[Bilateral Atrial Maze without Left Atrial Incision during Aortic Valve Replacement].

A 77-year-old man had severe aortic stenosis and continuous atrial fibrillation. We performed maze procedure without left atrial incision( Dallas lesion set) during aortic valve replacement for this patient. Dallas lesion set alternates the isolation of mitral isthmus by connecting ablation line beneath left coronary cusp and noncoronary cusp commissure of the aortic valve with ablation from epicardial side of the upper left atrium.

[Commando Procedure for Rapidly Progressing Infective Endocarditis in Immunosuppressive State: Report of a Case].

A 68-year-old woman with immunosuppressive state following chemotherapy for cancer of unknown primary origin developed infective endocarditis due to methicillin-resistant Staphylococcus aureus (MRSA). Echocardiography showed shunt blood flow from the aortic annular abscess into the left atrium, which indicated infection of the intervalvular fibrosa (IVF). She underwent Commando procedure owing to progression of heart failure.

[Resection of Left Upper Division by Uniportal Video-assisted Thoracoscopic Surgery for Congenital Bronchial Atresia:Report of a Case].

We report a case of congenital bronchial atresia resected by the uniportal thoracoscopic approach. A man in his 20s with congenital bronchial atresia diagnosed at 16 years of age visited our hospital with gradually worsening shortness of breath. Chest computed tomography revealed a localized emphysematous area that progressively increased in size, in the left upper lobe and the absence of a left upper division bronchus with mucoid impaction.

Huge Primary Cardiac Malignant Lymphoma in the Left Ventricle.

A 67-year-old man presented at the hospital with worsening exertional dyspnea. Echocardiography showed a tumor in the left ventricle (approximately 35 × 48 mm) that protruded into the left atrium and left ventricular outflow tract during systole. These findings suggested a high risk of sudden death resulting from aortic valve obstruction or tumor embolism.

Combined therapy using interventional radiology and surgical management for a ruptured pseudoaneurysm of the iliac artery: A case report.

Introduction: An optimal treatment strategy for a ruptured pseudoaneurysm of the iliac artery must necessarily control bleeding and prevent ischemia in the ipsilateral lower extremity.

Presentation Of Case: A 69-year-old man underwent resection of a metastatic lymph node from rectal cancer, which had invaded the sigmoid colon, the left internal iliac artery and vein, and his left ureter. The metastatic lymph node and the organs it invaded were resected together.

Pseudoaneurysm rupture after acute Type A dissection repair: possible reaction to BioGlue.

A 45-year-old man with acute Type A aortic dissection underwent the ascending aorta replacement with BioGlue (CryoLife Europa, Guildford, Surrey, UK) for anastomotic reinforcement. Postoperatively, he developed descending aortic dilation, a giant mediastinal cyst, Henoch-Schonlein purpura and an anastomotic-site pseudoaneurysm rupture. A BioGlue-induced inflammatory reaction was likely, according to a positive patch test (delayed allergic reaction).

[Surgical Treatment of Right Atrial Malignant Tumor Thrombus Under Deep Hypothermia with Intermittent Circulatory Arrest;Report of Two Cases].

Right atrial tumor thrombus is rare in patients with visceral malignant tumors and can cause right heart failure or sudden death. We present 2 cases of right atrial tumor thrombus treated under deep hypothermic intermittent circulatory arrest (DHICA). A 45-year-old man with right heart failure was diagnosed with right renal cancer extending to the right atrium.

[Effect of Ultra-fast-track Extubation in Cardiovascular Surgery].

Fast-track surgery has been widely implemented and allows such immediate extubation as in the operating room(OR). We retrospectively investigated the effect of routine ultra-fast-track(UFT) surgery extubating in the OR in patients undergoing cardiovascular operations. Among 333 consecutive patients, 224 (67.

[Leaflet Augmentation with an Autologous Pericardial Patch for Severe Functional Tricuspid Regurgitation].

An 85-year-old man, who had developed right-sided heart failure associated with isolated severe tricuspid regurgitation (TR), was referred to our institution to undergo cardiac surgery. Preoperative echocardiography revealed tricuspid annular dilatation and leaflet tethering, resulting in severe TR. The anterior leaflet was detached from the annulus with 1.

[Stuck valve detected during aortic valve replacement; report of a case].

Aortic valve replacement, ascending aorta replacement and coronary artery bypass grafting were performed in a 61-year-old woman with aortic stenosis, ascending aortic aneurysm, and angina pectoris. However, immediately after surgery, transient hypotension and pulmonary hypertension repeated every few beats.Transesophageal echocardiography revealed a stuck valve, and reimplantation was carried out.

Surgical procedure for coronary artery ectasia associated with saccular fistula.

Echocardiography of a 60 year-old woman with a three-year history of heart murmur revealed a coronary artery fistula. Coronary angiography indicated right coronary artery ectasia and fistula. The pulmonary-to-systemic blood flow ratio was 1.

Ratio of preoperative atrial natriuretic peptide to brain natriuretic peptide predicts the outcome of the maze procedure in mitral valve disease.

Background: Although the maze procedure is an established surgical treatment for eliminating atrial fibrillation (AF), its efficacy in patients with mitral valve disease has remained unsatisfactory. A useful predictive marker for the outcome of the maze procedure is needed. The aim of this study was to investigate whether the preoperative ratio of atrial natriuretic peptide (ANP) to brain natriuretic peptide (BNP) reflects atrial fibrosis and can be used to predict the maze procedure outcome in patients with mitral valve disease.

Mitral valve repair in patient with absent right superior vena cava in visceroatrial situs solitus.

We report on a 74-year-old woman with an absence of right superior vena cava in visceroatrial situs solitus who underwent mitral valve plasty for severe mitral regurgitation. Preoperative three-dimensional computed tomography revealed an absent right and persistent left superior vena cava that drained into the right atrium by way of the coronary sinus. Perioperaively, placement of pulmonary artery catheter, site of venous cannulation, and management of associated rhythm abnormalities were great concern.

[Surgical case of severe coronary artery obstructive disease with a giant coronary aneurysm; report of a case].

Coronary aneurysms in adults are rare. The natural history of such coronary aneurysms is unknown. Surgical treatment is often concomitant with the treatment of obstructive coronary lesions.

Staged surgical repair for extensive cardiovascular damage by syphilis.

A 45-year-old man had aortic regurgitation with a syphilitic true aneurysm of the ascending to transverse arch aorta and a descending aortic aneurysm from chronic Stanford type B aortic dissection. After antibiotic therapy, two-staged surgical repair was performed and there has been no evidence of recurrence in 12 months since the second stage. We describe the successful management of extensive cardiovascular syphilitic damage.

Secondary omental and pectoralis major double flap reconstruction following aggressive sternectomy for deep sternal wound infections after cardiac surgery.

Background: Deep sternal wound infection after cardiac surgery carries high morbidity and mortality. Our strategy for deep sternal wound infection is aggressive strenal debridement followed by vacuum-assisted closure (VAC) therapy and omental-muscle flap reconstrucion. We describe this strategy and examine the outcome and long-term quality of life (QOL) it achieves.

Simple geometrical infarct exclusion technique with a single patch for postinfarction ventricular septal perforation.

Six consecutive patients underwent emergency surgical repair of a postinfarction ventricular septal perforation. The principle of this technique is a simple three-dimensional repair with a nontailored square patch beforehand, which provides an adequate-sized pouch and prevents dehiscence of the patch being caused by excessive tension on the suture line. It also prevents a residual shunt.

Impact of intraoperative transesophageal echocardiography in cardiac and thoracic aortic surgery: experience in 1011 cases.

Background: Although intraoperative transesophageal echocardiography (IOTEE) has been widely used in cardiovascular surgery, the exact incidence of abnormalities detected by IOTEE in each type of surgical procedure is still unclear. The aim of this study was to review our experiences of IOTEE, in patients who underwent different types of cardiovascular surgery and to evaluate the clinical usefulness of IOTEE.

Methods And Results: Our database of 1011 consecutive patients, who underwent cardiovascular surgery and IOTEE monitoring was reviewed.

Identification of risk factors related to poor angiogenic potency of bone marrow cells from different patients.

Background: Therapeutic angiogenesis induced by the implantation of autologous bone marrow-derived cells has been used for the treatment of ischemic diseases. However, as the outcomes of cell implantation obviously vary among patients, it is essential to identify patients that would benefit the most from this treatment.

Methods And Results: We collected clinical and laboratory data from 25 patients scheduled to undergo sternotomy for various surgical procedures.

Ischemic pre-conditioning enhances the mobilization and recruitment of bone marrow stem cells to protect against ischemia/reperfusion injury in the late phase.

Objectives: The aim of this study was to investigate whether the mobilization and recruitment of bone marrow stem cells (BMSCs) contribute to cardioprotection in the late phase after ischemic pre-conditioning (IPC).

Background: IPC is an innate phenomenon in which brief exposure to sublethal ischemia provides tissue protection from subsequent ischemia/reperfusion (I/R) injury. A delayed cardioprotection also occurs after IPC, but the precise mechanism is unclear.

Computed tomographic angiography to evaluate the right gastroepiploic artery for coronary artery bypass grafting.

Objective: The right gastroepiploic artery (RGEA) is widely used as an in situ arterial graft for coronary artery bypass grafting (CABG); however, it is impossible to measure an RGEA or check for calcification or stenosis and assess its suitability as a graft before angiography or harvest. We evaluated the accuracy of preoperative three-dimensional computed tomographic angiography (3D-CTA) for assessing the suitability of RGEAs for CABG.

Method: We used 4-channel multidetector-row computed tomography with intravenous contrast medium.

Direct observation and image-based simulation of three-dimensional tortuous crack evolution inside opaque materials.

We present a combined novel methodology to study the three-dimensional complex geometry of a tortuous crack and identify the essential features of the crack and its propagation inside a heterogeneous material. We find that some severe damage events occur unexpectedly below a local mode-I crack within the sample; we realize that the severe plastic zone of the local mode-I crack is shifted down by another unseen crack segment hidden behind, which is responsible for the unusual damage phenomenon observed. We also find that the crack grows fast at some locations but slowly at some other locations along the crack front; we recognize that the crack-tip fields are reduced by neighboring hidden crack segments, which accounts for the retarded propagation of some part of the crack front.

Pravastatin improves remodeling and cardiac function after myocardial infarction by an antiinflammatory mechanism rather than by the induction of angiogenesis.

Background: Recent studies have reported that the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (or statins) can improve angiogenesis. Using an acute infarction model, we examined the therapeutic merit of statins on angiogenesis, alone and in combination with cell-based therapy.

Methods: Zucker fatty rats, a strain characterized by obesity, hyperglycemia, and hyperlipidemia, were used for this study.

Cytokines produced by bone marrow cells can contribute to functional improvement of the infarcted heart by protecting cardiomyocytes from ischemic injury.

It is well known that the implantation of bone marrow mononuclear cells (BM-MNCs) into ischemic hearts can induce angiogenesis and improve cardiac function after myocardial infarction, but the precise mechanisms of these actions are unclear. We hypothesize that the cytokines produced by BM-MNCs play a key role in this cell-based therapy. BM-MNCs from rats were cultured under normoxic or hypoxic (1% O2) conditions for 24 h, and then supernatants were collected for study.