Endovascular repair for abdominal aortic aneurysm followed by type B dissection.

An 86-year-old man with an abdominal aortic aneurysm was diagnosed with type B aortic dissection accompanied by a patent false lumen that started at the distal arch of the thoracic aorta and terminated at the left common iliac artery. Meticulous preoperative assessment detected 3 large intimal tears in the descending aorta, abdominal aortic aneurysm, and left common iliac artery. We performed single-stage thoracic and abdominal endovascular aneurysm repair and concomitant axillary-axillary bypass.

[Ascending-to-abdominal Aorta Bypass under Percutaneous Cardiopulmonary Support for Lower Body Organ Malperfusion Secondary to Acute Type B Aortic Dissection; Report of a Case].

A 66-year-old man was admitted to our hospital because of uncomplicated Stanford B acute aortic dissection. Antihypertensive therapy was initially started; however, he suddenly experienced vomiting, diarrhea, anuria, and paraparesis on the fourteenth hospital day. Contrast-enhanced computed tomography (CECT) revealed expansion of the false lumen and severe stenosis of the true lumen at the distal aortic arch, which caused malperfusion syndrome of the lower body.

Real chimney technique for total debranching of supra-aortic trunks.

Side-clamping of the ascending aorta is an indispensable technique for proximal anastomosis in total debranching of supra-aortic trunks and in endovascular aneurysm repair for arch aneurysm. However, this procedure may lead to the dislodging of multiple plaques and to clamp injury of the ascending aorta. We developed a clampless technique to achieve proximal anastomosis between the ascending aorta and an artificial graft used for total debranching of supra-aortic trunks.

Superior vena cava syndrome caused by a swollen absorbable haemostat after repair of ischaemic mitral regurgitation.

Surgicel, an absorbable haemostat, is widely used in cardiovascular surgery. An 81-year-old woman, who was diagnosed with ischaemic mitral regurgitation, underwent mitral valve plasty and coronary artery bypass grafting. On postoperative day two, her superior vena cava (SVC) pressure gradually rose to 38 mmHg and she developed low output syndrome.

[Aortic valve-sparing operation for chronic dissecting aneurysm of the sinus of valsalva associated with redissection in a young woman who experienced out-of-hospital cardiac arrest].

A 38-year-old woman was admitted to our hospital because she experienced cardiopulmonary arrest at her wedding;her cardiac beats were resumed 20 min after cardiopulmonary resuscitation performed by her relatives and hotel staffs. Enhanced computed tomography revealed acute aortic redissection in chronic dissecting aneurysm in the right sinus of Valsalva, which was believed to have occurred in the 4th month of pregnancy 2 years before. Echocardiography showed moderate aortic regurgitation.

[Surgical treatment of traumatic aortic rupture].

This report focuses on 3 cases of traumatic aortic dissection or rupture at the isthmus. We selected 3 different methods of treatment. In the 1st case, we performed an emergency operation with graft replacement of the proximal descending aorta.

Hypogastric and lumbar artery bypasses to restore gluteal perfusion after open aortoiliac aneurysm repair.

Gluteal ischemia is a rare but often fatal complication after open abdominal aortic aneurysm repair. A 67-year-old man with an aortoiliac aneurysm presented with a patent right internal iliac artery (IIA) and an occluded left IIA. A bifurcated graft replacement was performed with both limbs of the graft anastomosed to the external iliac arteries.

Early outcomes of chordal reconstruction for posterior mitral leaflet prolapse.

We retrospectively reviewed 16 patients (7 men and 9 women, aged 36 to 77 years) who underwent mitral valve repair with chordal reconstruction for isolated posterior mitral leaflet prolapse. Preoperative echocardiography demonstrated moderate mitral regurgitation in 1, and severe regurgitation in 15. We routinely used expanded polytetrafluoroethylene sutures as artificial chords, and ring annuloplasty was performed in all cases (mean ring size, 30 ± 2 mm).