RÉSUMÉ
A man in his fifties was diagnosed with retrograde type A acute aortic dissection. He underwent total arch replacement using the Gelweave Lupiae graft and staged thoracic endovascular aortic repair. Five days after discharge from the hospital, he was referred to our institution because of severe hemolytic anemia. Electrocardiography-gated computed tomography angiography demonstrated significant kinking of the graft adjacent to the proximal anastomotic site. Cine cardiac magnetic resonance imaging showed that graft kinking deteriorated during systole. We concluded that his hemolytic anemia was caused by graft kinking and surgical repair was required. The graft was transected at the kinking site and then reconstructed. After surgical repair, the hemolytic anemia improved immediately.
RÉSUMÉ
We describe a 50-year-old man who was diagnosed with anomalous aortic origin of the right coronary artery (AAORCA) by coronary angiography and coronary computed tomography performed for chest pain on exertion. Exercise-loaded myocardial scintigraphy revealed inferior wall ischemia, and hence surgery was performed. Intraoperatively, the right coronary artery was seen to run in the aortic wall, and hence, right coronary ostioplasty (unroofing) was performed. Postoperatively, coronary computed tomography revealed that the right coronary artery originated from a normal position, and exercise-loaded myocardial scintigraphy indicated no ischemia.
RÉSUMÉ
A 42-year-old woman with Turner syndrome was admitted to our hospital due to severe aortic stenosis. Transthoracic echocardiography demonstrated severe aortic stenosis with a bicuspid aortic valve. Enhanced computed tomography revealed that the left upper pulmonary vein connected to the innominate vein, and the ascending aorta was enlarged (maximum diameter of 41 mm). Surgical intervention was performed though median sternotomy with cardiopulmonary bypass. After achieving cardiac arrest by antegrade cardioplegia, we performed an anastomosis to connect the left upper pulmonary vein to the left atrial appendage. Then, aortic valve replacement was performed with an oblique aortotomy in the anterior segment of the ascending aorta. The aortic valve was a unicaspid aortic valve. Following completion of aortic valve replacement with a mechanical valve, reduction aortoplasty was performed on the ascending aorta. The postoperative course was uneventful.
RÉSUMÉ
An unconscious 79-year-old woman was admitted. Echocardiography showed cardiac tamponade with pericardial effusion. Enhanced computed tomography revealed pericardial effusion and a coronary artery aneurysm (maximum diameter of 16 mm) on the left side of the main pulmonary artery. Emergency coronary angiography confirmed the aneurysm, which originated from a branch of the left anterior descending artery. Emergency surgery was performed through median sternotomy with cardiopulmonary bypass. After cardiac arrest by antegrade cardioplegia, the aneurysm was opened and two orifices of the arteries were observed. The orifices were ligated, and the remaining aneurysmal wall was closed with a continuous suture. A pathological examination of the aneurysmal wall demonstrated an atherosclerotic true aneurysm.
RÉSUMÉ
A 52-year-old man underwent a medical examination, including abdominal computed tomography (CT). Abdominal CT revealed a common hepatic artery aneurysm (25 mm in diameter) ; a portion of the aneurysm depressed the pancreas. The gastroduodenal artery branched off the common hepatic artery aneurysm. We planned coil embolization for the common hepatic artery aneurysm. However, we could not avoid occluding the proper hepatic artery ; therefore, we performed abdominal aortic-proper hepatic artery bypass with coil embolization. The patient's postoperative course was uneventful.