Current Status of Off-Pump Coronary Artery Bypass.

Purpose: Off-pump coronary arterial bypass grafting (OPCAB) has become a common practice for coronary artery bypass grafting (CABG) in Japan, with approximately 65% CABG procedures currently being performed using OPCAB. However, it is unclear whether OPCAB is superior in terms of associated mortality, incidence of complications, graft patency rate, and long-term outcomes compared with conventional CABG (CCABG).

Methods: Literature consideration was performed, mainly based on observational studies involving large samples and randomized controlled trials (RCTs).

Randomized clinical trial of an elastomeric sealant for hemostasis in thoracic aortic surgery.

Objectives: This study aimed to demonstrate the efficacy and safety of a newly developed elastomeric sealant, which does not require any blood coagulation system to exert its effect, during thoracic aortic surgery.

Methods: This is a multicenter, randomized study conducted in six hospitals in Japan. A total of 81 patients undergoing replacement surgery of a thoracic aortic aneurysm using cardiopulmonary bypass were randomized with a ratio of 2-:1 for those patients designated to receive the sealant (Group S, 54 patients) or those without the usage of the sealant (Group C, 27 patients).

Clinicopathological study on penetrating atherosclerotic ulcers and aortic dissection: distinct pattern of development of initial event.

An intimal tear is responsible for the development of aortic dissection (AD). Plaque rupture is thought to progress to a penetrating atherosclerotic ulcer (PAU). However, the influences of mechanical stress and atherosclerosis on the intimal tear of AD and plaque rupture of PAU have not been fully understood.

[Coronary Artery Bypass Grafting and Biventricular Pacing for Severe Heart Failure due to Dilated Cardiomyopathy].

A 57-year-old man was diagnosed with dilated cardiomyopathy and coronary stenosis. His electrocardiogram showed a complete left bundle branch block and a prolonged QRS interval. As appropriate medical therapy improved his symptoms, he did not visit out-patient clinic after discharge.

Age-related distensibility and histology of the ascending aorta in elderly patients with acute aortic dissection.

Degradation and fragmentation of elastic fibers in the media dilate the aortic wall excessively in patients with acute Stanford type A aortic dissection (AD). Such dilatation occurs not via aortic stiffening, which is diagnosed using imaging under physiological loading, but due to the abovementioned intrinsic changes in elastic fibers, which can be detected at the low-stress region of the stress-strain relationship. Our objective is to determine an age-related correlation between distensibility and histology.

[Surgical excision of left atrial myxoma shortly after cerebral embolism;report of a case].

A 48-year-old male visited the emergency room suffering from acute dysarthria and right hemiplegia. Brain magnetic resonance imaging (MRI) revealed multiple cerebral infarctions. Echocardiography showed a mass in the left atrium.

Four-stitch side-to-side anastomosis for sequential coronary artery bypass grafting.

Sequential bypass (SB) is an effective method of implementing complete myocardial revascularization of complex coronary stenoses. The SB allows a single graft to be used for bypass in several locations, which facilitates multi-branch revascularization. We have developed a simple SB technique, four-stitch side-to-side anastomosis, and report its clinical effectiveness in 428 patients.

Preventive effect of intraoperative landiolol administration on atrial fibrillation after off-pump coronary artery bypass grafting.

Introduction: Postoperative atrial fibrillation (AF) is a common complication of cardiac surgery that is associated with an increased incidence of other complications. This study evaluated the safety and efficacy of landiolol hydrochloride--an ultrashort-acting β1-selective blocker and highly regulated drug, positioned as a class 1 antiarrhythmic in Japan guidelines--for the prevention of AF after off-pump coronary artery bypass grafting (CABG).

Methods: Between January 2011 and November 2013, 116 patients underwent CABG at Fukuoka University Hospital.

Direct and transapical central cannulation for acute type a aortic dissection.

Objective: The choice of cannulation site for the treatment of acute Stanford type A aortic dissection is much debated. We believe that central cannulation is quick to perform, easy to use, and safe to manage acute type A aortic dissection.

Materials And Methods: We retrospectively investigated 26 cases of acute aortic dissection performed using two different central cannulation methods between April 2011 and March 2012.

GM-CSF treated F4/80+ BMCs improve murine hind limb ischemia similar to M-CSF differentiated macrophages.

Novel cell therapy is required to treat critical limb ischemia (CLI) as many current approaches require repeated aspiration of bone marrow cells (BMCs). The use of cultured BMCs can reduce the total number of injections required and were shown to induce therapeutic angiogenesis in a murine model of hind limb ischemia. Blood flow recovery was significantly improved in mice treated with granulocyte-macrophage colony-stimulating factor (GM-CSF)-dependent BMCs that secreted inflammatory cytokines.

A case of type-2 endoleak from a bronchial artery after endovascular aortic repair for Kommerell diverticulum.

We describe a case of type-2 bronchial artery endoleak after endovascular aortic repair of Kommerell diverticulum (KD) involving right-sided aortic arch and aberrant left subclavian artery (LSA). A 68-year-old woman underwent an endovascular repair of KD with an aberrant LSA in our hospital. Follow-up computed tomography (CT) at 6 months after the procedure showed an endoleak.

Safety and efficacy of ascending aorta cannulation during repair of acute type A aortic dissection (PA29-04): "Presented at the 65th Annual Scientific Meeting of the Japanese Association for Thoracic Surgery".

Objective: Antegrade central perfusion for acute Stanford type A aortic dissection prevents malperfusion and retrograde cerebral embolism during cardiopulmonary bypass. Prompt establishment of antegrade perfusion via the ascending aorta may improve surgical results of type A dissections, especially in situations of hemodynamic instability. Thus, we evaluated the safety and efficacy of cannulation of the dissected ascending aorta in acute type A dissection.

Off-pump coronary artery bypass: techniques, pitfalls, and results.

In coronary artery bypass grafting (CABG), coronary artery anastomosis is generally performed under cardiac arrest using cardiopulmonary bypass (CPB). To avoid the invasiveness of CPB, off-pump coronary artery bypass (OPCAB) is currently also used. In Japan, in particular, OPCAB now accounts for 60 % of all CABG operations and has become a standard surgical procedure.

Effects of gender and aging in patients who undergo coronary artery bypass grafting: from the FU-Registry.

Background: It is unclear whether gender and aging influence the characteristics of patients who undergo coronary artery bypass grafting (CABG).

Methods: We retrospectively reviewed a clinical database of 1,498 patients (male/female = 1133/365, age 67 ± 9 years) who underwent CABG at Fukuoka University Hospital from 1994 to 2010.

Results: Male showed significantly younger, higher percentages (%) of smoking and hyperuricemia (HU), higher levels of serum creatinine, and lower % hypertension (HT) and diabetes mellitus (DM), and lower levels of left ventricular ejection fraction than female.

Vascular endothelial growth factor-C derived from CD11b+ cells induces therapeutic improvements in a murine model of hind limb ischemia.

Objective: The use of bone marrow cells (BMCs) in therapeutic angiogenesis has been studied extensively. However, the critical paracrine effects of this treatment are still unclear. Therefore, we studied autotransfusable cells that produce vascular endothelial growth factor (VEGF), especially VEGF-C.

[Ischemic stroke induced by a left atrial myxoma].

We reported a case of ischemic stroke induced by a left atrial myxoma. A 76-year-old man was found unconscious and transferred to the emergency ward in our hospital. He experienced consciousness disturbance, motor dominant aphasia, and severe right hemiparesis.

Safety and efficacy of an ultrashort-acting β1-blocker on left ventricular dysfunction.

Landiolol hydrochloride, an ultrashort-acting β1-selective blocker, is a highly regulated drug. This study evaluated the safety and efficacy of this drug for cases of coronary artery bypass grafting (CABG) with left ventricular dysfunction. Between September 2006 and August 2009, 32 patients with a left ventricular ejection fraction of <40% underwent CABG.

[Current strategy of surgical treatment for ischemic heart disease].

Coronary artery bypass grafting (CABG) surgery is the gold standard therapy for the complete revascularization of patients with multivessel coronary artery disease. Since off-pump CABG (OPCAB) began to be performed, to avoid any side effects from cardiopulmonary bypass, OPCAB is now performed in 66% of all isolated CABG in Japan, and this situation is markedly different from the procedures performed in North America and Europe. Furthermore, percutaneous coronary intervention (PCI) using drug eluting stents (DES) is now being increasingly performed for the treatment of patients with either left main trunk, diffuse or multivessel lesions.

Long-term prognosis of patients with Kawasaki disease complicated by giant coronary aneurysms: a single-institution experience.

Background: Some patients with Kawasaki disease develop giant coronary aneurysms and coronary stenosis, leading to ischemic heart disease. The aim of this study was to determine the long-term prognosis of patients with Kawasaki disease with giant aneurysms.

Methods And Results: From our institutional database, 76 patients (57 men and 19 women) who developed giant aneurysms after January 1, 1972, were identified.

Superior vena cava obstruction caused by ascending aortic pseudoaneurysm as assessed by multi-detector row computed tomography.

We describe a case of a 64-year-old man with superior vena cava (SVC) obstruction caused by a huge pseudoaneurysm of the ascending aorta. Pseudoaneurysm of the ascending aorta is an uncommon cause of SVC obstruction. Multi-detector row computed tomography (MDCT) simultaneously clarified the SVC obstruction and coronary artery stenosis.