Três casos de hipertensão e Fístula Arteriovenosa Renal: com uma fístula de novo / Three cases of hypertension and Renal Arteriovenous fistula with a de novo fistula / Tres casos de hipertención y Fístula Arteriovenosa Renal: con una fístula de novo

Fístula Arteriovenosa Renal (FAVR) é uma causa rara e potencialmente reversível de hipertensão e insuficiência renal e/ou cardíaca. O tratamento da FAVR visa preservar o máximo de parênquima renal e, concomitantemente, erradicar os sintomas e efeitos hemodinâmicos decorrentes da FAVR. No presente estudo, serão relatados três casos de FAVR, incluindo um caso de FAVR idiopática de novo, que se apresentaram com hipertensão e insuficiência renal e/ou cardíaca, e descrever a terapêutica adotada e os resultados obtidos.

The Renal Arteriovenous Fistula (RAVF) is a rare and potentially reversible cause of hypertension and kidney and/or heart failure. The treatment of RAVF aims at preserving the most of the renal parenchyma and, concomitantly, eradicating the symptoms and hemodynamic effects caused by the RAVF. The present study reports three cases of RAVF, including one case of a de novo idiopathic RAVF, which presented with hypertension and kidney and/or heart failure and describes the therapeutic measures used to treat these patients as well as the outcomes.

La Fístula Arteriovenosa Renal (FAVR) es una causa rara y potencialmente reversible de hipertensión e insuficiencia renal y/o cardíaca. El tratamiento de la FAVR busca preservar el máximo de parénquima renal y, concomitantemente, erradicar los síntomas y efectos hemodinámicos resultantes de la FAVR. En el presente estudio, se relatarán tres casos de FAVR, incluyendo un caso de FAVR idiopática de novo, que se presentaron con hipertensión e insuficiencia renal y/o cardíaca, y describir la terapéutica adoptada y los resultados obtenidos.

Morphological study of the human mitral-aortic intervalvular fibrosa

The mitral-aortic intervalvular fibrosa of the heart is of great clinical and surgical importance, because of its involvement in the anatomical and functional integrity of these two valves. In this work, we examined the morphology of the mitralaortic intervalvular fibrosa and its relationship to the mitral and aortic valves. Thirty formaldehyde-fixed adult human hearts of both sexes were dissected and the structural organization, dimensions and area of the mitral-aortic intervalvular fibrosa were determined. The mitral-aortic intervalvular fibrosa was a thin, translucent membranous area located between the root of the aortic artery and the left atrioventricular orifice. In most cases (63 por cento), the mitral-aortic intervalvular fibrosa was approximately triangular in shape, with an area of 93.9 ± 47.4 mm². The lower edge was associated with the anterior cusp of the mitral valve and was 18.0 ± 2.2 mm long, whereas the anterior edge was continuos with the left fibrous trigone and was 10.6 ± 3.0 mm long. The posterior edge was associated with the aortic wall and was continuos with the right fibrous trigone. This edge was 11.7 ± 3.4 mm long. These results may be useful for manufacturing protheses to substitute this injured membrane.

Estudo morfométrico e topográfico dos óstios coronarianos / Morphometric and topographic study of coronary ostia

OBJECTIVE: To investigate the morphometric and topographic aspects of coronary ostia, correlating them with the aortic leaflets. METHODS: Fifty-one hearts with the great vessels attached were analyzed in this study. The ascending aorta was transversally sectioned 1 cm above the commissures of the aortic leaflets. The right and left coronary ostia were analyzed, as were the distances from these ostia to the bottom of the aortic sinuses and to the commissures of the aortic leaflets. RESULTS: The left coronary ostium was located below the intercommissural line in 42 percent of cases, above that line in 40 percent of cases, and at the level of that line in 18 percent of cases. The mean distance from the left coronary ostium to the bottom of the corresponding sinus was 12.6±2.61 mm. The right coronary ostium was located below the intercommissural line in 60 percent of cases, above that line in 28 percent of cases, and at the level of that line in 12 percent of cases. The mean distance from the right coronary ostium to the bottom of the corresponding aortic sinus was 13.2±2.64 mm. The mean diameters of the left and right coronary ostia were 4.75±0.93 mm and 3.46±0.94 mm, respectively. The mean diameters of the juxtamural portion of the left and right coronary arteries were 3.75±0.79 mm and 2.9±0.73 mm, respectively. In one case, both ostia were located in the left coronary sinus. CONCLUSION: The left coronary ostium may be located either above or below the intercommissural line. The right coronary ostium is predominantly located below the intercommissural line. The coronary ostia have reduced diameters as compared with the juxtamural diameters of their respective coronary arteries