The aim of this study is to investigate the positive association between the presence of renal cysts and AAA. Patients and Methods: A retrospective chart review on the clinical data of 396 consecutive patients, who underwent CT scans for preoperative evaluation of thoracic and cardiovascular surgery in Sapporo Medical University from the period of January 2007 to December 2008, was conducted. Results: When comparing patients with renal cysts (n = 164) to those without (n = 233), there was a statistically significant difference between the presence of renal cysts and male gender (p = 0.007), hypertension (p = 0.003), and AAA (p < 0.001) on univariate analysis. In addition, when comparing patients with AAA to those without, although COPD but not AAA was associated with renal cysts in less than 65 years old, the presence of renal cysts was the strongest association with AAA among patients belonging to the 65 to 74 years old group and over 75 years old group on multivariate analysis. Conclusions: There is a statistically higher incidence of renal cysts in patients with AAA compared to patients without AAA in the group of elder cardiovascular patients. It is likely that AAA and renal cysts share a common pathogenesis.

A 65-year-old male developed acute myocardial infarction due to coronary artery dissection and tricuspid valve injury after blunt chest trauma. Acute myocardial infarction was treated by coronary artery intervention; however, refractory heart failure with pleural effusion remained. The first transthoracic echocardiography (TTE) on admission failed to clearly visualize the tricuspid valve and right ventricle due to poor image quality. A follow-up TTE with contrast ultrasonography revealed pericardial rupture in addition to tricuspid regurgitation. Ruptures of the tricuspid papillary muscle and pericardium were confirmed during surgery and were repaired successfully. Blunt chest trauma results in various cardiac injuries including cardiac rupture, intramural hematoma, valvular injury, coronary artery injury, and electrical disturbances, leading to critical conditions and high mortality. Of such blunt trauma-induced injuries, coronary artery dissection, tricuspid valve injury, and pericardial rupture caused by blunt chest trauma are rare, and simultaneous occurrence of the three types of injuries that were successfully repaired has not been reported. In addition, this case indicates the utility of contrast ultrasonography for diagnosis of pericardial rupture caused by blunt chest trauma.

Previously reported cut-off values for intraoperative TTFM parameters could not be adapted for the early patency of GEA grafts to the RCA. However, the smoothness of the graft-flow curve may be a reliable predictor of postoperative graft patency.

The RC-beating test is a simpler and more accurate evaluation for mitral valve repair than the saline injection test. This novel evaluation enables a safe and more complete mitral valve repair.

PATIENT 1. A 22-dayold infant was referred to our hospital because of hypoxia. The neonate received ventilatory support. A twodimensional echocardiogram revealed the presence of coronary sinus (CS) total anomalous pulmonary venous connection (TAPVC) with a large atrial septal defect (ASD); the presence of a membrane within the left atrium (LA) was suspected. The neonate underwent an emergency operation with conventional cardiopulmonary bypass. The right atrium was opened, and drainage of all 4 pulmonary veins (PVs) into the CS was confirmed. There was no communication between the PVs and the LA. The membrane in the LA was identified through a secundum ASD. The