[New Intracoronary Shunt Cannula in Off-pump Coronary Artery Bypass Grafting].

In off-pump coronary artery bypass grafting(OPCAB), a bloodless operative field has great influence on the quality of anastomosis. In addition, maintenance of distal coronary flow during anastomosis stabilizes hemodynamics. We introduced a new intracoronary shunt cannula, Mini Shunt Pro (MSP).

Successful diagnosis of pericardial rupture caused by blunt chest trauma using contrast ultrasonography.

A 65-year-old male developed acute myocardial infarction due to coronary artery dissection and tricuspid valve injury after blunt chest trauma. Acute myocardial infarction was treated by coronary artery intervention; however, refractory heart failure with pleural effusion remained. The first transthoracic echocardiography (TTE) on admission failed to clearly visualize the tricuspid valve and right ventricle due to poor image quality.

Utility of three-dimensional transesophageal echocardiography for diagnosis of unroofed coronary sinus.

We report a case of unroofed coronary sinus (URCS) in a 42-year-old female. At an outpatient clinic, she was found to have an atrioventricular septal defect and mitral regurgitation with pulmonary hypertension, and she was transferred to our institute for surgical treatment. Both atrioventricular valves were located at the same level, and both the right atrium (RA) and right ventricle were enlarged on two-dimensional transthoracic echocardiography.

[Mitral Valvuloplasty of Infective Endocarditis During Pregnancy].

This report describes a case in which we treated a patient who developed infective endocarditis in the mitral valve at 28 weeks' gestation. The condition was resolved by performing mitral valvuloplasty 2 days after an emergency cesarean section. Although the patient was in a relatively stable period at 32 weeks' gestation, the mother had an extremely high risk of embolism;thus, emergency surgery was required.

The impact of preoperative identification of the Adamkiewicz artery on descending and thoracoabdominal aortic repair.

Objective: To investigate the impact of preoperative identification of the Adamkiewicz artery (AKA) on prevention of spinal cord injury (SCI) through the multicenter Japanese Study of Spinal Cord Protection in Descending and Thoracoabdominal Aortic Repair (JASPAR) registry.

Methods: Between January 2000 and October 2011, 2435 descending/thoracoabdominal aortic repairs were performed, including 1998 elective repairs and 437 urgent repairs, in 14 major centers in Japan. The mean patient age was 67 ± 13 years, and 74.

Decellularized porcine aortic intima-media as a potential cardiovascular biomaterial.

Objectives: The aim of this research is to investigate the histological and mechanical properties of decellularized aortic intima-media, a promising cardiovascular biomaterial.

Methods: Porcine aortic intima-media was decellularized using two methods: high hydrostatic pressurization (HHP) and sodium dodecyl sulphate (SDS). The histological properties were characterized using haematoxylin and eosin staining and Elastica van Gieson staining.

Stress echocardiographic assessment of mitral valve function repaired using rough-zone trimming.

Background: We invented novel mitral valve repair technique; rough-zone trimming procedure (RZT) for anterior mitral valve prolapse. Prolapse site was resected in obtuse triangle shape and sutured edges to creates deep coaptation and improves regurgitation. Though it is simple and reproducible technique, functional mitral stenosis is a risk.

New parameter of the right gastroepiploic arterial graft using the power spectral analysis device named MemCalc soft.

Objectives: Transit-time flow measurement (TTFM) parameters such as mean graft flow (MGF, ml/min), pulsatility index (PI) and diastolic filling (DF, %) have been extensively researched for internal mammary arterial or saphenous vein grafts. In our experience of using the right gastroepiploic arterial (GEA) graft for right coronary artery (RCA) grafting, we observed unique GEA graft flow waveforms. We analysed the GEA graft flow waveforms for their effectiveness in determining GEA graft patency by power spectral analysis.

Risk factors for a persistent type 2 endoleak after endovascular aneurysm repair.

Purpose: To investigate the natural course of type 2 endoleaks (T2Es) and to identify the risk factors associated with a persistent T2E after endovascular aneurysm repair (EVAR).

Methods: The medical records of patients who underwent EVAR for the treatment of an atherosclerotic abdominal aortic aneurysm between October 2006 and December 2011 at our institute were reviewed. T2Es were diagnosed by contrast-enhanced computed tomography within 4 weeks of EVAR, and patients were followed up at 6 and 12 months.

Impact of novel intraoperative evaluation for mitral valve regurgitation: the retrograde cardio-protective beating test.

Purpose: The saline injection test is commonly employed during mitral valvuloplasty. However, discrepancies in regurgitation between the naked eye findings during the saline injection test and the postoperative echocardiographic findings have been noted. Here, we describe the new retrograde cardio-protective beating test (RC-beating test) which allows direct transatrial evaluation of the valve in the fully loaded, beating heart under cross-clamping by means of the retrograde perfusion of warm oxygenated blood into the coronary sinus.

Acute dilatation of the ascending aorta and aortic valve regurgitation in Loeys-Dietz syndrome.

Loeys-Dietz syndrome (LDS) is a recently recognized connective tissue disorder caused by mutations of the transforming growth factor (TGF)-β receptors. It is an autosomal dominant syndrome characterized by the triad of arterial tortuosity and aneurysms, hypertelorism, and bifid uvula or cleft palate. We treated an 18-year-old woman with a 100-mm-diameter aortic root aneurysm and severe aortic valve regurgitation.

Right axillary arterial perfusion for descending thoracic or thoracoabdominal aortic aneurysm repair with open proximal anastomosis through left thoracotomy.

Background: We examined the effectiveness of right axillary arterial perfusion through an interposed Dacron graft in the prevention of cerebral embolism or complications related to ascending aortic cannulation in open proximal anastomosis technique of descending thoracic aortic aneurysm (TAA) or thoracoabdominal aortic aneurysm (TAAA) repair under deep hypothermic circulatory arrest through left thoracotomy.

Methods: Between May 2000 and August 2012, 44 patients underwent TAA or TAAA repair using open proximal technique under DHCA. These patients were divided into two groups for evaluation of the effectiveness of right axillary arterial perfusion.

Fabrication of a heparin-PVA complex hydrogel for application as a vascular access.

A high hydrostatic pressure method, which can apply over 600 MPa pressure was employed for preparing a hydrogel of poly(vinyl alcohol) (PVA) loaded with heparin. The aim of this study was to fabricate a heparin-PVA hydrogel conduit and evaluate its potential for vascular access. Heparin-PVA complex hydrogel showed suppressed heparin release and prevented clot formation, depending on the molecular weight of the PVA.

Acute gallbladder necrosis in a patient with acute type B aortic dissection.

Although vascular complications induced by acute aortic dissection are varied and common, gallbladder necrosis induced by acute aortic dissection is rare. We experienced the case of a 42-year-old woman who suffered from acute gallbladder necrosis that occurred the following day after the onset of acute type B aortic dissection. Contrasted computed tomography, which showed the thickened wall of the gallbladder and the pericholecystic fluid, as well as the occluded celiac artery, was an effective diagnostic procedure.

[Neuroleptic malignant syndrome after cardiac surgery].

A 64-year-old man without any psychiatric disease, including Parkinson's disease underwent aortic valve replacement and mitral valve replacement for rheumatic valvular disease. One day after the cardiac surgery, he developed hyperthermina, muscle rigidity, coma and delirium, and his serum creatine kinase (CK) level was elevated. In spite of his negative brain computed tomography(CT), his consciousness remained unclear.

Esophago-Pleural Fistula Caused by Compression Necrosis In a Patient With Acute Type B Aortic Dissection.

Esophago-pleural fistula associated with thoracic aortic aneurysm is a rare and lethal complication. We report the case of a 62-year-old male who suffered from esophago-pleural fistula 56 days after thoracoabdominal aortic surgery. Contrasted CT showed that the fistula occurred at the level of the esophagus compressed by rapid dilatation of thoracic aorta and endoscopy revealed no ischemic signs on esophageal mucosa, demonstrating that the cause of esophago-pleural fistula was compression necrosis due to rapid dilatation of the thoracoabdominal aortic aneurysm.

Herniation of transverse colon into mediastinum after pedicled omental grafting for mediastinitis: report of a case.

We describe a rare complication and the treating experience of it after pedicled omental grafting for mediastinitis. The patient was diagnosed as an acute mediastinitis soon after the total arch replacement was performed. A two-staged strategy to treat postoperative mediastinitis was scheduled, i.

[Henoch-Schönlein Purpura with lung abscess].

A 72-year-old man had underwent left lower lobectomy for squamous cell carcinoma in our hospital in 2008. Postoperative stage was I A (T1N0M0). In 2010, follow-up chest computed tomography (CT) images showed similar cavitary nodules in segments 2 and 8 of the right lung with positive uptake on fluorodeoxyglucose-positron emission tomography (FDG-PET) images.

Mitral valve plasty for idiopathic rupture of mitral valve posterior chordae in infants.

Introduction: Idiopathic mitral valve chordal rupture is rare among infants. Once it has occurred, acute heart failure progresses, and emergency surgical repair is necessary in most cases. Our surgical experience with idiopathic mitral valve chordal rupture is reported.