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2.
Rev Med Liege ; 74(7-8): 375-377, 2019 07.
Artigo em Francês | MEDLINE | ID: mdl-31373448

RESUMO

We report a case of left ventricular pseudo-aneurysm and we take the opportunity to briefly review the literature concerning etiologies, diagnosis and management of this pathology, emphasizing some differences with the true aneurysm.


Assuntos
Síndrome Coronariana Aguda , Falso Aneurisma , Aneurisma Cardíaco , Síndrome Coronariana Aguda/complicações , Falso Aneurisma/etiologia , Aneurisma Cardíaco/etiologia , Ventrículos do Coração , Humanos
3.
Cardiol Young ; 29(9): 1206-1207, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31434603

RESUMO

Ventricular pseudoaneurysm is a rare but well-known complication after valvular endocarditis. The lesion was localised exactly where pre-operative CT scan showed lack of enhancement in the postero-lateral wall of the left ventricle. This case demonstrates how much attention must be paid to myocardial CT images and emphazises the need of close follow-up in patients with infective endocartitis.


Assuntos
Falso Aneurisma/diagnóstico , Insuficiência da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Endocardite Bacteriana/complicações , Aneurisma Cardíaco/diagnóstico , Implante de Prótese de Valva Cardíaca/efeitos adversos , Tomografia Computadorizada por Raios X/métodos , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Valva Aórtica/diagnóstico por imagem , Insuficiência da Valva Aórtica/diagnóstico , Criança , Ecocardiografia Transesofagiana , Endocardite Bacteriana/diagnóstico , Aneurisma Cardíaco/etiologia , Aneurisma Cardíaco/cirurgia , Ventrículos do Coração , Humanos , Masculino , Reoperação
4.
Intern Med ; 58(13): 1901-1905, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31257277

RESUMO

We report a case with the simultaneous occurrence of pseudo-aneurysm of the left ventricle and ventricular septal rupture, which was successfully surgically repaired. A 77-year-old woman with a history of aortic valve replacement and coronary bypass graft presented to our clinic due to chest pain. She was diagnosed with anterior ST-segment elevation myocardial infarction (STEMI) based on an electrocardiogram. Echocardiography revealed pseudo-aneurysm of the left ventricle and ventricular septal rupture. Coronary angiography revealed 99% stenosis with delayed contrast filling in the mid left anterior descending artery. Surgical repair with a bovine pericardium patch was performed, and the postoperative course was uneventful.


Assuntos
Falso Aneurisma/cirurgia , Aneurisma Cardíaco/cirurgia , Ventrículos do Coração/fisiopatologia , Ventrículos do Coração/cirurgia , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações , Ruptura do Septo Ventricular/cirurgia , Idoso , Falso Aneurisma/etiologia , Animais , Bovinos , Angiografia Coronária , Ecocardiografia , Eletrocardiografia , Feminino , Aneurisma Cardíaco/etiologia , Ventrículos do Coração/diagnóstico por imagem , Humanos , Resultado do Tratamento , Ruptura do Septo Ventricular/etiologia
5.
Int Heart J ; 60(4): 998-1002, 2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31257334

RESUMO

Ventricular pseudoaneurysm (PSA) is a rare, yet life-threatening complication of myocardial infarction, cardiac surgery, and transcatheter valve replacement. Although conventional surgery is the preferred treatment strategy, transcatheter closure has emerged as an effective alternative in selected candidates. In this report, we describe successful transcatheter closure of two unique cases of ventricular pseudoaneurysm (PSA): first, a complex post-myocardial infarction left ventricular PSA (LVPSA) with multi-communications, and second, a case of post-traumatic right ventricular PSA (RVPSA) following blunt chest injury caused by domestic violence.


Assuntos
Falso Aneurisma/cirurgia , Cateterismo Cardíaco/métodos , Aneurisma Cardíaco/cirurgia , Ventrículos do Coração , Infarto do Miocárdio/complicações , Traumatismos Torácicos/complicações , Ferimentos não Penetrantes/complicações , Idoso , Falso Aneurisma/diagnóstico , Falso Aneurisma/etiologia , Procedimentos Cirúrgicos Cardíacos/métodos , Violência Doméstica , Ecocardiografia , Feminino , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/etiologia , Humanos , Imagem Cinética por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Traumatismos Torácicos/diagnóstico , Ferimentos não Penetrantes/diagnóstico
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.
Tex Heart Inst J ; 46(2): 147-150, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31236084

RESUMO

Pseudoaneurysms of the mitral-aortic intervalvular fibrosa are rare complications that can develop after mitral or aortic valve surgery, endocarditis, or Takayasu arteritis. The optimal timing of surgery to avoid potentially life-threatening complications of pseudoaneurysms has not been established, and watchful waiting has been adopted in specific situations. We describe the case of a 50-year-old man in whom a pseudoaneurysm of the mitral-aortic intervalvular fibrosa developed after aortic root replacement with a homograft. After 13 years of watchful waiting, reoperation was deemed necessary because the pseudoaneurysm had grown to 48 mm and the aortic regurgitation caused by the degenerated homograft had become severe. This case highlights the need for increased awareness of mitral-aortic intervalvular fibrosa pseudoaneurysms and their management.


Assuntos
Falso Aneurisma/cirurgia , Aorta Torácica/cirurgia , Valva Aórtica/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Aneurisma Cardíaco/cirurgia , Valva Mitral/cirurgia , Falso Aneurisma/diagnóstico , Falso Aneurisma/etiologia , Aorta Torácica/diagnóstico por imagem , Insuficiência da Valva Aórtica/cirurgia , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/etiologia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos , Imagem Tridimensional , Imagem Cinética por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Reoperação , Tomografia Computadorizada por Raios X
9.
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
11.
Heart Surg Forum ; 22(2): E159-E161, 2019 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-31013228

RESUMO

We present the case of a 63-year-old male with post-myocardial infarction causing a giant left ventricular aneurysm and describe the surgical treatment via Dor Procedure.


Assuntos
Aneurisma Cardíaco/etiologia , Aneurisma Cardíaco/cirurgia , Ventrículos do Coração/cirurgia , Infarto do Miocárdio/complicações , Ponte Cardiopulmonar , Ponte de Artéria Coronária , Humanos , Masculino , Pessoa de Meia-Idade
12.
Am J Emerg Med ; 37(6): 1175-1183, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30987913

RESUMO

INTRODUCTION: Despite the declining incidence of coronary heart disease (CHD) in the United States, acute myocardial infarction (AMI) remains an important clinical entity, with many patients requiring emergency department (ED) management for mechanical, inflammatory, and embolic complications. OBJECTIVE: This narrative review provides an evidence-based summary of the current data for the emergency medicine evaluation and management of post myocardial infarction mechanical, inflammatory, and embolic complications. DISCUSSION: While 30-day mortality rate after AMI has decreased in the past two decades, it remains significantly elevated at 7.8%, owing to a wide variety of subacute complications evolving over weeks. Mechanical complications such as ventricular free wall rupture, ventricular septal rupture, mitral valve regurgitation, and formation of left ventricular aneurysms carry significant morbidity. Additional complications include ischemic stroke, heart failure, renal failure, and cardiac dysrhythmias. This review provides several guiding principles for management of these complications. Understanding these complications and an approach to the management of various complications is essential to optimizing patient care. CONCLUSIONS: Mechanical, inflammatory, and embolic complications of AMI can result in significant morbidity and mortality. Physicians must rapidly diagnose these conditions while evaluating for other diseases. In addition to understanding the natural progression of disease and performing a focused physical examination, an electrocardiogram and bedside echocardiogram provide quick, noninvasive determinations of the underlying pathophysiology. Management varies by presentation and etiology, but close consultation with cardiology and cardiac surgery is recommended.


Assuntos
Aneurisma Cardíaco/etiologia , Ruptura Cardíaca Pós-Infarto/etiologia , Insuficiência da Valva Mitral/etiologia , Infarto do Miocárdio/complicações , Pericardite/etiologia , Ecocardiografia , Eletrocardiografia , Medicina de Emergência , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/terapia , Ruptura Cardíaca Pós-Infarto/diagnóstico , Ruptura Cardíaca Pós-Infarto/terapia , Humanos , Insuficiência da Valva Mitral/diagnóstico , Insuficiência da Valva Mitral/terapia , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/fisiopatologia , Narração , Pericardite/diagnóstico , Pericardite/terapia , Exame Físico , Sistemas Automatizados de Assistência Junto ao Leito , Fatores de Risco
13.
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
17.
Ann Thorac Surg ; 107(4): e263-e265, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30359591

RESUMO

The surgical indication and optimal approach for ischemic mitral regurgitation with ventricular septal defect remain uncertain. Very few studies have reported the occurrence of left ventricular aneurysms after repair of ischemic ventricular septal defects. We report a case of a left posterior ventricular aneurysm that developed after an urgent operation to repair an acute ischemic posterior ventricular septal defect using the double-patch sandwich technique via a right ventriculotomy.


Assuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Aneurisma Cardíaco/etiologia , Comunicação Interventricular/etiologia , Comunicação Interventricular/cirurgia , Infarto Miocárdico de Parede Inferior/complicações , Doença Aguda , Idoso , Procedimentos Cirúrgicos Cardíacos/métodos , Estenose Coronária/complicações , Estenose Coronária/diagnóstico por imagem , Ecocardiografia/métodos , Feminino , Seguimentos , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/cirurgia , Ventrículos do Coração/cirurgia , Humanos , Infarto Miocárdico de Parede Inferior/diagnóstico por imagem , Monitorização Intraoperatória/métodos , Medição de Risco , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Doppler em Cores/métodos
18.
Cardiol Clin ; 37(1): 95-104, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30447720

RESUMO

Surgical septal myectomy is the preferred method of septal reduction for most patients with obstructive hypertrophic cardiomyopathy whose symptoms do not respond to medical management. Transaortic extended septal myectomy has low operative mortality and provides durable relief of symptoms. Surgical treatment is possible for patients with less common phenotypes, such as complex long-segment septal hypertrophy, midventricular obstruction, or apical hypertrophic cardiomyopathy. For these anatomic subtypes, transapical myectomy can be used alone or combined with transaortic myectomy. This article describes both of these surgical techniques and discusses preoperative considerations and postoperative management for patients with hypertrophic cardiomyopathy.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Cardiomiopatia Hipertrófica/cirurgia , Estenose da Valva Aórtica/patologia , Estenose da Valva Aórtica/cirurgia , Cardiomiopatia Hipertrófica/patologia , Ecocardiografia/métodos , Aneurisma Cardíaco/etiologia , Aneurisma Cardíaco/patologia , Humanos , Angiografia por Ressonância Magnética/métodos , Estenose da Valva Mitral/patologia , Estenose da Valva Mitral/cirurgia , Seleção de Pacientes , Cuidados Pós-Operatórios/métodos , Cuidados Pré-Operatórios/métodos , Resultado do Tratamento
20.
Kyobu Geka ; 71(13): 1109-1113, 2018 12.
Artigo em Japonês | MEDLINE | ID: mdl-30587752

RESUMO

A 79-year-old woman visited a hospital with coronary vasospastic angina and supraventricular tachycardia. Periodic inspection of echocardiography suggested a right atrial tumor which was not pointed out 6 months ago, but magnetic resonance imaging suggested a valve aneurysm. These findings were contradictory. We preoperatively diagnosed a cardiac tumor because of its new onset and mobility. Tumor resection and valve repair was planned in consideration of the risk of embolism. As a result, we finally diagnosed tricuspid valve aneurysm from the intraoperative findings and histopathological findings. We assumed that valve aneurysm was formed in the healing process of subclinical infective endocarditis. It was inferred that preoperative diagnosis of valve aneurysm is very difficult.


Assuntos
Aneurisma Cardíaco/diagnóstico por imagem , Neoplasias Cardíacas/diagnóstico por imagem , Valva Tricúspide/diagnóstico por imagem , Idoso , Ecocardiografia , Endocardite Bacteriana/complicações , Feminino , Aneurisma Cardíaco/etiologia , Átrios do Coração/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Período Pré-Operatório
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