We report a case of coronary artery bypass grafting for acute myocardial infarction which presented as cardio-pulmonary arrest during a marathon race. A 57-year-old man collapsed at the 18-km point in the Toyohashi half marathon. He was treated with an automated electrical defibrillator（ AED） for ventricular fibrillation in an ambulance. Immediately after arriving at our emergency department, he was diagnosed with acute myocardial infarction by electrocardiography. Emergency coronary angiography revealed severe stenosis of the left anterior descending artery. Percutaneous coronary intervention was tried, but it was given up because calcification of the stenotic lesion was severe. He was then referred to our department for emergency coronary artery bypass grafting. Complete re-vascularization was accomplished and the patient has been doing well with no signs of angina.

We report a case in which the double-patch technique was used to repair residual shunt after infarctexclusion technique for post-infarction ventricular septal perforation（ VSP）.A 68-year-old man was diagnosed with post-infarction VSP and surgical interveniton was performedby infarct exclusion technique through left ventriculotomy. Residual shunt was observed by left ventriculography,and he developed cardiac failure in spite of medical therapy. Additional surgery for residualshunt was performed 5 months after the initial operation. The VSP was closed with 2 pericardialpatches onto both sides of the septum through right ventriculotomy. Complete closure of the defect wasaccomplished, and no residual shunt was observed by post-operative left ventriculography. The patienthas been doing well with no signs of cardiac failure.

We describe a case of Stanford type A acute aortic dissection. Replacement of the ascending aortaand aortic arch was performed using an“ arch 1st technique”. Following the completion of replacement,hypotension of the left superficial temporal artery pressure was detected. Ultrasonography revealed dissectionof the left common carotid artery（LCCA）and compressive occlusion of the true lumen. Reconstructionof the LCCA was performed in the neck. The patient did well after the operation without anyneurological abnormalities.

Anaphylactic shock related to aprotinin has been reported to be induced exclusively in the presence of IgE antibody. And the possibility of anaphylactic shock induced by anti-aprotinin IgG antibody alone was controversial. In this paper, we describe the first case of anaphylactic shock induced by aprotinin-specific IgG antibody alone. A 55-year-old man underwent surgical repair of the descending aorta with the use of aprotinin at 2 months after first aprotinin usage. Immediately after initiation of cardiopulmonary bypass with the continuous infusion of aprotinin, clinical symptoms of anaphylactic reaction were found. Postoperative drug lymphocyte stimulation test for aprotinin and aprotinin-specific IgE antibody were negative, but aprotinin-specific IgG antibody was 163 mg/l and positive.