Single-Stage Surgical Treatment of Acute Type A Aortic Dissection and Blunt Abdominal Trauma: A Case Report.

A 53-year-old man suddenly developed chest and back pain while driving, resulting in an accident. Computed tomography revealed acute type A aortic dissection with malperfusion of the left lower extremity, retroperitoneal extravasation, hematoma in the anterior mediastinum, and ascites in the rectovesical pouch. Exploratory laparotomy before aortic repair revealed intestinal perforation and retroperitoneal bleeding, which were repaired, and an ascending aortic replacement was performed. Visceral trauma with active bleeding should be treated with priority, even if the need for systemic heparinization accompanies acute type A aortic dissection during surgery for aortic dissection.

Effectiveness of the taut-line hitch knot in accurately determining the length of artificial chordae during repair for degenerative mitral insufficiency.

Taut-line hitch, a type of ropework used in outdoor activities, was adopted to tie the artificial chordae during mitral valve repair for degenerative mitral insufficiency. This knot-tying technique facilitated artificial chordae length determination during surgery. Nineteen patients with degenerative mitral insufficiency were successfully treated using this technique.

Successful treatment of left ventricular patch infection by latissimus dorsi muscle flap covering without patch removal.

Removal of the infected prosthesis is considered an essential procedure in the treatment of prosthetic graft infection following cardiovascular surgery. Here, we present a case of left ventricular patch infection following repair of left ventricular rupture that was successfully treated by coverage with a latissimus dorsi muscle flap without patch removal. A 61-year-old man underwent double-patch repair for left ventricular-free wall rupture following posterior myocardial infarction. He underwent drainage and omental transposition with re-sternotomy for postoperative mediastinitis by Candida albicans, followed by pericardial fenestration via left thoracotomy for infectious pericarditis; however, left ventricular patch infection was detected. Considering the high invasiveness of a reoperation for patch removal, we preserved and covered the patch using a left pedicled latissimus dorsi muscle flap via left thoracotomy. The postoperative course was uneventful, and the patient was asymptomatic with no signs of recurrence at 30 months.

Chiroptical Inversion of Europium(III) Complexes by Changing a Remote Stereogenic Center of a C2-Symmetric Bispyrrolidinoindoline Manifold.

As an effort to integrate natural products chemistry and coordination chemistry, a diastereomeric pair of chiral alkaloidal manifolds composed of a bispyrrolidinoindoline (BPI) framework was designed and synthesized to generate luminescent EuIII complexes with switchable chiroptical properties. The C2-symmetric alkaloidal manifolds were linked with bis(benzimidazolyl)pyridine (BBIPy) as an achiral metal-binding component through substituents installed at the stereogenic 2/2' positions of the BPI manifolds. The resulting diastereomeric pair of ligands, syn-L1 and anti-L2, allow pseudomirror symmetrical presentation of the metal-binding BBIPy units due to the stereogenic centers on the alkaloidal manifold. The ligand syn-L1 induces intramolecular coordination to form the 1:1 complex EuIII( syn-L1) composed of a single stranded metal helicate which exhibits a negative split Cotton effect. In contrast, the ligand anti-L2 led to a supramolecular assembly comprising the 2:2 complex EuIII2( anti-L2)2 consisting of a bimetallic double-stranded helicate which shows a positive split Cotton effect. Thus, the sp3 stereogenic centers in the BPI manifolds play pivotal roles in controlling both metal-ligand equilibria and chirality-switching of luminescent EuIII complexes. This approach, which exploits diastereomeric natural product-based manifolds, provides a relatively unexplored means for diversifying metal coordination modes and for controlling the chiroptical properties of the resultant luminescent lanthanoid complexes.

Nickel-catalyzed formation of cyclopentenone derivatives via the unique cycloaddition of α,ß-unsaturated phenyl esters with alkynes.

Oxygen-containing organic compounds, such as ethers, carboxylates, and carbamates, have recently received increasing attention because of their newly discovered applications as electrophiles in cross-coupling reactions via transition metal-catalyzed C-O bond activation. However, no cycloaddition reaction involving their C-O bond activation has been demonstrated thus far. The present study developed a Ni(0)-catalyzed unique [3+2] cycloaddition reaction of α,ß-unsaturated phenyl esters with alkynes in (i)PrOH to yield cyclopentenone derivatives.