RESUMO
Traumatic aortic regurgitation (AR) is a rare complication of blunt chest trauma. We described the case of a 35-year-old male who presented to our hospital with shortness of breath 7 years after sustaining blunt chest trauma associated with a motorcycle accident. Transthoracic and transesophageal echocardiogram detected severe AR with two separate jets. The patient was diagnosed with congestive heart failure due to severe AR, and surgical aortic valve replacement was performed. A large perforation of the right coronary cusp likely sustained during the initial blunt chest trauma injury was confirmed surgically. As AR caused by blunt chest trauma can gradually worsen, it is necessary to confirm if there is a history of trauma in patients with severe AR of unknown origin.
Assuntos
Estenose da Valva Aórtica/cirurgia , Valvuloplastia com Balão/instrumentação , Cateteres Cardíacos , Remoção de Dispositivo/métodos , Substituição da Valva Aórtica Transcateter/instrumentação , Idoso de 80 Anos ou mais , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/fisiopatologia , Valvuloplastia com Balão/efeitos adversos , Falha de Equipamento , Feminino , Humanos , Índice de Gravidade de Doença , Substituição da Valva Aórtica Transcateter/efeitos adversos , Resultado do TratamentoRESUMO
Cardiovascular complications following cocaine use are well described. We present a case of myocardial infarction and ventricular rupture in a young individual with limited underlying coronary disease and habitual cocaine use. The role of each is discussed.
Assuntos
Transtornos Relacionados ao Uso de Cocaína/complicações , Aneurisma Cardíaco/cirurgia , Ruptura Cardíaca Pós-Infarto/cirurgia , Infarto do Miocárdio/induzido quimicamente , Revascularização Miocárdica/métodos , Adulto , Cateterismo Cardíaco/métodos , Ponte Cardiopulmonar/métodos , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Transtornos Relacionados ao Uso de Cocaína/fisiopatologia , Angiografia Coronária/métodos , Dispneia/diagnóstico , Dispneia/etiologia , Serviço Hospitalar de Emergência , Seguimentos , Aneurisma Cardíaco/diagnóstico por imagem , Ruptura Cardíaca Pós-Infarto/diagnóstico por imagem , Humanos , Masculino , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/cirurgia , Recuperação de Função Fisiológica , Medição de Risco , Esternotomia/métodos , Resultado do Tratamento , Técnicas de Fechamento de FerimentosRESUMO
Benign metastasizing leiomyomatosis is a very rare and significantly interesting pathology of the lungs. It is a challenge to clinicians when presenting a miliary pattern in preoperative radiologic imaging because it could be any other interstitial disease or infectious in etiology such as miliary tuberculosis. We report a case of innumerable tiny nodular densities spread evenly throughout both lungs in a patient with history of hysterectomy for a fibroid uterus.
Assuntos
Leiomiomatose/diagnóstico , Neoplasias Pulmonares/secundário , Pneumonectomia/métodos , Cirurgia Torácica Vídeoassistida/métodos , Neoplasias Uterinas/patologia , Adulto , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Histerectomia , Leiomiomatose/cirurgia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirurgia , Neoplasias Uterinas/cirurgiaRESUMO
Respiratory failure after Ivor-Lewis esophagectomy results in poor outcomes. Limited treatment strategies are available to manage this severe complication. One possibility is extracorporeal support. We report the successful use of extracorporeal support as a successful strategy for refractory respiratory failure.
Assuntos
Adenocarcinoma/cirurgia , Neoplasias Esofágicas/cirurgia , Esofagectomia/métodos , Oxigenação por Membrana Extracorpórea , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A 31-year-old woman was admitted to the emergency department with a stab wound to the heart. She was initially stable but rapidly developed hypotension. While the operating room and staff were in preparation, she underwent pericardiocentesis. She was then rushed to the operating room by the general surgical trauma team, who performed a bilateral anterior thoracotomy to control the bleeding. In the recovery room, the patient was still hypotensive, so cardiothoracic surgery was consulted. An echocardiogram revealed severe hypokinesis of both ventricles. The cardiothoracic surgeons returned her to the operating room and discovered that the anterior pericardium had been completely removed by the trauma team. This had caused the posterior pericardium to form a "bowstring" that almost totally obstructed pulmonary venous return and restricted right ventricular outflow of blood, inducing right-sided heart failure. This pericardial string also strangulated the left atrium posteriorly, forming 2 compartments. We repositioned the patient's heart and implanted ventricular assist devices bilaterally to provide temporary circulatory support. The patient made a good recovery. We suggest that bilateral assist device placement can be beneficial in the recovery of a stunned but otherwise normal heart.
