RESUMO
The mortality rate of post-infarction cardiogenic shock (CS) was 80.0-90.0%. Recent studies show a significant reduction of hospital mortality to approximately 50.0%. CS is defined as systemic tissue hypoperfusion resulting from systolic and/or diastolic heart dysfunction, the main cause of which is acute myocardial infarction (AMI). The main predictors are biological markers such as troponin, CKMB and lactate. A systematic literature review and meta-analysis is performed in order to present and correlate the main literary findings on CS and its evolution with possible changes in biomarkers such as troponin, lactate and CKMB. After criteria of literary search with the use of the mesh terms: cardiogenic shock; acute myocardial infarction; biomarkers; troponin; CKMB; lactate; clinical trials and use of the bouleanos "and" between the mesh terms and "or" among the historical findings. In the main databases such as Pubmed, Medline, Bireme, EBSCO, Scielo, etc., a total of 96 papers that were submitted to the eligibility analysis were collated and, after that, 41 studies were selected, following the rules of systematic review - PRISMA (Transparent reporting of systematic reviews and meta-analyzes-http://www.prisma-statement.org/). Some risk factors for its development in AMI are advanced age, female gender, anterior wall infarction, diabetes mellitus, systemic arterial hypertension, previous history of infarction and angina. The CS associated with AMI depends on its extent and its complications, being the main ones: mitral regurgitation, rupture of the interventricular septum and rupture of the free wall of the left ventricule. The diagnosis is based on the clinical manifestations, such as mental confusion, oliguria, hypotension, tachycardia, fine pulse, sweating, and cold extremities; in hemodynamic aspects: systolic blood pressure was < 90.0 mm Hg or 30 mm Hg below baseline, pulmonary capillary pressure was > 18.0 mm Hg and cardiac index was < 2.2 L/min/m2. Laboratory and imaging exams should be requested to evaluate the possible etiology of CS, its systemic repercussions and comorbidities. The treatment aims at the rapid reestablishment of the blood flow in the affected artery, to improve the patient's prognosis. The biomarkers dosage in the daily clinical practice of the different cardiological centers can facilitate the diagnosis and the conduction of the dubious cases and the best evaluation of the degree of myocardial suffering after CS.
RESUMO
The need for a new surgical procedure for correction of postoperative pseudoaneurysm of aortic coarctation makes the procedure especially challenging for the surgeon.ta abstract.
Assuntos
Falso Aneurisma/cirurgia , Coartação Aórtica/cirurgia , Procedimentos Endovasculares/métodos , Adulto , Coartação Aórtica/complicações , Prótese Vascular , Humanos , Masculino , Equipe de Assistência ao Paciente , Reoperação/métodosRESUMO
A morfologia do aneurisma coronariano configura um fator predisponente para formação de trombos. Porém, a estase sanguínea causada pela alteração do fluxo pode não ser o suficiente para causar fenômenos tromboembólicos.
The morphology of coronary aneurysm sets a predisposing factor to thrombus formation. However, the blood stasis caused by the change in flow may not be enough to cause thromboembolic events.
Assuntos
Feminino , Humanos , Adulto Jovem , Aneurisma Coronário/complicações , Ponte de Artéria Coronária/métodos , Trombose Coronária/complicações , Infarto do Miocárdio/cirurgia , Aneurisma Coronário , Trombose Coronária , Infarto do Miocárdio/etiologiaRESUMO
The morphology of coronary aneurysm sets a predisposing factor to thrombus formation. However, the blood stasis caused by the change in flow may not be enough to cause thromboembolic events.
Assuntos
Aneurisma Coronário/complicações , Ponte de Artéria Coronária/métodos , Trombose Coronária/complicações , Infarto do Miocárdio/cirurgia , Aneurisma Coronário/diagnóstico por imagem , Trombose Coronária/diagnóstico por imagem , Feminino , Humanos , Infarto do Miocárdio/etiologia , Radiografia , Adulto JovemRESUMO
Surgical treatment of aortic dissection is a challenge for the cardiac surgeon, especially in patients undergoing cardiac operations. Our objective in this case report is to demonstrate how we treat the chronic type A aortic dissection in patients revascularized using percutaneous arterial and venous cannulae.
Assuntos
Aneurisma Aórtico/cirurgia , Dissecção Aórtica/cirurgia , Ponte de Artéria Coronária , Dissecção Aórtica/diagnóstico , Aneurisma Aórtico/diagnóstico , Doença Crônica , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Fatores de Tempo , Resultado do TratamentoRESUMO
O tratamento operatório da dissecção aórtica é um desafio para o cirurgião cardíaco, sobretudo nos pacientes submetidos a operação cardíaca prévia. Nosso objetivo neste relato de caso é demonstrar como tratamos a dissecção aórtica crônica tipo A em paciente revascularizado utilizando cânulas arterial e venosa percutâneas.
Surgical treatment of aortic dissection is a challenge for the cardiac surgeon, especially in patients undergoing cardiac operations. Our objective in this case report is to demonstrate how we treat the chronic type A aortic dissection in patients revascularized using percutaneous arterial and venous cannulae.
