RESUMO
We report a successfully treated case of rapid progressive left ventricular (LV) thrombus with ischemic cardiomyopathy. Initially, the patient was scheduled to undergo only coronary artery bypass grafting. After two months, preoperative echocardiography revealed a previously undetected ball-like thrombus in the LV cavity. Surgical revascularization and thrombectomy were performed. No systemic embolism was associated with surgical manipulation during the perioperative period. Repeated preoperative evaluation for the presence of thrombus by transthoracic or transesophageal echocardiography is essential in cases of ischemic cardiomyopathy.
Assuntos
Cardiomiopatias/etiologia , Estenose Coronária/complicações , Trombose/etiologia , Disfunção Ventricular Esquerda/etiologia , Idoso , Cardiomiopatias/diagnóstico , Cardiomiopatias/cirurgia , Angiografia Coronária , Ponte de Artéria Coronária , Estenose Coronária/diagnóstico por imagem , Estenose Coronária/cirurgia , Progressão da Doença , Humanos , Masculino , Valor Preditivo dos Testes , Trombectomia , Trombose/diagnóstico por imagem , Trombose/cirurgia , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/cirurgiaRESUMO
Although a severely calcified ascending aorta is encountered infrequently, it presents formidable problems during cardiac surgery. We describe a case of severe aortic valve stenosis and coronary artery disease combined with a severely calcified ascending aorta. The patient was an 80-year-old man with a calcified ascending aorta. He successfully underwent an aortic valve replacement and a single coronary artery bypass graft (CABG) using a saphenous vein graft with the proximal end connected on a Dacron patch, which was used for aortoplasty of the calcified plate along the aortotomy. These procedures were performed under moderate hypothermia with aortic clamping. This patch aortoplasty can be a useful alternative in cases that require aortotomy and proximal anastomoses of a CABG on a calcified ascending aorta.
Assuntos
Doenças da Aorta/cirurgia , Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Ponte de Artéria Coronária , Doença da Artéria Coronariana/cirurgia , Calcificação Vascular/cirurgia , Idoso de 80 Anos ou mais , Aorta/cirurgia , Ponte de Artéria Coronária/métodos , Próteses Valvulares Cardíacas , Humanos , MasculinoRESUMO
We repaired a large defect in the posterior mitral leaflet after an extensive removal of infected tissue, using an extended leaflet sliding and annular downsizing with a small prosthetic ring in 2 patients with active endocarditis.
Assuntos
Endocardite Bacteriana/cirurgia , Próteses Valvulares Cardíacas , Valva Mitral/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Infecções Estafilocócicas/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Cordas Tendinosas/cirurgia , Terapia Combinada , Desbridamento/métodos , Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/tratamento farmacológico , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/microbiologia , Medição de Risco , Índice de Gravidade de Doença , Infecções Estafilocócicas/tratamento farmacológico , Resultado do TratamentoRESUMO
We report an extended parasternal approach to aortic and tricuspid valves used in a 31-year-old man. The patient presented with a deformed sternum and severe adhesion between the sternum and right ventricular outflow tract, caused by postoperative mediastinitis, which lasted for 4 years after a radical operation for tetralogy of Fallot during his childhood. The extended parasternal approach provided a safe and excellent exposure of both aortic and tricuspid valves without postoperative chest wall instability.