Right Parasternal Approach for Aortic Valve Replacement After Presternal Gastropexy.

Due to bicuspid aortic valve aortic stenosis, a 78-year-old man with a history of esophagectomy and presternal gastric tube reconstruction required aortic valve replacement (AVR). AVR with a bioprosthetic valve was performed through a right parasternal thoracotomy. Despite the unfavorable conditions for conventional median sternotomy, AVR was successfully performed through an alternate approach.

Cell Type-Specific Relationships Among Immune Cells in Human Aortic Dissection Tissue.

Background: Although recent studies have revealed the importance of inflammation in the pathogenesis of aortic dissection (AD), little is known about the relationships among inflammatory cells in human AD tissue.

Methods And Results: We assessed the relationships among various immune cell types, including neutrophils, macrophages (M1 and M2), B cells, and helper T cells (Th1, Th2, Th17, Treg and Tfh ) in human AD tissue. AD tissues displayed abundant infiltration of immune cells.

Delayed migration of a Sapien 3 Ultra Resilia following transcatheter aortic valve implantation after selection of a smaller-sized valve.

This report discusses a rare case of delayed migration of a Sapien 3 Ultra Resilia (S3UR) valve following transcatheter aortic valve implantation. An 81-year-old Japanese woman had a borderline aortic annular size of 20-23 mm according to the manufacturer's size chart. We chose to implant a smaller S3UR of 20 mm with an 80/20 depth ratio to allow for a second intervention, ensuring good hemodynamics and minimizing paravalvular leak.

Early thrombus formation including hypo-attenuated leaflet thrombosis after surgical bioprosthetic aortic valve replacement.

Objective: To assess the occurrence, predictors, and outcomes of hypo-attenuated leaflet thickening (HALT) and thrombus outside the prosthetic valve following surgical aortic valve replacement.

Methods: A total of 118 patients underwent surgical aortic valve replacement with bioprosthetic valves between July 2020 and June 2022. Sixty-two (52.

Cusp overlap technique decreases paravalvular leakage in self-expandable transcatheter aortic valve replacement.

The cusp overlap technique allows greater visual separation between the basal annular plane and the conduction system and decreases the permanent pacemaker implantation rate. We assessed the impact of the cusp overlap technique on conduction disturbance and paravalvular leakage after transcatheter aortic valve replacement. A total of 97 patients underwent transfemoral transcatheter aortic valve replacement with self-expandable valves at our institution from November 2018 to January 2023.

Review of Implantable Left Ventricular Assist Devices.

Mechanical circulatory support has been an indispensable treatment for severe heart failure. While the development of a total artificial heart has failed, left ventricular assist devices (LVAD) have evolved from extracorporeal to implantable types. The first generation implantable LVAD (pulsatile device) was used as a bridge to transplantation, and demonstrated improvement in survival rate and activity of daily living.

Hypo-attenuated leaflet thickening after Perceval sutureless bioprosthesis implantation.

Modern multi-slice computed tomography (CT) has increased the detection of hypo-attenuated leaflet thickening (HALT). Furthermore, HALT's impact on transcatheter or surgical biological aortic valve (AV) prostheses has attracted attention. However, few reports on HALT in sutureless bioprostheses exist.

Hemodynamic and clinical performance of the 25-mm Medtronic Mosaic porcine bioprosthesis in the mitral position.

The 25-mm Medtronic Mosaic porcine bioprosthesis (MB25) is the smallest bioprosthesis that has been approved for use in the mitral position in Japan. Various studies have reported satisfactory hemodynamic performance and good long-term outcomes of the Medtronic Mosaic porcine bioprosthesis. However, the hemodynamic and clinical performances of the MB25 in the mitral position remain unknown.

Evaluation of hemodynamics after mitral valve replacement with the St Jude Medical Epic bioprosthesis: a Japanese single-center experience.

To assess the early hemodynamics after mitral valve replacement (MVR) using the St Jude Medical (SJM) Epic bioprosthesis. MVR was performed using the SJM Epic bioprosthesis in 35 patients from June 2018 to April 2020; three patients were excluded because the postoperative transthoracic echocardiography (TTE) data were unavailable. Data from postoperative TTE at 1 week and 3 months after the procedure were reviewed.

Impact of the Trifecta bioprosthetic valve in patients with low-flow severe aortic stenosis.

Aortic stenosis (AS) is the most common valve disorder in advanced age. Previous reports have shown that low-flow status of the left ventricle is an independent predictor of cardiovascular mortality after surgery. The Trifecta bioprosthesis has recently shown favorable hemodynamic performance.

Clinical outcome of cardiac surgery in patients with remitted or active hepatocellular carcinoma.

Purpose: Hepatocellular carcinoma (HCC) is one of the most common primary cancers worldwide. HCC has unique characteristics such as co-existing chronic liver damage and a high recurrence rate. A negative impact on the surgical outcome due to these backgrounds could be expected.

Pathological Role of Receptor for Advanced Glycation End Products in Calcified Aortic Valve Stenosis.

Background Aortic stenosis (AS) is highly prevalent in patients with atherosclerotic cardiovascular disease. Advanced glycation end products (AGEs) and the receptor for AGEs (RAGE) play a pivotal role for vascular calcification in atherosclerosis. We hypothesize that the AGEs-RAGE axis could also be involved in the pathophysiological mechanism of calcified AS.

Aortic valve replacement with or without concomitant coronary artery bypass grafting in very elderly patients aged 85 years and older.

Degenerative aortic stenosis is the most common structural heart valve disease affecting the aging population. Catheter-based heart valve interventions are less invasive and very useful for very elderly patients. However, we often consider open heart surgery for these patients because of anatomical reasons and co-existing cardiac diseases, i.

Left ventricular apical pseudoaneurysm with aortic prosthetic valve endocarditis.

We report an 83-year-old man with a mycotic left ventricular apical pseudoaneurysm and aortic prosthetic valve endocarditis caused by Enterococcus spp. Mycotic left ventricular pseudoaneurysm is very rare and is associated with a high risk of rupture. Here, we report the clinical presentation, diagnosis, prognosis, and treatment of a case of mycotic left ventricular pseudoaneurysm to raise awareness regarding this unusual and potentially fatal complication.

Florida sleeve technique for a right sinus of Valsalva aneurysm: a case report.

Background: Florida sleeve technique was reported by Hess et al. as a new technique of valve sparing aortic root replacement without the requirement of entire aortic root wall resection and coronary artery reconstruction. We present a rare case of an unruptured aneurysm of the right sinus of Valsalva that was successfully treated with resection of the aneurysm and the Florida sleeve technique.

Multimodal imaging of cardiac-calcified amorphous tumor.

Cardiac-calcified amorphous tumor (CAT) is a rare non-neoplastic tumor and its origin and pathogenesis are still unclear. In addition, it is difficult to clinically diagnose as cardiac CAT without pathological findings. We present a case of a 78-year-male diagnosed with cardiac CAT after surgical resection.

Activation of the AKT Pathway in the Ascending Aorta With Bicuspid Aortic Valve.

Background: Dilatation of the ascending aorta affects those patients with bicuspid aortic valve (BAV), even after valvular surgery, possibly due to tissue fragility. The goal of the study was the molecular characterization of aorta with BAV compared to that with normal tricuspid aortic valve (TAV).

Methods and results: The subjects were patients who underwent surgery for aortic valve stenosis in 2013 and 2014.

Acute Swine Model for Assessing Biocompatibility of Biomedical Interface Materials.

We established an acute animal model for early, straightforward, and reproducible assessment of a biocompatible material interface. Bilateral femoral artery-to-vein shunts were created in 12 pigs: two tubes per shunt, the left two coated and the right two uncoated. We evaluated two groups: uncontrolled flow (UF; shunt flow unregulated) and controlled flow (CF; shunt flow ∼50 mL/min).

Successful Surgical Treatment of a Huge Candida albicans Aortic Fungus Ball with Pseudoaneurysm.

A 70-year-old woman with a history of aortic valve replacement and coronary artery bypass grafting (CABG) was transferred to the authors' hospital for further management of a three-month fever of unknown origin. Computed tomography showed a huge mass in the ascending aorta with pseudoaneurysm. Blood β-D-glucan levels were significantly high, and blood culture showed the growth of Candida albicans.

Short-term in vivo performance of the Cleveland clinic PediPump left ventricular assist device.

The PediPump was implanted in six healthy lambs (mean 25.6 ± 1.4 kg) between the left ventricular apex and the descending aorta to evaluate in vivo performance for up to 30 days.