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Aortic arch aneurysm associated with an acute aortopulmonary fistula is rare and usually diagnosis is made during the postmortem. Few reports of successful surgical management have been reported and a high mortality rate remains. The authors report on a 78-year-old male patient with an acute aortic arch aneurysm communicating with the main pulmonary artery suffering from cardiac chest pain, hemodynamic instability and lung congestion. The patient underwent surgery to replace the distal ascending aorta, transverse aortic arch and proximal descending aorta as well as fistula closure. The operation was successful.

RBCCV 44205-784Espasmo coronário no pós-operatório de cirurgia de revascularização do miocárdio: relato de caso e revisão concisa da literatura Coronary spasms after coronary artery bypass surgery: a case report and concise review of the literature Abstract:Coronary artery spasms may occur as a serious complication during trans-operative and immediate postoperative periods of coronary artery bypass surgery (CABS). The small number of cases reported is responsible for making it difficult not only to choose an adequate treatment but also to determine risk factors that might be responsible for its incidence. Coronary artery spasms have a multifactorial character, sudden appearance and must be part of the differential diagnosis of acute myocardial infarction and low output syndrome among patients submitted to heart surgery. We describe a case of a patient submitted to CABS with extracorporeal circulation who presented electrocardiographic alterations suggesting acute myocardial infarction during the immediate postoperative period but was diagnosed as having coronary artery spasms shown by a coronary catheterism performed afterwards. The patient was treated successfully with intracoronary vasodilators with good evolution over short and medium terms. SOBRAL, MLP ET AL -Coronary spasms after coronary artery bypass surgery: a case report and concise review of the literature Braz J Cardiovasc Surg 2005; 20(4): 441-444

No abstract

RBCCV 44205-784Espasmo coronário no pós-operatório de cirurgia de revascularização do miocárdio: relato de caso e revisão concisa da literatura Coronary spasms after coronary artery bypass surgery: a case report and concise review of the literature Abstract:Coronary artery spasms may occur as a serious complication during trans-operative and immediate postoperative periods of coronary artery bypass surgery (CABS). The small number of cases reported is responsible for making it difficult not only to choose an adequate treatment but also to determine risk factors that might be responsible for its incidence. Coronary artery spasms have a multifactorial character, sudden appearance and must be part of the differential diagnosis of acute myocardial infarction and low output syndrome among patients submitted to heart surgery. We describe a case of a patient submitted to CABS with extracorporeal circulation who presented electrocardiographic alterations suggesting acute myocardial infarction during the immediate postoperative period but was diagnosed as having coronary artery spasms shown by a coronary catheterism performed afterwards. The patient was treated successfully with intracoronary vasodilators with good evolution over short and medium terms. 442SOBRAL, MLP ET AL -Coronary spasms after coronary artery bypass surgery: a case report and concise review of the literature Braz J Cardiovasc Surg 2005; 20(4): 441-444