[Knowledge and skills and aptitudes in healthcare management].
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Biomedical subjects
Publications and source records attributed to M Torner.
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The presence of liver methastasis and serotonin in plasma in the carcinoid tumor are responsible for the carcinoid syndrome. We present a case of tricuspid and pulmonary valvular disease secondary to this syndrome. The finding of liver hyperechogenic nodules added to the described valvular disease by subcostal echocardiogram oriented the diagnosis.
Anomalous origin of left coronary artery from pulmonary artery is a rare congenital anomaly (0.25-0.46%). Mortality is high in the first months (65%). Paradoxically, some patients reach adulthood because of a net made of collaterals from the right coronary artery. Thus, we classify the entity in two ways of clinical onset: childhood and adulthood. Ideally, the best surgical approach is the arrangement of a double coronary system. The most well-known technique is the one described by Takeuchi, that links the aorta and the left coronary artery by a tunnel through the pulmonary artery, made from a pulmonary artery frontal wall flap (closing the defect with a pericardial patch). We present a case of anomalous origin of the left coronary artery in an adult, treated in our institution using a modified Takeuchi technique.
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A case of a 29 year old man with congenital aortic stenosis who developed a subvalvular annular aneurysm of the left ventricle after being run by a car is presented. At surgery his aortic valve was replaced and the opening of the aneurysm was closed with a patch of Dacron. Due to the dense adhesions to the aorta and left atrium no attempts were made to excise the sac, that was not compromising the dynamics of any one of these structures.
Two patients with Ebstein's anomaly and severe cardiac impairment underwent surgical repair with tricuspid valve replacement and closure of associated congenital septal defects. No attempt was made to plicate the atrialized right ventricle. Good cardiac function was obtained at the end of the procedure, with uniform contractions of the whole right ventricle. Both patients are leading normal and active lives 38 and 32 months after operation. We believe that successful repair is achieved chiefly by placing a competent tricuspid valve on its true anatomical position, leaving the underlying atrialized portion of the ventricular wall undisturbed. That portion will contract and work synchronously with the rest of the right ventricle.