A new device as an open stent graft for extended aortic repair: a multicentre early experience in Japan.

Objectives: Open stent grafting for extended aortic repair has been widely carried out around their world. We reported the effectiveness of a new device as an open stent graft for extended aortic repair.

Methods: A new device was used as an open stent graft in this study.

Multiple factors predict the risk of spinal cord injury after the frozen elephant trunk technique for extended thoracic aortic disease.

Objectives: Spinal cord injury (SCI) after the frozen elephant trunk (FET) technique is more frequent than after endovascular aneurysm repair. This study aimed to identify risk factors of SCI after the FET technique.

Methods: We performed the FET technique for extended thoracic aortic disease in 224 patients (mean age, 72.

In situ replacement for mycotic aneurysms on the thoracic and abdominal aorta using rifampicin-bonded grafting and omental pedicle grafting.

Background: The objective of this report is to discuss the efficacy of in situ replacement for treating mycotic aneurysm, particularly using rifampicin-bonded grafts and omental pedicle grafts, on the basis of our 7 years of experience.

Methods: Between December 2003 and December 2010, we performed surgical treatments in 23 patients (for the thoracic aorta in 6 patients, for the thoracoabdominal aorta in 8 patients, and for the abdominal aorta in 9 patients; 7 emergency, 10 urgent, and 6 elective operations) with mycotic aneurysm by using rifampicin-bonded grafting and omental pedicle grafting.

Results: One patient died in hospital because of local recurrent infection.

Frozen elephant trunk technique and partial remodeling for acute type A aortic dissection.

Objective: The aimed to describe the frozen elephant trunk (FET) technique and partial remodeling (PR) for acute type A aortic dissection (ATAAD), considering the long-term prognosis on the basis of our 13 years of experience.

Methods: There were 80 consecutive patients (mean age: 66.4 years) with an FET and PR technique for ATAAD between September 1997 and February 2010.

Long-term results of the frozen elephant trunk technique for extended aortic arch disease.

Objectives: This study describes the long-term safety and effectiveness of extended aortic arch replacement with the frozen elephant trunk technique from our 12 years of experience.

Methods: Between September 1997 and September 2008, 156 patients (mean age 67.9 years) with different pathologies from the aortic arch to the extended descending aorta in 100 dissections (acute A/acute B/chronic B=66/26/8) and 56 thoracic arteriosclerotic aneurysms (TAAs) had the frozen elephant technique performed upon them.

Long-term results of the frozen elephant trunk technique for the extensive arteriosclerotic aneurysm.

Objectives: The objective of this report is to elucidate the feasibility of the frozen elephant trunk technique as a one-stage operation for extensive arteriosclerotic aneurysms and to investigate the long-term durability and efficacy of this procedure from our 11 years of experience.

Methods: The subjects were 58 consecutive patients who electively received the frozen elephant trunk technique for arteriosclerotic aneurysms involving the aortic arch and the descending aorta between September 1997 and September 2008. Concomitant procedures included 15 coronary artery bypass grafts, 2 aortic valve replacements, 1 aortic root replacement, and 3 maze procedures.

Operative strategy for acute type a aortic dissection: ascending aortic or hemiarch versus total arch replacement with frozen elephant trunk.

Background: This report compares long-term results with total arch replacement with frozen elephant trunk (FET) to ascending aortic or hemiarch replacement (AHR) for acute type A aortic dissection.

Methods: The subjects were 120 consecutive patients, including 65 who received FET and 55 who had AHR for acute type A aortic dissection from 1997 to 2008. The late results after surgery were retrospectively compared between the FET and ARH groups.

Total arch replacement with an open stent graft for acute type A aortic dissection: fate of the false lumen.

Objective: To describe the fate of the false lumen remaining in the descending thoracic aorta after extensive primary repair of the thoracic aorta by the modified elephant trunk technique with a stent graft for acute type A aortic dissection, particularly the changes of the false lumen on enhanced CT scanning.

Methods: The subjects were 65 consecutive patients who received arch replacement with an open stent graft for type A acute aortic dissection. CT scanning was performed at 1, 3, 12, 36, and 60 months postoperatively to detect thrombus formation, absorption of thrombus, and obliteration of the false lumen after its exclusion by the stent graft.

Surgical strategies for organ malperfusions in acute type B aortic dissection.

This study is retrospectively to evaluate strategies for organ malperfusion on the view point of two mechanisms (true lumen collapse in the aorta=Ao type, or branch dissection=Br type) in acute type B aortic dissection. There were 16 of Ao type and 4 of Br type in 20 patients with organ malperfusion. In Ao type, we performed entry closure in 12 patients, surgical bypass grafting in two to superior mesenteric artery (SMA) in one and femoral artery in two, and surgical fenestration in two.

Midterm results of extensive primary repair of the thoracic aorta by means of total arch replacement with open stent graft placement for an acute type A aortic dissection.

Objectives: We sought to describe the midterm results of extensive primary repair of the thoracic aorta by means of the modified elephant trunk technique with a stent graft for acute type A aortic dissection, particularly the changes of the false lumen shown by enhanced computed tomographic scanning.

Methods: The subjects were 35 consecutive patients who received arch replacement with open stent grafting for type A acute aortic dissection between December 1997 and April 2002. The mean follow-up period was 55 months (range, 30-83 months).

Extensive primary repair of the thoracic aorta in Stanford type A acute aortic dissection by means of a synthetic vascular graft with a self-expandable stent.

Objectives: To minimize any residual false lumen when operating on patients with an acute type A aortic dissection, we tried to perform extensive primary repair of the thoracic aorta with the modified elephant trunk technique. The early and midterm results of these surgical interventions are reported and evaluated.

Methods: Among the acute type A aortic dissections with extensive false lumen encountered since December 1997, 19 consecutive patients, 15 DeBakey type I with the tear in the ascending, transverse, or both aortas, and 4 DeBakey type III-D with the tear located in the descending aorta, underwent insertion of a synthetic graft with a distally anchored stent in the descending thoracic aorta.

[Simultaneous operation of emergency coronary artery bypass grafting and gastrotomy with suturing ulcer].

A 62-year-old man with complaints of severe chest pain came to our hospital. An emergency coronary angiography was performed and he was diagnosed as having acute myocardial infarction. Due to severe triple vessels disease he was referred to the department of Cardiovascular Surgery to undergo emergency coronary artery bypass grafting.

[Short-term results of leaving elephant trunk in type A aortic dissection].

Elephant trunk prosthesis was devised for treatment of multiple aortic aneurysm. But it has applied to type A aortic dissection. Because residual false lumen often dilates gradually and come to have the risk of rupture.

[A case of left atrial thrombi following mitral valvuloplasty for mitral regurgitation associated with idiopathic thrombocytopenic purpura].

A 58-year-old man, who had been submitted to an indication of mitral valvuloplasty (MVP) because of severe mitral regurgitation, was diagnosed as idiopathic thrombocytopenic purpura (ITP). In order to diminish the peri-operative blood loss, splenectomy and high-dose bolus administration of gamma-globulin (400 mg/kg/day) were performed at the time of two weeks and during last five days respectively, prior to MVP surgery. In early post-operative stage, anticoagulant therapy was held down considering ITP, and we were not troubled with bleeding throughout the peri-operative period.

Gallbladder and biliary interventional radiology.

The past ten years have seen the introduction of a number of new techniques for the treatment of biliary diseases. In this report, we discuss the roles of both extracorporeal shock-wave lithotripsy and percutaneous treatment of gallstones, and we emphasize the changing role of these techniques since the advent of laparoscopic cholecystectomy. The literature on chemical cholecystectomy is reviewed with particular reference to experience in humans.

Percutaneous treatments for biliary diseases.

Percutaneous treatment of biliary disease was administered in 173 cases, mainly among high-risk or elderly patients. Diagnosis was acute cholecystitis in 32 cases, acute cholangitis in 16, hepatic abscess in five, gallbladder stones in 28, common bile duct stones in 11, intrahepatic stones in five, malignant obstructive jaundice in 61, and benign biliary stenosis in 15. The treatment was successful in 158 of 173 cases (91.