Yukiko Honma

Traumatic coronary artery dissection

A 14-year-old boy sustained blunt chest trauma resulting in dissection of the left main coronary artery, postinfarction left ventricular aneurysm, mitral regurgitation, and tricuspid regurgitation. He underwent pericardial patch angioplasty of the left main coronary artery, left ventricular aneurysmectomy, mitral valvuloplasty, and tricuspid annuloplasty. The patient continues to do well 4 years after operation.

Concomitant mitral and tricuspid valve infective endocarditis: report of a case.

A rare case of native valve endocarditis affecting both the normal mitral and tricuspid valves is presented. A 25-year-old woman with an acute ischemic stroke was found to have vegetation secondary to infective endocarditis as the embolic source. One month after the onset of embolic cerebrovascular intervention, a valve repair with the implantation of artificial chordae, sliding commissuroplasty, and ring annuloplasty resulted in a complete recovery.

Composite graft replacement after aortic valvuloplasty in Takayasu arteritis

A 24-year-old woman had undergone valvuloplasty of the aortic valve and external reinforcement of an aneurysm of the ascending aorta during the active phase of Takayasu arteritis 1 year prior to admission to our hospital. On examination, she was diagnosed as having a large false aneurysm of the ascending aorta with annuloaortic ectasia and severe aortic regurgitation, bilateral common carotid artery aneurysms with a left internal carotid artery saccular aneurysm, and bilateral subclavian artery and right vertebral artery obstructions due to Takayasu arteritis. Because of the risk of rupture, surgical intervention was carried out in spite of the fact that aortitis was in the active phase.

189. Sendai Virus Mediated Angiopoietin-1 Gene Therapy for Cardiovascular Diseases

Background: Sendai virus (SeV) is negative-stranded RNA virus, which is classified as a type I parainfluenza virus belonging to the family of Paramyxoviridae. SeV has been known as rodent respiratory virus, however it is considered to be non-pathogen for humans. Recently, efficient gene transduction into various types of cells and tissue has been reported. Angiopoietin-1 (Ang1) is a critical angiogenic factor for vascular maturation and enhances vascular endothelial growth factor (VEGF)-induced angiogenesis in a complementary manner. Previously we reported Ang1 gene therapy clearly promoted myocardial angiogenesis and prevented remodeling in a rat AMI model. In the present study, we created recombinant Sendai virus vector (SeVV) encoding human Ang1 and evaluated therapeutic effect in the cardiovascular diseases. We also evaluated the angiogenic effect of mesenchymal stem cells (MSCs) transplantation with SeVV-mediated Ang1 gene modification.

938. Myocardial Administration of Adenoviral Vector Encoding VEGF Induces Severe Pleural and Pericardial Effusion in Rat

Background: Clinical trials for severe coronary ischemia and critical limb ischemia using vascular endothelial growth factor (VEGF) gene have been on going for several years. However, the indication of VEGF therapy for ischemic heart disease is only limited to chronic ischemia, and acute myocardial infarction (AMI) is exception for this therapy at present. High levels of circulating VEGF were reported to arise following AMI in a short period after the ischemic event and surmised that it protects the blood vessels from apoptosis, modulates vasomotor response, and supports vessel formation in the ischemic area, and to contribute to quick recovery from the ischemic state. In this regard, we attempted adenoviral VEGF gene therapy for rat myocardial infarction model. However, we found the increase mortality of animals receiving adenoviral VEGF. Therefore, we re-evaluated the adverse effect of myocardial administration of adenoviral vector encoding VEGF in AMI rat.