Interrupção do Arco Aórtico: Tratamento Cirúrgico no Adulto em um Centro de Referência de Cardiopatia

A interrupção do arco aórtico (IAA) é uma condição extremamente rara, caracterizada pela interrupção luminal segmentar ou focal. O diagnóstico pormenorizado é realizado por angiotomografia computadorizada (AngioTC) ou ressonância nuclear magnética (RNM) e o tratamento e eminentemente cirúrgico. Entre 2013 e início de 2019, 4 pacientes adultos foram submetidos à cirurgia para tratamento de IAA tipo A no Hospital Santa Izabel (HSI) através da interposição cirúrgica de enxerto por via extra-anatômica, entre a aorta torácica ascendente e descendente, por via mediana. A mediana de permanência dos pacientes na Unidade de Terapia Intensiva (UTI) foi de 3 dias, hospitalar de 7 dias, tempo de acompanhamento médio de 31,2 meses ± 25,3, não havendo nenhuma complicação hemodinâmica, infecciosa ou óbito. Em comparação com outros centros de referência, como o Texas Heart Institute (USA), a técnica de tratamento cirúrgica aplicada no HSI demonstrou-se segura, sem mortalidade e com resultados a médio prazo adequados e compatíveis com a literatura.

A Historical Perspective on the Development of Mechanical Circulatory Support Devices

With any historical account, the perspective varies, depending on which part of the historical context the author participated in. The same can be said for the history of the development of mechanical circulatory support devices. This chapter is documented through the eyes of one of the few surgeons who has been an active participant from the beginning, based on more than 50 years of personal experience in both experimental and clinical work in Houston, Texas, at the Baylor College of Medicine and the Texas Heart Institute. There are many facets to this worldwide race, which spans more than a half century, to replace the anatomical structure itself, or at least the physiological function of this anatomical organ that defines life from death.

Rebel Heart

This article discusses features and advantages of BiVACOR, an artificial heart machine. It also presents a brief overview of medical successes of Billy Cohn, a medical doctor. The BiVACOR heart is a rotary pump with a single moving part that consists of two impellers on a magnetically suspended rotor. Cohn along with his older brother built homemade gadgets, rocket engines, and a variety of incendiary devices in the garage. As Cohn progressed in his medical career, he never stopped tinkering. He was fast becoming one of the finest heart surgeons in the country, yet he spent his free time in his home workshop, prototyping medical devices to assist his operations. Cohn and O.H. ‘Bud’ Frazier, a cardiac surgeon who had performed more than 1000 heart transplants, led the work on AbioCor from the Texas Heart Institute in Houston and worked on a completely novel approach to artificial heart design—continuous flow. The heart, built by the two surgeons, is set out to build would replace those metaphorical flappy wings with fixed ones.