Right Atrial Lipoma Resection And Partial Reconstruction Using Bovine Pericardium [ressecção De Um Lipoma De átrio Direito E Reconstrução Parcial Com Pericárdio Bovino]

The primary heart tumors have an incidence varying from 0.001% to 0.28% of all tumors, reported in necropsies series. Lipoma consists of a benign tumour corresponding to about 8% of all primary heart tumors. When present, the symptoms are related to the size and location of such tumor. We report a case of a 27-year-old man with a lipoma in the right atrium who underwent surgical treatment with tumor resection and partial reconstruction of the right atrium using bovine pericardium.242239241Silveira, W.L., Nery, W.M., Soares, E.C.G., Leite, A.F., Nazzetta, H., Batista, M.A.L., Lipoma de átrio direito (2001) Arq Bras Cardiol, 77 (4), pp. 361-4Heath, D., Pathology of cardiac tumors (1968) Am J Cardiol., 21 (3), pp. 315-27Fernandes, F., Soufen, H.N., Lanni, B.M., Arteaga, E., Ramires, F.J.A., Mady, C., Neoplasias primárias do coração. Apresentação clínica e histológica de 50 casos (2001) Arq Bras Cardiol., 76 (3), pp. 231-4Silverman, N.A., Primary cardiac tumors (1980) Ann Surg., 191 (2), pp. 127-38Lima, I.P.R.L., Crotti II, P.L.R., Tumores cardíacos malignos (2004) Rev Bras Cir Cardiovasc, 19 (1), pp. 64-73Lion, M.F., Moreira, A.E.L.C., Silva, M.V.B., Inversão de auricular esquerda por lipoma epicárdico. Comportamento atípico de um tumor levando a obstrução de veias pulmonares (1994) Arq Bras Cardiol., 62 (3), pp. 207-10Arslan, S., Gundogdu, F., Acikel, M., Kantarci, A.M., Asymptomatic cardiac lipoma originating from the interventricular septum diagnosed by multi-slice computed tomography (2007) Int J Cardiovasc Imaging, 23 (2), pp. 277-9Mousseaux, E., Idy-Peretti, I., Bittoun, J., Diebold, B., Paulylaubry, C., Carpentier, A., MR tissue characterization of a right atrial mass: Diagnosis of a lipoma (1992) J Comput Assist Tomogr., 16 (1), pp. 148-51Rubino, M., Hamad, A.M., Rea, F., Gerosa, G., Reconstruction of the right atrium with pulmonary artery homograft after resection of right atrial lipomatosis (2007) Interact Cardiovasc Thorac Surg., 6 (6), pp. 826-

The Use Of The Vancomycin Paste For Sternal Hemostasis And Mediastinitis Prophylaxis [o Uso Da Vancomicina Em Pasta Na Hemostasia Do Esterno E Profilaxia Da Mediastinite]

Introduction: Mediastinitis is one of the most feared complications for thoracic surgeons, being a significant factor in morbidity and mortality in thoracic surgery. Objective: To find a new alternative in order to prevent mediastinitis, reducing the morbidity and mortality. Methods: A retrospective study including 1020 patients operated between February 2002 and October 2005. Patients underwent bypass surgery and vancomycin paste was used rather than bone wax in all cases. Results: Patients were followed-up for 45 months; there were only five (0.49%) cases of mediastinitis; no deaths were observed. Conclusion: The use of Vancomycin paste to replace bone wax proved to be a great allied to prevent mediastinitis after thoracic surgery. Descriptors: Mediastinitis, prevention & control. Vancomycin. Cardiac surgical procedures.2313539Fonkalsrud, E.W., Chest wall abnormalities (1996) Glenn's thoracic end cardiovascular surgery, 1, pp. 581-592. , Glenn WWL, ed, 6th ed. Stanford:AppletonRupp, M.E., Mediastinitis (2000) Mandell principles and infectious diseases, pp. 941-949. , Mandell R, ed, 5th ed. Churchill:Churchill Livingstone;Kirklin/Barratt - Boyes. Cardiac surgery. 3a ed. Philadelphia:Churchill Livingstone;2003. p.230Souza, V.C., Freire, A.N.M., Tavares Neto, J., Mediastinite pósesternotomia longitudinal para cirurgia cardíaca: 10 anos de análise. (2002) Rev Bras Cir Cardiovasc, 17 (3), pp. 266-270Jakicic, J.M., Wing, R.R., Butler, B.A., Robertson, R.J., Prescribing exerercise in multiple short bouts versus one continuous bout: Effects on adherence, cardiorespiratory fitness, and weight loss in overweight women (1995) Int J Obes Relat Metab Disord, 19 (12), pp. 893-901Guaragna, J.C., Facchi, L.M., Baião, C.G., Cruz, I.B.M., Bodanese, L.C., Albuquerque, L., Preditores de mediastinite em cirurgia cardíaca. (2004) Rev Bras Cir Cardiovasc, 19 (2), pp. 165-170Merrill, W.H., Akhter, S.A., Wolf, R.K., Schneeberger, E.W., Flege Jr., J.B., Simplified treatment of postoperative mediastinitis (2004) Ann Thorac Surg, 78 (2), pp. 608-612Schimin, L.C., Batista, R.L., Mendonça, F.C.C., Mediastinite no Hospital de Base do Distrito Federal: Incidência em seis anos. (2002) Rev Bras Cir Cardiovasc, 17 (2), pp. 36-39El Oakley, R.M., Wright, J.E., Postoperative mediastinitis: Classification and management (1996) Ann Thorac Surg, 61 (3), pp. 1030-1036Barbero-Marcial, M., Tanamati, C., Jatene, M.B., Atik, E., Jatene, A.D., Transxiphoid approach without median sternotomy for the repair of atrial septal defects (1998) Ann Thorac Surg, 65 (3), pp. 771-774Calafiore, A.M., Giamarco, G.D., Teodori, G., Bosco, G., D'Annunzio, E., Barsotti, A., Left anterior descending coronary artery grafting via left anterior small thoracotomy without cardiopulmonary bypass (1996) Ann Thorac Surg, 61 (6), pp. 1658-1663Rosin, H., Rosin, A.M., Krämer, J., Determination of antibiotic levels in human bone. I. Gentamicin levels in bone (1974) Infection, 2 (1), pp. 3-6Smilack, J.D., Flittie, W.H., Williams Jr., T.W., Bone concentrations of antimicrobial agents after parenteral administration (1976) Antimicrob Agents Chemother, 9 (1), pp. 169-171Antoniali, F., Costa, C.E., Tarelho, L.S., Lopes, M.M., Albuquerque, A.P.N., Reinert, G.A.A., O impacto de mudanças nas medidas de prevenção e no tratamento de infecções incisionais em cirurgia de revascularização do miocárdio. (2005) Rev Bras Cir Cardiovasc, 20 (4), pp. 382-391Desmond, J., Lovering, A., Harle, C., Djorevic, T., Millner, R., Topical vancomycin applied on closure of the sternotomy wound does not prevent high levels of systemic vancomycin (2003) Eur J Cardiothorac Surg, 23 (5), pp. 765-770Abboud, C.S., Wey, S.B., Baltar, V.T., Risk factors for mediastinitis after cardiac surgery (2004) Ann Thorac Surg, 77 (2), pp. 676-683Eklund, A.M., Valtonen, M., Werkkala, K.A., Prophylaxis of sternal wound infections with gentamicin-collagen implant: Randomized controlled study in cardiac surgery (2005) J Hosp Infect, 59 (2), pp. 108-112Vander Salm, T.J., Okike, O.N., Pasque, M.K., Pezzella, A.T., Lew, R., Traina, V., Reduction of sternal infection by application of topical vancomycin (1989) J Thorac Cardiovasc Surg, 98 (4), pp. 618-622Chohfi, M., O cimento ortopédico associado a vancomicina. Estudo de seu comportamento mecânico e da difusão do antibiótico em meio líquido. (1994) Rev Bras Ortop, 29, pp. 363-370Massias, L., Dubois, C., Lentdecker, P., Brodaty, O., Fischler, M., Farinotti, R., Penetration of vancomycin in uninfected sternal bone (1992) Antimicrob Agents Chemother, 36 (11), pp. 2539-2541Buchholz, H.W., Elson, R.A., Heinert, K., Antibiotic-loaded acrylic cement: Current concepts (1984) Clin Orthop Relat Res, 190, pp. 96-108Harjula, A., Järvinen, A., Postoperative median sternotomy dehiscence (1983) Scand J Thorac Cardiovasc Surg, 17 (3), pp. 277-28