RESUMEN
Patients suffering from end-stage heart failure also suffer from multiple cardiovascular comorbidities such as abdominal aortic aneurysm (AAA). Mechanical support with left ventricular assist device with open repair of AAA repair has rarely been reported in literature. The authors describe a 60-year-old male with end-stage heart failure and a symptomatic AAA with sequential left ventricular assist device insertion and open AAA repair with aortic cross-clamping.
Asunto(s)
Aneurisma de la Aorta Abdominal , Insuficiencia Cardíaca , Corazón Auxiliar , Procedimientos Quirúrgicos Torácicos , Aneurisma de la Aorta Abdominal/complicaciones , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Aneurisma de la Aorta Abdominal/cirugía , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/cirugía , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Procedimientos Quirúrgicos VascularesRESUMEN
Clinical lung transplant was first performed in Hong Kong in 1995. In the early years, the volume of activity was very low. There has been a clear trend of increasing volume in the past few years. The recipient pathology is very different from the International Society for Heart and Lung Transplantation (ISHLT) database, with complete absence of cystic fibrosis and alpha-1-antitrypsin deficiency, and a predominance of diseases of the pulmonary circulation. Lymphangioleiomyomatosis (LAM) has a much higher representation on the waiting list than the ISHLT. The survival of patients who received a lung transplant in Hong Kong compares favorably with international data.
RESUMEN
Tricuspid regurgitation can progressively worsen years after left-sided heart valve surgery, requiring surgical intervention for which the prognostic factors are unclear. This study aimed to assess the prediction of surgical outcome using right ventricular function obtained from computed tomography. We prospectively enrolled 24 patients who underwent isolated tricuspid repair or replacement from 2005 to 2008. Right ventricular computed tomography was carried out before surgery. The primary endpoint was survival with symptomatic improvement after one year. Twelve patients survived with improvement of at least one New York Heart Association functional class, and 12 died or had no symptomatic improvement. All baseline characteristics, echocardiogram data, and surgical details were similar in both groups. Right ventricular computed tomography parameters including end-systolic volume, indexed end-systolic volume, end-diastolic volume, and indexed end-diastolic volume were significantly different between the two groups. We concluded that right ventricular function assessed by computed tomography can predict the surgical outcome in patients undergoing surgery for isolated late tricuspid regurgitation.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Implantación de Prótesis de Válvulas Cardíacas , Ventrículos Cardíacos/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Insuficiencia de la Válvula Tricúspide/cirugía , Función Ventricular Derecha , Adulto , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Procedimientos Quirúrgicos Cardíacos/mortalidad , Femenino , Implantación de Prótesis de Válvulas Cardíacas/efectos adversos , Implantación de Prótesis de Válvulas Cardíacas/mortalidad , Ventrículos Cardíacos/fisiopatología , Hong Kong , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Prospectivos , Recuperación de la Función , Medición de Riesgo , Factores de Riesgo , Volumen Sistólico , Análisis de Supervivencia , Tasa de Supervivencia , Factores de Tiempo , Resultado del Tratamiento , Insuficiencia de la Válvula Tricúspide/diagnóstico por imagen , Insuficiencia de la Válvula Tricúspide/mortalidad , Insuficiencia de la Válvula Tricúspide/fisiopatologíaRESUMEN
We report a patient with isolated left ventricular non-compaction diagnosed by echocardiography and cardiac magnetic resonance imaging. She developed refractory congestive heart failure and subsequently underwent successful heart transplantation. This type of cardiomyopathy is thought to be caused by the arrest of normal embryogenesis of the endocardium and myocardium. The spectrum of clinical, radiological, and pathological abnormalities is discussed.
Asunto(s)
Cardiomiopatía Hipertrófica/terapia , Trasplante de Corazón , Disfunción Ventricular Izquierda/terapia , Adulto , Cardiomiopatía Hipertrófica/complicaciones , Cardiomiopatía Hipertrófica/diagnóstico , Ecocardiografía/métodos , Femenino , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/terapia , Humanos , Imagen por Resonancia Magnética/métodos , Disfunción Ventricular Izquierda/complicaciones , Disfunción Ventricular Izquierda/diagnósticoRESUMEN
Cardiac angiosarcoma usually arises from the right atrium. We report an extremely rare case of primary angiosarcoma originating from the left atrium in a 70-year-old woman. This represents the ninth reported case of left-sided cardiac angiosarcoma in the English literature. Analysis of all nine cases shows that this malignant neoplasm occurs more in female patients with a mean age of 60 years, unlike the right-sided one which typically affects male patients in their early 40s. The prognosis of this tumor is extremely poor with life expectancy lying between 3 to 34 months despite early diagnosis by imaging and multimodality treatment.
Asunto(s)
Atrios Cardíacos/patología , Neoplasias Cardíacas/patología , Hemangiosarcoma/patología , Anciano , Resultado Fatal , Femenino , Atrios Cardíacos/cirugía , Neoplasias Cardíacas/cirugía , Hemangiosarcoma/cirugía , HumanosRESUMEN
Leg wound complications at the site of vein harvest for coronary artery bypass graft, although infrequent, cause significant morbidity. Pneumatic pressure therapy is valuable in venous and lymphatic diseases, but its usefulness after leg vein harvest has not been determined. A prospective randomized controlled trial was conducted on 200 patients, half of whom had sequential pneumatic leg pump therapy postoperatively. Wound healing, extent of lower limb edema, patient satisfaction, and the financial implications of pneumatic pressure therapy were assessed. In the study group, 71 patients had satisfactory wound healing vs. 23 in the control group. The leg wound infection rate in the study group was 3% vs. 15% in the control group ( p = 0.003). Lower limb edema was significantly reduced in the study group in the early postoperative period ( p < 0.05), and the mean postoperative length of hospital stay was reduced by 2.6 days in patients given pneumatic pressure therapy ( p = 0.003). The sequential pneumatic leg pump is an effective, inexpensive, and convenient device that reduces leg wound complications after coronary artery bypass grafting.