Continuous perfusion through the axillary artery with selective cerebral perfusion and replacement of the ascending and arch aorta may minimize cerebral complication leading to satisfactory results in patients with chronic aortic aneurysm involving aortic arch.

The prevention of peritoneal dialysis (PD) catheter complications is essential to achieve a successful outcome. In recent years, nephrologists have performed more PD catheter insertion surgeries in Japan. The prevention of catheter complications is crucial for nephrologists who do not have all-around surgical skills. PD catheter tip migration is a common complication and a significant cause of catheter malfunction. Several preventive techniques have been reported for the PD catheter tip migration. This perspective described the following: (1) surgical technique in laparotomy, (2) laparoscopic surgery, (3) peritoneal wall anchor technique, and (4) catheter type selection. We hope that more effective methods of preventing catheter complications will be developed to ensure the success of PD treatment.

Prevention of neurologic injury is one of the most important goals in reconstruction of the distal aortic arch. Femoral perfusion has a potential of embolic ischemic events including stroke and visceral malperfusion 1,2 in patients with chronic type B dissection. We have introduced an antegrade systemic perfusion technique via the left axillary artery graft for replacement of the

A 55-year-old man was admitted with a thoracic aortic aneurysm causing wheezing. Computed tomography and angiography revealed a large distal aortic saccular aneurysm, occupying the retrotracheal space and compressing the trachea.There has been only one report of this type of aneurysm. This patient needed emergency intubation because of severe dyspnea caused by premedication for surgery. Replacement of the distal arch was performed via left posterolateral thoracotomy.Profound hypothermia was used during open proximal anastomosis, which helped to make this procedure safe and simple. This patient recovered uneventfully.

This paper reviewed aortic root replacement with a stentless xenograft for Stanford Type A aortic dissection. Total aortic arch replacement plus aortic root reconstruction with a stentless xenograft was conducted in 2 patients with acute aortic dissection. In another 2 patients, aortic root replacement with a bioprosthesis was performed for chronic redissection of the aortic root which might be associated with the previous use of gelatin-resorcin-formalin glue. Full root replacement using this device is safe, reliable, reproducible, and technically less demanding. This device also provides a radical option for acute aortic dissection even in patients requiring concomitant aortic arch and root replacement.