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1.
J Assoc Physicians India ; 68(11): 74-76, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33187045

RESUMO

Leiyomyosarcoma of vascular origin is rarely seen occurring in the Inferior Vena Cava. We report a rare case of a young male with giant retroperitoneal leiyomyosarcoma which extended into the right atrium.


Assuntos
Fibrilação Atrial , Leiomiossarcoma , Neoplasias Vasculares , Átrios do Coração/diagnóstico por imagem , Humanos , Leiomiossarcoma/diagnóstico por imagem , Masculino , Veia Cava Inferior/diagnóstico por imagem
2.
Kyobu Geka ; 73(11): 905-909, 2020 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-33130711

RESUMO

A 48-year-old woman developed paralysis of the left upper limb and dysarthria. Two days later, she was admitted to a local hospital due to no improvement of symptoms. Brain magnetic resonance imaging showed acute hemorrhagic cerebral infarction in the left nucleus basalis. Echocardiography demonstrated a large left atrial mass in the left atrium, shuttling between the left atrium and the left ventricle and moderate mitral regurgitation. Then, she was transferred to our hospital for surgery. Five days after the initial symptoms, resection of the left atrial mass was performed under total cardiopulmonary bypass. First, heparin sodium, and then nafamostat mesilate were used as intraoperative anticoagulation treatment. The left mitral mass was removed via an atrial septal incision and the defect was repaired using a bovine pericardium. The mitral valve was intact and there was no regurgitation. The mass was immunohistologically diagnosed as myxoma. Postoperative brain computed tomography scans demonstrated no exacerbation of the cerebral infarction. She was discharged 13 days after surgery without neurological symptoms.


Assuntos
Fibrilação Atrial , Neoplasias Cardíacas , Insuficiência da Valva Mitral , Mixoma , Animais , Bovinos , Infarto Cerebral/diagnóstico por imagem , Infarto Cerebral/etiologia , Infarto Cerebral/cirurgia , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Humanos , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/etiologia , Insuficiência da Valva Mitral/cirurgia , Mixoma/complicações , Mixoma/diagnóstico por imagem , Mixoma/cirurgia
3.
Kardiologiia ; 60(9): 149-152, 2020 Oct 14.
Artigo em Russo | MEDLINE | ID: mdl-33131485

RESUMO

The left three-atrial heart (LTH) is a rare congenital abnormality where the left auricle (LA) is divided into two chambers with an additional membrane. This article describes for the first time a clinical case of congenital heart defect with four atrial chambers. A 41-old man was hospitalized for newly diagnosed paroxysmal atrial fibrillation. On transthoracic echocardiogram (EchoCG), LA was considerably enlarged and divided into two equal interconnected parts with a membrane. Additional examination with contrast-enhanced EchoCG and computed tomography revealed two membranes dividing the LA into three chambers. Prediction for the patient was beneficial since there were no other developmental abnormalities of the heart, and the LA transmembrane pressure gradient (PG) was small. Data of literature on the incidence and prognosis of LTH are provided.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Fibrilação Atrial/diagnóstico , Ecocardiografia , Átrios do Coração/diagnóstico por imagem , Humanos , Masculino , Prognóstico , Tomografia Computadorizada por Raios X
4.
Kardiologiia ; 60(9): 22-29, 2020 Oct 14.
Artigo em Russo | MEDLINE | ID: mdl-33131471

RESUMO

Aim To study the relationship between the serum level of growth differentiation factor 15 (GDF-15) and clinical and functional characteristics and severity of left atrial (LA) fibrosis in patients with nonvalvular atrial fibrillation (AF).Material and methods The study included 87 patients with nonvalvular AF (62 patients with paroxysmal AF and 25 patients with persistent AF) aged 27 to 72 years (mean age, 56.9±9.2 years, 32 women). 85 % of these patients had arterial hypertension (AH), 33 % had AH and ischemic heart disease, and 12.6 % had isolated AF and were hospitalized for primary catheter ablation. General clinical evaluation, echocardiography, laboratory tests including measurement of GDF-15 and NT-proBNP concentrations in blood were performed. As a surrogate substrate of LA fibrosis during the electroanatomical voltage mapping, the area of low-voltage (<0.5 mV) zones in LA was calculated, including the total LA fibrosis area (Sf, cm2) and a percentage of fibrosis of the total LA area (Sf%).Results Median concentration of GDF-15 was 767.5 [590.0; 951.0] pg /ml. The GDF-15 level positively correlated with age, presence and severity of AH and chronic heart failure, body mass index, and degree of obesity, CHA2DS2 VASc score, level of NT-proBNP, and LA fibrosis area (Sf and Sf%) and negatively correlated with the indexes of left ventricular diastolic function, e' septal and e' lateral. The area of fibrosis increased with increasing GDF-15 concentrations divided into quartiles; Sf% exceeded 20 % at GDF-15 levels higher than median. After a comparative analysis of patients with Sf% ≤20 % and >20 %, statistically significantly different variables were included into a stepwise logistic regression analysis. Two independent predictors of LA fibrosis >20% were identified: a concentration of GDF-15 higher than median (odd ratio (OR), 3.318, 95 % confidence interval (CI): 1.184-9.298) and LA volume index (OR, 1.079, 95 % CI: 1.014-1.147). According to results of the ROC analysis, the area under the curve (AUC) was 0.762 (p=0.000), the model specificity was 72.3 %, sensitivity was 72.4 %, and the prediction accuracy was 72.4 %.Conclusion Blood levels of GDF-15 were associated with the presence and severity of major risk factors for AF and the area of LA fibrosis. In this study, a level of GDF-15 above the median and the LA volume index were independent predictors of LA fibrosis > 20% of the LA area.


Assuntos
Apêndice Atrial , Fibrilação Atrial , Ablação por Cateter , Fator 15 de Diferenciação de Crescimento , Adulto , Idoso , Fibrilação Atrial/complicações , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/patologia , Feminino , Fibrose , Fator 15 de Diferenciação de Crescimento/sangue , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Humanos , Pessoa de Meia-Idade
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1178-1181, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018197

RESUMO

To date, regional atrial strains have not been imaged in vivo, despite their potential to provide useful clinical information. To address this gap, we present a novel CINE MRI protocol capable of imaging the entire left atrium at an isotropic 2-mm resolution in one single breath-hold. As proof of principle, we acquired data in 10 healthy volunteers and 2 cardiovascular patients using this technique. We also demonstrated how regional atrial strains can be estimated from this data following a manual segmentation of the left atrium using automatic image tracking techniques. The estimated principal strains vary smoothly across the left atrium and have a similar magnitude to estimates reported in the literature.


Assuntos
Átrios do Coração , Imagem Cinética por Ressonância Magnética , Suspensão da Respiração , Átrios do Coração/diagnóstico por imagem , Humanos
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1198-1202, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018202

RESUMO

Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with dramatic increases in mortality and morbidity. Atrial cine MR images are increasingly used in the management of this condition, but there are few specific tools to aid in the segmentation of such data. Some characteristics of atrial cine MR (thick slices, variable number of slices in a volume) preclude the direct use of traditional segmentation tools. When combined with scarcity of labelled data and similarity of the intensity and texture of the left atrium (LA) to other cardiac structures, the segmentation of the LA in CINE MRI becomes a difficult task. To deal with these challenges, we propose a semi-automatic method to segment the left atrium (LA) in MR images, which requires an initial user click per volume. The manually given location information is used to generate a chamber location map to roughly locate the LA, which is then used as an input to a deep network with slightly over 0.5 million parameters. A tracking method is introduced to pass the location information across a volume and to remove unwanted structures in segmentation maps. According to the results of our experiments conducted in an in-house MRI dataset, the proposed method outperforms the U-Net [1] with a margin of 20 mm on Hausdorff distance and 0.17 on Dice score, with limited manual interaction.


Assuntos
Fibrilação Atrial , Processamento de Imagem Assistida por Computador , Fibrilação Atrial/diagnóstico por imagem , Átrios do Coração/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Imagem Cinética por Ressonância Magnética
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1207-1210, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018204

RESUMO

Accurate segmentation of pulmonary vein (PV) and left atrium (LA) is essential for the preoperative evaluation and planning of total anomalous pulmonary venous connection (TAPVC), which is a rare but mortal congenital heart disease of children. However, manual segmentation is time-consuming and insipid. To free radiologists from the repetitive work, we propose an automatic deep learning method to segment PV and LA from Low-Dose CT images. In the method, attention mechanism is incorporated into the widely used V-Net and a novel grouped attention module is applied to enforce the segmentation performance of the V-Net. We evaluate our method on 68 3D Low-Dose CT images scanned from patients with TAPVC. The experiment result shows that our method outperforms the popular 3D-UNet and V-Net, with mean dice similarity coefficient (DSC) of 0.795 and 0.834 for the PV and LA respectively.Clinical relevance-We proposed a CNNs-based method for the automatic segmentation of PV and LA with good accuracy, which can be used for the preoperative evaluation and planning of TAPVC. Our method can improve the efficiency and reduce the workloads of radiologists (400 milliseconds vs. 2-3 hours per-case).


Assuntos
Veias Pulmonares , Síndrome de Cimitarra , Atenção , Criança , Átrios do Coração/diagnóstico por imagem , Humanos , Imageamento Tridimensional , Veias Pulmonares/diagnóstico por imagem
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2565-2568, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018530

RESUMO

In this study, we developed and analyzed different patient-specific 3D anatomical models of the left atrium including left atrial Appendage, in order to investigate the local hemodynamics. Particularly, we focused on the left atrial appendage and its impact on thrombus formation due to wall shear stress alterations. A 3D semi-automated reconstruction approach was carried out to segment and reconstruct the left atrium from CT scans. Six different patients were studied applying their patient-specific clinical data. Three different velocity profiles simulated for each patient case, representing one normal and two abnormal conditions. Simulations varied significantly according to different appendage morphologies. Our scope is to describe the hemodynamic behavior at the left atrium and the left atrial appendage according to different blood velocities based on their anatomic variety (chicken wing 0.14 m/s, windsock 0.10, cactus 0.08, and cauliflower 0.04). Wall shear stress results were demonstrated and correlated with the velocities and the thrombus formation inside the appendage cavity.


Assuntos
Apêndice Atrial , Fibrilação Atrial , Trombose , Apêndice Atrial/diagnóstico por imagem , Ecocardiografia Transesofagiana , Átrios do Coração/diagnóstico por imagem , Humanos , Trombose/diagnóstico por imagem
10.
Kyobu Geka ; 73(8): 623-626, 2020 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-32879294

RESUMO

A state in which thrombus is found in both right and left atria with thrombus penetrating the foramen ovale is called as impending paradoxical embolism (IPE). A 42-year-old man was found to have poor oxygenation and shock when his body was turned prone after induction of anesthesia. We inserted percutaneous cardiopulmonary support (PCPS), and his blood pressure was maintained. Transesophageal echocardiography revealed right heart pressure overload and left atrial thrombus. Computed tomography (CT) showed thrombosis in both main pulmonary arteries. The patient was judged to require emergency surgery. Bilateral pulmonary artery thrombus and thrombus between the right and left atria was removed under hypothermia using a heart-lung machine. Postoperatively, thrombus was detected in the bilateral posterior tibial vein and peroneal vein. He had a good postoperative course. There were few reports of IPE with pulmonary embolism that developed during operation.


Assuntos
Embolia Paradoxal , Embolia Pulmonar , Trombose , Adulto , Ecocardiografia Transesofagiana , Átrios do Coração/diagnóstico por imagem , Humanos , Masculino
11.
Am J Case Rep ; 21: e926915, 2020 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-32963216

RESUMO

BACKGROUND Recent studies demonstrated evidence of coagulation dysfunction in hospitalized patients with severe coronavirus disease 2019 (COVID-19) due to excessive inflammation, hypoxia, platelet activation, endothelial dysfunction, and stasis. Effective anticoagulation therapy may play a dominant role in the management of severe COVID-19 cases. CASE REPORT A 73-year-old man with a 6-day history of fever up to 38.5°C, dyspnea, cough, and fatigue was diagnosed with COVID-19. He had a past medical history significant for hypertension and coronary artery bypass grafting. Two days after hospital admission, the patient developed acute respiratory failure, requiring intubation, mechanical ventilation, and transfer to the intensive care unit (ICU). He received treatment including antibiotics, hydroxychloroquine, tocilizumab, vasopressors, prone positioning, and anticoagulation with enoxaparin at a prophylactic dose. After a 15-day ICU stay, the patient was hemodynamically stable but still hypoxemic; a transthoracic echocardiogram at that time, followed by a transesophageal echocardiogram for better evaluation, revealed the presence of a right atrium thrombus without signs of acute right ventricular dilatation and impaired systolic function. Since the patient was hemodynamically stable, we decided to treat him with conventional anticoagulation under close monitoring for signs of hemodynamic deterioration; thus, the prophylactic dose of enoxaparin was replaced by therapeutic dosing, which was a key component of the patient's successful outcome. Over the next few days he showed significant clinical improvement. The follow-up transesophageal echocardiogram 3 weeks after effective therapeutic anticoagulation revealed no signs of right heart thrombus. CONCLUSIONS The presented COVID-19 case, one of the first reported cases with evidence of right heart thrombus by transesophageal echocardiography, highlights the central role of diagnostic imaging strategies and the importance of adequate anticoagulation therapy in the management of severe COVID-19 cases in the ICU.


Assuntos
Infecções por Coronavirus/complicações , Ecocardiografia Transesofagiana/métodos , Átrios do Coração/diagnóstico por imagem , Cardiopatias/terapia , Pneumonia Viral/complicações , Síndrome Respiratória Aguda Grave/complicações , Trombose/terapia , Idoso , Terapia Combinada , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Tosse/diagnóstico , Tosse/etiologia , Cuidados Críticos/métodos , Progressão da Doença , Serviço Hospitalar de Emergência , Febre/diagnóstico , Febre/etiologia , Seguimentos , Grécia , Átrios do Coração/patologia , Cardiopatias/diagnóstico por imagem , Cardiopatias/etiologia , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Masculino , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Síndrome Respiratória Aguda Grave/diagnóstico , Síndrome Respiratória Aguda Grave/terapia , Índice de Gravidade de Doença , Trombose/diagnóstico por imagem , Trombose/etiologia , Resultado do Tratamento
13.
Arch Cardiovasc Dis ; 113(8-9): 525-533, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32873521

RESUMO

BACKGROUND: Transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE) can be used to detect the presence of left atrial thrombus and left atrial spontaneous echocardiographic contrast (LASEC). AIM: To evaluate the prognostic value of TTE and TOE in predicting stroke and all-cause death at 5-year follow-up in patients with non-valvular atrial fibrillation (NVAF). METHODS: This study included patients hospitalised with electrocardiography-diagnosed NVAF in Saint-Antoine University Hospital, Paris, between July 1998 and December 2011, who underwent TTE and TOE evaluation within 24hours of admission. Cox proportional-hazards models were used to identify predictors of the composite outcome (stroke or all-cause death). RESULTS: During 5 years of follow-up, stroke/death occurred in 185/903 patients (20.5%). By multivariable analysis, independent predictors of stroke/death were CHA2DS2-VASc score (hazard ratio [HR] 1.35, 95% confidence interval [CI] 1.25-1.47; P<0.001), left atrial area>20 cm2 (HR 1.59, 95% CI 1.08-2.35; P=0.018), moderate LASEC (HR 1.72, 95% CI 1.13-2.62; P=0.012) and severe LASEC (HR 2.04, 95% CI 1.16-3.58; P=0.013). Independent protective predictors were dyslipidaemia (HR 0.60, 95% CI 0.43-0.83; P=0.002) and discharge prescription of anti-arrhythmics (HR 0.59, 95% CI 0.40-0.87; P=0.008). Adding LASEC to the CHA2DS2-VASc score modestly improved predictive accuracy and risk classification, with a C index of 0.71 vs. 0.69 (P=0.004). CONCLUSIONS: In this retrospective monocentric study, the presence of moderate/severe LASEC was an independent predictor of stroke/death at 5-year follow-up in patients with NVAF. The inclusion of LASEC in stroke risk scores could modestly improve risk stratification.


Assuntos
Fibrilação Atrial/diagnóstico por imagem , Ecocardiografia Transesofagiana , Átrios do Coração/diagnóstico por imagem , Acidente Vascular Cerebral/etiologia , Idoso , Idoso de 80 Anos ou mais , Antiarrítmicos/uso terapêutico , Anticoagulantes/uso terapêutico , Fibrilação Atrial/complicações , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/mortalidade , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Inibidores da Agregação de Plaquetas/uso terapêutico , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/mortalidade , Acidente Vascular Cerebral/prevenção & controle , Fatores de Tempo
14.
Clin Nucl Med ; 45(10): 833-835, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32804771

RESUMO

A 52-year-old man had shortness of breath and chest discomfort for 2 months. Chest CT and MRI showed a mass in the left atrium attached to the mitral annulus without obvious enhancement. Initial diagnosis was suspected of myxoma. Preoperative FDG PET/CT demonstrated the corresponding lesion with abnormal FDG uptake, indicating a malignancy. Finally, histopathologic examination revealed primary undifferentiated sarcoma.


Assuntos
Fluordesoxiglucose F18 , Átrios do Coração/diagnóstico por imagem , Neoplasias Cardíacas/diagnóstico por imagem , Mixoma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Sarcoma/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Sarcoma/patologia
15.
Asian Cardiovasc Thorac Ann ; 28(8): 500-503, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32757656

RESUMO

A regular check up on a 59-year-old man showed a high carcinoembryonic antigen level in his blood. A computed tomography scan showed tumors in the right atrium. We performed tumor resection successfully. The resected specimen was found to be blood cysts that had developed from the right atrium to the inferior vena cava. Intracardiac blood cysts are generally observed in infants, spontaneously disappear during the first 6 months of life, and are located in the left side of heart and on atrioventricular valves. Therefore, this case is extremely rare. Also, it is worth considering the timing of this surgery.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Cistos/cirurgia , Átrios do Coração/cirurgia , Cardiopatias/cirurgia , Tempo para o Tratamento , Cistos/diagnóstico por imagem , Cistos/patologia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Cardiopatias/diagnóstico por imagem , Cardiopatias/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
16.
Cardiovasc Pathol ; 49: 107265, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32745615

RESUMO

BACKGROUND: Left atrial (LA) enlargement is associated with increased risk of adverse cardiovascular outcomes. Unlike the left ventricular mass, LA mass has not been described. We sought to define the anatomic mass of the LA using anatomic specimens from autopsy. We hypothesized that LA mass could be estimated by echocardiography. METHODS AND RESULTS: Using anatomic specimens of 22 subjects who died and underwent post mortem examination as well as echocardiogram, we defined normal LA mass by weighing anatomic specimens of those with normal LA volume on echocardiogram. Using 17 subjects with normal LA volume on echocardiogram, we found their LA mass on anatomic specimens to be 25.5 ± 6.3 grams (14.4 ± 3.2 g/m2). We developed an echocardiographic measure of LA mass and validated this measurement with paired LA anatomic specimens. We found the normal LA mass on echocardiogram to be 25.4 ± 6.3 g (14.4 ± 2.8 g/m2) which correlated well with anatomic specimens (ß = 0.99; Confidence interval CI 0.6-1.4, P < .0001; Pearson correlation coefficient r = 0.83). Furthermore, we defined the normal LA volume to mass ratio as 1.38 ± 0.45. CONCLUSIONS: LA mass is an additional parameter with which may contribute to the study of LA morphology.


Assuntos
Ecocardiografia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Idoso , Função do Átrio Esquerdo , Remodelamento Atrial , Autopsia , Feminino , Átrios do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos
17.
J Stroke Cerebrovasc Dis ; 29(9): 105066, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807470

RESUMO

BACKGROUND AND PURPOSE: The role of atrial fibrillation in cryptogenic stroke (CS) is well known. However, the usefulness of left atrial (LA) electrical and morphological abnormalities to identify more disabling strokes in sinus rhythm patients is less studied. We evaluated the association between electrocardiographic P-wave abnormalities and echocardiographic LA measures with neurological disability in patients with cryptogenic stroke. METHODS: In a retrospective cohort, we included all consecutive hospitalized patients with cryptogenic stroke. Patients were classified according to modified Rankin scale at hospital discharge and at 3 months. LA abnormalities were identified by electrocardiographic (ECG) P-wave, axis and LA enlargement criteria, and by bidimensional echocardiograph through left atrial diameter and volume index. RESULTS: Among the 143 patients with CS (63.4 ± 14.2 years, 53% women), 70 patients were classified as non-disabling stroke (Rankin score < 2) and 73 patients as disabling stroke (Rankin score ≥ 2) at hospital discharge. On echocardiogram, more patients with disabling stroke presented with enlarged LA volume index (48% vs. 25%; p = 0.01). This difference remained significant after adjustment for age, gender, CHA2DS2-VASc and NIHSS scores (p = 0.02) and even when the LA volume index was analyzed as a continuous variable (p = 0.055). Also, enlarged LA volume index was more prevalent (52% vs. 25%; p = 0.03) among those with disabling stroke at 3 months after hospital discharge. Among ECG criteria, only the LA enlargement assessed by downward deflection was more prevalent in disabling stroke. CONCLUSION: Our study demonstrated an association between left atrial enlargement, assessed by downward deflection from ECG and volume index from echocardiogram, and more disabling cryptogenic strokes. This information could help to identify patients with poorer prognosis, or a subgroup where atrial cardiopathy may play a role in cardioembolic pathway.


Assuntos
Fibrilação Atrial/diagnóstico , Função do Átrio Esquerdo , Remodelamento Atrial , Ecocardiografia , Eletrocardiografia , Átrios do Coração/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/complicações , Fibrilação Atrial/fisiopatologia , Bases de Dados Factuais , Avaliação da Deficiência , Feminino , Átrios do Coração/fisiopatologia , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/fisiopatologia
18.
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
19.
J Card Surg ; 35(10): 2863-2865, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32720392

RESUMO

BACKGROUND: Cardiac myxomas are common and account for 50% of primary intracardiac tumors. Atypical locations of cardiac myxoma increase the risk of intraoperative iatrogenic injuries. Herein, we report a case of using three-dimensional printing (3D) to facilitate the removal of an atypical cardiac myxoma in a 63-year-old woman. METHODS AND RESULTS: Mass in the high posterior atrial septum was confirmed through imaging. Due to the potential involvement of the mass to surrounding vital structures, 3D printing of the cardiac mass was performed. The tumor was completely resected via median sternotomy and the resulting defect was repaired with the bovine pericardium. The patient had an uncomplicated postoperative course except for the development of sick sinus syndrome. One-year follow-up showed no tumor recurrent. CONCLUSION: 3D printing technology in patients with atypical cardiac tumors enhances our understanding of the extent of the tumor invasion and facilitates planning the operation to avoid intraoperative complications.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Doença Iatrogênica/prevenção & controle , Complicações Intraoperatórias/prevenção & controle , Modelos Anatômicos , Mixoma/diagnóstico por imagem , Mixoma/cirurgia , Impressão Tridimensional , Animais , Bioprótese , Bovinos , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Átrios do Coração/cirurgia , Neoplasias Cardíacas/patologia , Septos Cardíacos/diagnóstico por imagem , Septos Cardíacos/cirurgia , Humanos , Pessoa de Meia-Idade , Mixoma/patologia , Invasividade Neoplásica , Pericárdio/transplante , Esternotomia/métodos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
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