Alternative redo sternotomy in a patient with tracheostoma and patent grafts.

We describe a redo mitral valve replacement operation in a 71-year-old man with a tracheostoma and patent bypass grafts to the coronary arteries. Preoperative investigations revealed that the patent right internal thoracic artery graft ran directly under the sternum just anterior to the ascending aorta, and a saphenous vein graft was adhering to a surgical wire. To prevent injury to the patent grafts and cardiac structures, and to avoid communication with the tracheostoma, the redo procedure was performed via an anterior minithoracotomy combined with a low T-shaped partial sternotomy. The reoperation was successfully completed without any complications

血管内治療での血栓塞栓症を予防する回収可能な新しい動脈フィルター

京都大学0048新制・課程博士博士(医学)甲第17395号医博第3738号新制||医||996(附属図書館)30161京都大学大学院医学研究科医学専攻(主査)教授 木村 剛, 教授 横出 正之, 教授 宮本 享学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDA

Surgical Treatment of Jejunal Artery Aneurysm

Introduction: A jejunal artery aneurysm (JAA) is rare and has few specific symptoms. Endovascular repair is widely used in the treatment of jejunal artery aneurysms; however, some patients still require open repair. Report: A 59 year old man underwent open surgery with resection of the aneurysm and reconstruction using a saphenous vein graft. Histopathological examination revealed heterotopic pancreas around the aneurysm. Discussion: Inflammation as a result of heterotopic pancreas was suspected as the cause of JAA. The advantage of open repair is to explore intestinal ischaemia directly. Furthermore, revascularisation with a saphenous vein graft may remove the possibility of post-operative intestinal ischaemia. Keywords: Heterotopic pancreas, Jejunal artery aneurysm, Open repair, Saphenous vein graft, Visceral artery aneurys