ABSTRACT
We treated a patient with recurrent isolated tricuspid regurgitation (TR) by repeated tricuspid valvoplasty (TVP) and tricuspid annuloplasty (TAP). The patient was a 56-year-old man who had undergone TVP eight years previously. Although the tricuspid annular dilatation was not seen in the first operation, the annular dilatation with elongation of chordae was apparent at this time. The chordal plasty with ePTFE threads and TAP with Carpentier-Edward's ring were carried out successfully. Since the annular dilatation may aggravate TR in the natural course of this disease, the combination of TVP and TAP is more effective than TVP alone.
ABSTRACT
The early postoperative use of continuous hemodiafiltration (CHDF) was effective in the postoperative management of two patients with chronic renal failure (CRF) undergoing cardiovascular operation. The first case was a 74-year-old man with a ruptured abdominal aortic aneurysm who underwent emergency Y-shaped artificial graft replacement. The second case was a 55-year-old man with aortic valve stenosis and regurgitation who underwent aortic valve replacement with a mechanical cardiac valve. Both patients had had chronic renal failure for several years before the operation, and the second patient had been on intermittent hemodialysis. Although a large amount of blood transfusion was needed postoperatively in both cases, CHDF enabled us to maintain the electrolytes in the normal range and control the water balance. The influence on the hemodynamics was minimized by adjusting the filtration rate. In conclusion, CHDF is useful for the management of CRF in the early postoperative period following cardiovascular surgery.
ABSTRACT
The patient was a 56-year-old male with an 8-year history of Behcet's syndrome, who presented with chest pain. A saccular aneurysm (4×4cm) of the descending aorta was disclosed by X-ray and CT. Impending rupture of the aneurysm was suspected and emergency surgery was performed under cardiopulmonary bypass. The aneurysm consisted of a large thrombus, and a punched-out lesion on the aorta (φ10mm) was found beneath the thrombus. Closure with a Dacron patch was carried out successfully. Pathologic examination revealed the patient to have vasculo-Behcet's syndrome. Generally this desease has a poor prognosis, especially if an aneurysm is present, since sudden rupture can occur. Thus, prompt surgical treatment of the aneurysm should be considered. The patient was free of recurrence at the time of writing this report.