RESUMEN
Cardiac allograft vasculopathy is the leading cause of death after the first year of transplantation. Treatment outcomes with medication, balloon angioplasty, bypass surgery, and retransplantation have been disappointing. We present our initial experience with stenting of the left main coronary artery in the setting of allograft vasculopathy.
Asunto(s)
Angioplastia Coronaria con Balón/métodos , Enfermedad Coronaria/etiología , Enfermedad Coronaria/cirugía , Trasplante de Corazón/efectos adversos , Revascularización Miocárdica/métodos , Stents , Anticoagulantes/uso terapéutico , Angiografía Coronaria , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trasplante Homólogo/efectos adversosRESUMEN
Management of anticoagulation in patients with heparin-induced thrombocytopenia (HIT) undergoing surgery requiring cardiopulmonary bypass (CPB), such as cardiac transplantation, represents a difficult clinical problem and no clear management strategy exists. The cases of 2 patients with HIT who underwent cardiac transplantation using differing anticoagulation strategies are presented with a discussion of potential advantages and pitfalls of each approach used.
Asunto(s)
Anticoagulantes/uso terapéutico , Trasplante de Corazón , Heparina/efectos adversos , Trombocitopenia/inducido químicamente , Adulto , Anticoagulantes/efectos adversos , Sulfatos de Condroitina/uso terapéutico , Dermatán Sulfato/uso terapéutico , Resultado Fatal , Femenino , Heparitina Sulfato/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Tiempo de Tromboplastina Parcial , Recuento de Plaquetas , Warfarina/uso terapéuticoRESUMEN
Acute onset dilated cardiomyopathy is a very common presentation encountered by cardiologists in clinical practice, but little is known about the etiology, pathophysiology, definitive diagnosis and management of this syndrome. The vast majority of cases are considered as idiopathic cardiomyopathy, or primary or secondary myocarditis, although rarely definitive diagnoses are obtained after extensive diagnostic procedures. Two scenarios are presented as a basis for a discussion of this challenging syndrome.
Asunto(s)
Cardiomiopatía Dilatada/diagnóstico , Cardiomiopatía Dilatada/etiología , Cardiomiopatía Dilatada/terapia , Enfermedad Aguda , Adulto , Algoritmos , Antiinflamatorios/uso terapéutico , Biopsia , Cateterismo Cardíaco , Cardiomiopatía Dilatada/diagnóstico por imagen , Cardiomiopatía Dilatada/microbiología , Cardiomiopatía Dilatada/fisiopatología , Fármacos Cardiovasculares/uso terapéutico , Árboles de Decisión , Diagnóstico Diferencial , Ecocardiografía , Electrocardiografía , Electrocardiografía Ambulatoria , Femenino , Humanos , Masculino , CintigrafíaRESUMEN
The authors report the case of a 31-year-old asymptomatic male who, following investigations for cardiac murmur, was found to have congenitally corrected (status solitus of the atria, left looping of the ventricles, leftward aorta in relation to the pulmonary artery [S,L,L]) transposition of the great vessels with significant right-sided ventricular outflow tract obstruction due to a large aneurysm of the membranous ventricular septum. Diagnosis was made with transesophageal echocardiography and confirmed during corrective surgery. The authors review the literature with regard to aneurysms of the membranous ventricular septum and their association with congenital heart disease, and they discuss the use of noninvasive tests aiding the diagnosis.