The Novel Technique of Sternal Closure With Absorbable Mesh for Osteoporotic Patients.

After a median sternotomy, sternal instability can result in sternal infection. The usual sternal closure with stainless steel wires may result in sternal instability, especially in osteoporotic patients. An absorbable mesh (Super-FIXSORB-MX®40, Takiron Co Ltd, Osaka, Japan) for reinforcing the sternum has become commercially available.

A Safe Technique for Using an Enclose II Anastomosis Assist Device During Off-Pump Coronary Bypass.

Several proximal anastomosis devices have been developed to facilitate the creation of a clampless, hand-sewn coronary artery bypass-to-ascending aorta anastomosis. An Enclose II anastomosis assist device (Novare Surgical Systems, Cupertino, CA) is a device commonly used for this purpose. We demonstrate a new, easy, and safe technique for cutting the aortic wall and making a punch hole over the aorta.

Clinical efficacy of thrombus aspiration on 5-year clinical outcomes in patients with ST-segment elevation acute myocardial infarction undergoing percutaneous coronary intervention.

Background: Adjunctive thrombus aspiration (TA) during primary percutaneous coronary intervention (PCI) was reported to promote better coronary and myocardial reperfusion. However, long-term mortality benefit of TA remains controversial. The objective of this study is to investigate the clinical impact of TA on long-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI.

Nine-year experience of recurrent anastomotic pseudoaneurysms after thoracoabdominal aneurysm graft replacement in a patient with Behçet disease.

A 47 year-old woman with Behçet disease presented with back pain. Computed tomography showed an extent IV thoracoabdominal aneurysm. Graft replacement with reconstruction of all visceral arteries was performed.

A novel chest packing technique for intractable bleeding after open heart surgical procedures.

Intractable bleeding after cardiac surgical procedures is a life-threatening complication. In most cases, the main bleeding site is present in the retrosternal space, not the pericardial space. Packing the chest may be a useful technique for achieving hemostasis.

Pancreaticoduodenal artery aneurysm involving papilla of vater successfully treated with endovascular approach despite intraoperative rupture.

An 81-year-old woman presented with dizziness and nasal bleeding. Gastrointestinal fiberscopy (GIF) showed a pulsatile aneurysm in the duodenum, and that the orifice of the papilla of Vater was involved. Three-dimensional computed tomography imaging showed an unruptured aneurysm in the pancreatic duodenal arcade.

Right ventricular perforation caused by pulmonary artery catheter three days after insertion in a patient with acute pulmonary embolism.

A 68 year-old man presented with dyspnoea and chest pain. Computed tomography showed a massive bilateral pulmonary embolism. A 7.

Cardiac xanthoma originating from primary cardiac lymphoma.

A 67-year-old man presented with dyspnea, general fatigue, and leg edema. Echocardiography demonstrated a large pericardial effusion with a 5 cm × 3 cm, dense hetero-echogenic tumor in the right atrium. At the time of the operation, the tumor was composed of soft but tough, yellowish, smaller smooth processes, and fragile, reddish, bigger nodules.

[Late mediastinal hematoma presenting cardiac tamponade after re-do off-pump coronary artery bypass grafting in octogenarian; report of a case].

An 86-year-old man was admitted to our hospital with angina due to the instent restenosis. He had a history of coronary artery bypass grafting( CABG). Re-do off-pump CABG was performed.

Aortic bleeding one week after removal of an intraoperative epicardial temporary pacing wire.

A 56-year-old man had left nephrectomy and resection of a cavoatrial tumor thrombus under a cardiopulmonary bypass assist for left renal cell carcinoma. An intraoperative bipolar temporary epicardial atrial pacing wire was removed on postoperative day 8. The patient collapsed on postoperative day 15.

A dental mirror provides excellent exposure of the right coronary artery during cardioplegia.

It sometimes is very difficult to achieve good exposure of the orifice of the right coronary artery through a typical aortotomy when inserting the cannula for the selective antegrade administration of cardioplegic solution to the right coronary artery. A simple technique of exposing the orifice of the right coronary artery using a dental mirror is described.

Deformities of pulmonary and aortic annulus 42 years after repair of tetralogy of Fallot.

We report an extremely rare case of deformity of the pulmonary sinus of Valsalva with pulmonary valvular stenosis 42 years after a pulmonary annular-sparing operation for tetralogy of Fallot. Aortic regurgitation with deformity of the sinus is also noted. At the previous operation, the right ventricular outflow tract was augmented by a prosthetic subvalvular patch.

Slime method: modified hemostatic technique of fibrin glue in major cardiothoracic surgery.

Surgical bleeding from anastomoses due to systemic heparinization or prolonged extracorporeal circulation, which is more effectively controlled with topical hemostatic agents than with sutures, has been one of the major problems in cardiovascular surgery. We describe a novel hemostatic technique using fibrin glue. Briefly, the two components of fibrinogen and thrombin solutions are mixed and put over the bleeding point immediately after the glue has become a viscous gel.

Early experience with combined use of two plant-based hemostatic agents.

Bleeding from anastomoses, which is more effectively controlled with topical hemostatic agents than with sutures, has been one of the major problems in cardiovascular surgery. We describe a novel hemostatic technique using microporous polysaccharide hemosphere (Arista; Medafor Inc, Minneapolis, MN) in conjunction with a patch of oxidized regenerated cellulose (Nu-Knit; Ethicon, Johnson & Johnson, Somerville, NJ). Both of them are plant-based products and eliminate the risk of animal-borne or human-borne contaminants and have bactericidal advantages.

The sinker technique: a simple, effective technique for exposing coronary arteries in off-pump surgery.

Exposure and stabilization of coronary arteries in the circumflex and right territory is essential for off-pump coronary artery bypass grafting. A new, easy technique of exposing and stabilizing coronary arteries using a sinker (weight) hung on a silicone elastomer suture for hemostasis from the arteriotomy is described.

Apicoaortic conduit for the dilated phase of hypertrophic obstructive cardiomyopathy as an alternative to heart transplantation.

We describe a 16-year-old suffering from the dilated phase of mid-ventricular obstructive hypertrophic cardiomyopathy with end-stage heart failure. Her plasma type-B natriuretic peptide level exceeded 8000 pg/ml, and she refused heart transplantation. She underwent an apicoaortic valved conduit as an alternative to the heart transplant procedure.

Mitral valve annular dilatation caused by left atrial myxoma.

We report a case of mitral valve annular dilatation caused by a large left atrial myxoma. A 69-year-old woman presented in pulmonary oedema. She was found to have a large left atrial myxoma prolapsing into the left ventricle in diastole causing severe functional mitral stenosis.

Misplacement of hemodialysis catheter to brachiocephalic artery required urgent sternotomy.

Objective: The cuffed, tunnelled hemodialysis catheterization through the right internal jugular vein is widely used for mid- to long-term hemodialysis for patients with renal failure. The purpose of this report is to address the potentially lethal complication among the variety of surgical problems in conjunction with this procedure. The case also illustrates the potential pitfalls in the management of renal failure.

Relationship of connexin43 expression to phenotypic modulation in cultured human aortic smooth muscle cells.

Transition of arterial smooth muscle cells from the contractile to the synthetic phenotype in vivo is associated with up-regulation of the gap-junctional protein, connexin43 (Cx43). However, the role of increased Cx43 expression in relation to the characteristic features of the synthetic phenotype - altered growth, differentiation or synthetic activity - has not previously been defined. In the present study, growth was induced in cultured human aortic smooth muscle cells by treatment with thrombin and with PDGF-bb; growth arrest was induced by serum deprivation and contact inhibition.

Aortic valve lipoma.

Cardiac lipoma (especially on the aortic valve) is extremely rare. We report a patient suffering from shortness of breath, chest pain, and recent presyncopal episodes who was found to have a mass on the aortic valve with mild aortic regurgitation. The patient had an uneventful aortic valve replacement.