1.A Case Report of Surgical Treatment for Infectious Endocarditis with Ventricular Septal Defect and Double-Chambered Right Ventricle
Ryusuke Suzuki ; Masamichi Nakajima ; Toshiaki Watanabe ; Ken Okamoto ; Akiyuki Takahashi
Japanese Journal of Cardiovascular Surgery 2003;32(5):300-303
We report a successfully treated case of infectious endocarditis with ventricular septal defect (VSD) and double-chambered right ventricle. A 41-year-old man complained of dyspnea. Echocardiography showed his tricuspid valve, aortic valve, and pulmonary valve had vegetation and severe regurgitation. He received treatment with antibiotics but it was not effective. He underwent TVR, AVR, pulmonary valve resection, VSD patch closure and RV abnormal muscle resection. Pathological findings of resected valves showed infectious endocarditis. He recovered uneventfully and resumed his original social activities.
2.A Successful Operation Case of Budd-Chiari Syndrome.
Akiyuki TAKAHASHI ; Syuuji SHIRAKATA ; Satoshi NIU ; Yutaka KANKI ; Yukio WADA ; Kouichi OGA ; Takahiro OKA
Japanese Journal of Cardiovascular Surgery 1991;20(7):1294-1298
A case of Budd-Chiari syndrome in which direct surgical intervention was successfully performed is reported. A 43-year-old female who had had a history of hepatic coma was pointed out complete obstruction of inferior vena cava (IVC) between the right atrium and diaphragma, associated with hepatic dysfunction and esophageal varices. At operation, the IVC lesion was visualized directly by thoracotomy through midsternal incision and by laparotomy through right hypochondrial oblique incision, with the liver retracted. Under partial extracorporeal circulation with suction of blood from hepatic vein, the IVC was incised, 3cm in length, and membranous tissue causing obstruction was resected. The defect of the IVC wall was repaired with ringed EPTFE patch. Postoperatively, both central venous and portal pressure were decreased, 21 mmHg to 10mmHg and 26cm H2O to 21cm H2O, respectively, with good patency of the IVC on venogram. Now the patient is up and well, 11 months after operation. Thus, complete removal of obstruction under direct vision is thought to be important for surgical treatment of Budd-Chiari syndrome.
3.A case of Successfully Operated Pelvic Arteriovenous Malformation.
Akiyuki Takahashi ; Shinichi Sato ; Jiro Hirai ; Syunsuke Nakajima ; Kazuhiro Kitaura ; Yukio Wada ; Takahiro Oka
Japanese Journal of Cardiovascular Surgery 1994;23(2):125-128
A lower abdominal tumor with thrill and bruit was pointed out in a 59-year-old female. Angiography showed a pelvic arteriovenous malformation (AVM) with remarkably dilated vessels resembling an aneurysm. Feeding arteries for this AVM originated from the right internal iliac artery, right lumbar artery and right renal artery, and drainage blood flowed into the inferior vena cava from the dilated vessel via a large vein. At operation the right internal iliac artery and right lumbar artery were ligated and the dilated vessel with AVM, which connected with the right renal artery, was resected. An angiography 16 days after the operation revealed the normal arteries without AVM and the right internaal iliac artery filled through collateral arteries. Recently catheter embolization in frequently the first choice for treatment of AVM. However, in the case of AVM with aneurysmal dilated vessels, surgical resection should be selected.
4.An Operated Case of Cardiac Compression by Chronic Expanding Hematoma in the Pericardial Cavity after Cardiac Surgery
Masahiro Dohi ; Tomoya Inoue ; Taiji Watanabe ; Osamu Sakai ; Akiyuki Takahashi ; Yuichirou Murayama ; Masamichi Nakajima
Japanese Journal of Cardiovascular Surgery 2009;38(2):130-134
A rare surgical case of chronic expanding hematoma in the pericardial cavity is reported. A 78-year-old man had undergone coronary artery bypass grafting 2 years previously. He had suffered from general malaise, increasing shortness of breath and systemic edema from 18 months after the operation. Echocardiography revealed an intrapericardial mass compressing the cardiac chambers resulting in insufficiency of the ventricular expansion. Under extracardiopulmonary bypass and cardiac beating, resection of the mass and additional coronary artery surgery were implemented. The mass was encapsulated with thick fibrous membrane containing old degenerated coagula the bacterial culture of which was negative and was histopathologically diagnosed as chronic expanding hematoma. The patient's postoperative course was uneventful and symptoms with cardiac failure were relieved. There has been no recurrence for more than 18 months.
5.Surgical Repair of Coronary Artery Fistulas with a Giant Coronary Artery Aneurysm Dilated from Valsalva Sinus
Nanae Nishiki ; Akiyuki Takahashi ; Masahiro Dohi ; Taiji Watanabe ; Osamu Sakai ; Masamichi Nakajima
Japanese Journal of Cardiovascular Surgery 2011;40(2):58-61
We report a case of a 64-year-old man who had a fistula from the right coronary artery to the right ventricle, with an asymptomatic giant coronary aneurysm. Multi-detector computer tomography showed an aneurysm from the sinus of Valsalva to the mid-right coronary artery (RCA). Its diameter was over 50 mm. We performed aneurysmectomy direct closure of the fistula, and coronary artery bypass graft with saphenous vein graft cardiopulmonary bypass. The enlarged RCA orifice was closed with a vascular prosthesis, and the postoperative course was uneventful.
6.Autotransplantation and Concomitant Pneunectomy for an Intracardiac Metastatic Lesion and Primary Pulmonary Blastoma of the Left Lung
Masaaki Yamagishi ; Keisuke Shuntoh ; Tsutomu Matsushita ; Akiyuki Takahashi ; Katsuji Fujiwara ; Takeshi Shinkawa ; Takako Miyazaki ; Nobuo Kitamura ; Shougo Toda
Japanese Journal of Cardiovascular Surgery 2004;33(1):38-41
Pulmonary blastoma is rare and its prognosis very poor. A 6-year-old boy was referred to our hospital with chest pain. Computed tomography demonstrated that the left pleural cavity was filled with a tumor. Cardiac echocardiography demonstrated that the tumor had invaded through the pulmonary vein into the left atrium and that the tumor extended into the left ventricle. Part of the tumor was adhered to the anterior leaflet of the mitral valve. To increase operative radicality, an autotransplantation technique was performed concomitantly with resection of the original lesion. Through a median sternotomy, a moderate hypothermic cardiopulmonary bypass was established to obtain cardiac arrest. First, longitudinal incision of right-sided of the left atrium was made. The tumor invaded into the left atrium through the left superior pulmonary orifice. The ascending aorta, the main pulmonary artery, and both caval veins were transected. The left atrium was incised along the pulmonary venous orifices. The heart was completely removed from the mediastinum and transferred to another table. Resection of the intracardiac metastatic lesion and mitral valve replacement was accomplished. During this time, thoracic surgeons performed a left pneunectomy. The left atrial wall around the left pulmonary venous orifices was resected in combination with the left lung. After the deficit of the left atrial wall was repaired with a Gore-Tex patch, the heart was replaced and we reconstructed the great arteries and caval veins. The autotransplantation technique is a useful procedure for combined lesions of the heart and lung.
7.Quadricuspid Aortic Valve Complicated with Severe Aortic Regurgitation and Left-Sided Inferior Vena Cava.
Jun SHIRAISHI ; Kazunari OKAWA ; Kohei MUGURUMA ; Daisuke ITO ; Masayoshi KIMURA ; Eigo KISHITA ; Yusuke NAKAGAWA ; Masayuki HYOGO ; Akiyuki TAKAHASHI ; Takahisa SAWADA
Journal of Cardiovascular Ultrasound 2017;25(1):34-37
No abstract available.
Aortic Valve Insufficiency*
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Aortic Valve*
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Echocardiography, Transesophageal
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Vena Cava, Inferior*