Paulo José de Freitas Ribeiro

Late surgical repair of ventricular septal defect due to nonpenetrating chest trauma: review and report of two contrasting cases.

Traumatic rupture of the interventricular septum is a rare condition usually presenting in infancy and childhood. This report describes two cases: a 3-year-old boy operated on soon after the diagnosis was made, and a 15-year-old girl operated on 12 years following the causative accident. Both patients had the diagnosis confirmed by cardiac catheterization. The typical appearance of a traumatic ventricular septal defect (VSD) was seen during surgical repair that was successfully carried out in both patients. The protracted clinical course of the second patient, eventually requiring corrective intervention, contributes to the understanding of natural history of traumatic VSD.

Dorsal minithoracotomy for ductus arteriosus clip closure in premature neonates

We present a new surgical technique for patent ductus arteriosus (PDA) occlusion in premature neonates (PN). Through a dorsal minithoracotomy the PDA is dissected extrapleurally with q-tips and clipped. The short surgical time, avoidance of pleural drainage, and prevention of late breast deformity are the operation highlights.

Submitral left ventricular aneurysm. Case report and review of published Brazilian cases

Submitral left ventricular aneurysm is a cardiac pathology widely recognized, but relatively unknown, occurred almost exclusively in African black patients. Although still this idea of racial prevalence exists, cases have been described in patients of all the races. Ten Brazilian cases were reported. One of them was presented inside an Italian paper that refers the surgical treatment of a Brazilian patient of black race. We reported one more submitral left ventricular aneurysm case in a brown female patient, with antecedents of peripheral thromboembolism initially not identified as consequence of the cardiac pathology.

Congenital coarctation of the lower thoracic aorta. A rare surgically correctable cause of hypertension in the young — case report

We report a case of congenital coarctation of the lower thoracic aorta. The patient, a 15-year-old man, presenting with the signs of classical coarctation, had the diagnosis confirmed by an aortography. A good surgical result was achieved by means of resection of the internal shelf and aortoplasty using a bovine pericardium patch. One year after the operation the patient has normal blood pressure with good femoral pulses.

Left atrial myxoma as the cause of syncope in an adolescent

A case of left atrial myxoma is reported in a 14-year-old female patient with recurrent episodes of syncope. The patient was immediately referred to the cardiologist after an inconclusive neurological investigation. Syncope is a symptom thoroughly described as being associated with heart myxomas, but its specific association with adolescence is extremely rare. The authors discuss the clinical manifestations of the disease, emphasizing the diagnostic difficulties on the basis of the unspecific symptoms. As part of the analysis a Brazilian literature review was carried out. Also, the authors experience in the surgical treatment of the heart tumors is briefly presented.

Myocardial Reperfusion by Thrombolysis After Acute Total Left Main Artery Occlusion—A Case Report

Coronary recanalization with thrombolytic agents is a new therapeutic approach to the treatment of acute myocardial infarction that can be beneficial even to patients in cardiogenic shock. Although few cases have been reported in the literature, treatment of acute occlusion of the left main coronary artery (LMCA) has been made possible by myocardial reperfusion. This communication concerns a patient with acute LMCA occlusion who was successfully treated by thrombolytic therapy with streptokinase followed by revascularization of the myocardium seventy-two hours after reperfusion was achieved.

Nonfunctioning paraganglioma of the posterior mediastinum (case report)

A case of nonfunctioning paraganglioma of the posterior mediastinum in a 20-year-old white man is presented. The diagnosis of aorticosympathetic paraganglioma (Glenner-Grimley classification) was established by histologic examination after surgical removal of the tumor.

Plastia valvar aórtica por ampliação de válvula com pericárdio bovino: nota prévia

A new technique for correction of aortic incompetence by the advancement of one more valve leaflets with bovine pericardial is presented. After experimental studies in isolated animal hearts this technique was used with success in one patient.

Surgical treatment of a floating non-occlusive thrombus in the ascending aorta: case report

We report the case of a 44-year-old diabetic woman who was a smoker using synthetic progestagen, with previous history of suspected thrombotic cerebral ischemia. She was admitted with clinical evidence of acute myocardial infarction. A coronary angiogram showed normal coronary arteries and distal occlusion of the left circumflex coronary artery. An ascending aorta angiogram and transesophageal echocardiography revealed a free floating mass attached to the aortic wall. The pedunculated thrombotic mass was surgically removed. Histological examination of the resected structure confirmed the macroscopic findings and revealed a recent thrombus. The patient was prescribed oral anticoagulant and released from hospital.

Experiência com dois tipos de técnicas para o tratamento cirúrgico da insuficiência mitral: I. Prótese com preservação de elementos do sistema valvar. II. Plastia valvar com reconstrução e avanço da cúspide posterior

The continuity between mitral valve and the left ventricular wall through chordae tendinae and papillary muscles plays a role in left ventricular function. The morbity and mortality for mitral valve replacement remain much higher than other cardiac procedures such as aortic valve replacement, mitral valvuloplasty and coronary artery bypass grafts. These facts justify all possible studies related to the correction of mitral valve insufficiency. The present paper presents our experience with two techniques for correction of mitral valve insufficiency: valve replacement with preservation of the mitral apparatus components and valvuloplasty by the reconstruction and advancement leaflet. Our main concern was the surgical details and ventricular function studies were not performed. Various techniques to maintain continuity of the mitral valve annulus and the ventricular musculature, when valve replacements is mandatory, are presented. The importance of the reconstruction and advancement of the posterior leaflet, alone or associated with other repair techniques such as comissurotomy, annuloplasty and shortening of chordae tendinae, is emphasized.