Background: There have been few detailed reports on the gender ratio of patients with congenital heart disease in Japan, so we investigated the gender ratio of patients undergoing congenital heart disease surgery.

Methods: Based on the NDB open data of the Ministry of Health, Labor and Welfare, we calculated the number of insured cases of surgery for congenital heart disease by surgical procedure and gender over the seven-year period (Fiscal Year 2014 to Fiscal Year 2020). The gender ratio for each disease derived from the surgical procedures was compared with that in previous publications.

Results: The total number of surgery over the 7-year period was 58,635, performed slightly more for female than male (26,553 vs. 25,643). In terms of surgical procedure, there were 214 cases of vascular ring or interrupted aortic arch surgery (82.9% were male), 868 cases of transposition of the great arteries (74.2% were male), and 1,482 cases of atrial septostomy (65.4% were male). Conversely, there were more female than male among 6,977 cases of patents ductus arteriosus surgery (39.2% were male), 932 cases of complete atrio-ventricular septal defect surgery (40.0% were male), and 13,837 cases of atrial septal defect closure (40.4% were male). The gender ratio for each disease identified from the surgical procedure was higher for vascular ring or interrupted aortic arch and complete transposition of the great vessels, while the girl ratio was higher for patent ductus arteriosus, complete atrioventricular septal defect, and atrial septal defect.

Conclusion: The gender ratio of congenital heart disease by surgical procedure in Japan was clarified, and a trend of gender ratio of congenital heart disease was inferred.

The patient was a 76-year-old man who had undergone aortic valve replacement, mitral annuloplasty, and tricuspid annuloplasty. The patient developed postoperative pneumonia and was managed on a ventilator. On the fifth postoperative day, he underwent right hemicolectomy due to non-occlusive mesenteric ischemia, which was complicated by perforation at the site of anastomosis, and a duodenal fistula and ileal colostomy were constructed. He also had dysphagia due to pharyngo-laryngeal muscle weakness, and enteral nutrition was initiated while performing functional swallowing exercises. However, nausea and abdominal fullness appeared after the injection of semi-digestible nutritional supplements, and watery drainage from the colostomy continued. As there was no evidence of gastrointestinal stenosis, a continuous infusion method using a pump was started at a slow infusion rate, while intestinal regulators, antidiarrheal drugs, and Chinese herbal medicine were infused. The infusion rate gradually increased, and the patient's nutritional intake increased to 1,680 kcal within approximately one month. The swallowing function was also restored by videofluorography, and oral feeding was started on the 125th postoperative day. On the 137th postoperative day, the patient was able to consume all food orally, even when eating gruel in small portions. The patient was discharged on postoperative day 150, and the colostomy was closed two months after discharge.

Non-obstructive mesenteric ischemia is a rare complication after open heart surgery, but it is difficult to diagnose and often leads to death from septic shock, although the diagnosis is only made after exploratory laparotomy. In the present case, the patient underwent extended right hemicolectomy, two laparotomies, and dysphagia, but was able to return home with enteral nutrition and swallowing therapy.

A patient was diagnosed with Peutz-Jeghers syndrome at the age of 27 years following the onset of intestinal accumulation due to hamartomatous polyps, who then underwent breast cancer surveillance. The patient was diagnosed with right breast cancer at 31 years of age. Furthermore, 3 years after undergoing right breast cancer surgery, left breast cancer was diagnosed during a routine examination. Computed tomography at the time of right breast cancer diagnosis showed ground-glass opacity in both lungs. During follow-up, the findings in the left lung indicated malignancy. Partial thoracoscopic resection was performed, and lung cancer was diagnosed. Although the effectiveness of surveillance for malignant tumors outside the gastrointestinal tract has not been established, we report a case in which we could diagnose juvenile heterochronic bilateral breast cancer and lung cancer through surveillance.