1.A Case of Thoracic Aortopulmonary and Left Coronary Artery-Pulmonary Artery Fistulas with Aneurysms Treated with Coil Embolization, Aneurysm Resection, and Fistula Closure
Yuria FURUYAMA ; Kota KAWADA ; Toru KAMEDA ; Makoto KOYAMA ; Tsubasa YOSHIKAWA ; Erika HANJI ; Takahide YAO ; Shinnosuke OKUMA ; Muneyasu KAWASAKI ; Takeshiro FUJII
Japanese Journal of Cardiovascular Surgery 2025;54(5):212-215
A 66-year-old man with an abnormal electrocardiogram during a health examination sought evaluation at the cardiology department. Contrast-enhanced computed tomography (CT) revealed the presence of aneurysms associated with aortopulmonary and left coronary artery-pulmonary artery fistulas. One of the identified aneurysms measured 20 mm. The patient was then referred to our department for surgical intervention. Although the patient was asymptomatic, surgery was planned due to the risk of rupture. Initially, coil embolization was performed to address the aortopulmonary fistula, which was followed by a median sternotomy. Intraoperatively, multiple tortuous abnormal vessels connecting both coronary arteries to the pulmonary artery were observed, along with aneurysms at the base of the pulmonary artery. The aneurysms were excised under cardiopulmonary bypass, and the opening of the pulmonary artery fistula was closed. Subsequent coronary angiography during surgery and postoperative cardiac CT confirmed the complete resolution of the abnormal vessels and aneurysms. The patient had an uneventful postoperative course and was discharged. We present the case of a patient with aneurysms associated with thoracic aortopulmonary and left coronary artery-pulmonary artery fistulas and review the relevant literature. The case was managed with a single-stage surgery involving coil embolization, aneurysm resection, and fistula closure.
2.A Case of Resection of Fibroelastoma by Endoscopy
Yoshio NUNOI ; Takeshiro FUJII ; Tomoyuki KATAYANAGI ; Shinnosuke OKUMA ; Yuzo KATAYAMA ; Tsukasa OZAWA ; Noritsugu SHIONO ; Yoshinori WATANABE
Japanese Journal of Cardiovascular Surgery 2018;47(3):105-108
We report a case of a 64-year-old woman who presented with symptoms for the common cold, for a medical examination. The chest X-ray showed enlargement of the heart, and echocardiography detected a mobile mass suggestive of a tumor 21×14 mm in the left ventricle. Because there was a risk of embolism, we decided to perform an operation. The tumor was elastic and soft and had a stalk arising from the wall of the left ventricle. We considered that it would be difficult to observe and expose the left ventricular tumor by direct vision. Therefore, we chose to perform a complete endoscopic resection. The tumor was determined histopathologically to be a papillary fibroelastoma. Here, we report the relatively rare benign tumor, a papillary fibroelastoma, and include a discussion of the literature.
3.An Operative Case of Traumatic Aortic Regurgitation
Shinnosuke Okuma ; Takahiko Misumi ; Tsutomu Itou ; Akihiro Yoshitake ; Osamu Ishida ; Akinori Hirano
Japanese Journal of Cardiovascular Surgery 2013;42(3):179-182
Case reports of traumatic aortic regurgitation are rare. We report a case of a 62-year-old man injured by falling from a paraglider. After recovering from multiple injuries and discharge, he began to suffer from dyspnea. Severe aortic regurgitation and pseudoaneurysm of the sinus of Valsalva were diagnosed by ultrasound cardio graphy (UCG) and multi-detector-row computer tomography (MDCT). After cardiac failure was controlled, we operated. The commissure between the left and the right coronary cusps was detached from the aortic wall, and a modified Bentall operation was performed. The patient recovered well and was discharged uneventfully.


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