que se leu este artigo
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(B) Neck of left ventricular aneurysm. The fibrous wall of the aneurysm, the endocardium and the papillary muscles of the mitral valve can be seen. (C) Exclusion of the aneurysm using a bovine pericardial patch sutured to the edges of the myocardium. (D) Occlusion and reinforcement of sutures with Teflon bands.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Elena Arnáiz-García, Ana M. Arnáiz-García, Ashesh D. Patel, Francisco J. Gutiérrez-Diez, Juan F. Nistal-Herrera, Javier Arnáiz" "autores" => array:6 [ 0 => array:2 [ "nombre" => "M. Elena" "apellidos" => "Arnáiz-García" ] 1 => array:2 [ "nombre" => "Ana M." "apellidos" => "Arnáiz-García" ] 2 => array:2 [ "nombre" => "Ashesh D." "apellidos" => "Patel" ] 3 => array:2 [ "nombre" => "Francisco J." "apellidos" => "Gutiérrez-Diez" ] 4 => array:2 [ "nombre" => "Juan F." "apellidos" => "Nistal-Herrera" ] 5 => array:2 [ "nombre" => "Javier" "apellidos" => "Arnáiz" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255113000772?idApp=UINPBA00004E" "url" => "/08702551/0000003200000005/v1_201308021350/S0870255113000772/v1_201308021350/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in cardiology</span>" "titulo" => "A case of coronary-vertebral subclavian steal syndrome" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "443" "paginaFinal" => "445" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Paulo G. Pedro, Berta Carôla, Rui Conduto, Isabel Barão, Rui Cruz Ferreira, Manuel Pedro Magalhães" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Paulo G." "apellidos" => "Pedro" "email" => array:1 [ 0 => "ppedro@netcabo.pt" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Berta" "apellidos" => "Carôla" ] 2 => array:2 [ "nombre" => "Rui" "apellidos" => "Conduto" ] 3 => array:2 [ "nombre" => "Isabel" "apellidos" => "Barão" ] 4 => array:2 [ "nombre" => "Rui Cruz" "apellidos" => "Ferreira" ] 5 => array:2 [ "nombre" => "Manuel Pedro" "apellidos" => "Magalhães" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "SAMS Hospital, Lisbon, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Um caso de síndrome de roubo subclávio coronário-vertebral" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1666 "Ancho" => 1667 "Tamanyo" => 210297 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Antero-posterior, volume rendering technique of the heart and great vessels, depicting subclavian artery occlusion and patent LIMA.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case report</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 59-year-old woman with type 2 diabetes and two-vessel disease had undergone double coronary bypass grafting (CABG) five years previously, with left internal mammary artery (LIMA) to left anterior descending (LAD) artery and free radial graft (Y type), from LIMA to obtuse marginal (OM). Three months ago, the patient began to suffer angina and episodes of dizziness after upper limb exercise, followed by a lateral wall myocardial infarction one month ago. Urgent femoral catheterization revealed thrombotic occlusion of the circumflex (Cx) artery; the LAD had an old occlusion and the LIMA could not be catheterized. The right coronary artery (RCA) was normal. Primary angioplasty of the culprit Cx was performed and two bare-metal stents were deployed. The acute chest pain resolved, but angina and dyspnea recurred one week later. Physical examination revealed absent pulses in the left arm. Cardiac CT angiography revealed abrupt occlusion of the left subclavian artery 1.8<span class="elsevierStyleHsp" style=""></span>cm after its origin, proximal to the LIMA and the ipsilateral vertebral artery. Both these arteries supplied a scant flow to the axillary artery (<a class="elsevierStyleCrossRefs" href="#fig0005">Figures 1 and 2</a>), but the LIMA was well contrasted, with a good anastomosis to the mid LAD (<a class="elsevierStyleCrossRefs" href="#fig0005">Figures 1, 2 and 3a</a>). The radial (LIMA to OM) anastomosis was totally occluded, only the path of the metal clips being visible (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>). The Cx stent was patent with no signs of restenosis, and the RCA was normal (<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>b and c). The right brachiocephalic and left carotid arteries were normal (<a class="elsevierStyleCrossRefs" href="#fig0005">Figures 1 and 2</a>). A triplex Doppler scan revealed reversal of left vertebral artery flow (<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>). A diagnosis of coronary-vertebral subclavian steal syndrome was made.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Discussion</span><p id="par0010" class="elsevierStylePara elsevierViewall">Coronary and/or vertebral subclavian steal syndrome is a late complication of CABG, occurring in patients with pre-existing subclavian atherosclerotic disease. It is unclear whether the surgical procedure itself accelerates the development of lesions in the subclavian artery, due to enhanced local flow and consequent endothelial shear stress.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> Systematic bilateral blood pressure measurement is mandatory prior to CABG, to exclude subclavian stenosis.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In this case, a large CT acquisition window was used, ranging from the middle neck region to the diaphragm, to ensure good anatomical coverage, particularly of the proximal supra-aortic vessels, in preparation for possible future surgery. Since the left carotid artery was disease-free, a carotid-left axillary shunt was proposed, without further invasive investigations.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Ethical responsibilities</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Protection of human and animal subjects</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that the procedures followed were in accordance with the regulations of the relevant clinical research ethics committee and with those of the Code of Ethics of the World Medical Association (Declaration of Helsinki).</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Confidentiality of data</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data and that all the patients included in the study received sufficient information and gave their written informed consent to participate in the study.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Right to privacy and informed consent</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Case report" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Discussion" ] 2 => array:3 [ "identificador" => "sec0015" "titulo" => "Ethical responsibilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Right to privacy and informed consent" ] ] ] 3 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflicts of interest" ] 4 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-09-24" "fechaAceptado" => "2012-10-22" "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1666 "Ancho" => 1667 "Tamanyo" => 210297 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Antero-posterior, volume rendering technique of the heart and great vessels, depicting subclavian artery occlusion and patent LIMA.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1674 "Ancho" => 1667 "Tamanyo" => 243766 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cranial left anterior oblique view, volume rendering technique of the heart and great vessels, depicting subclavian artery occlusion, circunflex artery stents and occluded radial graft.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 2080 "Ancho" => 2500 "Tamanyo" => 251153 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Curved multiplanar reconstructions of (a) LIMA to LAD, (b) Cx with stents and (c) RCA.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 2040 "Ancho" => 2500 "Tamanyo" => 279990 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Triplex Doppler scan, revealing reversal of left vertebral artery flow (arrow).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Myocardial thievery: the coronary-subclavian steal syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "T.J. Takach" 1 => "G.J. Reul" 2 => "D.A. Cooley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.athoracsur.2005.05.071" "Revista" => array:6 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2006" "volumen" => "81" "paginaInicial" => "386" "paginaFinal" => "392" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16368420" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Simultaneous coronary-subclavian and vertebral-subclavian steal syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S.R. Lee" 1 => "M.H. Jeong" 2 => "J.Y. Rhew" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Circ J" "fecha" => "2003" "volumen" => "67" "paginaInicial" => "464" "paginaFinal" => "466" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12736489" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000003200000005/v1_201308021350/S0870255113000760/v1_201308021350/en/main.assets" "Apartado" => array:4 [ "identificador" => "357" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Imagens em cardiologia" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003200000005/v1_201308021350/S0870255113000760/v1_201308021350/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255113000760?idApp=UINPBA00004E" ]
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2023 Novembro | 56 | 27 | 83 |
2023 Outubro | 35 | 19 | 54 |
2023 Setembro | 42 | 17 | 59 |
2023 Agosto | 42 | 22 | 64 |
2023 Julho | 45 | 9 | 54 |
2023 Junho | 44 | 15 | 59 |
2023 Maio | 62 | 24 | 86 |
2023 Abril | 42 | 8 | 50 |
2023 Maro | 38 | 15 | 53 |
2023 Fevereiro | 36 | 15 | 51 |
2023 Janeiro | 41 | 13 | 54 |
2022 Dezembro | 47 | 18 | 65 |
2022 Novembro | 54 | 28 | 82 |
2022 Outubro | 51 | 22 | 73 |
2022 Setembro | 49 | 35 | 84 |
2022 Agosto | 65 | 30 | 95 |
2022 Julho | 48 | 33 | 81 |
2022 Junho | 51 | 28 | 79 |
2022 Maio | 57 | 37 | 94 |
2022 Abril | 66 | 29 | 95 |
2022 Maro | 58 | 39 | 97 |
2022 Fevereiro | 63 | 17 | 80 |
2022 Janeiro | 49 | 25 | 74 |
2021 Dezembro | 32 | 23 | 55 |
2021 Novembro | 43 | 37 | 80 |
2021 Outubro | 107 | 37 | 144 |
2021 Setembro | 40 | 26 | 66 |
2021 Agosto | 60 | 30 | 90 |
2021 Julho | 39 | 25 | 64 |
2021 Junho | 64 | 26 | 90 |
2021 Maio | 59 | 27 | 86 |
2021 Abril | 84 | 59 | 143 |
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2021 Fevereiro | 110 | 24 | 134 |
2021 Janeiro | 54 | 15 | 69 |
2020 Dezembro | 57 | 18 | 75 |
2020 Novembro | 46 | 13 | 59 |
2020 Outubro | 56 | 18 | 74 |
2020 Setembro | 69 | 20 | 89 |
2020 Agosto | 54 | 11 | 65 |
2020 Julho | 60 | 13 | 73 |
2020 Junho | 92 | 11 | 103 |
2020 Maio | 60 | 5 | 65 |
2020 Abril | 72 | 16 | 88 |
2020 Maro | 59 | 14 | 73 |
2020 Fevereiro | 102 | 21 | 123 |
2020 Janeiro | 48 | 8 | 56 |
2019 Dezembro | 59 | 11 | 70 |
2019 Novembro | 37 | 6 | 43 |
2019 Outubro | 73 | 8 | 81 |
2019 Setembro | 32 | 12 | 44 |
2019 Agosto | 29 | 5 | 34 |
2019 Julho | 52 | 10 | 62 |
2019 Junho | 31 | 8 | 39 |
2019 Maio | 45 | 10 | 55 |
2019 Abril | 21 | 12 | 33 |
2019 Maro | 40 | 10 | 50 |
2019 Fevereiro | 52 | 17 | 69 |
2019 Janeiro | 26 | 4 | 30 |
2018 Dezembro | 37 | 18 | 55 |
2018 Novembro | 93 | 13 | 106 |
2018 Outubro | 142 | 19 | 161 |
2018 Setembro | 57 | 10 | 67 |
2018 Agosto | 58 | 12 | 70 |
2018 Julho | 46 | 11 | 57 |
2018 Junho | 62 | 9 | 71 |
2018 Maio | 74 | 13 | 87 |
2018 Abril | 47 | 11 | 58 |
2018 Maro | 74 | 11 | 85 |
2018 Fevereiro | 44 | 6 | 50 |
2018 Janeiro | 26 | 6 | 32 |
2017 Dezembro | 50 | 11 | 61 |
2017 Novembro | 35 | 7 | 42 |
2017 Outubro | 27 | 13 | 40 |
2017 Setembro | 42 | 10 | 52 |
2017 Agosto | 48 | 20 | 68 |
2017 Julho | 24 | 12 | 36 |
2017 Junho | 43 | 10 | 53 |
2017 Maio | 40 | 15 | 55 |
2017 Abril | 19 | 11 | 30 |
2017 Maro | 29 | 19 | 48 |
2017 Fevereiro | 23 | 7 | 30 |
2017 Janeiro | 25 | 5 | 30 |
2016 Dezembro | 24 | 5 | 29 |
2016 Novembro | 26 | 9 | 35 |
2016 Outubro | 41 | 13 | 54 |
2016 Setembro | 9 | 5 | 14 |
2016 Agosto | 20 | 3 | 23 |
2016 Julho | 9 | 5 | 14 |
2016 Junho | 0 | 7 | 7 |
2016 Maio | 10 | 8 | 18 |
2016 Abril | 31 | 4 | 35 |
2016 Maro | 56 | 10 | 66 |
2016 Fevereiro | 78 | 16 | 94 |
2016 Janeiro | 52 | 13 | 65 |
2015 Dezembro | 59 | 7 | 66 |
2015 Novembro | 50 | 4 | 54 |
2015 Outubro | 64 | 9 | 73 |
2015 Setembro | 81 | 10 | 91 |
2015 Agosto | 73 | 10 | 83 |
2015 Julho | 72 | 5 | 77 |
2015 Junho | 46 | 6 | 52 |
2015 Maio | 67 | 6 | 73 |
2015 Abril | 57 | 6 | 63 |
2015 Maro | 61 | 11 | 72 |
2015 Fevereiro | 66 | 8 | 74 |
2015 Janeiro | 54 | 8 | 62 |
2014 Dezembro | 70 | 12 | 82 |
2014 Novembro | 44 | 5 | 49 |
2014 Outubro | 104 | 10 | 114 |
2014 Setembro | 89 | 8 | 97 |
2014 Agosto | 98 | 8 | 106 |
2014 Julho | 107 | 11 | 118 |
2014 Junho | 104 | 4 | 108 |
2014 Maio | 115 | 14 | 129 |
2014 Abril | 105 | 5 | 110 |
2014 Maro | 133 | 11 | 144 |
2014 Fevereiro | 118 | 19 | 137 |
2014 Janeiro | 133 | 9 | 142 |
2013 Dezembro | 142 | 14 | 156 |
2013 Novembro | 115 | 17 | 132 |
2013 Outubro | 115 | 11 | 126 |
2013 Setembro | 115 | 20 | 135 |
2013 Agosto | 139 | 21 | 160 |
2013 Julho | 91 | 35 | 126 |
2013 Junho | 64 | 30 | 94 |