1.Surgical Treatment of Isolated Iliac Artery Aneurysm in Eight Cases.
Toshiyuki Yuda ; Hitoshi Matsumoto ; Takayuki Ueno ; Yosuke Hisashi ; Riichiro Toda
Japanese Journal of Cardiovascular Surgery 1999;28(3):146-150
Eight cases of isolated iliac artery aneurysms treated between January 1991 and December 1997 were reviewed. All patients were men and their ages ranged from 51 to 85 years (mean 69.6 years). The incidence rate relative to abdominal aortic aneurysm during the same period was 9.3%. The location of the iliac artery aneurysms was the common iliac artery in 6 patients and common and internal iliac artery in 2 patients. Rupture occurred in 3 patients (37.5%). Aneurysms ranged in size from 25mm to 55mm (mean 39.1mm) in 5 non-ruptured cases and from 50mm to 90mm (mean 71.7mm) in 3 ruptured cases (p<0.05). The operative procedures for common iliac artery aneurysms were aneurysmorrhaphy with prosthetic graft replacement in 7 patients and with common iliac-external iliac artery anastomosis in 1 patient. For internal iliac artery aneurysms, obliterative endoaneurysmorraphy was performed in 2 patients. Hartmann's operation with sigmoid colostomy was concomitantly performed in 1 case of rupture. Seven patients had good postoperative courses, however, one case of rupture that underwent Hartmann's operation died of multiple organ failure on the 13th postoperative day. Early diagnosis and elective surgery before rupture are recommended.
2.Infective endocarditis in a patient with lupus nephritis who was undergoing immunosuppressive therapy: A case of survival
Katsuhito Ihara ; Tatemitsu Rai ; Shotaro Naito ; Takayuki Toda ; Sei Sasaki ; Shinichi Uchida ; Noriaki Matsui
Journal of Rural Medicine 2017;12(2):139-145
Systemic lupus erythematosus is an autoimmune disease associated with mild valvular regurgitation. However, there have been no detailed reports of infective endocarditis in patients with systemic lupus erythematosus. Here, we describe a case of a 55-year-old woman without any cardiac abnormalities who was diagnosed with lupus nephritis by renal biopsy; she contracted infective endocarditis while receiving immunosuppressive therapy. Our case emphasizes that special consideration of the occurrence of infective endocarditis, and its early diagnosis and treatment are mandatory for patient survival. We propose that echocardiography should be performed before treating patients with systemic lupus erythematosus who have an uncertain cardiac status.