Proximal (entry) tear of dissecting aortic aneurysm visualized by three-dimensional echocardiography

AbstractJ Thorac Cardiovasc Surg 2002;124:1245-

Annual report by The Japanese Association for Thoracic Surgery

All data regarding cardiovascular surgery and thoracic surgery were obtained from NCD, whereas data regarding esophageal surgery were collected from survey questionnaire by The Japanese Association for Thoracic Surgery forms because NCD of esophageal surgery does not include non-surgical cases (i.e., patients with adjuvant chemotherapy or radiation alone). Based on the change in data aggregation, there are several differences between this 2015 annual report and previous annual reports: the number of institutions decreased in each category from 578 (2014) to 568 (2015) in cardiovascular, from 762 to 714 in general thoracic and from 626 to 571 in esophageal surgery. Because more than two departments in the same institute registered their data to NCD individually, we cannot calculate correct number of institutes in this survey. Then, the response rate is not indicated in the category of cardiovascular surgery (Table 1), and the number of institutions classified by the operation number is also not calculated in the category of cardiovascular surgery (Table 2)

Use of the index of pulmonary vascular disease for predicting long-term outcome of pulmonary arterial hypertension associated with congenital heart disease

AimsLimited data exist on risk factors for the long-term outcome of pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD-PAH). We focused on the index of pulmonary vascular disease (IPVD), an assessment system for pulmonary artery pathology specimens. The IPVD classifies pulmonary vascular lesions into four categories based on severity: (1) no intimal thickening, (2) cellular thickening of the intima, (3) fibrous thickening of the intima, and (4) destruction of the tunica media, with the overall grade expressed as an additive mean of these scores. This study aimed to investigate the relationship between IPVD and the long-term outcome of CHD-PAH.MethodsThis retrospective study examined lung pathology images of 764 patients with CHD-PAH aged <20 years whose lung specimens were submitted to the Japanese Research Institute of Pulmonary Vasculature for pulmonary pathological review between 2001 and 2020. Clinical information was collected retrospectively by each attending physician. The primary endpoint was cardiovascular death.ResultsThe 5-year, 10-year, 15-year, and 20-year cardiovascular death-free survival rates for all patients were 92.0%, 90.4%, 87.3%, and 86.1%, respectively. The group with an IPVD of ≥2.0 had significantly poorer survival than the group with an IPVD <2.0 (P = .037). The Cox proportional hazards model adjusted for the presence of congenital anomaly syndromes associated with pulmonary hypertension, and age at lung biopsy showed similar results (hazard ratio 4.46; 95% confidence interval: 1.45–13.73; P = .009).ConclusionsThe IPVD scoring system is useful for predicting the long-term outcome of CHD-PAH. For patients with an IPVD of ≥2.0, treatment strategies, including choosing palliative procedures such as pulmonary artery banding to restrict pulmonary blood flow and postponement of intracardiac repair, should be more carefully considered