A Síndroma de Cimitarra é uma malformação complexa e rara. A drenagem venosa de parte ou todo o p... more A Síndroma de Cimitarra é uma malformação complexa e rara. A drenagem venosa de parte ou todo o pulmão direito é feita para a veia cava inferior, por uma veia anómala que contorna o bordo direito da silhueta cardíaca, desenhando na radiografia de tórax uma hipotransparência curva semelhante à espada turca cimitarra. Apresentamos as imagens de uma menina de sete anos de idade com infecções respiratórias de repetição e Síndroma de Cimitarra. A radiografia de tórax (Figura 1) revelava uma hipotransparência difusa de todo o pulmão direito (congestão), assim como uma hipotransparência curvilínea junto ao bordo cardíaco direito (setas)-sinal de Cimitarra.
High frequency oscillatory ventilation with lung volume optimization in very low birth weight new... more High frequency oscillatory ventilation with lung volume optimization in very low birth weight newbornsa nine-year experience Ventilação de alta frequência oscilatória com otimização de volume pulmonar nos recémnascidos de muito baixo peso-experiência de nove anos
Introdução: A hipertensão renovascular constitui uma causa rara de hipertensão arterial na crianç... more Introdução: A hipertensão renovascular constitui uma causa rara de hipertensão arterial na criança. A publicação dos resultados das intervenções percutâneas endovasculares em crianças com hipertensão arterial é escassa. Foi objectivo avaliar o sucesso e a segurança do tratamento endovascular da hipertensão renovascular em idade pediátrica. Metodologia: Estudo casuístico, unicêntrico, de doentes com idade inferior a 18 anos, com hipertensão renovascular, submetidos a tratamento endovascular entre 1997 e 2011. Foram incluídos transplantados renais e portadores de doenças sistémicas. Resultados: Foram tratados sete doentes. A média de idade foi de oito anos. Todos apresentavam hipertensão arterial grave sob terapêutica farmacológica múltipla. Clinicamente, apresentaram-se com cefaleias (n=3), agravamento de hipertensão arterial conhecida (n=1) ou assintomáticos (n=3). A angiografia renal confirmou estenose artéria renal unilateral em seis doentes e bilateral num caso. Três doentes apre...
Revista Portuguesa de Cardiologia (English Edition), 2012
Introduction: Viral myocarditis can lead to heart failure that is refractory to medication. In th... more Introduction: Viral myocarditis can lead to heart failure that is refractory to medication. In these cases, a ventricular assist device is a good therapeutic option that can be used as a bridge to transplantation or recovery. We describe the first case in Portugal of recovery with ventricular assistance after severe myocarditis. Case report: A five-year-old boy with no previous cardiac disease presented with severe viral myocarditis, refractory to medical treatment, with positive serology for parvovirus B19 and Ebstein-Barr virus. A Berlin Heart Excor ® was implanted 15 days after diagnosis. A biopsy at the time of implantation showed subendocardial fibrosis. After 40 days of assistance ventricular function recovered and the device was explanted. The patient was discharged from hospital 15 days later. Discussion: Survival of children with ventricular assistance has improved significantly because of earlier implantation and coagulation monitoring. The presence of subendocardial fibrosis in the context of myocarditis is not a mandatory indication for transplantation.
Methods We describe our experience with percutaneous treatment of 15 coronary fistulas in 12 pati... more Methods We describe our experience with percutaneous treatment of 15 coronary fistulas in 12 patients between 1996 and 2011. Eight (67%) were males and the median age was 25 years. The most frequent symptoms were murmur and/or fatigue. All fistulas were ...
Infectious complications represent an important cause of morbidity and death in patients with tra... more Infectious complications represent an important cause of morbidity and death in patients with transplant. Parasitic infections are less frequent than viral and bacterial agents, and are often overlooked. We describe the case of a 13-year-old adolescent, born in São Tomé Island, who was under immunosuppressive therapy after a cardiac transplant. The patient had an intermittent course of diarrhoea, abdominal pain and vomiting. She was admitted dehydrated, and Strongyloides stercoralis, Schistosoma intercalatum and Cystoisospora belli were isolated in her stools. The patient was treated with ivermectin, albendazole, praziquantel and ciprofloxacin with clinical and microbiological resolution. Her immunosuppressive therapy was reduced during hospitalisation. We believe that the parasitic infection was a result of a recrudescence of dormant infections acquired in her homeland. To the best of our knowledge, there are no reports of cystoisosporiasis or schistosomiasis in heart transplant recipients.
Revista portuguesa de cirurgia cardio-torácica e vascular : órgão oficial da Sociedade Portuguesa de Cirurgia Cardio-Torácica e Vascular
An intra-thoracic mass is a diagnostic challenge. We report the clinical case of an intra-thoraci... more An intra-thoracic mass is a diagnostic challenge. We report the clinical case of an intra-thoracic mass which was incidentally detected in a 14-year old adolescent after a chest X-rays. The clinical investigation revealed a pericardial tumor. The immunohistological examination was consistent with Castleman disease. The rarity of this location was confirmed in the literature with only two cases previously published, to our knowledge.
Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular
An intra-thoracic mass is a diagnostic challenge. We report the clinical case of an intra-thoraci... more An intra-thoracic mass is a diagnostic challenge. We report the clinical case of an intra-thoracic mass which was incidentally detected in a 14-year old adolescent after a chest X-rays. The clinical investigation revealed a pericardial tumor. The immunohsitological examination was consistent with Castleman disease. The rarity of this location was confirmed in the literature with only two cases previously published, to our knowledege.
objective: To evaluate the clinical outcome of very low birth weight newborns, submitted to high ... more objective: To evaluate the clinical outcome of very low birth weight newborns, submitted to high frequency oscillatory ventilation with a strategy of early lung volume optimization. Methods: Descriptive prospective study in a nine-year period, between 1999 January 1st to 2008 January 1st. All the very low birth weight newborns were born in Dr. Alfredo da Costa Maternity, Lisbon, Portugal, were
The study contained 34 cases of ventriculomegaly, selected by clinical and imaging criteria from ... more The study contained 34 cases of ventriculomegaly, selected by clinical and imaging criteria from the premature newborn hospitalized in the Clinic of Neonatology. Head ultrasonography was used as method of diagnosis and prognosis evaluation.
Objective: To evaluate the clinical outcome of very low birth weight newborns, submitted to high ... more Objective: To evaluate the clinical outcome of very low birth weight newborns, submitted to high frequency oscillatory ventilation with a strategy of early lung volume optimization. Methods: Descriptive prospective study in a nine-year period, between 1999 January 1st to 2008 January 1st. All the very low birth weight newborns were born in Dr. Alfredo da Costa Maternity, Lisbon, Portugal, were
A Síndroma de Cimitarra é uma malformação complexa e rara. A drenagem venosa de parte ou todo o p... more A Síndroma de Cimitarra é uma malformação complexa e rara. A drenagem venosa de parte ou todo o pulmão direito é feita para a veia cava inferior, por uma veia anómala que contorna o bordo direito da silhueta cardíaca, desenhando na radiografia de tórax uma hipotransparência curva semelhante à espada turca cimitarra. Apresentamos as imagens de uma menina de sete anos de idade com infecções respiratórias de repetição e Síndroma de Cimitarra. A radiografia de tórax (Figura 1) revelava uma hipotransparência difusa de todo o pulmão direito (congestão), assim como uma hipotransparência curvilínea junto ao bordo cardíaco direito (setas)-sinal de Cimitarra.
High frequency oscillatory ventilation with lung volume optimization in very low birth weight new... more High frequency oscillatory ventilation with lung volume optimization in very low birth weight newbornsa nine-year experience Ventilação de alta frequência oscilatória com otimização de volume pulmonar nos recémnascidos de muito baixo peso-experiência de nove anos
Introdução: A hipertensão renovascular constitui uma causa rara de hipertensão arterial na crianç... more Introdução: A hipertensão renovascular constitui uma causa rara de hipertensão arterial na criança. A publicação dos resultados das intervenções percutâneas endovasculares em crianças com hipertensão arterial é escassa. Foi objectivo avaliar o sucesso e a segurança do tratamento endovascular da hipertensão renovascular em idade pediátrica. Metodologia: Estudo casuístico, unicêntrico, de doentes com idade inferior a 18 anos, com hipertensão renovascular, submetidos a tratamento endovascular entre 1997 e 2011. Foram incluídos transplantados renais e portadores de doenças sistémicas. Resultados: Foram tratados sete doentes. A média de idade foi de oito anos. Todos apresentavam hipertensão arterial grave sob terapêutica farmacológica múltipla. Clinicamente, apresentaram-se com cefaleias (n=3), agravamento de hipertensão arterial conhecida (n=1) ou assintomáticos (n=3). A angiografia renal confirmou estenose artéria renal unilateral em seis doentes e bilateral num caso. Três doentes apre...
Revista Portuguesa de Cardiologia (English Edition), 2012
Introduction: Viral myocarditis can lead to heart failure that is refractory to medication. In th... more Introduction: Viral myocarditis can lead to heart failure that is refractory to medication. In these cases, a ventricular assist device is a good therapeutic option that can be used as a bridge to transplantation or recovery. We describe the first case in Portugal of recovery with ventricular assistance after severe myocarditis. Case report: A five-year-old boy with no previous cardiac disease presented with severe viral myocarditis, refractory to medical treatment, with positive serology for parvovirus B19 and Ebstein-Barr virus. A Berlin Heart Excor ® was implanted 15 days after diagnosis. A biopsy at the time of implantation showed subendocardial fibrosis. After 40 days of assistance ventricular function recovered and the device was explanted. The patient was discharged from hospital 15 days later. Discussion: Survival of children with ventricular assistance has improved significantly because of earlier implantation and coagulation monitoring. The presence of subendocardial fibrosis in the context of myocarditis is not a mandatory indication for transplantation.
Methods We describe our experience with percutaneous treatment of 15 coronary fistulas in 12 pati... more Methods We describe our experience with percutaneous treatment of 15 coronary fistulas in 12 patients between 1996 and 2011. Eight (67%) were males and the median age was 25 years. The most frequent symptoms were murmur and/or fatigue. All fistulas were ...
Infectious complications represent an important cause of morbidity and death in patients with tra... more Infectious complications represent an important cause of morbidity and death in patients with transplant. Parasitic infections are less frequent than viral and bacterial agents, and are often overlooked. We describe the case of a 13-year-old adolescent, born in São Tomé Island, who was under immunosuppressive therapy after a cardiac transplant. The patient had an intermittent course of diarrhoea, abdominal pain and vomiting. She was admitted dehydrated, and Strongyloides stercoralis, Schistosoma intercalatum and Cystoisospora belli were isolated in her stools. The patient was treated with ivermectin, albendazole, praziquantel and ciprofloxacin with clinical and microbiological resolution. Her immunosuppressive therapy was reduced during hospitalisation. We believe that the parasitic infection was a result of a recrudescence of dormant infections acquired in her homeland. To the best of our knowledge, there are no reports of cystoisosporiasis or schistosomiasis in heart transplant recipients.
Revista portuguesa de cirurgia cardio-torácica e vascular : órgão oficial da Sociedade Portuguesa de Cirurgia Cardio-Torácica e Vascular
An intra-thoracic mass is a diagnostic challenge. We report the clinical case of an intra-thoraci... more An intra-thoracic mass is a diagnostic challenge. We report the clinical case of an intra-thoracic mass which was incidentally detected in a 14-year old adolescent after a chest X-rays. The clinical investigation revealed a pericardial tumor. The immunohistological examination was consistent with Castleman disease. The rarity of this location was confirmed in the literature with only two cases previously published, to our knowledge.
Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular
An intra-thoracic mass is a diagnostic challenge. We report the clinical case of an intra-thoraci... more An intra-thoracic mass is a diagnostic challenge. We report the clinical case of an intra-thoracic mass which was incidentally detected in a 14-year old adolescent after a chest X-rays. The clinical investigation revealed a pericardial tumor. The immunohsitological examination was consistent with Castleman disease. The rarity of this location was confirmed in the literature with only two cases previously published, to our knowledege.
objective: To evaluate the clinical outcome of very low birth weight newborns, submitted to high ... more objective: To evaluate the clinical outcome of very low birth weight newborns, submitted to high frequency oscillatory ventilation with a strategy of early lung volume optimization. Methods: Descriptive prospective study in a nine-year period, between 1999 January 1st to 2008 January 1st. All the very low birth weight newborns were born in Dr. Alfredo da Costa Maternity, Lisbon, Portugal, were
The study contained 34 cases of ventriculomegaly, selected by clinical and imaging criteria from ... more The study contained 34 cases of ventriculomegaly, selected by clinical and imaging criteria from the premature newborn hospitalized in the Clinic of Neonatology. Head ultrasonography was used as method of diagnosis and prognosis evaluation.
Objective: To evaluate the clinical outcome of very low birth weight newborns, submitted to high ... more Objective: To evaluate the clinical outcome of very low birth weight newborns, submitted to high frequency oscillatory ventilation with a strategy of early lung volume optimization. Methods: Descriptive prospective study in a nine-year period, between 1999 January 1st to 2008 January 1st. All the very low birth weight newborns were born in Dr. Alfredo da Costa Maternity, Lisbon, Portugal, were
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