RESUMO
After the popularization of transcatheter aortic valve-in-valve replacement, mitral valve-in-valve is being increasingly performed for failing bioprostheses or annuloplasty rings. In the tricuspid position, despite smaller experience, valve-in-valve is also becoming an alternative to high-risk redo tricuspid surgery. We report the case of a patient with 2 failing mitral and tricuspid bioprostheses who was successfully treated with simultaneous transapical mitral and percutaneous transjugular tricuspid transcatheter valve-in-valve replacements.
Assuntos
Bioprótese , Doenças das Valvas Cardíacas/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Próteses Valvulares Cardíacas , Valva Mitral/cirurgia , Valva Tricúspide/cirurgia , Idoso , Feminino , Doenças das Valvas Cardíacas/diagnóstico por imagem , Doenças das Valvas Cardíacas/etiologia , Humanos , Falha de Prótese , ReoperaçãoRESUMO
BACKGROUND: The surgical treatment for complex forms of d-transposition of the great arteries associated with ventricular septal defect and left ventricular outflow tract obstruction remains controversial. In this study, we describe the classical surgical options - namely, the Rastelli procedure and the "réparation à l'étage ventriculaire" - and present our experience with the modified Nikaidoh procedure with early and short-term follow-up results. METHODS: Between 2007 and 2014, four patients with d-transposition of the great arteries associated with ventricular septal defect and left ventricular outflow tract obstruction underwent surgical repair at our institution by means of a modified Nikaidoh procedure. RESULTS: With a mean follow-up of 4.5 years, survival was 100%, and none of the patients required re-intervention or mechanical circulatory support. There was no recurrence of left ventricular outflow tract obstruction and no aortic valve regurgitation classified as more than mild. Left ventricular function was preserved. CONCLUSIONS: Aortic translocation with the modified Nikaidoh procedure is a safe and effective surgical treatment for certain complex forms of transposition of the great arteries, particularly those associated with ventricular septal defect and left ventricular outflow tract obstruction. It is associated with less need for re-intervention and better morbidity and mortality results in the short- and mid-term follow-up, when compared with the classical alternatives such as the Rastelli procedure.
Assuntos
Transposição das Grandes Artérias/métodos , Comunicação Interventricular/cirurgia , Transposição dos Grandes Vasos/cirurgia , Obstrução do Fluxo Ventricular Externo/cirurgia , Aorta/cirurgia , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Espanha , Resultado do TratamentoRESUMO
Entrapment or device loss during percutaneous coronary intervention is a rare but potentially fatal complication. Percutaneous retrieval is possible but surgery can be required on an emergency basis. We present the case of an entrapped balloon catheter in the left anterior descending coronary artery during an elective percutaneous coronary intervention. The patient developed acute myocardial ischaemia and cardiac arrest. Emergency surgical intervention with device retrieval and distal bypass grafting was life-saving.
Assuntos
Catéteres/efeitos adversos , Vasos Coronários/cirurgia , Isquemia Miocárdica/cirurgia , Intervenção Coronária Percutânea/efeitos adversos , Choque Cardiogênico/cirurgia , Idoso , Angiografia Coronária , Vasos Coronários/diagnóstico por imagem , Falha de Equipamento , Humanos , Masculino , Isquemia Miocárdica/diagnóstico , Intervenção Coronária Percutânea/instrumentação , Reoperação , Choque Cardiogênico/etiologiaRESUMO
Exclusion of the left atrial appendage (LAA) may significantly reduce the incidence of stroke associated with atrial fibrillation (AF), since this is the main thrombus source. LAA closure is becoming a therapeutic target for preventing AF-related stroke, attracting much interest in recent years. Different devices are available to provide LAA exclusion during cardiac surgery. We describe herein our experience with the recently introduced TigerPaw II system for LAA exclusion, and report a high prevalence of device malfunction. Design improvements may address these issues and increase safety for new technological devices designed for surgical LAA closure.
Assuntos
Apêndice Atrial/cirurgia , Fibrilação Atrial/complicações , Átrios do Coração/cirurgia , Acidente Vascular Cerebral/prevenção & controle , Tromboembolia/cirurgia , Procedimentos Cirúrgicos Cardíacos , Humanos , Próteses e Implantes , Desenho de Prótese , Acidente Vascular Cerebral/etiologia , Grampeamento Cirúrgico , Tromboembolia/etiologiaRESUMO
The case of an 81-year-old male operated on for an infected false aneurysm of the aortic arch by Mycobacterium bovis (M. bovis) is described. Arch reconstruction with cryopreserved aortic patch was successfully performed under hypothermic circulatory arrest. Antituberculous chemotherapy was given for 12 months and presently the patient is leading a normal life. Vascular infection after bacillus Calmette-Guérin bladder therapy is uncommon and aortic arch involvement near exceptional. This diagnosis has to be considered in patients with such previous urologic interventions.