RESUMO
A five-year-old boy received a blunt trauma on chest by a kindergarten bus on Feb. 29, 1996. Pulmonary hemorrhage and pericardiac effusion were developed, followed by multi-organ failure threatening his life. All symptoms were improving when pansystolic harsh murmur (III/IV) originating from a tiny ventricular rupture with a blood leak to the pericardial space was auscultated on the 12th day after the trauma. This murmur disappeared with the left ventricular healing and progressive aneurysmatic formation. Howeve, on the 61st day after the trauma a continuous murmur (II/III) of aortic dissecting aneurysm on the left upper sternal border and dorsum was newly auscultated. Two-dimensional color doppler echocardiogram and aortogram by femoral artery catheterization revealed aneurysmatic dilatations of both the left ventricular free wall and descending aorta immediately after the origin of the subclavian artery with mild mitral regugitation. The patient underwent successful corrective surgery.
Assuntos
Humanos , Masculino , Aneurisma , Dissecção Aórtica , Aorta Torácica , Automóveis , Cateterismo , Catéteres , Dilatação , Artéria Femoral , Ventrículos do Coração , Hemorragia , Ruptura , Artéria Subclávia , TóraxRESUMO
From Feb. 1985 to Aug. 1996, 450 patients underwent open heart surgery with hypothermic cardiopulmonary bypass. In 450 cases of open heart surgery, 222 cases(49.3%) were congenital heart diseases and 228 cases(50.7%) were acquired heart diseases. In 222 cases of congenital heart diseases, there were 201 cases of acyanotic heart disease and 21 cases of cyanotic heart diseases. Among the 228 cases of acquired heart diseases, most cases were valvular heart diseases in which 206 valves were implanted. There were 32 cases of ischemic heart disease and the average graft anastomoses were 2.37 sites per operation. The operative mortality of congenital and acquired disease was 9.0% and 10.1% respectively and then overall mortality rate was 9.6%.
Assuntos
Humanos , Ponte Cardiopulmonar , Cardiopatias , Doenças das Valvas Cardíacas , Coração , Mortalidade , Isquemia Miocárdica , Cirurgia Torácica , TransplantesRESUMO
From October 1991 to April 1996, 27 patients underwent aortocoronary bypass graft. There were 17 men, 10 women. The mean age was 65 years(range 45 to 76). The preoperative clinical status were chronic stable angina in 11 cases, unstable angina in 13 cases and postinfarction angina in 3 cases. The involved risk factors were as follows: Hypertension in 7 cases, Diabetes Mellitus in 5 cases and any other diseases in 3 cases. We divided these patients into two groups in this survey: The A group was 15 patients who were managed with cardioplegia from 1991 to 1994. The B group of 12 patients was done with intermittent aortic clamping without cardioplegia from 1995 to 1996. The mean numbers of graft per patient was 2.0 in A group and 2.83 in B group. The ischemic time per graft was 27.3 minute in A group and 18.5 minute in B group respectively. The morbidity was occlusion of grafted vessel in one patient and one of postoperative angina in A group. The total mortality was 14.8%(4/27), but mortality of B group was 8.3%(1/12).
Assuntos
Feminino , Humanos , Masculino , Angina Estável , Angina Instável , Constrição , Ponte de Artéria Coronária , Vasos Coronários , Diabetes Mellitus , Parada Cardíaca Induzida , Hipertensão , Mortalidade , Fatores de Risco , TransplantesRESUMO
Traumatic aneurysm of both the thoracic aorta and the left ventricle are extremely rare in children because it is characterized by high mortality. We report a case which we experi- enced recently with sucessful outcome. A Five-year-old boy had a blunt trauma by bongo bus. He had pulmonary hemorrage and pericardial effusion complicated by multiorgan failure threatening his life. Aneurysm of LV and Descending aorta were showed by 2-D echocardiogram and MRI. The patient underwent successful corrective surgery 2 and half momths after trauma, the postoperative status of this patient was uneventful, now he is being followed up the OPD.