RESUMO
Anomalous aortic origin of the left coronary artery from an incorrect aortic sinus has been reported as the second most common causes of sudden cardiac arrest in young athletes. Intramural course of the proximal left coronary artery is considered a high-risk morphology. It is associated with a slit-like ostium and elliptical shape of the proximal artery. In this case, all pre-operative cardiac images demonstrated a round ostium and round luminal shape of the left coronary artery, which suggested no evidence of intramural course. On intraoperative inspection, although the ostium and proximal left coronary artery appeared round, the patient had a long intramural course of the left coronary artery which our surgeons performed a successful unroofing procedure. The post-operative images showed a patent new ostium from the correct aortic sinus. These findings are very unusual and proved that we should not exclude intramural course even in the absence of a slit-like ostium and elliptical shape of the proximal left coronary artery.
Assuntos
Artéria Coronária Esquerda Anormal , Anomalias dos Vasos Coronários , Humanos , Artéria Coronária Esquerda Anormal/complicações , Anomalias dos Vasos Coronários/complicações , Anomalias dos Vasos Coronários/diagnóstico , Anomalias dos Vasos Coronários/cirurgia , Aorta , Morte Súbita Cardíaca/etiologiaRESUMO
Ductus arteriosus aneurysm, a rare and potentially fatal condition, has been reported as a complication after surgical ductus arteriosus closure. Its spontaneous appearance as a septic complication, which was common in the presurgical and preantibiotic era, has been rarely reported in the contemporary literature. Persistence of silent ductus arteriosus in healthy children and adults is a frequent condition that currently has an increasing diagnostic possibility due to the availability of more accurate investigative methods, especially echocardiography. We report the case of a 1-year-old child, in whom no previous heart disease was known, who developed a giant aneurysm of the ductus arteriosus during a staphylococcal infection. This complication appeared after craniotomy for emptying an accidental subdural hematoma. This report associates the persistence of ductus arteriosus with a complication considered rare, which has a rapidly fatal evolution.
Assuntos
Aneurisma Infectado/complicações , Permeabilidade do Canal Arterial/complicações , Infecções Estafilocócicas/complicações , Aneurisma Infectado/diagnóstico , Aneurisma Infectado/cirurgia , Permeabilidade do Canal Arterial/diagnóstico , Permeabilidade do Canal Arterial/microbiologia , Humanos , Lactente , MasculinoRESUMO
Ductus arteriosus aneurysm, a rare and potentially fatal condition, has been reported as a complication after surgical ductus arteriosus closure. Its spontaneous appearance as a septic complication, which was common in the presurgical and preantibiotic era, has been rarely reported in the contemporary literature. Persistence of silent ductus arteriosus in healthy children and adults is a frequent condition that currently has an increasing diagnostic possibility due to the availability of more accurate investigative methods, especially echocardiography. We report the case of a 1-year-old child, in whom no previous heart disease was known, who developed a giant aneurysm of the ductus arteriosus during a staphylococcal infection. This complication appeared after craniotomy for emptying an accidental subdural hematoma. This report associates the persistence of ductus arteriosus with a complication considered rare, which has a rapidly fatal evolution
Assuntos
Humanos , Masculino , Lactente , Aneurisma , Permeabilidade do Canal Arterial , Aneurisma , Permeabilidade do Canal ArterialRESUMO
Objetivos: mensurar os níveis séricos da molécula de adesão intercelular-l, solúvel em condições basais e após exposição ao circuito de circulação extracorpórea, em lactentes submetidos à cirurgia cardíaca para correção de defeitos cardíacos congênitos. Métodos: estudo de coorte contemporâneo envolvendo 21 lactentes submetidos à cirurgia cardíaca com uso de circulação extracorpórea. Foram medidos os níveis séricos da molécula de adesão intercelular-l, solúvel na indução anestésica, ao término e 8 e 26 horas após o término da circulação extracorpórea. As amostras foram dosadas através do método de ELISA.Resultados: as patologias cardíacas congênitas mais comuns foram defeito do septo atrioventricular e Tetralogia de Fallot. As médias de idade e de peso foram 6,6 meses e 5,8 quilos. As medianas dos tempos de circulação extracorpórea e de clampeamento da aorta foram, respectivamente, 87 e 53 minutos. Todos os lactentes utilizaram inotrópicos. As medianas dos tempos de intubação e de internação foram 72 horas e 21 dias. A taxa de mortalidade dos pacientes foi de 9,5por cento. Os níveis basais da molécula avaliada foram mais elevados do que aqueles considerados normais (pAssuntos
Humanos
, Masculino
, Feminino
, Lactente
, Moléculas de Adesão Celular
, Circulação Extracorpórea
, Cirurgia Torácica
RESUMO
OBJECTIVE: To measure the intercellular adhesion molecule-1 serum levels at baseline and after cardiopulmonary bypass exposure in infants undergoing surgery of congenital heart disease. METHODS: Contemporary cohort study, which consisted of 21 infants undergoing cardiac surgery with cardiopulmonary bypass. The intercellular adhesion molecule-1 serum levels were measured at induction of anesthesia, at the end of cardiopulmonary bypass, and 8 hours and 26 hours after cardiopulmonary bypass. The samples were measured using ELISA. RESULTS: Atrioventricular septal defects and tetralogy of Fallot were the most common congenital cardiac pathologies. The age and weight mean values were 6.6 months and 5.8 Kg. The median values of cardiopulmonary bypass time and aortic cross-clamping time were 87 minutes and 53 minutes. All infants used inotropic drugs. The median values of intubation time and length of stay were 72 hours and 21 days. The patients' mortality rate was 9.5%. The baseline levels of the molecule were higher than the normal values (P<0.0001). The levels of the molecule significantly decreased at the end of the cardiopulmonary bypass (P<0.001), significantly increasing 8 hours after that period (P<0.005), without reaching baseline values 26 hours after that. CONCLUSIONS: The soluble intercellular adhesion molecule-1 baseline serum level is higher than normal in infants presenting congenital cardiac defects. This molecule serum levels vary after cardiopulmonary bypass exposure, presenting a characteristic behavior in these patients.
RESUMO
Apresenta-se um caso de Disostose Cleido-cranial em um neonato, enfatizando a importância do diagnóstico precoce e acompanhamento destes pacientes necessários para um manejo ortopédico e odontológico adequados, bem como para um oportuno aconselhamento genético. Foi realizada revisäo da literatura dos anos de 1980 a 1985
Assuntos
Recém-Nascido , Humanos , Masculino , Displasia Cleidocraniana/diagnósticoRESUMO
O trabalho descreve a experiência de um mês em um posto de saúde Colombiano, e objetiva a troca de informaçöes entre modelos de promoçäo da saúde nos países latino-americanos
Assuntos
Humanos , Centros Comunitários de Saúde/organização & administração , Promoção da Saúde , Pesquisa sobre Serviços de Saúde , ColômbiaRESUMO
Apresenta-se um caso de Síndrome de Treacher-Collins, enfatizando-se a importância do diagnóstico precoce desta patologia e da necessidade de acompanhamento destes pacientes, com a finalidade de detectar distúrbios auditivos capazes de alterar o desenvolvimento neuropsicomotor e social. A literatura mostra-se pobre pela raridade de ocorrência