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Direct visualization of postoperative aortobronchial fistula on computed tomography

World Journal of Radiology 2024年第8期16卷 337-347页

作者： Nanae Tsuchiya Hitoshi Inafuku Satoko Yogi Yuko Iraha Gyo Iida Mizuki Ando Takaaki Nagano Shotaro Higa Tatsuya Maeda yuya kise Kojiro Furukawa Koji Yonemoto Akihiro Nishie Department of Radiology Graduate School of Medical ScienceUniversity of the RyukyusOkinawa 903-0215Japan Department of Thoracic and Cardiovascular Surgery Graduate School of Medical ScienceUniversity of the RyukyusOkinawa 903-0215Japan Department of Biostatistics School of Health SciencesFaculty of MedicineUniversity of the RyukyusOkinawa 903-0215Japan

BACKGROUND Postoperative aortobronchial fistula(ABF)is a rare complication that can occur in 0.3%-5.0%of patients over an extended period of time after thoracic aortic *** visualization of the fistula via imaging is *** To investigate the relationship between computed tomography(CT)findings and the clinical signs/symptoms of ABF after thoracic aortic *** Six patients(mean age 71 years,including 4 men and 2 women)with suspected ABF on CT(air around the graft)at our hospital were included in this retrospective study between January 2004 and September *** CT findings included direct confirmation of ABF,peri-graft fluid,ring enhancement,dirty fat sign,atelectasis,pulmonary hemorrhage,and bronchodilation,and the clinical course were retrospectively *** proportion of each type of CT finding was *** ABF detection after surgery was found to have a mean and median of 14 and 13 years,*** signs and symptoms were asymptomatic in 4 patients,bloody sputum was found in 1 patient,and fever was present in 1 *** complications of ABF included graft infection in 2 patients and graft infection with hemoptysis in 2 *** the 6 patients,3 survived,2 died,and 1 was lost to *** locations of the ABFs were as follows:1 in the ascending aorta;1 in the aortic arch;2 in the aortic arch leading to the descending aorta;and 2 in the descending *** were directly confirmed by CT in 4/6(67%)***-graft dirty fat(4/6,67%)and peri-graft ring enhancement(3/6,50%)were associated with graft infection,endoleaks and pseudoaneurysms were associated with hemoptysis(2/6,33%).CONCLUSION Asymptomatic ABF after thoracic aortic surgery can be confirmed on chest *** is useful for the diagnosis of ABF and its complications.

关键词： Peri-graft air Aortobronchial fistula Chest computed tomography Postoperative Thoracic endovascular aortic repair Complication Thoracic aorta surgery

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Root Reconstruction with Total Replacement of Ascending Aorta Using Hypothermic Circulatory Arrest and Selective Cerebral Perfusion for Moderately Dilated Distal Ascending Aorta

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World Journal of Cardiovascular Surgery 2013年第3期3卷 101-105页

作者： Satoshi Yamashiro Ryoko Arakaki yuya kise Hitoshi Inafuku Yukio Kuniyoshi Department of Thoracic and Cardiovascular Surgery University of the Ryukyus Nishihara Okinawa Japan

Objective: We have occasionally encountered a moderately dilated distal ascending aorta while reconstructing an aortic root. We describe reconstruction of an extended root and ascending aorta using our current strategy. Patients and Methods: Between March 2011 and December 2012, 15 (11 men;mean age, 70.1 ± 7.3 years) patients underwent root reconstruction with hemi-arch replacement under hypothermic circulatory arrest with antegrade selective cerebral perfusion. The maximum diameter of the aortic root was 52.5 ± 4.4 mm. The distal ascending aorta just below innominate artery was moderately dilated to 41.7 ± 1.4 mm in diameter. Results: Operative outcomes excluding the diameter of the distal ascending aorta did not significantly differ from those of patients who had undergone root reconstruction under distal ascending aortic clamping during the same period. Postoperative computed tomography confirmed complete resection of the dilated ascending aorta in the patients, and did not develop neurological dysfunction or stroke. Conclusion: Postoperative computed tomography confirmed complete resection of dilated ascending aortae. We considered that complete resection under hypothermic circulatory arrest and selective cerebral perfusion might help to avoid repeated surgery to treat dilation of the distal ascending aorta over the long-term.

关键词： Annulo-Aortic Ectasia Re-Operation

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Detection of active bleeding from gastric antral vascular ectasia by capsule endoscopy

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World Journal of Gastrointestinal Endoscopy 2013年第3期5卷 138-140页

作者： Tetsuya Ohira Akira Hokama Nagisa Kinjo Manabu Nakamoto Chiharu Kobashigawa yuya kise Satoshi Yamashiro Fukunori Kinjo Yukio Kuniyoshi Jiro Fujita Department of Endoscopy University Hospital of the RyukyusOkinawa 903-0125Japan Department of Infectious Respiratory and Digestive MedicineGraduate School of MedicineUniversity of the RyukyusOkinawa 903-0125Japan Division of Thoracic and Cardiovascular Surgery Graduate School of MedicineUniversity of the RyukyusOkinawa 903-0125Japan

Gastric antral vascular ectasia(GAVE) has been recognized as one of the important causes of occult and obscure gastrointestinal *** diagnosis is typically made based on the characteristic endoscopic features,including longitudinal row of flat,reddish stripes radiating from the pylorus into the antrum that resemble the stripes on a *** appearances,however,can easily be misinterpreted as moderate to severe *** it is believed that capsule endoscopy(CE) is not helpful for the study of the stomach with its large lumen,GAVE can be more likely to be detected at CE rather than conventional *** can be regarded as "physiologic" endoscopy,without the need for gastric inflation and subsequent compression of the *** blood flow of the ecstatic vessels may be diminished in an inflated ***,GAVE may be prominent in *** herein describe a case of active bleeding from GAVE detected by CE and would like to emphasize a possibility that CE can improve diagnostic yields for GAVE.

关键词： Gastrointestinal bleeding Gastrointestinal endoscopy Capsule endoscopy Gastric antral vascular ectasia Argon plasma coagulation

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