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Ann Thorac Cardiovasc Surg 2022 May 19. Epub 2022 May 19.

Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.

We present a case report of a 30-year-old Marfan syndrome patient who underwent a David procedure for severe aortic valve insufficiency and Valsalva aneurysm. Harvested aortic walls were examined by pathologists. Although the tunica media of the ascending aorta contained aligned elastic fibers, the aortic root media lacked aligned elastic fibers. Read More

Ann Thorac Cardiovasc Surg 2022 May 10. Epub 2022 May 10.

Department of Cardiovascular Surgery, Sapporo City General Hospital, Sapporo, Hokkaido, Japan.

Purpose: This study focused on clarifying the durability of bioprosthetic valves in current practice.

Methods: A total of 238 consecutive patients who underwent aortic valve replacement at a single institution from 2011 to 2020 were reviewed. We evaluated valve-related outcomes such as structural valve deterioration (SVD), especially in dialysis patients who received bioprosthetic valve. Read More

Ann Thorac Cardiovasc Surg 2022 May 10. Epub 2022 May 10.

Department of Thoracic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami-machi, Ibaraki, Japan.

Castleman's disease with calcification of the chest wall is very rare, and there have been few reports of such cases to date. A 57-year-old woman was referred to our hospital for a tumor with calcification on her left lateral chest wall, which was detected on chest computed tomography. Findings of her chest magnetic resonance imaging suggested schwannoma or a solitary fibrous tumor, and therefore, we performed surgery for diagnostic and therapeutic purposes. Read More

Ann Thorac Cardiovasc Surg 2022 May 9. Epub 2022 May 9.

Department of Thoracic Surgery, St. Luke's International Hospital, Tokyo, Japan.

Ingested sharp foreign bodies rarely migrate extraluminally into adjacent organs such as the pharynx, lungs, and liver. Herein, we report a case of fish bone ingestion where the foreign body followed a unique migration trajectory. Computed tomography revealed a fish bone extraluminally located in the aortopulmonary space in the left mediastinum and peri-esophageal pneumomediastinum. Read More

Ann Thorac Cardiovasc Surg 2022 Apr 5. Epub 2022 Apr 5.

Department of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.

Purpose: Transit-time flow measurement (TTFM), consisting of pulsatility index (PI), mean graft flow, and diastolic filling, is mainly used as a bypass assessment for coronary artery disease (CAD). However, little was known about TTFM in the case of coronary malperfusion (CMP). This study aimed to clarify the difference in the results of TTFM between two different diseases. Read More

Ann Thorac Cardiovasc Surg 2022 Apr 6. Epub 2022 Apr 6.

Department of Thoracic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.

Pulmonary mucormycosis is an extremely rare disease. It often occurs in immunocompromised patients, such as patients with diabetes and those on long-term steroid use. The prognosis of the disease is poor despite the administration of antifungal agents and removal of the necrotic tissue. Read More

Ann Thorac Cardiovasc Surg 2022 Apr 7. Epub 2022 Apr 7.

Department of Vascular Surgery, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan.

Purpose: To analyze our contemporary experience in open abdominal aortic aneurysm (AAA) repair. We focused on the effects of suprarenal (SR) aortic cross-clamping and adjunctive renal reconstruction (RR) on postoperative outcomes.

Methods: We retrospectively reviewed our institutional data of 141 consecutive patients who received elective open AAA repair between January 2014 and December 2020. Read More

Ann Thorac Cardiovasc Surg 2022 Mar 25. Epub 2022 Mar 25.

Department of Thoracic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami-machi, Ibaraki, Japan.

A 51-year-old man who noticed discomfort in the pharynx was found to have a tracheal tumor on physical examination. He was diagnosed as having adenoid cystic carcinoma by a transbronchial biopsy and underwent tracheal segmental resection via a collar incision. He was additionally treated with radiation therapy owing to a positive surgical margin, and he subsequently developed anastomotic tracheal stenosis. Read More

Ann Thorac Cardiovasc Surg 2022 Mar 26. Epub 2022 Mar 26.

Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.

From April 2018 to February 2021, 150 patients underwent MitraClip implantation for severe functional mitral regurgitation (MR) at our hospital. Two of our patients, an 85-year-old man and an 84-year-old woman, developed a single leaflet device attachment in the acute phase after the implantation and had severe residual MR requiring surgical correction. The recurrent MR was first pointed out on day 5 and day 4, and the duration between MitraClip implantation and surgery was 13 and 55 days, respectively. Read More

Ann Thorac Cardiovasc Surg 2022 Mar 23. Epub 2022 Mar 23.

Department of Cardiovascular Surgery, Sapporo Central Hospital, Sapporo, Hokkaido, Japan.

A 56-year-old man with a history of left nephrectomy for Wilms' tumor on chronic hemodialysis underwent aortic valve neocuspidization using autologous pericardium (Ozaki procedure) for aortic stenosis (AS) due to a bicuspid aortic valve 6 years ago. The AS gradually progressed and a decrease in the left ventricular ejection fraction was observed. Because of this, we decided to perform reoperative aortic valve replacement using a mechanical valve. Read More

Ann Thorac Cardiovasc Surg 2022 Mar 16. Epub 2022 Mar 16.

Department of Thoracic Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Hiroshima, Japan.

Purpose: This study investigated the impact of skeletal muscle quality on the outcomes of patients undergoing surgery for early-stage non-small-cell lung cancer (NSCLC).

Methods: A total of 98 patients with pathological stage I-II NSCLC who underwent lobectomy or segmentectomy were retrospectively analyzed. Along with skeletal muscle quantity, muscle quality was evaluated by intramuscular adipose tissue content (IMAC) at the first lumbar vertebral level; a higher IMAC indicates lower skeletal muscle quality. Read More

Ann Thorac Cardiovasc Surg 2022 Mar 10. Epub 2022 Mar 10.

Department of Cardiovascular Surgery, Saitama Red Cross Hospital, Saitama, Saitama, Japan.

Werner's syndrome (WS) is a genetic disorder presenting with premature senility. In the present study, we performed minimally invasive cardiac surgery (MICS)-aortic valve replacement (AVR) on a patient with Werner's syndrome who presented with aortic stenosis. The patient, a 49-year-old Japanese man, was brought to the emergency room with dyspnea during exercise. Read More

Ann Thorac Cardiovasc Surg 2022 Mar 8. Epub 2022 Mar 8.

Department of Otorhinolaryngology, Faculty of Medicine in Pilsen, University Hospital Pilsen, Charles University, Pilsen, Czech Republic.

Purpose: The aims of this work were the retrospective analysis of a cohort of patients with acute mediastinitis treated at the authors' worksite over a 15-year period and the identification of factors that significantly affect the outcomes of the therapy.

Methods: During the period 2006-2020, 80 patients with acute mediastinitis were treated. Within the cohort, the following were observed: the causes and the type of acute mediastinitis, length of anamnesis, comorbidities, diagnostic methods, time from the diagnosis to surgery, types and number of surgical procedures, results of microbiological tests, complications, and outcomes of the treatment. Read More

Ann Thorac Cardiovasc Surg 2022 Feb 26. Epub 2022 Feb 26.

Department of Cardiovascular Surgery, Changhai Hospital, Naval Medical University, Shanghai, China.

Purpose: In this study, we compared the early results between the extensive arch repair with a novel two-branched stent graft (TSG) and the traditional technique.

Methods: Between 2013 July and 2015 March, 63 acute type A aortic dissection (ATAAD) patients from four cardiac centers with indications for extensive arch repair were included in this study. Finally, 28 patients were involved in the traditional procedure (TP) group (23 males with the age of 49. Read More

Ann Thorac Cardiovasc Surg 2022 Feb 9. Epub 2022 Feb 9.

Department of Cardiothoracic Surgery, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.

Background: Concomitant mitral regurgitation (MR) is frequently seen in patients undergoing surgical aortic valve replacement (AVR) for severe aortic stenosis (AS). When the severity of MR is moderate or less, the decision to undertake simultaneous mitral valve intervention can be challenging.

Methods: A systematic search of Medline, PubMed (NCBI), Embase and Cochrane Library was conducted to qualitatively assess the current evidence for concomitant mitral valve intervention for MR in patients with AS undergoing AVR. Read More

Ann Thorac Cardiovasc Surg 2022 Feb 10;28(1):4A-6A. Epub 2022 Feb 10.

Ann Thorac Cardiovasc Surg 2022 Jan 29. Epub 2022 Jan 29.

Department of Thoracic Surgery, Sasebo City General Hospital, Sasebo, Nagasaki, Japan.

Purpose: The surgical approach for anatomical lung resection includes open thoracotomy, video-assisted thoracoscopic surgery, and robot-assisted thoracoscopic surgery. We evaluated the short-term outcomes and the learning curve wherein a thoracic resident doctor consecutively performed video-assisted thoracoscopic anatomical lung resection for lung cancer.

Methods: We retrospectively reviewed 91 cases of consecutive video-assisted thoracoscopic anatomical lung resections for lung cancer performed by a thoracic resident doctor between November 2017 and March 2020. Read More

Ann Thorac Cardiovasc Surg 2022 Jan 29. Epub 2022 Jan 29.

Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan.

A patient underwent surgical resection twice for primary and metastatic dedifferentiated liposarcomas. Computed tomography revealed a tumor mass at the cavoatrial junction. Prompt surgical resection of the tumor with thrombectomy was successfully performed using cardiopulmonary bypass with hypothermic circulatory arrest. Read More

Ann Thorac Cardiovasc Surg 2022 Jan 25. Epub 2022 Jan 25.

Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

Purpose: With de novo cancer, esophagectomy after lung transplantation (LTx) can be challenging because of intrathoracic adhesions, delayed wound healing, and postoperative pulmonary complications, which might be lethal.

Case Presentation: A 52-year-old woman with esophageal cancer had undergone bilateral LTx for end-stage diffuse panbronchiolitis at 50 years of age. Thoracoscopic esophagectomy was performed. Read More

Ann Thorac Cardiovasc Surg 2022 Jan 25. Epub 2022 Jan 25.

Department of Cardiothoracic Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.

The patient was a 69-year-old man who underwent emergency surgery for acute aortic dissection that developed 5 months after coronary artery bypass grafting. The left internal thoracic artery (LITA) graft anastomosed to the left descending artery was not affected by the aortic dissection, and during the ascending aortic replacement, the artery was not identified for clamping. Although fully sufficient cardioplegia was not achieved due to the patent LITA graft, the patient's postoperative cardiac function was good. Read More

Ann Thorac Cardiovasc Surg 2022 Jan 20. Epub 2022 Jan 20.

Department of Cardiac Surgery, Asklepios Klinik St. Georg, Hamburg, Germany.

Objective: To analyze the results of hemoadsorption in patients with cardiac surgery to thoracic aortic surgery, who had been loaded beforehand with either Factor Xa inhibitor rivaroxaban or P2Y12 receptor antagonist ticagrelor.

Methods: We investigated 21 of 171 consecutive patients (median age 71 [interquartile range 62, 76] years) who underwent emergency cardiac operations for acute type A aortic dissection between 2014 and 2020. These patients were pretreated with rivaroxaban (n = 9) or ticagrelor (n = 12). Read More

Ann Thorac Cardiovasc Surg 2022 Feb 17;28(1):63-71. Epub 2022 Jan 17.

Department of Cardiovascular Surgery, Musashino Red Cross Hospital, Tokyo, Japan.

Purpose: Saphenous vein graft (SVG) is the most commonly used conduits in coronary artery bypass grafting (CABG), but the disadvantage of SVG is its tendency for progressive failure. We hypothesized that therapeutic-dose warfarin (international normalized ratio [INR] >1.6) plus aspirin improve SVG patency. Read More

Ann Thorac Cardiovasc Surg 2021 Dec 22. Epub 2021 Dec 22.

Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA.

Purpose: High-dose heparin has been suggested to reduce consumption coagulopathy.

Materials And Methods: In a randomized, blinded, prospective trial of patients undergoing elective, complex cardiac surgery with cardiopulmonary bypass, patients were randomized to one of three groups: 1) high-dose heparin (HH) receiving an initial heparin dose of 450 u/kg, 2) heparin concentration monitoring (HC) with Hepcon Hemostasis Management System (HMS; Medtronic, Minneapolis, MN, USA) monitoring, or 3) a control group (C) receiving a standard heparin dose of 300 u/kg. Primary outcome measures were blood loss and transfusion requirements. Read More

Ann Thorac Cardiovasc Surg 2021 Dec 22. Epub 2021 Dec 22.

Department of Vascular Surgery, University Hospital Zurich, Zurich, Switzerland.

Purpose: To compare open versus endovascular left subclavian artery debranching for thoracic endovascular aortic repair of thoracic aortic pathologies.

Methods: This is a retrospective study of patients receiving left subclavian artery debranching in our institution from October 2009 to January 2020. The primary outcome was freedom from aortic reintervention. Read More

Ann Thorac Cardiovasc Surg 2021 Dec 16. Epub 2021 Dec 16.

Department of Cardiovascular Surgery, Higashi Osaka Medical Center, Higashiosaka, Osaka, Japan.

Intraoperative bleeding from the distal anastomotic site during graft replacement of the arch to distal arch via median sternotomy to treat an aortic aneurysm is sometimes difficult to control because of the limited distal view. I herein report a case in which I addressed this uncontrollable bleeding using a commercialized frozen elephant trunk. Read More

Ann Thorac Cardiovasc Surg 2021 Dec 13. Epub 2021 Dec 13.

Department of Thoracic Surgery, First Hospital of Tsinghua University, Beijing, China.

Purpose: Reconstruction of the esophagus with sternohyoid muscle after enucleation of the cervical esophageal leiomyosarcoma (ELS) was rarely reported.

Methods: A case of 55-year-old female with a large leiomyosarcoma in the cervical esophagus was reported. The tumor was enucleated, and the defect of the esophagus was patched with left sternohyoid muscle flap. Read More

Ann Thorac Cardiovasc Surg 2022 Apr 10;28(2):83-95. Epub 2021 Dec 10.

Department of Cardiovascular Surgery, First Hospital of Lanzhou University, Lanzhou, China.

Purpose: The impact of chronic kidney disease (CKD) on the prognosis of transcatheter aortic valve replacement (TAVR) remains unclear. The purpose of this meta-analysis was to assess the impact of CKD and different stages of CKD on prognosis in patients undergoing TAVR.

Methods: As of June 2020, we performed a comprehensive literature search on relevant studies using PubMed, Embase, Cochrane Library, and Web of Science. Read More

Ann Thorac Cardiovasc Surg 2021 Dec 7. Epub 2021 Dec 7.

Department of Cardiovascular Surgery, Kansai Medical University, Hirakata, Osaka, Japan.

Purpose: The effect of our comprehensive strategy to reduce pain after minimally invasive mitral valve repair through a right mini-thoracotomy was assessed retrospectively.

Methods: Our comprehensive strategy constituted the following: planned rib cutting to avoid rib injury, sufficient intercostal muscle division to mobilize the cut rib, limiting the number of intercostal ports, avoiding nerve entrapment, continuous extra-pleural intercostal nerve block, and regular use of oral non-steroidal anti-inflammatory drugs. We compared patients treated with this comprehensive strategy (Group S, n = 13) and patients before this strategy was implemented (Group C, n = 13). Read More

Ann Thorac Cardiovasc Surg 2021 Dec 3. Epub 2021 Dec 3.

Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.

Cholesterol granulomas of the thymus are extremely rare benign entities. Herein, we describe a case of cholesterol granuloma in a 45-year-old man who presented with multifocal anterior mediastinal lesions on computed tomography (CT). Positron emission tomography (PET)-CT revealed increased fluorodeoxyglucose uptake, with a maximum standardized uptake value of 8. Read More

Ann Thorac Cardiovasc Surg 2021 Dec 3. Epub 2021 Dec 3.

Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Akita, Japan.

The advantages of salvage esophagectomy through robotic-assisted surgery for patients with clinically diagnosed tumor invasion of adjacent vital organs (cT4b) or patients with scar tissue from definitive chemoradiotherapy (dCRT) are still only rarely reported. A man in his 60s with middle thoracic esophageal cancer (cT4b [left main bronchus] N1 M0 cStage IIIC) received dCRT (60 Gy). After the chemoradiotherapy, upper gastrointestinal endoscopy revealed a residual primary tumor, and we performed robotic-assisted thoracoscopic subtotal esophagectomy and gastric tube reconstruction via a retrosternal route with three-field lymphadenectomy. Read More