RESUMO
We describe a case of Carney complex (CNC), a rare hereditary condition, that resulted in the development of cardiac myxomas. We would like to emphasize that we detected the first myxomas in both ventricles, followed by the second myxoma in the right atrium, although cardiac myxomas often originate in the left atrium. We highlight the heightened risk of recurrence and emphasize the importance of performing regular ultrasonic cardiac echography to preclude such outcomes.
Assuntos
Complexo de Carney/cirurgia , Neoplasias Cardíacas/cirurgia , Mixoma/cirurgia , Recidiva Local de Neoplasia/diagnóstico , Complexo de Carney/diagnóstico , Ecocardiografia , Feminino , Átrios do Coração , Neoplasias Cardíacas/diagnóstico , Ventrículos do Coração , Humanos , Pessoa de Meia-Idade , Mixoma/diagnóstico , Doenças Raras , Tomografia Computadorizada por Raios XRESUMO
We applied cardiac resynchronization therapy with an implantable cardioverter-defibrillator( CRT-D) and with concomitant cardiac surgery to 2 patients with left ventricular (LV) systolic dysfunction and dyssynchronous ventricular activation. A patient had severe ischemic dilated cardiomyopathy with coronary artery aneurysms (LV ejection fraction 12%, LV diastolic dimension 81 mm, LV systolic dimension 75 mm and atrial fibrillation, with complete left bundle branch block). Another patient had severe dilated cardiomyopathy with mitral valve regurgitation (LV ejection fraction 25%, LV diastolic dimension 75 mm, LV systolic dimension 61 mm atrial fibrillation, and complete left bundle branch block). Both epicardial LV leads were surgically implanted on the posterolateral wall. CRT-D achieved the resynchronization of the LV contraction, and improved cardiac function. The patients had an uneventful postoperative course and were discharged from hospital after operation. A key advantage of surgical epicardial lead placement is that lead placement is not confined to anatomic branches of the LV venous circulation as is the case with transvenous placement. CRT-D combined with cardiac surgery might be available for patients with LV systolic dysfunction.
Assuntos
Terapia de Ressincronização Cardíaca/métodos , Cardiomiopatia Dilatada/terapia , Desfibriladores Implantáveis , Insuficiência da Valva Mitral/terapia , Disfunção Ventricular Esquerda/terapia , Bloqueio de Ramo/complicações , Cardiomiopatia Dilatada/complicações , Terapia Combinada/métodos , Aneurisma Coronário/complicações , Humanos , Insuficiência da Valva Mitral/complicações , Implantação de Prótese/métodos , Resultado do Tratamento , Disfunção Ventricular Esquerda/cirurgia , Função Ventricular EsquerdaRESUMO
A 66-year-old man with a history of asymptomatic bilateral swelling of the axillary lymph nodes was admitted with hoarseness and pain of the right knee. Computed tomography showed a large pseudoaneurysm deriving from descending aorta. We planned to resect the pseudoaneurysm, and repair the aortic wall. Resection of the pseudoaneurysm and patch-closure of the defect of the aorta were performed successfully. Pathological examination of the pseudoaneurysm revealed malignant fibrous histiocytoma. The clinical course was very miserable. Intrathoracic recurrence occurred 7 months after surgery, and he died of multiple brain metastases 10 months postoperatively.
Assuntos
Falso Aneurisma/etiologia , Aorta Torácica , Aneurisma da Aorta Torácica/etiologia , Histiocitoma Fibroso Maligno/complicações , Neoplasias Vasculares/complicações , Idoso , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Aorta Torácica/patologia , Aorta Torácica/cirurgia , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Aortografia/métodos , Biópsia , Neoplasias Encefálicas/secundário , Progressão da Doença , Evolução Fatal , Histiocitoma Fibroso Maligno/secundário , Histiocitoma Fibroso Maligno/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Neoplasias Vasculares/patologia , Neoplasias Vasculares/cirurgia , Procedimentos Cirúrgicos VascularesRESUMO
Pseudoaneurysm is an unusual complication of coronary artery bypass grafting. Such aneurysms are caused by technical surgical failures, or inflammation of the sternum and mediastinum following sternotomy observed as an early or mid-term complication of cardiac surgery. This case was an 80-year-old man with a piece of artificial rubber pericardium used for complete closure of the pericardium. A large pseudoaneurysm developed in the body of the saphenous vein graft 15 years after surgery. The old rubber synthetic pericardium was severely degenerative, which induced inflammation and disrupted the saphenous vein graft.
Assuntos
Falso Aneurisma/etiologia , Ponte de Artéria Coronária , Pericárdio , Complicações Pós-Operatórias/etiologia , Próteses e Implantes/efeitos adversos , Veia Safena/transplante , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Fatores de TempoRESUMO
We present a case of an insertion of a left ventricular assist device for severe cardiac failure after the repair of a left ventricular free wall rupture. A 72-year-old man was admitted with chest pain and unconsciousness, and required emergency surgical repair of a left ventricular free wall rupture under percutaneous cardiopulmonary support. Severe cardiac failure occurred postoperatively, and weaning from percutaneous cardiopulmonary support was impossible. We implanted a left ventricular assist device, and this could be removed at one week after implantation. The left ventricular assist device was very useful as a "bridge to recovery".
