Pulmonary artery sarcoma successfully treated by right pneumonectomy after definitive diagnosis.

Pulmonary artery sarcoma (PAS) is a rare and lethal neoplasm that is usually diagnosed during surgery or autopsy. Early diagnosis and radical surgical resection offer the only chance for survival. However, making a preoperative histopathological diagnosis is quite difficult.

[Diffuse descending necrotizing mediastinitis with cardiac tamponade;report of a case].

Descending necrotizing mediastinitis( DNM) is often a lethal condition resulting from odontogenic or cervical infection, with a previously reported mortality rate of 25 to 40%, which is known to accompany occasional pericardial effusion. Here, we report a case of diffuse DNM with cardiac tamponade.

Castleman's disease along the left tracheobronchial tree with a difficult preoperative diagnosis.

A 39-year-old man was referred to our hospital because of an asymptomatic middle mediastinal tumor. A preliminary histological diagnosis of the tumor by bronchoscopy was difficult to obtain because the tumor was located along the left tracheobronchial tree, which is difficult to approach. The tumor was resected through a right anteroaxillary thoracotomy without any major complications, and histopathological examination revealed that the lesion was Castleman's disease, hyaline-vascular type.

[Rupture of a chronic dissecting giant aneurysm into the pulmonary artery; report of a case].

Aortopulmonary fistula is an extremely rare complication of aortic dissection. We report a case of a chronic dissecting giant aneurysm with an aortopulmonary fistula. A 78-year-old woman experienced sudden onset chest pain and oppression.

[Aortic valve replacement through a partial sternotomy].

Background: Instead of a median sternotomy which has been accepted as the standard approach to cardiaovascular surgery, we have selected a partial sternotomy as a minimally invasive surgery since 1997. Every technique and device must be reevaluated because the entire heart cannot be easily assessed.

Method: In this paper we reported the pitfalls and results of 108 cases of aortic valve replacement through an upper and lower partial sternotomy.

Venous drainage method for cardiopulmonary bypass in single-access minimally invasive cardiac surgery: siphon and vacuum-assisted drainage.

Vacuum-assisted venous drainage (VAVD) can facilitate venous drainage in single-access minimally invasive cardiac surgery (SAMICS). We retrospectively examined the use of VAVD in SAMICS in our hospital for this report. VAVD has been performed according to a VAVD protocol since 2000.

Kommerell's diverticular rupture complicated by aberrant left subclavian artery and right aortic arch successfully treated surgically.

We report a rare case of a rupture in Kommerell's diverticulum in a 73-year-old woman with Edwards IIIB aberrant left subclavian artery (A-LSA) and right aortic arch. This case was further complicated by an inferior vena cava defect. We performed an emergency operation through a right posterolateral approach.

[Surgical treatment for the valvular disease through partial sternotomy].

213 patients who underwent surgical treatment for the valvular disease through partial sternotomy were studied. We started the minimally invasive valvular surgery in July 1997. All the valvular diseases were indicated for the minimally invasive surgery except for the annulo-aortic ectasia and the concomitant disease with coronary artery bypass surgery.

Delayed blow-out type rupture of the right ventricle following blunt chest trauma.

A 36-year-old man suffered multiple traumatic injuries when he fell from a crane. Fractures of both lower extremities, a compression fracture of the fourth lumbar vertebra, and bilateral hemopneumothoraxes were identified. The sternum was not fractured, but was tender.

Vacuum-assisted venous drainage in single-access minimally invasive cardiac surgery.

This retrospective study evaluated the influence of vacuum-assisted venous drainage in single-access minimally invasive cardiac surgery. A total of 104 patients who underwent cardiac surgery via minimal access incision were included in this study. Cardiopulmonary bypass was initiated with gravity alone, and vacuum-assisted venous drainage was applied only when the bypass flow was 2.

Long-term follow-up of polyurethane vascular grafts for hemoaccess bridge fistulas.

The new polyurethane vascular graft (PVG) has been reported to be better than the expanded polytetrafluoroethylene (PTFE) graft in terms of early access and prompt hemostasis, but long-term patency and safety of PVGs have not been investigated objectively. To evaluate late clinical outcome of the PVG, we compared the complication and patency rates of stretch PTFE grafts with those of PVGs implanted for hemodialysis vascular access. Subjects were 53 patients who received 58 arteriovenous grafts between October 1997 and July 2000.