Surgical repair of partial anomalous pulmonary venous return with intact atrial septum in a 65-year-old woman: a case report.

Background: Partial anomalous pulmonary venous return is a rare congenital cardiac anomaly that usually involves the right pulmonary vein and an atrial septal defect. Isolated partial anomalous pulmonary venous return with an intact atrial septum is even rarer, and this condition is usually treated surgically in younger patients. We describe isolated partial anomalous pulmonary venous return in a 65-year-old woman who was treated by caval division with pericardial patch baffling through a surgically created atrial septal defect and reconstruction of the superior vena cava using a prosthetic graft.

Subzero 12-hour Nonfreezing Cryopreservation of Porcine Heart in a Variable Magnetic Field.

Background: A novel subzero nonfreezing heart preservation method has been developed. It uses a refrigerating device that generates a variable magnetic field, allowing the whole organ to be cooled simultaneously to a supercooled state without the use of cryoprotectant. As a fundamental experiment for heart preservation, we verified whether this novel method is able to suppress anaerobic metabolism and reduce damage in the hearts of large animals.

[Emergency Thoracic Endovascular Aortic Repair of Ruptured Kommerell's Diverticulum with an Acute Aortic Dissection].

This case report describes emergency thoracic endovascular aortic repair (TEVAR) of a ruptured Kommerell's diverticulum associated with a type B acute aortic dissection in a patient with a right aortic arch. A 64-year-old male was admitted with symptoms of sudden paraplegia and shock. The computed tomography imaging showed right aortic arch anomaly, with mirror image branching of the major arteries.

Fasudil Is an Effective Graft Vasodilator for Gastroepiploic Artery in Coronary Artery Bypass Grafting.

Objective: The gastroepiploic artery (GEA) has been used as an alternative arterial in situ graft for coronary artery bypass grafting (CABG). However, because of the large individual differences and the spastic nature of the GEA, caution has to be exercised during harvesting. We evaluated the usefulness of fasudil, a Rho kinase inhibitor, as a vasodilator for right GEA (RGEA) graft after harvesting, compared with the conventional agents papaverine and verapamil-nitroglycerin.

Robotic resection of dual accessory mitral valve tissue in an adult patient.

The presence of isolated accessory mitral valve tissue (AMVT) is extremely rare in adults. We successfully performed robot-assisted resection of dual AMVT that was attached to the papillary muscle and anterior mitral leaflet. Echocardiography was invaluable for identifying the most suitable approach.

A novel coronary active perfusion system using a conventional intra-aortic balloon pump for off-pump coronary artery bypass grafting.

Objective: It is important for coronary active perfusion systems to avoid myocardial ischemia during off-pump coronary artery bypass grafting. We have developed a new concept for a perfusion system to pump blood based on changes in helium gas volume. This system uses a conventional intra-aortic balloon pump to activate the perfusion pump.

Robot-assisted minimally invasive direct coronary artery bypass grafting. ThoraCAB.

Background:  The aim of this study was to assess the outcome of robot-assisted minimally invasive direct coronary artery bypass grafting (MIDCAB), which is also termed "ThoraCAB".

Methods And Results:  From 2005 to 2013, 35 consecutive patients underwent MIDCAB via a small thoracotomy on a beating heart. Before performing MIDCAB, the internal thoracic arteries (ITAs) were endoscopically harvested through 3 ports using the da Vinci Surgical System in a completely skeletonized fashion.

Potent vasodilatory effect of fasudil on radial artery graft in coronary artery bypass operations.

Background: The radial artery (RA) is a useful conduit for coronary artery bypass grafting (CABG) but is susceptible to vasospasm during harvesting. We evaluated the usefulness of fasudil, a Rho kinase inhibitor, in dilating the RA graft and increasing graft free flow (GFF) compared with the conventional graft-dilating agents papaverine and verapamil-nitroglycerin (VG).

Methods: Between June 2012 and January 2013, 45 patients with ischemic heart disease who underwent isolated CABG using the RA were enrolled and randomly assigned to fasudil (n = 15), papaverine (n = 15), or VG (n = 15).

Fasudil is a superior vasodilator for the internal thoracic artery in coronary surgery.

Background: The internal thoracic artery (ITA) is a very useful conduit for coronary artery bypass artery (CABG), with excellent long-term patency. With the purpose to dilate the ITA graft and increase graft free flow (GFF) intraoperatively, we evaluated the usefulness of intraluminal injection of fasudil, a Rho-kinase inhibitor, in comparison to the conventional graft dilating agent, papaverine.

Methods: Between June 2011 and January 2012, 30 patients with ischemic heart disease who underwent isolated CABG using ITA were enrolled.

Monitoring brain oxygen saturation during awake off-pump coronary artery bypass.

Objective: To evaluate the changes in cerebral blood flow during awake off-pump coronary artery bypass grafting and compare with the changes during off-pump coronary artery bypass grafting under general anesthesia, using continuous monitoring of regional cerebral oxygen saturation.

Methods: The study population comprised 3 groups of patients who had undergone off-pump coronary artery bypass grafting with thoracic epidural anesthesia, general anesthesia, or a combination of the two. Regional brain oxygen saturation, determined with a near-infrared oxygen monitor, and mean arterial pressure during surgery were calculated and compared among the 3 groups.

Simultaneous surgical correction of pectus excavatum and cardiac disease in two adults.

Thoracic reconstruction in patients with pectus excavatum with concomitant cardiac or aortic surgery poses a major clinical challenge. The report describes two cases of adult patients undergoing simultaneous surgical correction of cardiac disease and sternal deformity using one of two different techniques: a sterno-turnover method preserving the rectus muscle or a sternal elevation method with A-O plates.

Revival of continuous suture technique in aortic valve replacement in patient with aortic valve stenosis: a novel modified technique.

Objective: : The continuous suture technique has numerous advantages as simple, quick, and effective for aortic valve replacement; however, it is technically difficult. We have modified the continuous suture technique and evaluated our new technique in patients with aortic stenosis.

Methods: : Between July 2007 and May 2010, 86 patients with aortic valve stenosis underwent aortic valve replacement alone or with other concomitant cardiac procedures including mitral valve surgery in our hospital.

[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.

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.

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.

Advanced lung cancer invading the left atrium, treated with pneumonectomy combined with left atrium resection under cardiopulmonary bypass.

A 68-year-old man presented with a chief complaint being a cough. Based on a bronchoscopic biopsy, it was diagnosed at a nearby clinic as an advanced left lung cancer, and he was referred to our hospital. Chest computed tomography (CT) scans demonstrated a giant mass of the left lower lobe, 14 × 12 cm in size, which appeared to have invaded the left atrium (LA).

Automatic aortic anastomosis with an innovative computer-controlled circular stapler for surgical treatment of aortic aneurysm.

Objective: This study applied a computer-controlled mechanical stapler to vascular end-to-end anastomosis to achieve an automatic aortic anastomosis between the aorta and an artificial graft. In this experimental study, we created a mechanical end-to-end anastomotic model and assessed the strength of the anastomotic site under high pressure.

Methods: We used a computer-controlled circular stapler named iDrive (Power Medical Interventions, Covidien plc, Dublin, Ireland) for the anastomosis between the porcine aorta and an artificial graft.

Robotic skeletonized internal thoracic artery harvesting: the sliding fascia technique.

Robotic skeletonizing and harvesting of the internal thoracic artery, using the da Vinci surgical system, has a number of advantages over robotic pediculed ITA harvesting. The advantages include greater blood flow, a longer conduit, and less bleeding. The technique is facilitated by use of the EndoWrist spatula cautery and fine tissue forceps (Intuitive Surgical, Inc.

A new instrument of suction support adapter system for epicardial radiofrequency ablation.

Objective: Recently, epicardial ablation on a beating heart has been conducted as a minimally invasive surgical procedure for atrial fibrillation. We have developed a suction support adapter with the aim of ensuring contact between the ablation probe and the atrial wall to obtain transmural coagulation, and we evaluated the effectiveness of the adapter in electrophysiologic and histopathologic procedures.

Methods: To ensure contact between the radiofrequency ablation probe and the atrial wall, we designed and fabricated a suction support adapter.

Japan's first robot-assisted totally endoscopic mitral valve repair with a novel atrial retractor.

This case report presents the first robot-assisted totally endoscopic mitral valve plasty in Japan. A 54-year-old woman was found by echocardiography to have grade III mitral valve regurgitation because of prolapse of the posterior leaflet. Surgical repair was performed using the da Vinci Surgical System.