A 74-year-old man with renal failure had been treated with maintenance hemodialysis for 1.5 years at another hospital. The patient had an abdominal aortic aneurysm, bilateral iliac artery occlusion and coronary artery stenosis with a lesion in the left main trunk, but had been under observation because of the high risk of surgery. The patient elected to have surgery and was admitted to our hospital. We performed simultaneous surgery for severe coronary artery stenosis and abdominal aortic aneurysm with a maximum diameter of 85mm. The postoperative course was generally uneventful, but the patient required treatment of arrhythmia. We conclude that simultaneous surgery for angina pectoris and abdominal aortic aneurysm is feasible even in hemodialysis patients. It is important to pay attention to arrhythmia in the management of such patients, especially those with decreased cardiac function.

A 60-year-old male who had a history of Buerger's disease was admitted due to chest pain on exertion. Coronary angiography showed severe double vessel disease (the left anterior descending artery and the right coronary artery). Carotid angiography showed severe stenosis of the left internal carotid artery associated with brain ischemia. In addition, angiography of the lower extremities showed segmental occlusion and collateral arteries resembly a “corkscrew” appearance. We implanted a stent in the carotid artery followed by revascularization surgery of the left lower leg and simultaneous coronary artery bypass surgery. The postoperative course was excellent.

Positron emission tomography (PET) is an established imaging tool in oncology that has also been used in infectious and inflammatory diseases. PET combined with computed tomography (PET/CT) can be used to visualize metabolic activity with precise localization. We report an infant with late presentation of poststernotomy mediastinitis, the diagnosis and localization of which was confirmed by PET/CT. An 8-month old infant, who had undergone the Jatene procedure and right ventricle outflow reconstruction 6 months prior, was admitted for inflammation surrounding the superior aspect of the healed scar. Cultures from the wound grew methicillin-resistant Staphylococcus aureus (MRSA). Although the only symptom was discharge from the wound, and there were no other signs or symptoms suggestive of severe general infection, substernal abscess was suspected by magnetic resonance imaging. Since PET/CT revealed high accumulation of 18-fluorodeoxyglucose at the substernal region, the diagnosis of MRSA mediastinitis was made, which was confirmed by subsequent surgical treatment.