General Thoracic and Cardiovascular Surgery Cases最新文献

{"title":"Unsuccessful aortic fenestration for aortic dissection complicated with mesenteric malperfusion analyzed using computational fluid dynamics: a case report.","authors":"Shoki Iwanaga, Naoyuki Kimura, Shuta Imada, Mutsumi Mizoguchi, Mamoru Arakawa, Hirohiko Akutsu, Koji Kawahito, Masanori Nakamura","doi":"10.1186/s44215-025-00212-7","DOIUrl":"10.1186/s44215-025-00212-7","url":null,"abstract":"<p><strong>Background: </strong>We report a computational fluid dynamics (CFD)-based analysis of an unsuccessful open fenestration for aortic dissection with mesenteric malperfusion.</p><p><strong>Case presentation: </strong>A 75-year-old male was admitted for acute type B aortic dissection complicated by mesenteric malperfusion. He had a concomitant infrarenal abdominal aneurysm, prompting surgical infrarenal fenestration. Intraoperatively, the proximal intimal flap was resected near the renal arteries, and the aneurysm was replaced with a prosthetic graft. Despite the intervention, mesenteric malperfusion worsened, requiring additional endovascular aortic repair. CFD analysis revealed persistent false lumen flow and true lumen compression due to a large entry tear and residual proximal anastomotic stenosis.</p><p><strong>Conclusion: </strong>CFD analysis suggests that a large entry tear and residual stenosis from insufficient fenestration may result in inadequate false lumen depressurization.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"4 1","pages":"28"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful repair of traumatic tricuspid regurgitation with concomitant atrial septal perforation and right ventricular pseudoaneurysm: a case report.","authors":"Kazuki Mori, Takashi Shuto, Takahiro Tashima, Tomoko Fukuda, Naohiko Takahashi, Shinji Miyamoto","doi":"10.1186/s44215-025-00211-8","DOIUrl":"10.1186/s44215-025-00211-8","url":null,"abstract":"<p><strong>Background: </strong>Valvular injuries in chest trauma mostly affect the aortic and mitral valves, but traumatic tricuspid regurgitation (TR) remains rare. This report describes the successful repair of traumatic TR secondary to papillary muscle rupture complicated with right ventricular (RV) free wall injury and atrial septal perforation.</p><p><strong>Case presentation: </strong>A 50-year-old male suffered blunt chest trauma from a tree fall, leading to multiple fractures, mediastinal hematoma, and hemoperitoneum caused by splenic bleeding. Given that heart failure worsened eventually, echocardiography was conducted on day 7, showing significant TR resulting from leaflet prolapse caused by papillary muscle rupture with concomitant 4.8 mm atrial septal perforation and focal RV free wall thinning. Nonetheless, the heart failure was responsive to medical treatment. The patient was then scheduled for surgery 1 month later. The atrial septal defect was closed via direct suture closure. The RV free wall injury presented with scarring and did not require repair. The tricuspid valve repair included suturing the ruptured medial papillary muscle to the RV wall, reconstructing the ruptured posterior leaflet chordae with prosthetic chordae, and securing an annuloplasty ring. Consequently, TR was completely controlled.</p><p><strong>Conclusions: </strong>Traumatic tricuspid valve injuries are rare. The optimal timing of surgery for traumatic TR remains controversial. However, early diagnosis and intervention are recommended to prevent progressive RV dysfunction and improve the success of tricuspid valve repair.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"4 1","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Totally endoscopic mitral valve repair and papillary muscle ablation for arrhythmic mitral regurgitation.","authors":"Naoki Murata, Daisuke Endo, Hidemori Hayashi, Minoru Tabata","doi":"10.1186/s44215-025-00210-9","DOIUrl":"10.1186/s44215-025-00210-9","url":null,"abstract":"<p><strong>Background: </strong>Arrhythmic mitral regurgitation (MR), characterized by mitral valve prolapse accompanied by ventricular arrhythmias, poses diagnostic and therapeutic challenges. Treatment decisions, including the necessity for concomitant surgical ablation and the identification of specific ablation points, are highly case-specific and lack a consensus approach. Once determined, high-definition endoscopes and adaptable cryoablation tools facilitate simultaneous mitral valve repair and targeted surgical ablation via a minimally invasive approach, ensuring optimal visualization.</p><p><strong>Case presentation: </strong>The patient was a 49-year-old female with an episode of ventricular fibrillation. Severe MR was diagnosed at that time; however, surgery was not selected due to the absence of symptoms and left ventricular dysfunction. An implantable cardioverter-defibrillator was subsequently placed, which activated twice. Over the last 6 months, she developed dyspnea and was referred to us, where she was diagnosed with symptomatic arrhythmic MR. Subsequently, she underwent totally endoscopic minimally invasive mitral valve repair and papillary muscle cryoablation. Postoperative echocardiography showed trivial MR, with a mean pressure gradient of 1 mmHg, and an ejection fraction of 56%. She was discharged home on the fifth postoperative day. The Holter electrocardiogram performed 6 months after surgery showed no ventricular arrhythmias originating from the papillary muscles.</p><p><strong>Conclusions: </strong>We successfully diagnosed and treated a patient with symptomatic arrhythmic MR. Simultaneous mitral valve repair and papillary muscle cryoablation, performed through a totally endoscopic minimally invasive approach, was found to be effective in managing this complex condition.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"4 1","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracoscopic repair of penetrating lung trauma with pulmonary tractotomy: a case report.","authors":"Hiroyasu Koga, Katsuya Watanabe, Aya Saito","doi":"10.1186/s44215-025-00209-2","DOIUrl":"10.1186/s44215-025-00209-2","url":null,"abstract":"<p><strong>Background: </strong>Penetrating lung injuries are rare but potentially life-threatening. Pulmonary tractotomy (PT) allows for repair while preserving lung parenchyma. This case demonstrates the effectiveness of thoracoscopic PT.</p><p><strong>Case report: </strong>An 81-year-old woman sustained a right chest stab wound with a gardening stake. Imaging revealed a right pneumothorax without cardiac or major vascular injury. A chest tube was inserted, draining blood-stained fluid and revealing a persistent air leak. Progressive anemia necessitated transfusion, and surgery was planned due to suspected contamination. Thoracoscopy identified a 1.5 cm fistula in the S3 segment of the right upper lobe extending toward S2. A stapler was inserted to perform tractotomy, revealing a bronchial injury, which was sutured. The air leak resolved completely. The postoperative course was uneventful. Empirical antibiotics were administered for 5 days. The chest tube was removed on day 5, and the patient was discharged on day 13.</p><p><strong>Conclusion: </strong>Thoracoscopic PT is considered a safe and effective option for selected penetrating lung injuries, preserving lung function and reducing surgical trauma. Careful preoperative imaging and intraoperative bronchial evaluation are essential for safe and effective thoracoscopic PT.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"4 1","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma in a patient with a history of idiopathic lymphocytic interstitial pneumonia (iLIP).","authors":"Katsushi Toyohara, Hiroya Ishihara, Takuro Morita, Yuki Shindo, Sho Takeda, Satoshi Fumimoto, Kaoru Ochi, Yoshio Ichihashi, Kiyoshi Sato, Hiroko Kuwabara, Nobuharu Hanaoka, Takahiro Katsumata","doi":"10.1186/s44215-025-00208-3","DOIUrl":"https://doi.org/10.1186/s44215-025-00208-3","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma and idiopathic lymphocytic interstitial pneumonia (iLIP) are rare pulmonary diseases. MALT lymphoma is an extranodal marginal zone lymphoma (EMZL), whereas LIP is a benign lymphoproliferative disorder characterized by lymphocytic infiltration of the lungs. LIP should be closely monitored, as it has the potential to undergo malignant transformation into MALT lymphoma.</p><p><strong>Case presentation: </strong>A 45-year-old woman was diagnosed with LIP and followed up for 9 years before being referred to our hospital due to an enlarging shadow on chest radiographs. The volume of the sample collected via bronchoscopy was too small to make a diagnosis, so the patient underwent surgery. The pathology results revealed diffuse proliferation of medium-sized lymphocytes filling the alveolar spaces, leading to a diagnosis of MALT lymphoma. After a thorough examination, no other lesions were found, confirming the diagnosis of EMZL of the lung, a primary pulmonary lymphoma (PPL). No postoperative treatment was administered after surgery; however, 2 years later, recurrence was detected in the stomach, and the patient underwent chemotherapy. Complete remission was achieved through chemotherapy, and the patient has been recurrence-free for 3 years since her treatment.</p><p><strong>Conclusions: </strong>We report a rare case of MALT lymphoma that developed 9 years after the diagnosis of LIP. Since LIP can undergo malignant transformation into EMZL, it is important to be aware of this possibility. Differentiating between the two diseases onthe basis ofclinical and imaging findings is challenging, so biopsytechniques, such as transbronchial biopsy, CT-guided needle aspiration biopsy, and surgical resection, are essential. While surgery is the standard treatment for primary pulmonary lymphoma, observation is a viable option, as it provides results comparable to those of other treatment approaches.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"4 1","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-stage surgery for acute type B aortic dissection and aortic root aneurysm in a patient with Turner syndrome: a case report.","authors":"Kazunori Sakaguchi, Hidekazu Nakai, Takanori Tsujimoto, Atsunori Kono, Yojiro Koda, Katsuhiro Yamanaka, Kenji Okada","doi":"10.1186/s44215-025-00202-9","DOIUrl":"https://doi.org/10.1186/s44215-025-00202-9","url":null,"abstract":"<p><strong>Background: </strong>Patients with Turner syndrome are at high risk of aortic dissection and are more likely to present with fatal outcomes. Turner syndrome is classified as a heritable thoracic aortic disease in the latest EACTS/STS guidelines. Herein, we present a case of two-staged surgery for acute type B aortic dissection and aortic root aneurysm in a patient with Turner syndrome.</p><p><strong>Case presentation: </strong>A 29-year-old female patient with Turner syndrome was admitted to our center due to back pain and was diagnosed with acute type B aortic dissection. Echocardiography revealed a dilated aortic root with bicuspid aortic valve. On the 5 th day after admission, the patient presented with a higher level of back pain. Follow-up computed tomography scan revealed changes from two- to three-channel aortic dissection a further aortic dilation. Therefore, descending aorta and partial aortic arch replacement were initially performed. Then, valve-sparing aortic root replacement and residual arch replacement were performed 3 months after the first surgery. Postoperative echocardiography confirmed the absence of aortic regurgitation. The patient was discharged on the 17th postoperative day without any complications.</p><p><strong>Conclusions: </strong>Two-stage surgery was successfully performed for the thoracic aorta and aortic root aneurysms in a patient with Turner syndrome. The patient recovered for 3 months after the left thoracotomy surgery and underwent a two-stage surgery through a median sternotomy surgery with good surgical results.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"4 1","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migration of disrupted sternal wire to the pulmonary artery.","authors":"Yuji Naito, Fumitaka Suzuki, Tatsuya Murakami","doi":"10.1186/s44215-025-00207-4","DOIUrl":"10.1186/s44215-025-00207-4","url":null,"abstract":"<p><p>We report a case of sternal wire migration into the pulmonary artery. A 66-year-old man who had undergone thymectomy through median sternotomy 3 years ago was admitted because of a fractured sternal wire in the right pulmonary artery on computed tomography during the postoperative follow-up. It was removed directly from the pulmonary artery under cardiopulmonary bypass. The postoperative course was uneventful. Although migrated sternal wire into the heart or vascular tissue is very rare, care is necessary for its disruption and displacement after sternotomy.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"4 1","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successfully repaired adult cor triatriatum with mitral regurgitation and atrial fibrillation: a case report.","authors":"Shuhei Naito, Yoshiharu Enomoto, Sei Morizumi, Yuichiro Kaminishi, Bryan J Mathis, Yasuyuki Suzuki","doi":"10.1186/s44215-025-00206-5","DOIUrl":"10.1186/s44215-025-00206-5","url":null,"abstract":"<p><strong>Background: </strong>Rarely seen in adults, cor triatriatum is a congenital defect in which a membrane creates three atrial chambers in the heart. Atrial fibrillation (AF) is the most common complication, but repair procedures in adults remain unestablished.</p><p><strong>Case presentation: </strong>A 49-year-old woman had cor triatriatum sinister (Lucas-Schmidt classification type I-A) with moderate mitral regurgitation and atrial fibrillation. Communication between the accessory chamber and the main chamber was established via a 10-mm fenestration with a pressure gradient of 14 mmHg. Mitral valve repair and the maze procedure, via radiofrequency ablation, was done after complete resection of the anomalous septum in the left atrium. Mitral regurgitation was well-controlled and atrial fibrillation disappeared. Sinus rhythm has been continually maintained at 6 months post-surgery, with no mitral regurgitation recurrence.</p><p><strong>Conclusions: </strong>Here, a rare adult cor triatriatum case with simultaneous mitral valve regurgitation and atrial fibrillation was treated with good results. The maze procedure shows effectiveness for atrial fibrillation associated with cor triatriatum. Especially the anomalous membrane attachments must be resolved in addition to the conventional maze procedure because electrical mapping of Cor triatriatum sinister showed low-voltage zones at the membrane attachments and it cause macro-reentrant atrial tachycardia.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"4 1","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful mitral valve reconstruction using autologous pericardium in a pregnant patient with severe infective endocarditis: a case report.","authors":"Kimiaki Anai, Kazuki Mori, Takashi Shuto, Shinji Miyamoto","doi":"10.1186/s44215-025-00205-6","DOIUrl":"10.1186/s44215-025-00205-6","url":null,"abstract":"<p><strong>Background: </strong>A 34-year-old woman at 25 gestational weeks presented with severe respiratory distress secondary to heart failure caused by severe mitral regurgitation and infective endocarditis.</p><p><strong>Case presentation: </strong>Transthoracic echocardiography revealed a large (17 mm) vegetation attached to the posteromedial commissure of the mitral valve leaflet. Owing to pulmonary edema and circulatory failure, she underwent emergency cesarean section to improve maternal hemodynamics. Postoperatively, her pulmonary edema resolved, and the hemodynamic status was stable. Thus, mitral valve surgery was scheduled 2 days later. Intraoperative findings confirmed that the posteromedial site of the mitral valve was severely damaged by vegetation and chordae tendineae rupture. The damaged mitral valve leaflet was resected, with seamless reconstruction using a glutaraldehyde-fixed autologous pericardium. Postoperative echocardiogram revealed no residual mitral regurgitation. Despite premature birth, the infant survived but required surgery for patent ductus arteriosus.</p><p><strong>Conclusions: </strong>This case highlights that through timely intervention and advanced surgical techniques, a patient with severe infective endocarditis, despite being pregnant, can be successfully managed.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"4 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single coronary artery complicated with type A aortic dissection: a case report.","authors":"Yuji Naito, Fumitaka Suzuki, Tatsuya Murakami","doi":"10.1186/s44215-025-00204-7","DOIUrl":"10.1186/s44215-025-00204-7","url":null,"abstract":"<p><p>Congenital coronary artery anomalies complicated with aortic dissection are rare. We experienced a patient with a single coronary artery presenting with a type A dissecting aortic aneurysm. A 77-year-old woman who experienced sudden back pain and was diagnosed with type A acute aortic dissection was initially treated conservatively because the false lumen thrombosed entirely. Computed tomography taken during 5 weeks of hospitalization incidentally revealed an anomalous single coronary artery arising from the left sinus of Valsalva, and the right coronary artery orifice was absent. One month after being transferred to another institution for rehabilitation, she was reintroduced to us for re-dissection of the aorta. An urgent operation involving aortic arch replacement was performed. There was a solitary coronary artery orifice at the left sinus of Valsalva and no ostium at the right sinus. The postoperative course was uneventful, and the patient was discharged 14 days after the surgery. Only 3 cases involving a single coronary artery complicated with dissecting aortic aneurysm have been reported previously.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"4 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143757662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}