A woman with single coronary.She underwent aortic valve replacement.But aortic annulus abscess occurred 2 years later. We performed aortic root replacement and coronary artery bypass grafting using the Freestyle valve and saphenous vein graft. The patient was discharged and has visited us as an outpatient without relapse of infection.

Introduction: The impact of catheter ablation for atrial fibrillation (AF) on cardiovascular events and mortality is controversial. We investigated the impact of sinus rhythm maintenance on major adverse cardiac and cerebrovascular events after AF ablation from a Japanese multicenter cohort of AF ablation. Methods and Results: We investigated 2737 consecutive patients (25.6% female, mean age 63.4 ± 10.3 years) who underwent a first catheter ablation for AF from the Atrial Fibrillation registry to Follow the long-teRm Outcomes and use of aNTIcoagulants aftER Ablation (AF Frontier Ablation Registry). The primary endpoint was a composite of stroke, transient ischemic attack, cardiovascular events, and all-cause death. During a mean follow-up of 25.2 months, 2070 (75.6%) patients were free from AF after catheter ablation, and the primary composite endpoint occurred in 122 (4.5%) patients. The AF nonrecurrence group had a significantly lower incidence of the primary endpoint (1.7 per 100 person-years) compared with the AF recurrence group (3.2 per 100 person-years; P = 0.001). The multivariate analysis revealed that freedom from AF (hazard ratio 0.57; 95% confidence interval 0.39–0.83; P = 0.003) was independently associated with the incidence of the composite event.¬¬ Conclusion: In the multicenter cohort of AF ablation, sinus rhythm maintenance after catheter ablation was independently associated with lower rates of major adverse cardiac and cerebrovascular events.

Introduction: The clinical efficacy and safety of hot balloon ablation (HBA) for treatment of persistent AF (PerAF) remain unclear. We aimed to evaluate the clinical efficacy and safety of HBA vs. cryoballoon ablation (CBA) as treatment for PerAF. Methods: Of 195 consecutive patients who underwent initial catheter ablation for PerAF (AF lasting >7 days but <12 months), 158 propensity score-matched (79 HBA and 79 CBA) patients were included in our study. All patients who underwent HBA received applications of energy to the upper posterior LA wall with a larger balloon in addition to single shots to each pulmonary vein (PV) ostium, whereas those who underwent CBA received simple single-shot applications. The electrically isolated surface area (ISA), including the PV antrum and part of the posterior LA wall, was assessed by high-resolution mapping. Results: Success of the PV isolation with balloon shots alone did not differ between HBA and CBA (81% vs. 85%; P = 0.52). The ISA was generally wide in both groups and significantly larger in the HBA group than in the CBA group (61 ± 16% vs. 51 ± 12%, P < 0.001). The incidence of procedure-related complications did not differ significantly (HBA 4% vs. CBA 1%; P = 0.62) nor did the arrhythmia recurrence rate (HBA 11% vs. CBA 18% at 18 months; P = 0.26). Conclusion: Despite the difference in protocols, HBA and CBA performed for PerAF appear comparable in terms of wide antral lesion creation, clinical efficacy, and safety.