1.A Case of Infective Endocarditis with Incarcerated Vegetation in Mitral Orifice
Tomokuni Furukawa ; Tatsuhiko Komiya ; Nobunari Tamura ; Genichi Sakaguchi ; Taira Kobayashi ; Akihito Matsushita ; Gengo Sunagawa ; Takashi Murashita
Japanese Journal of Cardiovascular Surgery 2009;38(1):31-34
A 69-year-old woman was admitted with fever and dyspnea. We diagnosed the congestive heart failure due to infective endocarditis (IE) with mitral valve regurgitation and stenosis. We immediately started medical therapy in order to control both the heart failure and the infection. However, we had to semi-emergency mitral valve replacement additionally perform a days after the initial hospitalized due to a progression of the heart failure. The operative findings showed an area of vegetation to be incarcerated in the mitral orifice. In cases of IE which are associated with mitral stenosis, we therefore should consider the possibility that vegetation may be present in the mitral orifice and closely follow such patients by echocardiography.
2.A Case of Aortic Valve Plasty for Non-coronary Cusp Fracture after Infective Endocarditis
Tomokazu Furukawa ; Tatsuhiko Komiya ; Nobuyuki Tamura ; Genichi Sakaguchi ; Taira Kobayashi ; Akihito Matsushita ; Gengo Sunagawa ; Takashi Murashita
Japanese Journal of Cardiovascular Surgery 2009;38(1):35-39
A 20-year-old male was referred to our hospital to undergo operative treatment due to aortic valve insufficiency which had gradually worsened. The patient's chief complaint was a loss of breath upon effort which had progressively worsened after undergoing aortic valve plasty (AVP) for aortic valve insufficiency with infective endocarditis at another institution. AVP by the cusp extension method had been performed because of the patient's youth and there had been no change in the morbid state, except for the presence of a non-coronary cusp. In addition, the aortic valve insufficiency was controlable and postoperative course was also excellent. The cusp extension method was therefore considered to be an appropriate procedure for this case since it would allow the patient to return it to a state with a more normal heart, since the valve organization after this procedure would be able to reach a maximum level.
3.Two Cases of False Aneurysm Rupture Induced by Nonvascular Tumor
Hiromasa Nakamura ; Tatsuhiko Komiya ; Nobushige Tamura ; Genichi Sakaguchi ; Taira Kobayashi ; Tomokuni Furukawa ; Akihito Matsushita ; Gengo Sunagawa ; Takashi Murashita
Japanese Journal of Cardiovascular Surgery 2008;37(1):56-59
We presented here 2 cases of rare nonvascular tumor involving the aorta. Case 1: A 69-year-old woman. She presented leg edema and dyspnea on admission. Computed tomography revealed abdominal aortic aneurysm perforating left common iliac vein. Abdominal aortic aneurysm replacement and fistula closure were done on an emergency basis. Immunohistologic examination revealed that malignant mesothelioma invaded the aortic wall. Case 2: A 47-year-old woman presented with dyspnea. Enhanced computed tomography revealed rupture of the descending aortic aneurysm (saccular type). Aortic replacement was done on an emergency basis. One year after the operation, computed tomography revealed a giant mass (160×70mm) surrounding the descending thoracic aorta. On biopsy, malignant schwannoma was found to invade the descending aorta. Sometimes nonvascular tumors form aneurysms. So we should be careful in diagnosis before operation.