RESUMO
Immunosuppression can allow organisms that are not usually pathogenetic to cause disease; under such circumstances, Aspergillus species frequently form large masses of fungal elements. We describe the case of a 12-year-old girl with hematologic remission of leukemia. She had a left ventricular pedunculated mass that was detected by echocardiographic study; at surgery, the presence of Aspergillus terreus was confirmed.
Assuntos
Aspergilose/diagnóstico por imagem , Cardiopatias/microbiologia , Aspergilose/cirurgia , Criança , Feminino , Cardiopatias/diagnóstico por imagem , Cardiopatias/cirurgia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/microbiologia , Ventrículos do Coração/patologia , Humanos , UltrassonografiaRESUMO
Atrial myxoma is the most common benign tumor of the heart, but its appearance after radiofrequency ablation is very rare. We report a case in which an asymptomatic, rapidly growing cardiac myxoma arose in the left atrium after radiofrequency ablation. Two months after the procedure, cardiovascular magnetic resonance, performed to evaluate the right ventricular anatomy, revealed a 10 × 10-mm mass (assumed to be a thrombus) attached to the patient's left atrial septum. Three months later, transthoracic echocardiography revealed a larger mass, and the patient was diagnosed with myxoma. Two days later, a 20 × 20-mm myxoma weighing 37 g was excised. To our knowledge, the appearance of an atrial myxoma after radiofrequency ablation has been reported only once before. Whether tumor development is related to such ablation or is merely a coincidence is uncertain, but myxomas have developed after other instances of cardiac trauma.
Assuntos
Fibrilação Atrial/cirurgia , Ablação por Cateter/efeitos adversos , Proliferação de Células , Neoplasias Cardíacas/etiologia , Mixoma/etiologia , Fibrilação Atrial/diagnóstico , Septo Interatrial/patologia , Ecocardiografia Transesofagiana , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Mixoma/patologia , Mixoma/cirurgia , Reoperação , Fatores de Tempo , Carga TumoralRESUMO
Biological glue is increasingly used in cardiac surgery. We report a case of type A aortic dissection repair that was complicated by subsequent pulmonary embolism due to BioGlue(®) (Cryolife Inc, Hennesaw, GA, USA). To our knowledge this is the first report of a case with this complication.
Assuntos
Aneurisma Aórtico/cirurgia , Dissecção Aórtica/cirurgia , Implante de Prótese Vascular , Proteínas/efeitos adversos , Embolia Pulmonar/induzido quimicamente , Adesivos Teciduais/efeitos adversos , Idoso , Falso Aneurisma/etiologia , Ruptura Aórtica/etiologia , Implante de Prótese Vascular/efeitos adversos , Evolução Fatal , Humanos , Masculino , Embolia Pulmonar/diagnóstico por imagem , Embolia Pulmonar/cirurgia , Reoperação , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Long-term survival was investigated in 202 patients who underwent isolated aortic valve replacement (AVR) with 19 mm valves. There were 171 women with a mean age of 69+/-9 years and 31 men with a mean age of 64+/-13 years. Patients had a mean body surface area of 1.61+/-0.13 m(2). Patient-prosthesis mismatch was moderate in 196 and severe in six patients. The mean follow-up for all patients was 78 months. There were 79 late deaths. The actuarial survival rates for all patients were 95+/-1% at 1 year, 75+/-2% at 5 years, 56+/-2% at 10 years, 41+/-2% at 15 years, 34+/-3% at 20 years and 34+/-2% at 25 years. Patients over 70 years old had a lower survival rate (P=0.0001). There were significant differences between ejection fraction (EF) >55% and EF <55% (P=0.0305). AVR with 19 mm valves appeared to provide satisfactory mid-term survival. Age and low EF were risk factors for shorter survival.