ABSTRACT
A 72-year-old man was referred to our hospital because of lumbago and an abdominal aortic aneurysm (AAA). Computed tomography revealed the AAA to be 5cm in diameter with a retroperitoneal hematoma. A diagnosis of chronic contained rupture of an AAA was made, and an operation was performed. At laparotomy, a punched-out defect (10×20mm) that was thought to connect the thrombosed aneurysm to an organized retroperitoneal hematoma was discovered on the right side of the aorta. The aneurysm was replaced with a Y-shaped prosthetic graft. The patient's postoperative course was uneventful. This case of chronic contained rupture of an AAA was distinctly different from cases of acute rupture. Although patients with chronic contained rupture of an AAA are hemodynamically stable, such cases should be assessed and treated as quickly as possible because of the risk of re-rupture.
ABSTRACT
A 34-year-old man had been in a motor vehicle accident at age 21. Thirteen years later, he complained of fatigue and palpitations, and was evaluated at an outside hospital. Echocardiography revealed severe tricuspid regurgitation and the patient was referred to our institution for treatment. The anterior leaflet of the tricuspid valve was torn and the attached chorda was also torn. The torn anterior leaflet was sutured directly, and an artificial chorda was created using an e-PTFE suture. An annuloplasty was performed with a 34mm Carpentier-Edwards ring. The patient's recovery was uneventful, and postoperative echocardiography revealed no regurgitation.