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A 40-year-old woman underwent an atrial septal defect closure 4 years before presentation. During the operation, juxtaposition of the atrial appendages was found simultaneously but no obvious communication was found between the appendages. She recently experienced desaturation on exercise, and the residual communication was found between the juxtaposed atrial appendages. The residual communication was closed from the right to the left atrium. Herein, we report the rare case of juxtaposition of the atrial appendages with residual communication between them after an atrial septal defect closure.

A case of abdominal aortic aneurysm appeared to be compression of the antrum of the stomach and was suspected of causing a gastric obstruction. However, an upper gastrointestinal endoscopy to rule out an obstruction by a tumor revealed a gastric tumor, thus avoiding unnecessary intervention, such as open surgery. Abdominal aortic aneurysm (AAA)s rarely cause gastrointestinal obstruction, especially in the duodenum. However, clinicians should consider obstruction by a tumor, even if the obstruction appears to be caused by compression by an AAA.

PurposePostoperative spinal cord injury is a devastating complication after aortic arch replacement. The purpose of this study was to determine the predictors of this complication.MethodsA group of 254 consecutive patients undergoing aortic arch replacement via median sternotomy, with (n = 78) or without (n = 176) extended replacement of the upper descending aorta, were included in a risk analysis. The frozen elephant trunk technique was used in 46 patients. The patients’ atherothrombotic lesions (extensive intimal thickening of > 4 mm) were identified from computed tomography images.ResultsComplete paraplegia (n = 7) and incomplete paraparesis (n = 4) occurred immediately after the operation (permanent spinal cord injury rate, 1.97%; transient spinal cord injury rate, 2.36%). A multivariable logistic regression analysis identified the use of the frozen elephant trunk technique (odds ratio 36.3), previous repair of thoracoabdominal aorta or descending aorta (odds ratio 29.4), proximal atherothrombotic aorta (odds ratio 9.6), chronic obstructive lung disease (odds ratio 7.1) and old age (odds ratio 1.1) as predictors of spinal cord injury (p < 0.0001, area under curve 0.93).ConclusionsSpinal cord injury occurs with a non-negligible incidence following aortic arch replacement. The full objective assessment of the morphology of the whole aorta and the recognition of the risk factors are mandatory.

Kinetic characteristics of thermal energy storage (TES) using tetrabutylammonium acrylate (TBAAc) hydrate were experimentally evaluated for practical use as PCMs. Mechanical agitation or ultrasonic vibration was added to detach the hydrate adhesion on the heat exchanger, which could be a thermal resistance. The effect of the external forces also was evaluated by changing their rotation rate and frequency. When the agitation rate was 600 rpm, the system achieved TES density of 140 MJ/m3 in 2.9 h. This value is comparable to the ideal performance of ice TES when its solid phase fraction is 45%. UA/V (U: thermal transfer coefficient, A: surface area of the heat exchange coil, V: volume of the TES medium) is known as an index of the ease of heat transfer in a heat exchanger. UA/V obtained in this study was comparable to that of other common heat exchangers, which means the equivalent performance would be available by setting the similar UA/V. In this study, we succeeded in obtaining practical data for heat storage by TBAAc hydrate. The data obtained in this study will be a great help for the practical application of hydrate heat storage in the future.

The beating of a pulmonary vein during cardiac catheterization is a rare phenomenon caused by the heart beating through the pericardial effusion when a cardiac tamponade occurs. This “beating pulmonary vein” sign is useful for early detection of a tamponade before circulatory collapse occurs. The “beating pulmonary vein” sign during cardiac catheterization is useful for early detection of a tamponade before circulatory collapse occurs. Moreover, we need to be careful when finding the beating of venous system that does not usually beat.

Background Infected aortic arch aneurysms caused by Mycobacterium avium are rare in immunocompetent individuals. Promptly recognizing these aneurysms is important because delays in treatment result in aneurysm rupture and a high fatality rate. Although Salmonella species, Streptococcus species, Staphylococcus aureus , and S . epidermis are commonly found in immunocompetent individuals, to our knowledge, infected aortic arch aneurysms caused by M. avium have not yet been reported. Case presentation We report the case of a 63-year old immunocompetent man who underwent total arch replacement following infection by the nontuberculous mycobacteria M. avium . The procedure involved total aneurysmal resection and arch replacement with a rifampicin-bonded gelatin-sealed woven Dacron graft. He was discharged without complications and remained asymptomatic after 30 months. Conclusion In this brief report, we outline and discuss the rare successful case of total arch replacement using total aneurysmal resection and rifampicin-bonded gelatin-sealed woven Dacron graft for an infected aortic arch aneurysm resulting from M. avium in an immunocompetent patient.

Abstract Retrograde type A dissection (RTAD) is a rare but catastrophic complication of thoracic endovascular repair. However, only a few cases of RTAD associated with endovascular aortic repair (EVAR) have been reported. Additionally, aortic root rupture has not been reported. An 80-year-old woman presented with a progressively enlarging intrarenal abdominal aortic aneurysm, and she underwent EVAR. However, cardiac tamponade occurred because RTAD occurred at the end of the surgery, and the aortic root ruptured. Therefore, ascending aortic replacement was performed emergently, and the patient was saved. RTAD with EVAR is rare, but it could be a crucial complication. We could rescue the patient by early detection and surgery. Even with EVAR, the possibility of performing an open chest should be considered. Moreover, fluoroscopy could be used immediately if cardiac tamponade is suspected.

Loeys–Dietz syndrome involves vascular abnormalities and aortic root aneurysms. This study described a 10-year-old boy who presented with progressively enlarging ascending aortic aneurysm and mild aortic valve regurgitation. He was diagnosed with Loeys–Dietz syndrome and underwent aortic valve-sparing repair. However, 6 months after the surgery, aortic root pseudoaneurysms were detected. Thus, aortic root repair was performed by transseptal approach. The orifices of pseudoaneurysms were closed with double-layer patches composed of autologous and bovine pericardial patches. Based on the findings of this study, we conclude that the transseptal approach is useful for closing aneurysms at the aortic root.

Acute aortic dissection type A during cardiac catheterization has been reported as a rare but fatal complication. We present a case of acute aortic dissection type A occurring during catheter manipulation in the ascending aorta during mapping of ventricular premature contraction via the retrograde approach. In the present case, transthoracic echocardiography showed no pericardial effusion and no flap of the aorta, but intracardiac echo clearly showed the flap. Enhanced computed tomography revealed the aortic dissection, which extended from the ascending aorta to the bilateral common iliac artery, and the false lumen was thrombosed completely. Emergent surgery was performed and the postoperative course was uneventful, and he was discharged with no complications. Aortic dissection is a rare complication of cardiac catheterization, and early detection could prevent a fatal outcome. It is important to detect the signs and symptoms as quickly as possible and perform various diagnostic examinations.

Although the surgical technique for acute type A aortic dissection dramatically improved in recent years, the postoperative mortality and morbidity rates remain high. After the emergency surgery for acute type A aortic dissection, a small tear in the aorta may result in dilation of the false lumen in the future. Some tears originate from the suture line on the anastomosis. This report introduces the novel “plaster technique” that involves using a single interrupted suture with felt and plastering a minimum dose of BioGlue into the suture hole. Similar to patients with acute aortic dissection, we found that the plaster technique using a felt pledget and minimum dose of BioGlue is effective for fragile aortic walls. Moreover, it is a simple, safe, and durable technique to strengthen the suture line.