RESUMO
The importance of prompt diagnosis and early stenting of an aortic rupture cannot be overemphasized. We present a case of thoracic aortic rupture in a middle-aged gentleman who had recently suffered coronavirus disease 2019. The case was further complicated by the development of an unexpected spinal epidural hematoma.
RESUMO
Cellular cardiomyoplasty using various types of donor cells is now validated by a large number of experimental studies. We report a case of cellular cardiomyoplasty performed on a beating heart using autologous skeletal myoblasts, thus combining the efficacy of both procedures. Approximately 2.5 g of rectus femoris muscle tissue biopsy was taken from the patient and cultured using a patented procedure to generate human myoblasts. The cell type and the purity of the cell culture were ascertained by immunostaining for human desmin expression. Under direct vision and stabilization with the Octopus III tissue stabilizer, 3.70 x 10(8) myoblasts in 3 ml of the patient's own serum were injected into the myocardium in 20 sites on the anterior wall and near the apex on the posterior wall, in and around the infarcted areas. In this case report, this procedure was found to be a safe and viable option, with improvement in cardiac function.
Assuntos
Cardiomioplastia/métodos , Mioblastos Esqueléticos/transplante , Infarto do Miocárdio/cirurgia , Células Cultivadas , Ponte de Artéria Coronária sem Circulação Extracorpórea , Humanos , Masculino , Pessoa de Meia-Idade , Transplante AutólogoAssuntos
Ponte de Artéria Coronária , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/prevenção & controle , Pericárdio/cirurgia , Enfisema Pulmonar/etiologia , Enfisema Pulmonar/prevenção & controle , Pressão Sanguínea/fisiologia , Ponte Cardiopulmonar , Circulação Coronária/fisiologia , Humanos , Balão Intra-Aórtico , Complicações Intraoperatórias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Contração Miocárdica/fisiologia , Infarto do Miocárdio/fisiopatologia , Infarto do Miocárdio/cirurgia , Pericárdio/fisiopatologia , Enfisema Pulmonar/fisiopatologia , Esterno/cirurgiaRESUMO
Despite recent advances in the prevention and treatment of ischemic heart disease (IHD), treatment of patients with heart failure secondary to myocardial infarction remains a therapeutic challenge. Heart transplantation has emerged as a viable option but is fraught with problems of supply. Mechanical assist devices are extremely expensive and dynamic cardiomyoplasty has shown only limited success in the clinical setting. Recent insights into the pathogenesis of myocardial diseases and the progress made in the field of molecular biology have resulted in the development of new strategies at molecular as well as cellular levels for cardiac muscle repair. One such strategy is to augment ventricular function by means of cellular cardiomyoplasty through intracardiac cell grafting using adult and fetal cardiomyocytes, stem cells, and autologous skeletal myoblasts.