RESUMO
Tetralogy of Fallot is the most common form of cyanotic congenital cardiac disease. Patients with previously repaired tetralogy of Fallot are the most common patients seen in the Program for Adults with Congenital Heart Disease at The Johns Hopkins All Children's Heart Institute. Guidelines for the management of these patients are available from multiple sources including The American College of Cardiology (ACC) and The American Heart Association (AHA), The Canadian Cardiovascular Society, and The European Society of Cardiology (ESC). These guidelines describe multiple components related to the care for these patients including strategies for medical follow-up, the management of arrhythmias and electrophysiological diseases, and the treatment of chronic pulmonary insufficiency and stenosis. Several new strategies are available for replacement of the pulmonary valve including transcatheter replacement of the pulmonary valve and replacement of the pulmonary valve with a self-manufactured bicuspid polytetrafluoroethylene pulmonary valve.
Assuntos
Tetralogia de Fallot/terapia , Adulto , Humanos , Guias de Prática Clínica como AssuntoRESUMO
Recent studies report that American women are increasingly delaying their first births. While the proportion of births in older women has been increasing, there is also increased prevalence of cardiovascular risk factors and complications of pregnancy with increasing maternal age. We present 2 cases of acute myocardial infarction occurring during pregnancy. The mothers were both over 35 years old, and had significant risk factors for coronary disease. Both were found to have atherosclerotic coronary lesions, and were managed with coronary intervention with successful reperfusion. One woman successfully delivered a healthy infant at term. The other had a spontaneous abortion shortly after discharge from the hospital. Given current demographic trends, it is likely that such cases will be more commonly seen.
Assuntos
Angioplastia Coronária com Balão , Infarto do Miocárdio/terapia , Complicações Cardiovasculares na Gravidez/terapia , Adulto , Angioplastia Coronária com Balão/tendências , Angiografia Coronária , Estenose Coronária/diagnóstico , Estenose Coronária/terapia , Feminino , Humanos , Infarto do Miocárdio/diagnóstico , Reperfusão Miocárdica , Gravidez , Complicações Cardiovasculares na Gravidez/diagnósticoRESUMO
A 55-year-old male patient experienced 2 acute neurologic events 3 weeks after orthotopic cardiac transplantation. Transesophageal echocardiography demonstrated a patent foramen ovale in the native portion of the interatrial septum with bidirectional shunting by Doppler and microbubble contrast. The defect was closed successfully with a CardioSeal transcatheter septal closure device. This case demonstrates the advantages of the percutaneous approach for closure of residual defects in the post-operative patient.
Assuntos
Cateterismo Cardíaco/métodos , Comunicação Interatrial/cirurgia , Transplante de Coração , Transplantes , Ecocardiografia Transesofagiana , Comunicação Interatrial/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodosRESUMO
Percutaneous transvenous mitral commissurotomy was performed successfully via the transjugular approach in a patient with severe rheumatic mitral stenosis and obstruction of the inferior vena cava due to prior liver transplantation. This case demonstrates the advantage of the jugular approach in patients with difficult anatomy.