RESUMO
Mycotic aneurysm of the superior mesenteric artery (SMA) is a rare complication of infective endocarditis. We report a case with infective endocarditis involving the aortic valve complicated by multiple septic embolisms. The patient was treated with antibiotics for 6 weeks. During preparation for surgical treatment, the patient developed acute abdominal pain and was diagnosed with a ruptured SMA aneurysm, which was successfully treated with an emergency operation of aneurysm ligation. The aortic valve was replaced 17 days later and the patient recovered uneventfully. In conclusion, we present a rare case with infective endocarditis (IE) complicated by SMA aneurysm. Antibiotic treatment did not prevent the rupture of SMA aneurysm. Abdominal pain in a patient with a recent history of IE should be excluded with ruptured aneurysm.
Assuntos
Aneurisma Roto/prevenção & controle , Antibacterianos/uso terapêutico , Valva Aórtica , Endocardite/tratamento farmacológico , Doenças das Valvas Cardíacas/tratamento farmacológico , Artéria Mesentérica Superior , Adulto , Aneurisma Roto/cirurgia , Valva Aórtica/cirurgia , Endocardite/complicações , Endocardite/cirurgia , Doenças das Valvas Cardíacas/complicações , Doenças das Valvas Cardíacas/cirurgia , Implante de Prótese de Valva Cardíaca , Humanos , MasculinoAssuntos
Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Valva Mitral/patologia , Valva Mitral/cirurgia , Adolescente , Bioprótese , Procedimentos Cirúrgicos Cardíacos , Permeabilidade do Canal Arterial/complicações , Permeabilidade do Canal Arterial/cirurgia , Ecocardiografia , Feminino , Aneurisma Cardíaco/complicações , Aneurisma Cardíaco/patologia , Comunicação Interventricular/complicações , Comunicação Interventricular/cirurgia , Humanos , Resultado do TratamentoRESUMO
Swelling-activated chloride currents (ICl.swell) are thought to play a role in several physiologic and pathophysiologic processes and thus represent a target for therapeutic approaches. However, the mechanism of ICl.swell regulation remains unclear. In this study, we used the whole-cell patch-clamp technique to examine the role of protein kinase C (PKC) in the regulation of ICl.swell in human atrial myocytes. Atrial myocytes were isolated from the right atrial appendages of patients undergoing coronary artery bypass and enzymatically dissociated. ICl.swell was evoked in hypotonic solution and recorded using the whole-cell patch-clamp technique. The PKC agonist phorbol dibutyrate (PDBu) enhanced ICl.swell in a concentration-dependent manner, which was reversed in isotonic solution and by a chloride current inhibitor, 9-anthracenecarboxylicacid. Furthermore, the PKC inhibitor bis-indolylmaleimide attenuated the effect and 4α-PDBu, an inactive PDBu analog, had no effect on ICl.swell. These results, obtained using the whole-cell patch-clamp technique, demonstrate the ability of PKC to activate ICl,swell in human atrial myocytes. This observation was consistent with a previous study using a single-channel patch-clamp technique, but differed from some findings in other species.