scholarly journals Aneurisma del seno de Valsalva con doble rotura a la arteria pulmonar y al ventrículo derecho. Reporte de un caso y revisión de la literatura.

2013 ◽  
Vol 6 (2) ◽  
Author(s):  
Jesús Custodio ◽  
Víctor Arauco ◽  
Milvio Ramirez ◽  
Carlos Cerron
Keyword(s):  
Pulmonary Artery ◽  
Cardiac Catheterization ◽  
Clinical Examination ◽  
Cardiac Failure ◽  
Unusual Presentation ◽  
Congestive Cardiac Failure ◽  
Sinus Of Valsalva ◽  
Right Ventricule ◽  
The Right

We report a case of a 21 year old female who presented with congestive cardiac failure. In initial investigations an aneurysm of sinus of Valsalva was found ruptured to the pulmonary artery. It was surgically repaired uneventfully. The patient was discharged home after 10 days. During the follow-up appointments she was found to have reappearing symptoms of congestive cardiac failure. This lead to her readmission and a repeated cardiac catheterization found her to have an aneurysm of sinus of Valsalva reuptured to the right ventricule, which in a second operation was succesfully repaired. We review the bibliography over the last 20 year finding the unusual presentation of the rupture to the pulmonary artery. We point out the importance of a sharp clinical examination and the preference of cardiac catheterization to make the diagnosis.

Prenatal diagnosis of isolated coronary artery fistulas: progression and outcome in five cases

2015 ◽  
Vol 26 (5) ◽  
pp. 915-920 ◽  
Author(s):  
Gurleen K. Sharland ◽  
Laura Konta ◽  
Shakeel A. Qureshi
Keyword(s):  
Coronary Artery ◽  
Cardiac Failure ◽  
Transcatheter Closure ◽  
Coronary Artery Fistula ◽  
Congestive Cardiac Failure ◽  
Fetal Life ◽  
Circumflex Coronary Artery ◽  
Coronary Artery Fistulas ◽  
The Right

AbstractObjectivesThe aim of this study was to describe the clinical characteristics, progression, treatment, and outcomes in isolated coronary artery fistula cases diagnosed prenatally.MethodsWe carried out a retrospective review of babies diagnosed prenatally with coronary artery fistulas between January, 2000 and December, 2013; five fetuses were included. Echocardiographic features and measurements were noted during pregnancy and after birth. Treatment and outcome were noted.ResultsGestational age at initial diagnosis was between 19 and 22 weeks; four coronary artery fistulas originated from the right and one from the left circumflex coronary artery. Drainage was into the right atrium in four cases and into the left ventricle in one case. There was cardiomegaly in two cases at the initial scan. The size of the fistulas increased during pregnancy in all except one. All prenatal diagnoses were confirmed postnatally. Among all, two patients developed congestive cardiac failure soon after birth and required transcatheter closure of the coronary artery fistula, 5 and 17 days after birth, respectively; three patients remained asymptomatic, and all of them showed progressive dilation of the feeding artery and had closure of the fistula at 20 months, 4 years, and 7 years of age, respectively. During the follow-up period, which ranged 2–14 years, all the patients were alive and well.ConclusionsCoronary artery fistulas can be diagnosed accurately during fetal life. Some babies may develop congestive cardiac failure soon after birth requiring early treatment. Those treated conservatively should be kept under review as intervention may be required later.

Does thrombolysis for pulmonary embolism reduce the risk of chronic complications?

2021 ◽  
Vol 20 (1) ◽  
pp. 15-17
Author(s):  
Caroline Apsey ◽  
◽  
Muhammad Jawad ◽  
Martin Daschel ◽  
Daniel Woosey ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Chronic Complications ◽  
The Right

We assessed the efficacy of thrombolysis in avoiding long-term complications. Notes of patients thrombolysed for PE in the 2-year period were reviewed. The initial CTPA and echocardiogram results before thrombolysis were compared to the results of follow up imaging repeated after 6 months. Twenty-two patients were thrombolysed for PE. 14 patients had sub-massive PE and 8 patients had massive PE. The right ventricle (RV) was dilated on pre-thrombolysis echocardiogram in 16 patients. On follow up echocardiography all patients with massive PE (6 studies) had a normal RV size, with pulmonary artery pressures (PAP) of 29mmHg. Follow up echocardiography of patients with submassive PE (13 studies) showed 11 patients with a normal RV, with PAP of 28 mmHg.

scholarly journals Ruptured aneurysm of right sinus of valsalva - a case report

2016 ◽  
Vol 44 (3) ◽  
pp. 175-177
Author(s):  
Md Nazmul Hasan ◽  
Md Nazmul Hasan ◽  
Md Harisul Hoque ◽  
SM Mustafa Zaman ◽  
Md Rasul Amin ◽  
...  
Keyword(s):  
Case Report ◽  
Cardiac Failure ◽  
Annulus Fibrosus ◽  
Common Complication ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm ◽  
Aortic Media ◽  
Surgical Options ◽  
Potential Risks ◽  
The Right

The sinus of valsalva aneurysm (SVA) is a small dilatation caused by a separation between the aortic media and annulus fibrosus. It may be either acquired or congenital. The right coronary sinus is most frequently affected, with the most common complication being rupture of the sinus. Cardiac failure and sudden auscultation changes suggest the possibility of SVA rupture. Echocardiography is sufficient to diagnose SVA, its complications, repercussions and to determine surgical options. SVA, even if asymptomatic, has potential risks of expansion, rupture, cardiac failure, endocarditis, embolism and sudden death. This justifies surgical correction which has a low mortality rate in both the short and long-term.Bangladesh Med J. 2015 Sep; 44 (3): 175-177

Prognostic Factors for Late Ventricular Arrhythmias after Repair of Tetralogy of Fallot

1997 ◽  
Vol 5 (1) ◽  
pp. 20-24
Author(s):  
Fumikazu Nomura ◽  
Seiichiro Ikawa ◽  
Keishi Kadoba ◽  
Masataka Mitsuno ◽  
Yoshiki Sawa ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Ventricular Arrhythmias ◽  
Right Atrial ◽  
Age At Surgery ◽  
Group A ◽  
Group B ◽  
The Right

During a median follow-up period of 9 years (ranging from 9 months to 25 years), 24-hour ambulatory electrocardiographic studies were undertaken in 155 patients after repair of tetralogy of Fallot. The patients were divided into two groups. Group A consisted of 76 patients in whom the right ventricular approach was used and group B comprised 79 patients whose repair was through the right atrium. A transannular patch was employed in all patients in group A and in none of the patients in group B. Age at surgery was between 1 and 37 years (median age 4.8 years). During follow-up, 37 patients (48.6%) in group A had significant ventricular arrhythmias (Lown grade 2 or higher) and 13 patients (15.4%) in group B had significant ventricular arrhythmias. A close relationship was observed between age at surgery and Lown grade (R2 = 0.374, p < 0.001) and between follow-up duration and Lown grade (R2 = 0.514, p < 0.001), especially when the two groups were analyzed separately (R2 = 0.502, 0.476, p < 0.001). In contrast, no significant relationship was observed between the ratio of right ventricular to left ventricular pressure and Lown grade or between right ventricular systolic pressure and Lown grade. Discriminant analysis revealed risk factors associated with postoperative ventricular arrhythmias are follow-up duration (partial F = 3.22, p < 0.01), right ventricular to pulmonary artery pressure gradient (partial F = 3.35, p < 0.01), and operative method (partial F = 2.4, p < 0.05). Despite antiarrhythmic therapy, 11 of 22 late postoperative deaths occurred suddenly, presumably from ventricular arrhythmias. In this series of patients, the right atrial and pulmonary artery approach significantly reduced the risk of life-threatening ventricular arrhythmias after repair of tetralogy of Fallot.

Silent rupture of sinus of Valsalva aneurysm: a refutation of the Okham's razor principle

2011 ◽  
Vol 21 (6) ◽  
pp. 713-715 ◽  
Author(s):  
Joseph Dayan ◽  
Suvro Sett ◽  
Usha Krishnan
Keyword(s):  
Infective Endocarditis ◽  
Cardiac Failure ◽  
Adverse Outcomes ◽  
Unusual Presentation ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm ◽  
Unruptured Aneurysms ◽  
Congenital Lesion ◽  
History Of ◽  
Physical Examinations

AbstractAneurysm of the sinus of Valsalva is an uncommon congenital lesion rarely reported in children. Unruptured aneurysms commonly go undiagnosed until a rupture has occurred. Usually, ruptured sinus of Valsalva presents with cardiac failure. There may be a history of trauma or infective endocarditis preceding the rupture. Asymptomatic paediatric presentation of ruptured sinus of Valsalva is rare. We discuss the cases of two children who presented with a murmur and were diagnosed with ruptured sinus of Valsalva. This unusual presentation in children highlights the importance of careful routine physical examinations and the evaluation of new murmurs. The Okham's razor principle states that “when you hear hoofbeats – think horses not zebras”. Sometimes, it is important to think beyond the usual in medicine, to avoid missing lesions that, if left untreated, could lead to adverse outcomes.

A rare cause of cyanosis in newborns: arteriovenous fistula between the right pulmonary artery and the left atrium and its treatment

2018 ◽  
Vol 28 (4) ◽  
pp. 605-607 ◽  
Author(s):  
Kahraman Yakut ◽  
Birgul Varan ◽  
Murat Ozkan
Keyword(s):  
Pulmonary Artery ◽  
Arteriovenous Fistula ◽  
Left Atrium ◽  
Cardiac Failure ◽  
Transcatheter Closure ◽  
In Utero ◽  
Right Pulmonary Artery ◽  
The Right

AbstractThe formation of a fistula between the right pulmonary artery and the left atrium via a sac is a very rare cyanotic congenital cardiopulmonary defect. A fistula between the pulmonary artery and left atrium may cause cardiac failure in utero. It can safely be treated surgically and in selected cases closure can be performed with transcatheter insertion of a device. In this article, we present a case with a fistula between the right pulmonary artery and the left atrium that was considered unsuitable for transcatheter closure and was safely treated surgically.

Anomalous Origin of the Right Coronary Artery From the Pulmonary Artery: Unusual Presentation in an Adult

2012 ◽  
Vol 3 (2) ◽  
pp. 271-272
Author(s):  
Salah Eldien Altarabsheh ◽  
Sabrina D. Phillips ◽  
William C. Oliver ◽  
Harold M. Burkhart
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Adult Patient ◽  
Right Coronary Artery ◽  
Unusual Presentation ◽  
Anomalous Origin ◽  
The Right

We report an anomalous right coronary artery origin from the pulmonary artery presenting in an adult patient.

scholarly journals ANOMALOUS AORTIC ORIGIN OF THE LEFT MAIN CORONARY ARTERY ASSOCIATED WITH ARTERIAL COMPRESSION - CASE REPORT

2020 ◽  
Author(s):  
Davi Tenório ◽  
Leonardo Miana ◽  
Antonio Carlos de Almeida Barbosa Filho ◽  
Monica Gonzales Coronel ◽  
Gustavo Guerreiro ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Left Main Coronary Artery ◽  
Postoperative Recovery ◽  
Shortness Of Breath ◽  
Left Main ◽  
External Compression ◽  
The Right

Anomalous Aortic Origin of Coronary Artery (AAOCA) is a rare finding, with varied presentation and symptomatology. Increasingly recognized by cardiac imaging, when found it raises questions about the appropriate approach and management. We present a case of an 11-year-old female who presented with episodes of shortness of breath, angina and syncope during exercise. Further investigation demonstrated episodes of nonsustained ventricular tachycardia on Holter and coronary angiotomography revealed that the left coronary artery had an anomalous origin from the right cusp with initial short intramural segment and significant external compression in its initial course between the aorta and the pulmonary artery. Patient was submitted to surgical correction with dissection of left coronary artery posterior to the pulmonary artery, coronary arteriotomy, roof ampliation with autologous pericardium and creation of neo-ostium in aorta. Patient had satisfactory postoperative recovery, was discharged on the fifth day post op, and remains asymptomatic after six months follow-up. Herein we present surgical video and postoperative echo and CT scan.

scholarly journals Surgical Interventions Are Effective for Treating Unruptured Sinus of Valsalva Aneurysms

2021 ◽  
Vol 8 ◽  
Author(s):  
Juntao Qiu ◽  
Enzehua Xie ◽  
Yuetang Wang ◽  
Wei Wang ◽  
Cuntao Yu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Coronary Sinus ◽  
Surgical Repair ◽  
Heart Function ◽  
Early Death ◽  
Sinus Of Valsalva ◽  
Surgical Interventions ◽  
The Right

Background: This study investigates the optimal management for unruptured sinus of Valsalva aneurysms (USVAs) combined with other cardiovascular lesions.Methods: This retrospective study examined 33 USVA patients who underwent surgical repair from February 1, 2007 to January 31, 2012. We analyzed the surgical procedures and the patients' quality of life after surgery. Additionally, echocardiography follow-up was performed before and after the operation.Results: Most USVAs (87.8%) originated in the right coronary sinus. Aside from one patient who was preoperatively misdiagnosed as having a ruptured sinus of Valsalva aneurysm (SVA). USVAs of the right coronary sinus were addressed by reinforcing this sinus with a Dacron patch through the right ventricle. USVAs were corrected by aortotomy using an autogenous pericardium patch when they originated in the non-coronary or left coronary sinus. Thirty patients (90.9%) were followed up for 22–119 months. No early death, residual fistula or SVA recurrence were found during the follow-up period. They all had a good quality of life and good heart function (New York Heart Association class I–II).Conclusions: Active surgical repair of an USVA can be achieved with satisfactory results in patients combined with other cardiovascular lesions.

Unusual presentation of early-onset X-linked retinoschisis: Report after 1 year of multimodal follow-up

2020 ◽  
pp. 112067212091672
Author(s):  
Andrea Lembo ◽  
Giacomo Maria Bacci ◽  
Massimiliano Serafino ◽  
Stefano Lucentini ◽  
Roberto Caputo ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Early Onset ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Retinal Dystrophy ◽  
Unusual Presentation ◽  
Macular Dystrophy ◽  
Wide Field ◽  
The Right

Purpose: To describe the unusual presentation, diagnosis, and clinical course of an early-onset X-linked infantile retinoschisis Case report: A 6-month-old infant presented with strabismus and poor fixation. After the detection of bilateral intraretinal hemorrhage and diffuse dystrophic retinal pattern at indirect ophthalmoscopy, the patient received a complete evaluation under anesthesia. Retinal wide-field imaging, spectral domain optical coherence tomography, and electroretinogram were performed and revealed a retinoschisis involving the posterior pole and the inferior periphery in the right eye. In the left eye, an inferior retinal detachment extending to the macula was detected. Blood sample and genetic counseling were required in the strong suspicion of an inherited retinal dystrophy. Genetic tests confirmed the diagnosis of X-linked retinoschisis (RS1 gene mutation). After consultation with a pediatric vitreoretinal surgeon, a wait and see strategy was chosen. The follow up visits showed a surprisingly good natural course of the disease. Conclusion: X-linked retinoschisis is a well-known inherited retinal disease potentially affecting young children as early as 3 months old. In this case, the stunning presentation (diffuse retinal pigment epithelium dystrophic changes resembling a macular dystrophy) and the positive course of the disease (resolution of macular retinal detachment in the left eye and stability of schisis in the right eye) arise some interesting considerations about the necessity of an early surgical treatment.

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