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1.
Vasc Endovascular Surg ; 54(2): 195-197, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31597540

RESUMO

BACKGROUND: The carotid sheath contains clinically important and vital anatomical neurogenic, vascular, and lymphatic structures that allow for a great variety of lesions. Vascular anomalies found in the carotid sheath are rarely reported and may be easily misdiagnosed as arterial aneurysms, neurogenic tumors, paragangliomas, or lymphatic masses. METHOD: We present a 60-year-old woman with a vascular malformation arising within the carotid sheath at the right carotid bifurcation, which mimics carotid body tumor. RESULT: The mass was excised successfully with an uneventful postoperative course, and histological analysis suggested a vascular malformation with thin-walled blood vessels, lined by endothelial cells and separated by fibrous tissue. The patient was in good clinical condition without signs of relapse of the mass at 6-month follow-up. CONCLUSION: Vascular malformation is a rare but existing possibility of pathology in the carotid sheath, which can be effectively removed by meticulous surgery.


Assuntos
Tumor do Corpo Carotídeo/diagnóstico por imagem , Malformações Vasculares/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Resultado do Tratamento , Malformações Vasculares/cirurgia
2.
Br J Radiol ; 93(1106): 20190781, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31868522

RESUMO

OBJECTIVE: Sedation for pediatric patients undergoing interventional procedures in radiology is in increasing demand. Once only anesthesiology-performed, there is a demand for sedation services to perform sedations for these procedures. However, the safety of performing long sedations by non-anesthesiologists in interventional radiology has not been reported. This pilot study aimed at describing a single center's experience and outcome with sedation. METHODS: This study reviews the sedations performed at a single center by a pediatric emergency physician who performed the sedation. The results regarding safety and satisfaction were reviewed. RESULTS: A total of 52 sedations were documented. Four cases of significant adverse events and three adverse events occurred. In all cases, the procedures were completed. None of the patients required intubation or admission following the sedation. There was high satisfaction by the interventional radiologists. CONCLUSION: This small pilot study shows that sedations for procedures in interventional radiology can be performed safely and successfully by dedicated non-anesthesiology sedation services. This may be considered as an alternative when anesthesiology service is not available. ADVANCES IN KNOWLEDGE: This small, single center pilot study examines the safety of sedation by a non-anesthesiologist for interventional radiology procedures. This may offer an additional method of performing procedures in the pediatric population while anesthesia is not readily available.


Assuntos
Sedação Consciente/métodos , Medicina de Emergência/estatística & dados numéricos , Malformações Vasculares/cirurgia , Adolescente , Anestesiologistas , Criança , Pré-Escolar , Sedação Consciente/efeitos adversos , Medicina de Emergência/normas , Métodos Epidemiológicos , Feminino , Humanos , Lactente , Masculino , Segurança do Paciente
3.
Tech Vasc Interv Radiol ; 22(4): 100635, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31864534

RESUMO

Vascular malformations are generally congenital benign lesions that have multiple variations in treatment algorithms. Surgery can be used as a single modality or as an adjunct in multimodal therapy to treat these lesions. Here we discuss surgical treatment of the major vascular malformations, including lymphatic, venous, and arteriovenous malformations. We explain some of the basic principles to resection of simple and complex lesions and adjunctive therapies. These adjunct therapies include chemotherapeutic injections, embolization, and laser therapy. Surgical resection of complex lesions should only be performed by an experienced vascular anomalies surgeon. A team approach is generally necessary to provide safe and effective treatment. While surgery for these complex lesions is an option, the most important principle to adhere to when treating any of these lesions is that the treatment should be no worse than the disease.


Assuntos
Anormalidades Linfáticas/cirurgia , Malformações Vasculares/cirurgia , Procedimentos Cirúrgicos Vasculares , Tomada de Decisão Clínica , Humanos , Anormalidades Linfáticas/diagnóstico por imagem , Anormalidades Linfáticas/fisiopatologia , Seleção de Pacientes , Fatores de Risco , Resultado do Tratamento , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/fisiopatologia , Procedimentos Cirúrgicos Vasculares/efeitos adversos
4.
Medicine (Baltimore) ; 98(44): e17798, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689858

RESUMO

RATIONALE: Dieulafoy disease of the bronchus is a rare vascular deformity. To the best of our knowledge, reports of these involving both lung vascular are hitherto absent. PATIENT CONCERNS: A 67-year-old male was admitted to our department due to agnogenic hemoptysis. DIAGNOSES: Bronchoscopy was performed and some smooth, pulsatile nodular lesions were found in the middle and lower lobes, Computed tomography angiography of the bronchial artery confirmed a left bronchial artery arising from the aortic arch at T4 level, and both bronchial arteries were dilated and tortuous. INTERVENTIONS: Bronchial artery embolization was performed successfully. OUTCOMES: The patient was discharged with no hemoptysis. In addition, patient is under follow-up until today without any further incidents. LESSONS: This case reminds us that Dieulafoy disease of the bronchus could be a potential etiology for unexplained hemoptysis. The clinician should be aware of this disease when bronchoscopy revealed multiple some smooth, pulsatile nodular lesions, thereafter, bronchoscope biopsy should be avoided, as it could lead to fatal hemoptysis.


Assuntos
Artérias Brônquicas/anormalidades , Broncopatias/complicações , Hemoptise/etiologia , Malformações Vasculares/complicações , Idoso , Artérias Brônquicas/cirurgia , Broncopatias/patologia , Broncopatias/cirurgia , Broncoscopia/métodos , Angiografia por Tomografia Computadorizada , Hemoptise/cirurgia , Humanos , Pulmão/patologia , Masculino , Malformações Vasculares/patologia , Malformações Vasculares/cirurgia
6.
World J Pediatr Congenit Heart Surg ; 10(4): 464-468, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31307306

RESUMO

OBJECTIVES: To review the outcomes of direct innominate artery cannulation for continuous cerebral perfusion used for repair of interrupted aortic arch (IAA) in a consecutive cohort of neonates regardless of weight. METHODS: Between September 1999 and April 2016, forty-four children with IAA (18 type A and 26 type B) underwent repair using continuous, hypothermic (18°C) low-flow cerebral perfusion via direct innominate artery cannulation. Associated cardiac lesions were truncus arteriosus (TA; 5), ventricular septal defect (VSD; 30), transposition of the great arteries (TGA; 1), unbalanced atrioventricular septal defect (1), double-inlet left ventricle (1), double-outlet right ventricle (3), and aortopulmonary window (APW; 5). Truncus arteriosus, single VSD, TGA, and APW were corrected while the other patients were palliated. RESULTS: Age at the time of surgery was 7 days (4-120 days) and weight 3.1 kg (2.1-5.8 kg). Selective cerebral perfusion was maintained in all patients. During the selective cerebral perfusion, perfusion flow rate was maintained at 30 mL/kg/min. Aortic cross-clamp time, low-flow, and total cardiopulmonary bypass time were 63 (40-116), 28 (17-41), and 108 (80-217) minutes, respectively. There were no deaths nor clinical evidence of neurological injury. Postoperative ventilation time, length of intensive care unit, and hospital stay were 3 (2-14), 5 (3-21), and 13 (6-27) days, respectively. Follow-up, complete at 84 months (24-221), revealed no late clinically evident neurologic sequelae nor innominate artery complications. CONCLUSIONS: Direct innominate arterial cannulation with continuous selective cerebral perfusion can be safely applied for repair of IAA even in low birth weight neonates. It is technically simple and associated with excellent clinical outcomes.


Assuntos
Aorta Torácica/anormalidades , Cateterismo/métodos , Circulação Cerebrovascular/fisiologia , Recém-Nascido de Baixo Peso , Perfusão/métodos , Malformações Vasculares/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Angiografia , Aorta Torácica/cirurgia , Feminino , Humanos , Recém-Nascido , Masculino , Resultado do Tratamento , Malformações Vasculares/fisiopatologia
8.
World Neurosurg ; 130: e953-e960, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31302279

RESUMO

BACKGROUND: Vascular malformations of the spinal cord are a rare and complex clinical entity and can lead to severe morbidity with progressive spinal cord symptoms if not treated properly. In early stages, the disease is characterized by slowly progressive, nonspecific symptoms, such as gait disturbance, paresthesia, diffuse sensory symptoms, and radicular pain; in the late stages, bowel and bladder incontinence, erectile dysfunction, and urinary retention may develop. In recent decades, understanding and treatment of spinal vascular malformations have improved with the evolution of diagnostic tools and treatment modalities; however, it is still difficult to manage these cases because of the complexity of the pathology. The aims of this study were to present the long-term outcomes of our patients and to discuss the optimal management strategies. METHODS: We reviewed the records of 78 patients with spinal vascular malformations and performed a retrospective, single-center case series evaluating initial occlusion, recanalization, retreatment, and neurologic status of patients with dural arteriovenous fistulas, perimedullary arteriovenous fistulas, arteriovenous malformations, and extradural arteriovenous fistulas who had undergone embolization and/or surgery. RESULTS: No mortality was observed. Complete obliteration was achieved in 76 patients (97.4%). CONCLUSIONS: Both endovascular and surgical treatment of spinal vascular malformations resulted in significant long-term recovery from myelopathic symptoms and improvement in quality of life for most patients.


Assuntos
Medula Espinal/diagnóstico por imagem , Medula Espinal/cirurgia , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medula Espinal/irrigação sanguínea , Resultado do Tratamento , Adulto Jovem
9.
Urology ; 131: 223-227, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31163184

RESUMO

Glanular venous malformations are uncommon in pediatric patients. The diagnosis can be easily achieved by observation, even if color Doppler ultrasound is useful for a better characterization. Abdomino-pelvic MRI is necessary to assess the extension of complex lesions and check for associated anomalies. Several therapeutic options are reported in literature. We report 3 paediatric cases successfully treated by surgery with no complications and functional sequelae. Cosmetic results were satisfactory, with minimal surgical scarring. In our opinion, surgery for small glanular venous malformations is indicated within puberty to prevent traumatic bleeding and psychological impact.


Assuntos
Doenças do Pênis/patologia , Doenças do Pênis/cirurgia , Pênis/irrigação sanguínea , Malformações Vasculares/patologia , Malformações Vasculares/cirurgia , Criança , Pré-Escolar , Humanos , Masculino
10.
Pediatr Cardiol ; 40(5): 1026-1034, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31049646

RESUMO

Tetralogy of Fallot with unilateral absence of the pulmonary artery (UAPA) is a rare congenital heart disease. The aim of the present study was to examine the surgical strategy for Tetralogy of Fallot with UAPA by summarizing our experience of its treatment. We retrospectively evaluated 17 patients admitted to our hospital for treatment between 2006 and 2017. All patients were diagnosed with absence of the left pulmonary artery. The Nakata Index (NI), NI Z score, and McGoon ratio of the existing pulmonary artery were calculated. All patients were divided into one-stage complete repair (group A) or palliative procedure (group B) groups according to these criteria and surgical treatments. There were nine treated patients in group A, with a mean NI of 595.6 ± 690.32 mm2/m2 (169.3-2433 mm2/m2) and a mean NI Z score of - 1.57 ± 3.02 (- 4.60 to 5.27). There were eight treated patients in group B, with a mean NI of 107.61 ± 49.49 mm2/m2 (53.15-216.39 mm2/m2) and a mean NI Z score of - 6.27 ± 1.56 (- 8.22 to - 3.54). The mean follow-up time in group A was 5.58 ± 3.42 years (1-11.7 years), while that in group B was 5.4 ± 3.42 years (0.6-12.1 years). No hospital deaths occurred and the follow-up results were good in both groups. In conclusion, development of a single existing pulmonary artery can be evaluated using the NI and the NI Z score. These evaluations can be used to select complete repair or palliative procedures for patients and achieve good results.


Assuntos
Artéria Pulmonar/anormalidades , Tetralogia de Fallot/cirurgia , Malformações Vasculares/cirurgia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Cuidados Paliativos , Artéria Pulmonar/cirurgia , Estudos Retrospectivos , Tetralogia de Fallot/fisiopatologia , Resultado do Tratamento
11.
Cardiol Young ; 29(5): 699-700, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31122308

RESUMO

We describe the case of a newborn girl who displayed association of aortic atresia and interrupted aortic arch, with retrograde flow in ascending aorta, through extracranial anastomoses between vertebral arteries (arisen from descending aorta) and external carotids.


Assuntos
Anastomose Cirúrgica , Aorta/anormalidades , Doenças da Aorta/cirurgia , Malformações Vasculares/cirurgia , Aorta Torácica/anormalidades , Doenças da Aorta/congênito , Feminino , Humanos , Recém-Nascido , Procedimentos Cirúrgicos Vasculares
12.
A A Pract ; 13(5): 159-161, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-30985323

RESUMO

Ex utero intrapartum treatment procedures are mainly indicated to secure the airways of fetuses featuring a risk of obstruction at birth while ensuring uteroplacental circulation. This report documents a successful intubation case with a C-MAC video laryngoscope during an ex utero intrapartum treatment procedure in a newborn featuring an infiltrative neck mass. Despite technical challenges faced in this procedure, the C-MAC video laryngoscope allowed an optimal view of airway structures. This novel approach, where laryngoscopy relies on the usage of C-MAC to optimize intubation conditions, may lead to increased chances of success in this particular scenario.


Assuntos
Intubação Intratraqueal/instrumentação , Pescoço/anormalidades , Cirurgia Vídeoassistida/métodos , Adulto , Parto Obstétrico , Feminino , Humanos , Histerotomia , Laringoscopia , Anormalidades Linfáticas/diagnóstico , Anormalidades Linfáticas/cirurgia , Idade Materna , Pescoço/diagnóstico por imagem , Pescoço/embriologia , Pescoço/cirurgia , Gravidez , Resultado do Tratamento , Malformações Vasculares/diagnóstico , Malformações Vasculares/cirurgia
13.
Int J Dermatol ; 58(7): 854-855, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30990237

RESUMO

BACKGROUND: Venous lakes are asymptomatic, cosmetically unacceptable vascular malformations commonly present over the lips. Most of the lesions do not warrant any therapeutic intervention. OBJECTIVE: We herein report a 20-year-old male patient with venous lake who was treated using intralesional radiofrequency (RF) by modified insulated intravenous cannula as an extended probe. METHODS: An RF ablation was performed under local infiltration anesthesia using intravenous infusion cannula as an extended insulated probe to deliver current. RESULTS: The venous lake was obliterated immediately post-procedure with minimal inflammatory change. It showed good cosmetic results with minimal scarring and no recurrence at 18 months of follow-up. CONCLUSIONS: Intralesional RF using modified insulated probe is a useful alternative treatment and may be considered to treat small venous lakes.


Assuntos
Ablação por Radiofrequência/instrumentação , Malformações Vasculares/cirurgia , Humanos , Lábio/cirurgia , Masculino , Agulhas , Ablação por Radiofrequência/métodos , Resultado do Tratamento , Adulto Jovem
14.
Adv Clin Exp Med ; 28(6): 777-782, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30968612

RESUMO

BACKGROUND: Crossing vessels (CVs) are common in older children and adults with hydronephrosis but no gold standard exists on how to treat this condition. The final decision is made intraoperatively by the surgeon. OBJECTIVES: To assess the outcome of the laparoscopic dismembered pyeloplasty with translocation of the CVs in children and adults. MATERIAL AND METHODS: Prospectively collected data from 3 departments was reviewed. Inclusion criteria were: 1) a transperitoneal laparoscopic approach; 2) dismembered pyeloplasty; and 3) the same operating pediatric urologist (RC) or urologist (TS). In the case of CVs, pyeloplasty with vessel transposition (children) or with cephalad translocation (adults) was performed. Forty-eight children and 41 adults met these criteria. Patients were divided into 4 groups: children with (group 1A) and without (group 1B) CVs, and adults with (group 2A) and without (group 2B) CVs. Any surgical reintervention at the uretero-pelvic junction (UPJ) was deemed a failure. RESULTS: The overall reintervention rate was 3/48 (6.25%) in children and 2/41 (4.9%) in adults (p > 0.05), and involved the following: 4 endopyelotomies and 1 redo pyeloplasty. Crossing vessels were identified in 28/48 (58%) children and 12/41 (29%) adults. The mean operation time was 152 min in group 1A and 161 min in group 2A (p > 0.5). Reintervention was needed in 2/28 patients in group 1A and in 1/12 patients in group 2A (p > 0.05). There was no difference in the failure rate between group 1A and group 1B, nor between group 2A and group 2B (p > 0.05). CONCLUSIONS: Crossing vessels should be meticulously looked for during pyeloplasty in older children and adults. Dismembered laparoscopic pyeloplasty (LP) with dorsal transposition or cephalad translocation are comparable methods in terms of success rate for the treatment of UPJ obstruction in these patients.


Assuntos
Hidronefrose/congênito , Pelve Renal/cirurgia , Laparoscopia/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Obstrução Ureteral/cirurgia , Malformações Vasculares/cirurgia , Adulto , Idoso , Criança , Humanos , Hidronefrose/diagnóstico por imagem , Hidronefrose/cirurgia , Pelve Renal/patologia , Duração da Cirurgia , Resultado do Tratamento , Obstrução Ureteral/diagnóstico por imagem , Procedimentos Cirúrgicos Urológicos/métodos , Malformações Vasculares/diagnóstico por imagem , Procedimentos Cirúrgicos Vasculares/métodos
15.
Ann Thorac Surg ; 108(4): e265-e267, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30878458

RESUMO

A 75-year-old woman was referred to our hospital for dyspnea and edema of the lower limbs. Computed tomography angiography revealed a dilated left coronary artery from the left main trunk to the left circumflex branch and a dilated fistula originating from the left circumflex branch and draining into the persistent left superior vena cava. Physical examination revealed pulmonary hypertension and congestive heart failure. We performed closure of the fistula and left main coronary artery orifice and coronary artery bypass grafting. Postoperative computed tomography angiography showed patency of all grafts and progression of thrombosis in the dilated abnormal vessels.


Assuntos
Fístula Arteriovenosa/diagnóstico , Fístula Arteriovenosa/cirurgia , Doença da Artéria Coronariana/diagnóstico , Malformações Vasculares/diagnóstico , Malformações Vasculares/cirurgia , Veia Cava Superior/anormalidades , Idoso , Fístula Arteriovenosa/complicações , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/cirurgia , Feminino , Humanos , Malformações Vasculares/complicações
16.
Ann Thorac Surg ; 108(1): 161-166, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30849335

RESUMO

BACKGROUND: Vascular rings with a Kommerell diverticulum (KD) most commonly occur in patients with a right aortic arch. We report on a less commonly seen subset of vascular ring patients-those with a double aortic arch and a KD. METHODS: Between 2002 and 2017, 66 patients underwent an operation for a double aortic arch. Ten of those patients also had excision of a KD. We performed a retrospective medical record review of these patients to characterize their demographics and outcomes. RESULTS: All 10 patients (7 male, 3 female) had a double aortic arch that was right dominant and also had a KD. The patients were a mean age of 4.9 ± 4.3 years (range, 6 months to 29 years), and median age was 4 years. All patients had preoperative computed tomographic angiography or magnetic resonance imaging and mean compression of the distal trachea of 63% ± 12% (range, 40% to 80%). The distal left arch was atretic in all patients. All patients underwent division of their left aortic arch, division of the ligamentum, and resection of the KD. The left subclavian artery was transferred to the left carotid artery in 2 patients. The mean size of the diverticulum was 9 × 10 mm. There were no major postoperative complications or readmissions. The postoperative length of stay was 3.1 ± 0.8 days. Five of the patients reported no related persisting symptoms. The remaining 5 patients reported substantial symptomatic relief with only minor respiratory symptoms. CONCLUSIONS: Vascular ring patients with a double aortic arch can also have a KD. In addition to dividing the smaller aortic arch and the ligamentum, we recommend excision of the KD.


Assuntos
Aorta Torácica/anormalidades , Aorta Torácica/cirurgia , Doenças da Aorta/cirurgia , Divertículo/cirurgia , Malformações Vasculares/cirurgia , Adulto , Aorta Torácica/diagnóstico por imagem , Artérias Carótidas/cirurgia , Criança , Pré-Escolar , Angiografia por Tomografia Computadorizada , Feminino , Humanos , Imagem Tridimensional , Lactente , Masculino , Complicações Pós-Operatórias , Estudos Retrospectivos , Artéria Subclávia/cirurgia
17.
Ann Thorac Surg ; 108(2): 601-612, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30831109

RESUMO

BACKGROUND: The management of pulmonary atresia with ventricular septal defect (PA/VSD) and major aortopulmonary collateral arteries (MAPCAs) has significantly changed over the past 20 years. Unifocalization and rehabilitation have been described as diametrically opposed strategies. An updated review focused on the management of this complex and rare condition is needed. METHODS: Articles related to PA/VSD/MAPCAs issued until December 2017 were screened. Twelve main studies published in the modern era (since 2000) were selected and analyzed. RESULTS: Unifocalization and rehabilitation respectively focus on the mobilization of collateral arteries and the growth of native pulmonary vessels. A third strategy, called "combined strategy," was distinguished from the review of the literature. Surgical cohorts and methods of data reporting were found to be heterogenous. Outcomes, regardless of the strategy, have transformed the natural history of the condition, with a complete repair rate of approximately 80% and low rates of early and late mortality. Patients with the most unfavorable anatomy (absent central pulmonary arteries and hypoplastic MAPCAs) remain a challenge and are still left palliated. CONCLUSIONS: Variable surgical strategies are used in the management of PA/VSD/MAPCAs. Most teams report a repair rate of 70% to 80% and a mortality rate lower than 10%. Standardization in data reporting is necessary to better compare the existing strategies.


Assuntos
Anormalidades Múltiplas/cirurgia , Aorta Torácica/anormalidades , Procedimentos Cirúrgicos Cardíacos/métodos , Circulação Colateral , Defeitos dos Septos Cardíacos/cirurgia , Artéria Pulmonar/anormalidades , Atresia Pulmonar/cirurgia , Malformações Vasculares/cirurgia , Gerenciamento Clínico , Humanos
18.
J Cardiothorac Surg ; 14(1): 49, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30823928

RESUMO

BACKGROUND: Congenital tracheal malformations are less common than congenital cardiac diseases and surgical repair of these anomalies is complex. We sought to examine the surgical treatment and outcomes in cases of tracheal anomalies presenting with or without associated congenital malformations. METHODS: We retrospectively reviewed the demographic, clinical, and imaging data of 49 children who underwent surgery for congenital tracheal malformations between August 2013 and September 2017. Data were collected from the hospital records. RESULTS: In all, 49 patients (male, 30; female, 19) underwent surgeries at our center. The children were of ages between 3 and 36 months (average: 9.7 months). Associated congenital lesions included sling in31/49 (63%), vascularring: in 2/49; ventriculoseptaldefectin5/49; Fallot's tetraology in 2/49 (4.1%), and imperforate anus in 3/49 (6.1%). The outcomes of surgery were excellent in 42(85.7%) cases, good in 3 cases, while mortality occurred in 4(8.1%) cases. All cases of tracheal stenosis without any change in tracheobronchial arborization, 10/12 cases of bridge carina, and all cases of tripod carina were reconstructed using the slide tracheoplasty technique. Antetracheal translocation was performed for correction of associated pulmonary sling, without reimplantation of the pulmonary artery. CONCLUSIONS: Reconstructive surgery is a feasible treatment option for congenital tracheal malformations. Slide tracheoplasty can be safely applied in all cases for the correction of tracheal stenosis. Segment resection was not required for any portion of the trachea. Pulmonary artery translocation is safe and effective for patients with pulmonary artery sling, rather than reimplantation. Mortality was associated with severe cardiac complications.


Assuntos
Artéria Pulmonar/cirurgia , Traqueia/cirurgia , Estenose Traqueal/cirurgia , Malformações Vasculares/cirurgia , Pré-Escolar , Feminino , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/cirurgia , Humanos , Lactente , Masculino , Artéria Pulmonar/anormalidades , Artéria Pulmonar/diagnóstico por imagem , Procedimentos Cirúrgicos Reconstrutivos/métodos , Estudos Retrospectivos , Traqueia/anormalidades , Traqueia/diagnóstico por imagem , Estenose Traqueal/congênito , Estenose Traqueal/diagnóstico por imagem , Resultado do Tratamento , Malformações Vasculares/diagnóstico por imagem , Procedimentos Cirúrgicos Vasculares/métodos
19.
J Cardiothorac Surg ; 14(1): 35, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30744669

RESUMO

BACKGROUND: Congenital arterial abnormalities are unusual causes of hemoptysis in elder patients. Appropriate image examination and recognition of the variant vessels are crucial in achieving precise diagnosis and successful treatment. CASE PRESENTATION: We report a case of 70-year-old female presenting with hemoptysis. Computed tomography angiography showed hypervascular lesions in the lingula of the left lung abutting the pericardium. Three-dimensional reconstruction image revealed an aberrant systemic arterial supply communicating with the left pulmonary artery and co-supplying the pulmonary parenchyma of the left upper. Single-port video-assisted thoracoscopic surgery with anomalous vessel ligation and lingual segmentectomy were performed smoothly. The symptom of hemoptysis subsided after operation with 2-year follow up. CONCLUSION: An anomalous systemic arterial supply to the left upper lobe of the lung with an aberrant systemic system draining into the left pulmonary artery and co-supplying the lung parenchyma is extremely rare. Preoperative simulation with three-dimensional reconstruction image provides a clear spatial anatomy that allows clinicians to identify the orientation of the vessels more precisely when deciding on intervention.


Assuntos
Hemoptise/etiologia , Pulmão/cirurgia , Artéria Pulmonar/diagnóstico por imagem , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/cirurgia , Idoso , Angiografia por Tomografia Computadorizada , Feminino , Humanos , Imagem Tridimensional , Pulmão/irrigação sanguínea , Cirurgia Torácica Vídeoassistida , Malformações Vasculares/complicações
20.
Cardiol Young ; 29(3): 422-424, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30739622

RESUMO

An isolated left common carotid artery is very rare, and only 13 cases have been reported thus far. All those cases were accompanied by a right aortic arch and aberrant left subclavian artery, and the connecting vessel between the pulmonary artery and left common carotid artery was thought to be ductal tissue. However, there have been no reports that have followed the natural closure of this vessel. We present a case in whom we could observe the closing process of this vessel at the connection between the left common carotid artery and main pulmonary artery in association with a tetralogy of Fallot.


Assuntos
Anormalidades Múltiplas , Procedimentos Cirúrgicos Cardíacos/métodos , Artéria Carótida Primitiva/anormalidades , Permeabilidade do Canal Arterial/cirurgia , Artéria Pulmonar/anormalidades , Tetralogia de Fallot/cirurgia , Malformações Vasculares/cirurgia , Permeabilidade do Canal Arterial/diagnóstico , Ecocardiografia , Feminino , Humanos , Recém-Nascido , Tetralogia de Fallot/diagnóstico , Tomografia Computadorizada por Raios X , Malformações Vasculares/diagnóstico
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