Rare association between giant-cell aortitis and giant-cell aortic valvulitis

ABSTRACT Giant cell arteritis (GCA) is a type of chronic vasculitis that affects medium and large-caliber arteries, frequently related to aortic involvement and, consequently, to aneurysm formation. However, associated valvulitis with giant cells is uncommon. We describe the case of a 50-year-old female patient with aortic aneurysm and valvular insufficiency, whose anatomopathological examination revealed giant-cell aortic valvulitis associated with giant cell aortitis.

Impact of COVID-19 Pandemic in a Brazilian High-Volume Aortic Center

Abstract Introduction: The coronavirus disease 2019 (COVID-19) pandemic brought an unprecedented lack of control of what was to come. The intent of this document is to provide a balance of how much was ceased to be done for patients with aortic disease, to assess the mortality of these patients, and to show what happened to those who became COVID-19 positive during their hospitalization. Methods: From April 1st to July 31st 2020, the worst period of the pandemic in São Paulo, Brazil, the Institute's aortic surgical patients operated on were evaluated and those were compared with patients operated during the same period in 2019. Results: In 2019, 88 surgeries were performed; most of them were elective (66 [75%]), 10 were urgent, and 12 were emergency surgeries. In 2020, during the COVID-19 pandemic, we operated on only 31 patients, being 74.2% non-elective surgeries (P<0,001). There was a higher mortality for patients operated on during the pandemic surge of COVID-19 (P<0,001), but it was not specifically related to infected patients. Conclusion: The COVID-19 pandemic had an impact on surgical volume and outcome of patients with aortic disease, although it did not directly increase mortality.

Fístula coronário-cavitária da artéria coronária circunflexa para o átrio esquerdo como provável etiologia de insuficiência cardíaca: relato de caso / Coronary­cavitary fistula of the circumflex coronary artery to the left atrium as a probable etiology of heart failure: a case report

Fístulas de artérias coronárias têm incidência baixa, sendo diagnosticadas mais frequentemente pelo ecocardiograma ou angiotomografia coronariana, embora a cineangiocoronariografia seja o método padrão-ouro. Têm origem mais comumente na artéria coronária direita, sendo a drenagem para câmaras de baixa pressão o mais habitual. O tratamento pode ser expectante, cirúrgico ou percutâneo. Este relato descreve o caso de uma rara apresentação de insuficiência cardíaca, dada por fístula da coronária circunflexa com drenagem para o átrio esquerdo. (AU)

Coronary artery fistulas have a low incidence and are often diagnosed by echocardiography or coronary computed tomography angiography, although coronary angiography is the gold standard. They commonly originate in the right coronary artery, with drainage to low-pressure chambers being the most frequent finding. Treatment can be expectant, surgical, or percutaneous. This report describes a case of a rare presentation of heart failure due to a fistula of the circumflex coronary artery with drainage into the left atrium. (AU)

Insuficiência cardíaca aguda (ICA) - como avaliar o perfil hemodinâmico e quando internar / Acute heart failure (AHF) - how to evaluate the hemodynamic profile and when to hospitalize

A Insuficiência cardíaca é uma síndrome clínica cuja prevalência vem aumentado nos últimos anos, sendo uma das principais causas de internação no Brasil e no mundo. A apresentação da insuficiência cardíaca aguda compreende dois espectros, quais sejam, insuficiência cardíaca crônica agudizada e insuficiência cardíaca nova e ambas estão associadas a alta morbidade e mortalidade. A primeira abordagem desses pacientes deve ser realizada de maneira sistemática para estabelecer o diagnóstico, classificação hemodinâmica e estratificação de risco para orientar adequadamente as condutas iniciais. A decisão terapêutica imediata é essencial para otimizar o manejo desses pacientes, visando a melhor evolução prognóstica intra e extra-hospitalar

Heart failure is a clinical syndrome that has been increasing over the last few years and is currently one of the main causes of hospitalization in Brazil and in the world. Acute heart failure has two forms of presentation - chronic acute decompensated heart failure and new heart failure, both conditions being associated with high morbidity and mortality. The first approach to these patients should be conducted systematically in order to establish the diagnosis, the hemodynamic classification, and the risk stratification in order to adequately guide the initial conducts. An immediate therapeutic decision is essential to optimize the intra- and extra-hospital management of these patients for better prognostic evolution