Multicenter Analysis of Endovascular Aortic Arch In Situ Stent-Graft Fenestrations for Aortic Arch Pathologies.

Background: In situ fenestration of aortic stent grafts for treatment of aortic arch aneurysms is a new option for endovascular aortic arch repair. So far, only few reports have shown perioperative and short-term results of in situ fenestrations for aortic arch diseases. We present the multicenter experience with the aortic arch in situ fenestration technique documented in the AARCHIF registry for treatment of aortic arch aneurysms or localized type A aortic dissections and analyzed perioperative outcome and midterm follow-up.

Coil Embolization-Assisted Thoracic Endovascular Aortic Repair for Multiple Saccular Descending Aortic Aneurysms with Insufficient Landing Zone.

We report a coil embolization-assisted thoracic endovascular aortic repair technique successfully applied to multiple saccular descending aortic aneurysms in a 74-year-old man. Because of the most distal aneurysm being located at the celiac trunk level and the distance between the superior mesenteric artery and the aneurysm being only 10 mm, a coil embolization of the distal saccular aneurysm was performed before stent delivery to secure a sufficient landing zone. Postoperative computed tomography showed an appropriate positioning of the endovascular devices without endoleak.

[Fenestrated Stent Graft Repair for Thoracic Aortic Aneurysm].

Total arch replacement and ascending aorta and arch replacement are the gold standard treatments for aortic arch aneurysm and are possible treatment strategies for chronic type A dissection, with good outcomes. However, because total arch replacement is alternative invasive, it can be difficult to perform in some patients. The thoracic endovascular aneurysm repair (TEVAR) landing on zone2 is a less invasive and suitable treatment for descending aortic aneurysm.

Obturator foramen bypass for infective groin caused by closure device.

A 69-year-old man underwent carotid artery stenting through the right femoral artery with a percutaneous vascular closure device for hemostasis. Eleven days later, an infective femoral artery pseudoaneurysm was diagnosed by computed tomography. At surgery, a defect in the femoral artery was observed, corresponding to the remnants of the closure device.

Post-Thoracic Endovascular Aortic Repair Complicated with Mycotic Aneurysm Rupture, Repaired by Redo Thoracic Endovascular Aortic Repair.

Mycotic aneurysms although rare can be devastating. We encountered a dialysis patient with rapidly expanding distal aortic arch aneurysm who underwent axilloaxillary bypass and thoracic endovascular aortic repair (TEVAR). Three months later, he suffered mycotic aneurysm rupture for which redo TEVAR was performed.

[Surgical Treatment of Prosthetic Valve Endocarditis; Tips of Complete Resection of Infective Tissue and Valve Replacement].

Fifteen consecutive prosthetic valve endocarditis (PVE) patients were operated from March 2009 to September 2014. The average age of patients was 68 years ( range 49 to 82) and 7 patients were male. The interval between initial surgery and reoperation was 62.

Endovascular Total Arch Repair Using In Situ Fenestration for Arch Aneurysm and Chronic Type A Dissection.

Background: Total arch replacement and ascending aorta and arch replacement are the gold standard treatments for aortic arch aneurysm and are possible treatment strategies for chronic type A dissection, with good reported outcomes. However, because total arch replacement is extremely invasive, it can be difficult to perform in some patients. We designed an endovascular total arch repair procedure with the use of in situ fenestration and commercially available devices, and we present our initial experience.

Type IA endoleak embolization after TEVAR via direct transthoracic puncture.

We report the case of a 74-year-old man who developed type IA endoleak after endovascular thoracic aortic repair. The patient was admitted with expansion of the aneurysm after TEVAR, for additional therapy. Fluoroscopy and cone-beam computed tomography-guided direct transthoracic sac puncture and complete embolization of the endoleak channels with metal coils and glue were performed, and resulted in complete exclusion of the endoleak.

[Thoracic Endovascular Aortic Repair (TEVAR) Combined with Embolization Technique for Saccular Aortic Arch Aneurysm].

Many of saccular aortic arch aneurysms exist near left subclabian artery(LSA). The thoracic endovascular aneurysm repair( TEVAR) landing on zone 2 is a less invasive and suitable procedure for this type of aneurysm. However, there are several cases with the aneurysm located close to LSA necessitate landing TEVAR on zone 1 or zone 0, otherwise the aneurysm could not be sealed completely.

[Effectiveness of Mitral Natural Folding Plasty for Minimally Invasive Cardiac Surgery Mitral Valve Plasty (MICS MVP)].

We performed 45 cases of Natural folding plasty without leaflet resection for degenerative mitral regurgitation (MR) between September 2005 and July 2014. Twenty cases of 45 were operated by right small intercostal approach (MICS). There was no operative mortality.

[Introduction of Minimally Invasive Port-access Surgery for Aortic Valve Replacement;Yamagata University Hospital's Experience].

Background: Minimally invasive cardiac surgery (MICS) through a small intercostal thoracotomy has many advantages, but it is still challenging because of limited mobility through the small skin incision and surgical field. The benefits of MICS should be reached without compromising the quality of the operation and increasing the morbidity and mortality of standard sternotomy approach. We have recently introduced MICS-aortic valve replacement (AVR) in order to establish as a standard surgical technique for the treatment of aortic insufficiency.

Therapeutic strategy for treating aortoesophageal fistulas.

Purpose: The development fistulas between the thoracic aorta and the esophagus are highly fatal conditions. We aimed to identify a therapeutic strategy for treating aortoesophageal fistula (AEF) in this study, by investigating all AEF cases presented in this special symposium at the 65th Annual Scientific Meeting of the Japanese Association for Thoracic Surgery.

Methods: Forty-seven AEF patients were included in this study.

[Succesful case of open heart surgery in a dialysis patient with infectious endocarditis and severe bone marrow suppression: report of a case].

We report a case of infectious endocarditis due to Corynebacterium species. The patient was 71-yearold man, who was on dialysis and had tracheostomy preoperatively. He went to the hospital complaining of dyspnea.

Direct percutaneous puncture embolization of type II endoleaks using a coaxial technique.

Purpose: To demonstrate a coaxial needle technique for direct percutaneous puncture embolization of type II endoleaks.

Technique: The technique is demonstrated in a 79-year-old woman and an 80-year-old man who developed type II endoleaks after endovascular repair of thoracic and internal iliac artery aneurysms, respectively. Expansion of the aneurysms required additional therapy.

[Prevention of cerebral infarction in thoracic endovascular aneurysm repair(TEVAR) of distal aortic arch aneurysms; left subclavian artery balloon technique].

Thoracic endovascular aneurysm repair(TEVAR) has been applied more and more frequently to an atherosclerotic distal aortic arch aneurysm. Even if the procedure is successful, extensive cerebral infarction might occur, especially in the left vertebral artery area. We therefore devised a new method to prevent embolic events using a thrombectomy catheter with an end hole, which was placed at the origin of the letf subclavian artery via the radial artery.

The results of the enclose II proximal anastomotic device in 178 off-pump coronary artery bypass surgeries.

Objective: Enclose II is a new device for proximal coronary artery bypass anastomoses. We evaluated the safety and effectiveness of Enclose II in patients who underwent off-pump coronary artery bypass grafting (CABG).

Methods: Enclose II was used for isolated off-pump CABG in 178 patients at six heart centers between October 2005 and December 2009.