Disruption of a Dacron Graft Caused by the Vertebral Body of the Lumbar Vertebrae after Reconstruction of the Thoracoabdominal Aortic Aneurysm / 日本心臓血管外科学会雑誌

We report an extremely rare case of early disruption of a woven Dacron graft by the mechanical force of the lumbar vertebral body after a thoracoabdominal aortic aneurysm repair. A 75-year-old man with thoracoabdominal aortic aneurysm of Crawford type III underwent replacement of the thoracoabdominal aorta using a Gelweave thoracoabdominal graft (Vascutek) and a Gelweave bifurcate graft (Vascutek). His postoperative course was uneventful and discharged on postoperative day 20. On the 22nd postoperative day, he was re-hospitalized with low back pain. Computed tomography scanning showed a massive hematoma around the region of the graft-to-graft anastomosis. He underwent an emergency operation. At laparotomy, the Gelweave thoracoabdominal graft had a 2-mm hole which had been caused by the mechanical force of lumbar vertebral body, which was not related to the anastomosis. The graft was repaired with a 4-0 polypropylene buttress suture and a new prosthesis graft was used to wrap around the disrupted graft.

A Case of Jaundiced Constrictive Pericarditis / 日本心臓血管外科学会雑誌

We treated a constrictive pericarditis patients that developed jaundice. The 28-year-old male complained chiefly of dyspnea on exertion. In addition to hyperbilirubinemia, his chest X-ray showed calcification of the pericardium. Cardiac catheterization found increased central venous pressure (24mmHg), a dip and plateau of the right and left ventricular pressure, and a patent foramen ovale (PFO). Surgery to excise the pericardium and close the PFO was performed under extracorporeal circulation. Hypertrophic pericardium had expanded throughout the right atrium to the free wall of the right ventricle and was partially calcified. Surgery restored the patient's cardiac and liver functions and allowed him to resume normal social activity.

Cabrol, Technique Performed on a Patient with Corrected Transposition of the Great Arteries, Complicated by Annuloaortic Ectasia and Aortic Regurgitation / 日本心臓血管外科学会雑誌

Cabrol's technique was performed on a patient with corrected transposition of the great arteries (SLL), complicated by annuloaortic ectasia (AAE) and aortic regurgitation (AR). The patient, a 52-year-old male, complained mainly of dyspnea on physical exertion. In 1983, he underwent implantation of a pacemaker to treat advanced atrioventricular block. In 1994, his cardiac function deteriorated to NYHA III. Cardiac catheter examinations exhibited 2nd degree Seller's aortic valve insufficiency and 2nd degree insufficient closure of the left atrioventricular valve. The patient was Cardell classification B3, with a Shaher Type 4 coronary artery. A composite graft was made using a 27mm St. Jude Medical valve and a 30mm woven Dacron graft. The left atrioventricular valve had three leaflets, accessible from the right atrium using the septal approach. Kay's method was used to suture the posterior leaflet and reduce regurgitation. The patient has made favorable progress during the two-year follow-up period.

A Case of Common Hepatic Aneurysm with Anomalous Origin from the Aorta / 日本心臓血管外科学会雑誌

We describe a 52 year old woman who had an aneurysm involving the common hepatic artery directly originating from the aorta. It was successfully treated by aneurysmectomy without needing the arterial reconstruction. An aneurysm of the common hepatic artery that has an anomalous origin from the aorta is very rare and only 4 cases including the present case were reported in Japanese literature on our survey. The features and management of hepatic aneurysm are discussed.