In patients who undergo surgery for acute type A dissection with coronary artery dissection, preoperative CPA and myocardial ischaemia (particularly LCA territory ischaemia) negatively affect survival outcomes. Early revascularization by coronary stent placement is effective in preventing postoperative LOS.

1 Using fura-2¯uorometry, the e ects of FK506, an immunosuppressant, on changes in cytosolic Ca 2+ concentrations ([Ca 2+ ] i ) and tension were investigated in porcine coronary arterial strips. The e ects of FK506 on the activity of voltage-operated Ca 2+ channels were examined by applying a whole cell patch clamp to the isolated smooth muscle cells of porcine coronary artery. 2 FK506 inhibited the sustained increases in both [Ca 2+ ] i and tension induced by 118 mM K + depolarization and 100 nM U46619 in a concentration-dependent manner (1 ± 30 mM). The extent of inhibition of the K + -induced contraction was greater than that of the U46619-induced contraction. The increases in [Ca 2+ ] i and tension induced by histamine and endothelin-1 in the presence of extracellular Ca 2+ were also inhibited by 10 mM FK506. 3 FK506 (10 mM) had no e ect on Ca 2+ release induced by ca eine or by histamine in the Ca 2+ -free solution. 4 FK506 (10 mM) had no e ect on the [Ca 2+ ] i -tension relationships of the contractions induced by cumulative increases of extracellular Ca 2+ during K + depolarization or stimulation with U46619. 5 In the patch clamp experiments, FK506 (30 mM) partially inhibited the inward current induced by depolarization pulse from 780 mV to 0 mV. 6 In conclusion, FK506 induces arterial relaxation by decreasing [Ca 2+ ] i mainly due to the inhibition of the L-type Ca 2+ channels, with no e ect on the Ca 2+ sensitivity of the contractile apparatus.

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The replacement of artificial chordae was not complicated and it seemed to help to preserve a good relationship among leaflet tissues, chordae, and papillary muscles. We therefore suggest that the extensive use of PTFE artificial chordae appears to be a promising procedure for the repair of all kinds of mitral lesions causing mitral regurgitation.

BackgroundThe operation of aortic valve replacement (AVR) after CABG is a technically challenging procedure in respect to dissection of living grafts from its surrounding tissue, myocardial protection, and so on, especially that procedure to patients with living in situ functional arterial grafts to occluded native coronary arteries has a special problem in regard to myocardial protection because myocardial blood supply originates from various arteries including the left internal thoracic artery (LITA), the right internal thoracic artery (RITA), and the right gastroepiploic artery (GEA); hence, adequate myocardial protection should be fastidiously considered.Case presentationA 68-year-old woman, who underwent CABG comprised of the in situ LITA to the LAD, the in situ GEA to the RCA, and the saphenous vein graft (SVG) to the obtuse marginal branch of the left circumflex artery (LCX) to the triple vessel coronary disease 9 years before, was referred to our hospital due to the aortic valve stenosis.ConclusionWe successfully underwent an aortic valve operation to a patient with a functioning LITA to the occluded left anterior descending artery and a GEA to the right coronary artery (RCA) by using a temporary vein graft to the RCA for the infusion of cardioplegic solution in addition to the conventional antegrade and retrograde cardioplegic infusions with ice slush topical cooling.