An 84-year-old man underwent transcatheter aortic valve replacement (TAVR) for severe aortic stenosis with heart failure. Paravalvular leak (PVL) of the aortic valve was observed immediately after the operation, and the heart failure was difficult to manage; closure with a vascular plug was attempted, but PVL did not improve. Therefore, four months after TAVR, the decision was made to perform surgical aortic valve replacement (SAVR). The operation was expected to take a long time due to the concomitant mitral valve replacement, ascending aortic valve replacement and pulmonary vein isolation, in addition to SAVR with removal of the TAVR valve, so a rapid deployment valve was used for aortic valve replacement. The patient's postoperative course was good, with no complications. Postoperative echocardiography showed no problems with the replaced aortic or mitral valves. Twenty-six days after surgery, the patient was discharged home, although it took time for rehabilitation due to the long hospital stay after TAVR. More than two years have passed since the surgery, and the patient is currently an outpatient with no symptoms of heart failure. The present report describes the use of a rapid deployment valve for surgical AVR after TAVR with good results.

A 57-year-old man presented with a one-month history of dyspnea. Computed tomography revealed a pulmonary embolism, and echocardiography revealed multiple linear floating thrombi in the right atrium. An urgent surgical thrombectomy was performed, and most of the thrombi in the right atrium and bilateral pulmonary arteries were removed under cardiopulmonary bypass. The thrombi in the right atrium adhered to the linear Chiari networks. The patient was treated with rivaroxaban uneventfully and subsequently discharged on postoperative day 26. Herein, we report a case of right atrial thrombi and pulmonary embolism likely augmented by the Chiari network, which was successfully treated with surgical thrombectomy.

A 57-year-old man was admitted with high fever and chest discomfort associated with aortic valve infective endocarditis. An echocardiogram showed severe aortic valve regurgitation. An emergent operation was performed. The aortic valve was destroyed and an annulus abscess was observed. Aortic valve replacement was performed. There was a large amount of pleural effusion in both chest cavities. Bilateral chest drainage was performed. Cardiopulmonary bypass weaning was performed uneventfully. The operation was finished without any mechanical support required. However, respiratory failure was observed to progress rapidly immediately after the operation. A postoperative X-ray showed bilateral pulmonary edema. Re-expansion pulmonary edema was diagnosed. Because oxygenation was not improved in ventilator settings, venovenous extracorporeal membrane oxygenation (V-V ECMO) was installed. Respiratory support with V-V ECMO was needed for 17 days postoperatively. It took 36 days before the patient was removed from the ventilator. V-V ECMO successfully managed bilateral re-expansion pulmonary edema.

The purpose of this study was to investigate the characteristics of the past injuries of female junior high and high school soccer players in comparison with those of male junior high and high school soccer players. 41 female and 60 male players were examined for the past injuries that they had experienced. The incidence of injuries in females was 0.21±1.69 injuries per player per year compared to 0.28±0.41 injuries per player per year in males. There was not significant difference in the incidence of past injuries between males and females. The most frequently injured region was the ankle in females and the upper extremities in males. Females experienced frequent ligament injuries while males experienced frequent fractures. It was unusual that females experienced a higher rate of Osgood-Schlatter disease. Females also had more traumatic injuries caused by non-contact incidents. We conclude that it is important for female soccer players in junior high and high school to take measures to prevent ligament injuries in the lower leg and traumatic injuries caused by non-contact incidents. We need to conduct further research to reveal why the females experienced a higher rate of Osgood-Schlatter disease.

Purpose: To clarify the family-perceived usefulness of a pamphlet for families of imminently dying patients. Methods: Physicians and/or nurses provided medical and practical information about the dying process using a pamphlet for families of imminently dying patients. We surveyed family members 6 months after the death of the patient about the perceived usefulness. Results: We sent out a questionnaire to 325 bereaved, and obtained an answer from 260 (response rate: 85%). Overall, 81% reported the pamphlet to be “very useful” or “useful”. The experience reported by the bereaved included: “Helped me to understand the dying process” (84%); “Helped me to understand how symptoms and changes occur” (76%), “Useful in preparation for patient's death“ (75%), “Helped me to understand the physical conditions of the patient” (75%), “Helped me to know what I can do for the patient” (74%). Conclusion: “A pamphlet for families of imminently dying patients” may be useful for members of an imminently dying patient's family.