Aortic Valvulo-annuloplasty for Insufficient Bicuspid Aortic Valve; Experience in 3 Cases / 日本心臓血管外科学会雑誌

We have experienced 3 successful repair surgeries for insufficient bicuspid aortic valve. The operative procedure consisted of combinations of suture placation, raphe triangular resection, commisural annuloplasty, and patch closure of perforation due to infectious endocarditis. The postoperative course was uneventful and postoperative echocardiography showed residual regurgitation as only trivial or mild. Retrospective study done on 19 previous cases with insufficient bicuspid aortic valve demonstrated that this operative procedure could have been applied in 15 (79%) of the cases. These results showed that repair surgery for insufficient bicuspid aortic valve is useful and has a wide application.

Valvuloplasty for Aortic Valve Regurgitation Due to Congenital Bicuspid Valve / 日本心臓血管外科学会雑誌

We encountered a case of aortic valvuloplasty for aortic regurgitation due to congenital bicuspid valve. A 31-year-old man was found to have aortic regurgitation due to prolapse of a leaflet of the bicuspid valve by echocardiography. Under cardiopulmonary bypass, the right and left coronary cusps were conjoined and that conjoined cusp was larger than that of the opposing leaflet and had a longer free edge. A raphe was present in the conjoined leaflet. At first, we shortened the elongated free edge of the prolapsing leaflet by means of a triangular resection, and placed horizontal mattress sutures at each commissure. Furthermore, we performed subcommissular annuloplasty at each commissure, resulting in good coaptation of cusps. The patient survived and has shown an uneventful recovery. It is likely that this method of aortic valvuloplasty can be used for aortic regurgitation due to congenital bicuspid valve.

A Successful Case of Surgical Repair for a True Aneurysm of the Brachial Artery Caused by Blunt Injury / 日本心臓血管外科学会雑誌

We present one case of true aneurysm of the branchial artery which is very rare among peripheral aneurysms. A 52-year-old woman developed a bruise on the right upper arm around June 1993, but did nothing about it because she felt no symptoms. A pulsating mass became palpable at this site around the following month. Digital subtraction angiography revealed an aneurysm formation of 1.5×1.5cm in size in the right brachial artery. Operative findings showed that the wall of the aneurysm joined the normal region and all the vascular layers in the aneurysm were maintained. After resection of the aneurysm, end-to-end anastomosis was carried out. A diagnosis of true aneurysm was confirmed by the pathohistological findings that the vascular three-layer structure was maintained, with few arteriosclerotic changes.