[Type B aortic dissection--endovascular stent-graft repair. Case report]. / Disectie aortica tip B--rezolvare endovasculara prin stent-graft. Prezentare de caz.

The treatment of aortic dissections type B Stanford using endovascular stents represents one of the newest advances in the treatment of this diseases, less invasive alternative to classic surgical repair. Aortic stent-grafts initially were used in treatment of abdominal aortic aneurysms, and then to treat aneurysms, dissections and traumatic ruptures of the descending aorta, with good early and mid-term outcomes. Thoracic aortic aneurysms are frequently diagnosed in mid-age or elderly patients who have arterial hypertension, coronary artery disease, chronic obstructive pulmonary disease. Scientific data reveal a two-year mortality rate of > 70% in untreated patients, most deaths occurring due severe haemorrhages secondary aneurysm rupture. Development of endovascular techniques is naturally, due to the inherent complications of surgery in the distal thoracic aorta (paraplegia, renal failure, stroke). Endovascular deployment of stent-grafts in the treatment of Stanford B aortic dissections represents a possible and quite safe procedure. There is a continuous debate in medical literature about the best therapeutic decision in the treatment of extensive aortic dissections. We present a case of an extensive dissection of thoraco-abdominal aorta in a 55 years old hypertensive patient treated with an aortic stent-graft. Angiograms performed at the end of the procedure revealed complete occlusion of thoracic dissection, abdominal dissection remains untouched. One and three months post procedural evaluation showed a good follow up, with partial thrombosis of abdominal dissection without renal failure or ischaemic events.

[Tetralogy of Fallot--new appearance of an old technique]. / Tetralogia Fallot. Noua infatisare a unei tehnici vechi.

UNLABELLED: Tetralogy of Fallot represents one of the most frequent congenital heart disease in medical practice and a "corner stone" of any paediatric surgical team due to great anatomic and functional variability and clinical aspects. This paper presents a retrospective study of surgical experience in patients with tetralogy of Fallot admitted in Paediatric Cardiovascular Centre of Târgu Mures, Romania, between 2005, October to 2009, January. METHOD: There where retrospectively studied medical records of patients who undergo a surgical procedure: age, morphologic diagnosis, symptoms and type of surgical procedure, intraoperative data, postoperative follow-up and complications. RESULTS: In this period 110 cases of tetralogy of Fallot were operated, 81 total surgical repair (54 primary and 27 secondary procedures); also there were performed 29 "palliative" procedures: systemic/pulmonary shunts (eg. Blalock-Taussig). No intraoperative deaths were recorded; the percentage of in-hospital mortality was 1.8%. CONCLUSIONS: It's ideal to perform total primary repair of tetralogy of Fallot, especially in the first year of life; extreme cases (severe hypoplasic pulmonary arteries, emergency cases) benefit from "palliative" procedures. Surgical repair of Fallot tetralogy can be performed, with good results in specialised paediatric cardiac surgery centres. This paper represents the first Romanian clinical study on a large number of patients with tetralogy of Fallot surgically treated.