RESUMO
A 62-year-old woman was admitted suffering from chest tightness and palpitations. Coronary angiography revealed slight stenosis of the coronary artery requiring medical treatment. At that time right renal artery aneurysm was found accidentally. In addition abdominal echogram showed gallbladder stone. She underwent aneurysmectomy with reconstruction of the right renal artery and cholecystectomy. Postoperative course was uneventful and renal arteriography one month after operation depicted the patent right renal artery. Surgical indications for renal artery aneurysm should be carefully considered.
RESUMO
A 52-year-old man suffering from Behçet's disease had undergone 6 operations for recurrent aneurysms of the bilateral iliac and femoral arteries. Thereafter, the patient underwent graft replacement for abdominal aortic aneurysm. Six years later he complained of lower abdominal pain and back pain. Abdominal CT-scan revealed abnormality of the proximal anastomotic site. The proximal suture line was completely dehiscent. The distal edge of infra-renal abdominal aorta was closed with interrupted mattress sutures. A right axillo-iliac bypass using a Dacron graft was performed for arterial reconstruction of the lower extremity. The patient has been free of recurrence for 4 years after the operation.
RESUMO
Clinical evaluation of perioperative IABP use in valvular heart surgery was studied. There were 4 preoperative, 18 intraoperative and 20 postoperative applications of IABP. The indications of IABP were LOS in 19 patients, failed weaning from bypass in 11, life threatening arrhythmia in 11, and congestive heart failure in 1. Sixteen out of 26 patients with successful weaning from IABP support could be discharged. Ten died after removal of IABP. Longer duration of cardiopulmonary bypass and aortic clamp, lower value of cardiac index 24 hours after introduction of IABP support were implicated in unsuccessful IABP support. The causes of death were due to LOS in 8 patients, MOF in 12, GVHD in 2, others in 3. The outcome of IABP for patients with valvular heart surgery was not satisfactory. However, the results of IABP support in valvular surgery will be improved by reducing the incidence of postoperative complications, especially LOS, followed by MOF.
RESUMO
A 70-year-old woman was admitted with precordial pain. Two-dimensional echocardiography revealed a right atrial tumor. CT scan also showed a high density tumor in the right atrium. Right atriography demonstrated a mobile tumor with a stalk arising from the vicinity of the Eustachian valve. On open heart surgery the stalk of the tumor seen to be attached to the Eustachian valve. The tumor was very hard because of massive calcification. Removal of the tumor was accomplished in the standard fashion, excising the Eustachian valve together with surrounding endocardium to prevent recurrence. The weight of the tumor was 20g and the size was 6×3×2cm. Histologic examination of the tumor revealed myxoma. Thirty five cases of right atrial myxoma have been reported in Japan. There was only one previous report which reported a case originating from an Eustachian valve.