We report a case of minimally invasive cardiac surgery (MICS) for partial anomalous pulmonary venous return (PAPVR) to the high portion of the superior vena cava. A 34-year-old female was referred to our hospital for exertional chest oppression, and was diagnosed with PAPVR and a sinus venosus atrial septal defect. Two pulmonary veins were connected to the superior vena cava (SVC) : one to the SVC-atrial junction and the other to the high SVC adjacent to the azygos connection. We performed an intracardiac repair through a small right axillary incision. The postoperative course was uneventful. MICS may become a useful option for PAPVR repair.

Ascites is a rare sign of aortic valve disease. Here, we report two cases of refractory ascites that had resulted from aortic stenosis and insufficiency and consequently improved after aortic valve replacement. The first case was a 44-year-old female who had undergone aortic valve repair for aortic stenosis 15 years earlier. She complained of dyspnea and severe abdominal distension due to unimproved massive ascites despite medical therapy. She was diagnosed with aortic stenosis and insufficiency and functional tricuspid insufficiency as well as complete atrioventricular block. She underwent mechanical aortic valve replacement, tricuspid annuloplasty and DDD pacemaker implantation. The second case was a 61-year-old man with a history of alcoholic liver disease who had been hospitalized for massive ascites, progressing rapidly in spite of aggressive medical therapy. Echocardiography revealed severe aortic stenosis and insufficiency; thus, he underwent bioprosthetic aortic valve replacement. Both patients were completely free from ascites about 6 months after surgery.

Objective: Therapeutic antibodies have few varieties of side effects due to their high specificity; however, many therapeutic antibodies have serious side effects. A thorough understanding of the side effects is crucial for early recognition and optimal management. To facilitate the understanding of the side effects of therapeutic antibodies, this study attempted to classify therapeutic antibodies based on their side effects using principal component analysis (PCA) and cluster analysis. Method: We collected data on the serious side effects of therapeutic antibodies from package inserts and created a therapeutic antibody-side effect matrix, with therapeutic antibodies as indices and side effects as columns. PCA was performed on the therapeutic antibody-side effect matrix, and hierarchical cluster analysis was performed using principal components. Results: The therapeutic antibodies were classified into four clusters. Cluster 1 included immune checkpoint inhibitors, and featured type 1 diabetes, thyroid disorder, and myasthenia gravis. Cluster 2 included antibodies that inhibit the vascular endothelial growth factor pathway, and featured impaired wound healing, nephrotic syndrome, and thrombosis. Cluster 3 included anti-epidermal growth factor receptor antibodies, and featured diarrhea, hypomagnesemia, and skin disorders. Cluster 4 included other therapeutic antibodies, and featured infection, bone marrow suppression, and hypersensitivity. Conclusion: Therapeutic antibodies can be classified based on their side effects. The results of this study make it easier to understand the side effects of therapeutic antibodies with complex profiles. A better understanding facilitates early detection of side effects and enables high-quality management of side effects.