RESUMO
Peritoneovenous shunting (PVS) for intractable ascites has an extensive clinical experience, with several well-described complications. We recently noted an unusual complication of PVS with a Denver shunt. A 37-year-old woman who had placement of a shunt for chylous ascites 18 months prior to presentation demonstrated on a large, mobile mass filling the right atrium which, during atrial systole, partially prolapsed into the right ventricle. At cardiac surgery, a 4 X 10 cm mass with attachment to the tip of the shunt was found. Intracardiac ascitic pseudocyst is a potentially lethal complication of PVS with the Denver shunt which should be considered with a high index of suspicion and evaluated with echocardiography.
Assuntos
Ascite Quilosa/terapia , Cardiopatias/etiologia , Derivação Peritoneovenosa/efeitos adversos , Adulto , Feminino , Cardiopatias/fisiopatologia , Cardiopatias/cirurgia , HumanosRESUMO
Syncope, palpitations, ventricular tachycardia, and electrocardiographic changes of acute myocardial ischemia in a 19-year-old woman resulted from significant narrowing of the left main coronary artery and its ostium, producing high-grade obstruction to flow as documented by selective coronary arteriography. Because of these findings and markedly positive results of cardiovascular stress testing, surgical treatment by aortocoronary artery saphenous vein bypass grafting to the left anterior descending artery was carried out. Four years postoperatively, the patient was asymptomatic, and there are no abnormal findings on cardiovascular stress testing.
