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ABSTRACT: Chylopericardium is a rare entity which is usually associated with trauma (thoracic duct lesions), neoplasia or filaria infection. Primary forms are even rarer and are caused by lymphatic circulation malformations. We present the case of a 52-year-old male patient with primary chylopericardium. We discuss the diagnostic approach, as well as the favorable clinical evolution with conservative management.
Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 04/2009; 28(3):325-32.
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Rita Marín Fernandes,
Luísa Moura Branco,
Ana Galrinho,
Ana Teresa Timóteo,
Anabela Tavares,
Joana Feliciano,
Ricardo Oliveira,
António Fiarresga,
Andreia Mamede, Nuno Banazol,
Jose Roquette,
Rui Cruz Ferreira
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ABSTRACT: Caseous calcification of the mitral annulus is a rare form of mitral annular calcification, whose etiology is not completely understood and which can lead to an erroneous diagnosis of intracardiac tumor. The authors describe the cases of six patients, five of them female, mean age 74.8 +/- 6.4 years (65-81). Four patients presented with heart failure, two with atrial fibrillation and five with hypertension. Round, echogenic images, 18-26 mm in their largest diameter with a central echolucent area, were identified by transthoracic echocardiography on the lateral and posterior segments of the mitral annulus. Severe mitral regurgitation was also found in four patients. Only three patients with severe mitral regurgitation and heart failure were operated on, and one patient refused surgical treatment. A caseous mass, similar to toothpaste, was obtained from the mitral annulus zone during surgery.
Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 11/2007; 26(10):1059-70.
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ABSTRACT: Isolated anterior mitral leaflet cleft (not associated with atrio-ventricular septal defect) is a rare cause of congenital mitral regurgitation, and the treatment consists of direct suturing of the cleft. We present a clinical case with this entity.
European Heart Journal – Cardiovascular Imaging 02/2007; 8(1):59-62. · 2.32 Impact Factor
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Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 06/2003; 22(5):713-5.
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Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 03/2003; 22(2):281-5.
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Nuno Banazol
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ABSTRACT: This paper focus on the most common used prosthesis for replacement of diseased heart valves, when repair is not feasible. A brief historical review is made. New prosthesis and the trends for the future are also addressed.
Revista portuguesa de cirurgia cardio-toracica e vascular: orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular 12(2):87-93.
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ABSTRACT: Valve surgery in children is aimed at restoring correct hemodynamics with few reoperations and limited resort to prostheses, which would imply early deterioration or definitive hypocoagulation.
Report a series of paediatric pts with acquired mitral valve disease, mostly due to rheumatic disease, in whom it was possible, for the great majority, to repair the damaged valve. DEMOGRAPHICS: Fifty children with predominant mitral valve disease, 47 rheumatic (94%) and 3 after endocarditis were consequently operated by the same surgical team over the last five years. Ages were 12.5+/-3.1 yrs and weights 33.2+/-8.4 Kg, 30 pts presented with predominant mitral regurgitation and 20 pts had significant stenosis. In 8 pts there also moderate to severe aortic regurgitation and in 2 pts severe tricuspid regurgitation was present. Patients were not operated during the acute phase of the disease. Five pts were reoperations and from those, all but one received mechanical prosthesis.
In all operations the intention was to repair the mitral valve. In 46 pts complex mitral valvuloplasties were performed extended comissurotomies, shortening of chordae, chordal replacement with PTFE, and reconstruction of valve leaflefts by direct patching or pericardial extension of the retracted posterior leaflet (78.2% cases), plus reshaping of the annulus by using a fixed prosthetic CE ring (sizes 26 to 32) in every case. Ring sizes correlated poorly with body weights, but correlation was close and positive for the use of pericardial advancement of the posterior leaflet (p<0.01). There was no operative mortality, but one pt died early from sepsis and there was no late mortality. Maximum follow up extends now to 50 months (median 28 months) and functional evaluation, at latest follow up, as assessed by Doppler Echocardiography, showed residual mitral regurgitation, mild-moderate in 4 pts and LA-LV gradients mild in 5 and moderate in 2 pts. NYHA functional class, at present follow-up is class I for 43 pts (88%) and class II in the remaining 6 pts. Along the follow-up period 2 pts had to be reoperated for early repair failures and other three for late failures, presently freedom for reoperation is 91.8% at 5 years.
Mitral valve repair in children with rheumatic lesions can be achieved for the great majority of cases by using different techniques. Pericardial extension of the retracted posterior leaflet allowed the use of a bigger size prosthetic ring. Intermediate functional results are good with fair functional classes and few reoperations but follow-up is short and does not allow us to draw conclusions about the long-term results of the repair in these rheumatic patients.
Revista portuguesa de cirurgia cardio-toracica e vascular: orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular 11(4):189-93.
