ABSTRACT
Recent evidence has provided exciting proof of concepts for the use of pluripotent stem cell-derived cardiomyocytes (PSC-CMs) for cardiac repair; however, large animal studies, which better reflect human disease, are required for clinical application. Here, we describe how to create myocardial infarction in cynomolgus monkey followed by transplantation of PSC-CMs. This method ensures the establishment of a myocardial infarction model and enables reliable PSC-CM transplantation.
Subject(s)
Disease Models, Animal , Induced Pluripotent Stem Cells/cytology , Macaca fascicularis , Myocardial Infarction/therapy , Myocytes, Cardiac/transplantation , Anesthesia, Inhalation/methods , Anesthesia, Inhalation/veterinary , Animals , Atropine/therapeutic use , Bradycardia/drug therapy , Bradycardia/prevention & control , Cells, Cultured , Intraoperative Complications/drug therapy , Intraoperative Complications/prevention & control , LigationABSTRACT
The patient was a 48-year-old man, who had hemodynamic shock after orthopedic surgery. He was then diagnosed with right pulmonary artery embolism. Circulatory collapse remained, despite cardiac resuscitation. Therefore, he was treated with percutaneous cardiopulmonary support (PCPS) and intra-aortic balloon pumping (IABP). He was then transferred to our hospital and emergency pulmonary embolectomy was performed under cardiopulmonary bypass. The postoperative course was uneventful, and he was discharged without complications. Early diagnosis and early placement of PCPS and IABP allows safe transfer of patients and successful performance of emergency pulmonary embolectomy.
Subject(s)
Pulmonary Embolism/surgery , Shock/complications , Emergencies , Humans , Male , Middle AgedABSTRACT
An 81-year-old woman, who had undergone mitral valve replacement (MVR) with a porcine bioprosthesis after mitral valve repair, presented with hemolysis 4 years and 6 months after MVR. Transthoracic echocardiography (TTE) revealed trivial mitral regurgitation, which was diagnosed based on the observed perivalvular leakage. Hemolysis gradually increased, and she developed dyspnea and edema 2 years after the appearance of mitral regurgitation. We performed a reoperation. Intraoperative transesophageal echocardiography (TEE) after intubation showed no perivalvular leakage of the mitral prosthesis, but transvalvular leakage through a leaflet perforation was present. The leaflets of the bioprosthesis had slit-shaped perforations at their hinges. There was no sign of infection on the leaflet or annulus. We implanted a new bioprosthesis after removal of the deteriorated valve. The postoperative course was uneventful. Microscopic examination verified collagen degeneration, histiocyte infiltration, and hyalinization. It is important to perform TEE to rule out structural valve deterioration (SVD) even when regurgitation occurs soon after valve replacement.
Subject(s)
Bioprosthesis , Heart Valve Prosthesis Implantation/methods , Heart Valve Prosthesis , Mitral Valve Insufficiency/surgery , Mitral Valve/surgery , Prosthesis Failure , Aged, 80 and over , Animals , Echocardiography , Female , Humans , Reoperation , SwineABSTRACT
We report a case of early bioprosthetic valve calcification in a 76 year-old woman who had received supplementation with alfacalcidol, an analogue of vitamin D, for 3 years after her initial valve replacement. She underwent aortic valve replacement at the age of 71 and subsequently complained of shortness of breath. Ultrasonic cardiography revealed severe aortic stenosis and we performed a second aortic valve replacement with a bioprosthesis. Histopathologic and x-ray examination showed calcification on the explanted valve. She had not presented with any known risk for early bioprosthetic calcification, suggesting that vitamin D supplementation may accelerate calcification of bioprosthetic valves.
Subject(s)
Aortic Valve Stenosis/etiology , Bioprosthesis/adverse effects , Calcinosis/etiology , Heart Valve Prosthesis/adverse effects , Hydroxycholecalciferols/adverse effects , Aged , Aortic Valve/chemistry , Aortic Valve/pathology , Aortic Valve Stenosis/chemically induced , Aortic Valve Stenosis/metabolism , Calcinosis/chemically induced , Calcinosis/metabolism , Female , Humans , Hydroxycholecalciferols/therapeutic useABSTRACT
Persistent 5th aortic arch (PFA) is a rare congenital cardiac anomaly that was firstly reported by Van Praagh et al, in 1969. A 3-month-old boy was referred to us with no symptom but heart murmur. Cardiac echocardiography and the following 3-dimensional computed tomography (3D-CT) scan revealed PFA with coarctation of aorta. There was pressure gradient of 50 mmHg between upper and lower limbs. He was carefully observed at the outpatient clinic because of no afterload mismatch. At the age of 9 months, coarctectomy and end-to-end anastomosis was performed between the PFA and distal arch below left vertebral artery. A histological examination of resected tissue revealed the thickened intima and rough elastic fiber that is absolutely different from normal aorta. Careful observation is necessary with the possibility of future aneurysmal change or re-coarctation, although the postoperative course has been so far uneventful.
