Vena cubiti media for creation of a loop-shaped arteriovenous fistula at the elbow region.

Hemodialysis access is one of the major routes, for patients who need long-term hemodialysis. In this report, we tried a new secondary arteriovenous fistula technique. Between January 2000 and June 2003, hemodialysis access was created in more than 650 patients with end-stage renal failure at our institution. In 15 cases a loop-shaped hemodialysis access was created between the brachial artery and vena cubiti media as a second choice. The youngest patient was 12 years old, whereas the oldest was 75. The mean follow-up period (A+/-SD) for these patients was 10.4 A+/- 2.53A months. Twelve patients are still using these fistulas successfully for hemodialysis (86.6%), whereas one patient died 7A months after the operation (6.7%). In one patient, the arteriovenous fistula failed 6A months after the operation (6.7%). Thrombosis due to hypotension occurred in two cases (13.3%) and this was resolved by simple thrombectomy. One patient had an aneurysm over the vena cubiti media (6.6%). None of the patients had an infection. These results suggest that an end-to-side anastomosis between the brachial artery and, vena cubiti media can be used as a second choice for hemodialysis access in patients with end-stage renal disease.

Clinical features and surgical treatment of cardiac myxoma: report of 18 cases.

Myxomas are the most common benign primary cardiac tumors. As many patients with cardiac myxoma suffer from cerebral or systemic embolism, which are serious complications, diagnosis of the tumor is vital. Between 1990 and 2000, 18 patients (6 males, 12 females), aged 24 to 73 years (mean, 55.3 years), were operated on for cardiac myxoma. The most common location of the myxoma was the left atrium (78%), and the transseptal surgical approach was preferred (78%) as it allows total resection of the left atrial myxoma along with its pedicle. Carney complex, a familial autosomal dominant form of atrial myxoma, was not found in any of the patients. There had been no operative or postoperative mortality and morbidity. The mean postoperative follow-up period was 5 years (mean, 1 to 10 years). No recurrence had been seen. We believe that the transseptal approach, in allowing total resection of the myxoma, prevents recurrence.