ABSTRACT
El síndrome de Eisenmenger se define como una enfermedad vascular pulmonar de tipo obstructivo que se desarrolla a partir de la existencia previa de una comunicación entre la circulación sistémica y pulmonar, con desviación de la corriente sanguínea de izquierda a derecha. Durante el embarazo conlleva una mortalidad fetal y materna superior al 50 por ciento. El objetivo de este trabajo es describir un caso clínico de una paciente con síndrome de Eisenmenger asociado al embarazo. Se presenta el caso clínico de una paciente de 16 años de edad, primigesta, con antecedentes de síndrome de Eisenmenger que acude al servicio de Cardiopatía y embarazo con una gestación de 20 sem. Se mantiene hospitalizada con evaluación de la calidad de vida fetal por sospecha de retardo del crecimiento y se utilizan inductores de la madurez pulmonar fetal en las sem 30 y 33 de gestación. A las 34,4 sem se le practica una cesárea electiva y esterilización quirúrgica. Se obtiene un recién nacido masculino, peso 1 958 g, apgar 9/9 sin incidentes anestÚsicos ni quirúrgicos durante el procedimiento. La evolución del puerperio inmediato y mediato es satisfactoria y egresa a los 36 días. El síndrome de Eisenmenger implica un alto riesgo de morbilidad y mortalidad materno-perinatal y el manejo multidisciplinario optimiza los resultados
Eisenmenger's syndrome is defined as a obstructive pulmonary vascular disease developed from the previous existence of a communication between the systemic and the pulmonary circulation with a deviation of blood stream from left to right. During pregnancy entails a mother and fetus mortality higher than 50 percent. The objective of present paper is to describe a clinical case of a patient presenting with Eisenmenger's syndrome seen in the Heart Disease service and a 20 weeks pregnancy. Remains admitted with an evaluation of the fetal quality of life due to suspicion of growth retardation using inductors of the fetal pulmonary maturity at 30 and 33 weeks of pregnancy. At 34.4 weeks she undergoes an elective cesarean section and surgical sterilization. She give birth a male newborn weighing 1 958 g, Apgar 9/9 without surgical and anesthetic backgrounds during procedure. Immediate puerperium evolution is satisfactory and is discharged at 36 days. The Eisenmenger's syndrome entails a high risk of morbidity and mortality for mother and for fetus, and the multidisciplinary management optimizes the results
Subject(s)
Humans , Female , Pregnancy , Adolescent , Eisenmenger Complex/prevention & control , Eisenmenger Complex/drug therapy , Pregnancy Complications, Cardiovascular/physiopathology , Case ReportsABSTRACT
El síndrome de Eisenmenger se define como una enfermedad vascular pulmonar de tipo obstructivo que se desarrolla a partir de la existencia previa de una comunicación entre la circulación sistémica y pulmonar, con desviación de la corriente sanguínea de izquierda a derecha. Durante el embarazo conlleva una mortalidad fetal y materna superior al 50 por ciento. El objetivo de este trabajo es describir un caso clínico de una paciente con síndrome de Eisenmenger asociado al embarazo. Se presenta el caso clínico de una paciente de 16 años de edad, primigesta, con antecedentes de síndrome de Eisenmenger que acude al servicio de Cardiopatía y embarazo con una gestación de 20 sem. Se mantiene hospitalizada con evaluación de la calidad de vida fetal por sospecha de retardo del crecimiento y se utilizan inductores de la madurez pulmonar fetal en las sem 30 y 33 de gestación. A las 34,4 sem se le practica una cesárea electiva y esterilización quirúrgica. Se obtiene un recién nacido masculino, peso 1 958 g, apgar 9/9 sin incidentes anestÚsicos ni quirúrgicos durante el procedimiento. La evolución del puerperio inmediato y mediato es satisfactoria y egresa a los 36 días. El síndrome de Eisenmenger implica un alto riesgo de morbilidad y mortalidad materno-perinatal y el manejo multidisciplinario optimiza los resultados(AU)
Eisenmenger's syndrome is defined as a obstructive pulmonary vascular disease developed from the previous existence of a communication between the systemic and the pulmonary circulation with a deviation of blood stream from left to right. During pregnancy entails a mother and fetus mortality higher than 50 percent. The objective of present paper is to describe a clinical case of a patient presenting with Eisenmenger's syndrome seen in the Heart Disease service and a 20 weeks pregnancy. Remains admitted with an evaluation of the fetal quality of life due to suspicion of growth retardation using inductors of the fetal pulmonary maturity at 30 and 33 weeks of pregnancy. At 34.4 weeks she undergoes an elective cesarean section and surgical sterilization. She give birth a male newborn weighing 1 958 g, Apgar 9/9 without surgical and anesthetic backgrounds during procedure. Immediate puerperium evolution is satisfactory and is discharged at 36 days. The Eisenmenger's syndrome entails a high risk of morbidity and mortality for mother and for fetus, and the multidisciplinary management optimizes the results(AU)
Subject(s)
Humans , Female , Pregnancy , Adolescent , Eisenmenger Complex/drug therapy , Eisenmenger Complex/prevention & control , Pregnancy Complications, Cardiovascular/physiopathology , Case ReportsABSTRACT
Presentamos un caso de tumor funcional de las isletas de células beta (TFCB) produciendo una hipoglicemia severa incapacitante 20 años antes de ser diagnosticado por medio de la angiografía pancreática. La excisión local del tumor fue curativa (AU)
Subject(s)
Middle Aged , Humans , Male , Insulinoma/diagnosis , Pancreatic Neoplasms/diagnosis , Arteries/diagnostic imaging , Pancreas/blood supplyABSTRACT
Presentamos un caso de tumor funcional de las isletas de células beta (TFCB) produciendo una hipoglicemia severa incapacitante 20 años antes de ser diagnosticado por medio de la angiografía pancreática. La excisión local del tumor fue curativa
Subject(s)
Middle Aged , Humans , Male , Insulinoma/diagnosis , Pancreatic Neoplasms/diagnosis , Arteries , Pancreas/blood supplyABSTRACT
Forty-six modified human umbilical vein graft arteriovenous fistulae were used for maintenance hemodialysis in 45 patients with chronic renal failure. Complications were encountered in 15 of the 46 grafts after one to 24 months. In only one case did a graft become infected. The results show a significantly lower complication rate than for any other graft material.
ABSTRACT
A new aortic punch has been designed for use during cannulation of the ascending aorta. The instrument is extremely safe, and it effectively shortens the steps required for aortic cannulation.
ABSTRACT
A frustrating experience for thoracic surgeons is the breakage of a sternal wire at the time it is being tightened to close a median sternotomy. A simple technique to repair broken sternal wires and allow continuation of the procedure without opening the sternum is described.
ABSTRACT
Myocardial infarction has been the major cause of mortality following operation for cerebrovascular insufficiency. In our institution, a clinical diagnosis of coronary artery disease was made in 37 of 125 (29.6%) consecutive male patients having carotid endarterectomy. Six of these 37 patients developed postoperative myocardial infarction. In contrast, none of the 88 patients without coronary artery disease developed myocardial infarction. A more recently treated group of 20 patients who had undergone carotid artery surgery and had previously undergone coronary artery bypass for angina did not develop postoperative myocardial infarction. These data suggest that in patients with both coronary artery and carotid artery disease, prior or concomitant coronary artery bypass should be considered. Myocardial infarction has been the leading cause of early and late death following operation for cerebrovascular insufficiency.(1) DeBakey(2) found operative mortality in patients having surgery for cerebrovascular insufficiency directly related to the incidence of coronary artery disease. An increased operative mortality due to reinfarction has been found in patients recovering from recent myocardial infarction.(3) Cooley(4) found that in patients having aortocoronary bypass there was no increased operative mortality 30 days after myocardial infarction and this may apply to patients having carotid endarterectomy. Subendocardial postoperative infarction associated with minor T wave changes and slight enzyme elevation had a better prognosis than did transmural infarction causing significant Q waves, sequential ST and T wave changes and marked enzyme elevations.(5) The purpose of this study was to document our experience with myocardial infarction in patients undergoing carotid artery operation for clinical coronary artery disease. Consideration of the role of saphenous vein bypass in those patients with coronary artery disease was the background for this review even though the evidence that myocardial infarction can be prevented with saphenous vein bypass operation is only preliminary at the present time.(6)
