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3.
Med. clín (Ed. impr.) ; 149(9): 391-396, nov. 2017. tab, ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-168052

RESUMO

Introducción y objetivos: La dilatación de la aorta ascendente asociada a válvula aórtica bicúspide es una causa mayor de morbimortalidad en adultos. El objetivo principal fue reconocer la afectación aórtica en niños, así como sus características y factores de riesgo. Métodos: Se realizaron retrospectivamente las mediciones aórticas de todos los pacientes pediátricos con válvula aórtica bicúspide seguidos en un hospital pediátrico terciario entre 1997 y 2015. Se excluyeron los pacientes con síndromes asociados a dilatación aórtica (n=17). Resultados: Se incluyeron 206 pacientes, de los cuales el 67,9% eran varones. El patrón de apertura más común fue horizontal: 137 (66,7%). La mitad de los pacientes (101) tenía historia de coartación aórtica, 46 de ellos (22,3%) con estenosis aórtica≥moderada y 13 (6%) con insuficiencia aórtica≥moderada. El seguimiento medio fue de 6,1 (4,9) años; el diagnóstico de dilatación aórtica se realizó durante el primer año de seguimiento. La progresión de la dilatación de la aorta ascendente se documentó en el 17,1%, y en el 2,5% en la raíz aórtica. Más de un tercio (80/206) presentó dilatación aórtica (z-score>2). La afectación exclusiva de la aorta ascendente se produjo en 70/80 pacientes, con preservación de la raíz aórtica. En el análisis multivariado, los pacientes con dilatación de la aorta ascendente se asociaron a ausencia de coartación (p=0,001) y patrón de apertura vertical (p=0,007). Conclusiones: Está justificado el seguimiento en los pacientes pediátricos con válvula aórtica bicúspide debido a la frecuente asociación con disfunción valvular y/o dilatación aórtica (AU)


Introduction and objectives: Dilatation of the ascending aorta associated with bicuspid aortic valve is a major cause of morbidity and mortality in adults. The main objective was to recognize the aortic involvement in children, its characteristics and risk factors. Methods: Aortic measures of all pediatric patients with bicuspid aortic valve followed in a tertiary pediatric hospital between 1997 and 2015 were retrospectively taken. Patients with syndromes associated with aortic dilatation were excluded (n=17). Results: Two hundred and six patients were included, 67.9% males. The commonest opening pattern was horizontal: 137 (66.7%). Half of the patients (101) had a history of surgical aortic coarctation, 46 (22.3%) had≥moderate aortic valve stenosis and 13 (6%) had≥moderate aortic insufficiency. Mean follow-up time was 6.1 (4.9) years; diagnosis of aortic dilatation was made during the first year of follow-up. Progression of the dilatation of the ascending aorta was noted in 17.1%, and of the aortic root in 2.5%. More than one-third (80/206) had aortic dilatation (z-score>2). The ascending aorta was exclusively affected in 70/80 patients, with sparing of the aortic root. In the multivariate analysis, patients with dilatation of the ascending aorta were associated with absence of coarctation (P=.001) and vertical opening pattern (P=.007). Conclusions: Pediatric patients with bicuspid aortic valve warrant medical follow-up for the frequent association with valve impairment and/or dilatation of the ascending aorta (AU)


Assuntos
Humanos , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/patologia , Fatores de Risco , Aneurisma Aórtico/complicações , Coartação Aórtica/fisiopatologia , Seio Aórtico/diagnóstico por imagem , Estudos Retrospectivos , Análise Multivariada , Cardiopatias/congênito , Cardiopatias/complicações
4.
Med Clin (Barc) ; 149(9): 391-396, 2017 Nov 09.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28629660

RESUMO

INTRODUCTION AND OBJECTIVES: Dilatation of the ascending aorta associated with bicuspid aortic valve is a major cause of morbidity and mortality in adults. The main objective was to recognize the aortic involvement in children, its characteristics and risk factors. METHODS: Aortic measures of all pediatric patients with bicuspid aortic valve followed in a tertiary pediatric hospital between 1997 and 2015 were retrospectively taken. Patients with syndromes associated with aortic dilatation were excluded (n=17). RESULTS: Two hundred and six patients were included, 67.9% males. The commonest opening pattern was horizontal: 137 (66.7%). Half of the patients (101) had a history of surgical aortic coarctation, 46 (22.3%) had≥moderate aortic valve stenosis and 13 (6%) had≥moderate aortic insufficiency. Mean follow-up time was 6.1 (4.9) years; diagnosis of aortic dilatation was made during the first year of follow-up. Progression of the dilatation of the ascending aorta was noted in 17.1%, and of the aortic root in 2.5%. More than one-third (80/206) had aortic dilatation (z-score>2). The ascending aorta was exclusively affected in 70/80 patients, with sparing of the aortic root. In the multivariate analysis, patients with dilatation of the ascending aorta were associated with absence of coarctation (P=.001) and vertical opening pattern (P=.007). CONCLUSIONS: Pediatric patients with bicuspid aortic valve warrant medical follow-up for the frequent association with valve impairment and/or dilatation of the ascending aorta.


Assuntos
Aorta/patologia , Valva Aórtica/anormalidades , Valva Aórtica/patologia , Doenças das Valvas Cardíacas/patologia , Coartação Aórtica/epidemiologia , Estenose da Valva Aórtica/epidemiologia , Pré-Escolar , Comorbidade , Dilatação Patológica , Progressão da Doença , Feminino , Doenças das Valvas Cardíacas/epidemiologia , Hospitais Pediátricos , Humanos , Lactente , Masculino , Estudos Retrospectivos , Fatores de Risco , Seio Aórtico/patologia , Centros de Atenção Terciária
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