RESUMO
The finding of a mobile calcific plaque attached to the aortic valve cusp during transcatheter aortic valve implantation (TAVI/TAVR) necessitated utilization of an embolic protection device, for cerebral protection. We report the urgent but successful deployment of such a filter in a patient with a single patent internal carotid artery. Although stroke rates observed in first-generation TAVI trials were higher than those reported following conventional open aortic valve replacement, adjunctive neuroprotective measures, particularly in patients with a large amount of threatened cerebral territory, may minimize potential neurologic injury.
Assuntos
Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Artéria Carótida Interna , Dispositivos de Proteção Embólica , Neuroproteção , Substituição da Valva Aórtica Transcateter/métodos , Idoso de 80 Anos ou mais , Estenose da Valva Aórtica/complicações , Humanos , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/prevenção & controle , Masculino , Placa Aterosclerótica/complicações , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle , Resultado do Tratamento , Grau de Desobstrução VascularRESUMO
Acquired pulmonary stenosis is rare. When it occurs, it usually results from compression of the pulmonary artery or the heart by a mediastinal tumour. As these masses rarely cause compression that results in murmurs, it is hard to make a diagnosis. We describe a 23-year-old female patient who presented with dull, aching chest pain lasting for 6 months. Echocardiography showed a large anterior mediastinal cystic mass compressing the main pulmonary artery. She was operated through a left anterolateral thoracotomy and had an uneventful recovery.
Assuntos
Cisto Dermoide , Cisto Mediastínico , Estenose da Valva Pulmonar , Adulto , Ecocardiografia , Feminino , Humanos , Toracotomia , Adulto JovemRESUMO
We report a case of an elderly man who suffered an acute myocardial infarction (MI) with the complication of a post-MI ventricular septal defect (VSD). Situs inversus with dextrocardia was diagnosed during the course of hospitalization. Total myocardial revascularization was achieved using saphenous vein conduits. The VSD was approached through the right ventricle and repaired with a polytetrafluoroethylene patch. Although several cases of coronary artery bypass grafting (CABG) in the presence of dextrocardia have been reported in the literature, this is the first case of repair of a post-MI VSD along with CABG.