RESUMO
BACKGROUND: A newborn was diagnosed by echocardiogram with an asymptomatic cardiac mass in the right ventricle after a systolic cardiac murmur was detected at birth. CASE PRESENTATION: Nine days after birth, the newborn presented with three syncopal episodes and oxygen desaturation which required resuscitation. The mass induced a complete right ventricular outflow tract obstruction. The presence of a patent foramen oval and a patent ductus arteriosus explained the absence of symptoms at birth. Surgery was rapidly considered since the situation was life threatening. The tumor was successfully resected. The mass was a mature teratoma confirmed by microscopic examination, illustrated by pictures and video. CONCLUSIONS: This case was unique because of the absence of symptoms in the first 9 days of the newborn's life even though symptoms should have mounted due to the obstruction postpartum. The delay was correlated to the closure of the patent ductus arteriosus. It is recommended that newborns with any cardiac mass be followed up regularly due to hemodynamic changes at birth.
Assuntos
Neoplasias Cardíacas/diagnóstico , Ventrículos do Coração/patologia , Teratoma/diagnóstico , Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia/métodos , Feminino , Cardiopatias Congênitas/complicações , Cardiopatias Congênitas/cirurgia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/cirurgia , Hemodinâmica , Humanos , Recém-Nascido , Teratoma/complicações , Teratoma/cirurgiaRESUMO
A 78-year-old patient with ochronosis has developed symptomatic aortic stenosis. He has undergone an aortic valve replacement that was highly complicated by a severe aortic calcification. The right coronary artery was sacrificed and bypassed in order to control a massive aortic root haemorrhage. The patient has presented a sternal dehiscence that required surgical revision. The sternal frailty was related to chronic corticotherapy in a patient with chronic spondylarthrosis. Cardiac ochronosis in the elderly may be associated to surgical complications related to severe aortic root calcifications and chronic corticotherapy for arthropathies.