Assuntos
Coração/fisiopatologia , Leucemia/terapia , Transplante de Células-Tronco , Adolescente , Adulto , Idoso , Pressão Sanguínea , Diástole , Ecocardiografia , Feminino , Humanos , Leucemia/diagnóstico , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Sístole , Fatores de Tempo , Transplante Homólogo , Resultado do Tratamento , Função Ventricular Esquerda , Adulto JovemRESUMO
Preoperative cardiac evaluation of patients undergoing liver transplantation is not well established. Stress testing is used in many centers, and clinical guidelines suggest its use. However, the specificity and sensibility of stress echocardiography to predict coronary lesions have been very low in some studies. Moreover, it has a low positive predictive value to predict complications after liver transplantation. We retrospectively analyzed 143 patients who underwent liver transplantation in our center and report our experience in the use of stress echocardiography. We describe cardiac complications during and after liver transplantation. Low prevalence of ischemic heart disease in asymptomatic patients undergoing liver transplantation make stress testing useless in risk stratification because it has a low positive predictive value. So the risk stratification of these patients before liver transplant surgery remains a challenge.
Assuntos
Doença da Artéria Coronariana/diagnóstico , Ecocardiografia sob Estresse/métodos , Transplante de Fígado/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Cuidados Pré-Operatórios/métodos , Idoso , Doença da Artéria Coronariana/etiologia , Teste de Esforço , Feminino , Humanos , Transplante de Fígado/métodos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e EspecificidadeRESUMO
Aneurysms of the membranous ventricular septum can exceptionally produce subpulmonary obstruction. We report two patients, an 8-year-old and a 2-year-old respectively, with a perimembranous ventricular septal defect and subpulmonic stenosis caused by an aneurysm of the membranous septum. Diagnosis was made by Doppler two-dimensional echocardiography and was confirmed by cardiac catheterization and was surgery. It is shown that this obstruction may appear late due to the growth of the aneurysm. In conclusion, we believe that the appearance of an aneurysm on a ventricular septal defect is not always beneficial, as it may result in right ventricular outflow tract obstruction or other kinds of complications which may require cardiac surgery.