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1.
Medicine (Baltimore) ; 99(32): e21630, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32769926

RESUMO

RATIONALE: Hepatocellular carcinoma (HCC) with intracavitary metastasis extending to the heart, also known as inferior vena cava (IVC) tumor thrombus, is an extremely rare late-stage disease with no effective treatment. In fact, the median survival is reportedly less than 2 months; thus, there is an urgent need for better treatment. PATIENT CONCERNS: In this study, a 48-year-old patient was admitted to our hospital to seek medical treatment for advanced primary HCC with right atrial metastasis. DIAGNOSIS: The patient was diagnosed as primary HCC with a large mass in the right lobe of the liver and intracavitary metastasis to the right atrium. INTERVENTIONS: A new surgical treatment of right hemihepatectomy, complete resection of the involved IVC and the right atrium thrombus, plus reconstruction of the resected IVC using autologous pericardial tube graft were undertaken and successfully performed. OUTCOMES: The patient recovered rapidly, and 14 days after the surgical procedures, he was discharged from the hospital. Notably, serum levels of alpha-fetoprotein dropped to normal range and no clinical signs of recurrence were observed during follow-up. LESSONS: This report highlights an unusual case of right atrial metastasis from HCC. The surgical treatment appeared to be suitable and effective, together with postoperative administration of lenvatinib, a tyrosine kinase multitarget inhibitor selected by performing whole-exome sequencing. These therapies have offered favorable clinical outcomes such as prevention of recurrence and prolongation of patient survival. In addition, clinicians may benefit from our experience for their future treatment of patients with similar clinical conditions.


Assuntos
Carcinoma Hepatocelular/cirurgia , Átrios do Coração/anormalidades , Metástase Neoplásica/diagnóstico , Carcinoma Hepatocelular/complicações , Átrios do Coração/cirurgia , Hepatectomia/métodos , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica/fisiopatologia , Metástase Neoplásica/terapia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Veia Cava Inferior/cirurgia
2.
J Card Surg ; 35(10): 2798-2799, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32652587

RESUMO

We present a case of a 12-year-old boy with discordance between the atrial arrangement and the thoracoabdominal arrangement in the setting of twisted atrioventricular connections. This case highlights the importance of a separate description of all visceral organs and venous drainage for an accurate description of visceroatrial arrangement in cases of congenital heart defects.


Assuntos
Anormalidades Múltiplas/diagnóstico por imagem , Comunicação Interatrial/diagnóstico por imagem , Comunicação Interventricular/diagnóstico por imagem , Ventrículos do Coração/anormalidades , Levocardia/diagnóstico , Estenose da Valva Pulmonar/diagnóstico por imagem , Criança , Angiografia por Tomografia Computadorizada , Átrios do Coração/anormalidades , Átrios do Coração/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Humanos , Masculino
3.
Rev Neurol ; 71(5): 186-190, 2020 09 01.
Artigo em Espanhol | MEDLINE | ID: mdl-32729110

RESUMO

INTRODUCTION: Severe infection by SARS-CoV-2 has shown to entail an increased risk of thrombotic, especially venous, events. Central venous catheters have also been associated with an increased risk of thrombotic complications. Paradoxical embolism as an aetiological mechanism of ischaemic stroke should be considered in a highly prothrombotic context, where it may be more frequent. CASE REPORT: A 40-year-old woman with a central venous catheter, with a large vessel ischaemic stroke, treated with mechanical thrombectomy for an atypical paradoxical embolism while in intensive care for bilateral COVID-19 pneumonia. In the aetiological study, analysis highlighted an elevation of the D-dimer and right-left shunt with massive passage of contrast directly from the central peripheral access pathway in the left upper extremity to the left atrium in the transoesophageal echocardiogram. Thoracic tomographic angiography showed an anomalous venous structure with its origin in the subclavian vein and drainage to the segmental vein of the left upper lobe with direct emptying into the left atrium. Treatment consisted in anticoagulation until removal of the central venous catheter and simple anti-aggregating medication on discharge. CONCLUSIONS: Paradoxical embolism due to intra- or extra-cardiac shunt should be considered in patients with COVID-19, given the high associated risk of venous thromboembolism. Further studies are needed to be able to define optimal prophylactic and therapeutic management.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Embolia Paradoxal/etiologia , Átrios do Coração/anormalidades , Pneumonia Viral/complicações , Veia Subclávia/anormalidades , Adulto , Anticoagulantes/uso terapêutico , Cateterismo Venoso Central/efeitos adversos , Terapia Combinada , Angiografia por Tomografia Computadorizada , Meios de Contraste/farmacocinética , Infecções por Coronavirus/sangue , Ecocardiografia Transesofagiana , Embolia Paradoxal/diagnóstico por imagem , Embolia Paradoxal/tratamento farmacológico , Embolia Paradoxal/terapia , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Átrios do Coração/diagnóstico por imagem , Humanos , Trombólise Mecânica , Pandemias , Inibidores da Agregação de Plaquetas/uso terapêutico , Pneumonia Viral/sangue , Veia Subclávia/diagnóstico por imagem
4.
J Card Surg ; 35(7): 1743-1745, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32485051

RESUMO

The association of absent right superior vena cava and persistent left superior vena cava draining into unroofed coronary sinus with common atrium and the atrioventricular septal defect is an extremely rare form of the congenital cardiac disorder with only one case reported so far, hence, can be missed preoperatively if not carefully looked for. Failure to detect absent right superior vena cava beforehand may otherwise pose difficulties in carrying out invasive surgical or medical interventions.


Assuntos
Anormalidades Múltiplas/cirurgia , Procedimentos Cirúrgicos Cardiovasculares/métodos , Seio Coronário/anormalidades , Seio Coronário/cirurgia , Defeitos dos Septos Cardíacos/cirurgia , Malformações Vasculares/cirurgia , Veia Cava Superior/anormalidades , Veia Cava Superior/cirurgia , Pré-Escolar , Ecocardiografia , Ecocardiografia Transesofagiana , Feminino , Átrios do Coração/anormalidades , Átrios do Coração/cirurgia , Defeitos dos Septos Cardíacos/diagnóstico por imagem , Humanos , Resultado do Tratamento
5.
J Cardiothorac Surg ; 15(1): 59, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32295626

RESUMO

BACKGROUND: Uniatrial biventricular connection (UBC) is a rare cardiovascular anomaly characterized by absence of one atrioventricular connection and drainage of the other atrium via a solitary atrioventricular valve into both ventricles. The absent atrioventricular connection may affect either the left or right atrium. Because of the absence of one atrioventricular connection hearts with UBC have been classified among functionally univentricular hearts requiring palliative treatment according to the Fontan principle. AIMS/OBJECTIVE: We report two further patients with UBC. In one of these patients careful echocardiographic examination of the atrioventricular junction in early infancy revealed the possibility of biventricular repair based on the favorable anatomy of the atrioventricular valve and balanced ventricles in the presence of an inlet ventricular septal defect (VSD). CASE PRESENTATIONS: Both patients presented in the neonatal period for evaluation of complex congenital heart disease. The anatomy of the atrioventricular valves in our patients was indistinguishable from atrioventricular septal defects exhibiting the morphology of a common valve with superior and inferior bridging leaflets. The common atrioventricular valve was connected exclusively to the right atrium draining into both ventricles while the left atrium drained into the right atrium via a secundum atrial septal defect. In one of our patients biventricular repair with good longterm-result was performed by reseptation of the atria, patch repair of the VSD and septation of the atrioventricular valve. The second patient underwent univentricular palliation according to the Fontan principle. DISCUSSION/CONCLUSION: The echocardiographic findings in our patients suggest that at least some patients with UBC represent a variant of atrioventricular septal defects associated with extreme ventriculoatrial malalignment resulting in fusion of the deviated primary atrial septum with the lateral aspect of the atrioventricular junction. This offers the option of septation of the common atrioventricular valve and biventricular repair in patients with adequate size of both ventricles. Exact echocardiographic analysis of the morphology of the atrioventricular valve is essential to distinguish these patients with a morphologically common atrioventricular valve in early infancy from other variants of absent atrioventricular connection and to select those who are suitable for biventricular repair.


Assuntos
Defeitos dos Septos Cardíacos/cirurgia , Valvas Cardíacas/anormalidades , Criança , Pré-Escolar , Ecocardiografia , Feminino , Átrios do Coração/anormalidades , Átrios do Coração/cirurgia , Defeitos dos Septos Cardíacos/diagnóstico por imagem , Valvas Cardíacas/diagnóstico por imagem , Ventrículos do Coração/anormalidades , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/cirurgia , Humanos , Lactente , Recém-Nascido
6.
Semin Thorac Cardiovasc Surg ; 32(1): 140-142, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31520731

RESUMO

We describe an asymptomatic 7-year-old boy who was taken to the operating room for repair of a subaortic membrane and possible Gerbode's defect. He was found to have a double outlet right atrium associated with an accessory atrioventricular valve in addition to a small atrial septal defect and subaortic membrane. Regurgitant flow through this accessory valve led to the left ventricle to right atrial shunt that was seen on preoperative ECHO. The atrial septal defect was repaired and a baffle was used to isolate blood flow across the accessory valve from the left atrium to the left ventricle. The patient was discharged on postoperative day 4 and has been doing well 2 years postoperatively.


Assuntos
Anormalidades Múltiplas , Procedimentos Cirúrgicos Cardíacos , Estenose Subaórtica Fixa/cirurgia , Átrios do Coração/cirurgia , Cardiopatias Congênitas/cirurgia , Comunicação Interatrial/cirurgia , Valvas Cardíacas/cirurgia , Hemodinâmica , Doenças Assintomáticas , Criança , Estenose Subaórtica Fixa/diagnóstico por imagem , Estenose Subaórtica Fixa/fisiopatologia , Átrios do Coração/anormalidades , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/fisiopatologia , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/fisiopatologia , Comunicação Interatrial/diagnóstico por imagem , Comunicação Interatrial/fisiopatologia , Valvas Cardíacas/anormalidades , Valvas Cardíacas/diagnóstico por imagem , Valvas Cardíacas/fisiopatologia , Humanos , Masculino , Recuperação de Função Fisiológica , Resultado do Tratamento
7.
Pediatr Neonatol ; 61(1): 92-99, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31362863

RESUMO

BACKGROUND: Sinus venosus defect (SVD) is an unusual type of interatrial communication (IAC) and is virtually always associated with partial anomalous pulmonary venous drainage (PAPVD) of the right pulmonary veins (RPV) to the superior vena cava (SVC) or right atrium (RA). However, its definite morphogenesis is still elusive, and diagnostic fallibility continues. METHODS: We conducted a retrospective review of the echocardiograms, cardiac catheterization data, computed tomographic findings, and surgical notes of 44 children with surgery-confirmed isolated SVD from 1977 to 2016. We investigated the location of the IAC and its boundaries within the atrial septum and its anatomic relationship with the adjacent structures, including the anomalously draining RPV. We also tried to explore any possible associated abnormalities which might be implicated in the morphogenesis of SVD. RESULTS: Two distinct types of IAC were defined. Forty patients had an IAC that was located posterosuperior to the intact fossa ovalis (superior type), and all were associated with PAPVD of the right upper and often the right middle pulmonary veins to the SVC. The remaining 4 patients had an IAC that was located posterior to the intact fossa ovalis (inferior type), and all were associated with PAPVD of all the RPV to the RA. Another consistently associated abnormality was a defect between the anomalously draining RPV posteriorly and the SVC or RA anteriorly. All these 44 patients underwent successful surgical baffling the associated PAPVD via the IAC into the left atrium. CONCLUSION: A defect between the RPV posteriorly and the SVC or RA anteriorly will result in SVD, and an unusual type of IAC, and PAPVD of the RPV to the SVC or RA. The IAC is not a true atrial septal defect in the atrial septum proper, but it actually represents the left atrial orifice of the unroofed RPV.


Assuntos
Comunicação Interatrial/cirurgia , Morfogênese , Veias Pulmonares/anormalidades , Adolescente , Criança , Pré-Escolar , Drenagem , Feminino , Átrios do Coração/anormalidades , Humanos , Lactente , Masculino , Veias Pulmonares/embriologia , Estudos Retrospectivos , Veia Cava Superior/anormalidades
8.
Gen Thorac Cardiovasc Surg ; 68(6): 641-643, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31250204

RESUMO

Persistent left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect (Raghib complex) is an uncommon anomaly of systemic venous drainage. We present a unique case of simultaneous presentation of cor triatriatum and persistent left superior vena cava draining into the left atrium in an adult female with partial AV canal and common atrium. Complex intra-atrial baffling including a procedure to redirect flow from a proximal atrial chamber was successful.


Assuntos
Coração Triatriado/cirurgia , Átrios do Coração/cirurgia , Defeitos dos Septos Cardíacos/cirurgia , Veia Cava Superior/cirurgia , Anormalidades Múltiplas/cirurgia , Adulto , Procedimentos Cirúrgicos Cardíacos/métodos , Coração Triatriado/diagnóstico , Seio Coronário/anormalidades , Feminino , Átrios do Coração/anormalidades , Comunicação Interventricular/cirurgia , Humanos , Veia Cava Superior/anormalidades , Veia Cava Superior/diagnóstico por imagem
9.
World J Pediatr Congenit Heart Surg ; 11(1): 79-84, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31835981

RESUMO

BACKGROUND: Double-outlet right atrium (DORA) is a rare congenital cardiac defect, where the right atrium (RA) is connected to both the right ventricle (RV) and the left ventricle (LV). Double-outlet right atrium is classified into two types, each containing two subtypes: malaligned atrial septum with common or single atrioventricular (AV) valve and malaligned ventricular septum (VS) with adequate or inadequate RV. The VS type is characterized by straddling right AV valve (RAVV) with intact VS, resulting in two RAVV orifices. METHODS: We report a case of "acquired DORA" in a 17-year-old male patient previously treated with subaortic VSD closure. At admission, we diagnosed DORA with VS malalignment and adequate RV. The patient had 2 orifices within the RAVV, connecting the RA to both the RV (via RAVV orifice 1) and the LV (via RAVV orifice 2). The latter was insufficient, with severe LV to RA shunt. A review of the literature indexed in PubMed and Scopus databases was undertaken. RESULTS: The patient underwent biventricular repair through closure of the RAVV orifice 2 with a pericardial patch. Pacemaker implantation for complete AV block was necessary. Postoperative course and follow-up were regular. The literature review showed 39 cases of DORA, of which 8 had a malaligned VS and an adequate RV, as in our case. CONCLUSION: Acquired DORA is an interesting post-surgical variant of a rare congenital heart defect. Biventricular repair is a feasible and viable option, which involves closing the third AV orifice. Careful attention is required in order to avoid injury to the conduction system.


Assuntos
Átrios do Coração/anormalidades , Comunicação Interatrial/diagnóstico , Adolescente , Diagnóstico Diferencial , Ecocardiografia , Átrios do Coração/cirurgia , Cardiopatias Congênitas/diagnóstico , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/cirurgia , Comunicação Interatrial/diagnóstico por imagem , Comunicação Interatrial/cirurgia , Humanos , Masculino
10.
Medicine (Baltimore) ; 98(48): e18074, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770224

RESUMO

INTRODUCTION: An atrial septal aneurysm (ASA) is a rare congenital cardiac deformity characterized by interatrial septum protruding into atria forming a saccular structure. PATIENT CONCERNS: In our case, a 42-year-old female patient presented to our hospital complained of palpitation. DIAGNOSIS: Transthoracic echocardiography detected a 3.4 × 3.4 cm circular mass attached to the interatrial septum in right atrium complicated with a 6 mm secundum atrial septal defects (ASD). INTERVENTIONS: The patient received a cardiopulmonary bypass surgery to remove the mass and close the ASD. OUTCOMES: The mass turned out to be an organized thrombus with calcium deposition and fibrinoid necrosis. CONCLUSION: ASA is a potential location of atrial thrombus because of the stagnation of blood. Systemic embolism events are the main complications of ASA. Surgery or anticoagulation is both recommended in patients with ASA with thrombus.


Assuntos
Aneurisma Cardíaco/congênito , Átrios do Coração/anormalidades , Comunicação Interatrial/complicações , Trombose/congênito , Adulto , Ponte Cardiopulmonar/métodos , Ecocardiografia , Feminino , Aneurisma Cardíaco/cirurgia , Comunicação Interatrial/cirurgia , Humanos , Trombose/cirurgia
11.
Echocardiography ; 36(12): 2278-2281, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31755576

RESUMO

Congenital aneurysm of the left atrium is a rare cardiac anomaly, most commonly detected between the 2nd and 4th decades of life in a symptomatic patient. We report a congenital aneurysm of the left atrium diagnosed at 24 weeks of gestational age, associated with other congenital heart diseases and 47XY, +18 karyotype. The literature of the left atrial aneurysm diagnosed by fetal echocardiography is also reviewed in this report.


Assuntos
Dupla Via de Saída do Ventrículo Direito/diagnóstico , Ecocardiografia/métodos , Coração Fetal/diagnóstico por imagem , Aneurisma Cardíaco/congênito , Átrios do Coração/anormalidades , Síndrome da Trissomía do Cromossomo 18 , Ultrassonografia Pré-Natal/métodos , Anormalidades Múltiplas , Adulto , Diagnóstico Diferencial , Dupla Via de Saída do Ventrículo Direito/embriologia , Evolução Fatal , Feminino , Idade Gestacional , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/embriologia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/embriologia , Humanos , Gravidez
13.
World J Pediatr Congenit Heart Surg ; 10(6): 686-693, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31701828

RESUMO

BACKGROUND: To compare the incidence of arrhythmias and the overall survival at long-term follow-up of the right auricular baffle technique (RA) versus Gore-Tex® (GT) baffle as intra-atrial cavopulmonary lateral tunnel, as well as the Nakata index and tunnel dimensions on cardiac magnetic resonance. METHODS: Data were retrospectively collected. Serial 24-hour Holter recordings and cardiac magnetic resonance findings of the two groups were compared. RESULTS: There was no significant difference in the estimated freedom from arrhythmias (87% at 10 years and 78% at 15 years vs 80% at 10 years and 70% at 15 years in RA and GT, respectively; P = .44) nor cumulative survival (86% at 10 years and 84% at 15 years vs 97% at 10 years and 81% at 15 years in RA and GT, respectively; P = .8). Also, no difference between the groups was observed in the Nakata index. The tunnel dimensions on cardiac magnetic resonance were significantly wider in the RA group. In reference to other potential risk indicators, using Cox proportional hazard regression analysis, only age (5 years or older at the time of total cavopulmonary connection) was associated with an increased risk for both arrhythmia and mortality. CONCLUSIONS: This study demonstrated that there was no difference in freedom from arrhythmias, Nakata index, or survival between the two groups. This study confirmed the growth potential of the right auricular tunnel. However, the growth of the tunnel did not influence the incidence of arrhythmias.


Assuntos
Arritmias Cardíacas/etiologia , Técnica de Fontan/métodos , Átrios do Coração/cirurgia , Cardiopatias Congênitas/cirurgia , Politetrafluoretileno , Adolescente , Arritmias Cardíacas/fisiopatologia , Criança , Pré-Escolar , Feminino , Átrios do Coração/anormalidades , Átrios do Coração/diagnóstico por imagem , Cardiopatias Congênitas/diagnóstico , Humanos , Imagem Cinética por Ressonância Magnética , Masculino , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Estudos Retrospectivos
14.
World J Pediatr Congenit Heart Surg ; 10(6): 803-805, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31701841

RESUMO

Anomalous connection of the superior vena cava to the morphologic left atrium is a rare congenital systemic venous abnormality. As opposed to pulmonary venous anomalies, the significant right-to-left shunt in these patients warrants a correction early in life. Optimal repair technique for combined pulmonary and systemic venous anomalies is not defined yet. Herein, we describe a neonate with such a diagnosis treated with cavoatrial anastomosis, known as Warden procedure with excellent results.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Átrios do Coração/cirurgia , Cardiopatias Congênitas/cirurgia , Veia Cava Superior/cirurgia , Anastomose Cirúrgica/métodos , Átrios do Coração/anormalidades , Humanos , Recém-Nascido , Masculino
15.
Medicine (Baltimore) ; 98(36): e17044, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31490396

RESUMO

RATIONALE: A single atrium is a rare congenital heart disease (CHD) involving zero atrial septal traces and preserved intact ventricular septum and atrioventricular valves, requiring careful surgical intervention. However, developing to Eisenmenger syndrome (ES) makes the surgery complicated. Based on bidirectional cardiac shunting, vegetation easily develops in case of bacterial infection. PATIENT CONCERN AND DIAGNOSES: We reported a 35-year-old woman with a single atrium, patent ductus arteriosus, pulmonary hypertension, and ES who developed infective endocarditis on her left ventricular outflow tract and complicated cerebral abscess and who underwent challenged medical treatment. INTERVENTION: Infection was successfully controlled after 4-time change in antibiotics over 4 months. However, surgery is complicated for her. OUTCOMES: The patient presented a relatively good outcome during follow-up for >6 months. LESSONS: This case report suggests that patients with complex CHD should accept surgery therapy earlier before developing ES. It is imperative to avoid invasive interventions to prevent infectious endocarditis.


Assuntos
Abscesso Encefálico/complicações , Permeabilidade do Canal Arterial/complicações , Complexo de Eisenmenger/complicações , Endocardite/complicações , Átrios do Coração/anormalidades , Adulto , Antibacterianos/uso terapêutico , Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/tratamento farmacológico , Endocardite/diagnóstico por imagem , Endocardite/tratamento farmacológico , Feminino , Humanos
16.
Cardiol Young ; 29(11): 1407-1409, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31502531

RESUMO

We present two patients, one 10 years old and another 43 years old, who both had successful transcatheter closure of left main coronary artery to right atrium fistulas. The older patient had a larger fistula as well as more symptoms and a complicated post-procedure course. Closure of medium or large coronary artery fistulas should be considered at younger ages to minimise future complications.


Assuntos
Cateterismo Cardíaco/métodos , Anomalias dos Vasos Coronários/diagnóstico , Vasos Coronários/diagnóstico por imagem , Embolização Terapêutica/métodos , Átrios do Coração/anormalidades , Fístula Vascular/diagnóstico , Adulto , Criança , Angiografia por Tomografia Computadorizada , Angiografia Coronária/métodos , Anomalias dos Vasos Coronários/terapia , Progressão da Doença , Ecocardiografia Transesofagiana , Feminino , Seguimentos , Humanos , Fatores de Tempo , Fístula Vascular/congênito , Fístula Vascular/terapia
17.
Sultan Qaboos Univ Med J ; 19(2): e161-e163, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31538017

RESUMO

Cardiac blood cysts are rare benign neoplasms, usually involving the cardiac valves and are remnants of the Chiari network. They are usually detected in the first six months of life and rarely occur in children or adults. We report a 76-year-old male patient who was referred to the Imam Ali Hospital affiliated with Kermanshah University of Medical Sciences, Kermanshah, Iran, in 2018 with dyspnoea. Transthoracic echocardiography revealed a small patent foramen ovale (PFO) and a circumferential mobile cystic mass in the right atrium, with the impression of a tumour or thrombus. The patient underwent open-heart surgery with cardiopulmonary bypass to repair to PFO and remove the intra-atrial lesion. During surgical examination of the right atrial cavity, a blood cyst containing small stone-like structures on the coronary sinus valve of the right atrium was found. The post-operative course was uneventful and no recurrence of tumour was detected during six months of follow-up. To the best of our knowledge, this is the first reported case of a right atrial blood cyst with a few nodule-like stones in an adult with PFO in Iran and the second case in an adult with PFO worldwide.


Assuntos
Seio Coronário/anormalidades , Cistos/sangue , Átrios do Coração/anormalidades , Idoso , Complexos Atriais Prematuros/diagnóstico , Complexos Atriais Prematuros/etiologia , Complexos Atriais Prematuros/fisiopatologia , Procedimentos Cirúrgicos Cardíacos/métodos , Seio Coronário/fisiopatologia , Cistos/cirurgia , Átrios do Coração/fisiopatologia , Humanos , Irã (Geográfico) , Masculino
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