (CABG) in patients with ischemic heart disease and the effect of renal function on these outcomes. We included 2783 patients who underwent primary elective CABG at a single institution between 2002 and 2020 (age: 67.6 ± 10.

Surgical 5-year Outcomes of Extra-Anatomical Bypass for Middle Aortic Syndrome: A Case Series.

Background: Middle aortic syndrome is a rare disease. Several surgical treatments are available; however, the optimal treatment strategy and long-term outcomes remain unelucidated. We herein report the 5-year outcomes of six patients treated with extra-anatomical bypass surgery for middle aortic syndrome.

Simultaneous Estimation of Gender Male and Atrial Fibrillation as Risk Factors for Adverse Outcomes Following Transcatheter Aortic Valve Implantation.

Accurate outcome prediction following transcatheter aortic valve implantation (TAVI) has gained further importance along with expanding its indication to patients with a lower surgical risk. Although previous studies have evaluated the prognostic impacts of gender and atrial fibrillation (AF) in TAVI patients, these two factors have rarely been addressed simultaneously. This retrospective observational study based on a multicenter TAVI registry involved 1088 patients who underwent TAVI between May, 2010 and February, 2020 at 3 hospitals in Japan.

Changes in polysomnographic findings following transcatheter aortic valve implantation in a patient with aortic stenosis.

Patients with aortic stenosis (AS) are likely to have sleep-disordered breathing (SDB) and improvements in AS by transcatheter or surgical aortic valve replacement alter the type and severity of SDB. However, limited data are available whether polysomnographic findings changed following transcatheter aortic valve implantation (TAVI). In this report, we describe the case of a patient with severe AS and SDB whose polysomnographic findings showed that after TAVI, sleep disturbances occurred in association with worsened periodic leg movements despite improvement in the SDB.

Clinical indicators and coronary angiographic features of expansive arterial remodelling in patients with abdominal aortic aneurysms.

The co-existence of expansive arterial remodelling in both coronary arteries (CAs) and the abdominal aorta has already been reported, although the clinical indicators and quantitative analysis have not been well studied. We therefore aimed to clarify the clinical and anatomical characteristics of patients with abdominal aortic aneurysms (AAAs). 123 AAA patients who underwent coronary angiography were compared to 123 control patients selected by propensity score matching.

Independent Effect of Low Flow on Outcomes in Patients Undergoing Aortic Valve Replacement for Severe Aortic Stenosis.

Background: Low flow (LF; i.e., reduced left ventricular stroke volume index <35 mL/m) can occur with severe aortic stenosis (AS).

[Aortic Root Replacement for Patients with Aortic Root Aneurysms;Clinical Outcomes Compared Among Different Types of Abnormality and Operative Procedures].

Aortic root operations are established procedures for patients with aortic root aneurysms, however there is a little insight for comparative long-term outcomes among different types of anatomical abnormalities and procedures. In this study, we sought to compare the results of patients with aortic abnormalities undergoing different procedures. From January 2008 to March 2017, a total of 105 patients without aortic dissection were performed the elective aortic root surgery.

Low Serum Levels of EPA are Associated with the Size and Growth Rate of Abdominal Aortic Aneurysm.

Aim: Omega-3 polyunsaturated fatty acids (PUFAs) such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been reported to reduce the risk of cardiovascular disease. However, whether omega-3 PUFAs are involved in the pathogenesis of abdominal aortic aneurysms (AAA) remains unclear.

Methods: We analyzed 67 consecutive patients admitted for the elective surgical repair of AAA.

Push-Up Technique and Anatomical Deployment With the Endurant Stent-Graft System for Severely Angulated Aneurysm Necks.

Purpose: To describe a technique suitable for treating severely angulated (>75°) necks during endovascular aneurysm repair using the Endurant stent-graft.

Technique: In the push-up technique, the suprarenal stent is released early to fix the proximal stent-graft in place so that each stent in the neck can be deployed individually without displacing the device upward. It is important to push the delivery system up after each stent deployment to allow the fabric between the stents to fold up circumferentially.

Preoperative hepatic dysfunction could predict postoperative mortality and morbidity in patients undergoing cardiac surgery: Utilization of the MELD scoring system.

Background: According to recent advances in operative techniques, an increasing number of patients with liver dysfunction have been subjected to cardiac surgery. Model of End-Stage Liver Disease (MELD and MELD-XI) scores allow risk stratification of patients undergoing cardiac and non-cardiac surgeries.

Methods: We retrospectively analyzed 1856 consecutive patients (69.

Comparison of modern risk scores in predicting operative mortality for patients undergoing aortic valve replacement for aortic stenosis.

Background: The aim of our study was to examine and compare the predictive value of operative mortality of the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II, the Society of Thoracic surgeons (STS) score, the Ambler score, and the Japan score in patients undergoing aortic valve replacement (AVR) for aortic stenosis (AS).

Methods: A total of 406 patients undergoing AVR with or without coronary artery bypass grafting (CABG, n=139) at our institution from August 2002 to December 2013 were enrolled in this cohort study. Accuracy of calibration and discrimination performance of four risk scores was assessed in the overall patient population and quartiles of each risk score.

Factors for sac size change of abdominal aortic aneurysm after endovascular repair.

Objectives: Factor(s) affecting the sac size of an abdominal aortic aneurysm (AAA) after endovascular aneurysm repair (EVAR) remain unclear. We compared the diameter of the aneurysm sac at one year after surgery with the preoperative diameter using CT images.

Methods: Patients who underwent EVAR at Juntendo University Hospital were involved.

Predictors of early and mid-term results in contemporary aortic valve replacement for aortic stenosis.

Background: The purpose of this study was to evaluate clinical risk factors and assess the impact of the Society of Thoracic Surgeons (STS) scores on outcomes after contemporary aortic valve replacement (AVR) for aortic stenosis (AS).

Methods: We retrospectively analyzed the data from 209 consecutive patients with AS (mean 69 ± 9 years) who underwent AVR. The outcomes measured included operative mortality, postoperative complications, postoperative prolonged length of stay (PLOS), discharge to nonhome location, and mid-term mortality.

Comparing outcomes after off-pump coronary artery bypass versus drug-eluting stent in diabetic patients.

Background: Off-pump coronary artery bypass surgery and sirolimus-eluting stent placement have been widely used for the treatment of coronary artery disease. The goal of this study was to compare long-term outcomes after off-pump coronary artery bypass surgery or sirolimus-eluting stent placement in diabetic patients with multivessel disease.

Methods: This observational study enrolled 350 off-pump coronary artery bypass patients and 143 sirolimus-eluting stent patients receiving care at our institution between 2000 and 2007.

Effect of preoperative hemoglobin A1c levels on long-term outcomes for diabetic patients after off-pump coronary artery bypass grafting.

Background: Diabetes mellitus is an independent risk factor for cardiovascular events after coronary artery bypass grafting (CABG), and hemoglobin A1c (HbA1c) is the most convenient marker for monitoring glycemic control among diabetic patients. However, few studies have reported the impact of baseline HbA1c levels on outcomes for diabetic patients after CABG. This study therefore aimed to investigate whether preoperative HbA1c levels in diabetic patients are predictive of long-term outcomes after off-pump CABG (OPCAB).

Vacuum-assisted closure with a portable system for treatment of poststernotomy mediastinitis.

The patient was a 50-year-old man with diabetes who was on insulin. Complications of mediastinitis developed after coronary bypass surgery, which had been performed for unstable angina. Upon hospital admission, the patient was treated with antibiotics, and the wound was cleaned on a daily basis.

Prognostic effects of calcium channel blockers on cardiac events, stroke and end-stage renal disease in patients with angina pectoris. Retrospective comparative study of benidipine, diltiazem and nifedipine.

Background And Aim: Calcium channel blockers (CCBs) have been reported to reduce the incidence of stroke in hypertensive patients. CCBs are also commonly used to treat patients with angina pectoris (AP). However, there are very few reports on their effects on cardiovascular events, including stroke and end-stage renal disease (ESRD), in patients with AP.