RESUMEN
Coronary ectasia is a little common angiographic finding. Its prevalence varies between 0.3-5.3 por ciento in different series, although a recent study reports until 6.7 por ciento. Coronary ectasia is suffered mainly by males, and may be produced by different causes; however in most of the patients it seems to be related to coronary atherosclerosis. In fact, some authors consider it like a variant of the atherosclerotic disease of coronary arteries. We report the case of a 54-year-old white male who was admitted on intensive care unit because of ustable angina with electrocardiographic changes. Coronary angiography revealed severe coronary ectasia, mainly of the left main coronary artery and the proximal portion of left anterior descending artery. The greatest ectasia of the left main coronary artery that we have found in reviewed literature had 15.0 millimeters and ours sized 12.9 millimeters. Angiographic images are shown(AU)
Asunto(s)
INFORME DE CASO , Humanos , Adulto , Dilatación Patológica , Angina InestableRESUMEN
La recidiva de un mixoma auricular izquierdo es un proceso muy poco común que aparece de manera excepcional en la práctica clínica. La mayoría de los autores coincide en que su frecuencia de aparición está por debajo del 5% del total de pacientes operados de un mixoma primario y se plantea que es más frecuente en el sexo femenino, aparece después de 2-3 años de la primera cirugía y puede responder a la resección incompleta del tumor, proliferación de un segundo foco tumoral y el implante intracardiaco del tumor original durante el proceder quirúrgico. En el presente artículo trasmitimos nuestra experiencia con una paciente femenina de 82 años de edad, que había sido operada hace 10 años de un mixoma auricular izquierdo y un injerto aorto-coronario, con vena safena, hasta la coronaria derecha y, en esta ocasión, ingresa por presentar síncope breve, brusco y de recuperación rápida. Conociendo estos antecedentes practicamos ecocardiograma transtorácico donde demostramos la presencia de una enorme masa tumoral que ocupaba casi toda la cavidad auricular izquierda. Se realiza la exéresis quirúrgica y se confirma el diagnóstico. La paciente evoluciona favorablemente y es egresada al séptimo día de la operación
Reappearance of left atrial myxoma is an uncommon process that rarely appears in clinical practice. Most of the authors agree when they say that its frequency of appearance is under 5% of the total of operated patients suffering from primary myxoma, and consider that this disease is more frequent in females, it appears after 2-3 years of the first surgery, and it can respond to the incomplete resection of the tumor, proliferation of a second tumoral focus, and intracardiac implants of the original tumor during the surgical procedure. In this article we show the case of an 82 years old woman who had been operated 10 years ago of left atrial myxoma and coronary artery bypass graft, with saphenous vein, to the right coronary artery. In this occasion, she presented with brief, abrupt and fast recovery syncope. Knowing these antecedents we performed transthoracic echocardiogram which demonstrated the presence of an enormous tumorlike mass that almost occupied the whole left atrial cavity. Surgical excision was carried out and the diagnosis was confirmed. The patient evolved favorably and was withdrawn after the seventh day of the operation