Safe and favorable prognosis of thoracic endovascular aortic repair for the low-risk patients with non-acute type B aortic dissection.

Objective: Preemptive thoracic endovascular aortic repair (TEVAR) has the potential to improve the prognosis of Stanford type B aortic dissection (TBAD), however it is important to determine whether it could be safely performed as a prophylactic treatment. This study aimed to determine the short- and long-term outcomes of preemptive TEVAR for uncomplicated TBAD with a small aortic aneurysm.

Design: Retrospective multicenter analysis.

Optimal size of Frozenix for true thoracic aneurysms: is downsizing an option?

Objective: During total arch replacement (TAR) using frozen elephant trunk (FET) technique with Frozenix for true thoracic aortic aneurysm (tTAA), oversized FET tends to be chosen similar to the endovascular devise selection. However, the oversized FET is considered a risk factor for intimal injury. The appropriate size selection of FET remains insufficiently understood.

[Left Atrial Appendage Closure with Various Types of Surgical Technique and Its Results].

Background: Occlusion of the left atrial appendage( LAA) may prevent stroke in patients with atrial fibrillation. In this study, we reviewed various types of LAA occlusion techniques and results of patients underwent surgical LAA closure.

Methods: Between 2004 and 2022, 182 patients who underwent surgical LAA closure were enrolled in this study.

Safe and promising outcomes of in-hospital preoperative rehabilitation for coronary artery bypass grafting after an acute coronary syndrome.

Objective: In patients with stable hemodynamic status after an acute coronary syndrome (ACS), coronary artery bypass grafting (CABG) after preoperative investigations can provide outcomes comparable to those of emergency surgery. However, no established guidelines exist regarding the preparation period before surgery. We report the results of the use of an inpatient cardiac rehabilitation program followed by CABG after an ACS to improve post-operative outcomes and prognosis after discharge.

A case of a transcatheter valve-in-valve implantation using balloon expandable valve for failed SOLO SMART stentless bioprosthetic valve.

Unlabelled: A 74-year-old man who had undergone surgical aortic valve replacement with the SOLO SMART stentless bioprosthetic valve 25 mm (LivaNova PLC, London, UK) and mitral valve replacement with MOSAIC 29 mm (Medtronic, Minneapolis, USA) 4 years previously was diagnosed with congestive heart failure, and transferred to our hospital. Echocardiography revealed severe aortic regurgitation caused by degraded bioprosthetic valve. He required continuous dobutamine administration to maintain hemodynamics.

[Surgical Treatment of Extensive Annular Defects by Aortic Valve Infective Endocarditis Using Stentless Bioprosthesis].

Background: The optimal surgical technique and valve prosthesis in patients with active aortic valve infective endocarditis with annular abscess is controversial. If extensive annular defects occur after debridement, standard techniques are difficult;more complex aortic root replacement is inevitable. The SOLO SMART stentless bioprosthesis is specially designed for supra-annular implantation without annular stitches.

Ascending aortic graft penetration by fractured sternal wire: A word of caution.

The fractured sternal wire is a relatively common postoperative finding after sternotomy. However, fractured wires have the potential of surrounding organ injury, which can be fatal. Here, we describe the successful surgical treatment of ascending aortic penetration by fractured sternal wire.

Constrictive pericarditis caused by pericardial substitution using expanded polytetrafluoroethylene.

Background: Expanded polytetrafluoroethylene (ePTFE) is commonly used as a pericardial substitute during cardiac surgery to prevent cardiac injury during re-sternotomy. However, although rare, constrictive pericarditis associated with ePTFE has been reported.

Material, Methods And Results: Here, we report a rare case of constrictive pericarditis developed due to severe restriction of cardiac motion associated with the ePTFE membrane used as a pericardial substitute.

[Aortic Root Replacement with Patch Closure of Membranous Ventricular Septal Aneurysm].

Membranous ventricular septal aneurysm (MSA) complicated with annuloaortic ectasia (AAE) is rare in adults. Herein, we reported two successful surgical cases of this setting. One case is 50-year-old man with extensive infective endocarditis with underwent aortic coarctation repair in childhood.

[Successful Surgical Repair of Left Coronary Ostial Aneurysm after Modified Bentall Procedure Using the Carrel Patch Technique].

A 38-year-old woman underwent aortic root surgery using the Carrel patch technique at the age of 14 years for annuloaortic ectasia of 59 mm. Although there were no clinical findings of Marfan syndrome or bicuspid aortic valve, the pathological findings of the aortic aneurysmal wall showed degeneration of the media. After 24 years, contrast-enhanced computed tomography (CT) showed an enlargement of the left coronary ostial aneurysm of 17 mm with saccular formation.

[Successful Surgical Repair for Adult Ebstein Disease Using Cone Reconstruction Combined with One and a Half Ventricle Repair].

A 67-year-old woman presented with dyspnea on effort and cyanosis due to massive tricuspid regurgitation and an atrial septal defect with right to left shunt. She was diagnosed with Ebstein disease at the age of 53 when she underwent surgery for varicose veins. Echocardiography showed the severe apical displacement of the septal and posterior leaflet.

Unexpected Bare Metal Stent Migration Associated With Aortic Remodeling After PETTICOAT Technique for Aortic Dissection.

Purpose: To report a unique case of bare metal stent migration in the overlapping zone and subsequent distal stent graft-induced new entry (SINE) after the Provisional Extension to Induce a Complete Attachment (PETTICOAT) technique for aortic dissection.

Case Report: A 67-year-old man underwent thoracic endovascular aortic repair (TEVAR) using the PETTICOAT technique for acute complicated type B aortic dissection. The postoperative course was uneventful, and follow-up computed tomography (CT) showed not only favorable aortic remodeling but also progressive bare metal stent migration in the overlapping zone between the stent graft and the bare metal stent.

Spontaneous Lumbar Artery Injury Resulting in Retroperitoneal Hematoma Mimicking Abdominal Aortic Aneurysm Rupture.

A 73-year-old woman, who had previously undergone endovascular aortic repair (EVAR), developed severe back pain while shoveling snow. Preoperative computed tomography (CT) revealed marked retroperitoneal hematoma around the abdominal aortic aneurysm (AAA) with extravasation of contrast media. Intraoperative angiography demonstrated spontaneous lumbar artery injury (SLI).

Repeated aortic dissection in a patient with autosomal dominant polycystic kidney disease.

Autosomal dominant polycystic kidney disease is a systemic disorder associated with cardiovascular complications. However, there are few reports on autosomal dominant polycystic kidney disease-associated aortic dissection. Herein, we present a rare case of a 46-year-old man with autosomal dominant polycystic kidney disease who underwent endovascular repair for acute type B aortic dissection three years after his initial open surgery for acute type A aortic dissection.

Endovascular Repair for Abdominal Aortic Aneurysm Rupture With Neurofibromatosis Type 1.

Background: Neurofibromatosis type 1 (NF1), also known as von Recklinghausen disease, is a rare congenital disorder with an autosomal dominant inheritance. Severe perioperative complications owing to the congenital fragility of the vascular wall in NF1 patients have been reported. The optimal vascular surgical approach remains controversial.

Left coronary button aneurysm presenting with progressive enlargement after aortic root replacement.

Background: Aneurysmal degeneration of the coronary button after aortic root replacement using the button technique is a rare but potentially life-threatening complication. However, the appropriate management of this complication, including the indications for conservative and surgical treatment, is still unknown.

Case Presentation: Here we present a 38-year-old woman who successfully underwent surgical repair of a left coronary button aneurysm using the graft interposition technique 24 years after aortic root replacement.

Remote simulator training of coronary artery bypass grafting during the coronavirus disease 2019 pandemic.

Objectives: The coronavirus disease 2019 pandemic presents in-person exposure risk during surgical education. We aimed to validate the feasibility of fully remote faculty-supervised surgical training sessions focused on coronary artery bypass grafting using a synthetic simulator and online videochat software.

Methods: This observational study organized 24 sessions of 2-hour remote training.

Double left brachiocephalic vein in an adult patient who underwent cardiac surgery: a case report.

Background: A double left brachiocephalic vein is an extremely rare venous anomaly.

Case Presentation: Herein, we present the case of a 79-year-old woman with a double left brachiocephalic vein who underwent cardiac surgical procedures. The normal left brachiocephalic vein was patent, and the accessory left brachiocephalic vein passed across the heart and aorta in front of the pericardium and drained into the superior vena cava.

Surgical Treatment for a Super-Giant Right Coronary Artery Aneurysm Induced by Kawasaki Disease.

A 32-year-old man diagnosed with Kawasaki disease at the age of three years presented with coronary artery aneurysm (CAA). The aneurysm increased in size, and the patient was referred to our hospital for surgery. Preoperative computed tomography scan showed a super-giant right CAA and giant left CAAs; surgery was performed.

Step-by-step aortic clamping technique for safe retrieval of the elephant trunk.

Staged repair of the aortic arch and downstream aorta using the elephant trunk technique is widely accepted for extensive aortic disease. However, elephant trunk retrieval is challenging in patients with unclampable descending aorta caused by extreme aneurysmal dilation or surrounding tissue adhesion. Here, we introduce a new elephant trunk retrieval technique using the step-by-step aortic clamping in descending aortic replacement of dissecting aortic aneurysm.

Surgical repair of deep femoral artery aneurysm complicated by deep vein thrombosis and pulmonary embolism.

Isolated deep femoral artery aneurysms are rare and tend to be large at the time of diagnosis owing to their deep anatomic location. Deep femoral artery aneurysms are often complicated by rupture, with subsequent lower limb amputation. However, a large aneurysm can compress the surrounding deep femoral vein, leading to thrombosis.

[Total Arch Replacement with Brain Isolation Technique for Arch Aneurysm with Shaggy Aorta].

A shaggy aorta with a mobile atheromatous plaque in a thoracic lesion is considered a risk factor for cerebral infarction during aortic arch surgery. The brain isolation technique was introduced to prevent embolic stroke either by manipulating the severely atheromatous aorta, or by producing a sandblasting effect using the arterial jet in cardiopulmonary bypass. We performed total arch replacement with the aid of a brain isolation technique in four patients with aortic arch aneurysm complicated with a shaggy aorta between 2016 and 2020.

Large cardiac wall hematoma with rapid growth: a case report of a potentially catastrophic complication during cardiac surgery.

Background: Rapid growth of cardiac wall hematoma is a rare but potentially fatal complication of cardiac surgery. However, its pathophysiology and optimal management remain undefined.

Case Presentation: Here we present a rare case of a large cardiac wall hematoma in the right ventricle during a thoracic aortic and valvular surgery.