ABSTRACT
Considerando o crescente interesse e o constante aporte de novas informaçoes sobre o uso de betabloqueadores no tratamento da insuficiência cardíaca, os autores fazem uma ampla revisao do assunto. Nessa abordagem, sao focalizados os dados mais recentes de interesse prático, aspectos controversos e detalhes conclusivos
Subject(s)
Adrenergic beta-Antagonists/therapeutic use , Atenolol/therapeutic use , Cardiomyopathy, Dilated/therapy , Heart Failure/therapy , Metoprolol/therapeutic use , Pindolol/therapeutic useABSTRACT
Atualmente, há grande interesse em buscar métodos näo invasivos para a reduçäo e orientaçäo mais precisa das biópsias endomiocárdicas em transplante cardiaco. Relatam-se dois casos que foram submetidos a transplante cardíaco ortotópico, em acompanhamento diário com exames de eletrocardiografia de alta resoluçäo, pela análise do mapa espectro-temporal e cálculo da integral. Apresentam-se os resultados que possibilitaram a identificaçäo do processo de rejeiçäo e discutem-se vários aspectos desse novo método
At the present time there is great interest in seeking non invasive methods for reduction and precise orientation of the endomyocardial biopsy after heart transplant. Two cases of orthotopic heart transplant followed by spectro temporal mapping of signal averaging electrocardiography and integral calculation are reported. The results that identified the rejection process are presented and several aspects of this method are discussed
Subject(s)
Humans , Male , Adult , Middle Aged , Signal Processing, Computer-Assisted , Electrocardiography , Graft Rejection , Heart Transplantation/immunology , Time Factors , Postoperative CareABSTRACT
Purpose To assess this initial clinical experience with heart-lung transplantation in Brazil. Methods Four patients underwent heartlung transplantation from December 1988 to March 1990, one patient with cardiomyopathy and high pulmonary resistance, two patiens with primary pulmonary hypertension and another with pulmonry silicosis. The heart lung blocks were harvestedfrom the donor using cardiopulmonary bypass and deep hypotermia. They were transplanted to the recipient by anastomosing the tracheae, right atrium or venae cavae, and the ascending aorta. Results The second patient died on the 5th postoperative day due to respiratory insuffciency with consequent brain lesions. The first and third patients had survived nine manths and 42 days respectively. The 4th patients is assymptomatic eight months after the operation. The main complications were bleeding in two patients, acute pulmonary rejection in three of them and obliterans bronchiolitis in one patients. Conclusion The heart lung transplantation is a challenging procedure which results are progressively improving with the development of better surgical technique and clinical concepts.
Subject(s)
Heart-Lung Transplantation , Time Factors , Brazil , Cardiomyopathies/surgery , Postoperative Complications , Hypertension, Pulmonary/surgeryABSTRACT
Homem de 31 anos de idade, portador de mixoma de átrio direito, com manifestaçöes de tortura, mal-estar geral e dispnéia aos grandes esforços, apresentava ao exame físico sopros holossistólico e telediastólico de média intensidade em área trícuspide. Os sinais radiológicos e eletrocardiográficos foram de sobrecarga atrial e ventricular diretas e o diagnóstico de mixoma de átrio direito foi feito com auxílio do ecocardiograma bidimensional. A ressecçäo cirúrgica da massa tumoral confirmou o diagnóstico, através do estudo histopatológico da peça, que media 75x50x40mm. Houve remissäo das manifestaçöes clínicas, radiológicas e eletrocardiográficas