ABSTRACT
We present a 62-year-old woman who was diagnosed with primary pulmonary arterial sarcoma with pulmonary hypertension. CT showed a large defect inside both main pulmonary arteries in accordance with the accumulation of FDG-PET. To relieve the symptom and to prevent sudden death, removal of a massive pulmonary tumor and postoperative chemotherapy were planned. Utilizing the intermittent systemic circulatory arrest under deep hypothermia (18°C), the pulmonary artery trunk and both main pulmonary arteries were opened. The tumor stacking inside the pulmonary artery was removed and its origin at the commissure of the pulmonary artery valve was resected. The defect was repaired with a pulmonary valve replacement. Histopathological examination revealed high grade sarcoma. Her postoperative course was uneventful ; however, she died of cerebral hemorrhage during chemotherapy six months after surgery.
ABSTRACT
Introduction : Prevention of embolic stroke is the key issue to perform aortic arch replacement in patients with a shaggy aorta. The aim of this study is to report the utility of the isolation technique for total arch replacement in patients with a shaggy aorta. Methods : Clinical results of seven patients (71.7 years old, all men) with a shaggy aorta who underwent total arch replacement between January 2017 and November 2018 were retrospectively reviewed. The operative indications were a distal arch or proximal descending aortic aneurysm in 6 patients and a thrombus inside brachiocephalic artery in one. A cerebral perfusion was established by inserting a cannula directly into all supra-aortic branches before starting systemic perfusion. Result : Utilizing the isolation technique with clamping of all branches in 4 patients and the functional isolation technique with clamping of two branches in 3, total arch replacement was performed in all patients (operation time : 513 min, selective cerebral perfusion time : 162 min). No operative death was observed and no newly developed stroke was encountered. Conclusion : The isolation technique is a useful method to prevent stroke during total arch replacement in patients with a shaggy aorta.
ABSTRACT
The purpose of this study was to examine the recruitment state of synergistic muscles in the thigh muscles in leg press exercise with and without pre-fatigue method using transverse relaxation time (T2) on muscle functional magnetic resonance imaging (MRI). Nine healthy male subjects performed the following two types of exercise trials on separate days: 1) 5 sets of a leg press exercise with pre-fatigue method, which consisted of 3 sets of knee extension exercise (LP-pre), 2) 5 sets of a leg press exercise without pre-fatigue method (LP). Both exercises were performed at a load of 80% one-repetition maximum. Before and immediately after exercise, T2-weighted MR images of right-thigh were taken to calculate T2 values of twelve-thigh muscles. The T2 values for quadriceps femoris muscle and hamstrings in LP increased significantly after the exercise, except in the adductor magnus, adductor longus, gracilis, and sartorius. In contrast, the T2 values for all of the twelve-thigh muscles in LP-pre increased significantly after the exercise. Upon comparison between the two trials, the percentage changes in T2 value for the adductor magnus, adductor longus, and sartorius in LP-pre were found to be significantly greater than those in LP. These results suggest leg press exercise with pre-fatigue method may be effective to increase activity of synergistic muscles in thigh muscles during exercise.
ABSTRACT
Infectious abdominal aortic aneurysm is a relatively rare disease, and there is no consensus regarding its surgical treatment. Medical infectious control should be concerned comparison with surgical treatment if there is sepsis, however we sometimes have no other choice but emergency operation for uncontrollable cases. In many reports, cryopreserved homografts were used as <i>in</i>-<i>situ </i>alternative grafts for infectious aortic aneurysms because they had some merits such as anti-infectious effects, suitability and so on. However the number of <i>in-situ </i>cryopreserved homograft replacement cases are few, and the long term result is unclear. We encountered a ruptured cropreserved homograft case 7 months after urgent <i>in-situ </i>cryopreserved homograft replacement. We report the case and refer to the relevans literature.