RESUMO
A variety of techniques has been used to repair prolapse of the commissure of the mitral valve. However, the application of these techniques may be technically challenging. A simple edge-to-edge suture approximation of anterior and posterior mitral leaflets is an effective way of restoring mitral valve competence. We use this technique with "spaghetti" for reinforcement, and annuloplasty for repair of the prolapse. We have recognized it to be a simple, durable, and reproducible technique for repair of prolapse of the mitral valve commissure.
Assuntos
Implante de Prótese de Valva Cardíaca/métodos , Prolapso da Valva Mitral/cirurgia , Técnicas de Sutura , Ponte Cardiopulmonar , Implante de Prótese de Valva Cardíaca/instrumentação , Humanos , Insuficiência da Valva Mitral/cirurgiaRESUMO
A 47-year-old man with total anomalous pulmonary venous return met all the conditions necessary for long survival. In particular, his pulmonary vascular resistance was almost normal because of right ventricular outflow tract obstruction. Surgical treatment was performed with a good result.
Assuntos
Veias Pulmonares/anormalidades , Obstrução do Fluxo Ventricular Externo/diagnóstico , Obstrução do Fluxo Ventricular Externo/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Resistência Vascular/fisiologia , Obstrução do Fluxo Ventricular Externo/fisiopatologiaRESUMO
This study evaluates the effectiveness and potential complications of stent-grafting for the treatment of distal arch aneurysms using profound hypothermia and circulatory arrest with retrograde cerebral perfusion. Between December 1998 and December 2001, 9 consecutive patients with a distal arch aneurysm (6 men and 3 women, mean age 71 years) underwent surgical repair using a stent-graft. Profound hypothermic circulatory arrest and retrograde cerebral perfusion were performed in all patients. Endovascular leakage was screened postoperatively using three-dimensional computerized tomography. The mean follow-up period was 27.4 months. Thirty day mortality was 0%. One patient died 3 months after stent-grafting due to proximal leakage into her aneurysm. The mean postoperative extubation period was 2.1 days. No patients suffered cerebral infarction or paraplegia. Although preliminary outcomes using this technique were good, endovascular leakage is a concern. We suggest that, if major proximal leakage is recognized postoperatively, re-intervention should be performed as soon as possible. Endovascular stent-grafting appears to be a good alternative treatment for distal arch aneurysms, although longer follow-up is necessary to more comprehensively evaluate this procedure.
