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A 57-year-old man on maintenance hemodialysis was admitted to a hospital after suffering from cardiac arrest. He had collapsed soon after hemodialysis and was restored to sinus rhythm after receiving direct-current shocks. Further examination revealed old myocardial infarction with triple-vessel disease, and he was referred to our hospital for surgical treatment. Soon after performing coronary artery bypass grafting, we started the patient on intravenous amiodarone for frequent ventricular tachycardia. However, incessant ventricular tachycardia occurred frequently which necessitated several countershocks. Although ventricular tachycardia disappeared by replacing intravenous amiodarone with intravenous nifekalant, it reappeared when we initiated oral amiodarone instead of intravenous nifekalant. So therefore, we stopped using any anti-arrhythmic drug except bisoprolol fumarate, whereby ventricular tachycardia ceased once again. Amiodarone is known as relatively safe anti-arrhythmic drug that is often used after cardiovascular surgery. However, we should pay close attention to the possibility of amiodarone-induced arrhythmia.Transcatheter aortic valve replacement(TAVR) in the treatment of patients with severe aortic valve stenosis (AS) has evolved on the basis of evidence from clinical trials. A 84-year-old woman with a complaint of dyspnea was diagnosed with severe AS. A preoperative computed tomography (CT) revealed huge mural thrombus at descending aorta, therefore we planned direct aortic access for TAVR to avoid embolism. Transesophageal echocardiography revealed fluttering echogram at left ventricular outflow tract. After TAVR the fluttering echogram disappeared. A postoperative CT revealed spleen infarction. In such cases, we should keep in mind that surgical AVR can be a treatment option.A 70-year-old man, who had undergone aortic valve neocuspidization using his own pericardium 8 months before, complained of back pain, and was diagnosed with pyrogenic spondylitis. As the result of blood culture, Enterococcus faecalis was found to be the causative bacterium, and antibiotic therapy was started. Six days after admission, hemodynamics collapsed suddenly, and percutaneous cardio-pulmonary support was established. Echocardiography showed severe aortic valve regurgitation, and he was diagnosed with active infective endocarditis. We performed re-do aortic valve neocuspidization using bovine pericardium. There was a tear on the non-coronary cusp and the cusps were thickened because of infection. Aortic annular tissue was not destroyed and we could fix the neo-valve directly to the annulus. After these procedures, severe reduction of antero-septal wall motion was noted, which suggested dissection of the main trunk of the left coronary artery. Coronary artery bypass grafting to the left anterior descending and the circumflex branches was added. The patient came off percutaneous cardio-pulmonary support 5 days after surgery. Although trivial aortic regurgitation remained, he was discharged after 2 months of rehabilitation.Extrapleural hematoma caused by thoracic vertebral burst fracture is very rare. We present the case of a 70-year-old man who was treated with a combination of video-assisted thoracic surgery (VATS) and extrathoracic operation. The patient was admitted to our hospital with complaints of dyspnea and pain in both legs. Computed tomography (CT) demonstrated a massive extrapleural hematoma in the right thoracic cavity, and 12th thoracic vertebral burst fracture. We treated the patient with pharmacotherapy because CT showed no active bleeding and the circulation and respiratory dynamics were stable. One week later, the hematoma was not reduced by pharmacotherapy, so we performed combination surgery of VATS. After surgery, there were no serious complications and the patient was discharged from the hospital on day 11 from surgery. In the following 2 months, there was no evidence of recurrence. The combination of VATS and extrathoracic operation was safe, and good result was obtained.Desmoid tumors are rare mesenchymal proliferative tumors that are highly invasive but lack metastatic potential. We report the case of a 72-year-old man with a desmoid tumor arising from the anterior chest wall which invaded neighboring organs extensively. The patient complained of dyspnea on exertion and appetite loss and was referred to our hospital. Chest computed tomography revealed an anterior chest wall tumor 12 cm in diameter adjacent to the right lung, diaphragm, and sternum. An ultrasound-guided biopsy was conducted, and the tumor was diagnosed as a desmoid tumor. He underwent right-sided anterior chest wall resection with combined resection of the right lung, diaphragm, and sternum body. The chest wall defect was reconstructed using an expanded polytetrafluorethylene mesh (dualmesh). Although initial active surveillance has recently been recommended for asymptomatic patients with non-progressing desmoid tumors, our patient underwent resection because of his symptoms.We report a case of successful aortic valve translocation in a 71-year-old man with severe prosthetic valve endocarditis and an aortic annular abscess. Six years earlier, the patient had undergone aortic valve replacement for aortic regurgitation and coronary artery bypass grafting to the left anterior descending artery with a saphenous vein. Moreover, 4 years earlier, he had undergone total arch replacement for chronic aortic dissection. He was admitted to our hospital with suspected urinary tract infection. Despite antibiotic therapy, the patient developed a high fever. https://www.selleckchem.com/products/paeoniflorin.html Transthoracic echocardiography revealed a rocking motion of the prosthetic aortic valve, and an emergency operation was performed. An annular abscess surrounding the prosthetic aortic valve was observed, and the valve was detached. For destruction of the entire aortic annulus, we performed an aortic valve translocation procedure. Revascularization of the left coronary artery was performed by interposing an 8 mm artificial graft between the proximal anastomosis site of the previous venous graft and the composite tube graft. Revascularization of the right coronary artery was performed using a saphenous vein graft. The patient was discharged uneventfully at postoperative day 29 and doing well 1 year after surgery.