1.A Case of Surgical Treatment for Aortic Root Dissection after Full Aortic Root Replacement with Stentless Aortic Valve
Nobuaki Suzuki ; Tadaaki Koyama ; Katsuhiro Hosoyama ; Yoshinori Nakahara ; Yuusuke Tsukioka ; Takuya Miyazaki ; Ken Furuhata ; Tomohiro Iwakura ; Takeyuki Kanemura ; Shigehiko Yoshida
Japanese Journal of Cardiovascular Surgery 2012;41(4):185-187
A 84-year-old woman underwent aortic root replacement with stentless bioprosthesis and coronary artery bypass grafting. Four years later, she presented with dyspnea. Transthoracic echocardiography revealed aortic regurgitation, dilation and dissection of the sinus of Valsalva. A Bentall operation was performed by using prosthetic graft and bioprosthetic valve. Intimal tear caused the aortic wall dissection and aneurysm of the Freestyle valve.
2.Parasitology/medical zoology pointing toward medical education remodeling
Yuzo TAKAHASHI ; Yuzaburo OKU ; Takashi AOKI ; Nobuaki AKAO ; Junko SHIMADA ; Mamoru SUZUKI ; Hiroyuki MATSUOKA ; Naoki ARIZONO ; Takafumi TSUBOI ; Tamotsu KANAZAWA ; Katsuyuki YUI ; Tsutomu TAKEUCHI
Medical Education 2010;41(1):17-21
3.Penetrating Thoracic Trauma with Undetected Left Ventricular Injury Presenting as Sudden Hypotension during Surgery
Shinya MASUDA ; Kota ITAGAKI ; Keisuke KANDA ; Masaharu HATAKEYAMA ; Masaaki NAGANUMA ; Nobuaki SUZUKI ; Koichi NAGAYA
Japanese Journal of Cardiovascular Surgery 2020;49(2):72-76
A 55-year-old man was brought to our hospital with a knife penetrating his left anterior chest wall following a suicide attempt. Massive left hemothorax was identified on echocardiography ; however, there was no evidence of cardiac tamponade. After draining blood from the left thorax, computed tomography (CT) revealed that the tip of the knife had penetrated the left lung and reached the left pulmonary vein. In preparation for cardiopulmonary bypass, an emergency thoracotomy was scheduled with a plan to access the left lung and left pulmonary vein. The patient was transferred to the operating room, and the procedure was started with the patient in the supine position. During dissection of the femoral vessels, the patient suddenly developed hypotension. After surgical access to the heart was achieved via median sternotomy, a pericardiotomy was performed and cardiopulmonary bypass was established. A 50-mm stab wound was identified at the lateral wall of the left ventricle. The knife was removed, and the left ventricular wound was repaired. The lingular segment of the left lung was partially resected. The patient had no postoperative complications and was transferred to the referral hospital on postoperative day 25. This case report emphasizes the importance of taking appropriate measures for thoracotomy and cardiopulmonary bypass in patients with penetrating thoracic trauma with massive hemothorax, even in the absence of cardiac tamponade on imaging. We were able to successfully manage a life-threatening condition by taking appropriate measures.