Rupture of the left ventricular wall after mitral valve replacement is an infrequent but lethal complication. Reporting correction technique of ventricular rupture with bovine pericardium patch secured with glue and without suturing: a 51 years-old female patient, with double rheumatic mitral lesion, severe stenosis and discrete insufficiency, who had a mitral valve replacement. During surgery, the patient presented a ventricular rupture of the posterior wall (atrioventricular disruption), which was successfully repaired using bovine pericardium with sutureless biological glue over the epicardium of the damaged area. Sixty months after surgery the patient has no symptoms.
RESUMOFundamento: A influência do polimorfismo do gene da ECA na Hipertensão Arterial Sistêmica (HAS) ainda é muito controversa na literatura. Objetivo: Analisar o efeito do polimorfismo do gene da ECA na patogênese da hipertensão arterial, tanto a controlada quanto a resistente, em pacientes adultos da região dos Campos Gerais, estado do Paraná, Brasil. Métodos: Estudo caso-controle realizado com 91 pacientes adultos provenientes da região dos Campos Gerais, estado do Paraná, Brasil. Foram separados em 3 grupos (Não-hipertensos, Hipertensos controlados e Hipertensos de difícil controle). O polimorfismo do gene da ECA foi identificado por PCR (Polimerase Chain Reaction) do íntron 16 desse gene, analisando-se a ausência (deleção ou alelo "D") ou presença (inserção ou alelo "I") de 287 pares de base (pb). Resultados: Todas as variáveis estudadas na população foram estatisticamente diferentes, com valores bastante significativos, quando comparadas com os 3 grupos. Em relação aos genótipos apresentados, foi prevalente o genótipo DD nos três grupos, quando comparado aos outros dois genótipos (DI e II). Todas as variáveis estudadas e avaliadas para cada genótipo, dentro de cada grupo, não foram significativas estatisticamente após a correção de Bonferroni (p< 0.02). Conclusão: Na população estudada, não houve associação direta entre o polimorfismo do gene da ECA e a Hipertensão Arterial Sistêmica (HAS), indicando que múltiplos fatores estão influenciando na gênese e na gravidade da doença. To analyze the effect of the polymorphism of the ACE gene in the pathogenesis of hypertension, both controlled as resistant in adult patients in the region of Campos Gerais, Paraná, Brazil. Methods: A case-control study with 91 adult patients from the region of Campos Gerais, Paraná State, Brazil. The patients were divided in 3 groups (normotensive, controlled hypertensive and hypertensive difficult to control. The polymorphism of the ACE gene was identified by PCR (Polymerase Chain Reaction) of the intron 16 of this gene by analyzing the absence (deletion or allele "D") or presence (insertion or allele "I") of 287 base pairs (bp). Results: All variables in the population were statistically different, with values quite significant when compared with the 3 groups. Regarding the presented genotypes, the DD genotype was prevalent in all three groups when compared to the other two genotypes (DI and II). All variables studied and evaluated for each genotype within each group were not statistically significant after Bonferroni correction (p <0.02). Conclusion: In this population, there was no association between the ACE gene polymorphism and systemic arterial hypertension (SAH), indicating that multiple factors are influencing the genesis and severity of the disease. PALAVRAS-CHAVE
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