[Aortic Root Pseudoaneurysm due to Avulsion of Aortic Valve Commissure Following to Infective Endocarditis;Report of a case].

A 40-year-old man presented to our hospital with fever and slight palpitation. The echocardiogram revealed bicuspid aortic valve, massive aortic regurgitation, and aneurysm of Valsalva sinus. Operative findings showed an aortic root pseudoaneurysm originating just below the avulsion of the right to left commissure.

Need for radiation safety education for interventional cardiology staff, especially nurses.

Objective: Cardiac interventional radiology (IR) can cause radiation injury to the staff who administer it as well as to patients. Although education in the basic principles of radiation is required for nurses, their level of radiation safety knowledge is not known. The present study used a questionnaire protocol to assess the level of radiation safety knowledge among hospital nurses.

A novel biodegradable external mesh stent improved long-term patency of vein grafts by inhibiting intimal-medial hyperplasia in an experimental canine model.

Objectives: Increased hemodynamic stress on vein grafts used in the arterial system is associated with vein graft disease. We determined whether a novel biodegradable external mesh stent could inhibit medial-intimal hyperplasia by suppressing hemodynamic stress on vein grafts and improve long-term patency.

Methods: Twenty-four beagles underwent bilateral femoral interposition grafting using reversed femoral veins.

Is thoracic aortic disease a growing problem in Japan?

An article by Okita was recently published in General Thoracic and Cardiovascular Surgery. The paper thoroughly reviewed the surgical treatments for thoracic aortic disease in Japan. Valve-sparing aortic root operation, cerebral protection during aortic arch aneurysmectomy, and spinal cord protection during thoracoabdominal aneurysm repair are discussed in the present editorial.

[Leg amputation for severe lower limb ischemia caused by type A acute aortic dissection; report of a case].

A 41-year-old man underwent total arch replacement and aorto-bifemoral bypass owing to type A acute aortic dissection complicated by ischemia of both lower extremities. Just after the operation, he developed myonephropathic metabolic syndrome due to severe ischemia of the right leg, and hemodiafiltration was performed. However, the serum potassium was elevated to an uncontrollable level.

Results of the prospective multicenter Japanese bridge to transplant study with a continuous-flow left ventricular assist device.

Continuous-flow left ventricular assist devices (LVADs) are becoming the standard of care for patients with refractory end-stage heart failure. We present the outcomes of patients enrolled in a prospective multicenter clinical study in Japan using the HeartMate II continuous-flow LVAD for bridge to transplantation. The study evaluated 6 inotrope-dependent heart failure patients failing on medical management (3 males and 3 females, age 44.

Evaluation of spinal cord ischemia with a retrievable stent graft is useful for determining the type of repair for a case of patch aneurysm.

Patch aneurysms after thoracoabdominal aortic aneurysm repair are a serious late complication. We treated a patient with patch aneurysm (originating at the artery of Adamkiewicz) involving a portion of an implanted graft from a previous operation. First, thoracic endovascular aneurysm repair was planned.

Report from the Committee for Improving the Work Environment of Japanese Surgeons: survey on effects of the fee revision for medical services provided by surgeons.

Purpose: The aim of this study was to achieve improvements in the work environment of Japanese surgeons and shortage of surgeons.

Methods: Questionnaires were distributed to selected Japanese surgical Society (JSS) members. Retrospective analysis was conducted comparing the current 2011 survey with previous 2007 survey.

[Thoraco-abdominal aortic replacement in chronic phase in a patient with temporary paraplegia after Stanford B acute dissection].

A 42-year-old man underwent was performed with thoraco-abdominal aneurysm replacement accompaniedy with reconstruction of abdominal branches and intercostal arteries. Eighteen months before, he had suffered from Stanford already been cured with paraplegia on being type B acute aortic dissection combined with paraplegia. When paraplegia had been occurred, cerebrospinal fluid drainage was had been performed promptly, and 4 days later, neurologic deficit was disappeared in 1 day.

[The effects of Trans Pacific Partnership (TPP) for Japanese medical system].

The effects of Trans Pacific Partnership (TPP) for Japanese medical system were analyzed concretely. TPP has a great influence on the Japanese medical system, although, it was supposed that most of them would be capable to resolve except kaihoken: health insurance for all.

Aortic valve replacement in an elderly patient with factor XI deficiency.

Factor XI (FXI) deficiency is rare and associated with bleeding after surgical procedures. We report a case of an 80-year-old woman with severe aortic valve stenosis. FXI deficiency was diagnosed due to prolonged activated partial thromboplastin time.

Surgical treatment for an asymptomatic and unruptured sinus of Valsalva aneurysm: report of a case.

A 70-year-old male underwent a transthoracic echocardiography as a screening test for hypertension and an unruptured aneurysm was detected in the right sinus of Valsalva. The right sinus of Valsalva aneurysm obstructed the right ventricle outflow tract but he did not have any symptoms. The sinus of Valsalva aneurysm was treated successfully by a patch closure with a bovine pericardial patch.

[Is emergency aortic root replacement combined with arch replacement safe?].

Background: Aortic root replacement (ARR) combined with aortic arch replacement (AAR) is an invasive procedure even in elective cases. Nevertheless, such combined operations are often mandatory in acute type A aortic dissection. We examined whether emergency operation might have further incremental risks compared with elective surgery in this type of operations.

Relapsing infective endocarditis following closure of ventricular septal defect.

An 8-year-old boy who had undergone Dacron patch closure of a ventricular septal defect 5 years earlier, was admitted with relapsing methicillin-resistant Staphylococcus aureus infective endocarditis and lung abscesses. Echocardiography indicated vegetation attached to the tricuspid valve and the Dacron patch. The infected patch was replaced with glutaraldehyde-treated autologous pericardium.