RESUMO
Aneurysm of the left main coronary artery is a rare angiographic finding, with few cases described in the international literature. We report the case of a 42-year-old male with a previous history of acute myocardial infarction, whose coronary angiography indicated triple vessel coronary disease and an aneurysm of the left main coronary artery. A review of the etiology, clinical aspects, and surgical management of coronary arterial aneurysm is presented.
Assuntos
Aneurisma Coronário/etiologia , Adulto , Aneurisma Coronário/diagnóstico por imagem , Aneurisma Coronário/cirurgia , Humanos , Masculino , Revascularização Miocárdica , RadiografiaRESUMO
OBJECTIVES: The aim of this study is the assessment of immediate clinical and angiographic results and medium- to long-term clinical follow-up after Bard-XT (Bard, Billerica, Massachusetts) coronary stent deployment. METHODS: The implantation of 196 stents of various lengths (11, 15 and 19 mm) was attempted in 181 patients (70.1% male) from January 1997 to January 1998. Lesions were type A in 5.6% of the cases, type B1 in 44.4%, type B2 in 45.9% and type C in 4.1%. Implantation of the stent was elective in 53.6% and for bail-out situations in 46.4% of the lesions. RESULTS: The immediate angiographic success rate was 98.5% and the immediate clinical success rate (angiographic success with no major complications during in-hospital stay) was 96.9%. The minimal lumen diameter increased from 0.82 +/- 0.6 mm to 3.0 +/- 0.71 mm after intervention, relative to an immediate post-procedural residual stenosis of 3.05 +/- 9.12%. During the mean in-hospital stay of 2.6 +/- 1.9 days, 3.8% of the patients had a minor clinical event, and 1.5% had a major clinical event. During late follow-up, 3.9% of the patients died. Clinical follow-up of 89.5% of the eligible patients after 241.1 +/- 73.9 days showed that 80.6% of them had negative stress tests, thus reaching a clinical restenosis rate of 19.4%. In a multivariate analysis, only systemic arterial hypertension (p = 0.0012) and a previous history of myocardial infarction (p = 0.02) had a positive correlation with clinical restenosis. CONCLUSIONS: The preliminary experience with the Bard-XT coronary stent was associated with good immediate and medium- to long-term clinical outcome. The results were comparable to those obtained with slotted-tube stents.
Assuntos
Implante de Prótese Vascular/instrumentação , Estenose Coronária/terapia , Stents , Idoso , Angiografia Coronária , Estenose Coronária/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Paciente de 52 anos submetida a transplante cardíaco ortotópico em maio de 1991, tendo apresentado como complicaçäo tardia o surgimento de carcinoma epidermóide de amígdala. O diagnóstico inicial foi de neoplasia metastática de sítio primário desconhecido porque o tumor primário somente manifestou-se após 6 meses do surgimento da metástase à distância. A incidência de neoplasia no primeiro ano pós-transplante cardíaco é pouco freqüente, assim como o carcinoma epidermóide de amígdala na populaçäo normal. Näo encontramos relato de caso na literatura entre pacientes submetidos a transplante cardíaco e apresentando carcinoma epidermóide de amígdala.
