ABSTRACT
Syphilitic aortic insufficiency and coronary ostial stenosis is a rare condition. It was diagnosed in 8 patients referred for surgery. The infection, acknowledged in 3 cases, was contracted over 15 years prior to admission! The operative indication was aortic valve replacement in 6 cases (Stage II to IV dyspnoea) and coronary insufficiency in 2 cases (Stage III angina pectoris). Two cases of ostial stenosis were not identified at coronary angiography, illustrating the potential diagnostic pitfall of a disease which is often unrecognised nowadays. Preoperative echocardiography of the left main coronary artery, especially its intra-aortic segment, may be of value but was not performed in these old cases. Surgery consisted in aortic valve replacement and coronary revascularisation by decortication of the ostia or coronary bypass (1 case). The evolution was excellent in the 6 survivors, especially with respect to the anginal syndrome which was completely cured without associated treatment. A protocol of echocardiographic surveillance of the left main coronary artery has been instituted in these patients to detect any late postoperative changes after ostial decortication.
Subject(s)
Aortic Valve Insufficiency/etiology , Coronary Disease/etiology , Syphilis, Cardiovascular/complications , Aged , Aortic Valve Insufficiency/complications , Aortic Valve Insufficiency/surgery , Constriction, Pathologic , Coronary Disease/diagnostic imaging , Female , Heart Valve Prosthesis , Humans , Male , Middle Aged , Myocardial Revascularization/methods , Radiography , Syphilis, Cardiovascular/surgeryABSTRACT
Os autores apresentam um caso de lipoma gigante de mesenterio, tratado com sucesso cirurgicamente, sem resseccao intestinal.Fazem levantamento bibliografico, no qual se percebe a raridade da patologia. Os lipomas, quando encontrados devem sempre ser ressecados cirurgicamente
Subject(s)
Child , Humans , Female , Intestinal Neoplasms , Lipoma , MesenterySubject(s)
Adolescent , Middle Aged , Humans , Male , Female , Meckel Diverticulum , Diverticulitis , Gastrointestinal Hemorrhage , Intestinal ObstructionABSTRACT
E apresentado um caso de embolia da arteria mesenterica superior, tratado cirurgicamente atraves de embolectomia da referida arteria, com boa evolucao. A hipotese diagnostica e a consequente pronta intervencao, antecedendo a temivel necrose das alcas, viabilizam o prognostico, conforme enfatizam os autores
