A pseudoaneurysm of the ascending aorta is a complication found in aortic valve surgery. A 66-year-old man who had a previous history of aortic valve replacement due to infectious endocarditis was admitted to our hospital suffering from chest pain. Follow-up chest X-ray and transthoracic echocardiogram had revealed no findings of pseudoaneurysm during the intervening period. At admission, computed tomographic scan and transesophageal echocardiogram each showed a Type A acute aortic dissection and a pseudoaneurysm of the ascending aorta. Under cardiopulmonary bypass and deep hypothermic circulatory arrest, an ascending aortic graft replacement was carried out uneventfully. The patient is well 14 months postoperatively. Postoperative examinations following aortic surgery should be performed not only from the view point of cardiac function, but also from that of a pseudoaneurysm.

In the U-40 column, we conducted a questionnaire survey of the U-40 generation on the theme of the specialist system for cardiovascular surgery and reported on the present condition and problems in obtaining certification. With the introduction of a new system, off the job training and participatory training using extracorporeal circulation techniques were newly mandated. In this article, we report the results and discussion of the questionnaire survey regarding the present condition of extracorporeal circulation training for the U-40 generation and the pros and cons of training programs.

The U-40 generation of surgeons are practicing through trial and error, and form various careers. At the 51st Annual Meeting of the Japanese Society of Cardiovascular Surgery, U-40 Special Project, we looked back on the U-40 generation and more senior doctors to see what kind of future visions, problems and careers they have had. We conducted a questionnaire for the purpose of visualizing the future prospects of the U-40 generation. In this article, we report the results.