[Aortic Valve Replacement after Balloon Valvuloplasty for Aortic Valve Stenosis in a Dialysis Patient with Cardiogenic Shock;Report of a Case].

A 67-year-old man on chronic hemodialysis was admitted with worsening congestive heart failure due to critical aortic stenosis. Echocardiography showed severe aortic stenosis with a valve area of 0.67 cm2 and an ejection fraction of 0.

Extended resection of lung cancer invading the left subclavian artery by using cardiopulmonary bypass.

We treated a 54-year-old man with large cell carcinoma of the left upper lobe invading the esophagus and the left subclavian artery (SCA) from its origin. The tumor was completely resected by lobectomy under cardiopulmonary bypass. The left SCA was dissected at the aortic arch and reconstructed with a graft.

Mycotic aneurysm of the descending aorta with hemoptysis.

Mycotic aneurysm of the descending aorta is usually described as rare. We present two recent cases of mycotic aneurysm of the descending aorta complicated with hemoptysis. Urgent tube graft replacements were successfully performed under cardiopulmonary bypass support.

Risks and benefits of bilateral internal thoracic artery grafting in diabetic patients.

Background: There is a tendency to avoid the bilateral internal thoracic artery (ITA) grafting in diabetics. However, we no longer consider diabetes a reason for excluding the bilateral use of ITAs. We compare the early and long-term results in diabetic cases treated by coronary artery bypass grafting (CABG) using unilateral and bilateral ITA grafts.

Routine extended graft replacement for an acute type A aortic dissection and the patency of the residual false channel.

Background: Recent surgical progress has had an impact on the mortality of acute type A aortic dissection. Routine aortic arch replacement, irrespective of the location of the intimal tears, may improve not only the outcome of the residual dissection but the operative mortality, because complete resection of intimal tears, including those invisible through the aortotomy in the ascending aorta is achieved.

Methods: During the past 7 years, total aortic arch replacement was performed in 50 consecutive patients with acute type A aortic dissection.

Extended use of bilateral internal thoracic arteries for coronary artery bypass grafting in the elderly.

Objective: Internal thoracic artery (ITA) grafts provide better early and long-term patency than saphenous vein (SV) grafts. Furthermore, bilateral ITA grafting has recently demonstrated better long-term results than unilateral ITA grafting. However, its use in the elderly is controversial.

A modified infarct exclusion technique for a post-infarction ventricular septal defect.

Background: Operative mortality for a post-infarction ventricular septal defect (VSD) remains high. The infarct exclusion technique has been producing a favorable outcome for repairing this serious defect. However, there is the technical weakness, namely running suture along the base of the necrotic septum.

Cardiomyogenic differentiation in cardiac myxoma expressing lineage-specific transcription factors.

We investigated five cases of cardiac myxoma and one case of cardiac undifferentiated sarcoma by light and electron microscopy, in situ hybridization, immunohistochemical staining, and reverse transcriptase-polymerase chain reaction for cardiomyocyte-specific transcription factors, Nkx2.5/Csx, GATA-4, MEF2, and eHAND. Conventional light microscopy revealed that cardiac myxoma and sarcoma cells presented variable cellular arrangements and different histological characteristics.

Reoperation for coronary artery disease: devised management for reoperation including digital subtraction angiography.

Between December 1990 and August 1999, a consecutive series of 494 patients underwent coronary artery bypass grafting, while 19 (3.8%) patients underwent isolated reoperative coronary bypass grafting. The mean age of 16 males and 3 females who underwent reoperation was 63.

Feasibility and suitability of the routine use of bilateral internal thoracic arteries.

Background: It has been demonstrated that bilateral use of internal thoracic arteries (ITAs) confers better long-term results in patients than does unilateral use. However, routine use of bilateral ITAs has usually been avoided.

Methods: Since 1997, we have used bilateral ITAs extensively for patients who required multivessel bypasses.