[Long-term outcome of the surgical treatment for acute aortic dissection with a ringed intraluminal graft; report of a case].

A 61-year-old female, who had undergone the surgical treatment of acute type A aortic dissection with a ringed intraluminal graft 26 years before, presented with breathlessness. Computed tomography (CT) showed peri-prosthetic leakage and enlargement (45×50 mm in diameter), enlargement of the aortic root (42 mm in diameter), and aneurysm of the ascending aorta and the aortic arch (55 mm in diameter) with chronic type A aortic dissection. Echocardiography showed severe aortic regurgitation. She successfully underwent aortic root replacement( Bentall procedure) and total arch replacement.

[Surgical treatment of traumatic pseudoaneurysm of the brachiocephalic artery; report of a case].

Traumatic injury to the great vessels may be one of the highly lethal states. In many of these cases, the lesion was confirmed at the aortic isthmus. We report a case of successful surgical treatment of the traumatic pseudoaneurysm of the brachiocephalic artery. Pre-operative 3-dimension computed tomography (CT) showed an aneurysm at the left dorsal of the artery. At surgery, the proximal portion of the brachiocephalic artery, the right common cartid artery and the right subclavian artery were clamped with the simple extracorporeal shunting between the aortic arch and the distal of the right common cartid artery for maintaining the blood flow to the brain. A longitudinal dissection was found at the left dorsal position when the aneurysm was opened. The aneurysm was removed and interposed using an artificial vessel. After surgery, no neurologic complication or aftereffects were revealed, and the cerebral infarction due to the procedure was not detected by the brain CT.

Left ventricular-right atrial communication complicated by aortic regurgitation.

We report a case of left ventricular-right atrial communication complicated by aortic valve incompetence in a 29-year-old man. The patient had a history of heart murmur during childhood. There were no clinical signs of infection. We performed plication of the aortic valve and patch closure of the left ventricular-right atrial communication under cardiopulmonary bypass. The patient improved immediately after the operation.

Complete atrioventricular canal and tetralogy of Fallot with pulmonary atresia.

Our patient was diagnosed with complete atrioventricular canal and Tetralogy of Fallot with pulmonary atresia at the age of 1 month. Then he underwent right and left Blalock-Taussig shunts at the ages of 2 months and 5 years, respectively. His cyanosis had increased at 20 years of age. Cardiac catheterization showed occlusion of the left Blalock-Taussig shunt and absence of the left pulmonary artery. Lung perfusion scintigram showed late phase perfusion in the left lung. Chest computed tomographic scan demonstrated the left pulmonary artery. We describe the operative technique of total correction.

Simultaneous repair of pectus excavatum and congenital heart defect in adults by using the convex bar.

Simultaneous repair of pectus excavatum and cardiac lesions remains technically difficult. In adults, most repairs of pectus deformity and heart lesions have been performed through long incisions, sternal splits, excision of deformed cartilages, and sternal turnover, which can result in poor cosmetic appearance because of sternal devascularization. We performed concomitant repair of pectus excavatum and an atrial septal defect through a short midline incision in an adult. The sternum was fixed by using absorbable plates and screws and was supported by a convex steel bar. The cosmetic appearance remained excellent after the operation. The technique and a review of the literature are included.