ABSTRACT
The excellent long-term patency of no-touch (NT) saphenous vein grafts (SVGs) makes the grafts very attractive for coronary artery bypass grafting; however, NT-SVG harvesting has a greater incidence of wound complications than conventional methods. Since 2009, we have performed endoscopic vein harvesting (EVH) in our department with very few major wound complications. Because NT-SVG harvesting is expected to provide long-term patency, if performed with EVH, the incidence of wound complications will be reduced. Thus, we began performing endoscopic pedicle SVG harvesting (Pedicle-EVH) in March 2019. Herein, we report the early results obtained using our current Pedicle-EVH procedure. No major wound complications were reported, and the early results, including patency, were satisfactory. To harvest the pedicle SVG, however, we used a different method than the NT-SVG procedure, so careful monitoring will be needed to assess long-term outcomes.
Subject(s)
Coronary Artery Bypass , Saphenous Vein , Humans , Saphenous Vein/transplantation , Treatment Outcome , Coronary Artery Bypass/adverse effects , Coronary Artery Bypass/methods , Tissue and Organ Harvesting/adverse effects , Vascular Surgical Procedures/methods , Endoscopy/adverse effects , Endoscopy/methods , Vascular PatencyABSTRACT
A 60-year-old woman was admitted to our hospital for dyspnea. Contrast-enhanced computed tomography( CT) revealed acute pulmonary artery thromboembolism. An echocardiogram showed a movable structure in the right atrium. Emergency surgery was performed under general anesthesia. The movable structure in the right atrium looked like a Chiari network with a diameter of over 5 cm, and no obvious thrombus was found. The patient had a good postoperative course and was discharged home on postoperative day 17. The Chiari network is a remnant structure of the fetal venous sinus valve, and its diagnosis was important for determining the appropriate treatment plan for this case.
Subject(s)
Heart Defects, Congenital , Pulmonary Embolism , Thrombosis , Female , Humans , Middle Aged , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/surgery , Echocardiography , Heart AtriaABSTRACT
An 82-years-old woman was admitted with sudden chest pain. Coronary angiography did not reveal any significant stenosis, but left ventriculography showed akinesis and ballooning of the apex with a hyperkinetic basal segment, suggestive of takotsubo cardiomyopathy. She suffered intractable heart failure, and laboratory data, electrocardiogram signs of ST-segment elevation and left ventricular( LV) apical dysfunction failed to show improvement. LV plasty was performed on 106th day after the onset because of aneurysmal change of the left ventricular apex myocardium, unremitting sanguineous pericardial effusion, and anemia. She had a good postoperative course and end-diastolic ventricular volume index was remarkably reduced from 144 to 55 ml/m2. She discharged home on the 38th postoperative day.
Subject(s)
Heart Aneurysm , Takotsubo Cardiomyopathy , Female , Humans , Aged, 80 and over , Takotsubo Cardiomyopathy/complications , Takotsubo Cardiomyopathy/diagnostic imaging , Takotsubo Cardiomyopathy/surgery , Electrocardiography , Heart Aneurysm/complications , Heart Aneurysm/diagnostic imaging , Arrhythmias, Cardiac , ThoraxABSTRACT
A 19-year-old man, with a history of hospitalization for infective endocarditis associated with Streptococcus mitis/oralis 2 months before, was admitted to our hospital because of stomach ache and pulsatile mass on the left forearm. Computed tomography(CT) and ultrasonography revealed a thrombus in the superior mesenteric artery and an aneurysm of the left ulnar artery. As vegetation was noted on the anterior leaflet of the mitral valve, mitral valve replacement and ulnar artery aneurysmorrhaphy were performed. He was discharged 24 days after surgery without any complications. Although mycotic aneurysm is one of the complications of infective endocarditis, it is rarely formed in the ulnar artery. Moreover, mycotic aneurysm may develop even after inflammatory reaction has subsided. Thus, longterm observation of patients with infective endocarditis is necessary.