ABSTRACT
We report a 77-year-old woman who underwent mitral valve repair using leaflet folding plasty for mitral regurgitation due to bilatelal commissural prolapse. A Carpentier prosthetic ring was applied to remodel the annulus and to reinforce repair. Postoperative echocardiography revealed no regurgitation and good mitral valve opening. Leaflet folding plasty is considered to be a simple and effective technique to accomplish mitral valve repair for mitral regurgitation due to commissural prolapse.
ABSTRACT
The approach for the heart and proximal aorta in a patient with a tracheostomy poses difficult problems such as mediastinitis and inadequate operative exposure. We report a case of successful surgical treatment for type A aortic dissection in a patient with tracheostomy using a Y shaped skin incision and median full-sternotomy. A 63-year-old woman with a tracheostomy was referred to our hospital because of type A thrombosed aortic dissection and cardiac tamponade. At first we treated the patient conseservatively, but follow-up CT taken on the 20th day after onset revealed that false lumen of the ascending aorta was patent and the size of ascending aorta had increased to 6cm in diameter. We therefore performed hemiarch replacement (24mm Hemashield gold graft) through a Y shaped skin incision and median full-sternotomy. The postoperative course was uneventful and she was discharged on the 19th postoperative day.
ABSTRACT
We reviewed 223 cases of surgical treatment for abdominal aortic aneurysm in octogenarians in this hospital between 1981 and 2000, and investigated the characteristic features, complications, and indications of the operation. The cases were divided into two age groups. Group O included 23 cases of octogenarians, and Group Y included 200 cases of patients under 80 years old. The average age was 68.6 years old in group Y (33-79 years old), and 83 years old in group O (80-93 years old). The hospital mortality rate was 0% in elective operation cases. In emergency operation case, Group O had a hospital mortality rate of 57.1%, significantly higher than the 6.1% for group Y. The hospital mortality rate was 17% in group O and 0.5% in group Y. The rate of emergency operation case was significantly higher in group O (30.4%) compared to group Y (16.5%). As for the preoperative complications, group O had more cases of renal dysfunction, COPD and gastrointestinal complication. As for the coronary artery disease and other cardiovascular complications, there were no significant differences between the groups. In the postoperative complication, group O had more cases of ileus, pneumonia, and cardiovascular disease. These complications were fatal in group O. These results suggest that surgical treatment for abdominal aortic aneurysm was performed safely in both groups for elective operations. Because the results of emergency operations are poor, early diagnosis and treatment seem to be important for the improvement of operative results.