RESUMEN
Presented herein is a clinical case report concerning open surgical treatment of an arteriovenous fistula of the renal artery with a large venous aneurysm in the hilum of the right kidney and a giant cyst of the upper pole in a 28-year-old woman. The intraoperative findings revealed disunion of the arteriovenous fistula, followed by edge-to-edge suturing of the arterial defect. The venous aneurysm in the hilum of the right kidney was dissected and sutured by the edge-to-edge technique, with the additional varicose renal vein ligated. The postoperative period turned out to be uneventful with favourable convalescence and no complications. The check MSCT angiography performed 3 months later showed that the venous aneurysm was thrombosed, with no evidence of arterial blood ingress revealed. The excretory function of the kidney was preserved. Also discussed in the article are variants of diagnosis and treatment of an arteriovenous fistula of this localization and complications thereof.
Asunto(s)
Fístula Arteriovenosa/cirugía , Enfermedades Renales Quísticas , Riñón , Procedimientos Quirúrgicos Vasculares/métodos , Adulto , Aneurisma/diagnóstico , Aneurisma/cirugía , Fístula Arteriovenosa/diagnóstico , Fístula Arteriovenosa/etiología , Angiografía por Tomografía Computarizada/métodos , Disección/métodos , Femenino , Humanos , Riñón/irrigación sanguínea , Riñón/diagnóstico por imagen , Riñón/cirugía , Enfermedades Renales Quísticas/diagnóstico , Enfermedades Renales Quísticas/etiología , Enfermedades Renales Quísticas/fisiopatología , Enfermedades Renales Quísticas/cirugía , Arteria Renal/diagnóstico por imagen , Arteria Renal/patología , Arteria Renal/cirugía , Venas Renales/diagnóstico por imagen , Venas Renales/patología , Venas Renales/cirugía , Resultado del TratamientoRESUMEN
Surgical treatment of stenosis of the left main coronary artery (LMCA) is a special problem, a number of questions of surgical strategy for this lesion still remain unsolved. The question of direct plasty dilatation of LMCA has not lost its actuality. Operations were made on 6 patients in whom direct plasty dilatation of LMCA with a flap from autopericardium was performed for local, not lengthy constriction which was located in the initial and middle part of LMCA. The operations were made under conditions of extracorporeal circulation, moderate general hypothermia (about 32 degrees C), pharmacohypothermic cardioplagia with external cooling of the heart. In all cases there was good restoration of cardiac activity and the absence of myocardium ischemia at the postoperative period. The restoration of the anatomical lumen of LMCA by this method facilitated sufficient blood flow along LMCA. Five years later all the patients are alive, one patient has external angina of the 11 functional class.
