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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three cases of ruptured aneurysm of the aortic sinus of Valsalva (one each into the right atrium, right ventricle and pulmonary artery) are reported and clinical as well as haemodynamic features described. It is pointed out that the right sinus is most frequently involved, the non-coronary one only rarely, and the left one only quite exceptionally. The clinical findings depend on the size, site and direction of the rupture and its haemodynamic consequences. Rupture occurs most frequently into the right attrium or ventricle, much more rarely into the pulmonary artery or left ventricle. Cardinal clinical signs are retrosternal pain, marked shock with dyspnoea and tachycardia or rapidly progressive cardiac failure. Auscultation reveals either a continuous systolic-diastolic murmur or a holosystolic crescendo-decrescendo murmur followed by a high-frequency diastolic murmur, maximal parasternally in the second to fourth left intercostal spaces. As effective surgical treatment is available, early diagnosis is essential.
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PMID:[Ruptured aneurysm of the aortic sinus of Valsalva (author's transl)]. 112 62

We describe four patients with vasculitis of the coronary and other medium sized arteries. Three of them died as a consequence of cardiac failure and the fourth had a ruptured aneurysm of the left common iliac artery. Coronary vasculitis is pathognomonic for Kawasaki disease (KD), but our patients had few other signs of this disorder, suggesting so called atypical KD. Because the described patients lacked most of the clinical criteria, the diagnosis was delayed. We focus on other clinical features in these patients and stress the importance of early recognition and treatment.
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PMID:Atypical Kawasaki disease: an often missed diagnosis. 150 75

Intrapericardial ruptured aneurysm of the right anterior sinus of Valsalva. A intrapericardial ruptured aneurysm of the right anterior sinus of Valsalva is presented. An infectious origin was suspected. The aneurysm was treated by plication, which allowed to correct the preoperative insufficiency. Aneurysms of the Valsalva sinus can remain asymptomatic. When they are small, a conservative treatment is conceivable. Many complications can occur: rupture (more often in right cavities), aortic insufficiency, coronary insufficiency, cardiac failure, rhythm disturbances. This complications necessitate a surgical treatment. Aortic valvular replacement is indicated only when the structure of the valve is altered.
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PMID:[Intrapericardial rupture of an aneurysm of the right anterior sinus of Valsalva: clinical case and review of the literature]. 306 46

A retrospective review was done of all patients undergoing surgical repair of abdominal aortic aneurysm (AAA) on whom coagulation studies were obtained. Those patients with laboratory documented disseminated intravascular coagulation (DIC) were selected and their clinical records reviewed. This included 7 patients studied in the periods 1964-1965 and January 1971-July 1973. Of these 7 cases, 4 occurred in patients undergoing emergency operation for ruptured aneurysm and 3 were in elective cases. All 7 patients exhibited clinical evidence of abnormal bleeding, while 6 of the 7 progressed rapidly to renal shutdown. The seventh patient recovered spontaneously. Of the 6 patients with full blown clinical and laboratory evidence of DIC, 2 recovered. Both cases received heparin therapy and multiple hemodialyses. A third patient was started on heparin but died at 36 hours in heart failure. All 3 patients receiving heparin showed clinical cessation of abnormal bleeding and disappearance of soluble fibrin monomer complexes within 24 hours of starting therapy. The study suggests a higher incidence of DIC than has previously been appreciated in both the emergency and elective repair of AAA. The prompt recognition and treatment of this complication may reverse the abnormal intravascular clotting, minimize its more serious results and avoid futile and dangerous operative intervention.
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PMID:Disseminated intravascular coagulation as a complication of abdominal aortic aneurysm repair. 485 4

An isolated iliac aneurysm is an uncommon entity with a relative incidence to abdominal aortic aneurysm of 0.9 to 1.9 percent. Analysis of 16 cases with 20 isolated iliac aneurysms experienced at our vascular service makes the basis of this report. Seventeen aneurysms involved the common iliac artery, two the internal iliac artery and one the external iliac artery. As we experienced 341 abdominal aortic aneurysms during the same period, relative incidence of isolated iliac aneurysm to abdominal aortic aneurysm was 4.7 percent. Fifteen of the 16 cases were male; isolated iliac aneurysms had significantly higher preponderance for the male. Six of the cases were presented with ruptured aneurysms, giving a rupture rate of 37.5 percent. This rupture rate was significantly higher than that of abdominal aortic aneurysms of 11.1 percent. Operation was performed on 15 patients; the remaining one died before surgery. Although there was no operative death among the elective cases, three patients in the ruptured group died postoperatively giving a mortality rate of 60 percent. The least diameter of the ruptured aneurysms was 3.5 centimeter. Among the 16 patients 5 presented with a ruptured aneurysm and 3 had no symptoms related to the aneurysm. Five patients complained of a pulsatile abdominal mass. Two of the ruptured aneurysms were associated with an iliac arteriovenous fistula. Both of them involved the common iliac artery. Although emergency operation was performed on one of them, he died of acute renal failure due to preoperative dehydration and hypovolemia. The another one was operated on electively after intensive medical treatment for heart failure and the patient survived.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Isolated iliac aneurysms]. 650 53

During 1980 and 1981, 36 patients aged 70 years or older were operated on for abdominal aortic aneurysm. The aneurysm was already ruptured in almost half of the patients. Eight patients died early (22%), of whom 7 were operated on because of perforation. Main cause of early death was cardiac failure (5). During an average observation period of 12 months, 4 patients died late and 4 claimed unsatisfactory recovery. All patients over 70 years of age with abdominal aortic aneurysm should be investigated with respect to operability. The risk in elective surgery is low and the postoperative prognosis for these patients is good. Surgery for ruptured aneurysm still carries high operative mortality in this age group and a poor longterm prognosis.
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PMID:[Abdominal aortic aneurysm in the patient over 70--surgery in any case?]. 683 47

Seven cases of rupture of an abdominal aortic aneurysm into the inferior vena cava are reported. In the management of this rare condition it is important to make the diagnosis preoperatively. Most cases show evidence of a large arteriovenous fistula which can, on occasions, dominate the clinical picture, e.g. cyanosed lower extremities or cardiac failure, but abdominal pain is the major feature. Careful examination of all patients with a ruptured aneurysm, particularly listening for an abdominal bruit, will usually allow the diagnosis of aortocaval rupture to be made.
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PMID:Aortocaval fistula associated with ruptured aortic aneurysm. 687 27

The results of surgical treatment of 209 ruptured abdominal aortic aneurysms are reviewed. The mortality over the first period of ten years was 37.8% and over the second ten years 44.9%. An attempt was made to analyse the reasons for this somewhat disappointing experience, shared by other authors. The broader indications for surgical treatment and the rise in the average age of our patients at presentation may be partially responsible. This elderly aged group had a greater incidence of coexistent disease leading to increased postoperative complications. The duration of preoperative shock had a direct inverse relationship to mortality. It is stressed that, apart from close collaboration between surgeon and internist with early detection of many postoperative complications such as gastrointestinal bleeding, anuria or heart failure, correct and early diagnosis of the ruptured aneurysm offers the best chance for the improvement in the survival rate of these patients.
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PMID:Twenty years' experience of surgical treatment of the ruptured atherosclerotic aneurysm of the abdominal aorta. 730 Nov 57

Clinical features of 19 cases with congenital aneurysm of the right sinus of Valsalva rupturing into the right ventricular outflow region (Type 1) were analysed in relation to their pathoanatomic lesions and hemodynamic alterations. Sixteen cases were operated with one surgical death. All were catheterized together with ascending aortographic study. Rupture of the aneurysm in many cases was silent or symptomless and progressive heart failure was not quite common. Symptomatology of the patients did not seem to be related entirely to status of the pathoanatomical lesions or hemodynamic alterations. Time of the rupture, and inherent right ventricular characteristics, tolerating volume overload rather well, might be, in part, responsible for its better prognosis in some cases. However, all patients with ruptured aneurysm of the sinus of Valsalva should be treated surgically. Bacterial endocarditis is a serious complication leading to death.
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PMID:Ruptured congenital aneurysm of the right sinus of Valsalva into the right ventricle: with special reference to pathoanatomic and hemodynamic characteristics in symptomless cases. 736 87

A 71-year-old woman underwent surgical repair of a ruptured aneurysm of the sinus Valsalva. She had an aneurysm of the right coronary sinus ruptured into the right atrium. There was no VSD. The patient suffered from heart failure for 38 years and went into cardiac cachexia. Direct closure from the right atrium was performed and the patient has resumed full physical activities. As far as we know, this is one of the oldest patients who underwent successful surgery for this disease in this country.
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PMID:[A case report of surgical repair of a ruptured aneurysm of the sinus Valsalva in an aged person with cardiac cachexia]. 783 Mar 61


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