Long-Term Outcomes in Coronary Artery Bypass Graft Patients Using Internal Thoracic Artery with Ipsilateral Arteriovenous Shunt for Hemodialysis.

BACKGROUND: The goal of this study was to evaluate the long-term results of coronary artery bypass grafting (CABG) using internal thoracic artery (ITA) grafts in hemodialysis (HD) patients with arteriovenous (AV) fistulae or AV grafts involving the ipsilateral or contralateral brachial artery or radial artery. METHODS: From March 2007 to May 2017, 76 end-stage renal disease (ESRD) patients with an upper limb AV fistula or graft for HD underwent CABG at a single center. Group A included 23 patients who underwent CABG using an ITA graft ipsilateral to the AV vascular access (AVVA); Group B included 22 patients who underwent CABG using a contralateral ITA with AVVA; and Group C included 29 patients who underwent CABG with AVVA without the use of an ITA graft. The primary end-point was death from any cause. RESULTS: The average follow-up period was 34.4 ± 26.9 months. Death from any cause occurred in 6 (26.09%) patients in Group A, 8 (36.36%) patients in Group B, and 17 (58.62%) patients in Group C (log-rank p = 0.04). There was no significant difference in death rate between Groups A and B. The risk of death was lower in the patients with CABG using an ITA graft (ITA CABG) compared to the patients without ITA CABG [HR 0.41 (95% CI, 0.20-0.84), p = 0.015]. CONCLUSIONS: The HD patients who underwent CABG with an ipsilateral location of the ITA and AVVA did not have an increased risk of death compared to the patients who underwent CABG with a contralateral location of the ITA and AVVA. In addition, the use of ITA in CABG resulted in better outcomes in the HD patients.

Effect of Retrograde Cerebral Protection Strategy on Outcome of Patients with Stanford Type A Aortic Dissection.

BACKGROUND: Neurological complications are an important concern in the repair of type A aortic dissection. Supra-aortic involvement is considered to be an important risk factor for neurological injuries. However, the optimal brain protection strategy still remains controversial. The aim of the present study was to assess the efficacy and short-term results of retrograde cerebral protection techniques in the treatment of acute type A aortic dissection. METHODS: Between 2005 and 2013, 185 patients who underwent repair of acute type A aortic dissection were enrolled in this study, all of whom received retrograde cerebral perfusion. The patients were divided into two group: 102 patients who had at least one carotid artery involved as the carotid dissection group, and 83 patients who had no carotid artery involvement as the non-carotid dissection group. RESULTS: The mean age of the patients was 57.8 years and 69% were male. The 30-day mortality rate was 10.3%, and the overall in-hospital mortality rate was 11.9%. Eight patients (4.3%) developed new permanent neurological deficits (PNDs) including two in the non-carotid dissection group and six in the carotid dissection group. Although new PND was milder in the carotid dissection group, there was no significant difference (p = 0.248). The proportion of patients who received a coronary artery bypass graft was significantly higher in the carotid dissection group (1 vs. 8, p = 0.037). CONCLUSIONS: According to our study, the retrograde cerebral perfusion technique is an easy and safe procedure, especially for patients with concomitant carotid dissection.

Influence of imidazolium based green solvents on volume phase transition temperature of crosslinked poly(N-isopropylacrylamide-co-acrylic acid) hydrogel.

The volume phase transition temperature (VPTT) of crosslinked poly(N-isopropylacrylamide-co-acrylic acid) (PNIPAM-co-AA) hydrogel in water in the presence of five imidazolium based ionic liquids (ILs) was studied. The VPTT of PNIPAM-co-AA hydrogel can be modulated to different extents by the addition of different amounts of ILs. The modulations in VPTT values can be attributed to the IL-induced alterations in hydrophobic, hydrophilic and hydrogen bonding interactions of PNIPAM-co-AA hydrogel with the neighboring solvent and molecular chains. The influence of ILs having a common cation, 1-butyl-3-methylimidazolium cation ([Bmim]) and different anions, such as iodide (I-), tetrafluoroborate (BF4-), chloride (Cl-), acetate (CH3COO-) and hydrogen sulfate (HSO4-), on the phase transition of PNIPAM-co-AA hydrogel was monitored by the aid of differential scanning calorimetry (DSC), dynamic light scattering (DLS) and Fourier transform infrared (FT-IR) spectroscopy. Furthermore, the interfacial properties between aqueous IL and polymer surface were scrutinized with the help of contact angle (CA) measurements. The overall specific ranking of ILs in preserving the hydration layer around the PNIPAM-co-AA hydrogel in water was [Bmim][I]>[Bmim][BF4]>[Bmim][Cl]>[Bmim][Ac]>[Bmim][HSO4]. The trend of these ILs followed the well-known Hofmeister series. Interestingly, the PNIPAM-co-AA hydrogel in water shows abnormal salting-out property in the presence of [Bmim][BF4] at higher concentration and this abnormal behavior can be explained based on the lack of sufficient binding sites on the macromolecule for higher number of [Bmim][BF4] at a higher concentration.

Molecular identification for epigallocatechin-3-gallate-mediated antioxidant intervention on the H2O2-induced oxidative stress in H9c2 rat cardiomyoblasts.

BACKGROUND: Epigallocatechin-3-gallate (EGCG) has been documented for its beneficial effects protecting oxidative stress to cardiac cells. Previously, we have shown the EGCG-mediated cardiac protection by attenuating reactive oxygen species and cytosolic Ca2+ in cardiac cells during oxidative stress and myocardial ischemia. Here, we aimed to seek a deeper elucidation of the molecular anti-oxidative capabilities of EGCG in an H2O2-induced oxidative stress model of myocardial ischemia injury using H9c2 rat cardiomyoblasts. RESULTS: Proteomics analysis was used to determine the differential expression of proteins in H9c2 cells cultured in the conditions of control, 400 µM H2O2 exposure for 30 min with and/or without 10 to 20 µM EGCG pre-treatment. In this model, eight proteins associated with energy metabolism, mitochondrial electron transfer, redox regulation, signal transduction, and RNA binding were identified to take part in EGCG-ameliorating H2O2-induced injury in H9c2 cells. H2O2 exposure increased oxidative stress evidenced by increases in reactive oxygen species and cytosolic Ca2+ overload, increases in glycolytic protein, α-enolase, decreases in antioxidant protein, peroxiredoxin-4, as well as decreases in mitochondrial proteins, including aldehyde dehydrogenase-2, ornithine aminotransferase, and succinate dehydrogenase ubiquinone flavoprotein subunit. All of these effects were reversed by EGCG pre-treatment. In addition, EGCG attenuated the H2O2-induced increases of Type II inositol 3, 4-bisphosphate 4-phosphatase and relieved its subsequent inhibition of the downstream signalling for Akt and glycogen synthase kinase-3ß (GSK-3ß)/cyclin D1 in H9c2 cells. Pre-treatment with EGCG or GSK-3ß inhibitor (SB 216763) significantly improved the H2O2-induced suppression on cell viability, phosphorylation of pAkt (S473) and pGSK-3ß (S9), and level of cyclin D1 in cells. CONCLUSIONS: Collectively, these findings suggest that EGCG blunts the H2O2-induced oxidative effect on the Akt activity through the modulation of PIP3 synthesis leading to the subsequent inactivation of GSK-3ß mediated cardiac cell injury.

Excellent mid-term durability of the On-X mechanical aortic valve in the pulmonary position with a low international normalized ratio.

BACKGROUND AND AIM OF THE STUDY: Although the pulmonary position has been preferred for the placement of homografts or bioprosthetic valves, the limited longevity of these implants makes reoperation almost unavoidable. Good durability of mechanical valves in the pulmonary position has been reported. The mid-term outcomes were analyzed of patients who received an On-X mechanical heart valve for pulmonary valve replacement (PVR) with a relatively low International Normalized Ratio (INR). METHODS: Between February 2008 and February 2011, mechanical On-X valves (size range: 19 to 25 mm) were implanted for PVR in six patients. Tetralogy of Fallot (ToF) was the most common diagnosis (n = 6). Postoperatively, warfarin was used to maintain the INR at 1.5-2.0. The surgical results and follow up were reviewed retrospectively, with valve failure, thrombosis, embolism, bleeding, reoperation and death being defined as end-points. RESULTS: There was no intraoperative or in-hospital mortality. The mean age of patients at the time of PVR was 31 +/- 19.7 years (range: 16-61 years). In patients who underwent repair of ToF (n = 4) the average duration between PVR and previous right ventricular outflow tract (RVOT) reconstruction was 8.75 +/- 3.3 years (range: 5-12 years). The mean follow up period was 3.13 +/- 1.31 years (range: 2-5 years). There was no 30-day mortality, late death, thromboembolism, major bleeding event or valve dysfunction, and no patient needed reoperation. All survivors were categorized as NYHA class I or II. CONCLUSION: A three-year experience with the On-X bileaflet mechanical valve in the pulmonary position demonstrated excellent mid-term durability, with no thromboembolisms or bleeding events when the INR was maintained at 1.5-2.0. For patients who require PVR, either as primary procedure or reoperation, the On-X mechanical heart valve might represent an appropriate option.

One-Year and Five-Year Outcomes of Transcatheter Aortic Valve Replacement or Surgical Aortic Valve Replacement in a Taiwanese Elderly Population.

BACKGROUND: The aim of our study was to provide real-world data on outcomes for elderly Taiwanese patients who underwent transcatheter aortic valve replacement or surgical aortic valve replacement in different risk groups. METHODS: From March 2011 through December 2021, 177 patients with severe aortic stenosis who were ≥70 years old and had undergone TAVI (transcatheter aortic valve implantation) or SAVR (surgical aortic valve replacement) in a single center were divided by STS score (<4%, 4-8% and >8%) into three different groups. Then, we compared their clinical characteristics, operative complications, and all-cause mortality. RESULTS: In all risk groups, there were no significant differences in in-hospital mortality, or 1-year and 5-year mortality between patients in the TAVI and SAVR groups. In all risk groups, patients in the TAVI group had shorter hospital stay and higher rate of paravalvular leakage than the SAVR group. After univariate analysis, BMI (body mass index) < 20 was a risk factor for higher 1-year and 5-year mortality. In the multivariate analysis, acute kidney injury was an independent factor for predicting worse outcomes in terms of 1-year and 5-year mortality. CONCLUSIONS: Taiwan elderly patients in all risk groups did not have significant differences in mortality rates between the TAVI and the SAVR group. However, the TAVI group had shorter hospital stay and higher rate of paravalvular leakage in all risk groups.

A dimedone-phenylalanine-based fluorescent sensor for the detection of iron (III), copper (II), L-cysteine, and L-tryptophan in solution and pharmaceutical samples.

The development of fluorescence molecules for the fast and effective detection of L-tryptophan (L-Trp) has attracted a lot of attention because it is an important amino acid for baby growth, nitrogen equilibrium in adults, improving sleep, and mood regulation. A dimedone-phenylalanine-based chiral sensor (SDPA) was synthesized and exhibited a strong fluorescence quenching by Fe3+ and Cu2+ in a water/DMSO (3/7) solution with a detection limit of 2.29 × 10-6 M and 6.37 × 10-6 M, respectively. The factors affecting fluorescence sensings, such as the pH and competing cations, were studied. The sensor can be reused at least five times after being treated with EDTA. The Job plot, ESI-MS spectra, 1H NMR spectra, absorbance, and fluorescence titration experiments were investigated to study the mechanism of SDPA-Fe3+ and SDPA-Cu2+ complexation. The SDPA-Cu2+ complex can detect L-tryptophan and L-cysteine at trace levels by turn-on fluorescence with a detection limit of 9.35 × 10-6 M and 8.86 × 10-6 M, respectively. Moreover, applying the SDPA-Cu2+ complex for quantitative analysis of L-tryptophan in real sleep-improving capsules resulted in good recovery. The L-tryptophan level of the Elining capsule was determined at 190.8 ± 10.5 mg/g (mg L-tryptophan/g medicine), which is close to the announced quantity of 180 mg/g. Besides, the SDPA-Cu2+ complex can selectively detect free L-Try molecules and L-Try residues in proteins.

Factors associated with sexual quality of life in patients before and after coronary artery bypass grafting surgery.

BACKGROUND: Successful rehabilitation of patients after coronary artery bypass grafting (CABG) should include psychosocial outcomes such as sexual activity. However, little has been reported regarding the sexual quality of life of patients after CABG. OBJECTIVES: This study aimed to investigate the associations of demographic and disease characteristics, psychosocial factors, and sexual quality of life in patients before and after CABG surgery. METHODS: A longitudinal, descriptive design was used. A convenient sample of 70 patients with a diagnosis of coronary artery disease and under preparation for CABG surgery was recruited from the cardiovascular units of a medical center in central Taiwan. Participants were interviewed and completed a structured questionnaire before and 3 months after CABG surgery. Instruments used included EuroSCORE (European System for Cardiac Operative Risk Evaluation), Sexual Knowledge Scale, Spouse Communication Scale, Hospital Anxiety and Depression Scale, Perceived health status, and Sexual Quality of Life Scale. RESULTS: Sexual desire and sexual response of patients were significantly limited after CABG. Before surgery, age, disease duration, and spouse communication were all significant predictors, which explained 33.8% of the variance in the sexual quality-of-life scores. Significant predictors after surgery included sexual knowledge, disease duration, and EuroSCORE, which accounted for 25.6% of the variance of sexual quality of life. CONCLUSION: This study confirms that CABG surgery may have an impact on patients' sexual quality of life. With the numbers of CABG patients increasing, development of appropriate sexual counseling for cardiac patients is necessary to improve their sexual quality of life.

Naked-eye colorimetric and turn-on fluorescent Schiff base sensor for cyanide and aluminum (III) detection in food samples and cell imaging applications.

A new efficient Schiff base sensor SB3 for fluorescent and colorimetric "naked-eye" "turn-on" sensing of cyanide anion (CN-) with excellent sensitivity and selectivity was developed. The 4,4'-(perfluoropropane-2,2-diyl)bisphenol group and two phenyl groups were covalently linked by two C = N bonds to extend the conjugation length. The four hydroxyl groups can improve the water solubility of the SB3 sensor. The SB3 sensor exhibited high specificity towards CN- by interrupting its intramolecular charge transfer, resulting in a color change and remarkable "turn-on" green fluorescence emission. The sensing mechanism is caused by the nucleophilic addition of CN- toward imine groups of the SB3 sensor, leading to breaks of the conjugation, fluorescent spectral changes, and color change. It was confirmed by 1H NMR titration and Mass spectra. The detection limits for CN- and Al3+obtained by fluorescence spectrum are 0.80 µM and 0.25 µM, respectively. The SB3 sensor can act as an efficient chemical sensor for detecting the CN- and Al3+ ions under common environmental and physiological conditions (pH 5-12). Besides, the sensor can also detect CN- in food materials (such as sprouting potatoes and cassava flour) and imaging CN-in living cells with strong "turn-on" fluorescence at 490 nm. SB3 is an excellent CN- sensor that exhibits some advantages, including easy synthesis, distinct fluorescence and color change, high selectivity, low detection limit, and good anti-interference ability to analyze solution and food samples, together with fluorescence cell imaging.

Green tea extract given before regional myocardial ischemia-reperfusion in rats improves myocardial contractility by attenuating calcium overload.

There is evidence for a negative correlation between green tea consumption and cardiovascular diseases. The aim of the present study was to examine whether green tea extract (GTE) given before regional myocardial ischemia could improve depression of myocardial contractility by preventing cytosolic Ca(2+) overload. Regional ischemia-reperfusion (IR) was induced in rats by ligating the left anterior descending branch for 20 min, then releasing the ligature. Ligation induced ventricular arrhythmias in rats without GTE pretreatment, but decreased arrhythmogenesis was seen in rats pretreated 30 min earlier with GTE (400 mg/kg). During reperfusion, arrhythmias only occurred during the initial 5 min, and GTE pretreatment had no effect. After overnight recovery, serum cTnI levels were greatly increased in control post-IR rats but only slightly elevated in GTE-pretreated post-IR rats. Myocardial contractility measured by echocardiography was still depressed after 3 days in control post-IR rats, but not in GTE-pretreated post-IR rats. No myocardial ischemic injury was seen in post-IR rats with or without GTE pretreatment. Using freshly isolated single heart myocytes, GTE was found to attenuate the post-IR injury-associated cytosolic Ca(2+) overload and modulate changes in the levels and distribution of myofibril, adherens junction, and gap junction proteins. In summary, GTE pretreatment protects cardiomyocytes from IR injury by preventing cytosolic Ca(2+) overload, myofibril disruption, and alterations in adherens and gap junction protein expression and distribution.

Green tea extract protects rats against myocardial infarction associated with left anterior descending coronary artery ligation.

There is increasing evidence that green tea polyphenols can protect against myocardial damage. Recently, we showed that they bind to cardiac troponin C and alter myofilament Ca(2+) sensitivity in cardiac muscle. In the present study, we examined whether green tea extract (GTE) could prevent the progressive remodeling seen in ischemic myocardium and improve cardiac function by modulation of the contractile apparatus utilizing a myocardial infarction (MI) model in the rat involving ligation of the left anterior descending branch. Using this model, severe myocardial injury was found, including altered cardiac performance and the appearance of extensive fibrosis and left ventricular (LV) enlargement. Supplementation with 400 mg/kg/day of GTE for 4, 18, or 46 days had beneficial effects in preventing the hemodynamic changes. Histopathological studies showed that GTE attenuated the progressive remodeling seen after myocardial injury. Echocardiography confirmed that GTE prevented LV enlargement and improved LV performance in post-MI rats. In addition, we showed that GTE supplementation for 18 or 46 days increased the myofilament Ca(2+) sensitivity of the ischemic myocardium in post-MI rats. These results validate the novel action of green tea polyphenols in protecting against myocardial damage and enhancing cardiac contractility by modulating myofilament Ca(2+) sensitivity in post-MI rats.

Correctness of multi-detector-row computed tomography for diagnosing mechanical prosthetic heart valve disorders using operative findings as a gold standard.

The purpose was to compare the findings of multi-detector computed tomography (MDCT) in prosthetic valve disorders using the operative findings as a gold standard. In a 3-year period, we prospectively enrolled 25 patients with 31 prosthetic heart valves. MDCT and transthoracic echocardiography (TTE) were done to evaluate pannus formation, prosthetic valve dysfunction, suture loosening (paravalvular leak) and pseudoaneurysm formation. Patients indicated for surgery received an operation within 1 week. The MDCT findings were compared with the operative findings. One patient with a Björk-Shiley valve could not be evaluated by MDCT due to a severe beam-hardening artifact; thus, the exclusion rate for MDCT was 3.2% (1/31). Prosthetic valve disorders were suspected in 12 patients by either MDCT or TTE. Six patients received an operation that included three redo aortic valve replacements, two redo mitral replacements and one Amplatzer ductal occluder occlusion of a mitral paravalvular leak. The concordance of MDCT for diagnosing and localizing prosthetic valve disorders and the surgical findings was 100%. Except for images impaired by severe beam-hardening artifacts, MDCT provides excellent delineation of prosthetic valve disorders.

Preparation and non-invasive in-vivo imaging of anti-adhesion barriers with fluorescent polymeric marks.

Comb-like PEMLn polymers with pendent PEG-PLLA side chains were synthesized as tissue anti-adhesion barriers. The comb-like structure improved the flexibility of the films. Fluorescent polymer-biocompatible polymer guest-host materials were printed on the films as marking dots. Without sacrificing rats on different days after surgery, degradation behaviors of the marked films can be investigated non-invasively in the in-vivo imaging system (IVIS) by monitoring the location of fluorescent signals. Degradation properties of PEML1/G26L35 films were adjusted by incorporating G26L35 oligomers. PEML1 and PEML1/G26L35 films were very effective in preventing post-surgical tissue-adhesions. Degradation behaviors of various films observed in the animal study were consistent with those investigated by the in-vivo imaging method. Fluorescent polymer/biocompatible polymer blends were promising candidates for in-vivo imaging applications.

Modified Sleeve Technique in Aortic Valve-Sparing Operation for Marfan Syndrome.

We devised a simple modification of the Florida Sleeve procedure to perform aortic valve-sparing surgery. This technique is simple, quick, effective, and safe. We used this technique in operations performed on two young patients with Marfan syndrome. The initial and short-term results were satisfactory.

Detection of cyanide ions in aqueous solutions using cost effective colorimetric sensor.

Cyanide (CN̄) is one of the most toxic material to the human and environment. It is very important to develop the diagnostic tools for the detection of CN̄ ions. Moreover, detection of the ions in an aqueous medium is a challenging task as water molecules interfere with the sensing mechanism. In this context, we prepared chemical sensor, S1, having anthraquinone as a signaling unit and thiourea as a binding site. This sensor exhibited distinct visual color and spectral changes in response to CN̄ ion over other testing anions in 50% aq. DMSO solution. However, in 20% aq. DMSO solution, S1 exhibited obvious spectral and color changes in response to CN̄, fluoride (F̄), acetate (Ac̄) and benzoate (Bz̄). Another sensor, S2, having a same signaling unit with that of S1, but a different binding site of urea group. In contrast to S1, S2 exhibited obvious spectral and color changes to F̄ in 2.5% aq. DMSO solution. NMR titration results suggested that the spectral and colorimetric responses were due to the formation of host-guest complex and deprotonation events. Finally, economically viable paper-based colorimetric "test stripes" of S1 were fabricated to detect the CN̄ ions in 100% aqueous solution.

Hybrid Repair of Ruptured Arch Aneurysm Without Sternotomy Through an Unusual Extraanatomic Bypass.

A 42-year-old man experienced a complex aortic arch aneurysm rupture. He had previously undergone an operation for type A dissection and had extremely poor cardiac performance as well as deep sternal infection after the first procedure. The conventional open repair was considered to be a high risk for this patient. We therefore performed an alternative hybrid aortic procedure. The supraarch vessels were perfused through an extraanatomic bypass from an unusual and remote route, namely, the abdominal aorta. Then, stent grafts were implanted in the previously replaced aortic prostheses to exclude the aortic aneurysm. The patient recovered uneventfully with no neurologic adverse events.

Robust, sensitive and facile method for detection of F-, CN- and Ac- anions.

Sensing of F-, CN- and Ac- is important from the viewpoint of both medically and environmentally. Particularly, sensing of the anions in 100% water by a colorimetric chemical sensor is a highly difficult task as water molecules interfere the sensing mechanism. In this regard, sensor R1, having azo and nitrophenyl groups as signaling units and thiourea as a binding site was prepared. This sensor exclusively detected CN- ion over other testing anions in 30% aq. DMSO solution by exhibiting distinct spectral and visual color changes. However, in 15% aq. DMSO solution, R1 exhibited obvious spectral and color changes in response to F-, CN- and Ac-. On the other hand, we have also designed sensor, R2, having same signaling units of R1, but a different binding site of urea group. Surprisingly, in contrast to R1, R2 exhibited obvious spectral and color changes in 5% aq. DMSO solution only. Further, economically viable "test stripes" were prepared in a facile mode to detect the CN- in 100% aqueous solution. Such stripes can serve as a practical colorimetric probe for "in the field" detection of the ions and thus avoid additional expensive equipment.

Type A dissection and fistula to right atrium after aortic valve replacement.

A 73-year-old man with a history of severe aortic regurgitation underwent aortic valve replacement with a bioprosthesis. Nine years later, he presented with heart failure and was diagnosed with chronic type A dissection and severe aortic stenosis. During surgery, a fistula from the ascending aortic aneurysm to the right atrium was found incidentally. Replacement of the aortic valve and ascending aorta were performed successfully. The fistula was closed with sutures. The patient was discharged uneventfully on postoperative day 16.

Exploring the Behavior of Bovine Serum Albumin in Response to Changes in the Chemical Composition of Responsive Polymers: Experimental and Simulation Studies.

Knowledge of the interactions between polymer and protein is very important to fabricate the potential materials for many bio-related applications. In this regard, the present work investigated the effect of copolymers on the conformation and thermal stability of bovine serum albumin (BSA) with the aid of biophysical techniques such as fluorescence spectroscopy, circular dichroism (CD) spectroscopy and differential scanning calorimetry (DSC). In comparison with that of copolymer PGA-1.5, our fluorescence spectroscopy results reveal that the copolymer PGA-1, which has a lower PEGMA/AA ratio, shows greater influence on the conformation of BSA. Copolymers induced unfolding of the polypeptide chain of BSA, which was confirmed from the loss in the negative ellipticity of CD spectra. DSC results showed that the addition of PGA-1 and PGA-1.5 (0.05% (w/v) decreased the transition temperature by 14.8 and 11.5 °C, respectively). The results from the present study on the behavior of protein in response to changes in the chemical composition of synthetic polymers are significant for various biological applications such as enzyme immobilization, protein separations, sensor development and stimuli-responsive systems.

Successful salvage of inferior vena cava rupture during reoperative repair for ascending aortic aneurysm.

A 44-year-old man underwent reoperative repair for ascending aortic aneurysm at our hospital. He had received aortic valve replacement due to severe aortic regurgitation 4 years previously. The cardiopulmonary bypass was set up through the femoral arterial and venous cannula. An unusual experience of rupture of the abdominal inferior vena cava was encountered after total-body retrograde perfusion. The tragic situation was successfully salvaged by recannulation into the intrapericardial inferior vena cava and repair of the several perforations on abdominal inferior vena cava. The patient recovered smoothly except for mild pancreatitis. The causes of rupture of the inferior vena cava are discussed here.