RESUMO
BACKGROUND AND AIM: Oral anticoagulation (AC) and percutaneous left atrial appendage (LAA) occlusion are the primary treatment modalities for stroke prevention in atrial fibrillation (AF), but there remains a subset of patients in whom these approaches present excess risk and isolated surgical LAA excision should be considered. We describe a 63-year-old female with AF and recurrent thromboembolic events who presented with an acute intraparenchymal hemorrhage and was found to have an intracardiac thrombus. METHODS: Given contraindications to AC and LAA occlusion, an isolated LAA surgical excision was pursued. RESULTS: She underwent successful surgical LAA excision and has since remained event-free. CONCLUSION: It is important to recall the utility of therapies that have been previously used with success for intracardiac thrombi and still remain as viable options.
Assuntos
Apêndice Atrial/cirurgia , Fibrilação Atrial/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Administração Oral , Anticoagulantes/efeitos adversos , Fibrilação Atrial/complicações , Hemorragia Cerebral/etiologia , Contraindicações , Feminino , Cardiopatias/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Risco , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle , Trombose/etiologia , Resultado do TratamentoRESUMO
In an earlier report, we showed that a 2-week, residential summer camp (Kamp K'aana) led to improved body weight, body mass index, body mass index z score, and self-esteem among obese children. To assess whether improvements in body weight and self-esteem translate into improvement in body fat and weight-related quality of life, we measured the changes in body fat by bioimpedance and quality of life by Impact of Weight on Quality of Life instrument on 42 multiethnic obese children who took part in our Kamp K'aana program. Significant reduction in body fat was detected with significant improvements in the weight-related quality of life scores.
