RESUMO
PURPOSE: Our experience with surgical treatment of heart diseases in Indians living in the Amazon rain forest in primitive stages was reviewed. METHODS: From 1988 to 1995, 18 patients underwent cardiovascular surgical procedures at the São Paulo Hospital of the Escola Paulista de Medicina. Seven patients had valvar disease, nine congenital heart defects, one submitral aneurysm and one arrhythmia. Thirteen Indians came from tribes of the Amazon rain forest area: three from the Xavante, two from Waiapi, two from Tucano, two from Macuxi, two from Mayoruna, and one of each tribe of Xikrin, Guajajara, Terena, Surui, Galibi, Cinta-Larga and Pataxó. RESULTS: We performed 22 operations, with two hospital deaths. Follow-up was possible in 87.5 of cases, with one late death. The majority of cases were due to congenital heart defects and in this series it was noted the absence of operations to treat coronary artery disease. The incidence of valve disease was higher in accultured or semi-accultured Indians. CONCLUSION: The surgical treatment of cardiovascular disease has made possible to the surviving indians to return to and be accepted by their fellow tribesmen.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Adolescente , Adulto , Pessoa de Meia-Idade , Cardiopatias , Indígenas Sul-Americanos , Brasil , Seguimentos , Resultado do TratamentoRESUMO
O aneurisma subvalvar do ventrículo esquerdo é doença rara, de etiologia desconhecida e descrita principalmente em negros africanos. Neste artigo relata-se o caso de um índio brasileiro com sintomas de insuficiência cardíaca e sopro de insuficiência mitral. A radiografia de tórax observou-se abaulamento discreto do contorno cardíaco esquerdo em ao ecocardiograma bidimensional, aneurisma submitral do ventrículo esquerdo, confirmado por ventriculografia esquerda.O tratamento cirúrigico consistiu de ressecçöes do aneurisma e valvoplastia mitral. Durante a cirurgia encontrou-se uma perfuraçäo do aneurisma para a cavidade atrial esquerda que näo foi detectada por ecocardiografia nem por ventriculografia
Subralvar left ventricular aneurysm is a rare disease of unknown etiology, that has been described most often in black Africans. A case of Brazilian indian with heart failure and a murmur of mitral regurgitation is reported. The chest x-ray showed a mild bulge in the left cardiac border and two-dimensional echocardiography demonstrated submitral left ventricular aneurysm, confirmed by left ventricular angiography. Surgical treatment consisted of ressection of the aneurysm and mitral valvuloplasty. A perforation of the aneurysm, undetected neither by two-dimensional echocardiography nor by angiography was found at surgery.