RESUMO
Two cases of catheter-fragment embolism from a peripherical vein into the cardiac cavities and their extraction by means of a modified technique are presented. In the first case, the foreign body was located in the right cavities of the heart and it was extracted employing a modified technique by means of a Pigtail catheter and a Bioptom sequentially introduced percutaneously. In the second case, the embolus was located in the abdominal aorta and was extracted percutaneously with a Fogarty catheter. A review of the literature is made and, owing to the increasing frequency of the use of intravascular catheters, some recommendations are made in order to avoid this kind of complications.
Assuntos
Aorta Abdominal , Cateterismo Cardíaco/efeitos adversos , Cateterismo/efeitos adversos , Corpos Estranhos/terapia , Átrios do Coração , Idoso , Feminino , Migração de Corpo Estranho , Humanos , Masculino , Métodos , Pessoa de Meia-IdadeRESUMO
The results of a prospective study on the incidence of pulmonary thromboembolism and deep leg veins phlebitis in patients with congestive heart failure are presented. Pulmonary thromboembolism was diagnosed by means of pulmonary isotopic scanning and angiography; deep leg veins were studied using conventional and isotopic phlebography. A total incident of 60% for pulmonary thromboembolism and 92% for deep leg veins phlebitis was found, being of little significance the results suggested by clinical signs. ECG, chest X rays and laboratory tests such as arterial PO2, transaminase and lactic dehidrogenases. Among patients with pulmonary thromboembolism, the hospitalization periods were longer and more frequent, the incidence of deep leg veins phlebitis was 100%, mortality was slightly higher and the degree of hemodynamic derrangement was more advanced in patients without pulmonary thromboembolism. The rutinary use of pulmonary scanning and isotopic phlebography for detection of these complications in patients with congestive heart failure is recommended, emphasizing the need for prophylactic anticoagulant treatment in most of these patients.
Assuntos
Insuficiência Cardíaca/complicações , Perna (Membro)/irrigação sanguínea , Embolia Pulmonar/etiologia , Tromboflebite/etiologia , Insuficiência Cardíaca/mortalidade , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/mortalidade , Tromboflebite/diagnóstico , Tromboflebite/mortalidadeRESUMO
Determinations of dp/dt max, Vec and Vmax were made in 20 patients with chronic mitral regurgitation of several degrees. Each of these results was correlated with the corresponding ejection fraction. Only dp/dt max showed adequated correlation and few scattering of individual results, demonstrating its true dependence on the intrinsec contractile state of the left ventricule. Vec. and Vmax. determinations also reflected contractility changes, but their variability and difficult clinical applicability does not allow to recommend its routine utilization in a clinical setting. We could not demonstrate any influence of the valvular lesion on the results of the measured contractility indicators.