Biomedical subjects

R Macruz

Publications and source records attributed to R Macruz.

At least 19 recordsLinked to original sources

PubMed1992

[Directional coronary atherectomy. The initial experience].

Four male patients, 38 to 59 years old (mean 49 +/- 2.5), with angina and the angiographic features has been the classical indications for the method, underwent directional coronary atherectomy. Vessels treated were, respectively, left anterior descending artery (LAD), right coronary artery (RCA), saphenous vein graft (SVG) to LAD and SVG to left marginal branch. Reductions to 50% or less of the internal diameter was considered a satisfactory result. Early success was obtained in all four patients. Obstructions of 75 to 95% (mean of 83 +/- 7.5%) were reduced to 0-25% (mean 12 +/- 5%) after atherectomy. Only one patient died suddenly five days after de procedure. So, directional coronary atherectomy may represent a reliable and safe method for special situations.

Adult↗

PubMed1991

[Chronic active hepatitis and possible relationship with immunosuppressive therapy].

A 54-year-old man with Chagas cardiomyopathy that was submitted to a heart transplantation and five months later presented a progressive increase in liver enzymes. Diagnosis of chronic active hepatitis was confirmed by histopathologic studies. A transitory interruption of treatment with azathioprine and the posterior re-introduction of small doses, as well as the use of lesser amounts of cyclosporin-A improved the clinical and laboratory pictures. Despite several investigations the pathogenesis of hepatitis remained undetermined, although some type of drug injury was presumed to be involved. The eventual role of viruses as the primary inciting event could not be completely ruled out.

Chagas Cardiomyopathy↗

PubMed1991

[Coronary angioplasty in young patients].

PURPOSE: To evaluate the results of coronary angioplasty in patients at the age of 40 years old or under. METHODS: From July 1987 to July 1990, 878 coronary angioplasty procedures were performed. Sixty six patients (7.5%) were 40 years old or under. The coronary obstruction was considered significant when 70% or more of the arterial diameter was involved and the post angioplasty results were considered satisfactory when residual obstruction was less than the 50%. RESULTS: Fifty four patients (81.8%) were male with an average age of 37 years (ranging from 29 to 40). Forty four patients (67%) had stable angina, 18 (27%) unstable angina, 3 (4%) acute myocardial infarction (AMI) and one (1.5%) AMI after streptokinase treatment. Eight of these patients had previous report of AMI and 3 (4.5%) had undergone coronary bypass grafting surgery. Fifty five patients (83%) had single vessel disease and 11 (17%) had multivessel disease. Eighty coronary arteries had balloon dilatation. In 32 patients (58%) with single vessel artery, 12 (22%) in the RCA, 10 (18%) in the left circumflex and one (2%) into a saphenous vein bypass grafting. In 12 patients (48%) with multivessel disease it was performed in the LAD coronary artery, 8 (32%) in the RCA and 5 (20%) in the left circumflex. Angioplasty was successfully performed in 53 (96%) patients with single vessel disease and in 10 (01%) with multivessel disease. One of the patients died immediately after the procedure. A follow up of 11.6 months (ranged from 1 to 27 months) was possible in 63 patients. Re-stenosis was depicted in 10 (19%) of the 55 patients with single vessel disease and in 3 of the 11 patients (30%) with multivessel disease. Nine patients had a successful redilatation in the first group and 2 in the second one. The two remaining patients had undergone coronary bypass surgery. The clinical evaluation among patients who had been dilated as the first procedure and those who had redilatation (61 patients) showed: 92% were asymptomatic and 8% had mild angina. CONCLUSION: Coronary angioplasty performed in young patients is an effective procedure with very low rate of early complications and favorable clinical follow-up.

Adult↗

PubMed1989

[Doppler echocardiographic evaluation of heart transplantation].

In order to evaluate major Doppler-Echocardiographic parameters for the diagnosis of acute cardiac allograft rejection episodes a serial of 54 Doppler Echocardiograms were performed simultaneously with endomyocardial biopsy in five patients (mean age = 40.2 y/o). Measurements included: right and left chambers diameters, left ventricular (LV) myocardial diastolic thickness, LV systolic function parameters, LV mass, LV volume/mass ratio, LV isovolumic relaxation time, mitral flow peak velocities and pressure half-time. Episodes with acute rejection histopathologic findings, Billingham class III or IV, were associated to increase in LV free wall thickness and LV mass (p less than 0,005) as well as decreased isovolumic relaxation time and pressure half-time (p less than 0,001). Left ventricular systolic function parameters and heart rate were no different comparing rejection and no rejection episodes. However, in each patient, progressive lower values of LV ejection fraction were associated to higher incidence of acute rejection episodes. Isovolumic relaxation time increased promptly following immunosuppressive therapy. Thus, Doppler Echocardiography is a reliable method for early detection of acute cardiac allograft rejection and monitoring of the cardiac transplant recipient.

Adult↗

PubMed1979