RESUMO
We report on the case of a 65-year-old man with unstable angina due to a left anterior descending (LAD) coronary artery single aneurysm. On a beating heart, the aneurysm was partially resected and the left internal thoracic artery was grafted in situ as a patch to the LAD opening. The patient remains well and free of symptoms two years after the operation.
Assuntos
Aneurisma Coronário/cirurgia , Ponte de Artéria Coronária sem Circulação Extracorpórea/métodos , Vasos Coronários/patologia , Idoso , Aneurisma Coronário/diagnóstico , Angiografia Coronária , Vasos Coronários/cirurgia , Seguimentos , Humanos , MasculinoRESUMO
Posterior non-ischemic left ventricular aneurysms are unusual aneurysms of different etiology that develop adjacent to the mitral valve annulus causing mitral regurgitation and progressive heart failure. Surgical correction is mandatory and involves repair of the aneurysm along with repair or replacement of the mitral valve. Two cases of posterior non-ischemic left ventricular aneurysms are reported. Both patients were females (19 and 9 years old) and they presented with symptoms of progressive heart failure. Definite diagnosis was made with transesophageal echocardiography (TEE) and confirmed with left ventriculography. Both patients were successfully treated by surgery. The first patient underwent repair of the aneurysm from inside the left ventricle and mitral valve replacement. The second patient had resection of the aneurysm through an extracardiac route. Both patients are in NYHA class 1, 5 and 4 years respectively after their operation with no evidence of mitral valve dysfunction. Posterior non-ischemic left ventricular aneurysms can securely be diagnosed by TEE and angiocardiography. Surgical treatment is mandatory in order to forestall potential life threatening cardiovascular events and should be tailored to the operative findings.
Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/cirurgia , Insuficiência Cardíaca/diagnóstico , Ventrículos do Coração/fisiopatologia , Disfunção Ventricular Esquerda/cirurgia , Adulto , Angiografia , Criança , Ecocardiografia Transesofagiana , Feminino , Seguimentos , Aneurisma Cardíaco/complicações , Insuficiência Cardíaca/etiologia , Ventrículos do Coração/cirurgia , Humanos , Isquemia , Isquemia Miocárdica , Índice de Gravidade de Doença , Resultado do Tratamento , Disfunção Ventricular Esquerda/diagnóstico , Disfunção Ventricular Esquerda/etiologiaRESUMO
IMPLICATIONS: This report shows that if diffuse coronary thromboembolism is encountered during ascending aortic dissection-repair, the option of combining single-bolus, intracoronary thrombolysis with intraaortic balloon counterpulsation should be considered.
Assuntos
Aorta/cirurgia , Doença das Coronárias/terapia , Embolia/terapia , Balão Intra-Aórtico , Complicações Intraoperatórias/terapia , Terapia Trombolítica , Ponte Cardiopulmonar , Doença das Coronárias/etiologia , Eletrocardiografia , Embolia/etiologia , Serviços Médicos de Emergência , Feminino , Hemodinâmica , Humanos , Pessoa de Meia-Idade , Monitorização IntraoperatóriaRESUMO
Celiac artery compression syndrome occurs when the median arcuate ligament of the diaphragm causes extrinsic compression of the celiac trunk. We report a case of a 65-year-old woman who presented with a three-month history of postprandial abdominal pain, nausea and some emesis, without weight loss. There was a bruit in the upper mid-epigastrium and the lateral aortic arteriography revealed a significant stenosis of the celiac artery. At operation, the celiac axis was found to be severely compressed anteriorly by fibers forming the inferior margin of the arcuate ligament of the diaphragm. The ligament was cut and a vein by-pass from the supraceliac aorta to the distal celiac artery was performed. The patient remains well and free of symptoms two and a half years since operation.In this report we discuss the indications and the therapeutic options of this syndrome as well as a review of the literature is being given.
Assuntos
Arteriopatias Oclusivas/diagnóstico , Artéria Celíaca , Idoso , Artéria Celíaca/patologia , Constrição Patológica , Feminino , HumanosRESUMO
Chronic total left main coronary artery occlusion at angiography is very rare, and there are only four cases reported with concomitant total right coronary artery occlusion. We describe a case of total left main and proximal right coronary artery occlusion and review the clinical and angiographic characteristics of this condition which represents the most severe from of coronary artery disease compatible with life.