[Early and Late Outcomes of Valve Surgery in Active Infective Endocarditis Patients with Cerebral Complications].

We carried out a retrospective evaluation of the early and late outcomes of valve surgery for acute endocarditis patients with cerebrovascular disease. Between January 2002 and August 2014, a total of 17 patients (early group, n=10;delayed group, n=7) underwent valve surgery with or without an additional procedure. Craniotomy was performed in 1 patient in the early group and 2 patients in the delayed group before valve surgery.

Early and Late Outcomes of Aortic Valve Replacement with Aortic Annular Enlargement: A Propensity Analysis.

Objectives Early and late outcomes were evaluated in Japanese patients undergoing aortic valve replacement (AVR) with or without aortic annular enlargement (AAE). Propensity matching adjusted for baseline differences in this study. Methods Between January 2001 and July 2014, 589 patients underwent AVR for aortic stenosis.

Early and late outcomes of AVR with aortic annular enlargement in octogenarian.

Objective: There is no clear consensus on the procedures for octogenarians with a small aortic annulus who require aortic valve replacement (AVR). We evaluated surgical results in octogenarians who underwent AVR with aortic annular enlargement, Nicks procedure, for aortic stenosis with a small aortic annulus.

Methods: Between January 2001 and March 2014, 131 octogenarian patients were treated at our institution.

Heart failure caused by renal arteriovenous fistula with giant renal artery aneurysms.

We encountered an extremely rare case of a renal arteriovenous fistula (AVF) with 2 giant renal artery aneurysms (RAAs) in a 75-year-old woman who presented with congestive heart failure and pulmonary hypertension. A chest x-ray revealed cardiomegaly with a cardiothoracic ratio (CTR) of 65%. Computed tomography showed 2 giant left RAAs (diameter, 45 × 40 mm(2) and 75 × 60 mm(2)) associated with an AVF, dilated inferior vena cava, and dilated pulmonary arteries.

Descending aorta-external iliac artery bypass for middle aortic syndrome.

We encountered a surgical case of middle aortic syndrome (MAS) in a 56-year-old man who had resistant hypertension. Computed tomography showed severe stenosis of the abdominal aorta from below the superior mesenteric artery to above the inferior mesenteric artery. Although bilateral renal artery stenosis was confirmed, renal function was within normal limits.

[Early and mid-term outcomes of aortic valve replacement for aortic stenosis in hemodialysis patients].

We carried out a retrospective evaluation of the early and mid-term outcomes of aortic valve replacement (AVR) for aortic stenosis in hemodialysis patients. Between 2004 and 2012, a total of 40 dialysis patients underwent AVR with or without an additional procedure. Hemodialysis was performed routinely the day before and during the operation.

[Simplified aortic root replacement in the era of complex operation].

Objectives: The purpose of the present study is to assess the clinical results of aortic root replacement using the Carbo-Seal composite graft( CS) compared with the other type of homemade composite grafts. Fifty-nine patients who underwent aortic root replacement between January 1998 to December 2010 were retrospectively analyzed. Twenty-six received homemade composite graft( group 1;1998 ~ 2005) and 33 received CS( group 2;2005 ~ 2010).

[Single-stage procedure for multiple dissected aortic aneurysms with coagulopathy in an elderly patient].

An 86-year-old man was admitted for abdominal pain. Dissected descending thoracic aortic aneurysm and infrarenal abdominal aortic aneurysm were observed under computed tomographic (CT) scan. Hematologic studies revealed low platelet count and an increase in fibrin degradation products (FDP), and disseminated intravascular coagulation( DIC) associated with dissecting aortic aneurysm was highly suspected.

Evolving J waves prior to ventricular fibrillation postoperative coronary bypass.

A 74-year-old man without history of ventricular arrhythmias underwent coronary bypass surgery for 3-vessel disease. On the 4th postoperative day, he developed ventricular fibrillation (VF). His monitored ECG showed no elevation of the ST-segment and no prolongation of QT interval, but evolving J waves prior to VF were shown.

A modified infarct exclusion repair of posterior postinfarction ventricular perforation: triple-patch technique for postinfarction ventricular septal perforation in 2 female patients.

We describe a new technique for the early surgical repair of a posterior postinfarction ventricular septal perforation (VSP) in two consecutive female patients. The occurrence of a posterior VSP is rare, and its repair is technically difficult because the posteromedial papillary muscle is located adjacent to the intraventricular septum. This modification appears to prevent leaks to the right ventricle through the VPS with a single direct patch and the use of two equine pericardial patches to form a single endocardial pouch.

A case of abdominal aortic aneurysm associated with L-shaped crossed-fused renal ectopia.

Genitourinary anomalies are a tremendous challenge for the vascular surgeon, especially when dealing with an abdominal aortic aneurysm. We report a case of crossed-fused renal ectopia, a rare anomaly accompanied by abdominal aortic aneurysm. Bilateral renal arteries and one aberrant artery from the right common iliac artery supply the ectopic kidney.

[Assessment of pulse wave velocity as a marker of post-operative cardiovascular risk in off-pump coronary artery bypass grafting patients].

Objective: Pulse wave velocity is widely used as an index of arterial stiffness. The aim of this study is to assess the usefulness of pulse wave velocity as a risk factor in patients who underwent off-pump coronary artery bypass grafting (CABG) [OPCAB].

Methods And Results: Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV) and the ratio of patient's baPWV to age-matched normal value was calculated in 90 OPCAB patients.

Severe aortic regurgitation resulting from a downward displacement of anterior aortic annulus and fibrous strands in the bicuspid aortic valve.

Aortic regurgitation is occasionally caused by fibrous strands and more rarely by downward displacement of the aortic annulus. The present report describes an 18-year-old man with aortic regurgitation resulting from an anterior-posterior type of bicuspid aortic valve with fibrous strands and downward displacement of the anterior aortic annulus. A pair of fibrous strands at the anterior cusp of the bicuspid valve lifted the free margin of the cusp, and the anterior cusp originated from the intraventricular septum.

[Exposure for harvesting gastroepiploic artery graft].

We present out technique for harvesting the gastroepiploic artery (GEA). We use a Universal Stabilizer Arm and an assistant attachment to push the liver against the diaphragm, giving en enough working space to harvest the graft. Between January and December 2007, 99 isolated coronary artery bypass grafting (CABG)s were performed, and in 36 (36.

Large saphenous vein graft aneurysm with a fistula to the right atrium.

We report on a case of a 65-year-old man who was admitted for anterior chest pain on effort. He had received coronary artery bypass grafting (CABG) surgery 20 years ago with saphenous vein grafts (SVGs) to the left anterior descending artery (LAD) and right coronary artery (RCA). An angiography demonstrated large aneurysmal dilatation of both grafts and a fistulous communication between the middle portion of the right SVG and the right atrium (RA).

[Off-pump versus conventional coronary artery bypass grafting in octogenarians].

Coronary artery bypass grafting (CABG) in elderly patients is becoming increasingly common. From January 1996 to February 2002, 836 patients underwent CABG in our hospital, of whom 33 patients (3.9%) were aged 80 years or older.

Choledochal cyst and duodenal atresia: a rare combination of malformations.

A rare case of congenital duodenal atresia (DA) associated with a choledochal cyst (CC) is reported. At 38 weeks of gestation, a 1,610-g girl was born by cesarean section with a prenatal diagnosis of congenital DA. After the disease was confirmed by radiographs, she underwent a duodenoduodenostomy for complete separation of the duodenum with an annular pancreas.

Adventitial cystic disease of the femoral vein: report of a case.

Adventitial cystic disease (ACD) of the veins is a rare phenomenon, and ACD of the femoral vein is particularly difficult to diagnose due to the similarity in symptoms to those of deep vein thrombosis. We report a case of ACD of the femoral vein, which was initially misdiagnosed as deep vein thrombosis, in a 48-year-old woman who presented with a painless swelling in her right lower leg. The extensive cystic involvement of the femoral vein was completely resected and reconstructed with an 8-mm ringed polytetrafluoroethylene vascular graft with good results.

Aneurysm of the ductus diverticulum in adults: the diagnostic value of three-dimensional computed tomographic scanning.

Ductus arteriosus aneurysm is rare in adults and preoperative diagnosis has not been usually done. We report 2 cases of adult type ductus arteriosus aneurysm. In both cases, 3D computed tomographic scanning showed a saccular aneurysm originating from the distal aortic arch toward the left pulmonary artery, which had a notching in the orifice of the aortic side.

Gene therapy for myocardial angiogenesis: with direct intramuscular gene transfer of naked deoxyribonucleic acid encoding vascular endothelial growth factor and cell transplantation of vascular endothelial growth factor transfected H9c2 myoblast.

Objectives: We studied the therapeutic potential of ex vivo vascular endothelial growth factor (VEGF) gene-transduced H9c2 cell transplantation for myocardial neovascularization.

Methods: The left ventricular free wall of adult Sprague-Dawley rats was cryodamaged. Two weeks after, naked plasmid encoding VEGF (VEGF1: 1 1microg/100 microl, VEGF5: 5 microg/100 microl), or VEGF transfected H9c2 myoblasts (0.

Choledochal cyst and duodenal atresia: a rare combination.

A rare case of congenital duodenal atresia (DA) associated with a choledochal cyst (CC) is reported. At 38 weeks of gestation, a 1,610-g girl was born by cesarean section with a prenatal diagnosis of DA. After the disorder was confirmed by X-ray, she underwent a duodenoduodenostomy for a complete separation of the duodenum with an annular pancreas.