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We report a case of aortoesophageal fistula rupture during the course of chemotherapy following colon cancer resection. The patient was a 77-year-old woman. Following recurrence of cancer of the sigmoid colon, the patient received a course of XELOX plus bevacizumab(Bmab)to treat peritoneal dissemination and lung metastases. She was brought by ambulance to our hospital's emergency department 55 days after the last dose of Bmab, with a chief complaint of hematemesis. Hematolo- gy results showed severe anemia with a hemoglobin level of 4.0 g/dL. Descending thoracic aortic dissection was noted on chest CT with contrast, and the patient was diagnosed with an aortoesophageal fistula rupture. She underwent emergent endovascular chest stent grafting to control the bleeding. Although the ruptured esophagus was a potential source of infection, the patient and family members chose palliative treatment. Therefore, conservative treatment was administered without removing the esophagus. The patient's postoperative course was good; instead of resuming oral intake, the patient was discharged on home IVH 59 days after surgery. Outpatient follow-up continued, but multiple metastases led to gradual worsening of the patient's general condition. She died 168 days after being admitted for surgery.

We present a case of 30-year-old man with successful bypass grafting for coarctation of the aorta. Hypertension was identified during a health examination. Blood pressure difference between the upper and lower limbs was about 60 mmHg. Computed tomography( CT) revealed stenosis of the distal aortic arch and development of collateral arteries. The pressure gradient across the coarctation by catheterization was 56 mmHg. After left thoracotomy through the 4th intercostal space, a bypass graft using a 14-mm woven Dacron graft was placed between the left subclavian artery and descending aorta without the use of extracorporeal circulation. Postoperative course was satisfactory, with minimal pressure difference between the upper and lower extremities. The patient was discharged 16 days postoperatively. As of 7 years later, he remains asymptomatic, and CT has revealed no marked changes of the aorta or bypass graft.

Purpose: To determine whether a dynamic cultured biograft can positively affect the function of the damaged heart., Methods: We ligated the coronary artery (LAD) of rats to generate a model of myocardial infarction (MI) and then implanted them with the following grafts comprising vascular smooth muscle cells (VSMCs) derived from the rat aorta and seeded onto biodegradable patches (patch replacement therapy; (PRTx)): control without PRTx, PRTx without seeded cells, PRTx with static cultured VSMCs, PRTx with dynamic cultured VSMCs and sham-operated. Cultured VSMCs were labeled with PKH26 for identification after implantation, and the centre of the MI site was excised and replaced with an implanted biograft. Cardiac performance was monitored for 12 weeks thereafter and followed by a histological study., Results: Although the ejection fraction of the damaged heart improved in all groups that were transplanted with grafts, remodeling was prevented only in groups with a dynamic or static cultured patch. More cells were α-SMA-positive in the group with the dynamic, rather than the static cultured patch. Cells were positive for PKH26 in the biograft and in the infarcted myocardium., Conclusions: Dynamic cultured biografts improved the function of the infarcted myocardium more than statically cultured biografts or those without cells.

A 74-year-old female patient with left main trunk (LMT) and triple vessel disease underwent coronary artery bypass graft (CABG) surgery. The patient began to experience exertional dyspnea. A coronary artery angiogram confirmed a severe stenosis in the proximal side of the saphenous vein graft (SVG). The patient had impending infarction immediately after the unsuccessful attempt for percutaneous coronary intervention, which resulted in an emergent CABG procedure. A left thoracotomy at the 4th intercostal space was made with the patient in the right lateral position. We then interrupted the use of intra-aortic balloon pumping (IABP), confirmed on transesophageal echocardiography (TEE) that the balloon was in a position distal to the target anastomosis site, and made a proximal anastomosis using the PAS-Port system (Cardica, Redwood City, CA, USA). After its successful deployment, IABP was repositioned back and resumed. The distal anastomosis was made to the previously bypassed graft. The patient had no postoperative myocardial damage or complications and was discharged on postoperative day 21. A redo CABG for post-CABG acute coronary syndrome patient was thought to be an extreme high risk; however, the operative time could be minimized by using the PAS-Port system, which enabled a safe redo CABG with left thoracotomy.

Aortopulmonary window (APW) is a rare congenital heart defect that requires urgent repair, as it can lead to rapid development of pulmonary hypertension. A 6-day-old boy with a total-defect APW was transferred to our hospital and underwent definitive repair on the 15th day after birth. The ascending aorta and pulmonary trunk were divided to create a larger tissue margin on the aortic side for the next seam. Then, the aortic window was sutured and closed directly, while the large pulmonary defect was reconstructed with a fresh autologous pericardial patch. Although peritoneal dialysis was briefly required for acute renal failure due to low output syndrome, his condition improved and he was discharged 22 days after surgery. Six years later, he remains well, without complications or need for medication.