Hemodynamic Management with Vasopressin for Cardiovascular Surgery.

: Vasopressin increases blood pressure through aquaporin-2-mediated water retention and is useful for managing hemodynamics after surgery. However, even after decades of study, clear clinical guidelines on doses and ideal use cases after cardiovascular surgery remain unclear. Here, the existing literature is synthesized on vasopressin use for cardiac surgeries and coupled with real-world clinical experience to outline a clearer clinical path for vasopressin use.

Impact of Intraoperative Branch Embolization for Type 2 Endoleak Prevention During Endovascular Abdominal Aortic Repair.

Background: Endovascular abdominal aortic repair (EVAR) has a significantly higher revision rate than open repair, primarily due to type 2 endoleak (2EL). Although 2ELs are considered benign, late open conversion (LOC) due to the expansion of the aneurysm diameter of the 2EL is a concern in the mid- and long-term. In this study, we investigated the impact of embolization of the inferior mesenteric artery (IMA) or lumbar artery (LA) at the time of the initial EVAR and its long-term outcomes.

Extensive aortic replacement including aortic arch for a mega aorta with chronic aortic dissection via posterolateral thoracotomy.

Background: Mega-aortic syndrome including aortic arch and descending aortic aneurysm is a challenging surgical case. Because the aorta continuously dilates, creating the distal anastomosis sites becomes an issue. Despite the developments in endovascular techniques including frozen elephant trunk, in the case of mega-aortic syndrome or mycotic aneurysm, extensive surgical repair is still a strong armamentarium.

Improvement of image quality for bright-blood image in VISIBLE (volume isotropic simultaneous interleaved bright- and black-blood examination) by using k-space reordering and startup echoes.

Purpose: A volume isotropic simultaneous interleaved bright- and black-blood examination (VISIBLE) can simultaneously acquire images with suppressed vascular signals (black-blood images) and images without suppression (bright-blood images). We aimed to improve of the bright-blood images by adjusting the k-space filling and using startup echo.

Methods: The k-space arrangement of bright-blood images in the conventional VISIBLE followed a low-to-high frequency order, whereas that in the proposed VISIBLE sequence was in the reversed order, and a startup echo was added.

Amide proton transfer-weighted imaging with a short acquisition time based on a self B0 correction using the turbo spin echo-Dixon method: A phantom study.

Purpose: Conventional amide proton transfer (APT)-weighted imaging requires a chemical exchange saturation transfer (CEST) sequence with multiple saturation frequency offsets and a B0 correction sequence, plus a long acquisition time that can be reduced by applying the conventional method using CEST images with seven radiation pulses (i.e., the seven-points method).

Exploration of appropriate media to influence sustainable on-site sanitation choices in Sri Lanka- visualization with still images or a video.

Pit latrines are the most common form of improved sanitation in many rapidly developing countries. However, they cause the highest amount of groundwater pollution among on-site sanitation (OSS) facilities. Many households in developing countries use groundwater as their main or sub-source, and pit latrines are not a sustainable solution.

Large-view x-ray imaging for medical applications using the world's only vertically polarized synchrotron radiation beam and a single asymmetric Si crystal.

X-ray microangiography provides detailed information on the internal structure and function of a biological subject. Its ability to evaluate the microvasculature of small animals is useful for acquiring basic and clinical medical knowledge. The following three conditions are necessary to attain detailed knowledge of biological functions: (1) high temporal resolution with sufficient x-ray intensity, (2) high spatial resolution, and (3) a wide field of view.

Structures on the ventricular side of the prosthetic valve in extremely late mitral paravalvular leak: a case report.

Background: Mechanisms of paravalvular leak (PVL) after mitral valve replacement have not been fully delineated. Herein, we report a case of structures on the ventricular side of the mitral valve in a patient with an extremely late PVL.

Case Summary: A 68-year-old female underwent aortic and mitral valve replacement with a mechanical valve 29 years ago.

Grading of gliomas using 3D CEST imaging with compressed sensing and sensitivity encoding.

Purpose: We evaluated the usefulness of three-dimensional (3D) chemical exchange saturation transfer (CEST) imaging with compressed sensing and sensitivity encoding (CS-SENSE) for differentiating low-grade gliomas (LGGs) from high-grade gliomas (HGGs).

Methods: We evaluated 28 patients (mean age 51.0 ± 13.

Assessment of cerebral perfusion in moyamoya disease with dynamic pseudo-continuous arterial spin labeling using a variable repetition time scheme with optimized background suppression.

Purpose: Accurate assessment of cerebral perfusion in moyamoya disease is necessary to determine the indication for treatment. We aimed to investigate the usefulness of dynamic PCASL using a variable TR scheme with optimized background suppression in the evaluation of cerebral perfusion in moyamoya disease.

Methods: We retrospectively analyzed the images of 24 patients (6 men and 18 women, mean age 31.

Safety and arch complications after hemiarch versus total arch replacement with stented elephant trunk in acute type 1 dissection: Is a stent graft always beneficial?

Objective: We aimed to determine the efficacy of total arch replacement with stented elephant trunk by comparing it with hemiarch replacement with and without open stent graft for acute aortic dissection type 1.

Methods: We reviewed records of 177 patients who underwent hemiarch replacement (HAR group) (concomitant open stent, 125) and 98 patients who underwent total arch replacement (TAR group) (concomitant stented elephant trunk, 91) for acute type 1 dissection. Compared with the TAR group, the HAR group was older (68.

Effect of Saturation Pulse Duration and Power on pH-weighted Amide Proton Transfer Imaging: A Phantom Study.

Purpose: Amide proton transfer (APT) imaging may detect changes in tissues' pH based on the chemical exchange saturation transfer (CEST) phenomenon, and thus it may be useful for identifying the penumbra in ischemic stroke patients. We investigated the effect of saturation pulse duration and power on the APT effect in phantoms with different pH values.

Methods: Five samples were prepared from a 1:10 solution of egg-white albumin in phosphate-buffered saline at pH 6.

Fenestrated Fontan-like circulation under durable left-ventricular assist device support in fulminant myocarditis.

Fulminant myocarditis is a fatal development from profound biventricular heart failure and often requires both right- and left-ventricular assistance to maintain hemodynamics, even at the risk of increased mortality and morbidity. Here, we present a 42-year-old female with profound biventricular failure due to fulminant myocarditis, resolved by an isolated durable left-ventricular assist device support under a fenestrated, Fontan-like circulation and managed low-pulmonary vascular resistance.

Three-dimensional chemical exchange saturation transfer imaging using compressed SENSE for full z-spectrum acquisition.

Purpose: To evaluate the accuracy of three-dimensional (3D) chemical exchange saturation transfer (CEST) imaging with a compressed sensing (CS) and sensitivity encoding (SENSE) technique (CS-SENSE) for full z-spectrum acquisition.

Methods: All images were acquired on 3-T magnetic resonance imaging (MRI) scanner. In the phantom study, we used the acidoCEST imaging.

Total arch replacement using frozen elephant trunk technique with Frozenix for distal aortic arch aneurysms.

Objectives: Total arch replacement (TAR) using an endovascular approach has been initially introduced as the frozen elephant trunk technique (FET). In our institute, TAR using the FET with Frozenix has been used as the first-line treatment for distal aortic arch aneurysms since 2014. This study aimed to evaluate the early and long-term outcomes and demonstrate the efficacy of this procedure.

Surgical outcomes of bridge-to-bridge therapy with extracorporeal left ventricular assist device for acute myocardial infarction in cardiogenic shock.

Background: Extracorporeal left ventricular assist device is often required for acute myocardial infarction patients in cardiogenic shock when temporary mechanical circulatory support fails to provide hemodynamic stabilization. This study aimed to evaluate the clinical outcomes of acute myocardial infarction patients in cardiogenic shock supported by an extracorporeal left ventricular assist device.

Methods: This retrospective study enrolled 13 acute myocardial infarction patients in cardiogenic shock treated with an extracorporeal left ventricular assist device from April 2011 to July 2020.

Early and mid-term results of transcatheter aortic valve implantation and valve durability assessment.

This study aimed to evaluate the early and mid-term outcomes of transcatheter aortic valve implantation (TAVI) and to assess valve durability. A total of 146 consecutive patients who underwent TAVI for severe aortic stenosis between October 2013 and August 2018 were retrospectively reviewed. All patients (mean age, 84 ± 6 years; age range 53-98 years; 42 males [28.

An autopsy case of aortic dissection due to giant cell arteritis.

Giant cell arteritis (GCA) is a systemic vasculitis affecting mainly large and medium-sized arteries. GCA sometimes involves the aorta and its major branches and causes aortic dissection as a rare complication. We have experienced an autopsy case of aortic dissection due to GCA.

Optimization of the refocusing flip angle in the characterization of cerebrospinal fluid dynamics using multi-spin echo acquisition cine imaging (MUSACI).

Purpose: Multi-spin echo acquisition cine imaging (MUSACI) is a method used for cerebrospinal fluid (CSF) dynamics imaging based on the proton phase dispersion and flow void using 3D multi-spin echo imaging. In a previous study, the refocusing flip angle of MUSACI was set at a constant 80°. We conducted the present study to investigate the preservation the CSF signal intensity even in a long echo train and improve the ability to visualize CSF movement by modifying the refocusing flip angle in MUSACI.

Rejuvenation of mesenchymal stem cells by extracellular vesicles inhibits the elevation of reactive oxygen species.

Aging induces numerous cellular disorders, such as the elevation of reactive oxygen species (ROS), in a number type of cells, including mesenchymal stem cells (MSCs). However, the correlation of ROS and impaired healing abilities as well as whether or not the inhibition of elevating ROS results in the rejuvenation of elderly MSCs is unclear. The rejuvenation of aged MSCs has thus recently received attention in the field of regenerative medicine.

Midterm results of mitral valve repair for atrial functional mitral regurgitation: a retrospective study.

Background: Annular dilation by left atrial remodeling is considered the main cause of atrial function mitral regurgitation. Although acceptable outcomes have been obtained using mitral ring annuloplasty alone for atrial functional mitral regurgitation, data assessing outcomes of this procedure are limited. Therefore, we aimed to assess midterm outcomes of mitral valve repair in patients with atrial functional mitral regurgitation.

Trapezoidal resection of an elongated anterior mitral leaflet and Alfieri stitch in hypertrophic cardiomyopathy.

Background: In individuals with hypertrophic obstructive cardiomyopathy, elongated anterior mitral leaflets are commonly associated with systolic anterior motion. In patients with mild septal hypertrophy, a myectomy is considered insufficient to relieve systolic anterior motion and left ventricular outflow tract obstruction.

Case Presentation: In the patient, who had relatively mild septal hypertrophy, the section of the anterior leaflet protruding into the left ventricular outflow tract was resected, concomitant with septal myectomy and the relocation of the papillary muscles.

The change in the mitral-septal angle after surgery for atrial functional mitral regurgitation.

Objective: The optimal surgical strategy for atrial functional mitral regurgitation remains uncertain. Preoperative mitral-septal angle ≤ 70° has been reported as a risk factor for an abnormal vortex pattern in mitral valve repair. This study aimed to elucidate the change in the mitral-septal angle after surgery for atrial functional mitral regurgitation and its effect on the mid-term outcomes.