RESUMO
A 69-year-old man was transferred to our hospital because of sudden onset precordial pain and dyspnea. Transesophageal echocardiography revealed massive aortic regurgitation, diastolic separation of the closure line of the aortic cusps and prolapsing motion of the cusps during diastolic toward the left ventricular outflow tract. Aortic valve replacement was successfully performed. During the operation, we found a commissure between the left coronary cusp and the non-coronary cusp that had avulsed from the aortic wall and prolapsed into the left ventricular outflow tract. Valvular cusps were excised and replaced with a mechanical prosthesis. The postoperative course was uneventful and the patient was discharged from the hospital, 25 days after his operation. The histopathological examination showed fibrosis, hyalinosis of the avulsed commissure, and mucoid degeneration of the valve. There was no evidence of pathologic changes, such as aortitis, infective endocarditis, or specific connective tissue disorders.
Assuntos
Insuficiência da Valva Aórtica/cirurgia , Valva Aórtica/patologia , Valva Aórtica/cirurgia , Doença Aguda , Idoso , Valva Aórtica/diagnóstico por imagem , Insuficiência da Valva Aórtica/diagnóstico por imagem , Insuficiência da Valva Aórtica/etiologia , Procedimentos Cirúrgicos Cardíacos/métodos , Próteses Valvulares Cardíacas , Implante de Prótese de Valva Cardíaca , Humanos , Tempo de Internação , Masculino , Resultado do Tratamento , UltrassonografiaRESUMO
Pseudoaneurysm is a major complication of percutaneous balloon angioplasty to treat recoarctation and restenosis after an interrupted aortic arch repair. Endovascular stent grafting to manage this complication has rarely been performed in children. We used a combination of open stent grafting and a prosthetic ascending aorta-to-descending aorta bypass to treat a pseudoaneurysm and ascending aorta stenosis in a 7-year-old child.
Assuntos
Aorta Abdominal/cirurgia , Aorta Torácica/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Prótese Vascular , Reoperação/métodos , Stents , Anastomose Cirúrgica/métodos , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/etiologia , Procedimentos Cirúrgicos Cardíacos , Criança , Constrição Patológica , Diagnóstico Diferencial , Seguimentos , Cardiopatias Congênitas/cirurgia , Humanos , Angiografia por Ressonância Magnética , Masculino , Recidiva , Fatores de Tempo , Tomografia Computadorizada por Raios X , Falha de TratamentoRESUMO
For the improvement in the clinical results of open stent-grafting, the development of a device system and prevention of spinal cord injury are important. For that reasons, we devised 2 methods for the open stent-grafting with the Matsui-Kitamura (MK) stent. First, the applicator using transesophagial echo transducer cover made insertion of the stent-graft system easy and safe. Next, to prevent ischemic spinal injury and protect major abdominal organ, blood return to lower body was established from femoral artery with occluding the stent graft by balloon. However, these procedures might need to examine whether it really contributes to the improvement in the clinical results.
Assuntos
Aneurisma da Aorta Torácica/cirurgia , Prótese Vascular , Stents , Humanos , Isquemia do Cordão Espinal/prevenção & controleRESUMO
Right-sided aortic arch with aberrant left subclavian artery is an uncommon anomaly. We describe a case of Kommerell's diverticulum involving the distal portion of a right-sided aortic arch and the origin of an aberrant left subclavian artery in a 74-year-old man with hoarseness. The patient underwent successful endovascular repair of the aneurysm with use of a Gore TAG thoracic endoprosthesis and coil embolization of the left subclavian artery. Postoperative computed tomography showed complete exclusion of the lesion, without endoleaks. Endovascular repair is feasible and can be effective in such cases.
