ABSTRACT
A 71-year-old man presented to our hospital with sudden-onset epigastric pain. He reported a history of undergoing the following operations : aortic valve replacement for aortic regurgitation 11 years earlier and graft replacement of the ascending aorta for acute type A aortic dissection, 1 year earlier. His systolic blood pressure was 70 mmHg, and computed tomography revealed a pseudoaneurysm of the distal anastomosis of the ascending aorta with a connection to the right pulmonary artery. Cardiopulmonary bypass was established with cannulation of the right axillary artery and the right femoral vein, and systemic cooling was initiated before sternotomy. We identified an area showing 3 cm dehiscence at the distal aortic anastomosis after hypothermic circulatory arrest and selective cerebral perfusion. The ascending aorta was replaced as hemiarch replacement, and the defect in the right pulmonary artery was closed with bovine pericardium. The patient's postoperative course was uneventful, and he was transferred to a rehabilitation hospital on the 22nd postoperative day.
ABSTRACT
El cierre percutáneo de las fístulas coronario-pulmonares con implante de "coils" es eficaz y pueden realizarlo los cardiólogos intervencionistas de adultos. Se presentan tres casos clínicos de cierre percutáneo exitoso de fístulas coronario-pulmonares con implante de "coils".
Percutaneous closure of coronary-pulmonary fistula with "coils" implant is effective and may be accomplished by adult interventional cardiologists. We present three cases of successful percutaneous closure of coronary-pulmonary fistula with implant of "coils".
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Fistula , Arterio-Arterial Fistula , CardiologistsABSTRACT
Objective To discuss the diagnostic value of color Doppler echocardiography in small coronary-to-pulmonary fistula (SCPF) in children. Methods The clinical data of children who were diagnosed CPF by color Doppler echocardiography during 2011-2012 in my hospital were analyzed retrospectively. Results Seventeen cases with CAF including one diagnosed by forensic report and 8 cases diagnosed by AGA. Conclusion The results indicated that SCPF detection rate could be improved largely by observing spraying-up sign experienced in pulmonary artery diastolic combined with rich flow signal of coronary in color Doppler. In addition, it is valuable to diagnose children's SCPF by color Doppler echocardiography.
ABSTRACT
Se describe el estudio de caso de un receptor de autocuidadocon transposición de grandes arterias (TGA) sustentado con lateoría del déficit de autocuidado (DA) de Dorothea Orem, loque permite relacionar la teoría con la práctica de la disciplinade enfermería. Las variables del estudio de caso son los requisitosde autocuidado, desarrollo y desviación de la salud identificandoel déficit y capacidades de autocuidado con la aplicaciónmetodológica del proceso de atención de enfermería(PAE). Está realizado en dos tiempos: primero en el postoperatorioinmediato y segundo en la hospitalización y el egreso. Encada tiempo se valoraron las variables identificándose el déficitde autocuidado y las capacidades, se activó la agencia de enfermeríay se planearon los cuidados, satisfaciendo las respuestashumanas que se presentaron ante una desviación dela salud que alteraron la totalidad de la persona hasta el egresodel hospital a su domicilio con un plan de alta. El objetivodel presente estudio de caso es identificar el estado de salud delagente de autocuidado, los problemas reales y potenciales, elaborardiagnósticos de enfermería a través de las etiquetas de laNorth American Nursing Diagnosis Association (NANDA), establecerplanes para atender y satisfacer las necesidades humanasy determinar las intervenciones específicas de enfermeríapara cubrir dichas necesidades.
The study of case of a receiver of self medication with transpositionof great arteries (TGA) sustained with the theory ofthe Deficit of Self medication (IT GIVES) of Dorothea Oremis described, which allows to relate the theory to the practiceof the infirmary discipline. The variables of the case studyare the requirements of self medication, development and deviationof the health identifying the deficit and capacities ofself medication with the methodologic application of theprocess of infirmary attention (PAE). It is realized in two times:first in post-operative immediate and second momentin the hospitalization and debit. In every time the variableswere valued identifying itself the deficit of self medicationand the capacities, activated the infirmary agency and the careswere planned, satisfying the human answers that appearedbefore a deviation of the health which they alter the totalityof the person until the debit from the hospital to hisaddress with a discharge plan. The objective of the presentstudy of case is to identify the state of health of the self medicationagent, the real and potential problems of health, toestablish diagnoses of infirmary through the labels of NorthAmerican Nursing Diagnosis Association (NANDA), to establishplans to take care of and to satisfy the human needsand to determine the specific interventions of infirmary tocover these needs.
Subject(s)
Humans , Nursing Care/methods , Nursing Care , Surgical Procedures, Operative/nursing , Self Care , Heart Diseases/surgery , Heart Diseases/nursingABSTRACT
A communication between the coronary and pulmonary arteries, so called coronary to pulmonary fistula, is a rare source of pulmonary supply in pulmonary atresia (PA) with ventricular septal defect (VSD). A 4 year old girl referred to National Cardiovascular Center Harapan Kita, Jakarta with symptoms and signs of increased pulmonary blood flow since infancy and was confirmed by the chest x-rays. Heart examination revealed normal first heart sound with single loud second heart sound and an ejection systolic murmur at the pulmonary area. ECG demonstrated sinus rhythm with normal axis and biventricular hypertrophy. Echocardiography was performed and truncus arteriosus (TA) type I was suspected with perimembranus VSD, overriding of the aorta, and dilated main pulmonary artery. But on cardiac catheterization studies, a non obstructive fistula was found between the left coronary and main pulmonary artery coexisted with PA and VSD. A successful surgery was performed subsequently and confirmed the above diagnosis. Although there were episodes of pulmonary hypertension crisis during early post operative course, she was then discharge from the hospital in a good condition. Since irreversible pulmonary vascular disease may develop in a non restrictive coronary to pulmonary fistula, early recognition of this anomaly is very important for better surgical result.
Subject(s)
Pulmonary Artery , Heart Septal Defects, Ventricular , Pulmonary AtresiaABSTRACT
Among the late postoperative complications of the acute dissection of aorta, the fistula between dilated distal aorta and pulmonary parenchym is so rare that only few case have been reported sporadically. Although the aortopulmonary fistula is one of a fatal condition that needs prompt surgical intervention, with an appropriate management it is well controllable condition. Early diagnosis and urgent surgical intervention is the only way to prevent catastrophic hemorrhage. We experienced a surgical management of aortoplumonary fistula which occurred between upper lobe of the left lung and distal aortic dilatation of previous aortic bypass graft which was performed for Debakey type I acute aortic dissection.