RESUMO
A case of right ventricular tumor in a 14 year old male is presented. Congestive heart failure and a systolic pulmonary murmur due to right ventricular obstruction were the main symptoms. The diagnosis was confirmed by echocardiogram (M mode) and right ventricular angiography. The surgical treatment was curative and the histological exam revealed a myxoma.
Assuntos
Ecocardiografia , Neoplasias Cardíacas/diagnóstico , Mixoma/diagnóstico , Adolescente , Eletrocardiografia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Ventrículos do Coração , Humanos , Masculino , Mixoma/diagnóstico por imagem , Mixoma/cirurgia , RadiografiaAssuntos
Pré-Escolar , Criança , Adolescente , Humanos , Varizes Esofágicas e Gástricas , Hipertensão PortalRESUMO
Eighty-nine patients were treated surgically for coarctation of the aorta in a period of 16 years. In 79, the operative procedure consisted of excision of the coarcted segment and primary anastomosis; in 7 cases of hypoplastic arch and in 3 of aneurysm of the aorta, some form of aortoplasty utilizing the isthmus and the subclavian artery, or the use of a dacron prosthesis were required. In a group of 33 patients under 2 years, 76% had associated cardiac anomalies and 100% heart failure, which made immediate surgical treatment mandatory with a mortality of 42% and a recoarctation rate of 10.5%. Out of 56 cases over 2 years, 46% had other cardiac malformations; however, a less severe clinical conditions allowed for an elective operation, with a mortality of 1.8% and a recoarctation rate of 1.8%. This experience and the review of the literature support the concept of elective surgical treatment for coarctation of the aorta around the age of 4 years, prior to the occurrence of hypertension or its complications. In the neonate and infant, surgery is justified in the presence of heart failure non-responsive to medical treatment within 24 to 48 hours. A deeper understanding of the pathophysiology of the malformation in the very young and a better perioperative management of neonates, have led to a decline in mortality in recent years.
Assuntos
Anormalidades Múltiplas/cirurgia , Coartação Aórtica/cirurgia , Doenças do Recém-Nascido/cirurgia , Pré-Escolar , Ponte de Artéria Coronária/métodos , Estudos de Avaliação como Assunto , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , México , Complicações Pós-Operatórias , Estudos RetrospectivosRESUMO
Three patients with interruption and seven with hypoplasia of the aortic arch were treated surgically. The subclavian artery and the aortic isthmus were employed for reconstructing the aortic arch in five, and a Dacron prosthesis was used to restore the aortic continuity in five. A ductus arteriosus coexisted in all patients and a ventricular or atrial septal defect in nine. Congestive heart failure and pulmonary hypertension were prominent clinical features, and the role of the ductus and other intracardiac anomalies on their pathogenesis in discussed. Six patients, one with an interrupted and five with a hypoplastic arch survived but three have evidence of either pulmonary vascular disease or significant pulmonary hypertension. Only one patient with hypoplasia of the arch is now considered cured after his ventricular septal defect was closed in a second operation. The analysis of this and other series in the literature indicate a high mortality rate of the conditions; however, early surgical treatment, which is the only effective means to control heart failure and avoid the effects of prolonged pulmonary hypertension, has brought upon a decline in mortality in recent years.