Saburo Sugie

Surgical Treatment of Aneurysms of the Sinus of Valsalva

From 1962 to 1976, 15 patients with aneurysms of the sinus of Valsalva underwent operative correction. All patients survived operation. Follow-up has been carried out for as long as fifteen years (median, six years) after operation. There have been no late deaths and no recurrences. Aortic insufficiency, present in 2 patients before and in 2 after operation, remained well compensated and required no further aortic valve procedure. A double approach, that is, through both the aorta and the involved cardiac chamber, is recommended for sufficient correction.

Wall reinforcement with highly porous Dacron mesh in aortic surgery.

Wall reinforcement with highly porous synthetic Dacron mesh was devised and evaluated in various aortic operations. Excellent attachment of the mesh to the aortic wall, good preservation of pliability of the aorta, and efficient pressure resistance with minimal scar tissue formation were the usual findings. This type of wall reinforcement was employed in 60 patients for the following indications: 1) prevention of suture line complications; 2) wall reinforcement of aortic aneurysm without resection; 3) reinforcement of adventitia or autogenous vein following thromboendarterectomy. It is concluded that reinforcement with highly porous synthetic Dacron mesh should be superior to reinforcement with conventional prosthetic Dacron graft.

Results of Below Knee Bypass Operation for Limb Salvage in Thromboangiitis Obliterans

From the Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan. Supported in part by a grant from the Japanese Ministry of Health Welfare. The below knee bypass operation has become a widely accepted procedure for salvaging ischemic lower extremities with arteriosclerosis obliterans (ASO).1-4 However, surgical treatment of thromboangiitis obliterans (TAO) still raises unsettled questions about indications and operative techniques. Applications of reconstructive surgery are limited, and the reported results are not so favorable because of diffuse inflammatory occlusion in the peripheral arteries of limbs. Thus most ischemic limbs are treated by sympathectomy or amputation. Detailed results of the distal artery bypass in TAO are not yet available, but we have tried an aggressive application of the bypass operation for limb salvage in TAO. This report compares our experience with distal artery bypass in patients with TAO and in those with ASO.

Experimental and Clinical Evaluations of Superior Vena Caval Replacement

Replacement of the superior vena cava is difficult, and the results of operative treatment for superior vena caval syndrome are rather disappoint ing. This report describes extensive experimental and clinical experiences with superior vena caval revascularization, with special reference to the favorable results of patch angioplasty.