Clinical Features of 544 Patients With Ruptured Aortic Aneurysm - A Report From the Tokyo Acute Aortic Super Network Database.

Background: Epidemiological data on ruptured aortic aneurysms from large-scale studies are scarce. The aims of this study were to: clarify the clinical course of ruptured aortic aneurysms; identify aneurysm site-specific therapies and outcomes; and determine the clinical course of patients receiving conservative therapy.

Methods And Results: Using the Tokyo Acute Aortic Super Network database, we retrospectively analyzed 544 patients (mean [±SD] age 78±10 years; 70% male) with ruptured non-dissecting aortic aneurysms (AAs) after excluding those with impending rupture.

Untreated atrial septal defect after intracardiac repair for tetralogy of Fallot.

Tetralogy of Fallot was repaired previously in a preschooler through right ventriculotomy, providing excellent exposure for ventricular septal defect closure and right ventricular outflow tract obstruction relief. Herein, we describe the preschooler as a 50-year-old man with untreated atrial septal defect found at pulmonary valve replacement in the remote period after tetralogy of Fallot repair. It was inferred intraoperatively that the previous tetralogy of Fallot was repaired only through right ventriculotomy, and atrial septal defect closure was performed together with pulmonary valve replacement.

Intracardiac Three-Dimensional Image as Surgical Decision-Making Tool of Congenital Heart Disease.

This study aimed to evaluate the anatomical reproducibility of a preoperative intracardiac 3D image (IC image) created using computed tomography, and to investigate its usefulness as a surgical decision-making tool. Between 2012 and 2022, ventricular septal defect (VSD) patients, and double outlet right ventricle (DORV) or transposition of the great arteries (TGA) with pulmonary stenosis (PS) patients who underwent cardiac surgery and had preoperative computed tomography were enrolled. SYNAPSE VINCENT® (Fujifilm) was used to create an IC image which was analyzed retrospectively.

Non-bacterial Thrombotic Endocarditis Presenting as a Mass in the Right Atrium Diagnosed by Open Chest Surgery.

Non-bacterial thrombotic endocarditis (NBTE) is a condition that results in the development of vegetation on cardiac valves that are devoid of inflammation and bacteria. We herein report a 60-year-old man who transferred to our hospital because of a systemic embolism and heart failure. A mass in the right atrium and vegetation on the mitral valve were observed.

Successful Treatment of Infant Tricuspid Valve Dysplasia With Papillary Muscle-Splitting Technique.

We describe a 3-month-old girl who presented with massive and restrictive tricuspid regurgitation due to shortened chordae attached to an abnormal papillary muscle. The condition was improved by myotomy, which resulted in papillary muscle-splitting technique. We successfully treated tricuspid valve dysplasia in a young infant using a rare procedure based on a thorough understanding of the heart's morphologic features.

Outcomes of type A acute aortic dissection with cardiopulmonary arrest: Tokyo Acute Aortic Super-network Registry.

Objectives: Preventing loss of life in patients with type A acute aortic dissection (AAD) who present with cardiopulmonary arrest (CPA) can be extremely difficult. Thus, we investigated the early outcomes in these patients.

Methods: Patients with type A AAD who were transported to hospitals belonging to the Tokyo Acute Aortic Super-network between January 2015 and December 2019 were considered for this study.

Impact of computed tomography on the diagnosis of Takayasu arteritis with acute coronary syndrome: A case series.

Unlabelled: Both the diagnosis and treatment of coronary artery involvement with Takayasu arteritis (TA) are challenging. In this study, we report different clinical scenarios of two TA cases without Typical symptoms of TA that initially presented in the form of acute coronary syndrome (ACS). Patient 1 was a 24-year-old Japanese woman without coronary risk factors who presented with exertional chest pain, dyspnea, and syncope.

The prognostic impact of the controlling nutritional status (CONUT) score in patients undergoing cardiovascular surgery.

Background: Various postoperative predictive markers following cardiovascular surgery have been examined for use in the current aging population. The controlling nutritional status (CONUT) score, which is advocated not only as a screening tool for poor nutritional status, but also as an immunonutritional assessment, has started to attract attention in several clinical settings, such as in cancer and heart failure patients. The aim of this study was to evaluate the value of the CONUT score as a postoperative prognostic marker in patients who underwent cardiovascular surgery.

[Cardiac Strangulation Induced by Epicardial Pacemaker Leads Causing Heart Failure;Report of a Case].

A 5-year-old girl has a history of epicardial VVI-pacemaker implantation due to congenital heart block at the age of 2 months. Five years later, she developed heart failure at the same time of battery depletion. The chest X-ray indicated the loop formation of the epicardial leads and the echocardiogram demonstrated paradoxical movement of ventricles.

Endovascular Treatment for Kommerell's Diverticulum with a Right-Sided Aortic Arch.

We report a rare case of type A dissection involving a right-sided aortic arch with an aberrant left subclavian artery originating from Kommerell's diverticulum in a 76-year-old woman. Endovascular treatment for Kommerell's diverticulum including intimal tear of the dissection was performed. At the 5-year follow-up, the patient was doing well, with no endoleak or dilatation of the Kommerell's diverticulum.

Safety and effectiveness of tolvaptan for fluid management after pediatric cardiovascular surgery.

Background: Postoperative fluid management is important after open heart surgery, because cardiopulmonary bypass evokes an abnormal inflammatory response and increases vascular permeability, especially in pediatric patients. We assessed the safety and effectiveness of tolvaptan for management of postoperative fluid retention after congenital heart surgery.

Methods And Results: This retrospective study analyzed data from 43 children with uncomplicated congenital heart disease who underwent open heart surgery between September 2013 and August 2016.

Multidisciplinary Treatment Approach for Prosthetic Vascular Graft Infection in the Thoracic Aortic Area.

Prosthetic vascular graft infection in the thoracic aortic area is a rare but serious complication. Adequate management of the complication is essential to increase the chance of success of open surgery. While surgical site infection is suggested as the root cause of the complication, it is also related to decreased host tolerance, especially as found in elderly patients.

A Case of an Aortic Abscess around the Elephant Trunk.

A 52-year-old male patient with a history of total arch replacement using the elephant trunk technique for acute aortic dissection 4 years before visited our hospital with the chief complaint of persistent fever. Chest computed tomography (CT) suggested prosthetic vascular graft infection, which was treated surgically after chemotherapy. The first surgery consisted of debridement of an abscess around the vascular graft and in the aorta around the elephant trunk, and thoracic descending aorta replacement and vacuum-assisted closure (VAC) in view of the risk of bleeding from the peripheral region of the elephant trunk.

Morphological Evaluation of Proximal Anastomosis by PAS-Port(®) System in Patients with Long-Term Patent Grafts.

Purpose: We examined grafts employing for morphological analysis of early and long-term results on proximal anastomosis with the PAS-Port(®).

Methods: One hundred and four patients treated by OPCAB with PAS-Port(®) were performed postoperative MDCT. Morphological evaluation of the proximal anastomotic region was classified into three groups (A; graft was anastomosed almost perpendicularly to the aortic wall, B; graft was same type A, but subsequently curved to form an acute angle with the aortic wall, C; graft take off acute angle with the aortic wall) evaluated on planar and sagittal sections.

Interrupted aortic arch with massive saccular collateral aneurysm in an adult.

A 49-year-old man was diagnosed with an interrupted aortic arch (IAA), a massive saccular thoracic collateral aneurysm, ischemic renal insufficiency, and multiple abdominal collateral aneurysms. A bypass from the left subclavian artery to the descending aorta and thoracic collateral aneurysmectomy proceeded simultaneously through a posterolateral thoracotomy. The pressure gradient between upper and lower extremities disappeared and renal function was normalized.

Endovascular abdominal aortic aneurysm repair in patients with renal transplants: reports of two cases.

The artery and vein of the transplanted kidney are generally anastomosed to the external iliac artery and vein, respectively. Therefore, in open abdominal artery aneurysm (AAA) repair in renal transplant patients, kidney ischemia due to a proximal aortic clamp is a serious problem. We successfully performed endovascular aneurysm repair (EVAR) of AAA without aortic clamping in two renal transplant recipient cases.

Novel infectious agent-free hemostatic material (TDM-621) in cardiovascular surgery.

Subjects: Currently, hemostatic materials made from human blood components and animal-derived collagen is used for controlling operative hemorrhage in the cardiovascular surgery field. In this study, we focused on an entirely synthetic self-assembling peptide (development code: TDM-621) that gels when in contact with blood or other bodily fluids and stops bleeding upon contact with a wound site. We investigated its usefulness as a hemostatic material in animal and clinical studies.

Antibiotics and Drainage for Treating Stent-Graft Infection after EVAR.

The patient was a 64-year-old man. He developed fever and lumbago 6 months after the EVAR. Because CT showed an abscess in the aortic aneurysm surrounding the stent graft, stent-graft infection was diagnosed, and treatment with intravenous antibiotics was initiated.

Fontan conversion with novel direct ablation after childbirth: report of a case.

A 38-year-old woman underwent atriopulmonary Fontan surgery at age 18 years and subsequently successfully delivered a girl by cesarean section at age 34. Her condition later deteriorated due to atrial tachyarrhythmia and progressed to New York Heart Association (NYHA) class IV heart failure. Her treatment, at age 36, comprised total cavopulmonary connection conversion, direct right atrial ablation with bipolar radiofrequency devices, the creation of an atrial septal defect, and placement of a dual-chamber permanent pacemaker.

Stent graft implantation combined with coil embolization and external-internal iliac artery bypass surgery: report of a case.

A 73-year-old male patient was found to have an abdominal aortic aneurysm complicated with bilateral common iliac artery aneurysms. He also had hepatitis C, chronic liver cirrhosis (Child-Pugh class B), a rupture of esophageal varices, hepatocellular carcinoma, and intractable ascites. The functions of other systemic organs were also impaired.