RESUMO
O tratamento usual para pacientes sintomáticos com cardiomiopatia hipertrófica obstrutiva (CMHO) e doença arterial coronária (DAC), que requerem revascularização do miocárdio, tem sido a cirurgia combinada (revascularização e miectomia). Entretanto, esta abordagem aumenta significativamente o risco cirúrgico. O objetivo deste relato é mostrar a possibilidade e a eficácia da embolização da artéria septal com micromolas, associada a implante de stent na artéria descendente anterior, como modalidade alternative de tratamento em casos selecionados de pacientes com CMHO e DAC.
Symptomatic patients with HOCM and coronary artery disease (CAD) that require revascularization, surgery simultaneous myectomy and bypass has usually been performed. However, the procedure significantly increases surgical risk. The aimof our report is to show the feasibility and efficacy of septal artery embolization with microcoils and simultaneous coronary dilation and stenting in the anterior descending as an alternative therapy to selected patients with HOCM and CAD.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Stents , Ablação por Cateter/métodos , Angioplastia Coronária com Balão , Cardiomiopatia Hipertrófica/terapia , Doença das Coronárias/terapia , Embolização Terapêutica/métodos , Terapia CombinadaRESUMO
We report the case of a 21-year-old male with high-output heart failure due to a femoral arteriovenous fistula caused by a firearm wound. A new balloon expandable stent covered with polytetrafluorethylene was implanted in the artery to occlude the arteriovenous fistula. The fistula was immediately occluded and the artery remained patent. On the following day, the patient felt much better, with no symptoms of heart failure. Additional follow-up is required to assure the usefulness of this less invasive procedure in the treatment of arteriovenous fistulas