RESUMO
A 58-year-old man was admitted to our institution with sudden onset of hypotension and acute ischemia of left lower extremity. Electrocardiography showed ST segment elevation in leads V1~V6 and a transthoracic echocardiogram revealed antero-septal wall hypokinesis. He was given a diagnosis of acute myocardial infarction caused by left main coronary artery compression due to acute aortic dissection by enhanced computed tomography. We implanted a stent in the left main coronary artery and performed right external iliac-left femoral arterial bypass under general anesthesia. We performed a conventional total arch replacement and frozen elephant trunk and mitral valve repair at day 16. His postoperative course was good. Implantation of a left main trunk stent is an effective strategy for Stanford type A acute aortic dissection with left main coronary arterial occlusion before surgical repair.
Assuntos
Aneurisma Aórtico , Dissecção Aórtica , Infarto do Miocárdio , Dissecção Aórtica/complicações , Dissecção Aórtica/diagnóstico por imagem , Dissecção Aórtica/cirurgia , Aneurisma Aórtico/cirurgia , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/cirurgia , Stents/efeitos adversosRESUMO
True left ventricular aneurysms are thought to arise from the expansion and thinning of the transmural infarct area, whereas false aneurysms result from containment of ventricular rupture by pericardial adhesions. We reported a case of true left ventricular aneurysm with pseudoaneurysm( mixed type aneurysm) which was treated surgically.
Assuntos
Falso Aneurisma/cirurgia , Aneurisma Cardíaco/cirurgia , Idoso , Falso Aneurisma/complicações , Ventrículos do Coração , Humanos , MasculinoRESUMO
We present a rare case of papillary fibroelastoma arising from the pulmonary valve. A 45-year-old man had been suffered from palpitation. Transthoracic echocardiography clearly demonstrated a mobile rounded mass in the right ventricular outflow tract. He underwent surgical extirpation of the tumor. A fragile, yellow tumor on the pulmonary valve was recognized at operation. The pulmonary valve was repaired with autologous pericardium. Operation was performed successfully. The diagnosis as a papillary fibroelastoma was made by histopathological examination. The post-operative course was uneventful and echocardiography showed no residual tumor of the heart.