Traumatic Tricuspid Insufficiency Requiring Valve Repair in an Acute Setting.

Tricuspid insufficiency due to penetrating cardiac trauma is rare. Patients with tricuspid insufficiency due to trauma can tolerate this abnormality for months or even years. We report a case of a 66-year-old female with penetrating cardiac trauma on the right side of her heart that required tricuspid valve repair in an acute setting.

[Surgical management of metastatic colon cancer causing obstruction of the right ventricular outflow tract].

Metastatic cardiac tumors are commonly detected during autopsy. However, they are seldom diagnosed during life, and surgical resection is rarely indicated. Among the malignant tumors, colon cancer rarely metastasizes to the heart.

[Toward a paradigm for universal procedures of valve repair].

We developed novel methods to simplify valve repair techniques.Adequate exposure is crucial for mitral valve surgery. The right side of the pericardium is sutured to the chest wall, and both cava are mobilized and hitched up to the left.

Acquired pseudoaneurysm of the sinus of Valsalva.

Localized aneurysms of the sinus of Valsalva are uncommon. Repair is tailored to the defective anatomy of the sinus, the aortic valve, and the coronary artery. Herein, we report the successful surgical treatment of 2 patients who had unruptured pseudoaneurysms of the sinus of Valsalva.

Endoscopic observation following aortic cusp plication.

In valve-sparing operations for aortic root aneurysms, the dilated aortic root is replaced by a vascular graft. However, cusp disorders remain in some cases. We observed closed cusps endoscopically, and an improvement in the cusp coaptation was seen following plication.

Bacteremia causes mycotic aneurysm of the aortic arch in 110 days.

We report a surgical case of mycotic aneurysm of the aortic arch, the possible cause, and the growth of which were retrospectively determined. A 61-year-old man with diabetes mellitus, free of aneurysm had bacteremia develop that was caused by Staphylococcus aureus. A computed tomographic scan was taken 110 days afterward that revealed an aneurysm in his aortic arch.

Graft-to-coronary-artery shunt during off-pump coronary artery bypass grafting.

We have developed a simple technique for temporary shunt from the saphenous vein graft to the coronary artery during off-pump coronary anastomosis. The ends of a 2-mm diameter tube were inserted into the distal end of the saphenous vein graft in which proximal anastomosis had been established and into the right coronary artery crux. Blood flow sufficient to maintain adequate hemodynamics was obtained through the shunt tube while suturing around the tube.

Nonprosthetic surgical repair of pectus excavatum.

Background: Previously, a method was reported to correct pectus excavatum in which a convex steel bar is inserted beneath the sternum. This method gained popularity, but a relatively high incidence of complications has been reported. We review our experience of nonprosthetic repairs of pectus excavatum.

A case of fistula of the right common iliac aneurysm to the appendix.

We report a very rare case of spontaneous ilioappendicial fistula with right common iliac aneurysm. After the aneurysm was opened, afferent and efferent vessels were closed following extraanatomical femorofemoral bypass, and the appendectomy was performed. The wall of the aneurysm showed the atherosclerotic change and histologic study of the appendix confirmed the diagnosis of acute appendicitis.

Total aortic arch grafting for acute type A dissection: analysis of residual false lumen.

Background: In surgery for acute type A dissection, an unresected dissection and residual false lumina are causes of the progression of aneurysms and ruptures. We grafted the ascending aorta and total arch, the maximum grafting possible through a median sternotomy alone, in all patients with type A dissection extending to the descending aorta, wherever initial tears existed in the arch.

Methods: A total of 37 consecutive patients with acute type A dissection underwent ascending and total arch grafting between August 1994 and December 2000.