RESUMO
Stent placement in the patent ductus arteriosus (PDA) is becoming an alternative treatment to improve cardiac function and quality of life in patients with ductal dependent cardiac conditions. Although, today most of these cardiac defects can be surgically corrected without the need of maintaining PDA patency for a long period of time, some countries lack the resources, and in other cases, surgical intervention is preferably delayed due to medical reasons. This report presents 2 cases where stents were placed in the PDA.
Assuntos
Humanos , Feminino , Lactente , Permeabilidade do Canal Arterial , Stents , Grau de Desobstrução Vascular , Seguimentos , Fatores de TempoRESUMO
OBJECTIVE: Heart transplantation has become available as a possible treatment for patients with malignancies. Primary cardiac malignant tumors are extremely rare but several patients have been treated with this modality. Whether survival is improved over the direct removal of tumor or heart transplantation is not known. We compiled data regarding malignant primary heart tumors that have been treated at various transplant centers in order to determine if early diagnosis and treatment with cardiac transplantation has resulted in an improved mortality. METHODS: A total of 173 questionnaires were sent to the heart transplant centers across the United States and Canada inquiring about those patients who were found to have a primary cardiac malignant tumor and who underwent heart transplantation. Cases reported in the literature, which had undergone transplantation, were also reviewed by a search in MEDLINE. RESULTS: Twenty-four cases were collected. The overall survival time was from 1 month to 66 months. The actuarial survival was 54% at 12 months, 45% at 24 months and 35% at 36, 48 and 60 months respectively. Metastases were present in 10 out of the 14 deceased patients, possibly being one of the major factors affecting survival. Only 1 living patient developed metastases. CONCLUSION: Survival rates of patients with primary cardiac malignancies treated with resection, radiation, chemotherapy, or a combination of them (conventional therapy) versus heart transplantation are similar. Early diagnosis and resection are the most important factors for a better outcome, however these factors will not guarantee success since the presence or development of metastasis is a major contributor to death in both groups of patients
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Neoplasias Cardíacas/cirurgia , Transplante de Coração , Canadá/epidemiologia , Estados Unidos/epidemiologia , Pesquisas sobre Atenção à Saúde , Neoplasias Cardíacas/mortalidade , Neoplasias Cardíacas/terapia , Taxa de Sobrevida , Transplante de Coração/mortalidadeRESUMO
Primary cardiac osteogenic sarcomas are rare malignancies. Less than 30 cases have been reported in the literature. Most of them have been found in the left side of the heart. We report a case of a primary osteogenic sarcoma of the left atrium in a 28 year old female. She underwent resection of the tumor and subsequently heart transplantation. To our knowledge this is the second patient with a primary cardiac osteosarcoma who underwent heart transplantation
Assuntos
Humanos , Feminino , Adulto , Transplante de Coração , Neoplasias Cardíacas/cirurgia , Osteossarcoma , Evolução Fatal , Inoculação de Neoplasia , Neoplasias Cardíacas/diagnóstico , Neoplasias Encefálicas/secundário , OsteossarcomaAssuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Encefálicas , Lobo Frontal , Linfoma de Células B , Lobo Temporal , Neoplasias Cerebelares , Diagnóstico Diferencial , Linfoma de Células B/líquido cefalorraquidiano , Linfoma de Células B/diagnóstico , Imageamento por Ressonância Magnética , Neoplasias Cerebelares/diagnóstico , Neoplasias Encefálicas/líquido cefalorraquidiano , Neoplasias Encefálicas/diagnóstico , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios XRESUMO
Primary cardiac tumors are rare entities with a frequency between 0.0017 to 0.28. We report a 53 year old male with a primary cardiac myofibroblastic sarcoma that presented with a hemorrhagic pericardial effusion. A review of the literature is presented with a brief discussion of the clinical presentation diagnosis and treatment of benign and malignant primary cardiac tumors
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cardíacas , Sarcoma , Diagnóstico Diferencial , Derrame Pericárdico/etiologia , Átrios do Coração , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/terapia , Sarcoma/diagnóstico , Sarcoma/terapiaRESUMO
Pneumatic balloon dilatation of the esophagus is one of the current recommended treatment for achalasia. This procedure is associated with risks such as esophageal rupture. Surgery and percutaneous gastrostomy tube placement has been performed in severely affected individuals. The Botulinum Toxin A (BoTxA) is widely used to treat neuromuscular conditions in which spasticity is of concern. We present four cases in which BoTxA was used as an alternative of treatment and in which less invasive modalities were unsuccessful. The patients received a total of 80 units of BoTxA, applied to the submucosa in doses of 20 units in each predetermined quadrants to the lower esophageal sphincter. All patients demonstrated improvement of their symptoms without side effects in this study