Chiari Network Associated with Pulmonary Embolism: A Case Report / 日本心臓血管外科学会雑誌

The Chiari network is an embryological remnant. It has rarely clinical importance but may very infrequently cause thrombosis and some other complications. Chest pain and pulmonary thrombosis were developed in a 23-year-old man. Cardiac ultrasonography revealed Chiari network in his right atrium, and no other thrombogenic lesions were found. Although anti-coagulant therapy was performed, pulmonary thrombosis were redeveloped. Chiari network was thought the cause of chest pain and pulmonary thrombosis. Operative removal of Chiari networks performed. The patient was postoperatively free from chest pain and pulmonary thrombosis.

A Case of Aortic Regurgitation in Behcet's Disease / 日本心臓血管外科学会雑誌

Aortic valve replacement was carried out for aortic regurgitation in Behçet's disease. A prosthetic valve was fixed using reinforced felt-strip mattress sutures. Difficulty to ensure adequate myocardial protection due to ostial stenosis in the right coronary artery resulted in the occurrence of intraoperative myocardial infarction. Right ventricular assist with the help of a centrifugal pump was employed to obtain successful recovery from right cardiac failure. It was noted that at operation attention should have been paid to the aortic valve and also to abnormalities of the coronary artery and that control of the inflammatory reaction by steroids was essential before and after the operation.

Treatment of Acute Renal Failure Following Cardiovascular Operation Using Extracorporeal Circulation. Comparison between Continuous Peritoneal Dialysis(CPD) and Continuous Arterio-Venous Hemofiltration(CAVH) / 日本心臓血管外科学会雑誌

There were 16 patients who developed acute renal failure (ARF) follwing cardiovascular operation using extracorporeal circulation. They were treated by either CPD or CAVH because their ARF were resistant to medical treatment. These patients were divided into three groups according to their treatment; 7 patients treated by CPD (Group A), 5 patients treated both CPD and CAVH (Group B), 4 patients treated by CAVH (Group C). The survival rate was 33% in Group A, 20% in Group B, and 0% in Group C. The prognosis of the each group was poor. CPD and CAVH were effective to control the concentration of serum potasium and water removing. But CPD and CAVH were not very effective to control the concentrations of serum creatinine and blood urea nitrogen. There were three patients who developed low proteinemia which was one of the side effects of CPD. Seven of nine patients treated by CAVH, developed bleeding. The side effects of CAVH were seemed to be more severe than those of CPD.