[Mediastinal teratoma with malignant transformation of the somatic component. Clinical report].

Mediastinal germ cell tumours (M-GCT) are rare forms of neoplasms compared with other tumours of the same location. They are classified in seminomas, malignant non-seminomatous GCT and teratomas. The malignant transformation of the somatic component of the teratoma, with sarcomatous or carcinomatous degeneration, is even more uncommon.

[Post-partum spontaneous coronary artery dissection. Clinical report].

The authors report the clinical case of a 32 years old woman who suffered a spontaneous dissection of the common trunk, anterior descending, intermediary and circumflex coronary arteries, on the 6th post partum day. The diagnosis of acute myocardial infarction was made, through ECG and enzymatic studies and the patient was transferred to a Coronary Unit. Coronary angiography disclosed those lesions and the patient underwent a triple coronary bypass graft, under extracorporeal circulation.

Cardiac Surgery in very high-risk patients.

Purpose: To assess the results obtained in very high-risk patients, which are those patients with an EUROSCORE greater than 13 points.

Material And Methods: From September 2001 to September 2003, thirty-three very high-risk patients were operated on in our department, which represents 1.6% of all the surgical activity during that period of time, being 17 male and 16 female, with an average of 69 years old (maximum 86 and minimum 32).

[Comparative study of Toronto SPV prosthesis and bileaflet mechanical aortic prosthesis with 2D-Doppler echocardiography].

Aim: The aim of this study was to make a noninvasive comparison, by means of Doppler echocardiography, of the hemodynamic performance of biological stentless xenografts and mechanical bileaflet (MB) prostheses (P) in aortic position.

Methods: We studied 20 patients (pts) with normofunctional (nf) aortic Toronto (T) Stentless Porcine valves (SPV)--Group I--8 males, aged 69 +/- 12 years, 32 +/- 9 months after surgery, and 30 pts with nf MB aortic P (Carbomedics or St. Jude Medical)--Group II--17 males (p = NS vs G I), aged 61 +/- 12 years (p < 0.

[Experience of the exclusive use of arteries in myocardial revascularization].

Objectives: To present the initial experience of a surgical team from Santa Marta Hospital using exclusive arterial grafts on coronary bypass surgery.

Setting: Cardiology and Cardiothoracic Departments.

Population And Methods: From November 1987 to May 1994, 176 consecutive patients were submitted to surgical myocardial revascularization with the exclusive use of arterial grafts.

[Acute aortic dissection. Therapeutic strategies and results].

Objective: To analyse early and medium-term results of patients (pts) with acute aortic dissection (DAO) regarding the importance of the different therapeutic modalities adopted.

Design: Retrospective study of the cases with DAO admitted in the cardiology intensive care unit of Santa Marta Hospital.

Population: 46 pts (aged 25 to 80 years) with the diagnosis of DAO from January/1989 throughout December/1993.

[Acute aortic dissection in pregnancy. Report of a clinical case].

Aortic Dissection seldom affects young women. Nevertheless, the structural changes in the arterial wall, that occur during pregnancy, may predispose women to this complication, particularly in the third trimester and peripartum period. Aortic Dissection in gestation is associated specially with the Marfan's syndrome.

[Hemolytic anemia in the malfunction of a mitral bioprosthesis].

Valvular cardiac prosthesis have dramatically altered the prognosis of patients with valvular cardiac disease; however, they are not free of complications. Prosthesis disfunction and problems related to anticoagulation are the more common, but hemolytic anemia should also be considered. In this case, hemolytic anemia appears as the major complication of a mitral bioprosthesis; the decision concerning the presentation of this case report rests upon its rarity and peculiar circumstances of appearance.

[The assessment of the histomorphological characteristics of the arteria gastroepiploica dextra and its potential as an artery for myocardial revascularization].

Objective: Comparative analysis of the histomorphological characteristics of left (LIMA) and right (RIMA) internal mammary arteries, right gastroepiploic (RGEA) and anterior descending artery (ADA) with evaluation of the respective prevalence of atherosclerotic changes.

Settings: Laboratory of Anatomo-Pathology of a Central Hospital with necropsy material obtained from consecutive individuals, deceased of a non-cardiac cause and older than 60 years.

Material And Methods: In 31 cadaver fragments of the RIMA, LIMA, GEA and ADA, were obtain, subsequently fixed and stained in order to become evident the structure of the medial layer, and the presence of possible atherosclerotic changes (intimal Hyperplasia, cholesterol clefts, foam-cells, inflammatory cells infiltrate, rupture of the internal elastic lamina, medial fibroses and calcifications).

Aortic-left ventricular tunnel. A case report.

It is described a clinical case of aorto left ventricular tunnel, initially diagnosed as aneurysm of the right Sinus of Valsalva with aortic incompetence in a 18 years old patient. The rarity of this congenital abnormality, together with a successful surgical correction, stimulated us to publish this case. The patient improved from Class IV to Class I NYHA.