Combined Ascending-Abdominal Aortic Bypass and Aortic Valve Replacement for Residual Aortic Coarctation / 日本心臓血管外科学会雑誌

Extra-anatomical aortic bypass through median sternotomy for aortic recoarctation allows concomitant repair of associated cardiac defects while avoiding potential complications of anatomic repair, including hemorrhage, bleeding from adhesions, nerve damage and spinal cord ischemia. We describe here the case of a 13-year-old boy who presented with aortic regurgitation and aortic recoarctation after two previous anatomic repairs with a prosthetic graft through thoracotomies. Ascending-abdominal aortic bypass and aortic valve replacement (AVR) were performed concomitantly through a median sternotomy. Extra-anatomical aortic bypass through a median sternotomy is useful for aortic recoarctation. Careful observation is required for younger patients.

A Pseudoaneurysm of Abdominal Aorta after Intravesical bacillus Calmette-Guerin Therapy / 日本心臓血管外科学会雑誌

We report a patient who underwent an operation for an infectious abdominal aortic aneurysm 10 months after intravesical bacillus Calmette-Guerin therapy. A 68-year-old man had previous gastrectomy for early gastric cancer and intravesical BCG therapy for early stage urinary bladder cancer. His follow up CT scan revealed an abdominal aorta pseudoaneurysm. We performed aneurysmectomy, omentopexy and bilateral axillo-femoral bypass. The culture of an abscess in the aneurysm identified <i>Mycobacterium bovis</i>. The patients improved clinically with antituberculosis agents after operation. Intravesical bacillus Calmette-Guerin therapy is effective in the treatment of early stage urinary bladder cancer. Although this treatment is generally considered safe, serious complications including vascular complications have been reported.