No abstract

The skeletonization of the ITA with an ultrasonic scalpel had no deleterious effect on the endothelium. This morphological study confirmed the safety and the reliability of this technique, and we therefore recommend its clinical use in the skeletonization of the ITA for CABG.

Splenic abscess is a rare complication in infective endocarditis. Here, we present two cases of splenic abscess associated with active infective endocarditis. Body computed tomography before emergency valvular surgery revealed abscess in the spleen. In case 1, the abscess was localized within the spleen; splenectomy and valve replacement were performed through the same median skin incision. In case 2, the splenic abscess was diagnosed as ruptured; valve replacement was performed, followed by splenectomy through a separate skin incision. No recurrence of infection occurred after surgery in either case. In surgical treatment for active infective endocarditis, body computed tomography is essential to diagnose splenic abscess preoperatively. If there is an abscess, then splenectomy and valvular surgery should be performed simultaneously to prevent reinfection after valvular surgery. The approach to the spleen should be individualized according to the extension of the abscess.

We report a case of Type I dual left anterior descending artery (LAD) successfully treated by coronary artery bypass grafting including the long LAD. This rare coronary artery anomaly is of clinical importance in the field of myocardial revascularization.

We herein report a case with an aneurysm of the right sinus of Valsalva, which developed 14 years after an aortic valve replacement (AVR) for aortic regurgitation caused by Takayasu arteritis. The aortic wall around the right coronary artery ostium showed calcification, as a result, the modified Bentall procedure and coronary artery bypass to the right coronary artery were successfully performed. A pathological study of the resected aortic sinus wall showed a disruption of the elastic fibers in the media, granuloma formation, and a marked proliferation of the collagen fibers in the adventitia, and these findings were compatible with Takayasu arteritis. The development of an aneurysm of the sinus of Valsalva late after AVR indicates the necessity of a close and lifelong follow-up for patients with Takayasu arteritis, especially focusing on the aortic root morphology.