The Application and Pitfalls for Registering New Japanese Board of Cardiovascular Surgery / 日本心臓血管外科学会雑誌

The first examination of the new board of the Japanese cardiovascular surgery took place in 2022. As it is a transitional period for the new system, many doctors are not familiar with the changes and details of the new system, and some have their concerns. Here, we held a round-table discussion with doctors who actually took the new board of the Japanese cardiovascular surgery under the new system, and we summarized their opinion.

Double Valve Replacement Using Manouguian Technique for Deteriorated Bioprosthetic Mitral Valve after Aortic and Mitral Valve Replacement / 日本心臓血管外科学会雑誌

An 83-year-old woman (BSA 1.36 m2) who had undergone aortic valve replacement (Magna ease 19 mm), mitral valve replacement (Epic mitral 25 mm), tricuspid annuloplasty (De Vega technique), and pulmonary vein isolation eight years earlier was referred to our hospital due to her heart failure symptoms. Ultrasound cardiography revealed severe mitral regurgitation due to perforation of bioprosthetic valve, severe mitral valve stenosis (mean pressure gradient 7.8 mmHg) due to bioprosthetic deterioration, and subsequent pulmonary hypertension (mean pulmonary artery pressure 49 mmHg, tricuspid regurgitation pressure gradient 85.5 mmHg). We performed a redo aortic valve (Inspiris 23 mm) and mitral valve (Epic mitral 29 mm) replacement using the Manouguian technique. The postoperative course was uneventful and pulmonary hypertension improved (tricuspid regurgitation pressure gradient 39.6 mmHg).