Assuntos
Insuficiência da Valva Aórtica/diagnóstico por imagem , Angiografia Coronária/efeitos adversos , Doença da Artéria Coronariana/diagnóstico por imagem , Ecocardiografia Transesofagiana , Traumatismos Cardíacos/diagnóstico por imagem , Idoso , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/lesões , Insuficiência da Valva Aórtica/etiologia , Insuficiência da Valva Aórtica/cirurgia , Bioprótese , Ponte de Artéria Coronária , Doença da Artéria Coronariana/cirurgia , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/cirurgia , Próteses Valvulares Cardíacas , Implante de Prótese de Valva Cardíaca/instrumentação , Humanos , Lacerações , Masculino , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Percutaneous device closure of patent foramen ovale (PFO) has become an effective and safe alternative to medical or surgery treatment. Transesophageal echocardiography (TEE), as commonly used to guide this procedure, has the limitation to require general anesthesia. Recently, intracardiac echocardiography (ICE) with AcuNav probe was used to guide percutaneous PFO closure. We report a 42 year-old man with two previous cryptogenetic strokes in whom both diagnosis and guidance of PFO closure were performed by means of TEE using the AcuNav catheter introduced through nasal way (TEENW). This technique, that does not require general anesthesia, provided adequate and complete view of the Amplatzer procedure. TEENW might offer a feasible and equivalent echocardiographic alternative either to standard TEE or ICE as a guide to percutaneous PFO closure.
Assuntos
Oclusão com Balão , Ecocardiografia Transesofagiana , Comunicação Interatrial/diagnóstico por imagem , Comunicação Interatrial/terapia , Nariz , Adulto , Oclusão com Balão/instrumentação , Cateterismo Cardíaco/instrumentação , Comunicação Interatrial/complicações , Humanos , Masculino , Acidente Vascular Cerebral/etiologiaRESUMO
The ability of trimetazidine (2,3,4, trimethoxybenzylpiperazine dihydrochloride, TMZ) to protect the myocardium against anthracycline (ANT)-induced cardiotoxicity during chemotherapy has been evaluated in female patients with breast cancer. A clinical trial was conducted in 61 patients subdivided into three groups: group 1 (n = 15, G1 ) treated with standard ANT protocol and cardioprotection by dexrazoxane (DEX) plus TMZ (60 mg, daily dose); group 2 (n = 22, G2) treated with ANT and cardioprotection by TMZ only; and group 3 (n = 24, G3) scheduled to receive ANT therapy and DEX. All the patients submitted to an echocardiographic evaluation of diastolic function (E wave velocity, A wave velocity, isovolumetric relaxation time [IVRT], deceleration time [DT]) at enrollment (T0), at T1 time, at T2 time, and at T3 time. After a 12-month follow-up period, the patients showed a good conservation of diastolic function both in G1 and G2 groups. No statistically significant difference was observed in E wave and A wave velocity and E/A ratio after ANT treatment. TMZ produced a cardioprotective effect, comparable to DEX protection, against subacute and chronic subclinical cardiotoxicity with no significant changes in diastolic function after 1 year of follow-up.