RESUMEN
The endometrial stromal sarcoma (EES) is a rare uterine malignancy and its intracardiac metastasis are exceedingly rare. We report a case of a 53-year-old female patient diagnosed with a metastatic tumor of a ESS in the right side of the heart, who underwent successful surgical resection and initiated chemotherapy with docetaxel and gemcitabine. At a 9-month follow-up, the patient was in New York Heart Association-Class I, without any further complications.
Asunto(s)
Neoplasias Endometriales , Neoplasias Cardíacas , Sarcoma Estromático Endometrial , Femenino , Corazón , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Humanos , Persona de Mediana Edad , Sarcoma Estromático Endometrial/cirugíaRESUMEN
Hutchinson-Gilford progeria syndrome is a rare genetic disorder, characterized by progressive premature aging and early death in the first or second decade of life, usually secondary to cardiovascular events (myocardial infarction and stroke). We report a case of a 14-year-old boy with progeria syndrome and cardiac arrest due to myocardial infarction, who was submitted to an immediate coronary angiography which revealed left main stem and three-vessel coronary artery disease. A prompt double bypass coronary artery grafting surgery was performed, and, despite successful coronary reperfusion, the patient remained in coma and brain death was declared on fourth day after surgery.
Asunto(s)
Puente de Arteria Coronaria/métodos , Paro Cardíaco/cirugía , Infarto del Miocardio/cirugía , Progeria/complicaciones , Adolescente , Angiografía Coronaria , Electrocardiografía , Paro Cardíaco/diagnóstico , Paro Cardíaco/etiología , Humanos , Masculino , Infarto del Miocardio/complicaciones , Infarto del Miocardio/diagnóstico , Progeria/genética , Enfermedades RarasRESUMEN
OBJECTIVES: Cardiac surgery has little effect on life expectancy in elderly patients. Thus, improving the quality of life should be the main factor affecting therapeutic decisions. Most studies on quality of life in elderly patients undergoing cardiac surgery report improvement but have limitations. Consequently, we assessed improvements in the quality of life of elderly patients undergoing elective cardiac surgery, identified influencing variables and established patterns of mental and physical health variations in the first year postoperatively. METHODS: We conducted a prospective study of patients aged 65 or older who underwent elective cardiac surgery between September 2011 and August 2013. The 36-item Short Form (SF-36) surveys were obtained preoperatively and at 3, 6 and 12 months postoperatively. RESULTS: The 430 preoperative patients with a mean age of 74 years (SD 5.5 years) comprised 220 men. Most physical health improvements occurred within 3 months and continued to improve significantly until 12 months. Predictive variables for patients showing less improvement were poor preoperative physical health, female sex, older age and longer length of hospital stay. Mental health improved significantly through the third postoperative month. The negative predictive variables were poor preoperative mental health and longer intensive care unit stay. CONCLUSIONS: Most patients improved both physically and mentally after surgery, and most of the improvement occurred within 3 months post-surgery. These improvement patterns should be taken into account when creating rehabilitation programmes, and patients should be counselled on what improvements can be expected during the first 12 months after surgery.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Procedimientos Quirúrgicos Electivos/métodos , Cardiopatías/cirugía , Calidad de Vida , Anciano , Femenino , Cardiopatías/psicología , Humanos , Unidades de Cuidados Intensivos , Tiempo de Internación/tendencias , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Estudios Prospectivos , Encuestas y CuestionariosRESUMEN
Intracardiac teratomas are very rare primary cardiac tumors; only a few cases have been reported. We present the case of a 7-year-old boy who early in life showed pulmonary stenosis and needed percutaneous and surgical procedures, including sectioning of the right ventricular bands and reconstruction of the right ventricular outflow tract. At the age of 7 years the patient received a diagnosis of a multilobular cystic mass in the right ventricle adherent to the interventricular septum, which was not present at birth. Successful surgical resection was performed. Histologic examination revealed a mature teratoma. We emphasize the differential diagnosis of teratomas in cystic lesions of the interventricular septum.
Asunto(s)
Quistes/patología , Neoplasias Cardíacas/diagnóstico , Tabiques Cardíacos/patología , Complicaciones Posoperatorias/diagnóstico , Teratoma/diagnóstico , Procedimiento de Blalock-Taussing , Niño , Quistes/diagnóstico por imagen , Quistes/cirugía , Diagnóstico Diferencial , Equinococosis/diagnóstico , Ecocardiografía , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Tabiques Cardíacos/diagnóstico por imagen , Tabiques Cardíacos/cirugía , Humanos , Imagen por Resonancia Magnética , Masculino , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/cirugía , Estenosis de la Válvula Pulmonar/congénito , Estenosis de la Válvula Pulmonar/cirugía , Teratoma/complicaciones , Teratoma/diagnóstico por imagen , Teratoma/cirugía , Tomografía Computarizada por Rayos X , Obstrucción del Flujo Ventricular Externo/cirugíaRESUMEN
Primary sarcoma of the heart is a rare disease that has an ominous prognosis with either medical or surgical therapy. We report a case of a 25-year-old woman with sarcoma of the heart who received a transplant and is clinically well after 7 years. We believe that transplantation must be considered in this kind of pathology for selected cases.