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1.
Medicina (Kaunas) ; 58(6)2022 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-35743962

RESUMO

A 70-year-old male patient was admitted to the emergency room in cardiac arrest. The patient was resuscitated and then referred to our cardiac surgery department, where he was diagnosed with suspected effusive constrictive pericarditis. A failed trial of TEE-guided pericardiocentesis led to the decision of surgical intervention. Sternotomy was performed and revealed pericardial thickening and very dense adhesions involving the pericardium and both pleurae, suggesting a neoplastic disease. An extensive pericardiectomy and bilateral pleural decortication were performed. After surgery, the patient improved significantly and was discharged from the intensive care unit 24 h later. Pericardial thickening, dense adhesions, the amount and color of pericardial fluid and the aspect of epicardial tissue increased our suspicion of neoplastic disease. Histological samples were sent to be analyzed immediately; a few days later, they were unexpectedly negative for any neoplastic disease but showed a group-B-hemolytic Streptococcus agalactiae infection, which causes pericarditis in extremely rare cases. Postoperatively, the patient, under intravenous antibiotic and anti-inflammatory therapy, remained asymptomatic and was discharged ten days after the surgery. At the three-month follow-up, transthoracic echocardiography showed a normal right and left ventricular function with no pericardial effusion.


Assuntos
Derrame Pericárdico , Pericardite Constritiva , Infecções Estreptocócicas , Idoso , Humanos , Masculino , Derrame Pericárdico/microbiologia , Derrame Pericárdico/cirurgia , Pericardiectomia , Pericardiocentese , Pericardite Constritiva/cirurgia , Infecções Estreptocócicas/complicações , Streptococcus agalactiae
2.
J Vet Med Sci ; 84(8): 1079-1083, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35675979

RESUMO

This study aimed to evaluate the outcomes and complications of triple-combination surgery consisting of thoracic duct ligation (TDL), partial pericardiectomy (PPC), and cisterna chyli ablation (CCA) for the treatment of idiopathic chylothorax in dogs. Eleven privately owned dogs with idiopathic chylothorax underwent the triple-combination surgery: TDL and PPC were performed in left recumbency, followed by CCA in dorsal recumbency. Of the 11 dogs, seven were Shiba, two were Afghan hounds, and one each was Borzoi and mixed-breed. TDL and PPC required two intercostal thoracotomies in five dogs, whereas they were performed through a single intercostal incision in the other dogs. None of the dogs showed major intraoperative complications. The median operation time was 190 min (range, 151-234 min). Nine dogs showed no pleural effusion after surgery without medical management. Another dog showed the disappearance of chylous effusion, followed by the pleural accumulation of modified transudate. However, the residual one dog in whom chylothorax did not improve postoperatively died 4 months after the combination surgery. The mortality rate at the conclusion of this study was 9.1%. Although the triple-combination surgery with TDL, PPC, and CCA was complex and required a prolonged operation time, the success rate of resolving chylothorax in our study was comparable to that of open surgery as previously reported. Therefore, this study suggests that such triple-combination surgery can become one of the therapeutic options for the management of canine idiopathic chylothorax.


Assuntos
Quilotórax , Doenças do Cão , Animais , Quilotórax/cirurgia , Quilotórax/veterinária , Doenças do Cão/cirurgia , Cães , Ligadura/veterinária , Pericardiectomia/veterinária , Melhoramento Vegetal , Estudos Retrospectivos , Ducto Torácico/cirurgia
3.
J Investig Med High Impact Case Rep ; 10: 23247096221097530, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35546528

RESUMO

Although well documented, constrictive pericarditis is a rare entity and an uncommon cause of heart failure. A stiff and noncompliant pericardium creates the disease's unique hemodynamics and leads to elevated venous pressures, hepatic sinusoidal congestion, and draining of protein-rich fluid into the peritoneal cavity presenting as ascites. The low incidence in addition to its varied and subtle clinical presentations can often lead to a delay in diagnosis. Here, we present 2 clinical cases of constrictive pericarditis in which ascitic fluid analysis was important-one patient who presented with new-onset ascites with concern for cirrhosis and another patient who presented with symptoms concerning for heart failure with ascites. Through their hospital course and workup, we highlight the importance of diagnostic sampling of ascitic fluid to prompt the consideration of constrictive pericarditis followed by utilizing advanced diagnostics, such as echocardiogram and cardiac catheterization to reach the correct diagnosis in an otherwise often overlooked pathology.


Assuntos
Insuficiência Cardíaca , Pericardite Constritiva , Ascite/complicações , Ascite/diagnóstico , Líquido Ascítico , Insuficiência Cardíaca/complicações , Humanos , Pericardiectomia/efeitos adversos , Pericardite Constritiva/diagnóstico , Pericardite Constritiva/etiologia
4.
Medicine (Baltimore) ; 101(7): e28889, 2022 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-35363206

RESUMO

INTRODUCTION: Advances in critical care management have led to the recent increase in the use of extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation (LT). Patients with respiratory failure requiring venovenous ECMO usually experience progressive right ventricular (RV) failure. Diagnosis and treatment of RV failure during ECMO are essential for improving the prognosis of patients. PATIENT CONCERNS: A 28-year-old female patient underwent allogeneic hematopoietic stem cell transplantation (HSCT) from a matched unrelated donor for acute myeloid leukemia presenting with progressive dyspnea. DIAGNOSES: Computed tomography revealed multifocal patchy peribronchial and subpleural ground-glass opacities in both lungs, and the patient was clinically diagnosed with cryptogenic organizing pneumonia. INTERVENTIONS AND OUTCOMES: Despite intensifying systemic corticosteroid therapy, her symptoms deteriorated, and mechanical ventilation and ECMO were applied. During treatment, her respiratory failure continued to progress, and systemic hypotension developed. An echocardiogram showed evidence of RV failure, and percutaneous atrial septostomy was performed for RV decompression. After a balloon atrial septostomy was performed, RV failure of the patient improved, and LT was successfully performed. LESSONS: We report the first case of atrial septostomy as a successful bridge to LT in a HSCT recipient with venovenous ECMO. Atrial septostomy could be an option for management of RV failure during ECMO. Further studies need to be conducted to validate the effect of atrial septostomy in patients with RV failure during ECMO.


Assuntos
Oxigenação por Membrana Extracorpórea , Insuficiência Cardíaca , Transplante de Pulmão , Insuficiência Respiratória , Adulto , Oxigenação por Membrana Extracorpórea/métodos , Feminino , Insuficiência Cardíaca/etiologia , Humanos , Pericardiectomia , Insuficiência Respiratória/cirurgia , Insuficiência Respiratória/terapia
5.
J Cardiothorac Surg ; 17(1): 59, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35365165

RESUMO

BACKGROUND: Degos disease, also known as malignant atrophic papulosis, is characterised by cutaneous manifestations due to chronic thrombo-obliterative vasculopathy. There have been reports of the rare late-onset Degos disease complicated by constrictive pericarditis (CP). This study reports a case of CP caused by Degos disease that developed 20 years after diagnosis. CASE PRESENTATION: A 62-year-old woman who had been taking aspirin for 20 years for Degos disease was hospitalised for worsening of heart failure. The patient was diagnosed with CP and underwent pericardiectomy. Pathological findings suggested the involvement of Degos disease. The postoperative course was uneventful, and her heart failure and Degos disease did not worsen. CONCLUSIONS: The study findings suggests that Degos disease can cause long-term CP. Aspirin effectively inhibited the progression of Degos disease, and surgical treatment was necessary when heart failure due to CP was refractory to treatment.


Assuntos
Papulose Atrófica Maligna , Pericardite Constritiva , Aspirina/uso terapêutico , Feminino , Humanos , Papulose Atrófica Maligna/complicações , Papulose Atrófica Maligna/diagnóstico , Pessoa de Meia-Idade , Pericardiectomia , Pericardite Constritiva/complicações , Pericardite Constritiva/diagnóstico
6.
Heart Surg Forum ; 25(1): E056-E064, 2022 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-35238304

RESUMO

BACKGROUND: We aimed to investigate risk factors of early mortality following pericardiectomy. METHODS: This was a retrospective study of patients undergoing pericardiectomy between January 1994 and May 2021 at The People's Hospital of Guangxi Zhuang Autonomous Region, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, and The People's Hospital of Liuzhou City. RESULTS: This study included 826 patients, who were divided into two groups: group with operative deaths (N = 66) and group without operative deaths (N = 760). There were 66 operative deaths (66/826, 8.0%). The causes of operative deaths were multiorgan failure (86/826, 10.4%). Preoperative CVP (P < 0.001), chest drainage (P < 0.001), surgical duration (P < 0.001), fluid balance postoperative day D2 (P < 0.001), and tuberculosis pericarditis (P = 0.001) in group with operative deaths were significantly higher than those in group without operative deaths. Univariate and multivariate analyses showed that factors associated with operative deaths include male (P < 0.001), age (P < 0.001), ICU retention time (P < 0.001), postoperative hospitalization time (P < 0.001), preoperative central venous pressure (P = 0.018), postoperative central venous pressure (P < 0.001), D0 fluid balance (P < 0.001), D2 fluid balance (P < 0.001), postoperative chest drainage (P = 0.029), surgical duration (P = 0.003), serum creatinine baseline (P = 0.002), serum creatinine 24h after surgery (P < 0.001), serum creatinine 48h after surgery (P < 0.001), blood lactate (P < 0.001), and tuberculosis pericarditis (P = 0.033). CONCLUSION: In our study, incomplete pericardial dissection, fluid overload, and tuberculosis pericarditis are associated with operative deaths following pericardiectomy.


Assuntos
Pericardiectomia , Pericardite Constritiva , China/epidemiologia , Humanos , Masculino , Pericardiectomia/efeitos adversos , Pericardite Constritiva/cirurgia , Estudos Retrospectivos , Fatores de Risco
7.
Vet Surg ; 51(4): 611-619, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35257394

RESUMO

OBJECTIVE: To describe the clinical characteristics, perioperative protocols, and outcomes in dogs diagnosed with ventricular fibrillation (VF) while undergoing pericardiectomy. STUDY DESIGN: Retrospective, multi-institutional study. ANIMALS: Sixteen client-owned dogs. METHODS: Cases were accrued through a listserve request posted to 3 subspecialty veterinary societies. Dogs were included if they developed VF during a pericardiectomy performed through an open or thoracoscopic approach. Data collected included signalment, history and physical examination, surgical approach, histopathology, treatment, and outcome. RESULTS: Indications for pericardiectomy included idiopathic chylothorax (n = 7), neoplasia (4), idiopathic pericardial effusion (4), and foreign body granuloma (1). Surgical approaches included thoracoscopy (12), intercostal thoracotomy (3) and median sternotomy (1). Electrosurgical devices were used to complete at least part of the pericardiectomy in 15 of 16 dogs. Ventricular fibrillation appeared to be initiated during electrosurgical use in 8/15 dogs. However, in 5/15 dogs it was not obviously associated with electrosurgical use. In 3/16 dogs the timing of initiation of VF was unclear. In 7/16 dogs, cardiac arrhythmias were noted prior to the development of VF. Fourteen of 16 dogs died from intraoperative VF. CONCLUSION: In most dogs ventricular fibrillation was a fatal complication of pericardiectomy. Ventricular fibrillation might be associated with the use of electrosurgical devices and cardiac manipulation during pericardiectomy although a causal link could not be established from the data in this study. CLINICAL SIGNIFICANCE: Surgeons must be aware of the risk of VF during pericardial surgery. Electrosurgery might need to be used judiciously during pericardiectomy, particularly in dogs exhibiting cardiac arrythmias.


Assuntos
Doenças do Cão , Pericardiectomia , Animais , Arritmias Cardíacas/complicações , Arritmias Cardíacas/veterinária , Doenças do Cão/etiologia , Doenças do Cão/cirurgia , Cães , Pericardiectomia/efeitos adversos , Pericardiectomia/métodos , Pericardiectomia/veterinária , Estudos Retrospectivos , Fibrilação Ventricular/complicações , Fibrilação Ventricular/veterinária
8.
J Investig Med High Impact Case Rep ; 10: 23247096221077816, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35257621

RESUMO

Mulibrey (Muscle-Liver-Brain-Eye) Nanism syndrome is an extremely rare genetic disorder with multiorgan involvement. Constrictive pericarditis and diastolic dysfunction are the most common causes of mortality. We present a case of a patient with Mulibrey nanism syndrome who underwent pericardiectomy at 12 years old and was able to live 44 years more with relatively stable and asymptomatic diastolic congestive heart failure (CHF). This case highlights the importance of early recognition and treatment of constrictive pericarditis in these patients.


Assuntos
Nanismo de Mulibrey , Pericardite Constritiva , Criança , Humanos , Nanismo de Mulibrey/complicações , Nanismo de Mulibrey/genética , Pericardiectomia/efeitos adversos , Pericardite Constritiva/complicações , Pericardite Constritiva/cirurgia
9.
Am J Cardiol ; 170: 100-104, 2022 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-35227500

RESUMO

Pericardial disease secondary to sarcoidosis is a rare clinical entity with no observational studies in previous research. Therefore, we evaluated reported cases of pericarditis because of sarcoidosis to further understand its diagnosis and management. We performed a systematic review of previous research until December 16, 2020 in MEDLINE, Embase, Scopus, Cochrane Central Register of Controlled Trials, and Web of Science. Case reports and case series demonstrating pericardial involvement in sarcoidosis were included. Fourteen reports with a total of 27 patients were identified. Dyspnea (82%) was the most common presentation, with the lungs being the primary site of sarcoidosis in most patients (77%). The most frequently encountered pericardial manifestations were pericardial effusion (89%), constrictive pericarditis and cardiac tamponade (48%). Management of these patients included use of corticosteroids (82%), colchicine (11%), and nonsteroidal anti-inflammatory agents (7%). Similar to the general population, the most common intervention in these patients was pericardiocentesis (59%), pericardial window (30%), and pericardiectomy (19%). Overall, the majority of this population (70%) achieved clinical improvement during median follow-up time of 8 months. In conclusion, the prevalence and incidence of sarcoid-induced pericarditial disease remain unclear. Clinical manifestations of pericardial involvement are variable, though many patients present with asymptomatic pericardial effusions. No consensus exists on the treatment of this special population, but corticosteroids and combination therapies are considered first-line therapies because of their efficacy in suppressing pericardial inflammation and underlying sarcoidosis. Patients with refractory cases of pericarditis may also benefit therapeutically from the addition of nonsteroidal anti-inflammatory agents, colchicine, and/or biologics.


Assuntos
Derrame Pericárdico , Pericardite Constritiva , Pericardite , Sarcoidose , Corticosteroides/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Colchicina , Humanos , Derrame Pericárdico/diagnóstico , Derrame Pericárdico/epidemiologia , Derrame Pericárdico/etiologia , Pericardiectomia , Pericardiocentese , Pericardite/diagnóstico , Pericardite/epidemiologia , Pericardite/etiologia , Pericardite Constritiva/diagnóstico , Pericardite Constritiva/epidemiologia , Pericardite Constritiva/etiologia , Sarcoidose/complicações , Sarcoidose/diagnóstico , Sarcoidose/epidemiologia
10.
J Cardiothorac Surg ; 17(1): 50, 2022 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-35321732

RESUMO

BACKGROUND: The effects of matrix metalloproteases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) expressions on the patients with constrictive pericarditis undergoing pericardiectomy remain unclear. This study explored the associations of MMPs and TIMPs expressions with postoperative outcomes in these patients. METHODS: Pericardial specimens were obtained during pericardiectomy from the patients with constrictive pericarditis. The levels of MMP1, MMP2, MMP9 and TIMP1 in pericardium were analyzed by quantitative real-time polymerase chain reaction. The enrolled patients were divided into two groups according to the optimal cutoff value of gene expression predicting postoperative complications. Postoperative outcomes were compared between the two groups. Binary logistic regression analysis was performed to determine the degree of contribution of gene expression on postoperative outcomes. RESULTS: A total of 22 patients and their pericardial specimens were included. The level of MMP9 was significantly associated with postoperative complications and the optimal cutoff value predicting postoperative complications was 3.67. The patients with low level of MMP9 (< 3.67) had lower incidence of postoperative complications (P = 0.002), shorter postoperative intensive care unit (P = 0.040) and hospital stay (P = 0.043) in comparison to those with high level of MMP9 (≥ 3.67). Binary logistic regression analysis showed that high level of MMP9 increased the risk of postoperative complications (OR 27.096, 95% CI 1.166-629.886, P = 0.040). CONCLUSIONS: High level of MMP9 in the pericardium was associated with poor postoperative outcomes and was the independent risk factor of postoperative complications. The level of MMP9 could be used as a potential marker for prediction of surgical outcomes.


Assuntos
Metaloproteinase 9 da Matriz , Pericardiectomia , Pericardite Constritiva , Pericárdio , Humanos , Metaloproteinase 9 da Matriz/genética , Metaloproteinase 9 da Matriz/metabolismo , Pericardite Constritiva/cirurgia , Pericárdio/enzimologia , Reação em Cadeia da Polimerase em Tempo Real , Resultado do Tratamento
11.
J Cardiothorac Surg ; 17(1): 44, 2022 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-35313923

RESUMO

BACKGROUND: We report the first ante-mortem diagnosis of hemorrhagic pericardial effusion in hereditary hemorrhagic telangiectasia resulting in constriction; the case also demonstrates the unusual but well-described complication of right-sided heart failure requiring extracorporeal membrane oxygenation (ECMO) support after pericardiectomy. CASE PRESENTATION: A previously healthy 48 year old man with a strong family history of Osler-Weber-Rendu disease presented to our institution with signs and symptoms of advance heart failure. His workup demonstrated a thickened pericardium and constrictive physiology. He was brought to the operating room where old clot and inflamed tissue were appreciated in the pericardial space and he underwent complete pericardiectomy under cardiopulmonary bypass. Separation from bypass, hampered by the development of right ventricular dysfunction and profound vasoplegia, required significant pressor and inotropic support. The right heart dysfunction and vasoplegia worsened in the early postoperative period requiring a week of ECMO after which his right ventricle recovered and he was successfully de-cannulated. CONCLUSION: Given the poor outcome of severe postoperative right ventricular failure after pericardiectomy, with high central venous pressure, a low gradient between central venous and pulmonary artery pressures and high vasopressor requirements, ECMO should be instituted promptly.


Assuntos
Oxigenação por Membrana Extracorpórea , Derrame Pericárdico , Telangiectasia Hemorrágica Hereditária , Constrição , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/etiologia , Derrame Pericárdico/cirurgia , Pericardiectomia , Telangiectasia Hemorrágica Hereditária/complicações
12.
Gen Thorac Cardiovasc Surg ; 70(5): 430-438, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35119592

RESUMO

OBJECTIVE: Constrictive pericarditis (CP) is a rare disease, and the diagnosis and surgical treatment of CP remain challenging. The aim of this study was to evaluate our Japanese single-center experience with isolated pericardiectomy for CP to elucidate the factors associated with improved outcomes. METHODS: Over a 20-year period, 44 consecutive patients underwent isolated pericardiectomy at our institution. The cause of CP was: idiopathic (59%), postsurgical (32%), tuberculosis (7%), and postradiation (2%) of the patients. All patients were diagnosed with CP using multiple modalities, including echocardiography, cardiac catheterization, computed tomography, or magnetic resonance imaging (MRI). Median sternotomy was performed in 42 (95%) patients. Twenty-eight (68%) patients underwent radical pericardiectomy. RESULTS: The postoperative diagnosis in all patients was CP. Among the multiple modalities, cardiac MRI had the greatest diagnostic sensitivity (97.2%). There were no operative or hospital deaths; late mortality occurred in seven (15.9%) patients in the series. Multivariable analysis showed that preoperative low LVEF was a risk factor for long-term mortality. Seven patients were readmitted for heart failure postoperatively. Multivariable analysis showed incomplete pericardiectomy and use of a preoperative inotrope were risk factors for readmission for heart failure. CONCLUSIONS: The diagnosis using multimodality imaging for CP was effective in our institution and tagged cine MRI had the greatest sensitivity in diagnosing CP. Preoperative condition, including preoperative low LVEF or inotrope use, was correlated with long-term outcome after pericardiectomy. Pericardiectomy should be performed early and as radically as possible to prevent recurrent heart failure.


Assuntos
Insuficiência Cardíaca , Pericardite Constritiva , Insuficiência Cardíaca/etiologia , Humanos , Japão , Pericardiectomia/efeitos adversos , Pericardiectomia/métodos , Pericardite Constritiva/diagnóstico por imagem , Pericardite Constritiva/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
14.
J Vet Cardiol ; 39: 63-68, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34979483

RESUMO

An 11-year-old neutered male Border Terrier presented for pericardiectomy after a nine-month history of tricavitary effusion, dyspnoea and lethargy. Transthoracic echocardiography revealed a fluid-filled structure at the heart base, starting at the mid-right ventricle and extending to the middle of the right atrium. Almost complete compression of the right atrium and the cranial vena cava was noted. Thoracic computed tomography revealed a heterogeneously enhancing and poorly marginated mass within the cranial aspect of the pericardium. A median sternotomy and subtotal pericardiectomy were performed. A non-distinct fluid-filled structure within the pericardium adhered to the epicardium was visualised. The structure was removed via marsupialisation along with extirpation of enlarged sternal lymph nodes. Histopathological examination of the sternal lymph nodes revealed expansile, well-demarcated, unencapsulated nodules of neoplastic cells consistent with a neuroendocrine tumour suspected to be thyroid in origin. After surgery, intractable pleural effusion resulted in euthanasia. Intrapericardial ectopic thyroid tumours are rarely reported in animals. The location of the mass and unusual presentation may have made it challenging for echocardiography to identify this neoplasia. Thoracic computed tomography at an earlier stage may have identified the neoplasia and potentially allowed for surgical intervention.


Assuntos
Doenças do Cão , Tumores Neuroendócrinos , Animais , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia , Cães , Ecocardiografia/veterinária , Eutanásia Animal , Masculino , Tumores Neuroendócrinos/diagnóstico por imagem , Tumores Neuroendócrinos/cirurgia , Tumores Neuroendócrinos/veterinária , Pericardiectomia/veterinária , Pericárdio/diagnóstico por imagem , Pericárdio/cirurgia
15.
Vet Clin North Am Small Anim Pract ; 52(2): 531-548, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35082091

RESUMO

Novel approaches and innovations in small animal thoracoscopy are being rapidly developed; this article aims to describe recent updates in commonly performed thoracoscopic procedures, including lung lobectomy, pericardiectomy and pericardial and cardiac neoplasia evaluation, chylothorax treatment, cranial mediastinal mass resection, persistent right aortic arch treatment, and management of pyothorax and primary spontaneous pneumothorax.


Assuntos
Pneumopatias , Toracoscopia , Animais , Pneumopatias/veterinária , Pericardiectomia/métodos , Pericardiectomia/veterinária , Toracoscopia/métodos , Toracoscopia/veterinária
17.
Inquiry ; 59: 469580211064462, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35044271

RESUMO

Chronic constrictive pericarditis (CCP) is one of the common causes of cardiogenic cirrhosis; it is rare for a patient to have both CCP and recurrent black stool, so we consider that CCP causes cardiogenic cirrhosis. Cardiogenic cirrhosis caused portal hypertension which then resulted in gastrointestinal bleeding. Herein, we report a case of a 40-year-old Chinese woman suffering from CCP who had upper gastrointestinal bleed and had to undergo emergency surgery. Two years after the emergency surgery, multiple reexaminations showed significantly improved cardiac functions, hemoglobin, and WBC levels and gastrointestinal functions.


Assuntos
Pericardite Constritiva , Adulto , Feminino , Seguimentos , Hemorragia Gastrointestinal/complicações , Humanos , Cirrose Hepática/complicações , Pericardiectomia/efeitos adversos , Pericardiectomia/métodos , Pericardite Constritiva/complicações , Pericardite Constritiva/cirurgia
19.
Cardiol Young ; 32(1): 130-131, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34210380

RESUMO

Balloon atrial septostomy is a palliative procedure that is performed in D-transposition of great arteries when surgery is not immediately available. Although D-TGA and left isomerism association are rare, it is an important condition as the BAS procedure approach is unique. In this case report, we present two cases of D-TGA with left isomerism where BAS was performed due to restrictive atrial septal defect and lack of immediate availability of the paediatric cardiac surgeon.


Assuntos
Síndrome de Heterotaxia , Procedimentos Cirúrgicos Torácicos , Transposição dos Grandes Vasos , Veia Ázigos/diagnóstico por imagem , Veia Ázigos/cirurgia , Criança , Síndrome de Heterotaxia/cirurgia , Humanos , Pericardiectomia , Transposição dos Grandes Vasos/diagnóstico por imagem , Transposição dos Grandes Vasos/cirurgia
20.
J Small Anim Pract ; 63(1): 72-77, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34370318

RESUMO

A juvenile boxer dog was diagnosed with gastroesophageal intussusception that occurred after the induction of emesis with apomorphine. A ventral midline coeliotomy and diaphragmotomy were performed and the intussusception was manually reduced. Despite initial satisfactory recovery, the dog was diagnosed with cardiac tamponade 1 week post-operatively. Escherichia coli was cultured from pericardial and pleural effusion samples. During subtotal pericardiectomy surgery the pericardium was found to be markedly thickened with adhesions to the epicardium, thoracic wall and diaphragm. Substantial haemorrhage and refractory hypotension necessitated the administration of a blood transfusion during surgery. The dog entered cardiac arrest in the immediate post-operative period and cardiopulmonary resuscitation was unfortunately unsuccessful. Gastroesophageal intussusception should be considered a possible severe adverse effect of administering apomorhine to induce emesis in dogs. Additionally, septic pericardial and pleural effusions may occur post-reduction of gastroesophageal intussusception.


Assuntos
Doenças do Cão , Intussuscepção , Derrame Pericárdico , Animais , Doenças do Cão/diagnóstico , Doenças do Cão/etiologia , Doenças do Cão/cirurgia , Cães , Intussuscepção/etiologia , Intussuscepção/cirurgia , Intussuscepção/veterinária , Derrame Pericárdico/veterinária , Pericardiectomia/efeitos adversos , Pericardiectomia/veterinária , Vômito/etiologia , Vômito/veterinária
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