Ana Carolina Leiroz Ferreira Botelho Maisano Kozak

A Trileaflet “Mitral Valve” with Three Papillary Muscles: Brand New Echocardiographic Finding

Congenital mitral valve malformations are rare, but are well known and described entities. Mitral valve malformations involve mitral valve apparatuses (leaflets and annulus) and subvalvar apparatuses (chordae and papillary muscle). Case reports of accessory mitral leaflets were already described, but were usually an appendix of the normal valve. We describe here a case report and present the images of a trileaflet mitral valve sustained by three papillary muscles in a young girl with subaortic stenosis.

A Trileaflet "Mitral valve" with three papillary muscles

Congenital mitral valve malformations are rare, but are well known and described entities. Mitral valve malformations involve mitral valve apparatuses (leaflets and annulus) and subvalvar apparatuses (chordae and papillary muscle). Case reports of accessory mitral leaflets were already described, but were usually an appendix of the normal valve. We describe here a case report and present the images of a trileaflet mitral valve sustained by three papillary muscles in a young girl with subaortic stenosis.

Fatores associados à insuficiência da valva atrioventricular esquerda nos primeiros 30 dias após correção de defeito de septo atrioventricular total

Introduction Left atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defects. Objective To determine factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of surgical repair of complete atrioventricular septal defect. Methods We assessed the results of 53 consecutive patients 3 years-old and younger presenting with complete atrioventricular septal defect that were operated on at our practice between 2002 and 2010. The following variables were considered: age, weight, absence of Down syndrome, grade of preoperative atrioventricular valve regurgitation, abnormalities on the left atrioventricular valve and the use of annuloplasty. Median age was 6.7 months; median weight was 5.3 Kg; 86.8% had Down syndrome. At the time of preoperative evaluation, there were 26 cases with moderate or severe left atrioventricular valve regurgitation (49.1%). Abnormalities on the left atrioventricular valve were found in 11.3%; annuloplasty was performed in 34% of the patients. Results At the time of postoperative evaluation, there were 21 cases with moderate or severe left atrioventricular valve regurgitation (39.6%). After performing a multivariate analysis, the only significant factor associated with moderate or severe left atrioventricular valve regurgitation was the absence of Down syndrome (P=0.03). Conclusion Absence of Down syndrome was associated with moderate or severe postoperative left atrioventricular valve regurgitation after surgical repair of complete atrioventricular septal defect at our practice.

Factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of repair of incomplete atrioventricular septal defect

Introduction Left atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defect. Objective To determine factors associated with moderate or greater left atrioventricular valve regurgitation within 30 days of surgical repair of incomplete atrioventricular septal defect. Methods We assessed the results of 51 consecutive patients 14 years-old and younger presenting with incomplete atrioventricular septal defect that were operated on at our practice between 2002 and 2010. The following variables were considered: age, weight, absence of Down syndrome, grade of preoperative left atrioventricular valve regurgitation, abnormalities on the left atrioventricular valve and the use of annuloplasty. The median age was 4.1 years; the median weight was 13.4 Kg; 37.2% had Down syndrome. At the time of preoperative evaluation, there were 23 cases with moderate or greater left atrioventricular valve regurgitation (45.1%). Abnormalities on the left atrioventricular valve were found in 17.6%; annuloplasty was performed in 21.6%. Results At the time of postoperative evaluation, there were 12 cases with moderate or greater left atrioventricular valve regurgitation (23.5%). The variation between pre- and postoperative grades of left atrioventricular valve regurgitation of patients with atrioventricular valve malformation did not reach significance (P=0.26), unlike patients without such abnormalities (P=0.016). During univariate analysis, only absence of Down syndrome was statistically significant (P=0.02). However, after a multivariate analysis, none of the factors reached significance. Conclusion None of the factors studied was determinant of a moderate or greater left atrioventricular valve regurgitation within the first 30 days of repair of incomplete atrioventricular septal defect in the sample. Patients without abnormalities on the left atrioventricular valve benefit more of the operation.

Correção de coarctação de aorta com anastomose término-terminal em recém-nascido prematuro

O VIDEO REFERENTE AO TEXTO ENCONTRA-SE NO SITEDA REVISTA: http://www.rbccv.org.br/video/v25n4/1. Servico de Cirurgia Cardiovascular Pediatrica de Sao Jose do RioPreto – Hospital de Base (HB) – Faculdade de Medicina de SaoJose do Rio Preto (FAMERP), SP, Brasil.Endereco para correspondencia:Ulisses Alexandre CrotiHospital de Base – Faculdade de Medicina de Sao Jose do Rio Preto

Total correction of tetralogy of Fallot in child with left pulmonary artery agenesis

Endereco para correspondencia: Ulisses Alexandre CrotiHospital de Base - FAMERP - Avenida Brigadeiro Faria Lima, 5544.CEP 15090-000 - Sao Jose do Rio Preto, SP, Brasil.Fone (Fax): 17 - 3201 5025 / 3222 6450 / 9772 6560.E-mail: uacroti@uol.com.brArtigo recebido em 6 de agosto de 2009Artigo aprovado em 8 de setembro de 2009

Ostium Secundum-type interatrial communication: few clinical symptoms and great hemodynamic repercussion

DADOS CLINICOSCrianca com 9 anos e 6 meses, 37,4 kg, sexo feminino,natural de Colombia, SP. Nao apresentava sinais ousintomas, exceto pela queixa a familia, nao valorizada, de“sensacao de aperto no peito” que melhorava comrespiracao profunda. Em consulta medica de rotina, devidoa quadro de amidalite, foi percebida alteracao da auscultacardiaca, sendo solicitado ecocardiograma e diagnosticadacardiopatia congenita com hiperfluxo pulmonar.O exame fisico de entrada em nosso Servico erapraticamente normal, estando em bom estado geral,eutrofica, afebril e acianotica. Chamava atencao apenas oritmo cardiaco regular, sem sopros, com desdobramentofixo da segunda bulha, mais audivel em foco pulmonar.ELETROCARDIOGRAMARitmo sinusal, frequencia 88 bat/min, SÂP 0o, SÂQRS+120°, PR 160 ms, QRS 80 ms. Sobrecarga de ventriculodireito (VD), com eixo do QRS para a direita em V1 e onda Rentalhada com amplitude de 13 mm (Figura 1).RADIOGRAMA

Portadora de transposição das grandes artérias operada em idade pré-escolar

Correspondence address: Ulisses Alexandre Croti Hospital de Base – FAMERP – Avenida Brigadeiro Faria Lima, 5544. CEP 15090-000 – São José do Rio Preto – SP Fone (Fax): 17 3201 5025 / 3222 6450 / 9772 6560 E-mail: uacroti@uol.com.br Ulisses Alexandre CROTI1, Domingo Marcolino BRAILE1, Ana Carolina Leiroz Ferreira Botelho MAISANO KOZAK1, André Luis de Andrade BODINI1 Rev Bras Cir Cardiovasc 2007; 22(3): 367-368 SURGICAL-CLINICAL CORRELATION

Rastelli procedure with decellularized pulmonary homograft

Correspondence adress: Ulisses Alexandre Croti Hospital de Base – FAMERP – Avenida Brigadeiro Faria Lima, 5544 CEP 15090-000 – São José do Rio Preto – São Paulo Phone (fax): 17 3201 5025 / 9772 6560 E-mail: uacroti@uol.com.br Ulisses Alexandre CROTI, Domingo Marcolino BRAILE, Ana Carolina Leiroz Ferreiro Botelho Maisano KOZAK, Lilian BEANI Braz J Cardiovasc Surg 2006; 21(3): 356-357 CLINICAL-SURGICAL CORRELATION