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1.
Gen Thorac Cardiovasc Surg ; 68(4): 392-395, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30968260

RESUMO

Hemorrhagic pericardial effusion is life-threatening and mostly occurs during pericarditis; however, its underlying mechanism is unclear. We report a case of pericardial hematoma with obvious hemorrhage. A 56-year-old man without prior chest trauma presenting with exertional dyspnea and abdominal fullness was treated for idiopathic pericarditis. The echocardiogram showed a thickened pericardium with effusion. Imaging showed extravasation and neovascularization. Following ineffective pharmacotherapy, we performed pericardiectomy. The site of bleeding was undetectable. Because parietal pericardiectomy with hematoma evacuation did not improve diastolic function, we removed the epicardium. During the follow-up period, the patient remained almost asymptomatic. We identified neovascularization as the potential source of idiopathic pericardial hemorrhage.


Assuntos
Hemorragia/etiologia , Derrame Pericárdico/etiologia , Pericardite Constritiva/complicações , Pericárdio/patologia , Diástole , Dispneia , Ecocardiografia , Hemorragia/diagnóstico por imagem , Humanos , Inflamação , Masculino , Pessoa de Meia-Idade , Neovascularização Patológica/diagnóstico por imagem , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/cirurgia , Pericardiectomia , Pericardite Constritiva/diagnóstico por imagem , Pericardite Constritiva/cirurgia , Pericárdio/diagnóstico por imagem , Pericárdio/cirurgia
2.
J Med Case Rep ; 12(1): 350, 2018 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-30470244

RESUMO

BACKGROUND: Partial anomalous pulmonary venous return is a rare congenital cardiac anomaly that usually involves the right pulmonary vein and an atrial septal defect. Isolated partial anomalous pulmonary venous return with an intact atrial septum is even rarer, and this condition is usually treated surgically in younger patients. We describe isolated partial anomalous pulmonary venous return in a 65-year-old woman who was treated by caval division with pericardial patch baffling through a surgically created atrial septal defect and reconstruction of the superior vena cava using a prosthetic graft. CASE PRESENTATION: A 65-year-old Asian woman who presented with exertional dyspnea was diagnosed with isolated partial anomalous pulmonary venous return. The surgical indications and strategy were controversial because of the rarity of this pathology. She had an indication for surgery because she was symptomatic and had a high ratio of pulmonary to systemic blood flow. We considered that surgical procedures should avoid postoperative stenosis of a reconstructed flow tract, sinus node dysfunction, and thrombogenesis. We created a caval division with pericardial patch baffling through a surgically created atrial septal defect and reconstructed the superior vena cava using a prosthetic graft for the isolated partial anomalous pulmonary venous return. She has since remained free of exertional dyspnea, arrhythmia, and thrombotic complications. This surgical strategy is safe and effective for treating isolated partial anomalous pulmonary venous return in older symptomatic adults. CONCLUSIONS: The long-term outcome of surgical repair of partial anomalous pulmonary venous return with an intact atrial septum in our patient, a symptomatic 65-year-old woman, was excellent.


Assuntos
Septo Interatrial/patologia , Cardiopatias Congênitas/cirurgia , Veias Pulmonares/cirurgia , Veia Cava Superior/cirurgia , Idoso , Implante de Prótese Vascular , Dispneia , Feminino , Cardiopatias Congênitas/diagnóstico , Cardiopatias Congênitas/fisiopatologia , Humanos , Veias Pulmonares/anormalidades , Resultado do Tratamento , Veia Cava Superior/anormalidades
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