RESUMEN
Double outlet right ventricle (DORV) is almost always associated with a ventricular septal defect. The variant of DORV with intact ventricular septum is very uncommon and may be associated with fetal demise or death immediately after birth. Reports of successful palliation of these patients to the stage of superior cavopulmonary anastomosis (bidirectional Glenn shunt) are rare. We describe the case of a child with DORV with intact ventricular septum who underwent successful palliation. This condition often provides a diagnostic, interventional, and surgical challenge. Patients generally require either balloon atrial septostomy or surgical atrial septectomy for survival, with the addition of a Blalock-Tausig shunt or pulmonary artery band depending on the pulmonary blood flow. Very few patients survive to a Glenn procedure. For those who do survive, a decision must be made regarding the management of the hypertensive and hypoplastic left ventricle (LV) and associated mitral regurgitation. The LV can be excluded by either mitral valve avulsion or closure (exclusion) of the mitral valve with a patch. The choice of the technique should be carefully made and depends in part on the size of the LV. In our patient, who was successfully palliated by bidirectional Glenn shunt, the LV was managed by means of mitral valve avulsion.
Asunto(s)
Ventrículo Derecho con Doble Salida/cirugía , Procedimiento de Fontan/métodos , Válvula Mitral/cirugía , Estenosis de la Válvula Pulmonar/cirugía , Ventrículo Derecho con Doble Salida/diagnóstico por imagen , Femenino , Hemodinámica , Humanos , Lactante , Cuidados Paliativos , Estenosis de la Válvula Pulmonar/diagnóstico por imagen , Tabique Interventricular/diagnóstico por imagenAsunto(s)
Aneurisma Falso , Cardiopatías , Ventrículos Cardíacos , Anciano , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/cirugía , Electrocardiografía , Cardiopatías/diagnóstico por imagen , Cardiopatías/cirugía , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/cirugía , Humanos , Imagen por Resonancia Magnética , MasculinoRESUMEN
Synovial cell sarcoma is a rare variety of soft tissue tumour. Very few cases of this tumour affecting the tendon sheath have been reported so far. We report a rare presentation of synovial cell sarcoma of the flexor hallucislongus tendon in a 35-year-old female. She presented with a painful lump (tumour) arising from postero medial aspect of the right ankle. The mass produced erosion of the overlying calcaneum over the time of one year. She was managed surgically by enucleation of the tumour followed by augmentation of calcaneum with bone cement.
RESUMEN
Piezoelectric based bimorph mirrors (PBM) find extensive use in focusing of x-ray beams. Many optical instruments require use of PBM whose radii of curvature can be tuned precisely. The 100 mm and 300 mm PBMs were fabricated with varying piezoelectric to fused silica plate thicknesses. The radii of curvature of free standing mirrors were measured as a function of voltage and it was found to decrease with increasing voltage. For a given piezoelectric plate thickness, as the fused silica thickness increases, the radii of curvature was found to increase owing to increase in stiffness of the mirror. On the other hand, for a given fused silica plate thickness, when the piezoelectric plate thickness is increased, the radii of curvature are decreased for a given electric field, due to increase in generated force. This study brings out the influence of piezoceramic to fused silica plate thickness on the radii of curvature of PBM.
RESUMEN
Myxoma of the right ventricle is of very rare occurrence. An adult male patient presented with Class III dyspnoea and occasional haemoptysis and clinically was suspected to have pulmonary stenosis. Magnetic resonance imaging study revealed presence of myxoma arising from the right-ventricular free wall and prolapsing into the pulmonary artery but not involving the pulmonary valve. The myxoma was excised via right ventriculotomy using cardiopulmonary bypass. The patient had an uneventful recovery. The relevant literature is reviewed.
Asunto(s)
Neoplasias Cardíacas/complicaciones , Mixoma/complicaciones , Obstrucción del Flujo Ventricular Externo/etiología , Adulto , Neoplasias Cardíacas/cirugía , Ventrículos Cardíacos , Humanos , Masculino , Mixoma/cirugía , Arteria Pulmonar/patologíaRESUMEN
Of the 4170 open intracardiac operations performed at our hospital in the last 6 years, 55 (1.3%) were reoperations. Of these failed valve repairs or valve substitutes formed the major group (58%) and the interval between first and second operation ranged from 6 months to 8 years. There were 4 deaths on table and another 6 patients died during their hospital stay giving an early mortality rate of 18 per cent. There was one late death during a follow-up period of 1 month to 3 years. There was no death due to perioperative bleeding complications. We conclude that it should now be possible to perform reoperations with an acceptable mortality and good late functional results.