Infected abdominal aortic aneurysm (IAAA) are rare, but life-threatening. This time we experienced six cases of infected abdominal aortic aneurysm. We measured the soothing of bacteremia by two weeks of antibiotic treatment before operation, if not in a state of impending rupture or rupture. The in situ prosthetic graft replacement surgery was the first choice. In five cases, we replaced by an in situ dacron graft with Rifampicin. However, one case that was by pondylitis caused by Helicobacter cinaedi was treated by extra-anatomical bypass. There was no post-operative infectious complication. In addition, surgery/hospital death was 0%.

A-54-year-old man with an extensive dissecting thoracic aortic aneurysm underwent staged surgery which consisted of preceding total aortic arch replacement with the frozen elephant trunk technique using J Graft Open Stent Graft, followed by open descending aorta repair. During the second operation, a Dacron graft was anastomosed directly to the stent graft and the true lumen thus, the true lumen could be preserved around the stent graft. We herein discuss our approach in this case, focusing on prevention of bleeding from the elephant trunk.

Behcet's disease (BD) is a systemic vasculitis, while myelodysplastic syndrome (MDS) is a heterogeneous group of clonal hematologic disorders characterized by ineffective hematopoiesis. Some studies suggest a relationship between MDS and BD, especially intestinal BD, and trisomy 8 seems to play an important role in both diseases. There are several reports on patients with BD comorbid with MDS involving trisomy 8 that frequently have intestinal lesions refractory to conventional medical therapies. Tumor necrosis factor (TNF)-alpha is strongly involved in the pathophysiology of several autoimmune diseases such as rheumatoid arthritis, inflammatory bowel disease, and BD. In addition, TNF-alpha plays an important role in the pathophysiology of MDS by inhibiting normal hematopoiesis and inducing the programmed cell death of normal total bone marrow cells and normal CD34+ cells. Recent clinical reports demonstrate the favorable effect of TNF-alpha antagonists in patients with refractory intestinal BD and in those with MDS. We present the case of a patient with intestinal BD and MDS involving trisomy 8 who was successfully treated with adalimumab.
Adalimumab ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Behcet Syndrome ; Bone Marrow Cells ; Cell Death ; Hematopoiesis ; Humans ; Inflammatory Bowel Diseases ; Myelodysplastic Syndromes* ; Systemic Vasculitis ; Trisomy* ; Tumor Necrosis Factor-alpha

A 59-year-old man, diagnosed with severe mitral regurgitation, moderate tricuspid regurgitation, and chronic atrial fibrillation with situs inversus totalis, was referred to our hospital. A median sternotomy approach was performed. The surgeon operated from the left side of the operating table, and had an excellent exposure to the mitral and tricuspid valves during the operation. The mitral valve was repaired with the posterior cusp plication technique and ring annuloplasty. The tricuspid valve was repaired with ring annuloplasty. We use a conventional semi rigid ring turned over, because the tricuspid valve has an asymmetric configuration. FullMAZE, and left atrial appendage closure were performed, too. The postoperative course was uneventful.