ABSTRACT
No disponible
Subject(s)
Adult , Humans , Male , Truncus Arteriosus/injuries , Truncus Arteriosus/surgery , Truncus Arteriosus , Brachiocephalic Trunk/surgery , Brachiocephalic Trunk , Aorta, Thoracic/injuries , Aorta, Thoracic/surgery , Aorta, Thoracic , Thoracic Injuries/surgery , Thoracic Injuries , Hypoventilation/complications , Aortography , Aortography/instrumentation , Aortography/methodsABSTRACT
Relata-se um caso de cardiopatia isquêmica como manifestação inicial da arterite de Takayasu (AT). Paciente internada para cirurgia de revascularização miocárdica(CRVM), devido à angina estável e lesão isolada do tronco de coronária esquerda, apresentava alterações vasculares ao exame físico que sugeriram o diagnóstico de AT. O presente caso leva à reflexão sobre a pesquisa de etiologias alternativas à doença aterosclerótica coronariana, especialmente em indivíduos jovens ou com poucos fatores de risco. O acometimento da artéria coronária na AT, embora infrequente se comparado a outras lesões vasculares encontradas nesta doença, determina elevada morbimortalidade.
Subject(s)
Humans , Female , Takayasu Arteritis/complications , Takayasu Arteritis/diagnosis , Coronary Artery Disease/complications , Coronary Artery Disease/diagnosis , Truncus Arteriosus/injuries , Myocardial Ischemia/complications , Myocardial Ischemia/diagnosis , Risk FactorsABSTRACT
La obesidad es un factor de riesgo para el desarrollo de complicaciones posquirúrgicas e incrementa de forma significativa la tasa de mortalidad intrahospitalaria. Presentamos el caso de una mujer de 65 años con obesidad mórbida, estenosis aórtica severa y enfermedad de tronco que se trató con éxito mediante valvuloplastia aórtica y angioplastia e implantación de stent en tronco coronario izquierdo. Tras una intervención quirúrgica bariátrica y perder el 30% de su peso, la paciente fue aceptada en cirugía cardíaca y se le realizó recambio valvular aórtico y bypass de mamaria a la descendente anterior (DA) sin complicaciones
Obesity increases significantly the rate of postsurgical complications and mortality in patients undergoing major surgery. We present the case of a morbidly obese 65-year-old female with severe aortic stenosis and left main coronary artery disease who underwent successful aortic valvuloplasty and angioplasty, with placement of a stent in the left main coronary artery. After undergoing bariatric surgery and losing 30% of her body weight, the patient was accepted for cardiac surgery to replace the aortic valve and to bypass the left anterior descending coronary artery using the mammary artery. There were no surgical complications
Subject(s)
Female , Aged , Humans , Aortic Valve Stenosis/surgery , Obesity, Morbid/complications , Truncus Arteriosus/injuries , Angioplasty, Balloon, Coronary , Treatment Outcome , Severity of Illness IndexABSTRACT
In recent years there has been some improvement in surgical and interventional techniques that have modified the classical indications making them more risky. Left main coronary stenoses are even more dreadful lesions, and the results of percutaneous management are odd with varying mortality (10-12 per cent on average), and high morbidity. Moreover we have small number of cases in the literature. Comparing these results with surgery, we find the later to be safer with mortality under 4 per cent, low morbidity and a long term experience in the management of this pathology. Results, moreover, tend to favor surgery in the coronary restenosis in spite of the use of stents.
