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2.
Turk J Pediatr ; 61(1): 117-119, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31559732

RESUMO

Yakut K, Varan B, Erdogan I. Asymptomatic giant congenital left atrial aneurysm. Turk J Pediatr 2019; 61: 117-119. Congenital aneurysm of the left atrial appendage can be caused by congenital dysplasia of the pectinate muscles and may be accompanied by a congenital absence of the pericardium. Symptoms generally manifest after two decades and the most common symptom is atrial arrhythmia in the form of atrial fibrillation / flutter. A four year-old patient with no symptoms underwent an echocardiographic examination for the investigation of a heart murmur. Echocardiographic examination revealed a large cystic lesion occupying the left hemithorax and compressing the left ventricle. The patient was referred to our center. The lesion caused displacement of the heart rightward behind the sternum which made the examination difficult. We aimed to present this rare case of giant left atrial appendage aneurysm in the light of current literature.


Assuntos
Apêndice Atrial/diagnóstico por imagem , Aneurisma Cardíaco/congênito , Aneurisma Cardíaco/diagnóstico por imagem , Doenças Assintomáticas , Pré-Escolar , Sopros Cardíacos , Humanos , Angiografia por Ressonância Magnética , Masculino , Radiografia
3.
Turk J Pediatr ; 61(1): 142-146, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31559738

RESUMO

Ergül Y, Öztürk E, Özgür S. Successful radiofrequency ablation of accessory pathway associated with left atrial appendage aneurysm in a low birthweight premature patient. Turk J Pediatr 2019; 61: 142-146. Tachyarrhythmias are common cardiac arrhythmias in newborns and infants. We present a premature case with a 2.4-kg birth weight, with non-immune hydrops due to supraventricular tachycardia. Despite the combination of amiodarone, esmolol and flecainide, tachyarrhythmia could not be controlled and radiofrequency ablation was applied due to left ventricular dysfunction. After the procedure the rhythm returned to normal sinus and left ventricular functions improved rapidly. The follow-up of the case continues without any problems. In this presentation, successful ablation of the accessory pathway associated with structural heart disease have been covered in the youngest and smallest patient to date.


Assuntos
Apêndice Atrial/diagnóstico por imagem , Aneurisma Cardíaco/diagnóstico por imagem , Ablação por Radiofrequência , Taquicardia Supraventricular/terapia , Ecocardiografia , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Masculino
6.
Int J Cardiovasc Imaging ; 35(11): 2049-2056, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31325066

RESUMO

Left atrial (LA) enlargement is a marker of LA cardiopathy and, in patients with patent foramen ovale (PFO), is associated with an increased risk of ischemic stroke. The primary study outcome was the comparison of LA diameter between patients undergoing percutaneous PFO closure versus those treated conservatively. The secondary endpoints were the association of LA diameter with the Risk of Paradoxical Emboli (ROPE) score and the presence of Atrial septal aneurysm (ASA) and Right-To-Left Shunt (RLS). Retrospective analysis of clinical and instrumental data of 1040 subjects referred to a single tertiary center for PFO evaluation and treatment. Seven hundred and nineteen patients were enrolled: 495 patients (closure group, mean RoPE score 7.6 ± 0.8) underwent PFO closure while 224 patients (control group, mean RoPE score 4.1 ± 0.9. p < 0.001) were left to medical therapy. Preoperative LA diameter was significantly larger in closure group and reduced from 44.3 ± 9.1 to 37.3 ± 4.1 mm (p = 0.01) 1 year after the procedure to the size of controls. A larger LA diameter was associated with permanent RLS, RLS curtain pattern, ASA presence and multiple ischemic brain lesions pattern at neuroimaging. A LA diameter ≥ 43 mm was a predictor a RoPEscore > 7. In our patients' cohort, LA diameter was associated with the clinic severity of PFO and RLS. The reversal of LA enlargement after PFO closure suggests a role for RLS to induce LA cardiopathy. LA enlargement has the potential to be considered per se as an indication to transcatheter PFO repair.


Assuntos
Função do Átrio Esquerdo , Remodelamento Atrial , Cateterismo Cardíaco , Tratamento Conservador , Forame Oval Patente/terapia , Adulto , Cateterismo Cardíaco/efeitos adversos , Transtornos Cerebrovasculares/diagnóstico por imagem , Transtornos Cerebrovasculares/etiologia , Tratamento Conservador/efeitos adversos , Embolia Paradoxal/diagnóstico por imagem , Embolia Paradoxal/etiologia , Feminino , Forame Oval Patente/complicações , Forame Oval Patente/diagnóstico por imagem , Forame Oval Patente/fisiopatologia , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Recuperação de Função Fisiológica , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento
7.
Pan Afr Med J ; 32: 178, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31312292

RESUMO

Mitral valve aneurysm is a rare abnormality whose pathophysiology is poorly understood. It is defined as a bulge of the mitral valve leaflet toward the left atrium. Aneurysm in the posterior leaflet is exceptional. We report the case of a 26-year old man, who had been followed up for rheumatic aortic regurgitation for 4-years, hospitalized for febrile syndrome associated with episodes of left heart failure. Transthoracic echocardiographic examination (TTE) and transesophageal echocardiography (TEE) showed aortic valve vegetations with wide aneurysm of the small mitral valve associated with severe mitral valve regurgitation. The patient underwent mitral and aortic valve replacement with simple postoperative outcome. Clinical suspicion associated with suitable preoperative imaging and early surgical treatment are essential to recognize and treat this rare complication of infectious endocard.


Assuntos
Endocardite/complicações , Aneurisma Cardíaco/etiologia , Insuficiência da Valva Mitral/etiologia , Valva Mitral/diagnóstico por imagem , Adulto , Insuficiência da Valva Aórtica/patologia , Insuficiência da Valva Aórtica/cirurgia , Ecocardiografia/métodos , Ecocardiografia Transesofagiana/métodos , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Masculino , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/cirurgia
8.
Innovations (Phila) ; 14(4): 369-373, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31244359

RESUMO

Surgical ventricular reconstruction (SVR) is the therapy of choice for patients with left ventricular dilatation, apical and anterolateral transmural scar, and low ejection fraction. STICH trial did not show that SVR led to improved survival but several observational studies did. However, because of the considerable operative risk, open heart surgery is considered risky in debilitated patients and clinical results are controversial. Alternative less invasive strategies for left ventricular aneurysm repair have been proposed. We present a case of a left ventricular aneurysm repair using the less invasive ventricular enhancement technique (LIVE) with the Revivent TC system (BioVentrix Inc., San Ramon, CA) in a totally surgical approach, instead of a hybrid interventional-surgical one, as previously described.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Aneurisma Cardíaco/cirurgia , Ventrículos do Coração/cirurgia , Disfunção Ventricular Esquerda/cirurgia , Procedimentos Cirúrgicos Cardíacos/instrumentação , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/etiologia , Ventrículos do Coração/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/etiologia , Remodelação Ventricular
9.
BMJ Case Rep ; 12(6)2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31248896

RESUMO

Atrial septal aneurysms have two mechanisms for cardioembolic events. One is the aneurysm itself can act as a nidus for thrombus formation in the left atrium. The aneurysm creates an area of low turbulence leading to haemostasis allowing fibrin-platelet adhesions to form. If the clot is on the left atrial wall, it may be dislodged by oscillations of the septum and travel into the systemic circulation. The second mechanism is via, an often comorbid, interatrial shunt such as a Patent Foramen Ovale or Atrial Septal Defect. We report a unique case where the associated right to left shunt leading to the cryptogenic stroke is a pulmonary arteriovenous malformation.


Assuntos
Malformações Arteriovenosas/complicações , Malformações Arteriovenosas/diagnóstico por imagem , Aneurisma Cardíaco/complicações , Aneurisma Cardíaco/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/etiologia , Adulto , Encéfalo/diagnóstico por imagem , Diagnóstico Diferencial , Ecocardiografia Transesofagiana , Evolução Fatal , Feminino , Septos Cardíacos/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Veias Pulmonares/diagnóstico por imagem
10.
Am J Case Rep ; 20: 810-815, 2019 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-31177265

RESUMO

BACKGROUND Response to cardiac resynchronization therapy (CRT) is variable among patients. Extensive scar tissue burden has been characterized as a negative predictor of significant response. Whereas mid-term and long-term response has been thoroughly investigated in randomized clinical trials; however, little is known about acute hemodynamic effects of biventricular pacing. CASE REPORT We report a case of an elderly female patient with severe ischemic cardiomyopathy and a large anterior wall aneurysm, who received right ventricular and biventricular pacing during ablation of incessant pleomorphic ventricular tachycardia. During the procedure, biventricular pacing was associated with a 20% acute increase in systolic blood pressure compared to right ventricular pacing, although there was no acute or long-term effect on left ventricular function. CONCLUSIONS The acute hemodynamic effect of CRT in our patient suggests an effect of CRT even in patients with negative predictors of CRT response such as severe ischemic cardiomyopathy with a large aneurysm. Although no marked increase in left ventricular function might be observed, the acute effect of CRT might contribute to stabilization of heart failure in these patients.


Assuntos
Terapia de Ressincronização Cardíaca/métodos , Ablação por Cateter/métodos , Aneurisma Cardíaco/complicações , Hemodinâmica/fisiologia , Isquemia Miocárdica/diagnóstico por imagem , Taquicardia Ventricular/cirurgia , Idoso de 80 Anos ou mais , Dispneia/diagnóstico , Dispneia/etiologia , Eletrocardiografia/métodos , Feminino , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/cirurgia , Humanos , Imagem Tridimensional/métodos , Multimorbidade , Isquemia Miocárdica/complicações , Isquemia Miocárdica/terapia , Prognóstico , Medição de Risco , Taquicardia Ventricular/diagnóstico por imagem , Resultado do Tratamento
12.
J Vet Cardiol ; 23: 15-20, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31174725

RESUMO

Aneurysmal dilation of the atrial appendage (auricle) is rare in humans and dogs. Congenital and acquired etiologies are hypothesized. Although right auricular aneurysm has been described in dogs, this is the first case report of an aneurysm of the left auricle of a dog with an intact pericardium. In humans, because complications of arrhythmia and thromboembolic disease have been reported, surgical resection of left auricular aneurysm is recommended. This report describes the successful surgical resection of a left auricular aneurysm in a dog, including a one-year follow up. Surgical resection can be considered in dogs with auricular aneurysm.


Assuntos
Apêndice Atrial/cirurgia , Doenças do Cão/cirurgia , Aneurisma Cardíaco/veterinária , Animais , Apêndice Atrial/diagnóstico por imagem , Doenças do Cão/diagnóstico por imagem , Cães , Ecocardiografia/veterinária , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/cirurgia , Masculino , Resultado do Tratamento
13.
J Cardiothorac Surg ; 14(1): 93, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101055

RESUMO

BACKGROUND: Left ventricular (LV) pseudo-false aneurysm is a rare complication secondary to myocardial infarction and is caused by intramyocardial dissecting hematoma due to fragile myocardium. Very occasionally, intramyocardial dissecting hematoma appears as a neocavitation entirely contained within the myocardial wall (so called "pseudo-false LV") and is an unusual form of subacute cardiac rupture. CASE PRESENTATION: A 38-year-old male experienced chest discomfort 3 weeks ago, which improved within few days. However, after that episode, he presented at our hospital with rapidly deteriorating severe breathlessness in a preshock state with acute heart failure. Emergency coronary angiography revealed an occluded left anterior descending artery. An intra-aortic balloon catheter was inserted because of unstable hemodynamics. Enhanced computed tomography revealed extensive aneurysm formation in the LV anterior wall and contrast leakage from the inner cavity to the LV myocardium, with a moderately accumulated pericardial effusion. Emergency surgery revealed a large aneurysmal sac on the anterior wall, slightly attached to the pericardium. A 5-mm, slit-like, oozing-type, rupture site was detected in the LV after dissecting the pericardium. CONCLUSIONS: To our knowledge, this is the first report of a pseudo-false aneurysm on the LV anterior wall. Subacute rupture of pseudo-false LV aneurysm is rare.


Assuntos
Falso Aneurisma/diagnóstico , Aneurisma Roto/diagnóstico , Infarto Miocárdico de Parede Anterior/diagnóstico , Aneurisma Cardíaco/diagnóstico , Ventrículos do Coração , Adulto , Falso Aneurisma/complicações , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Aneurisma Roto/complicações , Aneurisma Roto/diagnóstico por imagem , Aneurisma Roto/cirurgia , Infarto Miocárdico de Parede Anterior/complicações , Infarto Miocárdico de Parede Anterior/diagnóstico por imagem , Infarto Miocárdico de Parede Anterior/cirurgia , Angiografia Coronária , Diagnóstico Diferencial , Aneurisma Cardíaco/complicações , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/cirurgia , Humanos , Masculino
14.
Intern Med ; 58(16): 2373-2376, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31118390

RESUMO

Aorto-mitral discontinuity is considered a relatively rare complication of infective endocarditis, usually requiring invasive surgical procedures, including double valve replacement in addition to aortic root replacement/repair. In the present case report, images were produced using transthoracic echocardiograms and transesophageal echocardiograms, which may assist in the planning of surgical procedures. The images captured using real-time three-dimensional transesophageal echocardiograms revealed aorto-mitral discontinuity and a perforated mitral valve aneurysm of the anterior leaflet.


Assuntos
Endocardite Bacteriana/complicações , Aneurisma Cardíaco/complicações , Aneurisma Cardíaco/cirurgia , Insuficiência da Valva Mitral/etiologia , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Idoso , Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia/métodos , Ecocardiografia Transesofagiana/métodos , Aneurisma Cardíaco/diagnóstico por imagem , Humanos , Masculino , Insuficiência da Valva Mitral/diagnóstico por imagem , Resultado do Tratamento
17.
BMC Cardiovasc Disord ; 19(1): 80, 2019 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-30943895

RESUMO

BACKGROUND: There are three major mechanical complications after acute myocardial infarction: left ventricular free-wall rupture, ventricular septum rupture and acute mitral valve regurgitation. The left ventricular free-wall rupture is a serious and often lethal complication following an ST elevation myocardial infarction. However, very rarely this rupture can be contained by the pericardium, forming a pseudoaneurysm. CASE PRESENTATION: We report a case of a 66-year-old man with multiple cardiovascular risk factors and previous ST elevation myocardial infarction, complaining of atypical chest pain. His electrocardiogram was in normal sinus rhythm, with the presence of Q wave in inferior leads and T-wave inversion in lateral leads. A transthoracic echocardiogram showed a left ventricular pseudoaneurysm. In the coronary angiography, multi-vessel disease was found. On-pump CABG was performed and a posterolateral left ventricular giant pseudoaneurysm were observed. Due its "petrous" consistency it was impossible to perform an aneurysmectomy. CONCLUSIONS: The diagnosis of left ventricular pseudoaneurysm can be difficult, as patients often present either asymptomatic or with non-specific symptoms attributed to other causes. A multimodality imaging diagnostic approach can be necessary. Immediate surgery is considered the treatment of choice because untreated pseudoaneurysms have a high risk of rupture leading to cardiac tamponade, shock and death.


Assuntos
Falso Aneurisma/etiologia , Aneurisma Cardíaco/etiologia , Ruptura Cardíaca Pós-Infarto/etiologia , Infarto do Miocárdio/complicações , Idoso , Falso Aneurisma/diagnóstico por imagem , Ponte de Artéria Coronária , Aneurisma Cardíaco/diagnóstico por imagem , Ruptura Cardíaca Pós-Infarto/diagnóstico por imagem , Humanos , Masculino , Imagem Multimodal , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/cirurgia , Resultado do Tratamento
18.
Echocardiography ; 36(5): 987-991, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30868653

RESUMO

Asian hypertrophic cardiomyopathy (AHCM) is a rare variant of hypertrophic cardiomyopathy (HCM) that is more prevalent in the Asian population. There is significant overlap between AHCM, mid-cavitary obstruction, and apical aneurysms. Although more benign compared to HCM, the course of AHCM is not clearly defined. We present an interesting case of an African American male with known AHCM who develops symptomatic mid-cavitary obstruction and apical aneurysm 11 years after initial diagnosis.


Assuntos
Cardiomiopatia Hipertrófica/complicações , Ecocardiografia/métodos , Aneurisma Cardíaco/complicações , Aneurisma Cardíaco/diagnóstico por imagem , Obstrução do Fluxo Ventricular Externo/complicações , Obstrução do Fluxo Ventricular Externo/diagnóstico por imagem , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade
19.
Kyobu Geka ; 72(3): 178-181, 2019 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-30923292

RESUMO

An 80-year-old male was admitted to our hospital because of subacute myocardial infarction with moderate mitral regurgitation. Though he recovered well and went home within 2 weeks, the transthoracic echocardiography revealed rapid growing aneurysmal changes at the left ventricular posterior wall. We made diagnose of a pseudoaneurysm by the multi detector-row computed tomography, and planed a surgical treatment. Following the cardiac arrest, an endoscope was inserted into the left ventricle, we inspected the relation between the mitral valve and papillary muscles to detect proper suture lines and to avoid the mitral regurgitation. The defect of the left ventricular wall was repaired with 2-layer bovine pericardial patches reinforced with fibrin glue. His postoperative course was uneventful, and he was discharged from hospital on 12th postoperative day. We consider that inspections of intra-ventricle apparatus with the endoscope are useful to prevent the mitral valve insufficiency and keep the optimal left ventricle shape.


Assuntos
Falso Aneurisma/cirurgia , Aneurisma Cardíaco/cirurgia , Idoso de 80 Anos ou mais , Falso Aneurisma/diagnóstico por imagem , Aneurisma Cardíaco/diagnóstico por imagem , Ventrículos do Coração/cirurgia , Humanos , Masculino , Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/prevenção & controle , Tomografia Computadorizada Multidetectores , Infarto do Miocárdio/complicações , Músculos Papilares/diagnóstico por imagem , Complicações Pós-Operatórias/prevenção & controle , Cuidados Pré-Operatórios , Técnicas de Sutura
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