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R de Lima

Publications and source records attributed to R de Lima.

12 recordsLinked to original sources
PubMed2001

[Prognosis of postoperative aortic dissection. Assessment with magnetic resonance].

OBJECTIVE: To evaluate operated type A aortic dissection by Magnetic Resonance Imaging (MRI), in order to detect long-term complications and identify prognostic indexes of evolution. DESIGN: Prospective study with a three-year period of follow-up. Prognosis evaluation. SETTINGS: Outpatient Clinic at Hospital de Santa Maria and Magnetic Resonance Imaging Center at Hospital da Cruz Vermelha. PATIENTS: A sample of 37 patients submitted to type A aortic dissection surgery, included sequentially, after exclusion of those with contraindication to MRI. METHODS: Initial evaluation (clinical and MRI study) at 3 to 4 months and at 1, 2 and 3 years after surgery. The mean follow-up time was 39.3 +/- 2.9 months. We evaluated the following complications over the aorta (aortic graft and five segments of residual aorta) and the aortic valve: aneurysm, pseudoaneurysm, rupture, re-dissection, progressive aortic valve regurgitation, reoperation and death. The prognostic indexes analysed were: presence of residual flap; false lumen patency; presence of re-entry points; false lumen to aorta dimension ratio; initial aortic dimension; increase of aortic dimension. RESULTS: All patients, with the exception of three that died, remained asymptomatic. COMPLICATIONS: Aneurysm was detected in 45.9% of patients, located in one or more segments; rupture occurred in three patients, preceded by aneurysm and pseudoaneurysm development; moderate or severe aortic regurgitation was detected in 47.8% of patients. Prognostic indexes: 1. Aneurysm development in each segment yeilded a significant association with: presence of residual flap in the same and other segments; higher initial dimension of the same and other segments, with the exception of the abdominal segment; higher increase in dimension of the same and other segments, with the exception of the abdominal segment; 2. Moderate or severe aortic regurgitation development showed a tendency to association with higher increase in dimension of proximal ascending aorta. 3. No association was found between aneurysm and aortic regurgitation development. CONCLUSIONS: Patients operated for type A aortic dissection had a high incidence of late complications which lead to reoperation and in some cases death. The presence of a residual flap, increased aortic dimensions and higher increase rate of aortic dimensions were associated with a complicated evolution. MRI was a very useful technique for long-term monitoring and to identify prognostic indexes of evolution.

Aortic Dissection↗
PubMed1990

[A case of rupture of the left ventricle free wall with papillary muscle dysfunction following acute myocardial infarction, operated on successfully].

The authors present a case of left ventricular free wall rupture post acute myocardial infarction, associated with mitral papillary posterior muscle necrosis, operated by infartectomy and mitral valvular protesis replacement. They refer the various complications occurred during the hospital staying, and discuss its medical and surgical approach. The patient was discharged alive and six months after the infarction keeps a moderate activity.

Female↗
PubMed1989

[Early left ventricular dysfunction in acute myocardial infarct. Evaluation using imaging methods].

A patient admitted in a Coronary Care Unit with an acute anterior myocardial infarction, is presented. He had initially normal left ventricular function and, on the 11th day he had, suddenly, an acute pulmonary edema. The reason for this episode was detected through imaging techniques--echocardiography and isotopic studies, and consisted on infarct expansion with early evolution for apical aneurysm. Contrast angiography confirmed the presence of a huge aneurysm and two vessels disease. Tallium Scintigraphy showed reversible ischemia beyond necrotic areas. The patient was submitted to aneurysmectomy and received three aorto-coronary bypass. He is now doing well, in class I, NYHA. The discussion emphasizes the actual role of imaging techniques in the diagnosis of infarct expansion and early functional aneurysm. We discuss the prognostic of infarct expansion and the importance of perfusion studies on defining areas of myocardium in jeopardy, enabling a better surgical approach.

Echocardiography↗
PubMed1989

[Surgical treatment of variant angina. Apropos of a clinical case].

A case of a male 66 years-old patient who presented with a clinical picture of Prinzmetal's variant angina early in the evolution of an acute myocardial infarction is reported. Transient elevation of ST-segment was documented on Holter monitoring in association with angina at rest as well as asymptomatic episodes of ST-segment changes. Significant two-vessels obstructive lesions (left anterior descending and circumflex arteries) was present. As variant angina had several recurrences in spite of medical therapy with nitrates and calcium antagonists, the patient was submitted to coronary by-pass surgery associated to plexectomy. A Thallium myocardial scintigraphy suggests that a peroperative infarction had occurred. The patient was asymptomatic at six months follow-up.

Aged↗
PubMed1980

Bronchial adenoma. Clinicopathologic study and results of treatment.

Among 1,700 primary tumors of the lung, there were 53 cases of bronchial adenoma (3.1 percent); 38 (72 percent) of the 53 were typical carcinoids, and the remaining 15 were of a higher grade of malignant neoplasm. There was a slight predominance of female patients, and the age of greatest incidence was between 30 and 50 years (31/53; 58 percent). The most frequent localization was in the main bronchi and in the left bronchial tree. In cases of higher grades of malignant neoplasm, extensive bronchopulmonary resections were performed, while in the less active and less metastatic carcinoids, partial resections were generally performed, using bronchoplastic techniques, sleeve resections, and grafts, except in those cases in which bronchial obstruction had produced extensive and irreversible lesions. Survival at five and ten years after surgery is presented.

Adenocarcinoma↗
PubMedDate not supplied

[A case of perforation of the interventricular septum with free wall rupture, in the acute phase of myocardial infarct, successfully treated with surgery].

The authors present a case of interventricular septal rupture with left ventricular free wall rupture post acute myocardial infarction operated on the third day after the onset of symptoms, by enfartectomy and application of a septal patch. Then, they compare this case with four cases referred in the literature, discussing the different and similar points between them. They emphasize the good results of this kind of surgery, but they also remark the need of an early diagnosis and surgery in these patients.

Aged↗