RESUMEN
A 14-year-old male patient with a history of atypical Kawasaki disease at age 2 presents with triple vessel giant coronary aneurysms. Over the last several years, he began experiencing angina and dyspnea on exertion, which was a result of fully occluded right coronary and left circumflex arteries and 90% stenosis in the left anterior descending artery. He underwent off-pump coronary artery bypass using the left and right internal mammary arteries. At 18-month follow-up, there is no evidence of ischemia. Off-pump bypass is a feasible option for surgical management of the stenotic and occlusive complications of Kawasaki disease.
Asunto(s)
Aneurisma Coronario/cirugía , Puente de Arteria Coronaria Off-Pump/métodos , Electrocardiografía/métodos , Síndrome Mucocutáneo Linfonodular/complicaciones , Síndrome Mucocutáneo Linfonodular/diagnóstico por imagen , Calidad de Vida , Adolescente , Angina de Pecho/diagnóstico , Angina de Pecho/etiología , Aneurisma Coronario/diagnóstico por imagen , Aneurisma Coronario/etiología , Disnea/diagnóstico , Disnea/etiología , Estudios de Seguimiento , Humanos , Masculino , Arterias Mamarias/cirugía , Arterias Mamarias/trasplante , Recuperación de la Función , Medición de Riesgo , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
A 20-year-old man was transferred to our institution with multiple penetrating thoracoabdominal wounds from a shotgun. Imaging revealed several retained shotgun pellets, 1 of which appeared to be located in the left atrium. He was asymptomatic from a cardiac standpoint and was first taken to the operating room to manage his multiple abdominal injuries. Neither an intraoperative echocardiogram nor a formal postoperative echocardiogram definitively determined pellet location (myocardium versus chamber). Because of concerns for pellet embolus from left atrial positioning, the patient was returned to the operating room. After placing the patient on cardiopulmonary bypass, the pellet was identified within the wall of the left atrium and was successfully removed without complication.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Armas de Fuego , Lesiones Cardíacas/cirugía , Traumatismo Múltiple/cirugía , Heridas por Arma de Fuego/cirugía , Traumatismos Abdominales/diagnóstico , Traumatismos Abdominales/cirugía , Ecocardiografía Transesofágica/métodos , Estudios de Seguimiento , Cuerpos Extraños/cirugía , Atrios Cardíacos/lesiones , Atrios Cardíacos/cirugía , Lesiones Cardíacas/diagnóstico , Humanos , Puntaje de Gravedad del Traumatismo , Laparotomía/métodos , Imagen por Resonancia Magnética/métodos , Masculino , Traumatismo Múltiple/diagnóstico , Medición de Riesgo , Traumatismos Torácicos/diagnóstico , Traumatismos Torácicos/cirugía , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Heridas por Arma de Fuego/diagnóstico , Adulto JovenRESUMEN
A 24-year-old male pedestrian with situs inversus and dextrocardia was struck by a car and sustained multiple injuries, including a pseudoaneurysm of the proximal descending thoracic aorta. A thoracic endograft was deployed to exclude the blunt aortic injury. We are not aware of any report of endovascular repair of blunt aortic injury in a patient with this congenital finding. A brief review of the literature is also included.
