[Ruptured Thoracic Aortic Aneurysm Treated with Total Arch Replacement and Direct Transaortic Thoracic Endovascular Aortic Repair].

Open stent grafting is an effective technique in surgery for treating-ruptured aortic aneurysms in the distal aortic arch, but it is not always applied as it depends on the shape of the aneurysm. In this case, the aneurysm was long in the distal aortic arch and sharply angulated into the descending aorta;thus, it was anticipated that an off-the-shelf open stent graft would not cover the ruptured area. Therefore, we used a stent graft device for thoracic endovascular aortic repair as an open stent and succeeded in saving the patient's life.

[Selective Branch Embolization and Thoracic Endovascular Aortic Repair for Asymptomatic Bronchial Artery Aneurysm:Report of a Case].

Bronchial artery aneurysm (BAA) is a rare disease, for which early treatment is recommended due to the risk of rupture often resulting in severe consequences. We report a case of successful treatment of an asymptomatic BAA by selective branch embolization combined with thoracic endovascular aortic repair (TEVAR). A 68-year-old man was accidentally found to have a bronchial artery aneurysm by computed tomography. The distance from the origin of the bronchial artery to the aneurysm was only 6 mm, at which branches were found. The BAA was completely excluded by selective branch coil embolization and deployment of a thoracic stent graft to cover the orifice of the BAA. Angiography confirmed that there was no endoleak. Selective branch embolization of BAA combined with TEVAR is effective to completely occlude the blood stream to BAA.

Removal of a left ventricular thrombus complicated by cardiac sarcoidosis using a 3D microscope system.

A woman in her 60s was brought to the previous hospital with respiratory distress. She was referred for the treatment of severe cardiac dysfunction and a mobile mass in the left ventricle. Echocardiography revealed the mass to be of 20×11 mm in size, mobile and slightly attached to the left ventricle by a stalk. As MRI had already revealed a small cerebral infarction, we have decided to perform emergency thrombectomy of the left ventricle. As the left ventricular contractility was diffusely impaired, we were able to remove the mass without any residuals using a transseptal approach without a left ventricular incision using a three-dimensional microscope system. The pathological diagnosis of the mass was thrombus, and subsequent close examination led to the diagnosis of cardiac sarcoidosis. We report the surgical technique and removal of a left ventricular thrombus complicated by cardiac sarcoidosis.

Superficial femoral artery-anterior tibial artery bypass with great saphenous vein grafting via the lateral femoropopliteal route for infection after Viabahn placement.

We report a case involving an elderly man who successfully underwent superficial femoral artery-anterior tibial artery bypass via the lateral femoropopliteal route following development of a stent infection after placement of a small-diameter covered stent for a ruptured superficial femoral artery pseudoaneurysm. This report suggests that appropriate treatment strategies for device infection subsequent to device removal are paramount for the prevention of reinfection and preservation of the affected extremity.

Successful Removal of a Posterior Cardiac Lipoma by Transection of the Ascending Aorta and Main Pulmonary Artery.

Primary cardiac tumors are unusual, whereas lipomas are particularly rare. We successfully removed a very large posterior cardiac lipoma by transecting the ascending aorta and main pulmonary artery. Transecting both the ascending aorta and the main pulmonary artery facilitated surgical exposure and complete removal of the posterior cardiac lipoma.