RESUMO
A positively charged micelle loaded with substrates was transported selectively to the reaction site (cathode) to promote the proximity and localization of the reactants (ester and hydroxide). The guided vehicular delivery coupled with electrolysis allows the hydrolysis of non-activated esters at near physiological pH with significant yields along with recyclability.
Assuntos
Ésteres/química , Sítios de Ligação , Concentração de Íons de Hidrogênio , Hidrólise , Hidróxidos/química , CinéticaRESUMO
The management of giant aneurysms associated with aortic coarctation is challenging. The location, the size of the aneurysm, whether it has ruptured, previous coarctation repair, the presence of stenosis, and the ascending and distal aortic pathology will all influence the treatment approach. With more patients surviving to adulthood after early coarctation repair, a better understanding of the anatomy, pathophysiology, and radiological findings of coarctation-related aneurysms is imperative to providing sound care. We present here our experience with a series of giant aneurysms of the aorta, all with a background of underlying aortic coarctation. We highlight the decision-making process and review current management trends.
Assuntos
Aneurisma Roto/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Coartação Aórtica/cirurgia , Complicações Pós-Operatórias/cirurgia , Adolescente , Adulto , Algoritmos , Anastomose Cirúrgica , Falso Aneurisma/diagnóstico , Falso Aneurisma/cirurgia , Aneurisma Roto/diagnóstico , Angioplastia , Aorta Torácica/anormalidades , Aneurisma da Aorta Torácica/diagnóstico , Coartação Aórtica/diagnóstico , Valva Aórtica/anormalidades , Valva Aórtica/cirurgia , Aortografia , Implante de Prótese Vascular , Ecocardiografia , Falha de Equipamento , Feminino , Seguimentos , Humanos , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Polietilenotereftalatos , Politetrafluoretileno , Complicações Pós-Operatórias/diagnóstico , Reoperação , Stents , ToracotomiaRESUMO
The surgical management of d-transposition of great arteries (d-TGAs) with ventricular septal defect (VSD) and left ventricular outflow tract obstruction (LVOTO) is ever evolving and still remains a challenge because of wide anatomic variability, age of presentation, surgical options available, and their variable long-term results in different series. We describe a patient with d-TGA, VSD, and LVOTO who presented to us at 13 years of age and underwent an arterial switch operation along with neoaortic valve replacement with a mechanical prosthesis. The postoperative course was uneventful, and at hospital discharge, the echocardiogram was satisfactory. We present the pros and cons of this hitherto undescribed treatment option.