Management with closed irrigation for post-sternotomy mediastinitis: experience with the use of electrolyzed strong acid aqueous solution.

Objective: The aim of this study was to assess the adequacy of our treatment strategy for patients with post-sternotomy mediastinitis.

Methods: Between May 1997 and December 2000, 1,045 consecutive adult cardiac operations were performed at our center. Mediastinitis occurred in 8 patients (0.

Perioperative serum procalcitonin concentrations in patients with acute aortic dissection.

We investigated the perioperative serum procalcitonin (PCT) concentrations in 5 consecutive patients who underwent surgery for acute aortic dissection (2 men, 3 women; mean age 72 +/- 9 years, age range 52-81 years). Surgery used cardiopulmonary bypass with deep hypothermic circulatory arrest. Blood samples were taken prior to surgery, upon arrival in the intensive care unit, and 6, 12, 18, 24, and 48 h after intensive care unit arrival.

Midterm results of conservative repair of the incompetent bicuspid aortic valve.

Aim: Repair of the bicuspid aortic valve is not generally considered the treatment of choice. Our success with this procedure leads us to report our immediate and mid-term

Methods: From August 1993 to December 2000, 19 patients with aortic regurgitation due to congenital aortic valve underwent aortic valve repair (17 men and 2 women with a mean age of 42+/-17 years; range, 16 to 70 years). The mean preoperative aortic regurgitation grade was 3.

[Valvular heart surgery in osteogenesis imperfecta].

Osteogenesis imperfecta is a disease in which fragile bones readily cause fracture. Valvular disease concurrently develops. However, the surgery-related mortality rate is approximately 30%.

Selection of surgical methods for infected infrarenal abdominal aortic aneurysms.

Background: There is no standard treatment for patients with infected abdominal aortic aneurysm (AAA). To determine the basis for selection of a surgical method, we reviewed our experiences with all patients who underwent surgery for infected infrarenal AAA.

Methods: Between 1993 and 2000, 6 patients with infected infrarenal AAA underwent surgery.

Severe stenosis of the true lumen in the abdominal aorta after an ascending aorta reconstruction for an acute type a dissection: report of a case.

We encountered a case of severe symptomatic stenosis of the abdominal aorta after a surgical repair of an ascending aortic dissection. A 75-year-old woman underwent a reconstruction of the ascending aorta to treat a Stanford type A acute aortic dissection and cardiac tamponade. Eight hours postoperatively, the patient was anuric.

Subvalvular circular annuloplasty as a component of aortic valve repair.

Background And Aim Of The Study: A recently developed technique of aortic annuloplasty, together with immediate postoperative results, are described.

Methods: Between June 1998 and October 2000, 26 patients (22 men, four women; mean age 59 years) with chronic dominant aortic regurgitation (AR) underwent aortic valve repair in which subvalvular circular annuloplasty was used. A concomitant repair technique was performed in all patients.

Usefulness of nitric oxide treatment for pulmonary hypertensive infants during cardiac anesthesia.

Background: The beneficial effect of inhaled nitric oxide (NO) on pulmonary hypertension is well known. However, the indications for NO inhalation therapy for pulmonary hypertension associated with congenital heart lesions are still unclear. The aim of the current study was to seek a measure that would predict the effectiveness of inhaled NO in infants undergoing cardiac surgery.

Vascular relaxant effects of toborinone on the isolated canine internal mammary artery.

This study was conducted to evaluate the vascular relaxant effects of toborinone on canine internal mammary ring preparations. We determined the concentration-contraction curves for various vasoconstrictors, namely norepinephrine, serotonin, U46619, endothelin-1, phenylephrine, and KCl in internal mammary artery (IMA) preparations, then assessed the vascular relaxant effects of the test drugs. As models, preparations with and without functional endothelium were used.

Aortic valve repair of congenital bicuspid aortic valve associated with aneurysm of the ascending aorta.

Two unusual cases of congenital bicuspid aortic valve associated with aneurysm of the ascending aorta are reported. One patient with a 7-cm ascending aortic dilatation and aortic regurgitation (AR) (II/IV), and another with a 6-cm ascending aorta and AR (III/IV), presented for treatment. Replacement of the ascending aorta and aortic valve repair were performed in both cases.

Aortic valve repair in dominant aortic regurgitation.

Objective: We studied immediate and mid-term results after aortic valve repair.

Methods: Immediate and mid-term results were studied in 63 patients undergoing aortic valve repair, calculating survival and reoperation free rates.

Results: Subjects were 49 men and 14 women aged 15 to 76 years (mean: 53 +/- 17 years).

Survival and sinus rhythm maintenance after modified Cox/maze procedure and mitral valve operation in patients with chronic atrial fibrillation.

Objective: Sinus rhythm gained after the Cox/maze procedure concomitant with mitral valve operation has demonstrated long-term attrition during the follow-up, no information exists on whether the type of mitral valve operation--(repair vs. replacement)--affects this sinus rhythm maintenance rate. We retrospectively studied patients undergoing concomitant mitral valve operation and Cox/maze procedure to answer this question.

Annuloaortic repair in the treatment of aortic regurgitation and aortic root pathology.

We developed a new technique of aortic root repair which may be able to eliminate the potential problem of leaflet damage, resulting from the direct contact of the aortic leaflets with synthetic vascular grafts during systole. This report describes our technique of annuloaortic repair and the operative results. Between February 1995 and October 1998, 13 patients underwent annuloaortic repair.

[A case of aconitine poisoning saved with cardiopulmonary bypass].

"Torikabuto" is a kind of plant which contains deadly poison. Its ingredient is aconitine alkaloids. We report a case of aconitine poisoning with fatal arrhythmia and acute pulmonary edema who was saved with cardio pulmonary bypass.

New technique of posterior mitral annuloplasty.

We have developed a new technique of mitral annuloplasty applicable in patients with rheumatic mitral regurgitation. This technique is designed to advance anteriorly the posterior annulus and leaflet and to gain more coaptation area. Technical details of this procedure are presented.

Medium-term results after the modified Cox/Maze procedure combined with other cardiac surgery.

Objective: Long-term results after the modified Cox/Maze III procedure combined with other cardiac procedure for the treatment of organic heart disease and chronic atrial fibrillation (AF) has not been clarified. This report describes our medium-term results after such operation.

Methods: Between March 1993 and August 1995, 104 consecutive patients with chronic AF underwent the modified Cox/Maze III procedure combined with other cardiac procedure.

[Aortic valve papillary fibroelastoma in a patient with mitral valve regurgitation].

Papillary fibroelastoma is a rare cardiac tumour. We describe a patient with mitral valve regurgitation and aortic valve papillary fibroelastoma. The patient was 62-year-old woman.

AP window and anomalous origin of right coronary artery from the window.

Aortopulmonary window (APW) is a rare malformation. We recently operated on a child with APW, ventricular septal defect, right aortic arch, and anomalous right coronary artery from the APW. This patient also had a chromosomal abnormality.

Double valve repair and maze procedure for degenerative valvular disease and chronic atrial fibrillation.

A 61-year-old male with degenerative aortic valve regurgitation, mitral valve regurgitation and chronic atrial fibrillation underwent a combined reparative procedure consisting of aortic valve repair, mitral valve repair and maze procedure. Surgery was successful and postoperatively the patient is in NYHA class I, without anticoagulation. To the best of our knowledge, this is the first clinical report of this combined reparative surgery.

Operative results after the Cox/maze procedure combined with a mitral valve operation.

Background: There have been few reports on postoperative morbidity and mortality analyses after concomitant mitral valve operation and the Cox/maze procedure.

Methods: Between April 1993 and August 1995, 87 consecutive patients with chronic atrial fibrillation underwent a mitral valve operation and concomitant Cox/maze procedure at Iwate Medical University. The patients were divided into the replacement group (n = 31) and repair group (n = 56) according to the method of mitral valve replacement.