RESUMEN
Our purpose was to investigate the long term outcome of Hancock bioprostheses at our Hospital. There were 128 bioprostheses, with histopathological study on 17 of them. The 12.8 years follow-up disclosed dysfunction on 48.18% with an annual dysfunction rate of 3.34 +/- 1.3. One half of the patients with prosthetic dysfunction were re-operated. A comparison of our results is made with those of the literature, either with biological or mechanical prostheses.
Asunto(s)
Bioprótesis , Enfermedades de las Válvulas Cardíacas/cirugía , Prótesis Valvulares Cardíacas , Análisis Actuarial , Adolescente , Adulto , Anciano , Niño , Femenino , Estudios de Seguimiento , Prótesis Valvulares Cardíacas/métodos , Humanos , Masculino , Persona de Mediana Edad , Diseño de Prótesis , Falla de PrótesisRESUMEN
The echocardiographic findings of two unusual cases of malignant uterine tumors that invaded the heart are reported. A woman previously operated on for invasive cervical carcinoma had multiple embolic phenomena and evidence of obstruction to mitral flow. An echocardiogram showed a mass in the left atrium that reached the mitral valve ring. The tumor was implanted in a pulmonary vein and was removed with no complications. Cell type indicated metastatic carcinoma of the cervix. In the second case the patient had a large abdominal mass and precordial manifestations of obstruction and regurgitation of the tricuspid valve. An echocardiogram showed that a mass emanating from the inferior vena cava filled the right atrium and part of the right ventricle. The trajectory of the tumor was followed to its origin in an ovarian vein by tomography. The entire tumor was removed and identified as endometrial stromal sarcoma. An increase in operations with or without radiation therapy for malignant tumors has augmented the frequency of metastatic invasion of the heart; intracavitary extension tends to results from embolization or propagation along great veins. This is the first report of a uterine carcinoma reaching the heart by way of the pulmonary veins and of invasion of the heart by endometrial stromal sarcoma, both with successful excision.
Asunto(s)
Neoplasias Cardíacas/secundario , Neoplasias Uterinas , Adulto , Ecocardiografía , Femenino , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/patología , Humanos , Persona de Mediana Edad , Células Neoplásicas Circulantes/patología , Venas Pulmonares/patología , Radiografía , Sarcoma/diagnóstico por imagen , Sarcoma/patología , Sarcoma/secundario , Neoplasias Uterinas/patología , Vena Cava Inferior/diagnóstico por imagenRESUMEN
We describe a case of uterine leiomyosarcoma with four elongations that, through the vena cava, reached the pulmonary artery, left atrium, and right renal artery respectively. Clinical features suggested congenital pulmonary artery stenosis with pulmonary emboli. Clinical diagnosis was not made in spite of angiography and radionuclide scans. We review the literature on the subject. We also discuss the amenability of surgical correction as well as the mechanisms of the intravenous growth of this type of tumor.