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1.
Asian Cardiovasc Thorac Ann ; 17(6): 643-6, 2009 Dec.
Article in English | MEDLINE | ID: mdl-20026545

ABSTRACT

A 54-year-old man underwent left anterior descending artery bypass grafting with cell patch therapy for myocardial infarction. We applied a novel approach to replicating the infarcted myocardium by anchoring polyglycolic acid felt seeded with autologous peripheral blood mononuclear cells in front of the infarcted area. The cell patch remained fixed to the myocardium for 1 month, and the infarcted myocardium was reperfused.


Subject(s)
Cardiac Surgical Procedures , Coronary Vessels/physiopathology , Leukocytes, Mononuclear/transplantation , Myocardial Infarction/surgery , Neovascularization, Physiologic , Regeneration , Coronary Artery Bypass , Humans , Male , Middle Aged , Myocardial Infarction/diagnosis , Myocardial Infarction/physiopathology , Myocardium/pathology , Polyglycolic Acid , Time Factors , Tissue Scaffolds , Tomography, Emission-Computed, Single-Photon , Tomography, X-Ray Computed , Transplantation, Autologous , Treatment Outcome
2.
Asian Cardiovasc Thorac Ann ; 16(6): e55-7, 2008 Dec.
Article in English | MEDLINE | ID: mdl-18984747

ABSTRACT

Computed tomography in a 74-year-old man with intermittent claudication revealed an abdominal aortic aneurysm, retroperitoneal hematoma, vertebral erosion, and total aortic occlusion. Surgery was delayed for 9 months after definitive diagnosis of contained rupture of the aortic aneurysm to allow treatment for ischemic heart disease and cardiac failure. After interposing a Y-shaped woven Dacron graft, the intermittent claudication was alleviated. The postoperative course was uneventful.


Subject(s)
Aortic Aneurysm, Abdominal/surgery , Aortic Rupture/surgery , Blood Vessel Prosthesis Implantation , Aged , Angioplasty, Balloon, Coronary , Aortic Aneurysm, Abdominal/complications , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortic Rupture/diagnostic imaging , Aortic Rupture/etiology , Aortography/methods , Blood Vessel Prosthesis , Blood Vessel Prosthesis Implantation/instrumentation , Chronic Disease , Coronary Stenosis/complications , Coronary Stenosis/therapy , Heart Failure/complications , Heart Failure/therapy , Humans , Male , Polyethylene Terephthalates , Prosthesis Design , Time Factors , Tomography, X-Ray Computed , Treatment Outcome
3.
Circ J ; 69(4): 500-2, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15791050

ABSTRACT

Involvement of the pulmonary arteries is common in systemic Takayasu's arteritis, but pulmonary arteritis alone is very rare. A 67-year-old woman had severe right pulmonary artery stenosis and left pulmonary arterial obstruction caused by Takayasu's arteritis. Surgical treatment was successfully performed with extracorporeal circulation, without transection of the ascending aorta and the right pulmonary artery was enlarged with an autologous pericardial patch.


Subject(s)
Arteritis/surgery , Pulmonary Artery/surgery , Aged , Arterial Occlusive Diseases/etiology , Arteritis/pathology , Constriction, Pathologic/etiology , Extracorporeal Circulation , Female , Humans , Pulmonary Artery/pathology
4.
Ann Thorac Surg ; 79(4): 1425-7, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15797104

ABSTRACT

In patients with infective aortic false aneurysms, repair using artificial materials is in danger of becoming an additional focus for infection. We used harvested autologous fascia lata as a vascular patch in such operations on 2 patients with infected mediastinal false aneurysm after coronary artery bypass surgery. These patients have not had any recurrences of mediastinitis and false aneurysm for 4 to 6 years after the operations.


Subject(s)
Aneurysm, False/surgery , Aneurysm, Infected/surgery , Aortic Aneurysm/surgery , Fascia Lata/transplantation , Aged , Female , Humans , Transplantation, Autologous
5.
Artif Organs ; 28(9): 840-5, 2004 Sep.
Article in English | MEDLINE | ID: mdl-15320947

ABSTRACT

The advantage of completely closing the pericardium after a coronary artery bypass grafting is the avoidance of injury of the heart and grafts during a re-operation. However, it would obviously be counterproductive to close the pericardium with a substitute that is predisposed to infection. This study was designed to evaluate the safety of ePTFE surgical membrane in comparison to native pericardium or autologous tissue. Between January 1992 to March 2003, 695 coronary artery bypass graftings were performed. The hearts and grafts were covered with ePTFE surgical membrane (474 cases: ePTFE group), or autologous pericardium and/or other autologous tissue (221 cases: non-ePTFE group). Often, a bilateral dissection of the internal thoracic artery was performed, which lengthened the surgery, the cardiopulmonary bypass, and the aortic clamp, in the ePTFE group. But there was no difference between the ePTFE group (2.1%) and the non-ePTFE group (3.2%) in the development of postoperative mediastinitis. There was also no difference between the two groups in the organism type of the infection. Methicillin resistant Staphylococcus aureus (MRSA) is the most common organism cultured from sternal wound infections; there were five cases in the ePTFE group, and four cases in the non-ePTFE group. In the ePTFE group, the hospital mortality due to postoperative mediastinitis was zero, and there was also no significant difference between the ePTFE group and the non-ePTFE group in time from the drainage operation to discharge; 74.3 days in the ePTFE group, and 81.0 days in the non-ePTFE group. The clinical use of ePTFE surgical membrane for a coronary artery bypass grafting does not appear to be a risk factor for mediastinitis.


Subject(s)
Coronary Artery Bypass/methods , Mediastinitis/etiology , Polytetrafluoroethylene/adverse effects , Surgical Wound Infection/etiology , Adult , Aged , Coronary Artery Bypass/adverse effects , Female , Humans , Male , Mediastinitis/microbiology , Methicillin Resistance , Middle Aged , Polytetrafluoroethylene/therapeutic use , Staphylococcal Infections/etiology , Staphylococcus aureus , Surgical Wound Infection/microbiology
6.
Ann Thorac Surg ; 73(1): 131-7, 2002 Jan.
Article in English | MEDLINE | ID: mdl-11833999

ABSTRACT

BACKGROUND: Flow dynamics in internal thoracic artery grafts 10 years after surgery are not known. METHODS: Doppler examination was performed in native internal thoracic arteries as a control (n = 8) and in internal thoracic artery grafts to the left anterior descending coronary artery 6 months postoperatively (group A, n = 25), at 5 years (group B, n = 14), and at 10 years (group C, n = 11). RESULTS: Each graft group showed a diastolic to systolic peak velocity ratio of less than 1.0 at the proximal end, and more than 1.0 at the distal end, but the control group showed a ratio of less than 1.0 throughout the length of the artery. The diastolic peak velocity of the graft groups was significantly faster than that of the control group at the distal end (versus group A, p < 0.01; versus group B, p < 0.005; and versus group C, p < 0.05). The systolic peak velocity of the graft groups was significantly lower than that of the control at the proximal end (versus group A, p < 0.0001; versus group B, p < 0.005; and versus group C, p < 0.0005). There were no significant differences of flow velocities among the graft groups and graft diameter among the four groups. CONCLUSIONS: Although the internal thoracic artery is systolic predominant, when native artery is used as graft, it changes its hemodynamics to diastolic predominance, especially at the distal end. Even after 10 years, graft flow dynamics are unchanged. This hemodynamic character may be one of the factors related to the superior long-term patency.


Subject(s)
Aorta, Thoracic/transplantation , Coronary Artery Bypass , Angina Pectoris/physiopathology , Angina Pectoris/surgery , Aorta, Thoracic/physiology , Blood Flow Velocity , Echocardiography, Doppler , Hemorheology , Humans , Postoperative Period , Vascular Patency/physiology
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