In vivo optical coherence tomography visualisation of coronary artery embolism caused by BioGlue in a middle-aged woman with Marfan syndrome who underwent the Bentall procedure: a case report.

Background: Coronary artery embolism caused by BioGlue is a rare complication; therefore, its diagnosis and treatment remain undefined. Case summary: A 47-year-old woman underwent ascending aortic replacement and coronary artery bypass grafting (CABG) for type A acute aortic dissection involving the right coronary artery ostium in 2017. Subsequently, she was diagnosed with Marfan syndrome. Five years later in 2022, she underwent aortic arch replacement, the Bentall procedure, and repeat CABG because of aortic root enlargement and aortic regurgitation progression. Twelve days after surgery, coronary computed tomography angiography (CCTA) revealed left anterior descending (LAD) artery stenosis, whereas pre-operative CCTA was normal. On post-operative day 13, coronary angiography revealed 99% LAD artery stenosis. Intravascular ultrasound (IVUS) showed a non-echoic mass with clear margins, and optical coherence tomography (OCT) demonstrated a crystalloid mass. Both images suggested that the embolus was inorganic matter, suspected as being the surgical adhesive BioGlue. We could not remove the embolus by repeated thrombectomy; therefore, drug-eluting stent implantation was performed. Seven months after surgery, she had no symptoms, and CCTA confirmed stent patency. Discussion: To our knowledge, this is the first case report to describe BioGlue embolism observed by OCT. We performed an in vitro study using a blood vessel model, and the obtained OCT image was very similar to the in vivo image. Although BioGlue embolism is a rare complication, it should be considered in cases of perioperative myocardial infarction of uncertain aetiology, and coronary imaging is useful for diagnosis.

Successful Transcatheter Aortic Valve Implantation in a Patient with Radiation-induced Aortic Stenosis for Mediastinal Hodgkin Lymphoma.

Aortic stenosis (AS), a late complication of thoracic radiation therapy for chest lesions, is often coincident with porcelain aorta or hostile thorax. We herein report a 59-year-old man with a history of mediastinal Hodgkin lymphoma treated with radiation therapy but later presenting with heart failure caused by severe AS. Severe calcification in the mediastinum and around the ascending aorta made it difficult to perform surgical aortic valve replacement. The patient therefore underwent transcatheter aortic valve implantation (TAVI). It is important to recognize radiation-induced AS early, now that TAVI is a well-established treatment required by increasing numbers of successfully treated cancer patients.

Characterization of the human mandibular osteoblastic osteosarcoma cell line HOSM-2 after long-term culture.

We have been subculturing a human mandible-derived osteosarcoma cell line (HOSM-2) for approximately 15 years, and have compared the characters of early generations, which did not exhibit tumorigenicity, to those in the later generations. The shape and doubling time of the cells did not change during long-term culture. The number of chromosomes, however, changed from 59-81 in the 6th generation (modal number: 70) to 54-59 (modal number: 56 and 57), and the chromosomal structure also changed. In addition, the cell line in the later generations showed tumorigenicity in nude mice, and Codon 306 of the p53 gene was mutated to a stop codon due to a point mutation. HOSM-2 cells expressed osteoblast markers, thus confirming them to be osteoblastic osteosarcoma cells. These results showed that changes in certain genes in the HOSM-2 cells led to tumorigenicity in nude mice following long-term culture. In addition, as a mandible-derived cell line with characteristics different from those of limb-derived osteosarcoma cell lines, HOSM-2 cells may be a valuable model for mandibular osteosarcoma and osteoblasts.