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Biomedical subjects

J M Caffarena

Publications and source records attributed to J M Caffarena.

At least 37 records · Page 2Linked to original sources
PubMed1980

Aorta--right atrial communication. Report of an unusual case.

An unusual aneurysmal aorta--right atrial communication was found in a 25-year-old man with a rounded mass in the right cardiophrenic angle. Differential diagnoses included ruptured aneurysm of the sinus of Valsalva, coronary arteriovenous fistula, rupture of a dissecting aneurysm of the ascending aorta into the right atrium, and pseudoaneurysm of the right coronary artery followed by formation of a fistula between the aneurysm and the right atrium. Closure of the communication was performed under cardiopulmonary bypass. Complete absence of the right superior vena cava with a large persistent left superior vena cava draining to the coronary sinus was an unexpected finding at operation. The origin of the communication is not known; possible anomalous coronary and noncoronary origins are considered.

Adult↗
PubMed1978

Aortic levopositions without ventricular inversion.

A multi-center series of aortic levoposition (aorta anterior and to the left of the pulmonary artery) without ventricular inversion is presented and analyzed from an anatomical viewpoint. All the cases are exceptions to the 'loop rule' and amount to 0.9% of the total number or cases reviewed. A combined study of our own cases and those reported in the literature is presented. There is a high incidence of anomalies (malrotations, juxtaposition of the atrial appendages, atrioventricular valve anomalies, ventricular septal defects, pulmonary outflow tract obstructions and abnormal conal types) which may be related to the primary cause of the aortic levoposition, suggesting that they may form part of a new syndrome of diagnostic and surgical importance. In some cases, absence of coronary sinus was noted without asplenia or left superior vena cava draining into the left atrium. The major coronary artery pattern in cases of antomically corrected malposition with two well-developed ventricles was similar to that seen with ventricular inversion. Most of these cases can be helped surgically provided accurate and detailed preoperative evaluation and operative assessment and treatment is carried out.

Aorta↗
PubMed1977

[The scimitar syndrome in children. Apropos of 3 cases].

The authors describe three new cases in children of abnormal right pulmonary venous drainage into the inferior vena cava, associated with sequestration of the right lower lobe and dextrocardia caused by right pulmonary hypoplasia with a scimitar sign. The term scimitar syndrome used in the literature is to some extent inaccurate as it is neither constant nor pathognomonic. The authors have reviewed 45 paediatric cases reported in the literature and compared the different clinical, diagnostic and therapeutic aspects with their patients. To their knowledge they report the first case in childhood with right lobar sequestration, which received its blood supply from an abnormal artery arising from the right internal mammary artery.

Bronchopulmonary Sequestration↗
PubMed1976

Double outlet right ventricle with L-position of the aorta, D-loop, subaortic VSD, and pulmonary stenosis.

We describe a case of double outlet right ventricle with subaortic ventricular septal defect and pulmonary stenosis treated successfully with cardiopulmonary bypass. We consider the clinical history and angiocardiographic and surgical findings of this rare anomaly. We stress the difficulties of reconstruction of the outflow tract of the right ventricle, because of the anomalous pathway of the right coronary artery, the posterior situation of the pulmonary artery, and the abnormal anatomy present in the outflow tract of the right ventricle.

Angiocardiography↗
PubMedDate not supplied

Late cardiac tamponade after open heart surgery.

Delayed cardiac tamponade after open heart surgery is relatively uncommon, but constitutes a life-threatening condition that must be diagnosed and managed promptly. We report 21 patients who developed cardiac tamponade 5 to 53 days after open heart operations. Possible etiological factors included anticoagulant therapy (19 patients), excessive mediastinal drainage in the postoperative period (10 patients), postpericardiotomy syndrome (4 patients), and coagulation disorders (1 patient). The clinical presentation was insidious and the diagnosis was often difficult to establish at the outset. A high index of clinical suspicion and echocardiography were the most reliable means to reach an early diagnosis. Twenty patients in whom delayed tamponade was suspected were operated and all of them survived. In one patient tamponade was not diagnosed antemortem and he died; on autopsy left heart compression by a large loculated clot was found. Decompression of the pericardial space can be accomplished by pericardiocentesis or by surgical means (subxiphoid pericardiotomy, median sternotomy, or thoracotomy). Although pericardiocentesis alone may be effective, mainly when the postpericardiotomy syndrome is the suspected etiology, we recommend open procedures since the presence of blood clots and adhesions has been a frequent finding.

Acenocoumarol↗