RESUMO
BACKGROUND: Tricuspid annuloplasty is the most common surgical approach to correct tricuspid regurgitation (TR). In some patients, however, anterior leaflet patch augmentation may be necessary to optimize tricuspid competence. We reviewed our center cohort over the midterm and long term. METHODS: From January 2013 to August 2018, 424 tricuspid valve procedures were performed, of which 420 were repairs and 4 were replacements. Indications were either isolated severe TR or moderate or greater TR, concomitant with other surgery. In the repair cohort, we identified those that had a patch augmentation, and the database was interrogated for preoperative characteristics. The resulting patients had outpatient assessment (clinical and echocardiography) at 6 weeks and at a later interval. Additionally, a comparison was made between those who had good and poor results (moderate or greater TR or cardiac death). RESULTS: In the repair cohort, 19 patients underwent complex tricuspid valve repair with CorMatrix anterior leaflet augmentation. Preoperative characteristics were as follows: age, 65.5 ± 13.5 years; New York Heart Association (NYHA) class, 3.5 ± 0.5; left ventricular ejection fraction, 48.3% ± 5.9%; tricuspid annular plane systolic excursion, 17.1 ± 3.7 mm; right ventricle (good, mild, moderate, poor), 10, 5, 4, 0; annulus size, 40.9 ± 6.9 mm; mean tethering distance, 1.00 ± 0.3 cm; and mean tethering area, 1.53 ± 1.16 cm2. Mean follow-up was 2.1 ± 1.9 years, and survival at 2 years was 73.8%. There were 2 in-hospital deaths. Mean NYHA class was 1.0 ± 0.5 (6 weeks) and 1.5 ± 0.6 (later follow-up); mean residual TR grade was 0.5 ± 0.6 (6 weeks) and 1.3 ± 1.4 (follow-up). Ten of 13 survivors had a good result at last follow-up (TR 0 to 1). We compared the preoperative and operative data of this group versus those with poor results (TR >1 or cardiac mortality). Significant univariate predictors of poor results were larger preoperative tethering area (1.18 ± 0.43 versus 2.4 ± 1.5 cm2; P = .02), longer tethering distance (0.87 ± 0.21 versus 1.2 ± 0.19 cm; P = .007), or the presence of mild or greater TR at 6 weeks (0.2 ± 0.4 vs 1.25 ± 0.5; P = .03). CONCLUSIONS: CorMatrix anterior leaflet augmentation produces successful, stable repair in the majority of this complex population. The presence of even mild TR at 6 weeks' follow-up predicts a poor result. When the tethering area or the tethering distance is significantly high, replacement is probably a better option.
Assuntos
Anuloplastia da Valva Cardíaca/métodos , Volume Sistólico/fisiologia , Insuficiência da Valva Tricúspide/cirurgia , Valva Tricúspide/cirurgia , Função Ventricular Esquerda/fisiologia , Idoso , Ecocardiografia/métodos , Feminino , Seguimentos , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Valva Tricúspide/diagnóstico por imagem , Insuficiência da Valva Tricúspide/diagnóstico , Insuficiência da Valva Tricúspide/fisiopatologiaRESUMO
While the focus of the medical community is on the management of COVID-19 and its associated complex presentations, it is critical to recognize that patients will continue to present with other medical problems that require urgent therapeutic interventions. There is growing concern that such interventions might have an impact on the natural history of COVID-19. We present a case of a patient who presented with unstable angina and multivessel coronary artery disease for which coronary artery bypass surgery was indicated and performed. Unfortunately, he succumbed to respiratory complications attributed to COVID-19. Our experience suggests concern about adverse outcomes in patients undergoing cardiac surgery who might be infected with COVID-19. Clearly, additional investigations and experience are needed.
Assuntos
Angina Instável/cirurgia , Ponte de Artéria Coronária , Doença da Artéria Coronariana/cirurgia , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Complicações Pós-Operatórias , Betacoronavirus , COVID-19 , Ponte de Artéria Coronária/efeitos adversos , Infecções por Coronavirus/complicações , Humanos , Masculino , Pandemias , Pneumonia Viral/complicações , SARS-CoV-2 , Resultado do TratamentoRESUMO
BACKGROUND: Saphenous vein conduits are still used in a large proportion of coronary artery bypass graft (CABG) operations. A recently commercialized nitinol mesh seems to improve venous graft patency. The aim of this study was to control nitinol mesh vein graft patency in a series of isolated CABG patients by computed tomographic (CT) scan. METHODS: In 25 patients (mean age: 61.0 ± 9.65 years), operated for isolated CABG, the eSVS nitinol mesh (Kips Bay Medical Inc., Minneapolis, Minnesota, United States) was used to wrap one vein graft in each patient. Nitinol mesh vein graft was used to revascularize the right coronary (4 patients; 16%), the posterior descending (18 patients; 72%), and the obtuse marginal (3 patients; 12%) arteries. CT scans were performed at 1, 6, and 12 months postoperatively. RESULTS: The procedure was uneventful in all patients. CT controls showed an overall patency rate of 86.9, 42.7, and 34.1% at 1, 6, and 12 months, respectively. The 4 mm mesh had a significantly higher patency rate at 12 months (83.33%) than the 3.5 mm one which showed quite unsatisfactory results (20%) (p = 0.02). Patients with graft occlusion underwent stress testing which was mildly positive in two cases. One of them underwent a percutaneous revascularization. CONCLUSION: Despite promising early results, use of nitinol mesh for saphenous veins was disappointing in our experience. Further refinements are probably needed.
Assuntos
Ligas , Ponte de Artéria Coronária/instrumentação , Doença da Artéria Coronariana/cirurgia , Veia Safena/transplante , Telas Cirúrgicas , Idoso , Angiografia Coronária/métodos , Ponte de Artéria Coronária/efeitos adversos , Ponte de Artéria Coronária/métodos , Doença da Artéria Coronariana/diagnóstico , Desenho de Equipamento , Feminino , Oclusão de Enxerto Vascular/etiologia , Oclusão de Enxerto Vascular/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Veia Safena/diagnóstico por imagem , Veia Safena/fisiopatologia , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Grau de Desobstrução VascularRESUMO
In the era of direct oral anticoagulants, vitamin K antagonists retain a clinically relevant role in thrombotic disorders. In Italy, approximately 20% of the patients on anticoagulant therapies receives a VKA, in most cases warfarin. The optimal management of this drug is challenging and cannot disregard its intricate and unpredictable pharmacokinetic properties and patient's thrombotic and bleeding risk. Several clinical issues encountered during warfarin treatment are still unanswered and are tentatively addressed by physicians. In this regard, the Italian Federation of Centers for the diagnosis of thrombotic disorders and the Surveillance of the Antithrombotic therapies (FCSA) provides some experience-based good clinical practice's suggestions on the following topics: (1) how to start the anticoagulant treatment with warfarin and warfarin induction regimen; (2) how to manage a subtherapeutic INR value; (3) how to manage a supratherapeutic INR value in asymptomatic patients; and (4) how to manage the association of warfarin with interfering drugs.
Assuntos
Anticoagulantes , Hemorragia , Coeficiente Internacional Normatizado , Trombose , Vitamina K , Varfarina , Humanos , Vitamina K/antagonistas & inibidores , Varfarina/uso terapêutico , Varfarina/efeitos adversos , Anticoagulantes/uso terapêutico , Anticoagulantes/efeitos adversos , Itália/epidemiologia , Trombose/diagnóstico , Trombose/tratamento farmacológico , Trombose/prevenção & controle , Trombose/sangue , Hemorragia/induzido quimicamente , Monitoramento de Medicamentos/métodos , Interações Medicamentosas , Coagulação Sanguínea/efeitos dos fármacos , Fibrinolíticos/uso terapêutico , Fibrinolíticos/efeitos adversosRESUMO
Paraplegia in aortic surgery is due to its impact on spinal cord perfusion whose hemodynamic patterns (SCPHP) are not clearly defined. Detailed morphological analysis of vascular network and collateral network modifications within Monro-Kellie postulate due to the fixed theca confines was performed to identify SCPHP. SCPHP may begin with intraspinal "backflow" (I-BF), that is, hemorrhage from anterior and posterior spinal arteries, backward via the connected anterior and posterior radicular medullary arteries, through the increasing diameter and decreasing resistance of segmental arteries (SAs), off their aortic orifices outside vascular network at 0 operative field pressure. The I-BF blood bypasses both intra- and extraspinal capillary networks and causes depressurization (0 diastolic pressure) and full ischemia of dependent spinal cord. When the occlusion of those SAs orifices arrests I-BF, the hemodynamic pattern of intraspinal "steal" (I-S) may take place. The formerly I-BF blood, in fact, is now variably shared between the fraction maintained in its physiological intraspinal network and that keeping flowing as I-S through the extraspinal capillary network. I-S is, however, counteracted by the extraspinal "steal" from the connected mammary/paraspinous-independent extraspinal feeders, all physically competing for the same room left by the missed physiological SA direct aortic blood inflow. Steal phenomenon evolves within the 120-hour time frame of CNm, whose intraspinal anatomical changes may offer the physical basis within the Monro-Kelly postulate, respectively of the intraoperative and postoperative paraplegia. The current procedures could not prevent the unphysiological SCPHP but awareness of details of their various features may offer the basis for improvements tailored, to the adopted intra- and postoperative procedures.
RESUMO
AIMS: The aim of this study was to assess the performance of a self-expanding valve in bicuspid aortic valve (BAV) stenosis. METHODS AND RESULTS: An international registry included a total of 712 patients with aortic stenosis treated with the ACURATE neo in bicuspid (n=54; 7.5%) or tricuspid (n=658; 92.4%) anatomy. The overall mean age was 81±5.6 years. At baseline, no significant differences were found between the two groups. BAV more frequently required both predilatation (94.4% vs. 78.1%, p=0.004) and post-dilation (57.4% vs. 38.7%, p=0.007). Moderate perivalvular regurgitation was more frequently found in patients with BAV (7.4% vs. 3.18%, p=0.0001). After propensity score matching (PSM), the rate of predilation and post-dilation was confirmed to be higher in the BAV group (94.4% vs. 66.6%, p=0.001, and 57.4% vs. 37.1%, p=0.034, respectively), while the incidence of moderate perivalvular regurgitation was similar between the two groups (BAV 3.1% vs. 5.5% in tricuspid anatomy, p=0.734). In unmatched cohorts, the 30-day outcome showed a higher rate of stroke in the BAV group (7.4% vs. 1.8%, p=0.001). After adjustment for PSM quintiles, the rate of stroke resulted in being similar (odds ratioadj 1.20, 95% confidence interval [CI]: 0.81-1.76, p=0.819). The other 30-day clinical endpoints were similar between the two populations. CONCLUSIONS: This preliminary analysis shows that the use of the ACURATE neo in bicuspid aortic valves is feasible and has acceptable 30-day outcomes. Larger studies are needed to confirm our preliminary findings.
Assuntos
Estenose da Valva Aórtica , Substituição da Valva Aórtica Transcateter , Idoso , Idoso de 80 Anos ou mais , Valva Aórtica , Dente Pré-Molar , Humanos , Resultado do TratamentoRESUMO
BACKGROUND: Aortic valve stenosis is the most common valvular disease in the elderly. Transcatheter aortic valve implantation represents a viable alternative to conventional aortic valve replacement. In our Department, the transapical approach is the preferred method in patients with severe peripheral vascular disease. The aim of this study was to analyze the early and midterm results of Symetis Acurate TA implantation in our series. METHODS: From June 2013 to January 2017, 21 patients with severe peripheral vascular disease (11 male, mean age 78 ± 2.8 years) underwent transapical implantation of the Symetis Acurate TA device. Mean logistic EuroSCORE I was 21.9 ± 8.6, mean left ventricular ejection fraction was 51.9 ± 12.2%, and mean aortic gradient was 46.7 ± 12.3 mmHg. Valve implantation was performed through a left anterior minithoracotomy. Patients were followed up on a regular basis. Cardiac echocardiographic assessment was performed at 6 months post-implantation. RESULTS: Valve implantation was successful in all patients. Valve sizes were as follows: 7 size S, 6 size M, and 8 size L. Two patients died before hospital discharge (9.5%). Among survivors, 2 patients showed more than mild aortic regurgitation at discharge. Mean aortic gradient was 13.1 ± 4.3 mmHg (p<0.01). Median follow-up was 11.3 months. Mean NYHA class at follow-up was 1.9 ± 0.4 (p<0.05). Mean actuarial survival was 80%. CONCLUSIONS: Our series, even if small, demonstrates that transapical implantation of the Symetis Acurate TA device represents a viable solution in patients with severe peripheral vascular disease carrying a high operative risk. The relatively high operative mortality may be attributable to the learning curve of our team.
Assuntos
Estenose da Valva Aórtica/complicações , Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Próteses Valvulares Cardíacas , Doenças Vasculares/complicações , Idoso , Feminino , Humanos , Masculino , Desenho de Prótese , Medição de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do TratamentoRESUMO
A rare case of systolic anterior motion (SAM) after mitral valve repair is described. A temporary postoperative left ventricular (LV) dysfunction protected against this complication during the early postoperative period. Only on day 9 postoperatively did the left ventricle recover and SAM develop, with significant obstruction of the LV outflow tract. Subsequently, mitral valve replacement was required. This case demonstrates the importance of the LV geometrical relationships that predispose to this complication.
Assuntos
Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Movimento (Física) , Complicações Pós-Operatórias/etiologia , Sístole/fisiologia , Obstrução do Fluxo Ventricular Externo/cirurgia , Idoso , Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia , Ecocardiografia Transesofagiana , Seguimentos , Implante de Prótese de Valva Cardíaca , Humanos , Tempo de Internação , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiopatologia , Prolapso da Valva Mitral/fisiopatologia , Prolapso da Valva Mitral/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagem , Reoperação , Fatores de Tempo , Resultado do Tratamento , Obstrução do Fluxo Ventricular Externo/diagnóstico por imagem , Obstrução do Fluxo Ventricular Externo/etiologiaAssuntos
Aneurisma Cardíaco/diagnóstico por imagem , Ruptura Cardíaca/diagnóstico por imagem , Implante de Prótese de Valva Cardíaca/efeitos adversos , Estenose da Valva Mitral/cirurgia , Tomografia Computadorizada Multidetectores , Idoso , Feminino , Aneurisma Cardíaco/etiologia , Aneurisma Cardíaco/cirurgia , Ruptura Cardíaca/etiologia , Ruptura Cardíaca/cirurgia , Ventrículos do Coração , Humanos , Estenose da Valva Mitral/etiologia , Cardiopatia Reumática/complicaçõesRESUMO
Primary cardiac paragangliomas are extremely rare. Recently this neoplasm has been associated with a familiar syndrome as a result of mutation of genes that encode proteins in the mitochondrial complex II. We report a case of a 46-year-old woman having cases of vertebral paraganglioma in her family showing an unusual anatomic and clinical presentation of cardiac paraganglioma and expressing a genetic mutation never associated before with cardiac localization of this neoplasm.
Assuntos
Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Procedimentos Cirúrgicos Cardíacos/métodos , Neoplasias Cardíacas/cirurgia , Paraganglioma Extrassuprarrenal/cirurgia , Tomografia por Emissão de Pósitrons/métodos , Succinato Desidrogenase/genética , Neoplasias das Glândulas Suprarrenais/genética , Neoplasias das Glândulas Suprarrenais/cirurgia , Ponte Cardiopulmonar/métodos , Feminino , Átrios do Coração , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/genética , Humanos , Imagem Cinética por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Paraganglioma Extrassuprarrenal/diagnóstico por imagem , Paraganglioma Extrassuprarrenal/genética , Linhagem , Feocromocitoma/complicações , Feocromocitoma/diagnóstico por imagem , Feocromocitoma/genética , Doenças Raras , Medição de Risco , Esternotomia/métodos , Síndrome , Resultado do TratamentoRESUMO
AIMS: Transcatheter aortic valve implantation (TAVI) is increasingly considered as a viable alternative to conventional aortic valve replacement (AVR) in high-risk patients. Long-term results, however, are still scarce and medical community hesitates in enlarging indications to lower-risk patients. Moreover, available devices are expensive and a strict potential candidate selection is necessary. METHODS: From April 2008 to August 2012, a total of 212 patients, originally referred for percutaneous treatment, were thoroughly evaluated by the aortic team of our department in order to choose the optimal procedure. Of them, 55 patients (35 women; 20 men) were considered as still acceptable candidates for conventional AVR. RESULTS: Mean age was 80.7â±â4.7 years; mean additive and logistic Euroscore I were 9.7â±â1.8 and 17.8â±â9.5%, respectively. Mean Euroscore II was 7.9â±â5.5%. Mean New York Heart Association class was 2.9â±â0.5. The majority of patients (87.2%) presented a geriatric frailty score of 0-1. Four patients showed a heavily calcified ascending aorta, and five patients (9%) underwent reoperations. Hospital mortality was 10.9% (six patients). Mean follow-up was 535.9â±â407.4 days (range: 6-1365 days). Six other patients died during this period for a mean survival of 74.4â±â6.9% at 2 years. Mean New York Heart Association class at 1 year was 1.25â±â0.5 (Pâ<â0.01 vs. preoperative value). CONCLUSION: AVR should be indicated with caution in high-risk patients originally referred for TAVI. Despite medium-term results being good, with excellent functional status, hospital mortality is not negligible.
Assuntos
Estenose da Valva Aórtica/mortalidade , Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Substituição da Valva Aórtica Transcateter/efeitos adversos , Substituição da Valva Aórtica Transcateter/mortalidade , Idoso , Idoso de 80 Anos ou mais , Valva Aórtica/patologia , Estenose da Valva Aórtica/fisiopatologia , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Seleção de Pacientes , Reoperação/estatística & dados numéricos , Medição de Risco/métodos , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Substituição da Valva Aórtica Transcateter/métodos , Resultado do TratamentoRESUMO
Takayasu's arteritis (TA) is a chronic large vessel vasculitis, first described in 1908 by the Japanese ophthalmologist Takayasu, affecting more frequently young women. The typical lesions represented by aneurysmatic dilatation or obliteration, and narrowing of the arterial lumen may pose technical difficulties as well as demanding decision making for treatment. Since Jarvell first described aortic regurgitation in TA in 1954, unresolved problems still remain for aortic valve replacement, particularly because of the young age of these patients. We report the case of a 28-year-old woman, with a known history of TA, referred to our department.
Assuntos
Valva Aórtica/transplante , Arterite de Takayasu/cirurgia , Adulto , Feminino , Humanos , Procedimentos Cirúrgicos Vasculares/métodosRESUMO
Despite current low overall perioperative mortality, ischemic complications due to coronary artery translocation remain the most unwanted early complication of the arterial switch operation. We describe the case of a boy who underwent, at five days of age, one-stage arterial switch operation for transposition of the great arteries with repair of ventricular septal defect and coarctation of the aorta. Early postoperative course was complicated by severe ischemic left ventricle (LV) dysfunction and development of a ventricular septal aneurysm. At four years of age he underwent successful surgical ventricular restoration associated with implantation of a biventricular pacing, with complete resolution of heart failure symptoms.
Assuntos
Aneurisma Cardíaco/cirurgia , Complicações Pós-Operatórias/cirurgia , Transposição dos Grandes Vasos/cirurgia , Aneurisma Cardíaco/etiologia , Comunicação Interventricular/cirurgia , Humanos , Recém-Nascido , Masculino , Disfunção Ventricular Esquerda/cirurgiaRESUMO
Porcelain aorta represents a serious condition for coronary artery bypass graft operations. Here we describe a simple technique to avoid any aortic manipulation during an off-pump coronary artery bypass graft procedure. The right internal thoracic artery is used as the source of blood inflow for single or sequential venous grafts. We have used this technique with good results in 5 elderly patients with eggshell aorta.
Assuntos
Doenças da Aorta , Calcinose , Ponte de Artéria Coronária/métodos , Doença das Coronárias/cirurgia , Artérias Torácicas/cirurgia , Idoso , Doença das Coronárias/complicações , Humanos , Técnicas de SuturaRESUMO
To reduce the time needed for clamping or circulatory arrest (or both) during substitution of a prosthesis for the thoracic aorta, we developed an expandable device that can be used with any commercially available prosthetic graft to enable sutureless aortic anastomosis. Improvements upon a previous version of the device include the use of nickel-titanium alloy (Nitinol) instead of stainless steel. This, together with an improved wire-looping design, now enables continuous control of diameter, even when the device is in contact with blood. A further improvement consists of 4 metallic hooks on the outer surface, which enable firm fixation to the aortic stump. In March 2001, a 47-year-old man was admitted to our institution for evaluation of left upper-lobe bronchogenic adenocarcinoma that had infiltrated the distal aortic arch and upper descending aorta. Re-staging of the neoplasm ruled out distant metastasis. We resected the infiltrated aortic wall en bloc with the upper lobe. The expandable device enabled the distal anastomosis of the aortic prosthesis to be performed easily, in less than 3 minutes. The main advantages of this device are an easier, quicker anastomosis and the absolute prevention of suture-line hemorrhage (no suture line). The expandable device overcomes the drawbacks of the intraluminal ringed prosthesis used in the past.
Assuntos
Aorta Torácica/cirurgia , Doenças da Aorta/cirurgia , Carcinoma Broncogênico/cirurgia , Neoplasias Pulmonares/cirurgia , Técnicas de Sutura/instrumentação , Anastomose Cirúrgica/instrumentação , Anastomose Cirúrgica/métodos , Aorta Torácica/patologia , Doenças da Aorta/patologia , Carcinoma Broncogênico/patologia , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Invasividade NeoplásicaRESUMO
We present a case of hoarseness in a 68-year-old man with a post-traumatic saccular aortic arch aneurysm, effort dyspnea, and dysphonia. Oropharyngeal examination and flexible nasal endoscopy revealed left vocal fold palsy, with the left fold lying in the paramedian position. On account of these and other findings, we made the diagnosis of Ortner's syndrome. We treated the patient surgically by endoluminal repair with a Dacron patch. The postoperative course was uneventful. No additional procedure was necessary on the vocal folds, since he showed prompt postoperative speech improvement.We believe that an accurate evaluation should be made before switching a patient to endovascular treatment. Our case shows that careful preoperative planning, coupled with the most recent cerebral protection techniques, can enable a safe and straightforward surgical solution to a complex anatomic problem.
Assuntos
Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular , Rouquidão/etiologia , Síndromes de Compressão Nervosa/etiologia , Nervo Laríngeo Recorrente , Lesões do Sistema Vascular/cirurgia , Paralisia das Pregas Vocais/etiologia , Acidentes de Trânsito , Idoso , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/etiologia , Aortografia/métodos , Endoscopia , Rouquidão/diagnóstico , Humanos , Masculino , Síndromes de Compressão Nervosa/diagnóstico , Síndrome , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Lesões do Sistema Vascular/diagnóstico , Lesões do Sistema Vascular/etiologia , Paralisia das Pregas Vocais/diagnósticoRESUMO
Cardiovascular diseases are the leading cause of death in women, and female patients exhibit peculiar features as to symptoms, diagnosis and treatment. This sex difference is also observed in cardiac surgery, with mortality and morbidity being higher in female patients. Whether female gender is an independent variable for mortality still remains controversial. This review summarizes the data available in the literature on cardiac surgery in the female population.
Assuntos
Procedimentos Cirúrgicos Cardíacos/mortalidade , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/cirurgia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/terapia , Feminino , Humanos , Masculino , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Resultado do TratamentoRESUMO
Pulmonary pseudoaneurysms are an uncommon but life-threatening condition of congenital or acquired cause, most commonly involving the branch pulmonary arteries and generally requiring emergent intervention. We describe a case of postoperative main pulmonary artery pseudoaneurysm after a complex aortic arch procedure, in which thoracic computed tomography provided full information for its definition before surgical correction.