ABSTRACT
La disección aórtica es la patología más común de la aorta que requiere intervención quirúrgica urgente, siendo más frecuente en la sexta década de la vida, generalmente asociada a hipertensión arterial. Cuando aparece por debajo de esta edad se suele asociar a patología del tejido conectivo. En este artículo se presenta una revisión sobre esta patología a propósito de dos casos de disección aórtica en varones menores de 50 años, sin factores de riesgo, que fueron intervenidos urgentemente presentando una buena evolución. Estos casos resaltan la posibilidad de que la disección aórtica se presente en personas jóvenes sin factores de riesgo; por ello, y ante un cuadro clínico sugestivo, esta entidad debe ser rápidamente descartada, ya que la precocidad de la intervención es uno de los principales factores pronósticos (AU)
Subject(s)
Adult , Male , Humans , Risk Factors , Connective Tissue Diseases/diagnosis , Connective Tissue Diseases/epidemiology , Aortic DiseasesABSTRACT
We studied several parameters of the jugular flebogram in 70 patients who had undergone cardiac surgery. Fifty six of them were on sinusal rithm and 14 in auricular fibrillation. We found among them 39 who had undergone commissurotomy and 16 who had got valvular prothesis. The results of these studies were analyzed and compared with those of 94 normal subjects, taking in consideration the type of surgical intervention and the time elapsed since the operation was performed--the latter in the more numerous group. It is interesting to observe that the sinus grows deeper after the intervention so making the relation xv/yv lower than the unit in 33% of the patients maintaining sinusal rithm. This alteration remained stationary during some years in some of the cases, the results suggesting a greater frequency during the first months of the post-operatory period. We didn't find any relation of this morphologic alteration with the presence of a pericardial construction, pulmonary hypertension, valvular injuries with repercussion on the right heart or modifications on the nenous pressure which we think due to functional changes following the pericardiotomy. It is interesting to observe these mechanographic signs in relation with the post-operatory period of cardiac surgery, but we must avoid hypervaluation of those cases suspicious of pericardial constriction.
