Recurrent giant left ventricular aneurysm of tuberculous etiology in a child: case report.

We report a case of myocardial tuberculosis in a 10-year-old girl, diagnosed after recurrence of left ventricular aneurysm, treated surgically.

[Thrombolytic therapy in thrombosis of prosthesis]. / Terapêutica trombolítica nas tromboses de próteses mecânicas.

PURPOSE: To relate our experience with thrombolytic therapy in 8 patients with cardiac metal prosthesis complicated with thrombosis. METHODS: Eight patients with clinical and echocardiographic diagnosis of cardiac valvar prosthesis thrombosis were treated. RESULTS: The treatment efficacy was evaluated by clinical and echocardiographic improvement. The authors recognized improvement in all 8 patients. One case of hemorrhage was observed (coxo-femoral articulation). Late death were observed twice: 24 months after, sudden death and 30 months later by hemorrhagic stroke. CONCLUSION: The results indicated that thrombolytic therapy is best way to treat patients with cardiac valve thrombosis, instead of surgical treatment.

[Mitral valve replacement with porcine bioprosthesis in children. Evaluation of 29 patients during 12 years]. / Substituição valvar mitral por bioprótese porcina em crianças. Avaliação de 29 pacientes durante 12 anos.

PURPOSE: To analyze the clinical result of the mitral valve substitution for the porcine bioprostheses, the incidence of dysfunction caused by calcification and its importance related to the durability of bioprostheses and also the patients' survival. METHODS: Twenty-nine children of about seven to sixteen years old were operated on from November 1977 to August 1982 and all of them received porcine bioprostheses of low profile. RESULTS: There were three (10.34%) hospital deaths and nine other late mortalities. The follow-up period varied from 4 to 128 months with average of 58.17 months and with the loss of nine patients. An actuarial survival rate of 46.08% has been observed at 11 years after surgery. Calcification of 21 bioprostheses occurred in 14 out of 17 follow-up patients; 47.6% of them happened until the third year of pos-operative and 85.7% until the fifth year. Eleven patients were reoperated on with 9.09% of hospital mortality. There were no cases of thromboembolism. CONCLUSION: Porcine bioprostheses works well with an evident clinical improvement of patients, with no thromboembolic accidents. However, its durability has been affected by the high incidence of calcification, which is responsible for an increase in late morbidity and mortality. Mitral valve disease treatment in children must be conservative, in an attempt to solve the problem with the different available plastic technics and leave the valve substitution to be a last option. In that case, the preference is given to the homologous bioprostheses.