ABSTRACT
Ventricular septal rupture (VSR) has been a lethal complication after acute myocardial infarction. It occurs mostly within one week following onset of myocardial infarction. Medical managements and percutaneous defect closure are still of limited value. Surgical closure of VSR has been developed since the first report in 1957, however the recent STS database reported high surgical mortality of 54.2% in cases within 7 days following onset of myocardial infarction. Posterior VSR has been reported worse surgical mortality than anterior VSR. A novel procedure, the extended sandwich patch (ESP) method via the right ventricle (RV) incision was proposed and developed for overcoming these weaknesses. ESP method starts with the incision close to the culprit artery and the left ventricle (LV) is reached through the defect. After sufficient debridement of the necrotic myocardium, an octagonal fabric patch sized 6 centimeter is introduced into the LV. About eight transmural anchoring sutures are placed inside-out. The second fabric patch is placed on the RV septum and felt pledgetts on the free wall of LV. Before the final closure of the ESP, glue is placed into the defect. The RV incision is then simply closed. Low mortality and least the shunt recurrence were reported by our group. This life-saving procedure seems promising to employ for VSR closure even in cases within 7 days following onset of myocardial infarction or in the posterior type. To improve clinical outcomes of VSR, it is crucial to perform VSR closure with the secure method prior to developing multi-organ failure due to the deteriorating heart failure.
ABSTRACT
Introducción: en Venezuela las enfermedades del corazón son la primera causa de defunción, y es frecuente la hospitalización por infarto en la clínica popular «Simón Bolívar¼. Hasta la fecha no existen estudios sobre el comportamiento de esta enfermedad en la misión Barrio Adentro. Objetivo: caracterizar a los pacientes con diagnóstico de infarto agudo del miocardio tratados en la clínica popular «Simón Bolívar¼. Métodos: se realizó un estudio descriptivo, retrospectivo y transversal, desde enero hasta septiembre de 2006, en la clínica popular «Simón Bolívar¼, del municipio Diego Ibarra, Carabobo, Venezuela, con los 52 pacientes con infarto agudo del miocardio, atendidos en ella. Resultados: el 63,5 % de los pacientes que sufrieron infarto pertenecían al sexo masculino, los intervalos de 60-69 años representaron el 40,4 %, el 71,2 % de los pacientes tenían hipertensión arterial, el infarto Killip I se presentó en 80,8 % de los casos, y el 13,5 % de los pacientes se complicaron con insuficiencia del ventrículo izquierdo. Conclusiones: predominó el sexo masculino con edades entre 60 y 69 años, los principales factores de riesgo fueron: hipertensión arterial, obesidad, diabetes mellitus y tabaquismo. La mayoría presentó infarto del miocardio Killip I, y las complicaciones intrahospitalarias fueron la insuficiencia del ventrículo izquierdo, las arritmias y el infarto recurrente.
Introduction: In Venezuela, the heart diseases are the leading cause of decease and it is frequent admission from infarction in the "Simón Bolivar" popular clinic. To date there are not studies on the course of this entity in the "Barrio Adentro" mission. Objective: To characterize the patients diagnosed with myocardial acute infarction treated in the above mentioned clinic. Methods: A descriptive, retrospective and cross-sectional study was conducted from January to September, 2006 in "Simón Bolivar" popular clinic from Diego Ibarra municipality, Carabobo, Venezuela in 52 patients presenting with myocardial acute infarction seen there. Results: The 63,5% of patients with infarction were men, intervals of 60-69 years old represented the 40,4%, the 71,1% of patients suffered arterial hypertension, Killip infarction was present in the 80,8% of cases, and the 13,5% becomes complicated with a left ventricle failure. Conclusions: There was predominance of male sex aged between 60 and 69, major risk factors were: arterial hypertension, obesity, diabetes mellitus and smoking. Most had a Killip I myocardial infarction and the intrahospital complications included a left ventricle failure, arrhythmias and the recurrent infarction.
Subject(s)
Animals , Magnetic Resonance Imaging, Cine/methods , Myocardial Infarction/physiopathology , Contrast Media/administration & dosage , Gadolinium DTPA/administration & dosage , Image Processing, Computer-Assisted , Linear Models , Myocardium/pathology , SwineABSTRACT
@# ObjectiveTo observe the effect and security of Batroxobin vein injection on patients with diabetes mellitus and acute cerebral infarction.Methods66 patients with diabetes mellitus and acute cerebral infarction were treated with Batroxobin vein injection and assessed with the scale of neurological deficit before treatment and at 3rd and 6th day after treatment.At the same time the coagulant function and the count of blood platelet were measured.ResultsAfter treatment,the concentration of fibrinogen in blood plasma of patients decreased and scores of neurological deficit assessment improved both significantly(P<0.001).The total validity of Batroxobin vein injection was 93.9%.No side actions of drug were found.ConclusionBatroxobin vein injection can be used as a therapeutic method of dissolving thrombus in patients with diabetes mellitus and acute cerebral infarction in early stage.
ABSTRACT
Objective:To observe characteristics of TCM syndrome types in the patient of cerebral infarction,and cerebral infarction with respiratory disorder at sleep.Methods:90 in-patients of cerebral infarction were monitored by polychannel sommocinematogram (PSG)within 72 hours of admission,which were used as diagnosis of respiratory disturbance at sleep,and all of the patients with apoplexy involving the channels and collaterals were divided into 3 types,collaterals hollow and pathogenic wind attacking the interior;Yin-deficiency of the liver and kidney,and wind-Yang stirring upper,hot phlegm and excess of Fu-organs,and wind- phlegm stirring the upper.Results:The patient had sleep structure disorder,with large change of blood pressure and lower heart variety,and decrease of degree of blood oxygen saturation.The apnea indexes were the highest for the patient with phlegm-heat hollow-organ excess,wind-phlegm stirring the upper,and baic normal for collateral hollow and pathogenic wind attacking the interior.Conclusion:There is close relation of cerebral infarction,especially in the patient of hot phlegm and excess of Fu-organ, with respiratory disorder at sleep.