RESUMO
: The usual surgical practice after repair of a Total Anomalous Pulmonary Venous Connection (TAPVC) is to ligate the vertical vein (VV). Many surgeons find it expedient to leave the VV unligated to reduce pulmonary arterial pressure, decrease perioperative pulmonary hypertensive crisis, provide better hemodynamics postoperatively (1), and enable the adaptation of cardiac chambers to a new workload. Afterwards, the unligated VV may cause significant left-to-right shunt, likewise an atrial septal defect, mandating later surgical ligation or device closure (2). This report details transcatheter occlusion of a patent VV using a device Amplatzer Vascular Plug II, after TAPVC repair in early infancy. The transcatheter occlusion of an unligated VV after repair of supracardiac TAPVC represents an effective alternative to surgical redo. The device Amplatzer Vascular Plug II achieves great results.
Assuntos
Cateterismo/instrumentação , Veias Pulmonares/cirurgia , Síndrome de Cimitarra/cirurgia , Ecocardiografia Doppler em Cores , Hemodinâmica , Humanos , Recém-Nascido , Ligadura , Masculino , Flebografia , Circulação Pulmonar , Veias Pulmonares/anormalidades , Veias Pulmonares/diagnóstico por imagem , Veias Pulmonares/fisiopatologia , Síndrome de Cimitarra/diagnóstico por imagem , Síndrome de Cimitarra/fisiopatologia , Resultado do TratamentoRESUMO
In the present case report, we describe a malformation consisting of a double-outlet right ventricle with an intact ventricular septum diagnosed in a 3-day-old female newborn. To our knowledge 35 cases have been described in the literature. The diagnosis was made by two-dimensional echocardiography and confirmed by angiocardiography. An inadequate opening in the interatrial septum and hypoplasia of the mitral valve and left ventricle were present. In this condition the only outlet of the left ventricle is via the atrial septal defect. Balloon atrial septostomy was performed. At 1 month of age the patient required a right modified Blalock-Taussig shunt and surgical atrial septectomy. Five months after surgery, the patient was in good clinical conditions.
Assuntos
Dupla Via de Saída do Ventrículo Direito/diagnóstico por imagem , Septos Cardíacos/diagnóstico por imagem , Ecocardiografia , Feminino , Humanos , Recém-NascidoAssuntos
Ecocardiografia , Neoplasias Cardíacas/diagnóstico , Rabdomiossarcoma/diagnóstico , Encéfalo/diagnóstico por imagem , Eletrocardiografia , Feminino , Neoplasias Cardíacas/fisiopatologia , Humanos , Lactente , Recém-Nascido , Masculino , Rabdomiossarcoma/fisiopatologia , Tomografia Computadorizada por Raios XRESUMO
Pharmacological clinical studies about beta-blocking agents provide profound insights into the effects of these kinds of drugs in adults. Very little research on children has been done up to now. The hydroalcoholic solution of a beta-blocking agent (Visken Sandoz) facilitated this research on children. This paper investigates the effects of a beta-blocking agent in 19 healthy children aged between 5 and 13 years: arterial blood pressure, heart rate, systolic and diastolic parameters were controlled. The children were examined before and after a 10 day therapeutical cycle in which Pindolol 250 gamma/kg/die was administered. Statistically significant variations were obtained for TD, TT, TT/TET, QTc, but no variation for heart rate, TET, SM, QA2, diastolic parameters and arterial blood pressure. It is supposed that negative chronotropic effect and hypotensive activity were found only in patients with an altered cardiac rate and with an altered arterial blood pressure respectively. The kinetics of the drug is also described and its easy pediatric utilization is underlined.