An 85-year-old woman was diagnosed with traumatic ascending aortic dissection, right clavicle and left first rib fracture, and abdominal contusions after a vehicle accident. After admission, the aortic dissection progressed, and emergent surgery was performed. Although the risk of hemorrhagic complications needs to be evaluated, prompt aortic repair is required
An 88-year-old man ingested coins accidentally and developed mediastinitis and septic shock. Esophageal injuries by sharped-shape foreign bodies are often reported, but esophageal perforation by round coins is rare. Even rounded-shape foreign bodies that are unlikely to injure esophagus may lead to severe outcomes.
A 63-year-old male, with a history of coronary artery bypass grafting using bilateral internal thoracic artery grafts, underwent surgical aortic valve replacement. Avoiding the graft injury, we selected the right anterior mini-thoracotomy approach under cardiac arrest with systemic hyperkalemia with remaining bilateral internal thoracic artery grafts open. Deep hypothermia was induced to obtain more reliable myocardial protection. We believe this strategy can be considered as a therapeutic option in patients requiring aortic valve replacement but unsuitable for transcatheter aortic valve replacement.
An 86-year-old man who had undergone two mitral valve replacements developed heart failure due to prosthetic valve infection and left ventricular pseudoaneurysm (LVPA). LVPA due to infective endocarditis is rare and caused by the abscess formation in the left ventricular myocardium. Multiple mitral valve replacements may predispose to LVPA forming.
A 78-year-old woman underwent surgical intervention for severe atrial functional mitral regurgitation and left ventricular apical aneurysm secondary to apical hypertrophic cardiomyopathy. Apical hypertrophic cardiomyopathy can cause atrial fibrillation and atrial functional mitral regurgitation. Left ventricular apical aneurysms can cause fatal arrhythmias, which may require surgical intervention.
A 59-year-old man with a long smoking history presented with sudden back pain. Frank's sign was noticed in his bilateral ears, and computed tomography revealed Stanford type A acute aortic dissection. If young patients have Frank's sign, attention should be paid to atherosclerotic disease including aortic disease.
We report a case of a 63-year-old man without a history of atrial fibrillation or mitral valve disease who was admitted to our hospital. Echocardiography revealed a large left atrial mass attached to the atrial septum. We suspected the mass to be a myxoma, but it turned out to be a large thrombus after the surgery. Left atrial thrombus without mitral valve disease or atrial fibrillation is rare. Although the degree of urgency varies based on the case, early surgical resection is recommended for a large left atrial thrombus to prevent embolism.