Angiosarcoma primario de aurícula derecha: aportación de un caso y revisón de la literatura / Primary angiosarcoma of the right auricule: A case study and review of the literature

El angiosarcoma cardíaco es el tumor maligno más frecuente en el corazón, dentro de la extrema rareza que suponen las neoplasias en este órgano. Describimos un caso clínica y anatomopatológicamente representativo, originado en la aurícula derecha y tratado con trasplante cardíaco (AU)

[Pseudoaneurysm as a complication of the reconstruction of the ascending aorta using valved graft: periannular dehiscence simulating severe aortic insufficiency]. / Seudoaneurisma como complicación de la reconstrucción de aorta ascendente mediante injerto valvulado: dehiscencia perianular simulando una insuficiencia aórtica severa.

The development of a pseudoaneurysms of the ascending aorta is a potential complication after composite grafts surgery for combined disorders that simultaneously affect the aortic valve and ascending aorta. Pseudoaneurysm has been reported to range from 7% to 25% of cases, and it is due to dehiscence of the suture line at anastomosis. Clinical spectrum, which depends on the location of this dehiscence varies from the totally asymptomatic patient to one with NYHA class IV heart failure, with the possibility of its clinical status rapidly worsening. We report a case of progressive haemodynamic deterioration as a consequence of a peri-annular dehiscence that led to a significant regurgitant volume from the pseudoaneurysm cavity to the left ventricle mimicking a severe aortic insufficiency. The role of echocardiography is reviewed in the diagnosis and the management of complications, as well as the necessary follow up of patients with composite aortic grafts.

[A right atrial thrombus in transit: its echocardiographic diagnosis 72 hours before a pulmonary embolism]. / Trombo en tránsito en aurícula derecha: diagnóstico ecocardiográfico 72 horas antes de un embolismo pulmonar.

We report a case of a 72-year-old woman with coronary artery disease in whom a thrombus in transit in the right atrium was diagnosed accidentally. After 72 hours of treatment with intravenous anticoagulants she developed a pulmonary thromboembolism resolved with systemic fibrinolysis. This is a rare case in which such a diagnosis preceded an embolic event. This fact raises the controversy about the best therapeutic management of this unusual form of thromboembolic illness.

[Acute myocardial infarction secondary to Wegener's granulomatosis]. / Infarto agudo de miocardio secundario a granulomatosis de Wegener.

Wegener's granulomatosis (WG) is a necrotizing and granulomatous vasculitis that usually affects the upper and lower respiratory tract and the kidneys. Cardiac involvement is rare although pericarditis, coronary arteritis, myocarditis, valvulitis and arrhythmias have been described. Acute myocardial infarction with clinical expression is an exceptional complication of Wegener's granulomatosis. We report a case of a 30-year-old man with Wegener's granulomatosis who suffered an acute myocardial infarction during the initial phase of the disease, following seven days of treatment with glucocorticoids and cyclophosphamide. Transthoracic echocardiography showed abnormal regional wall motion with septal hypokinesia and apical akinesia. Cardiac catheterization revealed an ectasic segment in the proximal left anterior descending coronary artery and total occlusion in the mid-segment. Medical therapy with prednisone and cyclophosphamide was continued. No complications and initial remission were achieved.