Valva aórtica quadricúspide: diagnótico ecocardiográfico / Quadricuspid aortic valve: echocardiographic diagnosis

Este é m artigo de relato de caso de valva aórtica quatricúspide (ou quadrivalvular), tipo AHurwitz e Roberts, com leve insuficiência e dilatação da aorta ascendente, em adulta assintomática diagnósticada em exame ecocadiográfico de rotina, confirmado à ecocardiografia transesofágica. Ao relato de caso e imagens correspondentes segue uma breve revisão da literatura. A valva aórtica quadrcúspide (VAQ) é rara, tem diagnóstico ecocardiográfico, em uma maioria assintomática. A importância do diagnóstico desta patologia justifica-se pelo risco de valvopatia aórtica de caráter progressivo, pelo potencial aumento de endocardite e pela possibilidade de origem anômala do óstio da coronária ou outras malformações associadas.

This article is a case report of a quadricuspid (or quadrivalve) aortic valve, type A of Hurwitz and Roberts, with mild insufficiency and dilatation of the ascending aorta, in an asymptomatic adult diagnosed during a routine echocardiography exam, confirmed by a transesophageal echocardiography. The article, with images, is followed by a brief literature revision. A quadricuspid aortic valve (QAV) is rare, and the diagnosis occur by an echocardiography exam, usually in an asymptomatic group. The importance of diagnosing this pathology is justified by the risk of progressive aortic valve disease, by the potential increase of endocarditis and possible association with anomalous origin of the coronary ostium or other associated malformations.

Vacuum-assisted venous drainage in cardiopulmonary bypass and need of blood transfusion: experience of service.

OBJECTIVE: To report the experience with the vacuum-assisted venous drainage (VAVD) technique in cardiopulmonary bypass (CPBP) and blood transfusion need. METHODS: A retrospective study was made about data from 111 patients who were operated, using VAVD between October 2006 and February 2008, at the Esperança Hospital, Recife, Pernambuco. The necessity of blood transfusion was verified on the single group of patients who underwent VAVD, comparing with sex, age and weigh, before the beginning of the CPBP and during the surgery, using Chi-square test and t-student test. RESULTS: Before the beginning of the CPBP only 10% of patients had need for blood transfusion and 12% during the surgery. It was observed that 17% of women received blood transfusion versus 4.7% of men before the beginning of CPBP (P=0.51), and 38% of women versus 9% of men during the surgery (P<0.001). The weight of patients who received blood transfusion were lower both before the beginning of the CPBP as during the surgery (P=0.049 e P=0.001, respectively). CONCLUSION: The VAVD technique has been used safely and satisfactorily, optimizing venous drainage during CPBP, in the hospital that conducted the study. However, prospective and comparative investigations between conventional drainage and VAVD are needed to better clarify this relation with blood transfusion.