Root aneurysm following aortic valve replacement 20 years after an arterial switch operation.

Late development of annuloaortic ectasia (AAE) and progression of aortic regurgitation (AR) are widely recognized outcomes following an arterial switch operation (ASO). We treated a 29-year-old male with AAE and rapid aortic root expansion, who underwent ASO as a neonate and aortic valve replacement (AVR) as an adult. He was diagnosed as having dextro-(D-loop) transposition of the great arteries after birth and underwent ASO at the age of 13 months. At the age of 19 years, AVR was performed for progressive AR. AAE developed after AVR. In patients who have undergone neonatal ASO, AAE may occur following AVR decades later.

[Native Aortic Valve Endocarditis Caused by Nocardia asteroides;Report of a Case].

Infection by Nocardia sp. is rare and usually affects immuno-depressed patients, such as those receiving chemotherapy and long-term steroid therapy. Cardiac involvement is uncommon and usually occurs as endocarditis. We present a case of native aortic valve endocarditis caused by Nocardia asteroides. Aortic valve translocation method was chosen because of extensive root infection with major disruption of the aortic annulus. Over 2 years after the surgery, there is no recurrence and no enlargement of the aortic annulus.

[Infective endocarditis with destruction of the mitral valve annulus and the left atrial posterior wall after cancer chemotherapy].

The case is reported of a 48-year-old man who underwent distal pancreatectomy, splenectomy, and 4 cycles of postoperative chemotherapy for stage I pancreatic cancer, at the age of 47. Four days after completion of chemotherapy, the patient developed high-grade fever (40 degrees C). In addition, on day 10, he developed disturbance of consciousness, followed by symptoms of shock, which led to emergency hospitalization. On day 4 of admission, the patient was diagnosed as having infective endocarditis and severe mitral valve insufficiency, and was started on antibiotic and heart failure therapy. Surgery was performed on day 16 of admission; the mitral valve infection had spread to the valve cusp and ring, and thence to the posterior wall of the left atrium. After excision of the lesions, the patient underwent mitral valve replacement with a collared prosthesis valve and a translocation procedure. The postoperative course was uneventful, and there has been no recurrence of inflammation or paraprosthetic leakage over the year and 6 months since the operation.

A single stage hybrid repair of a complicated acute type B dissection with aortic arch involvement.

We present a case in which a single stage hybrid repair was successfully for a complicated acute type B dissection of the aortic arch involvement in a 63-year-old male patient. We performed a combination of different techniques; left subclavian artery debranching, elephant trunk insertion without aortic arch replacement, and thoracic endovascular aortic repair (TEVAR) from antegrade approach. The postoperative course was successful, and the patient was discharged on day 11 after surgery. A-half-year's follow up computed tomography (CT) scan showed shrinkage of thrombus lumen, vascular reverse remodeling.

Posterior ventricular septal perforation: sandwich technique via right ventriculotomy using BioGlue.

We present a case in which the sandwich technique was successfully applied via right ventriculotomy for posterior infarction ventricular septal perforation 2 days after acute posterior myocardial infarction in a 73-year-old male patient. The sealant BioGlue was applied to the space between the two patches instead of gelatin-resorcinol-formaldehyde biological glue. The postoperative course was good, and the patient was discharged on day 24 after surgery with no recognized residual shunt.