Aortic arch aneurysm generally requires an urgent treatment due to the risk of catastrophic aortic rupture. However, conventional surgery for aortic arch repair still carries significant risks of postoperative morbidity and mortality, especially in patients with old age. In an effort to correct the aortic pathology while minimizing the risks of complications, we performed a hybrid technique which comprises the off pump arch vessels debranching and endocascular aortic stent grafting in an 86-old male patient with an aortic arch aneurysm.
Aneurysm ; Aorta, Thoracic ; Aortic Rupture ; Chimera ; Humans ; Male ; Stents ; Transplants

Sarcoidosis is a systemic inflammatory disease with granulomatous lesions, and cardiac involvement occurs in 20~60% of patients. Isolated cardiac sarcoidosis is extremely rare, and heart transplantation can be performed, if indicated, contingent upon the absence of systemic manifestations of the disease. We present a case of isolated cardiac sarcoidosis with progressive heart failure, which was successfully managed by heart transplantation.
Heart ; Heart Failure ; Heart Transplantation ; Humans ; Sarcoidosis

BACKGROUND: The durability of the tissue valve is important in choice between a mechanical valve and a tissue valve in cardiac surgery. We studied the mid-term results of tissue valve in the aortic position. MATERIAL AND METHOD: The subjects were 380 patients who had undergone aortic prosthesis replacement between May 1990 and March 2009. We retrospectively analyzed hospital and outpatient records: the mean age was 69+/-9 years; the male to female ratio was 227 : 162; and the mean follow-up duration was 46.7+/-40.8 months (range 0~196 months). RESULT: 389 surgical cases in total had been taken with 380 patients. Early death occurred in 15 patients (3.9%). Overall survival rate at 1, 5 and 10 years were 92.3%, 78.1% and 54.2% respectively. Freedom from reoperation at 1, 5 and 10 years were 98.4%, 97.1% and 91.7% respectively. Freedom from structural valvular deterioration at 1, 5 and 10 years were 96.1%, 92.3% and 88.0% respectively. In the multivariate analysis of preoperative risk factors, young age (p<0.001) was significant risk factor for reoperation. High peak velocity in the postoperative period (p=0.034) and young age (p=0.029) were significant risk factors for structural valvular deterioration. Old age (p=0.001), long bypass time (p=0.035), concomitant coronary artery bypass graft surgery (p=0.003) and preoperative low left ventricular ejection fraction (p=0.003) were significant factors for early mortality. Preoperative estimated glomerular filtration rate (<60 mL/min) (p=0.025) and persistent left ventricular hypertrophy (p=0.032) were the risk factors for late mortality. CONCLUSION: This study showed that the freedom from reoperation and the freedom from structural valvular deterioration in aortic tissue valve replacement were acceptable. It will be necessary to conduct further studies with long-term follow-up and more patients.
Aortic Valve ; Coronary Artery Bypass ; Female ; Follow-Up Studies ; Freedom ; Glomerular Filtration Rate ; Heart Valve Prosthesis ; Humans ; Hypertrophy, Left Ventricular ; Male ; Multivariate Analysis ; Outpatients ; Postoperative Period ; Prostheses and Implants ; Reoperation ; Retrospective Studies ; Risk Factors ; Stroke Volume ; Survival Rate ; Thoracic Surgery ; Transplants