Methods: This study included 62 patients with Lenke type 2 AIS who underwent posterior correction and fusion surgeries. The patients were categorized into the PSI and non-PSI groups based on their radiographic shoulder height 2 years after surgery. Radiographic parameters, lower end vertebra (LEV), lower instrumented vertebra (LIV), sagittal stable vertebra (SSV), postoperative DA and DJK, and Scoliosis Research Society 22 scores were compared between the two groups using unpaired t -tests or Pearson’s chi-square tests. Results: Twenty-eight patients in the PSI group and 34 in the non-PSI group were evaluated. Three patients had DA in the PSI group and 10 with DA and four with DJK in the non-PSI group. LIV–LEV was higher in the PSI group than in the non-PSI group. Although the LIV–SSV was not significantly different between the two groups, among the three patients with DJK, two had LIV–SSV of −3, one had −1, and one had 0. No significant differences in other examinations were noted between the two groups. Conclusions Although more proximal LIV selection might lead to stable DA and DJK, the LIV selection should not be extended distally to prevent DA and DJK because favorable shoulder balance and clinical outcome can still be achieved.

Methods: This single-center study included 130 patients with osteoporotic vertebral fractures who underwent BKP and preoperative computed tomography and magnetic resonance imaging. After propensity score matching for age; sex; body mass index; fracture level; use of steroids, teriparatide, or osteoporosis medication; and previous AVF, patients were classified into the AVF (−) and AVF (+) groups, each of which included 34 patients. Bone strength was assessed using the L1 HU, L1–4 HU (mean HU of L1–L4), L1 VBQ, and L1–4 VBQ. Group differences were analyzed, and the predictive accuracy for AVF was evaluated using area under the receiver operating characteristic curve (AUC). Results: L1 HU was significantly lower in the AVF (+) group than in the AVF (−) group (92.1±29.4 vs. 71.6±21.4, p =0.013). No significant differences between the groups were observed for L1–4 HU, L1 VBQ, and L1–4 VBQ. L1 HU had the highest AUC (0.657), compared with those for L1–4 HU (0.625), L1 VBQ (0.524), and L1–4 VBQ (0.523). The predictive accuracy of L1 was superior to that of L1–4 for both HU and VBQ scores. Conclusions HU was superior to VBQ in predicting AVF risk after BKP, with L1 HU being the most effective indicator of bone strength and AVF risk.

We report a 69-year-old woman with transient mitral valve regurgitation and hemolysis following mitral valve replacement with a Carpentier-Edwards pericardial bioprosthesis. She had a history of congestive heart failure caused by mitral valve regurgitation so we performed mitral valve replacement with a Carpentier-Edwards pericardial bioprosthesis (Model 6900). Three days after surgery, a systolic murmur became clearly audible and the serum LDH level reached a maximum of 2, 018IU/l on postoperative day 10. Echocardiography showed regurgitant flow through the center of the bioprosthetic valve. It was thought that stent distortion of the implanted pericardial bioprosthesis had occurred and re-operation would be necessary, but the regurgitant flow disappeared suddenly on postoperative day 12. If mitral valve regurgitation occurs following mitral valve replacement with a pericardial bioprosthesis, stent distortion should be taken into consideration.

From 1985 through 1994, 12 consecutive patients with Taussig-Bing anomaly underwent an arterial switch. Age at operation varied from 8 to 42 months (mean 21 months). Coarctation of the aorta was present in 6 patients (including 4 with hypoplasia of the aortic arch), interruption of the aortic arch in one, straddling mitral valve in one and subaortic stenosis in two. The relationship of the great arteries was D-transposition in 11 patients (oblique in 6 and anteroposterior in 5) and side-by-side in one. Eleven patients had previous palliative surgery. Pulmonary artery banding was done in 11 patients, Blalock-Hanlon in 3, carotid flap aortoplasty in 3, subclavian flap aortoplasty in 2, extended aortic arch anastomosis in 2 and ligation of PDA in 1. The Lecompte maneuver was adopted in all but one patient with side-by-side great vessels. Intraventricular reconstruction was done through the right ventricle in 11 patients and through the right atrium in one who underwent one-stage repair. There was one early death, which was related to thrombosis of the superior mesenteric artery. One patient with side-by-side great vessels died at home 6 months after the arterial switch operation. The suspected cause of death was myocardial infarction due to compression of the left coronary artery by the pulmonary artery. In the follow-up of 10 patients ranging from 1.8 to 9.4 years (average 6.3 years), one required reoperation for pulmonary stenosis. We conclude that two-staged arterial switch operation of Taussig-Bing anomaly with D-transposition can be performed with low mortality, but there seems to be some risk of the compression of the left coronary artery in the original Jatene method for Taussig-Bing anomaly with side-by-side great vessels.

Case 1 was a 2-year-old girl who underwent mitral valve replacement with a St. Jude Medical valve for severe mitral regurgitation 14 days following common atrioventricular canal defect correction. The postoperative course was uneventful, but an unilateral thrombosed leaflet of a St. Jude Medical valve was observed 3 times by echocardiography and fluoroscopy. Thrombolytic therapy with urokinase was done each time and the thrombus was successfully dissolved. Case 2 was a 1-year-old girl who underwent closure of ventricular septal defect and mitral valve replacement with a St. Jude Medical valve for ventricular septal defect, severe mitral regurgitation and pulmonary hypertension. Unilateral thrombosed leaflet of the St. Jude Medical valve and poor left ventricular function were found by echocardiography 11 days after the operation. Thrombolytic therapy with urokinase was successfully performed without any complications. Thrombolytic therapy with urokinase was considered to be effective treatment for unilateral thrombosed leaflet of a mechanical bileaflet valve prosthesis in a child. Poor left ventricular function might be one of the causative factors of unilateral thrombosed leaflet of a mechanical bileaflet valve prosthesis.

Aortic valve replacement was carried out for aortic regurgitation in Behçet's disease. A prosthetic valve was fixed using reinforced felt-strip mattress sutures. Difficulty to ensure adequate myocardial protection due to ostial stenosis in the right coronary artery resulted in the occurrence of intraoperative myocardial infarction. Right ventricular assist with the help of a centrifugal pump was employed to obtain successful recovery from right cardiac failure. It was noted that at operation attention should have been paid to the aortic valve and also to abnormalities of the coronary artery and that control of the inflammatory reaction by steroids was essential before and after the operation.