Biomedical subjects
A Graça
Publications and source records attributed to A Graça.
Cardiac papillary fibroelastoma of a mitral valve chordae revealed by stroke.
We report the case of a young male patient referred to our hospital after having a stroke due to a papillary fibroelastoma arising from a mitral valve chorda. The tumor was identified by two-dimensional echocardiography and was treated by surgery with preservation of valve integrity. Cardiac papillary fibroelastoma as an uncommon source of cerebral emboli is discussed.
Impact of season and discharge weight on complications and growth of Kangaroo Mother Care treated low birthweight infants in Mozambique.
This study aimed to determine the impact of season and weight at discharge on growth rate and complications in low birthweight infants treated with Kangaroo Mother Care (KMC) in Maputo, Mozambique. The study population included 246 infants of birthweight < 2000 g. Follow-up until 2400 g was obtained in 64%. There were no seasonal differences in weight gain and the risk of complications of infants treated with KMC in hospital. During the cold season after discharge, the risk of serious complications, including death, was higher (risk ratio 1.96; p = 0.02) and more readmissions occurred (risk ratio 2.77; p = 0.04). We postulate that after discharge mothers are unable to comply with the kangaroo position at all hours of the day and that exposure to low ambient temperatures may explain the more frequent occurrence of complications in the cold season. The weight at discharge did not affect complications or growth rate. We conclude that the current policy to discharge infants when having gained weight on 3 consecutive days, regardless of the actual weight, or whether the weight at birth has been regained, is adequate. In the cold season particularly, more efforts may be needed to ensure compliance with kangaroo position after discharge and to educate mothers on early signs of complications such as bronchopneumonia to encourage timely care seeking. With this method, low birthweight infants can grow adequately.
[Valve replacement with Macchi prosthesis].
OBJECTIVE: to evaluate the performance of a new ball valve prosthesis. DESIGN: set up of two groups of patients who underwent mitral valve replacement with two different prosthesis: the Macchi prosthesis under evaluation and the well known Starr-Edwards model prosthesis. The chi-square test was used to compare the results. PATIENTS: Patients referred for valvular surgery. INTERVENTIONS: One group of 98 consecutive patients who underwent isolated mitral valve replacement with a Macchi prosthesis from January 1984 to June 30 1986 was compared to a matched group of 49 patients who received a Starr-Edwards prosthesis in the same period of time. Follow-up data were available from 99% patients in the Macchi group 96% in the Starr-Edwards group, with a mean follow-up time of 35.2 (2-57) and 42.9 (4-62) months, respectively. RESULTS: There was no statistical difference in the incidence per 100 patients--month of prosthetic complications--thromboembolism, hemorrhagic events, prosthetic endocarditis, reoperation and mechanical failure. CONCLUSIONS: In our experience and with the available follow-up data the Macchi prosthesis is a good cost effective option when there is indication for a ball valve prosthesis.
[Pseudoaneurysm of the outflow chamber of the left ventricle as a complication of bacterial endocarditis of the aortic valve -- a clinical case].
After reporting a clinical case of a patient with a Staphylococcus Aureus Acute Endocarditis involving the aortic valve being complicated with cardiac failure irresponsive to medical treatment, which required a surgical procedure, the authors describe the preoperative echocardiography features. These features have the particularity of identifying a pseudoaneurysm rising in the outflow tract of the left ventricle, that involves the annulus and the anterior mitral leaflet, opening into the left atrium. They also take the opportunity to review the main local complications of Infective Endocarditis, affecting native or prosthetic valves, and make some comments on the diagnostic echocardiographic possibilities.
[Results of mitral substitution surgery using the Ionescu-Shilley bioprosthesis (1979-1986)].
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