Impact of direct mesenteric perfusion on malperfusion in acute type A aortic dissection repair.

Objectives: Mesenteric malperfusion in acute aortic dissection remains a life-threatening complication with no standardized treatment strategy. This study aimed to describe and evaluate the outcomes of our integrated approach combining exploratory laparotomy, immediate mesenteric reperfusion, and central aortic repair.

Methods: We retrospectively reviewed patients with acute aortic dissection with a preoperative diagnosis of mesenteric malperfusion who were treated between August 2011 and November 2022.

Recurrent Mural Thrombosis of the Ascending Aorta in a Patient with Antiphospholipid Syndrome.

A 38-year-old man presented with embolic occlusion of the brachial artery. As per his computed tomography results, a pedunculated mass in the proximal ascending aorta was detected. Since discrimination between a thrombus and a tumor was deemed difficult, the patient underwent replacement of the ascending aorta.

Albuminuria Predicts Short-Term Worsening Renal Function After Transcatheter Aortic Valve Replacement.

Albuminuria is a major risk factor of cardiovascular events, however, the impact of albuminuria on clinical outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) has not been fully investigated. This retrospective study included 206 patients who underwent TAVR for severe aortic stenosis. Patients were divided into two groups according to the preoperative urinary albumin-to-creatinine ratio (ACR): high (ACR ≥ 30 mg/g) and low (ACR < 30 mg/g).

Coronary artery bypass grafting in a patient with situs inversus totalis: a case report.

Background: Coronary artery bypass grafting in situs inversus totalis patients has been seldom reported in the literature.

Case Presentation: A 76-year-old woman visited our hospital for chest pain and dyspnea that had started about 5 years earlier. Coronary angiography revealed triple-vessel disease, and computed tomography showed situs inversus totalis.

Long-term Outcome 10 Years After Free Gastroepiploic Artery Graft for Coronary Artery Bypass Surgery.

Background: The long-term benefits of "free" gastroepiploic artery (GEA) grafts remain unclear. The aim of this study is to investigate the long-term patency and clinical results of en bloc free GEA grafts.

Methods: Of the 1478 patients undergoing coronary artery bypass graft surgery at our institution between January 1997 and December 2009, 137 patients underwent en bloc free GEA grafting.

A modified technique for supra-annular implantation of prosthetic tricuspid valve.

In conventional tricuspid valve replacement, there is a risk of valve detachment because stitches are placed on relatively fragile tissues. In the supra-annular implantation technique, stitches are placed lateral to the triangle of Koch and the coronary sinus instead of the anterior and septal leaflets as in conventional tricuspid valve replacement. This procedure relieves stress at the antero-septal commissural area, as well as avoids injury to the conduction system.

Routine presternotomy extracorporeal circulation for redo surgery.

To reduce the risk of adverse events, presternotomy extracorporeal circulation (ECC) is routinely performed at our institution for patients who require resternotomy. We report our 10-year experience of performing presternotomy ECC for cardiac reoperation and the clinical results. Fifty-seven consecutive cardiac reoperations involving resternotomy were performed between January 2006 and December 2015.

Saphenous Vein Graft Aneurysm Repaired with Radial Artery Graft Pre-Sewn Vascular Prosthesis Patch.

Saphenous vein graft aneurysms are rare but are potentially fatal and their optimal management is not clearly established. Herein, we report a case of a saphenous vein graft aneurysm that was successfully treated with surgical intervention, including aneurysmal resection and re-grafting. The aneurysm, detected 36 years after coronary artery bypass grafting, was located at the proximal part of the saphenous vein graft to the posterolateral branch; the flow of the left anterior descending coronary artery was limited due to compression of the left internal thoracic artery by the adjacent aneurysm.