ABSTRACT
The patient was a 75-year-old man who was referred due to hematuria. CT revealed bladder carcinoma 8cm in length, a 5-cm aneurysm of the abdominal aorta and a 3-cm aneurysm of the left common iliac artery. He was referred to our hospital for the treatment of bladder carcinoma and aneurysms. We simultaneously performed Y graft replacement, radical cystectomy and bilateral cutaneous ureterostomy. His postoperative course was uneventful, without any prosthetic infection.
ABSTRACT
A 51-year-old woman was referred to our hospital for investigation of an abnormal ECG. Transesophageal echocardiogram revealed a round mass which originated from the right coronary cusp of the aortic valve. The tumor was successfully excised from the aortic valve, and the postoperative echocardiogram showed normal aortic valve function. Pathological examination demonstrated papillary fibroelastoma.
ABSTRACT
Since arteriosclerosis is a general progressive disease, an aneurysm of the thoracic aorta is not infrequently complicated by ischemic heart disease. Therefore, assessment of indications of surgical treatment and selection of the surgical procedure and auxiliary procedures on the basis of accurate preoperative evaluation of ischemic heart disease are considered to be very important for improving the results of operations for thoracic aortic aneurysm. Recently. we successfully operated on a 64-year-old patient with a left ventricular aneurysm and a descending aortic aneurysm. One-stage operation was performed by a left thoracotomy approach and partial left heart bypass by draining the pulmonary artery into the femoral artery with mild hypothermia. The approach and the auxiliary procedures employed in this patient are considered to be a useful combination applicable also to one-stage operation for descending aortic aneurysm and coronary artery bypass grafting.
ABSTRACT
A 72-year-old man suffering from postinfarction angina and atrial septal defect (ASD) underwent a combined operation of four bypass graftings and direct closure of ASD. The great saphenous vein was harvested with the use of a bipolar Nd-YAG laser dissector without scissors or threads. Nd-YAG laser (wavelength: 1.064um) was irradiated to the branches of the saphenous vein through the ceramic tips of the dissector. After about five minutes exposure, the branch was dissected and bleeding from the dissected edge was not seen. Postoperative angiogram six months after grafting showed all grafts were patent, and morphological abnormalities such as reginoal shrinkage, diffuse narrowing and aneurysmal dilation were not observed. We conclude that laser graft harvesting using the bipolar dissector is safe and effective in saving time.