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L Sousa

Publications and source records attributed to L Sousa.

25 records · Page 2Linked to original sources
PubMed1995

[Emergency catheterization in a coronary intensive care unit. The diagnostic and therapeutic implications].

OBJECTIVE: to evaluate the diagnostic and therapeutic role of emergency hemodynamic studies, in the coronary intensive care (UCI). STUDY DESIGN: Retrospective study of--patients (P) submitted to emergency catheterization. PATIENTS: 183 P (152 M and 31 F), mean age 56 +/- 11.5 years, admitted to UCI of Hospital Santa Marta and who had cardiac catheterization performed, between October 88 and November 92. METHODS: Patient clinical files were reviewed. We considered the reasons for emergency cardiac catheterization; final diagnosis; complications in the first 24 hours; catheterization role in the therapeutic orientation. RESULTS: Reasons for hemodynamic study were: coronary artery disease (CAD) in 127 P (69%); aortic dissection in 33 P (18%); valvular disease in 19 P (10%) and other in 4 P (3%). Clinical diagnosis was confirmed in 92% and changed in 8% by hemodynamic study results. Left main coronary artery disease was diagnosed in 6.5% of CAD patients. Coronary artery disease was excluded in 5 P with previous CAD diagnosis, in 19 P with aortic dissection and in 11 valvular patients. 32% of P were sent to emergent surgery: 93% ascending aortic dissection and 20% of CAD, 76% of valvular disease. The hemodynamic study was decisive in the therapeutic option of myocardial revascularization in 77% of P with CAD: 39 emergent PTCA (31%), 13 primary (33%) and 14 P oriented to elective PTCA (11%); 26 emergent surgery and 19 P oriented to elective surgery (15%). The emergency cardiac catheterization mortality rate was 0.5%, and the morbidity 2.7%. CONCLUSIONS: The contribution of Hemodynamic Department to UCI was decisive in the diagnostic and therapeutic orientation of critical patients.

Adult↗
PubMed1992

[Torsion of wandering spleen. An unusual case of abdominal pain].

Wandering spleen is uncommon and of difficult diagnosis. New Imaging Modalities (Eco; TC), can suggest or confirm the preoperative diagnosis of wandering spleen, permitting conservative surgery, mainly in children. We report two cases of wandering spleen. The first one, with acute surgical abdomen and tumor on left iliac fossa, operated as an ovarian cyst torsion: the laparotomy showed a necrotic spleen in pelvis. The second case presented as intestinal sub-occlusion with recurrent abdominal pain, and a left iliac fossa movable tumor. It was diagnosed by eco and radionuclides before laparotomy. Even diagnosed in different ways, the surgical treatment was the same.

Abdominal Pain↗
PubMedDate not supplied

Percutaneous occlusion of patent foramen ovale in patients with paradoxical embolism.

INTRODUCTION: A patent foramen ovale can be found in about one quarter of adults and in a small percentage it is a wide opening and may be associated with aneurysmal formation. The association between a wide patent foramen ovale and paradoxical embolism is well established. In such cases percutaneous closure is indicated, as an alternative to life-long anticoagulant therapy or surgery. Percutaneous closure is an attractive technique and is more advantageous than other methods. METHODOLOGY: We describe the first cases of percutaneous occlusion of patent foramen ovale performed in Portugal, using the Amplatzer PFO occluder, in three female patients with documented cerebrovascular accidents due to paradoxical embolism. We also analyze the rationale for using this technique in such patients and its preliminary results. RESULTS: All three patients submitted to percutaneous occlusion of patent foramen ovale had a similar history of ischemic cerebrovascular accident. Transesophageal echocardiography showed a wide-open foramen ovale ranging from 9 to 12 mm, with spontaneous right-to-left shunt in all patients, and one of them also had an aneurysmal formation. Total procedure time ranged from 30 to 55 minutes and fluoroscopic time from 9 to 12 minutes. There were no complications and during the short follow up all patients are asymptomatic and free of recurrent events. CONCLUSIONS: Percutaneous closure of patent foramen ovale is a safe and promising technique in the prevention of recurrent systemic thromboembolism in appropriately selected patients. Prospective studies comparing antithrombotic therapy or surgery with percutaneous closure should clarify its efficacy and therapeutic value.

Adult↗