RESUMEN
Papillary fibroelastoma is rare but one of the most common benign primary cardiac tumors after myxoma. This lesion may be associated with embolization, angina and sudden death. The incidental finding of a small pedunculated papillary fibroelastoma arising from the atrial septum detected by transesophageal two-dimensional echocardiography (TEE) in a patient undergoing coronary artery bypass grafting is reported. The advantage of TEE in diagnosing intracardiac tumors is also described.
Asunto(s)
Ecocardiografía Transesofágica , Fibroma/diagnóstico por imagen , Neoplasias Cardíacas/diagnóstico por imagen , Puente de Arteria Coronaria , Femenino , Fibroma/patología , Atrios Cardíacos/diagnóstico por imagen , Atrios Cardíacos/patología , Neoplasias Cardíacas/patología , Tabiques Cardíacos/diagnóstico por imagen , Tabiques Cardíacos/patología , Humanos , Persona de Mediana EdadAsunto(s)
Estenosis de la Válvula Aórtica/etiología , Endocarditis Bacteriana/complicaciones , Enterococcus faecalis , Infecciones por Bacterias Grampositivas/complicaciones , Estenosis de la Válvula Mitral/etiología , Streptococcus sanguis , Enfermedad Aguda , Femenino , Humanos , Persona de Mediana Edad , Infecciones Estreptocócicas/complicacionesAsunto(s)
Obstrucción de las Vías Aéreas/etiología , Quemaduras/etiología , Puente de Arteria Coronaria , Electrocoagulación/efectos adversos , Falla de Equipo , Complicaciones Intraoperatorias/etiología , Intubación Intratraqueal , Tráquea/lesiones , Anciano , Quemaduras/cirugía , Humanos , MasculinoRESUMEN
This report describes the feasibility of restoring motor function of the diaphragm by early repair of a transected phrenic nerve, and discusses causes and consequences of phrenic nerve damage.
Asunto(s)
Nervio Frénico/cirugía , Parálisis Respiratoria/cirugía , Adulto , Diafragma/diagnóstico por imagen , Humanos , Masculino , Nervio Frénico/lesiones , Radiografía , Parálisis Respiratoria/diagnóstico por imagen , Parálisis Respiratoria/etiología , Heridas Punzantes/complicacionesRESUMEN
Differentiation of bicuspid aortic valve from other causes of calcific aortic stenosis is not possible by echocardiography or, in many cases, by aortography. This report describes newly recognized patterns of calcification on plain films that are diagnostic for a bicuspid aortic valve. These are based on identification of the calcified raphe and/or the calcified conjoint leaflet. In 120 patients who underwent surgical repair of calcific aortic stenosis, 40 were found to have bicuspid valve. Examination of the plain films retrospectively allowed a correct recognition of 26 (65%) of these valves. In contrast, only 10 (25%) could be recognized by aortography. Patterns of calcification on plain films represent an important tool for detection of calcified cogenital bicuspid aortic valve.
Asunto(s)
Válvula Aórtica/anomalías , Calcinosis/diagnóstico por imagen , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/cirugía , Estenosis de la Válvula Aórtica/diagnóstico por imagen , Estenosis de la Válvula Aórtica/etiología , Aortografía , HumanosRESUMEN
Closure of the pericardium after cardiac operations is desirable but is not always possible to achieve. We describe here a simple technique for tension-free, anterior closure of the pericardium.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Humanos , Pericardio/cirugíaRESUMEN
Intravenous rupture of abdominal aortic aneurysms occurs infrequently but should be considered with the coexistence of severe congestive failure, anasarca, and abdominal bruits. Six patients are presented with four survivors. In only two patients was the diagnosis considered preoperatively without angiography. Two were variants in that thrombus occluded the fistula, thereby negating findings usually manifested clinically. Diagnosis of this type can be made only during operation when copious venous bleeding ensues with evacuation of the aortic thrombus. Careful fluid management and prompt surgery are prerequisites to obtaining a successful outcome. Repair is accomplished easily by suturing the fistula from the aortic aspect, but care is required to avoid dislodgement of thrombus and atherosclerotic debris resulting in pulmonary embolism.
Asunto(s)
Aneurisma de la Aorta/complicaciones , Rotura de la Aorta , Fístula Arteriovenosa/etiología , Vena Ilíaca , Vena Cava Inferior , Anciano , Aorta Abdominal , Rotura de la Aorta/cirugía , Fístula Arteriovenosa/cirugía , Femenino , Humanos , Vena Ilíaca/cirugía , Masculino , Persona de Mediana Edad , Vena Cava Inferior/cirugíaRESUMEN
Twenty-three patients aged 5 to 53 years with recurrent or complex coarctations of the aorta were successfully operated upon using bypass grafts. This technique of repair was selected for 5 patients with recurrent coarctation, 11 with long-segment coarctation with or without hypoplasia of the transverse aortic arch, and 7 with inadequate collateral circulation. Nineteen patients had bypass grafts from the left subclavian artery to the distal descending thoracic aorta. The other 4 had a combined approach through a left thoractomy and median sternotomy with grafts between the ascending and descending thoracic aorta. All patients survived the operative procedure. One patient were reexplored for a hemothorax and 5 developed transient postoperative hypertension. There were no instances of abdominal vasculitis or lower extremity paralysis. These patients have been followed from 3 months to 11 years postoperatively, and all but 1 are alive and well. Twenty-two are normotensive, and none have the sequelae of hypertensive disease. Gradients up to only 15 mm Hg exist between upper and lower extremity blood pressures. Five patients have undergone postoperative catheterization and aortography, and all have patent grafts. This procedure is a useful and adjunct in difficult coarctations of the aorta and can be safely performed with excellent reproducible long-term results.