Antegrade thoracic endovascular aortic repair via the left axillary artery in a patient with aortoiliac occlusive disease (Leriche syndrome).

We present the case of a 77-year-old man with a saccular descending thoracic aortic aneurysm who underwent successful antegrade thoracic endovascular aortic repair (TEVAR) via the left axillary artery. The patient had a history of axillo-bifemoral bypass grafting due to aortoiliac occlusive disease (Leriche syndrome), which precluded normal retrograde TEVAR. Upon successful procedure completion, no endoleak was noted on postoperative computed tomography.

Total arch replacement in a patient with a tracheostoma through a reverse L-shaped partial sternotomy.

A conventional median sternotomy in a patient with a tracheostoma is susceptible to postoperative mediastinitis or graft infection after total arch replacement (TAR). An optimal surgical procedure has still not been established to circumvent these complications in such patients. We report a successful case of a 74-year-old man with a tracheostoma who received TAR through a reverse L-shaped partial sternotomy.

Strategy for thoracic endovascular aortic repair based on collateral circulation to the artery of Adamkiewicz.

Purpose: Spinal cord ischemia (SCI) is a serious complication of thoracic endovascular aortic repair (TEVAR). The purpose of this study was to establish if preoperative identification of the artery of Adamkiewicz (AKA) can help prevent post-TEVAR SCI.

Methods: Of 74 post-TEVAR patients, 51 had the critical segmental artery (CSA) to the AKA pre-identified to help the surgeon deploy stent grafts.

Spontaneous spinal epidural hematoma presenting as paraplegia after cardiac surgery.

An 86-year-old woman was scheduled to undergo aortic valve replacement and coronary artery bypass graft. On postoperative day 3, she developed sudden-onset neck pain followed by weakness in the right arm. Her symptoms worsened with time, and she developed paraplegia.

Aortic translocation using the hemi-mustard procedure for corrected transposition.

The management of congenitally corrected transposition of the great arteries and associated lesions is frequently challenging. Restrictive ventricular septal defect and mild pulmonary stenosis are contraindications to the double switch procedure, including the atrial-Rastelli switch procedure, due to the production of postoperative left ventricular outflow tract obstruction. We describe a case of aortic translocation using the hemi-Mustard procedure after left ventricular training in order to prevent postoperative left ventricular outflow obstruction.

Experimental study on effective application of fibrin glue.

Purpose: Fibrin glue is effective for maintaining hemostasis after anastomosis and for filling needle holes after cardiothoracic and vascular surgery, but few experimental studies concerning methods of application to obtain more effective hemostasis have been reported.

Methods: Bolheal was used as the fibrin glue. Fibrinogen solution (A, 0.

Left coronary artery ostial stenosis from Takayasu's arteritis diagnosed using transthoracic color flow and pulsed Doppler echocardiography.

Coronary artery stenosis is seen in 10-45% of patients with Takayasu's arteritis (TA) and coronary ostia are most frequently involved. It may cause angina pectoris and sudden death during the early course of the disease. We describe a 14-year-old girl who first presented with exertional angina and syncope and was diagnosed as having left coronary artery ostial stenosis from TA by using transthoracic echocardiography.

Papillary fibroelastoma of the aortic valve visualized by 320-slice computed tomography: report of a case.

A 72-year-old man presented with a papillary fibroelastoma on the non-coronary cusp of the aortic valve. He was asymptomatic, with a history of hypertension and paroxysmal atrial fibrillation. Echocardiography revealed a mobile, round mass (13 × 15 mm) on the non-coronary cusp of the aortic valve.

Successful valve repair in traumatic aortic valve regurgitation.

Case 1 was a 20-year-old male who had been involved in a traffic accident and developed aortic regurgitation (AR) eight months later. He was admitted with dilatation of the left ventricle. Transesophageal echocardiography (TEE) showed severe AR with perforation of the right coronary cusp.

[The method of atriotomy, ventriculotomy and their repairs].

In this series, we describe the method of atriotomy, ventriculotomy and their repairs. Right atriotomy is needed for expose tricuspid valve, atrial and ventricular septal defect. Left atriotomy is needed for expose mitral valve disease and technique for, maze or pulmonary vein isolation.

[Off-pump coronary artery bypass grafting in an early-teen patient with aortitis syndrome].

A 14-year-old girl was admitted to our hospital with a history of syncope and chest pain on exercise. Multi-slice coronary computed tomography (CT) demonstrated ostial stenosis of the left main trunk as well as wall thickening in the ascending aorta. Magnetic resonance imaging (MRI) also showed occlusion of the left carotid artery.

Feasibility of the extracardiac conduit Fontan procedure in patients weighing less than 10 kilograms.

Objective: The extracardiac conduit Fontan procedure has led to improved outcomes. We performed the procedure in patients weighing less than 10 kg and evaluated its feasibility.

Methods: Since January 1999, 72 patients weighing less than 20 kg underwent extracardiac conduit Fontan procedure with polytetrafluoroethylene conduits.

Aortic dissecting aneurysm with a bicuspid aortic valve in Turner's syndrome: report of a case.

We herein report the performance of a successful, modified Bentall procedure and a total arch replacement for a Stanford type A chronic aortic dissection and a bicuspid aortic valve in Turner's syndrome (TS). The patient was a 45-year-old woman with 45, XO karyotype TS, who had had a history of hypertension since the age of 20. She had also been diagnosed as having a dilatation of the ascending aorta and a bicuspid aortic valve 3 years earlier.

Midterm results of aortic repair using a fabric neomedia and fibrin glue for type A acute aortic dissection.

Background: Controversy exists concerning the optimal surgical treatment of acute type A aortic dissection to reduce mortality rate and the need for reoperation. The goal of the present study was to evaluate midterm results of repair using a fabric and fibrin glue for acute type A aortic dissection.

Methods: From 1994 to 2005, 100 patients with acute type A aortic dissection underwent supracommissural graft replacement using a fabric as "neomedia" and fibrin glue.

Risk factors for hypoxemia after surgery for acute type A aortic dissection.

Purpose: Postoperative hypoxemia is a frequent complication of surgery for acute type A aortic dissection. We tried to determine the factors associated with postoperative hypoxemia.

Methods: Between 1997 and 2003, 114 patients underwent surgery for acute type A aortic dissection.

Aortic valve repair for aortic regurgitation: intermediate-term results in patients with tricuspid morphology.

Background And Aim Of The Study: Surgical results after aortic valve repair in patients with aortic regurgitation (AR) of tricuspid valve morphology and with no evidence of aortic root disease have not yet been clarified.

Methods: Between January 1994 and June 2001, aortic valve repair was performed in 40 patients (eight females, 32 males; mean age 61.0 +/- 10.

Magnetic resonance angiography in coronary artery bypass grafting.

An attempt was made to reduce the incidence of perioperative stroke by detecting cerebrovascular disease with preoperative head and neck magnetic resonance angiography and by selecting the coronary artery bypass grafting technique. This strategy was used in 268 patients with ischemic heart disease who had undergone both head and neck magnetic resonance angiography before elective coronary artery bypass in our hospital between May 1997 and April 2001. In patients with significant stenosis or obstruction detected by head and neck magnetic resonance angiography, the findings were evaluated and cerebral blood flow was examined using brain single-photon emission computed tomography.

All internal thoracic artery composite graft revascularization.

The aim of this study was to determine the most efficient design of composite grafts and clarify the technical feasibility rate of composite grafting using internal thoracic artery exclusively in patients undergoing triple-vessel revascularization. Retrospective analysis of 104 consecutive patients was carried out. An in situ left internal thoracic artery graft for the left anterior descending artery area, with attachment of the right internal thoracic artery to the side of the left internal thoracic artery to revascularize the circumflex and right coronary vessels, was the most efficient graft design.

Late complications following surgery for type A acute aortic dissection using gelatin-resorcin-formaldehyde glue: report of two cases.

Gelatin-resorcin-formaldehyde (GRF) glue has been widely applied during operations for acute aortic dissection (AAD). At our institution, GRF glue was applied in 40 patients who underwent surgical procedures for AAD from 1995, two of whom needed a reoperation because of the development of a redissection and/or a pseudoaneurysm at the anastomotic sites. The operative findings and histological examinations suggested that the application of GRF glue during the initial operations might be related to the development of a redissection and/or a pseudoaneurysm.

Head and neck magnetic resonance angiography before coronary artery bypass grafting.

Purpose: To evaluate the incidence of vascular lesions in the head and neck by magnetic resonance angiography (MRA), and investigate the factors correlated with severe stenosis.

Methods: Elective coronary artery bypass grafting (CABG) was performed in 413 patients at our center between May 1997 and April 2001. We used MRA to detect head and neck vascular lesions, then evaluated the occlusive lesions and determined their prevalence.

Effective use of fibrin glue for acute aortic dissection.

The use of gelatin-resorcine-formalin (GRF) glue for reconstruction of the vascular wall in the context of acute aortic dissection has become more common. However, anecdotal evidence suggests that use of the GRF glue results in higher rates of postoperative redissection. We describe an alternative method of reinforcing the dissected aorta with fibrin glue that may avoid this complication.

Influence of gelatin-resorcin-formalin glue on mid-term redissection after aortic repair.

Purpose: To determine whether the development of mid-term redissection after surgery for acute type A aortic dissection using gelatin-resorcin-formalin (GRF) glue could be prevented by applying less formalin.

Methods: Between 1995 and 1999, 59 patients underwent surgery with GRF glue to repair acute type A aortic dissection. Forty-one patients underwent surgery before October 1998, and 18 patients underwent surgery after November 1998.

[Diagnostic and prognostic evaluation of unstable angina pectoris using ECG-gated single photon emission computed tomography (SPECT) with 99mTc-tetrofosmin].

Purpose: The purpose of this study is to the diagnostic accuracy and the value as prognostic predictors based on the perfusion and/or functional analysis using the QGS program on 99mTc-tetrofosmin gated SPECT (Tf-QGS-SPECT) in patients with unstable angina pectoris (UAP) who admitted to the CCU.

Methods: Fifty seven consecutive patients (37 males and 20 females, mean age: 62 +/- 7 years) with suspected UAP, who underwent Tf-QGS-SPECT and coronary angiography, were entered into this study. We compared the accuracy for diagnosing UAP in the following 3 analyses: 1.

Transaortic mitral valve repair combined with a modified Bentall procedure in a patient with Marfan's syndrome: report of a case.

We report a case of transaortic mitral valve repair combined with aortic root and arch replacement in a patient with Marfan's syndrome. Preoperative computed tomography and echocardiography showed acute aortic dissection (DeBakey type 1), severe aortic regurgitation, annuloaortic ectasia, and mild mitral regurgitation (MR). We performed artificial chordae implantation to the anterior mitral leaflet (AML) through the aortic root, followed by insertion of an aortic composite graft and replacement of the aortic arch.