We describe a new surgical procedure for the scimitar syndrome using the walls of the right atrium and inferior vena cava as a flap to prevent kinking and stenosis of the scimitar vein-left atrium anastomosis.

The development of a secondary aortoenteric fistula is a well-described complication after open or endovascular repair of an abdominal aortic aneurysm. However, evidence regarding aortocolonic fistulas (ACFs) and their pathogenesis is currently limited. We present a case of ACF that developed 18 years after open repair of an abdominal aortic aneurysm with atypical symptoms. The patient was successfully treated with total resection of the involved aorta, prosthetic graft, and sigmoid colon, with extra-anatomic bypass and primary anastomosis of the residual colon. Pathologic examination revealed that the pathogenesis of ACF was attributed to sigmoid diverticulitis. This case report highlights the uncommon pathogenesis of ACF and the importance of considering revascularization and intestinal reconstruction in the surgical strategy for each individual case.

No abstract

No abstract

Background: The incidence of pulmonary thromboembolism has been considered rare in Japan. However, its occurrence has been increasing because of westernized lifestyle and diet, increased diagnostic technique, and recognition of this disease.Method: Between January 2003 and September 2014, 179 patients were treated for pulmonary thromboembolism. We classified these patients into 3 groups; Massive (n=35), Sub-massive (n=29) and Nonmassive (n=115) and retrospectively reviewed the treatment options and the outcome.Results: Percutaneous cardiopulmonary support (PCPS) was applied for patients with hemodynamic instability and IVC filter was inserted if there was proximal DVT. In non-massive group (n=115), 95.7% of the patient underwent anticoagulant therapy and 47.0% of the patients received IVC filter. In submassive group (n=29), 48.3% of the patient received thrombolytic therapy and 93.1% of the patient underwent IVC filter insertion. Surgical pulmonary embolectomy was performed in 3 patients who had high risk of thrombolytic therapy in submassive group. There was no death in this group. In massive group, 4 patients who had cardiogenic shock died in acute phase. PCPS was applied in 5 patients, pulmonary embolectomy was performed in 13 patients, thrombolytic therapy was performed in 4 patients and 13 patients underwent anticoagulant therapy alone. There were 7 deaths (20.0%) in this group.Conclusions: In submassive group, treatment should be decided depending on the bleeding risk. In massive group, pulmonary embolectomy was effective. (This is a translation of Jpn J Phlebol 2016; 27: 53–59.)