ABSTRACT
A 35-year-old man was followed up for systemic lupus erythematous with antiphospholipid antibody-positive. He underwent an echocardiogram for a closer examination of his heart murmur. Transthoracic echocardiography revealed a calcified mass of 30 mm in diameter in the right ventricular outflow tract. Surgery was performed through an upper hemi-sternotomy. After establishment of beating-heart cardiopulmonary bypass, the pulmonary trunk was opened with a longitudinal incision. The highly calcified mass was located immediately below the pulmonary valve. We exfoliated the mass from the right ventricle, and resected it en bloc during short-term cardiac arrest. The postoperative pathological diagnosis was a calcified amorphous tumor. The patient was discharged from our hospital on postoperative day 12．No tumor recurrence was observed 9 months after the surgery.
ABSTRACT
A man in his fifties was diagnosed with retrograde type A acute aortic dissection. He underwent total arch replacement using the Gelweave Lupiae graft and staged thoracic endovascular aortic repair. Five days after discharge from the hospital, he was referred to our institution because of severe hemolytic anemia. Electrocardiography-gated computed tomography angiography demonstrated significant kinking of the graft adjacent to the proximal anastomotic site. Cine cardiac magnetic resonance imaging showed that graft kinking deteriorated during systole. We concluded that his hemolytic anemia was caused by graft kinking and surgical repair was required. The graft was transected at the kinking site and then reconstructed. After surgical repair, the hemolytic anemia improved immediately.