Cardiac calcified amorphous tumor in a hemodialysis patient.

We present a case of cardiac calcified amorphous tumor, a rare intracardiac non-neoplastic tumor, in a hemodialysis patient. A 72-year-old woman with no history of thromboembolic, malignant, or inflammatory disease presented with dyspnea. Echocardiography revealed a highly echoic, slightly mobile mass with an acoustic shadow originating from the mitral subvalvular apparatus, extending to the left ventricular outflow tract.

A Case of Adventitial Cystic Disease of the Popliteal Artery Progressing Rapidly after Percutaneous Ultrasound-guided Aspiration.

Adventitial cystic disease is a rare non-atherosclerotic vascular disease. We report a 36-year-old man with right intermittent claudication by adventitial cystic disease. computed tomography (CT) and magnetic resonance imaging (MRI) revealed an ovoid cystic mass compressing the right popliteal artery and causing severe stenosis of the lumen.

A huge pseudoaneurysm of the left ventricle after simple gluing of an oozing-type postinfarction rupture.

Objectives: Left ventricular free wall rupture is a major complication after myocardial infarction. Simple gluing for a rupture site, without a cardiopulmonary bypass, has been reported useful.

Methods: We experienced a left ventricular pseudoaneurysm, of 8 cm in size, emerging at a previous rupture site 1 year after gluing with TachoComb for an oozing-type rupture due to an acute anteroseptal myocardial infarction.

Favourable clinical outcome in patients with cardiogenic shock due to fulminant myocarditis supported by percutaneous extracorporeal membrane oxygenation.

Aims: The clinical outcome of severe acute myocarditis patients with cardiogenic shock who require circulatory support devices is not well known. We studied the survival and clinical courses of patients with fulminant myocarditis supported by percutaneous extracorporeal membrane oxygenation (ECMO) and compared them with those of patients with acute non-fulminant myocarditis.

Methods And Results: Patients with acute myocarditis were divided into the following two groups.

[Perioperative multivessel coronary vasospasm as a cause of cardiogenic shock immediately after off-pump coronary artery bypass grafting surgery: a case report].

Perioperative coronary vasospasm has been recognized as a possible cause of myocardial infarction or low output syndrome after open heart operations. A 57-year-old male suffered cardiogenic shock immediately after off-pump coronary artery bypass grafting surgery. Emergent angiography performed under intraaortic balloon pumping and percutaneous cardiopulmonary support revealed severe multivessel coronary vasospasm which was effectively treated with a high dose intracoronary administration of isosorbide dinitrate.

Durability and outcome of aortic valve replacement with mitral valve repair versus double valve replacement.

Background: The purpose of this study was to evaluate morbidity and mortality after double valve replacement (DVR) and aortic valve replacement with mitral valve repair (AVR + MVP).

Methods: From 1977 to 2000, 379 patients underwent DVR (n = 299) or AVR + MVP (n = 80). Actuarial survival and freedom from reoperation were determined by the Kaplan-Meier method.

Aortic valve replacement for a patient with warm-reactive autoimmune hemolytic anemia.

We treated a 68-year-old woman with warm-reactive type of autoimmune hemolytic anemia (AIHA) who underwent aortic valve replacement. In consideration of the different hemolytic mechanisms between cardiopulmonary bypass and warm-reactive AIHA, conventional surgical procedures could be performed after the discontinuation of steroid therapy.

Effect of maze procedure in patients with atrial fibrillation undergoing valve replacement.

Background And Aims Of The Study: The study aim was to elucidate the impact of the maze procedure on late outcome after valve replacement.

Methods: Between 1992 and 2000, 241 patients underwent the maze procedure combined with valve replacement. Patients were allocated to three groups: aortic valve replacement (AVR/maze, n = 16); mitral valve replacement (MVR/maze, n = 148); and combined aortic and mitral valve replacement (DVR/maze, n = 77).

The effect of cryo-maze procedure on early and intermediate term outcome in mitral valve disease: case matched study.

Background: The maze procedure is an effective way to treat atrial fibrillation (AF) associated with mitral valve disease. In a last several years, cryoablation was substituted for atrial incision in many reports to simplify the maze procedure. However, there has been no comparative study to delineate the feasibility of the use of cryoablation.

Impact of Cox maze procedure on outcome in patients with atrial fibrillation and mitral valve disease.

Objective: We sought to determine whether the Cox maze procedure provides additional benefit to patients with atrial fibrillation undergoing mitral valve operations.

Methods: Between May 1992 and August 2000, we performed 258 Cox maze procedures with mitral valve replacement (n = 147) or mitral valve repair (n = 111). We compared the outcomes of these patients with those of 61 control patients with preoperative atrial fibrillation who underwent mitral valve replacement alone during the same interval.

[Intractable infective endocarditis associated with supraaortic stenosis in Williams syndrome: a case report].

A 17-year-old man with supravalvular aortic stenosis associated with Williams syndrome was admitted to our hospital for intensive treatment for intractable infective endocarditis. The patient had a history of percutaneous balloon valvuloplasty for aortic stenosis in 1992. He was well until late in 1999, when he had a high temperature after dental work-up.

The impact of diabetic retinopathy on long-term outcome following coronary artery bypass graft surgery.

Objectives: We sought to assess the impact of diabetic retinopathy on long-term outcome among patients with diabetes and multivessel coronary artery disease (MVD) following coronary artery bypass graft surgery (CABG).

Background: For diabetics, CABG is the preferred revascularization strategy. Diabetic retinopathy is a major microvascular complication of diabetes, and its severity is directly related to total glycemic exposure.

Multiple off-pump coronary revascularization with "aorta no-touch " technique using composite and sequential methods.

Background: Although off-pump coronary artery bypass grafting (OPCAB) has been widely applied in patients who are considered high risk for cardiopulmonary bypass (CPB), there is still a risk of stroke during the operation because of the ascending aortic partial clamp for proximal anastomosis. In the present study, we report the initial results of an "aorta no-touch " technique using an in-situ graft and composite and sequential grafting methods.

Methods: Between March 2000 and April 2001, 120 patients underwent OPCAB with this technique.

Eight-year experience of combined valve repair for mitral regurgitation and maze procedure.

Background And Aims Of The Study: Although atrial fibrillation (AF) is often associated with severe mitral regurgitation (MR), a simultaneous maze procedure for AF associated with repair of MR remains controversial. In this study, mid-term results of combined mitral valve repair and the maze procedure were examined.

Methods: Between May 1992 and April 2001, 85 patients (61 males, 24 females) underwent valve repair for MR and the maze procedure.

[Heart transplantation for dilated cardiomyopathy possibly caused by fulminant acute myocarditis: a case report].

A 13-year-old boy [corrected] underwent heart transplantation for severe congestive heart failure due to dilated cardiomyopathy possibly caused by fulminant acute myocarditis. He suddenly suffered chest discomfort and loss of consciousness during running, and was referred to a hospital with cardiogenic shock. Electrocardiography showed ventricular tachycardia and echocardiography revealed severe hypokinesis in an extensive area of the left ventricular wall with markedly decreased left ventricular ejection fraction.

Plasma atrial natriuretic peptide concentration inversely correlates with left atrial collagen volume fraction in patients with atrial fibrillation: plasma ANP as a possible biochemical marker to predict the outcome of the maze procedure.

Objectives: We hypothesized that the plasma atrial natriuretic peptide (ANP) level reflects atrial degenerative change and may predict the outcome of the maze procedure.

Background: Although a larger preoperative left atrial dimension and longer duration of atrial fibrillation (AF) have been reported in patients with persistent AF than in those with sinus rhythm (SR), these individual factors were not enough to predict the outcome of the maze procedure.

Methods: Preoperative plasma ANP levels were measured in consecutive 62 patients who underwent the Kosakai's modified maze procedure.

Clinical Experience of Percutaneous Cardiopulmonary Support.

Recently, percutaneous cardiopulmonary support (PCPS) combined with femoro-femoral bypass without reservoir has become valued because of its quick and easy application. We developed a fully preconnected compact integrated cardiopulmonary bypass (CPB) unit (priming volume of 250 ml) with a blind pore membrane oxygenator (Kuraray Menox) for PCPS. From 1990 to 1995, PCPS was performed in 49 patients of whom 26 were weaned from support.