Impact of Accessory Renal Artery Embolization on Renal Deterioration Under Endovascular Aortic Repair.

Objective: The optimal management strategy for patients with accessory renal arteries undergoing endovascular aortic repair is unclear. This study aimed to investigate the impact of accessory renal artery (aRA) embolization on postoperative renal deterioration and to identify the predictors of postoperative renal deterioration in patients who underwent endovascular aortic repair (EVAR).

Methods: A retrospective single-centre observational study was conducted at our hospital.

Reversed L-shaped incision for resection of a large azygos vein aneurysm: a case report.

Background: Azygos vein aneurysms are rare and asymptomatic in many cases. The management for these aneurysms is controversial, and there is no clear guideline or evidence-based threshold for surgical or interventional therapy.

Case Presentation: Herein, we report the case of a giant azygos vein aneurysm in a 78-year-old man that was treated with a reversed L-shaped incision.

Hemolytic anemia caused by kinked graft 6 months after aortic dissection repair.

Background: Clinically insignificant hemolytic anemia is occasionally a complication of prosthetic valve replacement. However, hemolysis related to kinked grafts is a very rare complication after central repair for acute aortic dissection.

Case Presentation: A 42-year-old man had undergone replacement of the ascending aorta and a root repair for type A aortic dissection 6 months previously.

Extreme Elevation of the Prothrombin Time-International Normalized Ratio due to a Probable Interaction between Warfarin and Flutamide.

Flutamide, a chemotherapeutic agent for prostate cancer, is known to enhance warfarin anticoagulation. However, not much is known about its pharmaceutical interaction. We herein report the case of a patient with an implanted pacemaker for atrial fibrillation with bradycardia who was on warfarin.

Efficacy of new multimodal preventive measures for post-operative deep sternal wound infection.

Background: Deep sternal wound infection (DSWI) is a critical complication of cardiovascular surgery. This study aimed to confirm the efficacy of new, multimodal preventive measures for post-operative DSWI.

Methods: From January 2008 to December 2012, 1240 patients underwent cardiovascular surgery via median sternotomy at our hospital.

Left Ventricular Outflow Tract Obstruction of Double Valve Re-Replacement Using Bioprosthesis.

We present a case of left ventricular outflow tract (LVOT) obstruction after double valve re-replacement with bioprostheses. A 72-year-old man, who had undergone double valve replacement (DVR) with bioprosthetic valves 9 years previously, underwent re-replacement of valves because of structural valve deterioration. However, owing to LVOT obstruction related to the bioprosthesis in the mitral position, acute pulmonary edema occurred immediately after surgery.

Pericardial Sandwich Technique for End-to-End Anastomosis of Artificial Graft.

End-to-end anastomosis between prosthetic grafts seems technically easy; however, bleeding from the needle hole or at the site of anastomotic discrepancy can be problematic. The pericardial sandwich technique helps to resolve this issue. The grafts are generally anastomosed to each other with a continuous suture, and a strip of autopericardium is sandwiched circumferentially between the two grafts.

Paralytic ileus as the first presentation in type A acute aortic dissection.

A 78-year-old female was referred to our hospital with a diagnosis of type A acute aortic dissection. There was a history of thrombosed aortic dissection six months prior and conservative management has been performed. Enhanced computed tomography showed type A acute aortic dissection with patent false lumen limited to the ascending aorta and ileus of the small intestine.

Pulmonary Valvuloplasty by Autologous Pericardium in a Patient with Active Infectious Endocarditis and Osler's Disease.

Osler's disease is a rare condition of autosomal dominant inheritance characterized by bleeding and telangiectasia of the skin and mucosal membranes. A few reports exist of open-heart surgery in patients with Osler's disease. Here, the case is presented of a successful pulmonary valvuloplasty using autologous pericardium to treat active infectious endocarditis of the pulmonary valve in a patient with Osler's disease.

Trans-Septal Approach for Hypertrophic Obstructive Cardiomyopathy.

Transaortic septal myectomy, known as Morrow's procedure, is a standard treatment for hypertrophic obstructive cardiomyopathy (HOCM). The case is described of a 58-year-old male patient who suffered a repetition of syncope due to HOCM, in whom septal myectomy was performed. As resection of the hypertrophied septum using Morrow's procedure was considered insufficient by palpation to release mitral regurgitation (MR) and systolic anterior motion of the mitral valve, the surgical approach was changed such that the right ventricular outflow tract and ventricular septum was incised.

Does the number of redo mitral valve replacements for structural valve deterioration affect early and late outcomes?: experience from 114 reoperative cases.

Background And Aim Of The Study: Whether the number of reoperative mitral valve replacements (MVRs) for structural valve deterioration (SVD) affects early or late survival is unclear. Hence, the aim of the present study was to investigate this issue.

Methods: A total of 114 consecutive patients (84 females, 30 males; mean age 63.

Late outcome of tricuspid annuloplasty using a flexible band/ring for functional tricuspid regurgitation.

Background: We assessed late outcome after tricuspid annuloplasty (TAP) using a flexible band or ring for functional tricuspid regurgitation (FTR).

Methods And Results: We reviewed 220 consecutive patients (mean age, 65.4±11.

Long-term outcomes of mitral valve repair with the Duran flexible ring.

Background: Mitral annuloplasty is a reliable mitral valve repair technique. There are two types of annuloplasy rings: the rigid ring and the flexible ring. This study sought to examine the long-term results of mitral valve repair using a Duran flexible ring.

The number of valves requiring surgery does not affect early and late survival in redo valvular surgery.

Objectives: The purpose of this study was to determine whether the number of operated valves affects early and late outcomes in redo valvular surgery.

Methods: We analysed 328 consecutive patients who underwent a total of 431 redo valvular surgeries from January 1990 to December 2010. The mean age was 61.

[Successful treatment of Candida albicans mediastinitis after open-heart surgery using vacuum-assisted closure device].

An 82-year-old man suffered from Candida albicans mediastinitis following emergency aortic valve replacement. After repeated debridement of the anterior portion of the mediastinum, we applied a vacuum assisted closure device with UrgoTul Absorb placed on the right ventricle. Despite relatively short-term application of this device, mediastinitis was cured in combination with transposition of the great omentum.

Persistent tricuspid regurgitation after tricuspid annuloplasty during redo valve surgery affects late survival and valve-related events.

Background: Long-term survival and incidence of late tricuspid regurgitation (TR) were studied in patients who underwent tricuspid annuloplasty (TAP) during redo valve surgery. METHODS AND RESULTS: We retrospectively analyzed 125 patients (mean age, 64.5±10.

Efficacy of Stentless Aortic Bioprosthesis Implantation for Aortic Stenosis with Small Aortic Annulus.

Background: In patients with small aortic annulus, sufficient size of stented aortic bioprosthesis cannot be implanted without additional procedures. In such cases, we use stentless aortic bioprosthesis to obtain sufficient effective orifice area. In this study, we investigated long-term impact of stentless aortic bioprosthesis on clinical outcomes, compared with stented aortic bioprosthesis.

Redo valvular surgery in elderly patients aged > 75 years.

Background And Aim Of The Study: Very few data exist regarding the clinical outcome of redo valvular surgery in patients aged > 75 years.

Methods: A retrospective analysis was conducted of 42 consecutive patients (mean age 78.3 years) who had undergone redo valvular surgery between January 1991 and December 2010, and who had been followed up for a mean of 2.

Long-term outcomes after mitral valve repair for degenerative mitral regurgitation with persistent atrial fibrillation.

Background: Atrial fibrillation (AF) adversely affects surgical outcomes of mitral valve surgery. However, the long-term impact of Maze procedure has not been clear yet.

Patients And Methods: We retrospectively investigated 159 patients who underwent mitral valve repair for degenerative mitral regurgitation with persistent AF between 1991 and 2010.

Mitral valve repair for severe organic mitral regurgitation in the elderly.

Background And Aim Of The Study: Although mitral valve repair has become the standard surgical procedure for mitral regurgitation (MR), the procedure does not necessarily apply to elderly patients aged > 75 years because of high morbidity and mortality.

Methods: A total of 104 patients aged > 75 years who underwent mitral valve repair between January 1991 and December 2011 was reviewed retrospectively. The mean age was 78 years, and the mean follow up was 3.

The impact of preoperative and postoperative pulmonary hypertension on long-term surgical outcome after mitral valve repair for degenerative mitral regurgitation.

Purpose: The aim of this study is to elucidate the impact of preoperative and postoperative pulmonary hypertension (PH) on long-term clinical outcomes after mitral valve repair for degenerative mitral regurgitation.

Methods: A total of 654 patients who underwent mitral valve repair for degenerative mitral regurgitation between 1991 and 2010 were retrospectively reviewed. Patients were divided into PH(+) group (137 patients) and PH(-) group (517 patients).

Surgical revasculization for pediatric renovascular hypertension caused by fibromuscular dysplasia.

A 4-year male was referred to our hospital for high fever. Incidentally, abnormally high blood pressure was detected. A thorough examination revealed severe stenosis at the origin of two left renal arteries and elevation of plasma renin activity as well as aldosterone level.

Long-term outcomes of tricuspid annuloplasty for functional tricuspid regurgitation associated with degenerative mitral regurgitation: suture annuloplasty versus ring annuloplasty using a flexible band.

Purpose: We investigated the long-term outcomes of suture/ring tricuspid valve annuloplasty for functional tricuspid regurgitation associated with degenerative mitral regurgitation.

Methods: We retrospectively reviewed patients who underwent flexible ring tricuspid valve annuloplasty (n = 120) or suture tricuspid valve annuloplasty (n = 42) for functional tricuspid regurgitation concomitant with surgery for degenerative mitral regurgitation (mean follow-up duration, 5.3 ± 5.