RESUMO
We report a case of huge aortic root aneurysm 19 years after aortic valve replacement. A 58-year-old woman was referred to us for aortic root dilatation. She underwent aortic valve replacement with mechanical valve due to severe aortic regurgitation of tricuspid aortic valve 19 years ago. We performed graft replacement of aortic root preserving prior mechanical prosthetic valve. Histological examination of aneurysm showed myxomatous change in medial layer. Aortic root dilatation after aortic valve replacement is caused by bicuspid valve, aortic dissection, Marfan syndrome, tissue disorder disease, aortitis, and dilated Valsalva sinus at the time of prior operation. It is important to follow-up a patient for root dilatation after aortic valve replacement.
Assuntos
Aneurisma da Aorta Torácica , Insuficiência da Valva Aórtica , Próteses Valvulares Cardíacas , Seio Aórtico , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/etiologia , Aneurisma da Aorta Torácica/cirurgia , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Insuficiência da Valva Aórtica/diagnóstico por imagem , Insuficiência da Valva Aórtica/etiologia , Insuficiência da Valva Aórtica/cirurgia , Dilatação Patológica/complicações , Dilatação Patológica/patologia , Feminino , Próteses Valvulares Cardíacas/efeitos adversos , Humanos , Pessoa de Meia-Idade , Seio Aórtico/diagnóstico por imagem , Seio Aórtico/cirurgiaRESUMO
A 68-year-old woman with a history of bipolar disorder was admitted to another hospital with a gastric ulcer. On admission, Takotsubo cardiomyopathy was suspected because her electrocardiogram was abnormal and the characteristic left ventricular wall motion was apparent. On hospital day 11, echocardiography revealed a thrombus in the apex of the left ventricle. She was transferred to our hospital and heparin treatment was commenced. On follow-up echocardiography, the left ventricular wall motion had normalized but thrombus mobility had increased. Thrombectomy was performed via a transmitral approach with endoscopic assistance. Endoscopy allowed excellent visualization of the intracardiac structure.
Assuntos
Endoscopia , Cardiomiopatia de Takotsubo/complicações , Trombectomia/métodos , Trombose/cirurgia , Idoso , Ecocardiografia , Feminino , Humanos , Cardiomiopatia de Takotsubo/diagnóstico por imagem , Cardiomiopatia de Takotsubo/fisiopatologia , Trombose/diagnóstico por imagem , Trombose/etiologia , Trombose/fisiopatologia , Resultado do Tratamento , Função Ventricular EsquerdaRESUMO
A new fluorescent europium chelate labeling reagent, 5-(4"-chlorosulfo-1',1"-diphenyl-4'-yl)-1,1,1,2,2-pentafluoro-3,5-pentanedione (CDPP), was synthesized for the time-resolved fluorometric detection of HPLC. The label can be directly bound to amino or phenolic hydroxyl groups of analytes with its chlorosulfonyl group, and the labeled analytes are separated on a HPLC column. After separation, EuCl(3), TOPO (tri-n-octylphosphine oxide), and Triton X-100 were added by post-column introduction to the eluent, and the fluorescence of the europium chelate was measured with the time-resolved fluorometric detector. Estrone (E1), 17beta-estradiol (E2), ethynylestradiol (EE2) and estriol (E3) were measured with the detection limits of 0.65, 0.65, 0.65 and 0.60 ng/ml, respectively. The recovery for river water samples was in the range of 86.0-105.1% with the RSD of 1.9-5.8%. The method was applied to the analysis of a river water sample and estrone (E1) was determined to be 2.1 ng/l. The results and processing have been compared with those of a GC-MS method and a high degree of correlation (r> or =0.98) was observed.