[Late evaluation with spiral computed tomography of smooth bovine pericardium grafts]. / Avaliação tardia por tomografia computadorizada espiral de enxertos de pericárdio bovino liso como substitutos aórticos.

PURPOSE: To evaluate morphologically by spiral computed tomography (SCT) bovine pericardial grafts as aortic substitutes. METHODS: Ten patients were submitted to aortic graft evaluation with SCT. There were 8 ascending and 2 descending grafts. Examination was done after 2 to 7 years post operative. Ages ranged from 49 to 67 years, with 6 male and 4 female patients. All had implanted smooth surface naked pericardial grafts. RESULTS: Surgical result was good in all. Distal dissection persisted in some cases. One had a peri-graft hematoma, 5 had no structural changes and 4 presented mild graft dilatation. There were no graft calcification or pseudoaneurysm. CONCLUSION: Glutaraldehyde preserved naked smooth surface bovine pericardial aortic grafts present satisfactory structural aspect, as seen by SCT, at medium term follow-up. Mild dilatation may be seen in some cases.

Avaliaçäo tardia por tomografia computadorizada espiral de enxertos de pericárdio bovino liso com substitutos aórticos / Late evaluation of bovine pericardium grafts as aortic substitutes by spiral computed tomography

OBJETIVO - Avaliar, morfologicamente, por tomografia computadorizada espiral, enxertos de pericárdio bovino liso empregados como substitutos aórticos. MÉTODOS - Dez pacientes foram submentidos a exame por tomografia computadorizada espiral para reconstituiçäo da imagem dos enxertos. Os critérios de seleçäo foram tempo de seguimento superior a 2 anos, enxertos de pericárdio liso näo revestido, implantados na aorta ascendente ou descendente. RESULTADOS - Os exames demonstram bom resultado cirúrgico em todos os casos, persistindo em alguns, a imagem de dissecçäo aórtica distal à anastomose. Um caso apresentava hematoma entre o enxerto e a parede aórtica, em 5 näo foram encontradas alteraçöes estruturais no pericárdio e, nos demais, foi detectada dilataçäo de grau leve, em relaçäo ao diâmetro descrito do enxerto implantado. Näo foram vistos sinais de calcificaçäo ou pseudoaneurismas. CONCLUSÄO - Os enxertos tubulares de pericárdio bovino liso, näo revestido, apresentam resultados satisfatórios quando empregados como substitutos aórticos. A médio prazo, näo foram detectados anormalidades estruturais relacionadas ao material empregado, pela tomografia computadorizada espiral, exceto dilataçäo em alguns casos.

[Countercurrent aortography by contrast injection into a peripheral artery]. / Aortografía a contracorriente por inyección de contraste en arteria periférica.

Countercurrent aortography performed through left brachial artery in 8 children, aging 27 days to 42 months. Systemic-pulmonary anastomosis was possible to be assessed in 3 out of 4 cases, even in one aging 42 months. Aortic coarctation could be evaluated in another 3 patients. In the last case with a clinical suspection of vascular ring, countercurrent aortography disclosed an anomalous right subclavian artery. We concluded that the procedure is safe and useful to assess some conditions involving thoracic aorta, even in older children.

[Atrio-septostomy using a Rashkind catheter in complete transposition of the great arteries. Immediate and late results]. / Atrioseptostomía con catéter de Rashkind en la transposición completa de las grandes arterias. Resultados inmediatos y tardíos.

Seventy one patients with complete transposition of the great arteries (TGA) who underwent balloon atrial septostomy (BAS) were studied, with the purpose to evaluate its early and late results within the first year of life. Fifty four patients were male (76,1%) and 17 female (23,9%), aged 2 days to 11 months (mean = 2,3 +/- 0,3%), being 46,5% less than 1 month old. Increase in mean aortic oxygen saturation (Ox. Sat.) after BAS was highly significant (p less than 0,001), irrespective of age and morphological features of TGA. Analysis of the group of 55 patients who underwent only BAS during the first year of life showed: mean age in the 13 non-survivors was 3,3 +/- 0,2 months; increase in Ox.Sat. was highly significant in the 42 survivors and not significant in the 13 patients who died; mortality in children with and without patent ductus arteriosus was 23,1% and 23,8%, respectively. Death directly related do BAS occurred in 2 patients (2,8%), without other complications being observed. We conclude that BAS is an effective and low-risk procedure, even in neonates with poor clinical condition. Early response to BAS is predictive of survival in the first year of life.

Cateter venoso central. Posições anômalas e complicações / Central venous catheter. Anomalous positioning and complications

A incidencia de complicacoes decorrentes de ma posicao do cateter foi analizada em 98 pacientes submetidos a 136 puncoes de subclabia. A incidencia de posicoes incorretas foi 31,5% e as complicacoes 16,3%.As complicacoes encontradas nao tiveram relacao com a resistencia a introducao do cateter e sua posicao, correta ou incorreta

Avaliacao radiologica convencional da dupla via de saida do ventriculo direito, da conexao atrio-ventricular univentricular e da drenagem venosa pulmonar anomala total. / Conventional radiologic evaluation of double outlet right ventricule, univentricular atrioventricular conexion and total anomalous pulmonary venous drainage

Os autores apresentam revisao dos sinais radiologicos convencionais mais frequentes na dupla via de saida do ventriculo direito, na conexao atrio-ventricular e na drenagem venosa pulmonar anomala total, enfatizando as diferencas observadas nos diversos subgrupos morfo-funcionais de cada uma dessas cardiopatias