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1.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431448

RESUMO

Embolised needles causing injury to the right heart and cardiac tamponade has been reported before in intravenous drug users, but to our knowledge, this is the first reported case of a needle migrating via the pulmonary arterial system to cause perforation of the left ventricle. Appropriate utilisation of imaging modalities such as plain X-ray and point-of-care focused cardiac ultrasound can be vital and life-saving in the emergency setting, and the value of gated multidetector CT as a powerful tool for imaging moving structures is highlighted.


Assuntos
Migração de Corpo Estranho/diagnóstico , Traumatismos Cardíacos/diagnóstico , Ventrículos do Coração/lesões , Agulhas/efeitos adversos , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Ponte Cardiopulmonar , Ecocardiografia , Migração de Corpo Estranho/complicações , Migração de Corpo Estranho/cirurgia , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/cirurgia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/cirurgia , Humanos , Pulmão/irrigação sanguínea , Pulmão/diagnóstico por imagem , Pulmão/cirurgia , Masculino , Pericardiocentese , Artéria Pulmonar/diagnóstico por imagem , Cirurgia Torácica Vídeoassistida , Resultado do Tratamento
2.
Methods Mol Biol ; 2158: 63-69, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32857366

RESUMO

The zebrafish (Danio rerio) possesses a spectacular capacity for cardiac regeneration. Zebrafish have been used in cardiac regeneration research for nearly two decades, contributing to the identification of signals and cellular mechanisms as potential targets for human heart repair. Investigations into cardiac regeneration in zebrafish have been facilitated by multiple methods of inducing cardiac tissue damage. Among the established methods, cardiac resection injury is a relatively simple, yet robust approach traditionally used to induce cardiac tissue damage in a reproducible manner. Here, we describe a detailed protocol to perform a cardiac resection injury in adult zebrafish and discuss potential complications for researchers who are new to this technique.


Assuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Modelos Animais de Doenças , Traumatismos Cardíacos/patologia , Coração/fisiologia , Remodelação Ventricular , Animais , Proliferação de Células , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/cirurgia , Peixe-Zebra
3.
Asian Cardiovasc Thorac Ann ; 28(9): 598-600, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32762246

RESUMO

Iatrogenic atrial septal defect is an issue after percutaneous interventions for structural heart disease. A 63-year-old man, who had previously received 5 catheter ablations for paroxysmal atrial fibrillation, was found to have an iatrogenic atrial septal defect that persisted after the fourth intervention. Approximately 4 years later, he suffered exertional dyspnea. Pulmonary hypertension was caused by a left-to-right shunt via a large iatrogenic atrial septal defect. We performed surgical closure and the symptom improved. The timing of treatment for persistent iatrogenic atrial septal defect is difficult to determine, but preferable before the appearance of right ventricular dysfunction or embolism.


Assuntos
Fibrilação Atrial/cirurgia , Septo Interatrial/lesões , Cateterismo Cardíaco/efeitos adversos , Ablação por Cateter/efeitos adversos , Traumatismos Cardíacos/etiologia , Doença Iatrogênica , Septo Interatrial/diagnóstico por imagem , Septo Interatrial/cirurgia , Traumatismos Cardíacos/diagnóstico por imagem , Traumatismos Cardíacos/cirurgia , Humanos , Hipertensão Pulmonar/etiologia , Masculino , Pessoa de Meia-Idade , Reoperação , Resultado do Tratamento
4.
J Card Surg ; 35(10): 2860-2862, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32827157

RESUMO

Left atrial perforation is a known complication following pulmonary vein catheter ablation. Our case of a 62-year-old female underwent urgent surgery for repair of left atrium perforation with left pleural effusion as a late complication after multiple transcatheter radiofrequency pulmonary vein ablations for persistent atrial fibrillation.


Assuntos
Fibrilação Atrial/cirurgia , Ablação por Cateter/efeitos adversos , Ablação por Cateter/métodos , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/cirurgia , Lesão Pulmonar/etiologia , Veias Pulmonares , Procedimentos Cirúrgicos Cardíacos/métodos , Emergências , Feminino , Átrios do Coração/lesões , Átrios do Coração/cirurgia , Humanos , Lesão Pulmonar/cirurgia , Pessoa de Meia-Idade , Derrame Pleural/etiologia , Derrame Pleural/cirurgia , Resultado do Tratamento
5.
Am Surg ; 86(5): 538-540, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32684024

RESUMO

Blunt traumatic cardiac rupture is an uncommon event in trauma and survival is rare. While multiple isolated accounts of repair of blunt cardiac rupture have been reported in the literature, there is not a single report of survival from right ventricular rupture following an emergency department thoracotomy (EDT). We report 2 cases where patients have survived such injuries and have made a full recovery. These patients are from a single institution who lost pulses on arrival to the emergency department; then underwent EDT with relief of cardiac tamponade with hemorrhage control by temporary closure, and subsequent definitive repair of right ventricular rupture in the operating room. Both were multiply injured and survived to discharge without neurologic sequelae and have made a full recovery back to their baseline function. This setting may represent an important use of EDT among blunt trauma patients, where time to survival and recovery may dependent on the speed of hemorrhage control and return of cardiac activity.


Assuntos
Traumatismos Cardíacos/cirurgia , Toracotomia , Ferimentos não Penetrantes/cirurgia , Idoso , Serviço Hospitalar de Emergência , Tratamento de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Indução de Remissão
6.
J Card Surg ; 35(7): 1597-1599, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32485004

RESUMO

BACKGROUND AND AIM OF THE STUDY: Cardiac wounds have been described for centuries and still remain to be fatal. For a long period of time, the suturing of a myocardial laceration was thought to be absolutely impossible if not sacrilege. METHODS: It is only at the end of the 19th century that pioneers decided to defy such a dogma in desperate cases. RESULTS: Nowadays, it seems obvious that a cardiac stab wound requires emergent surgery whenever possible. CONCLUSIONS: The story of cardiac wounds highlights nicely the change of mind that is required to accept progress and new procedures in medicine.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Procedimentos Cirúrgicos Cardíacos/tendências , Traumatismos Cardíacos/cirurgia , Técnicas de Sutura , Ferimentos Perfurantes/cirurgia , Humanos , Lacerações/cirurgia , Técnicas de Sutura/tendências
7.
Asian Cardiovasc Thorac Ann ; 28(5): 276-278, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32479110

RESUMO

An 86-year-old female with severe aortic valve stenosis underwent transcatheter aortic valve replacement. A balloon-expandable valve was used, guided by a double-stiff guidewire that successfully straightened the aorta. During valve placement, the balloon shifted. After placement of the prosthetic valve, intraoperative transesophageal echocardiography revealed severe mitral regurgitation from the anterior mitral leaflet. Open conversion was performed immediately. A 5-mm hole was identified in the anterior leaflet, and direct closure was chosen for mitral valve repair. While transcatheter aortic valve replacement has gained popularity for patients with severe aortic stenosis and high operative risk, reports of mitral valve perforation are rare.


Assuntos
Estenose da Valva Aórtica/cirurgia , Valvuloplastia com Balão/efeitos adversos , Traumatismos Cardíacos/etiologia , Insuficiência da Valva Mitral/etiologia , Valva Mitral/lesões , Substituição da Valva Aórtica Transcateter/efeitos adversos , Idoso de 80 Anos ou mais , Estenose da Valva Aórtica/diagnóstico por imagem , Feminino , Traumatismos Cardíacos/diagnóstico por imagem , Traumatismos Cardíacos/cirurgia , Humanos , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/cirurgia , Índice de Gravidade de Doença , Resultado do Tratamento
9.
Asian Cardiovasc Thorac Ann ; 28(4): 205-212, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32276539

RESUMO

BACKGROUND: Mechanical complications of percutaneous coronary interventions are treated percutaneously in most cases. If the rescue intervention is unsuccessful, bailout bypass surgery is necessary to restore the coronary flow. The surgical risk in these cases is higher than that of patients operated on for other indications. The aim of our study was to characterize patients who underwent surgical treatment at our institution and to compare their long-term outcomes with patients who underwent emergency bypass surgery for other indications. METHODS: We analyzed 707 consecutive patients who underwent isolated emergency bypass surgery at our institution from 2007 to 2015. In 44 of these cases, the surgery was necessitated by mechanical complications of percutaneous coronary interventions. There were 31 coronary dissections, 5 entrapped guidewires, and 8 coronary perforations. We compared patients in these three groups with one another. Follow-up was performed to assess long-term outcomes. RESULTS: The median age of the cohort was 68 years (range 59-75 years), and 36 (81.8%) patients presented in cardiogenic shock. Thirty-seven (84.1%) patients had history of a percutaneous coronary intervention. The courses were typical for bypass patients. The long-term survival was similar in all three subgroups (p = 0.16). The survival profiles within our sample did not differ significantly from that in patients who underwent emergency bypass surgery for other indications. CONCLUSIONS: Surgical risk and short- and long-term outcomes of patients undergoing emergency bypass surgery due to mechanical complications of percutaneous coronary interventions are similar to those of patients receiving the same surgery for other indications.


Assuntos
Ponte de Artéria Coronária , Doença da Artéria Coronariana/terapia , Vasos Coronários/cirurgia , Traumatismos Cardíacos/cirurgia , Doença Iatrogênica , Intervenção Coronária Percutânea/efeitos adversos , Idoso , Ponte de Artéria Coronária/efeitos adversos , Ponte de Artéria Coronária/mortalidade , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/mortalidade , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/lesões , Emergências , Feminino , Traumatismos Cardíacos/diagnóstico por imagem , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea/mortalidade , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
10.
Ann Thorac Surg ; 109(6): e453-e456, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31987827

RESUMO

Accidental entry into the right ventricular cavity is a common occurrence during exposure of the intra-myocardial left anterior descending artery. Several techniques have been described for repair of the perforation. Although these methods can be used, there is still a danger of persistent bleeding or distal ischemia. We describe a method that is safe and reproducible.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Vasos Coronários/cirurgia , Traumatismos Cardíacos/cirurgia , Ventrículos do Coração/cirurgia , Técnicas de Sutura , Humanos
12.
J Card Surg ; 35(2): 488-491, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31778592

RESUMO

BACKGROUND: Electric shock-induced cardiac injuries, such as myocardial infarction, thrombosis, and dissection, are rare. Few cases have been previously reported. The right coronary artery is most often affected because of its proximity to the chest wall. AIMS: To study the extend of electrical injuries on cardiac tissues and its surgical management. MATERIALS AND METHODS: We conducted a retrospective study on our patients in the last five years, looking for cardiac electrical injuries treated surgically in our department, we identified three cases. RESULT: Our three-case series, reported herein, showed that multiple cardiac tissues are susceptible to electrical injuries, specifically the left coronary artery, inferior vena cava, and right ventricular free wall. In our series, the first patient was a 32-year-old man with triple vessel thrombosis and dissection who survived the electric shock. The second patient was a 23-year-old man who had an inferior vena cava burn and bruising; his heart was used for transplantation. After the transplant, the recipient had a left coronary artery dissection and underwent coronary artery bypass grafting. The third patient was a 30-year-old man (potential heart donor) who had a hematoma of the right ventricular free wall, possible coronary artery dissection, inferior vena cava bruising, and tissue damage. His heart was not used for transplant because of quality concerns. CONCLUSION: We recommend that any person who sustains high voltage (500 V or more) electric shock should be evaluated carefully in the emergency department, including with echocardiography and cardiac catheterization, if indicated, to determine the extent of the injury and the viability of the heart, for patients who do not survive as a donor organ.


Assuntos
Eletricidade/efeitos adversos , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/cirurgia , Adulto , Cateterismo Cardíaco , Ponte de Artéria Coronária , Ecocardiografia , Evolução Fatal , Traumatismos Cardíacos/diagnóstico , Transplante de Coração , Humanos , Masculino , Estudos Retrospectivos , Doadores de Tecidos , Adulto Jovem
13.
A A Pract ; 14(4): 116-118, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31876557

RESUMO

With the ongoing development of safer anesthesia, pregnant women with cardiac disease are presenting more frequently for cesarean delivery. We report the successful anesthetic management of a 31-year-old parturient, on long-term anticoagulant therapy, who presented with acute cardiac tamponade due to perforation of the left atrium from a dislodged atrial septum defect occluder. The cesarean delivery was followed by temporary repair of the perforation without extracorporeal circulation (EC) due to concerns about excessive postpartum bleeding. The definitive repair of the atrial defect and the perforation were successfully accomplished under (EC) 5 days after delivery.


Assuntos
Anestesia/métodos , Tamponamento Cardíaco/cirurgia , Traumatismos Cardíacos/cirurgia , Comunicação Interatrial/cirurgia , Complicações Cardiovasculares na Gravidez/cirurgia , Adulto , Tamponamento Cardíaco/genética , Cesárea , Feminino , Traumatismos Cardíacos/complicações , Traumatismos Cardíacos/etiologia , Humanos , Gravidez , Falha de Prótese , Dispositivo para Oclusão Septal , Resultado do Tratamento
14.
Injury ; 51(1): 122-123, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31551121

RESUMO

Blunt trauma causing cardiac rupture is usually fatal. We report a patient with blunt cardiac injury that suffered traumatic cardiac arrest in the pre-hospital phase of their care. A cardiac tamponade was confirmed with portable ultrasound in a brief return of circulation. The patient had a further cardiac arrest and subsequently underwent damage control emergency surgery via a clamshell thoracotomy at the scene. The tamponade was released and a clamp was applied to the identified left atrial appendage rupture, a return of circulation then occurred. He was transferred to a cardiothoracic centre where a left atrial appendage rupture was identified and closed. The patient had a complicated recovery in hospital but went on to survive neurologically intact. This is the first documented case report of a neurologically intact survivor of a pre-hospital clamshell thoracotomy for blunt trauma. Although survivors of blunt trauma who have pre-hospital thoracotomy are extremely rare it should be considered in very specific circumstances.


Assuntos
Parada Cardíaca/etiologia , Traumatismos Cardíacos/cirurgia , Ressuscitação/métodos , Toracotomia/métodos , Ferimentos não Penetrantes/cirurgia , Serviço Hospitalar de Emergência , Parada Cardíaca/mortalidade , Parada Cardíaca/terapia , Traumatismos Cardíacos/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Taxa de Sobrevida/tendências , Ferimentos não Penetrantes/mortalidade
16.
Ann Thorac Surg ; 109(1): e29-e31, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31233721

RESUMO

Pectus excavatum repair using a Nuss bar is a widely performed procedure and generally regarded to be quite safe. Rare catastrophic cardiovascular complications have been previously reported, by even the most experienced surgeons. These cases typically present with fulminant cardiogenic shock and have an associated high mortality rate. We present a delayed and atypical presentation for a patient with a cardiac perforation after repair of pectus excavatum who underwent successful repair.


Assuntos
Tórax em Funil/cirurgia , Traumatismos Cardíacos/cirurgia , Complicações Intraoperatórias/cirurgia , Adulto , Traumatismos Cardíacos/diagnóstico , Humanos , Complicações Intraoperatórias/diagnóstico , Masculino , Procedimentos Ortopédicos/métodos , Fatores de Tempo
17.
Catheter Cardiovasc Interv ; 95(1): E30-E36, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31141311

RESUMO

OBJECTIVES: Left atrial dissection (LatD) is a rare and heterogeneous condition affecting many cardiovascular areas. The present article, by the means of personal case report illustration and systemic review of different clinical management, is aimed to give to clinicians further knowledge on this controversial topic. BACKGROUND: LatD is an exceedingly rare but potentially fatal complication of cardiac surgery or catheter-based interventional procedures. Most of the cases are iatrogenic and its incidence is expected to grow due to an increase in the number of percutaneous coronary intervention and structural heart disease procedures. The management of this complication is controversial, and it may depend on related etiologies. METHODS: We have reported our single-case experience and review of the scientific literature, focusing on the decision-making process and the strategical approach by multimodality imaging techniques. RESULTS: Our case of LatD with initial hemodynamic instability was surgically treated. Conservative approach is often employed in literature despite the fact that conservative versus surgical approach is debatable, depending on clinical presentation, hemodynamic stability, multimodal imaging findings, and personal experience of the center. CONCLUSIONS: According to systematic literature review, a watchful-waiting strategy supported by multimodality imaging could be a safe and effective management in stable LatD.


Assuntos
Átrios do Coração/cirurgia , Traumatismos Cardíacos/cirurgia , Hematoma/cirurgia , Doença Iatrogênica , Intervenção Coronária Percutânea/efeitos adversos , Idoso , Função do Átrio Esquerdo , Tomada de Decisão Clínica , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/lesões , Átrios do Coração/fisiopatologia , Traumatismos Cardíacos/diagnóstico por imagem , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/fisiopatologia , Hematoma/diagnóstico por imagem , Hematoma/etiologia , Hematoma/fisiopatologia , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Seleção de Pacientes , Recuperação de Função Fisiológica , Resultado do Tratamento
18.
Semin Thorac Cardiovasc Surg ; 32(3): 486-489, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31306765

RESUMO

Iatrogenic coronary injury after mitral repair is related to blind annuloplasty suture ligation or kinking of the circumflex artery (CxA) and can present with early ST segment changes, malignant ventricular arrhythmias, and segmental wall motion abnormalities. Corrective treatment is imperative to avoid myocardial infarction and can include removal of the annuloplasty ring or CxA bypass. We present a novel hybrid approach for the rapid diagnosis and management of iatrogenic CxA injury after mitral repair.


Assuntos
Vasos Coronários/cirurgia , Traumatismos Cardíacos/cirurgia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Doença Iatrogênica , Anuloplastia da Valva Mitral/efeitos adversos , Insuficiência da Valva Mitral/cirurgia , Prolapso da Valva Mitral/cirurgia , Técnicas de Sutura/efeitos adversos , Adulto , Idoso , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/lesões , Feminino , Traumatismos Cardíacos/diagnóstico por imagem , Traumatismos Cardíacos/etiologia , Humanos , Masculino , Insuficiência da Valva Mitral/diagnóstico por imagem , Prolapso da Valva Mitral/diagnóstico por imagem , Resultado do Tratamento
19.
Ann Thorac Surg ; 109(2): e107-e108, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31276648

RESUMO

Patients undergoing sternotomy routinely undergo sternal closure with stainless steel wires. Occasionally these wires can fracture, although normally this presents no concern as the broken wire remains fixed and is not problematic. We report a case of a segment of a broken sternal wire that migrated through the pericardium onto the right ventricular. It was removed with a minimally invasive approach with endoscopic assistance.


Assuntos
Fios Ortopédicos/efeitos adversos , Remoção de Dispositivo/métodos , Endoscopia/métodos , Migração de Corpo Estranho/cirurgia , Traumatismos Cardíacos/cirurgia , Ventrículos do Coração/lesões , Pericárdio/lesões , Idoso , Falha de Equipamento , Feminino , Fluoroscopia , Migração de Corpo Estranho/diagnóstico , Traumatismos Cardíacos/diagnóstico , Traumatismos Cardíacos/etiologia , Ventrículos do Coração/diagnóstico por imagem , Humanos , Pericárdio/diagnóstico por imagem , Radiografia Torácica , Esternotomia/efeitos adversos
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