Early Outcomes of Modified De Vega Annuloplasty for Functional Tricuspid Regurgitation at a Brazilian Hospital

Abstract Background: Right valve diseases are not benign, the tricuspid regurgitation has a significant impact on morbidity and mortality of patients. Objectives: This study aimed to report the short-term results of tricuspid annuloplasty using the De Vega technique modified by Manuel Antunes. Methods: A descriptive-analytical study was performed to evaluate the results of the tricuspid valvuloplasty performed at the Instituto de Medicina Integral Professor Fernando Figueira between 2012 and 2017. Data were collected by reviewing charts and databases of the Department of Cardiology and Cardiovascular Surgery of the institution. Those with rheumatic diseases or infective endocarditis with tricuspid valve involvement, or reoperation of the tricuspid valve were excluded. Student's t-test and McNemar's were used for statistical analysis. A p-value < 0.05 was considered statistically significant. Results: A total of 87 patients were studied, most of them were women (56.3%). The most associated heart valve diseases were mitral regurgitation (27.6%) and aortic regurgitation (20.7%). There was a significant decrease in the degree of tricuspid regurgitation in the postoperative period, with 83.3% of patients with none or mild regurgitation and only 1.1% with severe regurgitation (p = 0.0077). Conclusions: In the current study, tricuspid valve annuloplasty using the modified De Vega technique was shown to be effective in the short term. Further studies are needed to evaluate the long-term results.

Embolization by Bullet Dislodged from the Heart

Abstract Embolization by a dislodged projectile is a rare complication that may occur in cases of gunshot cardiac injuries. We report a case of a firearm projectile cardiac injury that evolved, with dislocation of the projectile during cardiac surgery, into embolization of the right external carotid artery.

Hemorragia digestiva por fístula gástrica de pseudoaneurisma de artéria esplênica: relato de caso / Gastric bleeding from splenic artery pseudoaneurysm: case report

Hemorragia digestiva por ruptura de pseudoaneurisma de artéria esplênica (PAAE) é incomum. Pancreatite é a responsável pela maioria dos PAAEs. Tomografia computadorizada de abdome é um bom método não-invasivo para identificar complicações vasculares de pancreatite. Angiografia localiza o sítio arterial sangrante. Tratamento de PAAE é mandatório, independentemente do tamanho do pseudoaneurisma ou sintomas associados. Embolização transarterial percutânea da artéria esplênica é tratamento padrão-ouro em pacientes hemodinamicamente estáveis. Cirurgia está indicada para pacientes hemodinamicamente instáveis ou com falha terapêutica angiográfica. Relatamos um caso de paciente com hemorragia digestiva alta por fístula gástrica de pseudoaneurisma de artéria esplênica, associada a quadro de pancreatite alcoólica.

Gastrointestinal hemorrhage due to rupture of splenic artery pseudoaneurysm (SAPA) is unusual. Pancreatitis is responsible for most SAPAs. Computed tomography of the abdomen is a good noninvasive method to identify vascular complications of pancreatitis. Angiography located arterial site bleeding. Treatment of SAPA is mandatory, regardless of size or symptoms associated pseudoaneurysm. Percutaneous transarterial embolization of the splenic artery is the gold standard treatment in hemodynamically stable patients. Surgery is indicated for hemodynamically unstable patients or angiographic treatment failure. We report a case of a patient with upper gastrointestinal bleeding by gastric fistula of splenic artery pseudoaneurysm associated with alcoholic pancreatitis.