ABSTRACT
BACKGROUND: Most patients with uncorrected coarctation of the aorta die before reaching age 50 years. In those who survive, the beneficial effect of surgical repair on systolic hypertension has been questioned. METHODS: Surgical repair of aortic coarctation was performed in 8 patients aged 51 to 73 years (mean, 58+/-9 years). Preoperative mean systolic pressure was 185+/-34 mm Hg and systolic gradient, 70+/-11 mm Hg. In addition, 3 patients had significant coronary artery disease. Severe calcification of the aortic arch and left subclavian artery was found in 3 patients. The surgical technique involved bypass of the coarctation with a Dacron tube graft (16 or 18 mm) in all patients. One patient underwent concomitant coronary artery bypass grafting. RESULTS: There were no operative or late deaths during a mean follow-up of 4.3 years. Mean systolic blood pressure decreased significantly in the postoperative period to 128+/-16 mm Hg (p < 0.001). At the last visit, systolic blood pressure was a mean of 127+/-9 mm Hg. Five patients were not taking antihypertensive medication. CONCLUSIONS: Surgical repair of aortic coarctation in patients more than 50 years of age with a Dacron tube bypass graft reduces systolic hypertension and the need of antihypertensive medication.
Subject(s)
Aortic Coarctation/surgery , Blood Vessel Prosthesis Implantation , Aged , Blood Pressure , Female , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
A 2-year-old patient with severe mitral regurgitation associated with a mass originating from the anterior leaflet of the mitral valve is reported. Excision of the tumor and mitral valve repair was performed. Four years later the child remains asymptomatic with no recurrence of the tumor or regurgitation.
Subject(s)
Heart Neoplasms/complications , Heart Neoplasms/surgery , Lipoma/complications , Lipoma/surgery , Mitral Valve Insufficiency/surgery , Mitral Valve/surgery , Child, Preschool , Humans , Male , Methods , Mitral Valve Insufficiency/etiologyABSTRACT
The presence of liver methastasis and serotonin in plasma in the carcinoid tumor are responsible for the carcinoid syndrome. We present a case of tricuspid and pulmonary valvular disease secondary to this syndrome. The finding of liver hyperechogenic nodules added to the described valvular disease by subcostal echocardiogram oriented the diagnosis.
