ABSTRACT
A heroin addict who appeared to have recovered clinically from infective endocarditis of the tricuspid valve as judged by the usual criteria underwent prophylactic resection of a large vegetation on the tricuspid valve in order to prevent severe pulmonary embolism. Prophylactic surgery was justified by the size and as judged by cross-sectional echocardiography of the vegetation and its morphology.
Subject(s)
Endocarditis, Bacterial/surgery , Staphylococcal Infections/surgery , Tricuspid Valve/surgery , Adult , Echocardiography , Endocarditis, Bacterial/pathology , Humans , Male , Staphylococcal Infections/pathology , Tricuspid Valve/pathologyABSTRACT
A case of a patient of 44 years of age with nonspecific thoracic symptomatology and anomalous protrusion of the second arch of the left border of the cardiac silhouette is reported. Cineangiocardiography showed a herniation of the left atrium and ventricle through a partial defect in the left pericardium demonstrating a mechanism that can give rise to sudden death by cardiac incarceration. Prophylactic longitudinal pericardiectomy was performed and the patient made an uneventful recovery.
Subject(s)
Heart Atria/abnormalities , Heart Ventricles/abnormalities , Pericardium/abnormalities , Adult , Angiocardiography , Cineangiography , Heart Atria/diagnostic imaging , Heart Atria/surgery , Heart Ventricles/diagnostic imaging , Heart Ventricles/surgery , Hernia/congenital , Hernia/diagnostic imaging , Herniorrhaphy , Humans , Male , Pericardium/diagnostic imaging , Pericardium/surgeryABSTRACT
Pregnant women with cardiac valvular prostheses present an important risk factor and the major complications are endocarditis and thromboembolism. Thromboembolism is determined by a hypercoagulation state. Compulsory anticoagulation treatment is an associated risk factor producing maternal and fetal complications. Different open heart surgical cases during pregnancy have been reported and a review of the literature shows favourable maternal prognosis. A 30-year-old woman with a Björk-Shiley mitral prosthesis, during the 6th week of pregnancy presented with thrombosis and embolism due to a change in anticoagulation treatment from acenocumarol to heparin. Open heart surgery was carried out and the patient's course was favourable. A fetal hydrocephaly of unknown etiology was discovered during the 18th week of pregnancy. Open heart surgery during pregnancy and the necessity of thromboembolic prophylaxis, have been analysed and revised.
