Language：Japanese   Publisher：Japanese College of Angiology  

<p>A 71-year-old woman was referred to our hospital due to left ventricular dysfunction and a coronary pulmonary artery fistula with heart failure symptoms. She underwent on-pump beating heart surgery, including direct closure of the fistula, coronary artery bypass grafting, and left ventricular biopsy. We also obtained the direct measurement of the fistula flow, which was continuous-like flow of 43 mL per minute and a pulsatility index of 0.3. Following surgery, the heart failure symptoms and left ventricular dysfunction improved. There have not been reports which described the direct measurement of the fistula flow of coronary pulmonary artery fistula. Herein, we report this case along with a literature review.</p>

DOI： 10.7133/jca.24-00030

Language：English   Publisher：シュプリンガー・ジャパン(株)  

症例は66歳男性で、左肩後部の痛みと拍動性腫瘤を訴えて来院した。2年前に解離性大動脈瘤に対し、woven Dacron人工血管(J GraftシールドNEO、日本ライフライン社)を用いた弓部大動脈および下行大動脈の部分的置換術を施行されていた。入院時の造影CTおよび大動脈造影において、人工血管本体からの活動性出血を伴う巨大な筋膜下血腫を認め、2ヶ所の出血部位は人工血管置換術の際に使用した肋骨固定用ストラット(KANI、USCIジャパン社)の爪の位置に一致していた。さらに別の爪の肺への侵入を認めた。これらの所見から、肋骨固定用ストラットの爪の変形に起因する人工血管の破裂ならびに肺損傷と診断した。緊急にthoracic endovascular aortic repairを施行したところ、活動性出血は消失した。さらに3週後、すべてのストラットを除去し、肺損傷を修復した。術後の経過に問題は認めなかった。

Language：Japanese   Publisher：General Thoracic and Cardiovascular Surgery  

A 66-year-old-man who had undergone partial aortic arch and descending aortic graft replacement for a dissecting aortic aneurysm presented to our hospital with pain and beating swelling of his left back shoulder. Enhanced computed tomography and aortic angiography revealed graft rupture caused by one of the claws of a rib fixation strut. Furthermore, another claw had invaded a lung. We performed emergency thoracic endovascular aortic repair, and removed all of the struts 3 weeks later. Claw-type rib fixation struts have the potential to injure other organs, including prosthetic grafts. Careful follow-up is mandatory after implantation of this type of strut.

DOI： 10.1007/s11748-021-01697-z

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PubMed

Event date： 2024.8

Venue：福岡市   Country：Japan  

Event date： 2024.8

Venue：鹿児島市   Country：Japan  

Event date： 2024.6

Venue：鹿児島市   Country：Japan  

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Venue：鹿児島市   Country：Japan  

Event date： 2024.5