Surgical Treatment of Coronary to Pulmonary Artery Fistulas in Adults.

Coronary to pulmonary artery fistulas (CPAFs) are abnormal communications between the coronary and pulmonary arteries. They are an uncommon congenital heart disease and usually remain asymptomatic until later in life. However, there is no consensus on their management.

Effectiveness and long-term outcomes of surgical intervention for constrictive epicardium in constrictive pericarditis.

Objective: Epicardial resection is considered effective in patients with constrictive pericarditis accompanied by epicardial constriction, but few publications have evaluated its long-term outcomes. The study objective was to evaluate early and late results of epicardial resection.

Methods: A total of 22 patients with pericardiectomy for constrictive pericarditis were treated at our institution between 1989 and 2016.

[Coronary-pulmonary Artery Fistula in a Hemodialysis Patient].

We report a case of coronary-pulmonary artery fistula in a hemodialysis patient treated surgically. A 47-year-old man was admitted with chest pain and exertional dyspnea that progressively worsened over the previous 2 months. He had a history of end-stage renal disease and has been on hemodialysis for 5 years.

[Unroofed Coronary Sinus in an Adult; Report of a Case].

Unroofed coronary sinus( UCS) is a rare cardiac anomaly and the most uncommon type of atrial septal defect. It is rarely diagnosed by only echocardiography prior to surgery. We herein report a case of UCS (partially unroofed terminal portion) without persistent left superior vena cava that was precisely diagnosed by cardiac multi-detector low computed tomography (MDCT).

[Coronary artery bypass grafting in a patient with chronic bird fancier's lung].

Acute exacerbation is a devastating and fatal event of hypersensitivity pneumonitis. We report an 80-year-old man with chronic bird fancier's lung which acutely exacerbated after off-pump coronary artery bypass grafting. Our perioperative management included avoidance of inhalation of high concentration oxygen, administration of neutrophil elastase inhibitor, and long-term administration of antibiotics.

[IgG4-related constrictive pericarditis treated by waffle procedure].

A 59-year-old man was admitted for evaluation of short of breath and bilateral leg edema that had progressively worsened over 3 months. Chest computed tomography revealed marked pericardial thickening. Cardiac echocardiography revealed right heart volume load and diastolic dysfunction.

[Quadricuspid aortic valve associated with rapidly progressive aortic stenosis during chronic hemodialysis; report of a case].

A 70-year-old man was referred to our department for surgical treatment for aortic valve stenosis. He was diagnosed with aortic regurgitation 30 years ago, but he was asymptomatic at that time. Ten years ago, chronic hemodialysis was instituted for diabetic nephropathy.

Venous reconstruction with radial artery harvesting: Domino method.

We describe two cases of venous reconstruction after radial artery (RA) harvesting for coronary artery bypass grafting (CABG). Patient 1, a 70-year-old man who underwent CABG 16 years earlier, presented with acute posterolateral myocardial infarction caused by total occlusion of the saphenous vein graft (SVG). RA grafting was considered ideal, but he had bilateral hypoplastic ulnar arteries.

Characteristics of revascularization treatment for arteriosclerosis obliterans in patients with and without hemodialysis.

Background: Limb ischemia is a major complication in patients who are receiving hemodialysis (HD). In this study, distinctive features and factors affecting the outcome of HD patients with limb ischemia are identified.

Methods And Results: One hundred and eighty consecutive symptomatic limb ischemic patients who were or were not receiving HD and who successfully underwent surgical bypass grafting (bypass, n=75) or endovascular angioplasty (percutaneous transluminal angioplasty (PTA), n=105) were retrospectively compared at our hospital.

Infective endocarditis complicated with splenic abscess successfully treated with splenectomy followed by double valve replacement.

Splenic abscess (SA) is a rare complication of infective endocarditis (IE). A successful outcome lies with a choice between medical and surgical treatments. However, there is still insufficient evidence in the decision-making process.

[Long-term prognosis after coronary revascularization in patients with end-stage renal disease on dialysis: comparison of percutaneous coronary intervention and coronary artery bypass grafting].

Objectives: To investigate the optimal method of coronary revascularization in patients on dialysis.

Methods: We retrospectively analyzed 145 patients on dialysis who underwent percutaneous coronary intervention (PCI) (81 patients) or coronary artery bypass grafting (CABG) (64 patients). Survival and non-fatal cardiac event-free rates were compared between the two groups by the Kaplan-Meier method.

Left pneumonectomy for lung cancer after correction of contralateral partial anomalous pulmonary venous return.

We report the successful treatment of a 48-year-old man with left lung cancer and contralateral partial anomalous pulmonary venous return (PAPVR). He was found to have an abnormal shadow on a regular checkup. Sputum cytology revealed squamous cell carcinoma.

[Acute infective endocarditis].

Between January 1987 and June 2004, 65 patients with infective endocarditis underwent aortic and/or mitral surgery. Nine of these patients with active native valve endocarditis required emergency surgery. Indications for emergency operation were progressive congestive heart failure in 5 patients, systemic emboli in 2 patients and uncontrolled infection in 2 patients.

Multiple atherosclerotic aneurysms of the bilateral subclavian artery, aortic arch and abdominal aorta.

Subclavian artery aneurysms are relatively rare in comparison with other peripheral aneurysms. We report a 65-year-old woman with multiple atherosclerotic aneurysms of the subclavian artery, aortic arch saccular aneurysm and abdominal aortic aneurysm. Two-staged operations by which the infrarenal abdominal aorta was replaced first and median sternotomy extending to the supraclavicular space for the concomitant resection of bilateral subclavian as well as aortic arch aneurysm resulted in good results.

Resection of paraaortic lymph node metastasis of colon cancer with graft replacement.

The metastasis sites of colon cancer are the liver, lungs, bones, peritoneum, and lymph nodes. Lymph node recurrences, however, are seldom resected metachronously. We report here a case of en-bloc resection of paraaortic lymph node recurrence together with the invaded abdominal aorta, left kidney and ureter 4 years after curative resection of sigmoid colon cancer.

False aneurysm due to suture loosening after aortic arch replacement.

We describe a case of false aneurysm due to loosening of the anastomotic sutures 5 years after graft replacement for subacute type A aortic dissection. Leakage from the graft was controlled by tightening the suture slack indicating that suture loosening was the cause of the aneurysm. The mechanism was probably the progressive thinning of the edematous swollen aortic wall over the years causing the sutures to loosen.