ABSTRACT
We report the case of a 27-year-old male patient with dyspnea on physical exertion. Clinical assessment and various tests led to the diagnosis of aortopulmonary window and double aortic arch. According to a literature search, this may be the first report on such association
Subject(s)
Humans , Male , Adult , Aorta, Thoracic , Aortopulmonary Septal Defect , Heart Defects, CongenitalABSTRACT
Objetivo Avaliar os resultados da angioplastia coronária em pacientes com idade igual ou inferior a 40 anos. Métodos De junho de 1987 a julho de 1990, 878 angioplastias foram realizadas sendo que, em 66 (7,5%) os pacientes tinham idade igual ou inferior a 40 anos. Considerou-se a obstrução coronária significativa quando maior ou igual a 70% de diâmetro da artéria e, resultado satisfatório quando o procedimento determinou redução desta obstrução a valores menores que 50%. Resultados Cinqüenta e quatro pacientes eram do sexo masculino, e a idade média de 37 (29 a 40) anos. O diagnóstico era angina estável em 44 (67%), instável em 18 (27%), infarto agudo do miocárdio (IAM) em 3 (4,5%), IAM após tratamento com estreptoquinase em 1 (1,5%). Destes pacientes, IAM prévio ocorreu em 8 (12%) e cirurgia prévia de revascularização miocárdica em 3 (4,5%). Cinqüenta e cinco (83%) eram uniarteriais e 11 (17%) multiarteriais. Oitenta vasos foram dilatados. Nos uniarteriais o procedimento foi na descendente anterior (DA) em 32 (58%), na coronária direita (CD) em 12 (22%), circunflexa (CX) em 10 (18%) e em ponte de safena em 1 (2%). Nos multiarteriais foi na DA em 12 (48%), na CD em 8 (32%) e na CX em 5 (20%). O resultado imediato foi obtido com sucesso em 53 (96%) dos uniarteriais e em 10 (91%) dos multiarteriais. Houve 1 óbito por complicação imediata. O seguimento médio de 11,6 (1 a 27) meses com 63 pacientes mostrou: reestenose em 10 (19%) uniarteriais sendo 9 (90%) redilatados com sucesso, e em 3 (30%) multiarteriais com redilatação em 2 (67%), também com sucesso em todos. Dois pacientes com reestenose foram...
Purpose To evaluate the results of coronary angioplasty in patients at the age of 40 years old or under. Methods From July 1987 to July 1990, 878 coronary angioplasty procedures were performed. Sixty six patients (7,5%) were 40 years old or under. The coronary obstruction was considered significant when 70% or more of the arterial diameter was involved and the post angioplasty results were considered satisfactory when residual obstruction was less than the 50%. Results Fifty four patients (81,8%) were male with an average age of 37 years (ranging from 29 to 40). Forty four patients (67%) had stable angina, 18 (27%) unstable angina, 3 (4%) acute myocardial infarction (artery, 12 (22%) in the RCA, 10 (18%) in the left circunfex and one (2%) into a saphenous vein bypass grafting. In 12 patients (48%) with multivessel disease it was performed in the LAD coronary artery, 8 (32%) in the RCA and 5 (20%) in the left circunflex. Angioplasty was successfully performed in 53 (96%) patients with single vessel disease and in 10 (01%) with multivessel disease. One of the patients died immediately after the procedure. A follow up of 11,6 months (ranged from 1 to 27 months) was possible in 63 patients. Re-stenosis was depicted in 10 (19%) ofthe 55 patients with single vessel disease and in 3 of the 11 patients (30%) with multivessel disease. Nine patients had a successful redilatation in the first group and 2 in the second one
Subject(s)
Humans , Male , Adult , Angioplasty, Balloon , Coronary Artery Disease/therapy , Recurrence , Retrospective Studies , Risk Factors , Age FactorsABSTRACT
Purpose To describe a new alternativetechnique for treating coronary artery disease: the coronary atherectomy with the transluminal endarterectomy-extraction catheter. Methods Four patients, 1 female and 3 males age 46 to 65 years (mean 53 ± 8.5 years), were submitted to coronary atherectomy with the transluminal endarterectomy-extraction catheter. One patient presenting stable angina, one presenting recent angina, one with residual stenosis after acute myocardial infarction treated with intravenous streptokinase and one with two episodes of syncope and ECG alterations. The treated arteries were: left anterior descending in 3 patients and left circumfCex in one. Two lesion were concentric and two were segmentary and excentric. Results The coronary artery stenosis ranged from 80 to 95% (mean of 90 ± 7.1%) before the atherectomy and from 20-50% (mean of 32.5 ± 12.6%) after the atherectomy. Except thefirst patient, the other 3 were discharged in less than 48 hours after the atherectomy. None presented chest pain during the procedure and in three of them were no recordings of dissection or coronary artery perfuration. In one patient the treated artery presented total occlusion (thrombus) 15 minutes after the procedure, but was immediate and successfully reopered with balloon angioplasty. Conclusion Coronary atherectomy with the "transluminal endarterectomy-extraction catheter" has shown to be a safe and feasible procedure and to bring satisfactory immediate results.