Transesophageal Echocardiogram as a Diagnostic Tool for Cardioembolic Cerebrovascular Event Secondary to Thrombus into Valsalva Sinus Aneurysm
Se presenta el caso de una paciente femenina de 54 años de edad remitida para la realización de un ecocardiograma transesofágico por sospecharse evento cerebrovascular cardioembólico secundario a fibrilación auricular, en el estudio se documentó una masa de aspecto quístico en aspecto posterior de l...
- Autores:
- Tipo de recurso:
- Fecha de publicación:
- 2018
- Institución:
- Universidad del Rosario
- Repositorio:
- Repositorio EdocUR - U. Rosario
- Idioma:
- spa
- OAI Identifier:
- oai:repository.urosario.edu.co:10336/18224
- Acceso en línea:
- https://doi.org/10.48713/10336_18224
http://repository.urosario.edu.co/handle/10336/18224
- Palabra clave:
- Aneurisma de senos de Valsalva
Stroke
Trombos
Ginecología & otras especialidades médicas
Stroke
Thrombus
Valsalva sinus aneurysm
Enfermedades de la mama
Seno aórtico
- Rights
- License
- Atribución-NoComercial-SinDerivadas 2.5 Colombia
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| dc.title.spa.fl_str_mv |
Transesophageal Echocardiogram as a Diagnostic Tool for Cardioembolic Cerebrovascular Event Secondary to Thrombus into Valsalva Sinus Aneurysm |
| title |
Transesophageal Echocardiogram as a Diagnostic Tool for Cardioembolic Cerebrovascular Event Secondary to Thrombus into Valsalva Sinus Aneurysm |
| spellingShingle |
Transesophageal Echocardiogram as a Diagnostic Tool for Cardioembolic Cerebrovascular Event Secondary to Thrombus into Valsalva Sinus Aneurysm Aneurisma de senos de Valsalva Stroke Trombos Ginecología & otras especialidades médicas Stroke Thrombus Valsalva sinus aneurysm Enfermedades de la mama Seno aórtico |
| title_short |
Transesophageal Echocardiogram as a Diagnostic Tool for Cardioembolic Cerebrovascular Event Secondary to Thrombus into Valsalva Sinus Aneurysm |
| title_full |
Transesophageal Echocardiogram as a Diagnostic Tool for Cardioembolic Cerebrovascular Event Secondary to Thrombus into Valsalva Sinus Aneurysm |
| title_fullStr |
Transesophageal Echocardiogram as a Diagnostic Tool for Cardioembolic Cerebrovascular Event Secondary to Thrombus into Valsalva Sinus Aneurysm |
| title_full_unstemmed |
Transesophageal Echocardiogram as a Diagnostic Tool for Cardioembolic Cerebrovascular Event Secondary to Thrombus into Valsalva Sinus Aneurysm |
| title_sort |
Transesophageal Echocardiogram as a Diagnostic Tool for Cardioembolic Cerebrovascular Event Secondary to Thrombus into Valsalva Sinus Aneurysm |
| dc.contributor.advisor.none.fl_str_mv |
Rodríguez, Jaime |
| dc.subject.spa.fl_str_mv |
Aneurisma de senos de Valsalva Stroke Trombos |
| topic |
Aneurisma de senos de Valsalva Stroke Trombos Ginecología & otras especialidades médicas Stroke Thrombus Valsalva sinus aneurysm Enfermedades de la mama Seno aórtico |
| dc.subject.ddc.none.fl_str_mv |
Ginecología & otras especialidades médicas |
| dc.subject.keyword.eng.fl_str_mv |
Stroke Thrombus Valsalva sinus aneurysm |
| dc.subject.lemb.spa.fl_str_mv |
Enfermedades de la mama Seno aórtico |
| description |
Se presenta el caso de una paciente femenina de 54 años de edad remitida para la realización de un ecocardiograma transesofágico por sospecharse evento cerebrovascular cardioembólico secundario a fibrilación auricular, en el estudio se documentó una masa de aspecto quístico en aspecto posterior de la raíz aórtica, trabeculada, con flujo dinámico y la presencia de trombos en su interior además esclerosis valvular aórtica con insuficiencia leve sin estenosis, válvula mitral engrosada con aspecto reumático con insuficiencia leve, hipertrofia concéntrica severa del ventrículo izquierdo con hipoquinesia leve generalizada FEVI 48% y derrame pericárdico circunferencial de aprox. 80 ml sin repercusión hemodinámica, no trombos en auriculilla izquierda, se consideró aneurisma de seno de Valvalva, la paciente fue llevada a corrección quirúrgica en donde se confirma hallazgo de seno de Valsalva con flujo a través de un orificio de la comisura hacia seno de Valsalva derecho sin comunicación con la aurícula derecha, 12 días posterior a la cirugía la paciente es egresada sin complicaciones cardiovasculares para continuar con rehabilitación por secuelas del evento cerebro vascular. El aneurisma de senos de Valsalva es un hallazgo raro encontrándose entre el 0.14- 0.35% de pacientes sometidos a cirugía cardíaca con una prevalencia en la población de 0.09%. La presentación clínica puede ser desde asintomática a causar disnea, dolor torácico, simular infarto del miocardio o incluso endocarditis. La corrección quirúrgica cuando se presenta el aneurisma sin otras comorbilidades es baja con sobrevida de 94% en 10 años. |
| publishDate |
2018 |
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2018-07-23T20:19:22Z |
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2018-07-23T20:19:22Z |
| dc.date.created.none.fl_str_mv |
2018-07-17 |
| dc.date.issued.none.fl_str_mv |
2018 |
| dc.type.eng.fl_str_mv |
bachelorThesis |
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http://purl.org/coar/resource_type/c_7a1f |
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Reporte de caso |
| dc.type.spa.spa.fl_str_mv |
Trabajo de grado |
| dc.identifier.doi.none.fl_str_mv |
https://doi.org/10.48713/10336_18224 |
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http://repository.urosario.edu.co/handle/10336/18224 |
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https://doi.org/10.48713/10336_18224 http://repository.urosario.edu.co/handle/10336/18224 |
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spa |
| language |
spa |
| dc.rights.spa.fl_str_mv |
Atribución-NoComercial-SinDerivadas 2.5 Colombia |
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http://purl.org/coar/access_right/c_abf2 |
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Abierto (Texto Completo) |
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http://creativecommons.org/licenses/by-nc-nd/2.5/co/ |
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Atribución-NoComercial-SinDerivadas 2.5 Colombia Abierto (Texto Completo) http://creativecommons.org/licenses/by-nc-nd/2.5/co/ http://purl.org/coar/access_right/c_abf2 |
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application/pdf |
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Universidad del Rosario |
| dc.publisher.department.spa.fl_str_mv |
Facultad de medicina |
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Especialización en Ecocardiografía |
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Universidad del Rosario |
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Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, et al. (2013) An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 44: 2064-2089 Easton JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, et al. (2009) Definition and evaluation of transient ischemic attack: A scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardio. Stroke 40: 2276-2293. Organization WH (2016) World health statistics 2016: Monitoring health for the SDGs Sustainable Development Goals: World Health Organization. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, et al. (2016) Heart disease and stroke statistics-2016 Update: A report from the American Heart Association. Circulation 133: e38-360. National Institute of Health ONdS. (2015) Fifth ONS Report: Burden of disease due to chronic noncommunicable diseases and disability in Colombia. Bogotá: National Printing of Colombia. Adams HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, et al. (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST Trial of Org 10172 in Acute Stroke Treatment. Stroke 24: 35-41. Saric M, Armour AC, Arnaout MS, Chaudhry FA, Grimm RA, et al. (2016) Guidelines for the use of echocardiography in the evaluation of a cardiac source of embolism. J Am Soc Echocardiogr 29: 1-29. Wolf PA, Abbott RD, Kannel WB (1991) Atrial fibrillation as an independent risk factor for stroke: The Framingham study. Stroke 22: 983-988. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, et al. (2016) 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 37: 2893-2962. Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, et al. (2014) Worldwide epidemiology of atrial fibrillation: A global burden of disease 2010 Study. Circulation 129: 837-847. Sarıkaya S, Adademir T, Elibol A, Büyükbayrak F, Onk A, et al. (2012) Surgery for ruptured sinus of Valsalva aneurysm: 25-year experience with 55 patients. Eur J Cardiothorac Surg 43: 591. Moustafa S, Mookadam F, Cooper L, Adam G, Zehr K, et al. (2007) Sinus of Valsalva aneurysms: 47 years of a single center experience and systematic overview of published reports. Am J Cardiol 99: 1159-1164. Feldman DN, Roman MJ (2006) Aneurysms of the sinuses of Valsalva. Cardiology 106: 73-81. Smith WA (1914) Aneurysm of the sinus of valsalva: With report of two cases. J Am Med Assoc 32: 1878-1880. Venning GR (1951) Aneurysms of the sinuses of Valsalva. Am Heart J 42: 57-69. Batiste C, Banzal RC, Razzouk AJ (2004) Echocardiographic features of an unruptured mycotic aneurysm of the right aortic sinus of Valsalva. J Am Soc Echocardiogr 17: 474-477. Greiss I, Ugolini P, Joyal M, Bouchard D, Mercier LA (2004) Ruptured aneurysm of the left sinus of valsalva discovered 41 years after a decelerational injury. J Am Soc Echocardiogr 17: 906-909. Weinreich M, Yu PJ, Trost B (2015) Sinus of Valsalva Aneurysms: Review of the literature and an update on management. Clin Cardiol 38: 185-189. Bricker AO, Avutu B, Mohammed THL, Williamson EE, Syed IS, et al. (2010) Valsalva sinus aneurysms: Findings at CT and MR imaging. Radiographics 30: 99-110. Hoda M, Verma A, Alapati S, Alapati S, Yarrabolu TR (2017) Diagnostic paradox: Ruptured aneurysm of sinus of Valsalva simulating tricuspid valve endocarditis. Echocardiography 34: 465-467. Herrador JA, Aragon V, Fernandez JC (2017) Thrombosis of a valsalva sinus aneurysm causing AMI. Rev Esp Cardiol 71: 1-44. Yan F, Huo Q, Qiao J, Murat V, Ma S (2008) Surgery for sinus of valsalva aneurysm: 27-year experience with 100 patients. Asian Cardiovasc Thorac Ann 16: 361-365. Vural KM, Şener E, Taşdemir O, Bayazıt K (2001) Approach to sinus of valsalva aneurysms: A review of 53 cases. Eur J Cardiothorac Surg 20: 71– 76. |
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Rodríguez, Jaimee94c3db9-4fef-43b5-aca1-d1f75dc6a8c4600Somoza, César FernandoZuluaga, José FernandoRodriguez, JaimeEspecialista en Ecocardiografíad6448288-1e9d-41aa-86c6-b3ce519e731160021ab0026-4481-4415-9053-b740d09a1cf0600dace17b3-1130-4b9a-b8f4-14b1c77eadf26002018-07-23T20:19:22Z2018-07-23T20:19:22Z2018-07-172018Se presenta el caso de una paciente femenina de 54 años de edad remitida para la realización de un ecocardiograma transesofágico por sospecharse evento cerebrovascular cardioembólico secundario a fibrilación auricular, en el estudio se documentó una masa de aspecto quístico en aspecto posterior de la raíz aórtica, trabeculada, con flujo dinámico y la presencia de trombos en su interior además esclerosis valvular aórtica con insuficiencia leve sin estenosis, válvula mitral engrosada con aspecto reumático con insuficiencia leve, hipertrofia concéntrica severa del ventrículo izquierdo con hipoquinesia leve generalizada FEVI 48% y derrame pericárdico circunferencial de aprox. 80 ml sin repercusión hemodinámica, no trombos en auriculilla izquierda, se consideró aneurisma de seno de Valvalva, la paciente fue llevada a corrección quirúrgica en donde se confirma hallazgo de seno de Valsalva con flujo a través de un orificio de la comisura hacia seno de Valsalva derecho sin comunicación con la aurícula derecha, 12 días posterior a la cirugía la paciente es egresada sin complicaciones cardiovasculares para continuar con rehabilitación por secuelas del evento cerebro vascular. El aneurisma de senos de Valsalva es un hallazgo raro encontrándose entre el 0.14- 0.35% de pacientes sometidos a cirugía cardíaca con una prevalencia en la población de 0.09%. La presentación clínica puede ser desde asintomática a causar disnea, dolor torácico, simular infarto del miocardio o incluso endocarditis. La corrección quirúrgica cuando se presenta el aneurisma sin otras comorbilidades es baja con sobrevida de 94% en 10 años.Transesophageal echocardiogram as a diagnostic tool for cardioembolic cerebrovascular event secondary to thrombus into Valsalva sinus aneurysm. This is a case report of a 54-years-old female with a history of systemic arterial hypertension treated with enalapril 20 mg and amlodipine 5 mg both once daily. She was admitted 15 days ago in a Hospital Center of Bogotá for having presented sudden loss of consciousness followed by complex focal seizure pisodes. She presented with motor and sensory aphasia and left hemiparesis, atrial fibrillation was documented in electrocardiogram and an ischemic cardiovascular event was documented in a brain computer tomography. A cardioembolic event due atrial fibrillation was considered and for that reason the patient was referred to the Shaio Clinic Foundation for a transesophageal echocardiography, finding in the aortic root to the posterior aspect a mass with cystic appearance, trabeculated, with dynamic flow and inside it the presence of thrombus, with an aortic valve sclerosis with mild insufficiency, without stenosis, The patient was remitted for a multidisciplinary management by cardiology, neurology and cardiovascular surgery. During the hospitalization, a chest angiography was performed, reporting multilobed dilatation of the non-coronary Valsalva sinus with a mobile thrombus inside. On the 22nd day of admission surgical correction of the aneurysm was performed through aortotomy, locating an orifice that feeds it below the commissure. The coronary and right coronary valves without communication with the right atrium with a Dacron patch. During the postoperative period she presented signs of low cardiac output and myoclonus the patient was managed with inotropes, levosimendan and levetiracetam, 48 hours after surgery she was extubated and 12 days after surgery she is discharged without complications.application/pdfhttps://doi.org/10.48713/10336_18224 http://repository.urosario.edu.co/handle/10336/18224spaUniversidad del RosarioFacultad de medicinaEspecialización en EcocardiografíaAtribución-NoComercial-SinDerivadas 2.5 ColombiaAbierto (Texto Completo)EL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.http://creativecommons.org/licenses/by-nc-nd/2.5/co/http://purl.org/coar/access_right/c_abf2Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, et al. (2013) An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 44: 2064-2089Easton JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, et al. (2009) Definition and evaluation of transient ischemic attack: A scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardio. Stroke 40: 2276-2293.Organization WH (2016) World health statistics 2016: Monitoring health for the SDGs Sustainable Development Goals: World Health Organization.Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, et al. (2016) Heart disease and stroke statistics-2016 Update: A report from the American Heart Association. Circulation 133: e38-360.National Institute of Health ONdS. (2015) Fifth ONS Report: Burden of disease due to chronic noncommunicable diseases and disability in Colombia. Bogotá: National Printing of Colombia.Adams HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, et al. (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST Trial of Org 10172 in Acute Stroke Treatment. Stroke 24: 35-41.Saric M, Armour AC, Arnaout MS, Chaudhry FA, Grimm RA, et al. (2016) Guidelines for the use of echocardiography in the evaluation of a cardiac source of embolism. J Am Soc Echocardiogr 29: 1-29.Wolf PA, Abbott RD, Kannel WB (1991) Atrial fibrillation as an independent risk factor for stroke: The Framingham study. Stroke 22: 983-988.Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, et al. (2016) 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 37: 2893-2962.Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, et al. (2014) Worldwide epidemiology of atrial fibrillation: A global burden of disease 2010 Study. Circulation 129: 837-847.Sarıkaya S, Adademir T, Elibol A, Büyükbayrak F, Onk A, et al. (2012) Surgery for ruptured sinus of Valsalva aneurysm: 25-year experience with 55 patients. Eur J Cardiothorac Surg 43: 591.Moustafa S, Mookadam F, Cooper L, Adam G, Zehr K, et al. (2007) Sinus of Valsalva aneurysms: 47 years of a single center experience and systematic overview of published reports. Am J Cardiol 99: 1159-1164.Feldman DN, Roman MJ (2006) Aneurysms of the sinuses of Valsalva. Cardiology 106: 73-81.Smith WA (1914) Aneurysm of the sinus of valsalva: With report of two cases. J Am Med Assoc 32: 1878-1880.Venning GR (1951) Aneurysms of the sinuses of Valsalva. Am Heart J 42: 57-69.Batiste C, Banzal RC, Razzouk AJ (2004) Echocardiographic features of an unruptured mycotic aneurysm of the right aortic sinus of Valsalva. J Am Soc Echocardiogr 17: 474-477.Greiss I, Ugolini P, Joyal M, Bouchard D, Mercier LA (2004) Ruptured aneurysm of the left sinus of valsalva discovered 41 years after a decelerational injury. J Am Soc Echocardiogr 17: 906-909.Weinreich M, Yu PJ, Trost B (2015) Sinus of Valsalva Aneurysms: Review of the literature and an update on management. Clin Cardiol 38: 185-189.Bricker AO, Avutu B, Mohammed THL, Williamson EE, Syed IS, et al. (2010) Valsalva sinus aneurysms: Findings at CT and MR imaging. Radiographics 30: 99-110.Hoda M, Verma A, Alapati S, Alapati S, Yarrabolu TR (2017) Diagnostic paradox: Ruptured aneurysm of sinus of Valsalva simulating tricuspid valve endocarditis. Echocardiography 34: 465-467.Herrador JA, Aragon V, Fernandez JC (2017) Thrombosis of a valsalva sinus aneurysm causing AMI. Rev Esp Cardiol 71: 1-44.Yan F, Huo Q, Qiao J, Murat V, Ma S (2008) Surgery for sinus of valsalva aneurysm: 27-year experience with 100 patients. Asian Cardiovasc Thorac Ann 16: 361-365.Vural KM, Şener E, Taşdemir O, Bayazıt K (2001) Approach to sinus of valsalva aneurysms: A review of 53 cases. 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