1.A Case of Descending Graft Replacement of the Anastomotic Aneurysm Using Simple Hypothermic Retrograde Cerebral Circulation 9 Years after Surgery of the Distal Aortic Arch.
Akihiko Sasaki ; Junichi Sakata ; Hiroki Satou ; Teruhisa Kazui
Japanese Journal of Cardiovascular Surgery 2002;31(4):311-313
Anastomotic aneurysm was diagnosed in a 77-year-old man following graft replacement of the distal aortic arch aneurysm using the inclusion method in 1991, Enhanced CT demonstrated the aneurysm of the distal anastomotic site with a maximum diameter of 5cm between the graft and the aneurysmal wall. On left thoracotomy the aneurysm was found to severely adhere to the lung, so it was difficult to dissect its adhesion and clamp the proximal aorta. The rectal temperature was cooled to 18°C with the aid of femoro-femoral bypass. We anastomosed the previous graft-end to the new graft with one side branch during simple hypothermic retrograde cerebral circulation (RCC). RCC time was 16min and the distal end was anastomosed to the descending thoracic aorta. Though it took a long time to undertake systemic cooling and rewarming, intraoperative bleeding was small and the postoperative course was satisfactory without cerebral complication.
2.A Case of Myxoma Originating from the Anterior Leaflet of the Mitral Valve.
Tomio Abe ; Noriyasu Watanabe ; Hidehiro Hamaya ; Satomi Inoue ; Hiroki Satou ; Sakuzo Komatsu
Japanese Journal of Cardiovascular Surgery 1995;24(5):330-332
We reported a rare case of myxoma originating from the anterior leaflet of the mitral valve. A 65-year-old woman was admitted with sympotomes of easily fatigability and palpitation. On auscultation, a grade II/IV systolic murmur was audible at the apex. Echocardiography demonstrated a dense mass arising from the anterior mitral leaflet. The tumor (16×13×10mm in size) was resected from the anterior leaflet of the mitral valve. There was no definite evidence of a tumor stalk on the mitral valve nor valve regurgitation after the operation. Microscopically, polyhedral cells were recognized, indicating myxoma. The postoperative course was uneventful and no recurrence has been noticed during the past 6 years.