RESUMO
This is a report of a primary cardiac angiosarcoma in a woman who, several years earlier, had undergone repair of an aortic dissection with a Dacron graft prosthesis. Dacron prostheses have rarely been associated with neoplasia, and this, to our knowledge, is the first reported case of primary cardiac angiosarcoma in association with Dacron. Our patient presented with extensive metastases. If tumors are localized, they can be treated successfully with a combination of surgical resection, chemotherapy, and radiotherapy. Cardiac transplantation can also be beneficial, but the overall prognosis remains poor.
Assuntos
Aneurisma Aórtico/cirurgia , Dissecção Aórtica/cirurgia , Implante de Prótese Vascular/efeitos adversos , Prótese Vascular/efeitos adversos , Neoplasias Cardíacas/etiologia , Hemangiossarcoma/etiologia , Polietilenotereftalatos/efeitos adversos , Implante de Prótese Vascular/instrumentação , Ecocardiografia , Evolução Fatal , Feminino , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/terapia , Hemangiossarcoma/secundário , Hemangiossarcoma/terapia , Humanos , Pessoa de Meia-Idade , Desenho de Prótese , Tomografia Computadorizada por Raios XRESUMO
Echocardiographic findings in the fastest growing segment of our population, the very elderly, are limited in the literature. We performed a retrospective analysis of 431 consecutive nonagenarians who underwent transthoracic echocardiography (2-dimensional, M-mode, pulse and continuous wave Doppler with color flow mapping) at our center. Mean age was 92.4 years, with women being the majority (73% vs 27%). Men were more likely than women to have coronary artery disease (45% vs 36%, p = 0.03), impaired left ventricular (LV) ejection fraction (51% vs 40%, p <0.04), lower mean LV ejection fraction (50% vs 54%, p = 0.01), and regional wall motion abnormalities (31% vs 19%, p = 0.009). Women were much more likely than men to have hypertension (76% vs 52%, p = <0.0001), LV hypertrophy (82% vs 72%, p <0.001), severe left atrial enlargement (31% vs 16%, p = 0.004), moderate to severe mitral annular calcification (22% vs 10, p = 0.006), and tricuspid regurgitation (70% vs 51, p = 0.002). In this, largest to date, study of echocardiographic findings in nonagenarians, abnormal findings were much more common than previously reported. Men were more likely to have coronary artery disease and related findings, whereas women were more likely to have hypertension and related findings.
