RESUMO
The advent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in China at the end of 2019 has developed into a global outbreak, and COVID- 19 is an ongoing major public health issue. During the pandemic, transplant programs had to devise strategies to deal with the possibility of COVID-19-positive donors and recipients. We describe the case of a heart transplant recipient who tested positive with the SARS- CoV2 swab upon admission to our Unit of Cardiac Surgery when a suitable donor became available. Given his clinical status of end-stage heart failure and the absence of imaging and clinical signs suggestive of COVID-19, and his having been vaccinated with three doses, we decided to proceed with the transplant.
Assuntos
COVID-19 , Transplante de Coração , Humanos , SARS-CoV-2 , Doadores de Tecidos , China , TransplantadosRESUMO
Endocarditis of a prosthetic heart valve is a life-threatening condition that is associated with high morbidity and mortality. Perivalvular extension in infective endocarditis includes complications such as periannular or intramyocardial abscesses, pseudoaneurysms and fistulae. The incidence of perivalvular extension ranges from 10 to 30% in native valve endocarditis and 30 to 55% in prosthetic aortic-valve endocarditis. Herein, we describe a case of a 66-year-old man who presented endocarditis of a prosthetic aortic valve complicated by infective pseudoaneurysm with localization next to the right coronary sinus of Valsalva. Moreover, we underscore the importance of the diagnostic imaging tools options and surgical timing.
Assuntos
Falso Aneurisma/cirurgia , Insuficiência da Valva Aórtica/cirurgia , Seio Coronário/cirurgia , Endocardite Bacteriana/cirurgia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Infecções Relacionadas à Prótese/cirurgia , Idoso , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Insuficiência da Valva Aórtica/diagnóstico por imagem , Seio Coronário/diagnóstico por imagem , Seio Coronário/fisiopatologia , Remoção de Dispositivo , Ecocardiografia/métodos , Ecocardiografia Transesofagiana/métodos , Endocardite Bacteriana/etiologia , Endocardite Bacteriana/fisiopatologia , Seguimentos , Próteses Valvulares Cardíacas , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Masculino , Infecções Relacionadas à Prótese/diagnóstico por imagem , Reoperação/métodos , Resultado do TratamentoRESUMO
We present the case of a 54-year-old woman in which a diffuse congenital supravalvular aortic stenosis (SVAS) was associated with a severe aortic valve incompetence and heavy calcification of the aortic annulus. Repair consisted in resection of the ascending aorta, patch augmentation of the hypoplastic aortic root and annulus, placement of a 20 mm Dacron tubular graft (Vascutek, Renfrewshire, UK) and aortic valve replacement with a mechanical prosthesis (Sorin, Turin, Italy). Follow-up echocardiography demonstrated normal prosthetic valve function and a postoperative three-dimensional computed tomographic scan showed a normal shape of the reconstructed ascending aorta.
