array:24 [
  "pii" => "S0870255117301518"
  "issn" => "08702551"
  "doi" => "10.1016/j.repc.2016.04.019"
  "estado" => "S300"
  "fechaPublicacion" => "2017-04-01"
  "aid" => "975"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2017"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "sco"
  "cita" => "Rev Port Cardiol. 2017;36:319-20"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2338
    "formatos" => array:3 [
      "EPUB" => 155
      "HTML" => 1750
      "PDF" => 433
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S0870255116303018"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2016.04.013"
    "estado" => "S300"
    "fechaPublicacion" => "2017-04-01"
    "aid" => "911"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "sco"
    "cita" => "Rev Port Cardiol. 2017;36:321-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 7459
      "formatos" => array:3 [
        "EPUB" => 216
        "HTML" => 6626
        "PDF" => 617
      ]
    ]
    "pt" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Imagem em Cardiologia</span>"
      "titulo" => "M&#227;os quentes&#8230; p&#233;s frios&#8230;"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "321"
          "paginaFinal" => "322"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Warm hands but cold feet"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 623
              "Ancho" => 1251
              "Tamanyo" => 76231
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Coronariografia direita&#58; &#40;A&#41; oclus&#227;o do segmento m&#233;dio da art&#233;ria coron&#225;ria direita&#59; &#40;B&#41; reperfus&#227;o ap&#243;s aspira&#231;&#227;o de trombo&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Carina Arantes, Jorge Marques, S&#237;lvia Ribeiro, Catarina Quina&#8208;Rodrigues, Gl&#243;ria Abreu, S&#233;rgia Rocha"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Carina"
              "apellidos" => "Arantes"
            ]
            1 => array:2 [
              "nombre" => "Jorge"
              "apellidos" => "Marques"
            ]
            2 => array:2 [
              "nombre" => "S&#237;lvia"
              "apellidos" => "Ribeiro"
            ]
            3 => array:2 [
              "nombre" => "Catarina"
              "apellidos" => "Quina&#8208;Rodrigues"
            ]
            4 => array:2 [
              "nombre" => "Gl&#243;ria"
              "apellidos" => "Abreu"
            ]
            5 => array:2 [
              "nombre" => "S&#233;rgia"
              "apellidos" => "Rocha"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2174204917300533"
        "doi" => "10.1016/j.repce.2016.04.009"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917300533?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116303018?idApp=UINPBA00004E"
    "url" => "/08702551/0000003600000004/v1_201704060057/S0870255116303018/v1_201704060057/pt/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S087025511730152X"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2016.07.014"
    "estado" => "S300"
    "fechaPublicacion" => "2017-04-01"
    "aid" => "976"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "sco"
    "cita" => "Rev Port Cardiol. 2017;36:317-8"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2167
      "formatos" => array:3 [
        "EPUB" => 183
        "HTML" => 1508
        "PDF" => 476
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>"
      "titulo" => "Fever in an elderly patient unmasks Brugada syndrome"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "317"
          "paginaFinal" => "318"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Febre num idoso desmascara s&#237;ndrome de Brugada"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "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" => 667
              "Ancho" => 2252
              "Tamanyo" => 181135
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Electrocardiogram at admission showing coved ST-segment elevation in V1 and V2 followed by a negative T wave&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Sofia L&#225;zaro Mendes, Lu&#237;s Elvas, Domingos Ramos, Mariano P&#234;go"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Sofia L&#225;zaro"
              "apellidos" => "Mendes"
            ]
            1 => array:2 [
              "nombre" => "Lu&#237;s"
              "apellidos" => "Elvas"
            ]
            2 => array:2 [
              "nombre" => "Domingos"
              "apellidos" => "Ramos"
            ]
            3 => array:2 [
              "nombre" => "Mariano"
              "apellidos" => "P&#234;go"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511730152X?idApp=UINPBA00004E"
    "url" => "/08702551/0000003600000004/v1_201704060057/S087025511730152X/v1_201704060057/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>"
    "titulo" => "Left-sided endocarditis extending to the right chambers&#58; Usefulness of three-dimensional echocardiography in preoperative assessment"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "319"
        "paginaFinal" => "320"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Zorba Bl&#225;zquez Bermejo, Teresa L&#243;pez Fern&#225;ndez, Ulises Ram&#237;rez Valdiris, Juan Caro Cod&#243;n, In&#233;s Ponz de Antonio, Sandra Rosillo Rodr&#237;guez, Jos&#233; Mar&#237;a Mesa Garc&#237;a, Mar Moreno Yang&#252;ela"
        "autores" => array:8 [
          0 => array:4 [
            "nombre" => "Zorba"
            "apellidos" => "Bl&#225;zquez Bermejo"
            "email" => array:1 [
              0 => "zorbablbe&#64;gmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Teresa"
            "apellidos" => "L&#243;pez Fern&#225;ndez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Ulises"
            "apellidos" => "Ram&#237;rez Valdiris"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Juan"
            "apellidos" => "Caro Cod&#243;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "In&#233;s"
            "apellidos" => "Ponz de Antonio"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Sandra"
            "apellidos" => "Rosillo Rodr&#237;guez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Jos&#233; Mar&#237;a"
            "apellidos" => "Mesa Garc&#237;a"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Mar"
            "apellidos" => "Moreno Yang&#252;ela"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Cardiology Department&#44; Hospital Universitario La Paz&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Cardiac Surgery Deparment&#44; Hospital Universitario La Paz&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Endocardite esquerda com extens&#227;o direita&#58; utilidade da ecocardiografia tridimensional na avalia&#231;&#227;o pr&#233;-operat&#243;ria"
      ]
    ]
    "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" => 1417
            "Ancho" => 1882
            "Tamanyo" => 191954
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transesophageal echocardiography in mid-esophageal view&#58; &#40;A&#41; two-dimensional transesophageal echocardiography &#40;2D-TEE&#41; showing a cavity between the aortic prosthesis and the right atrium RA corresponding to a PA&#44; which communicates with the RA &#40;blue arrow&#41; and with the RV through the base of the TSL &#40;yellow arrow&#41;&#59; &#40;B&#41; three-dimensional transesophageal echocardiography &#40;3D-TEE&#41;&#44; showing the PA from the RA in the middle of the image&#44; the aortic prosthesis on the left&#44; the superior vena cava on the right&#44; the interatrial septum at the top and the TSL at the bottom&#59; &#40;C&#41; 2D-TEE showing turbulent flow from the PA to the RA and to the RV&#59; &#40;D&#41; 3D-TEE image showing the same defects in more detail&#46; PA&#58; pseudoaneurysm&#59; RA&#58; right atrium&#59; RV&#58; right ventricle&#59; TSL&#58; tricuspid septal leaflet&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0195" class="elsevierStylePara elsevierViewall">A 35-year-old man was admitted to our hospital because of dyspnea&#46; He had undergone surgery two months before&#44; in another hospital&#44; for replacement of the aortic and mitral valves with mechanical prostheses due to infective endocarditis&#46; No signs of active infection were found&#46; A IV&#47;VI holosystolic murmur was detected at the left sternal border&#46; On transthoracic echocardiography&#44; turbulent flow was observed in the anterior area of the aortic root &#40;AR&#41;&#46; Three-dimensional transesophageal echocardiography &#40;3D-TEE&#41; showed a pseudoaneurysm &#40;PA&#41; in the anterior area of the aortic annulus extending to the right atrium &#40;RA&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A and B&#44; <a class="elsevierStyleCrossRef" href="#sec0020">Video 1</a>&#41;&#46; Turbulent flow was detected from the PA to the RA &#40;blue arrow&#41; and to the right ventricle &#40;RV&#41; &#40;yellow arrow&#41;&#44; the latter through the base of the tricuspid septal leaflet &#40;TSL&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>C and D&#44; white star&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0200" class="elsevierStylePara elsevierViewall">In the operating room&#44; a small defect was seen in the anterior area of the aortic annulus &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>A&#41;&#46; After the RA was opened&#44; a PA communicating with the RA through the perimembranous septum was found &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>B and C&#41;&#46; The PA was opened and another defect was seen communicating with the RV through the base of the TSL &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>D&#41;&#46; Both defects were repaired with bovine pericardial patches&#44; the TSL was reconstructed and a new mechanical aortic prosthesis was implanted&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0205" class="elsevierStylePara elsevierViewall">In complex cases of endocarditis&#44; 3D-TEE provides an accurate picture of the anatomical defects&#44; which enables optimal planning of the surgical strategy&#46;</p><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0215" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0220" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0225" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0190" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:3 [
          "identificador" => "sec0085"
          "titulo" => "Ethical disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0090"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0095"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0100"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "Conflicts of interest"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-04-05"
    "fechaAceptado" => "2016-04-14"
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0210" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0025"
          ]
        ]
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1417
            "Ancho" => 1882
            "Tamanyo" => 191954
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transesophageal echocardiography in mid-esophageal view&#58; &#40;A&#41; two-dimensional transesophageal echocardiography &#40;2D-TEE&#41; showing a cavity between the aortic prosthesis and the right atrium RA corresponding to a PA&#44; which communicates with the RA &#40;blue arrow&#41; and with the RV through the base of the TSL &#40;yellow arrow&#41;&#59; &#40;B&#41; three-dimensional transesophageal echocardiography &#40;3D-TEE&#41;&#44; showing the PA from the RA in the middle of the image&#44; the aortic prosthesis on the left&#44; the superior vena cava on the right&#44; the interatrial septum at the top and the TSL at the bottom&#59; &#40;C&#41; 2D-TEE showing turbulent flow from the PA to the RA and to the RV&#59; &#40;D&#41; 3D-TEE image showing the same defects in more detail&#46; PA&#58; pseudoaneurysm&#59; RA&#58; right atrium&#59; RV&#58; right ventricle&#59; TSL&#58; tricuspid septal leaflet&#46;</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" => 1417
            "Ancho" => 1968
            "Tamanyo" => 406107
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Surgical photographs&#58; &#40;A&#41; a small defect in the anterior area of the aortic annulus&#59; &#40;B&#41; the PA with a previous pericardial patch after the RA was opened&#59; &#40;C&#41; a defect communicating with the perimembranous septum &#40;blue arrow&#41;&#59; &#40;D&#41; the PA after being opened with a defect communicating with the RV &#40;yellow arrow&#41; through the base of the TSL &#40;white star&#41;&#46; PA&#58; pseudoaneurysm&#59; RA&#58; right atrium&#59; RV&#58; right ventricle&#59; TSL&#58; tricuspid septal leaflet&#46;</p>"
        ]
      ]
      2 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:3 [
          "fichero" => "mmc1.mp4"
          "ficheroTamanyo" => 288673
          "Video" => array:2 [
            "mp4" => array:2 [
              "fichero" => "mmc1.m4v"
              "poster" => "mmc1.jpg"
            ]
            "flv" => array:5 [
              "fichero" => "mmc1.flv"
              "poster" => "mmc1.jpg"
              "tiempo" => 0
              "alto" => 0
              "ancho" => 0
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/08702551/0000003600000004/v1_201704060057/S0870255117301518/v1_201704060057/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "29264"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Imagens em Cardiologia"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003600000004/v1_201704060057/S0870255117301518/v1_201704060057/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117301518?idApp=UINPBA00004E"
]
Partilhar
Informação da revista
Vol. 36. Núm. 4.
Páginas 319-320 (abril 2017)
Partilhar
Partilhar
Baixar PDF
Mais opções do artigo
Vol. 36. Núm. 4.
Páginas 319-320 (abril 2017)
Image in Cardiology
Open Access
Left-sided endocarditis extending to the right chambers: Usefulness of three-dimensional echocardiography in preoperative assessment
Endocardite esquerda com extensão direita: utilidade da ecocardiografia tridimensional na avaliação pré-operatória
Visitas
5248
Zorba Blázquez Bermejoa,
Autor para correspondência
zorbablbe@gmail.com

Corresponding author.
, Teresa López Fernándeza, Ulises Ramírez Valdirisb, Juan Caro Codóna, Inés Ponz de Antonioa, Sandra Rosillo Rodrígueza, José María Mesa Garcíab, Mar Moreno Yangüelaa
a Cardiology Department, Hospital Universitario La Paz, Madrid, Spain
b Cardiac Surgery Deparment, Hospital Universitario La Paz, Madrid, Spain
Este item recebeu

Under a Creative Commons license
Informação do artigo
Texto Completo
Baixar PDF
Estatísticas
Figuras (2)
Material adicional (1)
Texto Completo

A 35-year-old man was admitted to our hospital because of dyspnea. He had undergone surgery two months before, in another hospital, for replacement of the aortic and mitral valves with mechanical prostheses due to infective endocarditis. No signs of active infection were found. A IV/VI holosystolic murmur was detected at the left sternal border. On transthoracic echocardiography, turbulent flow was observed in the anterior area of the aortic root (AR). Three-dimensional transesophageal echocardiography (3D-TEE) showed a pseudoaneurysm (PA) in the anterior area of the aortic annulus extending to the right atrium (RA) (Figure 1A and B, Video 1). Turbulent flow was detected from the PA to the RA (blue arrow) and to the right ventricle (RV) (yellow arrow), the latter through the base of the tricuspid septal leaflet (TSL) (Figure 1C and D, white star).

Figure 1.

Transesophageal echocardiography in mid-esophageal view: (A) two-dimensional transesophageal echocardiography (2D-TEE) showing a cavity between the aortic prosthesis and the right atrium RA corresponding to a PA, which communicates with the RA (blue arrow) and with the RV through the base of the TSL (yellow arrow); (B) three-dimensional transesophageal echocardiography (3D-TEE), showing the PA from the RA in the middle of the image, the aortic prosthesis on the left, the superior vena cava on the right, the interatrial septum at the top and the TSL at the bottom; (C) 2D-TEE showing turbulent flow from the PA to the RA and to the RV; (D) 3D-TEE image showing the same defects in more detail. PA: pseudoaneurysm; RA: right atrium; RV: right ventricle; TSL: tricuspid septal leaflet.

(0.18MB).

In the operating room, a small defect was seen in the anterior area of the aortic annulus (Figure 2A). After the RA was opened, a PA communicating with the RA through the perimembranous septum was found (Figure 2B and C). The PA was opened and another defect was seen communicating with the RV through the base of the TSL (Figure 2D). Both defects were repaired with bovine pericardial patches, the TSL was reconstructed and a new mechanical aortic prosthesis was implanted.

Figure 2.

Surgical photographs: (A) a small defect in the anterior area of the aortic annulus; (B) the PA with a previous pericardial patch after the RA was opened; (C) a defect communicating with the perimembranous septum (blue arrow); (D) the PA after being opened with a defect communicating with the RV (yellow arrow) through the base of the TSL (white star). PA: pseudoaneurysm; RA: right atrium; RV: right ventricle; TSL: tricuspid septal leaflet.

(0.39MB).

In complex cases of endocarditis, 3D-TEE provides an accurate picture of the anatomical defects, which enables optimal planning of the surgical strategy.

Ethical disclosuresProtection of human and animal subjects

The authors declare that no experiments were performed on humans or animals for this study.

Confidentiality of data

The authors declare that no patient data appear in this article.

Right to privacy and informed consent

The authors declare that no patient data appear in this article.

Conflicts of interest

The authors have no conflicts of interest to declare.

Copyright © 2017. Sociedade Portuguesa de Cardiologia
Baixar PDF
Idiomas
Revista Portuguesa de Cardiologia
Opções de artigo
Ferramentas
Material Suplementar
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

Ao assinalar que é «Profissional de Saúde», declara conhecer e aceitar que a responsável pelo tratamento dos dados pessoais dos utilizadores da página de internet da Revista Portuguesa de Cardiologia (RPC), é esta entidade, com sede no Campo Grande, n.º 28, 13.º, 1700-093 Lisboa, com os telefones 217 970 685 e 217 817 630, fax 217 931 095 e com o endereço de correio eletrónico revista@spc.pt. Declaro para todos os fins, que assumo inteira responsabilidade pela veracidade e exatidão da afirmação aqui fornecida.