Revista Brasileira de Cirurgia Cardiovascular via MedWorm.com

Letters to the Editor

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

We reported a case of Kirschner wire withdrawal, for right postero-lateral thoracotomy, which were transfixanting ascendent thoracic aorta artery, in its due to its migration of left clavicle, where it was placed to fix an occurred fracture 10 years before. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Checklist in pediatric cardiac surgery in Brazil: an useful and necessary adaptation of the Quality Improvement Collaborative International Congenital Heart Surgery in Developing Countries

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

Migration of a Kirschner wire into the thoracic ascendent aorta artery

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

A large pericardial cyst presenting with compression of the right-side cardiac chambers

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

Cistos pericárdicos são raros, comumente congênitos, com localização mais frequente no ângulo cardiofrênico direito. O diagnóstico é suspeitado pela radiografia de tórax anormal. O presente relato descreve um caso de cisto pericárdico com aspecto radiográfico atípico, em um paciente atleta, manifestando-se clinicamente com sintomas de insuficiência ventricular direita. O diagnóstico foi sugerido pelo ecocardiograma transesofágico e confirmado pelo estudo anatomopatológico.Pericardial cysts are rare, usually congenital. Cysts frequently occur in the right cardiophrenic angle and their diagnosis is usually suspected after an abnormal chest X ray. The present case report shows a case of pericardial cyst with atypical radiographic aspect in an athletic patient who presented cl...

Calcified amorphous tumor of the heart: case report

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

We present a case of tumor 17-year-old young, male, in tricuspid valve, with classic pathological findings. It was preferred to approach for classic median esternotomy, installation of the circuit of extracorporal circulation and right atriotomy, exereses of tumor, DeVega's plasty in tricuspid valve and bicuspidization. The amatomopathological study demonstrated presence of extensive calcification and metaplastic bone areas. The patient had an uneventful hospitalization. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Multiple left atrial myxoma: case report

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

We report a case of a patient in functional class (FC) IV New York Heart Association (NYHA) and postoperative histological diagnosis of multilobular myxoma originating in the posterior left atrial wall. Clinical evaluation 3 months after surgery suggested NYHA functional class I and echocardiographic absence of intracardiac masses. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Effects of cryopreservation and/or decellularization on extracellular matrix of porcine valves

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

The objective of this study was to evaluate the morphology of decelluarized and/or cryopreserved porcine pulmonary valves, to determine a solution capable of completely remove the cells without damaging the extracellular matrix. Porcine pulmonary valves were incubated for 24 hs in sodium deoxicholate 1% or sodium dodecyl sulfate 0.1 and 0.3%, with or without associated cryopreservation. Evaluation was done with optical microscopy (Hematoxilin-Eosin, Acetic Orcein and Gomori) and with morphometric analysis. The effectiviness of the solutions was variable, but the best results were obtained with the sodium dodecyl sulfate solution 0.1%. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Lymphoscintigraphic changes after harvesting of the saphenous vein for coronary artery bypass graft

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

Bridged incisions do not eliminate lesions to the lymphatic vessels and so the identification of risk factors associated to lymphatic lesions is important.Incisões-ponte não eliminam a lesão de vasos linfáticos e assim a identificação de fatores de risco associados às lesões linfática é importante. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Geli Putty®: a new alternative on sternal hemostasis in cardiac surgery

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

We present a gelatin that fills the medullary of sternum providing effective hemostasis plus protection for each sternal end. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Terminal ischemic cardiomyopathy associated with complication of stenting in the treatment of acute myocardial infarction

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

Uma complicação grave, como a dissecção do tronco de coronária esquerda, com redução relevante do fluxo sanguíneo coronário pela luz verdadeira, requer ação rápida. Diante disso, a escolha imediata do stent no comprimento e calibre adequados para tratar a complicação se faz necessária.A serious complication such as dissection of the left main coronary artery, with significant reduction in coronary blood flow by the true light, requires quick action. Therefore, the immediate choice of stent with appropriate length and size to treat the complication is necessary. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Endovascular repair of ascending aorta and coronary stent implantation

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

Endovascular treatment of ascending aorta pseudoanerysms with coronary stents implantation at the same procedure was feasable, although longer followup is necessary.Tratamento endovascular de pseudoaneurismas da aorta ascendente com o implante de stents coronários no mesmo procedimento foi factível, embora seja necessário um maior seguimento. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Experimental model of myocardial infarction induced by isoproterenol in rats

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

CONCLUSIONS: The isoproterenol-induced myocardial infarction essay in rats was adequately reproduced in our laboratory, causing alterations in hematological, biochemical, oxidative stress markers and histopathological parameters. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Near-fatal pulmonary embolism in an experimental model: hemodynamic, gasometric and capnographic variables

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

This study aimed to submit animals under spontaneous ventilation and without supplemental oxygen to PE. METHODS: PE was induced in six pigs using autologous blood clots, and cardiorespiratory and gasometric records were performed before and after PE. The values of "near fatal" mean pulmonary arterial pressure (MPAP) were previously determined. RESULTS: The presence of obstructive shock could be evidenced by increased MPAP (from 17.8±3.5 to 41.7±3.3 mmHg) (P

Respiratory physiotherapy in the pre and postoperative myocardial revascularization surgery

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

This study aimed at updating the knowledge regarding the respiratory physiotherapy performance in the pre and postoperative period of the myocardial revascularization surgery enhancing the prevention of lung complications. The Physiotherapy uses several techniques in the preoperative period; such as: the incentive spirometry, exercises of deep breathing, cough, inspiratory muscle training, earlier ambulation and physiotherapeutic orientations. While in the postoperative period, the objective is the treatment after lung complications took place, performed by means of physiotherapeutic maneuvers and noninvasive respiratory devices, aiming at improving the respiratory mechanism, the lung reexpansion and the bronchial hygiene. Respiratory physiotherapy is an integral part in the care managemen...

Surgical treatment of atrial fibrillation: integrative review

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

A fibrilação atrial (FA) no pré-operatório de operações cardíacas abertas, incluindo revascularização cirúrgica do miocárdio (RCM) e operações valvares, representa fator de risco independente para eventos cardíacos maiores e redução de sobrevida. Devido à complexidade do assunto, principalmente na avaliação das taxas de sucesso, foi proposta recentemente uma declaração de consenso pela International Society of Minimally Invasive Cardiothoracic Surgery (ISMICS), com o intuito de determinar se a ablação operatória da FA promove resultados clínicos favoráveis em pacientes submetidos a outras operações cardíacas na comparação com operações isoladas sem ablação. O objetivo deste trabalho é apresentar dados da literatura que possam contribuir para o consenso s...

Absence of arteriosclerosis in intramyocardial coronary arteries: a mystery to be solved?

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

Several studies show that portions of intramyocardial coronary arteries are spared of arteriosclerosis, involving morphological, embryological, biochemical and pathophysiological aspects. Endothelial function is significantly affected in the segment of transition, as estimated by the vasoactive response to Ach. These findings suggest that myocardial bridge can provide protection against arteriosclerosis by counteracting the negative effects of endothelial dysfunction. The intramyocardial portion's protection phenomenon deserves further scientific research on all research fronts. Improved morphological, biomechanical and especially physiological and embryological knowledge may be the key to a future window of opportunity for chronic arterial disease therapy and prevention. In addition, this...

Pantoprazole provides myocardial protection similar to ischemic preconditioning: experimental study of isolated hearts of rats

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

OBJECTIVE: To evaluate pantoprazole effect in the functional recovery of isolated hearts of rats, submitted to ischemia and reperfusion with and without ischemic preconditioning. METHODS: In four groups of eight Wistar breed rats, the hearts were removed after anesthesia and perfused with Krebs-Henseleit solution (95% O2, 5% CO2, 37ºC). GI, GII, GIII and GIV hearts were submitted to ischemia (20 min) and reperfusion (30 min). In GII and GIV, preconditioning was performed with 5 min of ischemia and 5 min of reperfusion before 20 min of the ischemia period induction. In GIII and GIV pantoprazole 100 mg was done before a 20 min-period of ischemia induction. Heart Rate (HR), Coronary Flow (CoF), Systolic Pressure (SP), +dP/dt and -dP/dt were registered before (t0) and after reperfusion (t30)....

Adiponectin expression in epicardial adipose tissue after percutaneous coronary intervention with bare-metal stent

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

CONCLUSION: There were no correlation between adiponectin gene expression and presence of BMS (Source: Revista Brasileira de Cirurgia Cardiovascular)

Decellularization as an anticalcification method in stentless bovine pericardium valve prosthesis: a study in sheep

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

CONCLUSION: The decellularization with 0.1% SDS was effective as an anticalcification method in bovine pericardial grafts implanted in a sheep circulatory model for 180 days (Source: Revista Brasileira de Cirurgia Cardiovascular)

Parents' knowledge of infective endocarditis in children with congenital heart disease

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

INTRODUÇÃO: As diretrizes para profilaxia de endocardite infecciosa mudaram, mas muitas cardiopatias congênitas seguem sendo consideradas de alto risco para o desenvolvimento da doença. OBJETIVO: Avaliar o conhecimento dos pais ou responsáveis pelas crianças e adolescentes portadores de cardiopatias atendidos em um serviço de referência no estado do Rio Grande do Sul, Brasil, sobre endocardite infecciosa e sua profilaxia. MÉTODOS: Estudo transversal com 90 pacientes portadores de cardiopatias congênitas em acompanhamento ambulatorial regular. O conhecimento dos pais foi avaliado com o uso de questionário específico e os demais dados foram obtidos por meio da revisão de prontuários. RESULTADOS: A mediana da idade dos pacientes foi de 5,6 anos (3 meses - 14 anos e 7 meses), sen...

Plasmatic vasopressin in patients undergoing conventional infra-renal abdominal aorta aneurysm repair

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

OBJECTIVES: To evaluate plasmatic arginine vasopressin (AVP) levels in patients undergoing scheduled conventional abdominal aortic aneurysm (AAA) repair. METHODS: Plasmatic AVP concentrations were measured by radioimmunoassay in 22 non-consecutive adult patients undergoing infra-renal AAA repair. They were under combined general and epidural anesthesia at the following time frames: 1 - pre-operative (T0); 2 - 2h (T1) and 6h (T2) after the surgical procedure; 3 - in the morning at the first (T3), second (T4) and third (T5) post-operative days. Some clinical and laboratory variables were also recorded. RESULTS: The mean age of patients was 68±10 years; 17 were males. Plasmatic AVP (mean±SD; pg/mL) was within the normal range at T0 (1.4±0.7; baseline), increasing significantly at T1 (62.6�...

Transforming growth factor-β/Smad signaling function in the aortopathies

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

CONCLUSIONS: Aortic dissection, aortic aneurysm and atheroslerosis might be associated with an enhanced TGF β/Smad signaling function, with aortic dissection exhibiting a less prominent upregulation. It might have implications for downstream signal activation presumably translating into matrix degradation in the condition of aortic dissection in comparison to matrix deposition in aortic aneurysm and coronary artery diseaseOBJETIVOS: Fator transformador de crescimento (TGF) -β/ Smad como via de sinalização em casos de dissecção aórtica e indivíduos normais não foi descrito anteriormente. O presente estudo foi elaborado para avaliar as expressões TGF-β/Smad como via de sinalização nos pacientes com dissecção aguda da aorta, em comparação com que nos pacientes com aneurisma d...

Validation of MagedanzSCORE as a predictor of mediastinitis after coronary artery bypass graft surgery

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

OBJECTIVE: The aim of this study is to evaluate the applicability of a new score for predicting mediastinitis - MagedanzSCORE - in patients undergoing coronary artery bypass graft (CABG) surgery in the Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco - PROCAPE. METHODS: Retrospective study involving 500 patients operated between May/2007 and April/2010. The registers contained all the information used to calculate the MagedanzSCORE. The outcome of interest was mediastinitis. We calculated sensitivity, specificity, positive predictive value, negative predictive value, concordance and accuracy. The accuracy of the model was evaluated by ROC (receiver operating characteristic) curve. RESULTS: The incidence of mediastinitis was 5.6%, with a lethality rate of 32....

Long-term evolution of mitral commissurotomy in rheumatic patients with low echocardiographic score

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

CONCLUSION: Open mitral commissurotomy presented excelent long term results in rheumatic patients with low echocardiographic score (Source: Revista Brasileira de Cirurgia Cardiovascular)

The use of inhibitors of angiotensin-converting enzyme and its relation to events in the postoperative period of CABG

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

CONCLUSION: The use of preoperative ACE inhibitors was associated with increased need for inotropic support and higher incidence of acute renal failure and postoperative atrial fibrillation, not associated with increased rates of myocardial infarction, stroke or death (Source: Revista Brasileira de Cirurgia Cardiovascular)

Atrioventricular block in the postoperative period of heart valve surgery: incidence, risk factors and hospital evolution

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

INTRODUÇÃO: Distúrbios do sistema de condução cardíaco são complicações potenciais e conhecidas dos procedimentos de cirurgia cardíaca valvar. OBJETIVOS: Investigar a associação entre fatores peri-operatórios com bloqueio atrioventricular (BAV) e a necessidade de estimulação cardíaca artificial temporária (ECAT) e, se necessário, implante de marcapasso definitivo no pós-operatório de cirurgia cardíaca (POCC) valvar. MÉTODOS: Coorte histórica de pacientes submetidos a cirurgia cardíaca valvar, sendo realizada análise de banco de dados por regressão logística. RESULTADOS: No período de janeiro de 1996 a dezembro de 2008, foram realizadas 1102 cirurgias cardíacas valvares: 718 (65,2%) na valva aórtica e 407 (36,9%) na valva mitral; destas, 190 (17,2%) cirurgias d...

Influence of respiratory muscle strength in evolution of patients with heart failure after cardiac surgery

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

CONCLUSION: In this study, preoperative respiratory muscle dysfunction does not seem to influence the evolution of heart failure patients for the presence of pulmonary complications after cardiac surgery (Source: Revista Brasileira de Cirurgia Cardiovascular)

Transcatheter implantation of self-expandable valved prosthesis in outlet right ventricle an experimental study in pigs

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

CONCLUSION: These findings highlight the need for studies with the use of anticoagulants and antiplatelet, an attempt to reduce this event. The study aims to contribute for the start of the use of prosthetic heart valves that could be implanted through minimally invasive techniques without the use of cardiopulmonary bypass (Source: Revista Brasileira de Cirurgia Cardiovascular)

Transcatheter aortic valve implantation: results of the current development and implantation of a new Brazilian prosthesis

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

CONCLUSION: The transapical implantation of catheter mounted bioprosthesis is a safe procedure with acceptable midterm results. Long term follow-up with increased sample power is mandatory in order to access hemodynamic, life quality and survival (Source: Revista Brasileira de Cirurgia Cardiovascular)

Outcomes of patients subjected to aortic valve replacement surgery using mechanical or biological prostheses

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

CONCLUSIONS: The authors have concluded that: 1) mortality was statistically similar in the groups; 2) patient characteristics at baseline were a major determinant of late mortality after surgery; 3) there was a tendency toward reoperation in the bioprostheses group; 4) patients using mechanical prosthesis had more bleeding events as time passed; 5) data presented in this paper is in accordance with current literature (Source: Revista Brasileira de Cirurgia Cardiovascular)

Hidden renal dysfunction causes increased in-hospital mortality risk after coronary artery bypass graft surgery

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

INTRODUÇÃO E OBJETIVOS: Insuficiência renal crônica pré operatória é fator preditivo independente para mortalidade em cirurgia cardíaca. Como creatinina sérica normal não representa obrigatoriamente função renal normal, comparamos as taxas de mortalidade, de permanência hospitalar total e de permanência hospitalar pós-operatória em pacientes submetidos à cirurgia de revascularização miocárdica isolada com creatinina < 1,5 mg/dL, de acordo com a depuração estimada, normal ou alterada. MÉTODOS: Em 4.765 pacientes submetidos à revascularização cirúrgica do miocárdio entre janeiro/1996 e junho/2004, a depuração da creatinina foi estimada através da equação de Cockcroft-Gault. Considerou-se função renal alterada uma depuração da creatinina

Terminal ischemic cardiomyopathy associated to stent extrusion to the aortic lumen

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

Quality of valve prostheses: are we treating our patients well in the Brazilian national health system?

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

Myocardial revascularization without cardiopulmonary bypass: historical background and thirty-year experience

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

After the Impact Factor, the DOI

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

Letter to the editor

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

We report a patient, victim of an attempted armed robbery, who had a transfixing gunshot wound to the heart, successfully operated at our institution. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Write well or perish: courses and services help researchers to write a good scientific paper

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

Prof. Dr. Rubens de Guimarães Santos: flawless surgeon

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

Immediate postoperative period of cardiac surgery: routine nursing for patient's admission to the Intensive Care Unit

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

Transfixing gunshot wound to the heart: case report

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

Postpartum patient with thrombosis of mechanical prostheses and acquired supravalvular aortic stenosis

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

We report the case of an immediate postpartum patient with aortic mechanical prostheses and acquired supravalvular aortic stenosis who underwent emergency heart surgery, with severe hemodynamic instability, using adapted surgical technique for correction of supravalvular stenosis with satisfactory clinical and echocardiography results. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Emergency autologous vein graft reconstruction after using a vascular closure device

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

An emergency operation for access related acute critical limb ischemia with signs of infection is described. Inguinal femoral reconstruction was performed with a bifurcated graft constructed from the ipsilateral saphenous vein.Uma operação de emergência relacionada à isquemia aguda com sinais de infecção é descrita. Reconstrução femoral inguinal foi realizada com um enxerto bifurcado feito a partir da veia safena ipsilateral. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Comparative experimental study between L-Hydro treated pulmonary homograft and fresh pulmonary homograft

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

CONCLUSIONS: These data indicate that both groups presented similar clinical/hemodynamic performances. The LH group's echocardiogram presented a better performance. It also presented histological evidences of interstitial and endothelial cell repopulation. In the macro/optic and electronic microscopic analysis, group L-H presented macroscopy/histological structure and ultra-structural similar to the fresh group, with the exception of nodules with higher interstitial cellularity, present only in the fresh homograft group. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Cardiac surgery and hypertension: a dangerous association that must be well known

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

This article is to present these conditions, and to further discuss the possible etiologies and the potential treatment strategies so as to highlight the relevance at a prognostic level.É sabido que a hipertensão é uma doença muito comum, e que os acidentes cerebrovasculares graves podem ocorrer se a pressão sanguínea não for apropriadamente controlada. Contudo, as condições associadas à hipertensão não controlada podem ser negligenciadas, e tornarem-se críticas, necessitando, eventualmente, uma intervenção cirúrgica urgente. Doença coronariana, síndrome aórtica aguda, cardiopatias congênitas, valvopatias e arritmias são sob este tópico de discussão. Dentre eles, a doença corornariana, inclusive o infarto do miocárdio e especialmente a ruptura cardíaca pós-infart...

Pediatric cardiac surgery: what to expect from physiotherapeutic intervention?

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

This study aims to gather and present scientific evidence on the role of a physiotherapist in the pre, peri and postoperative of pediatric cardiac surgery. This professional is able to prevent, minimize or reverse possible respiratory dysfunction and motor sequelae resulting from these interventions. Studies discuss the involvement of respiratory system, specifically the clearance of bronchial secretions and ventilatory adequacy, as a result of surgical procedure. Scientific evidences suggest the effectiveness of physiotherapy in reducing indices of: pneumonia, atelectasis, hospitalization, sequelae deleterious and length of bed restriction, beyond clinical improvement. These data confirm positive contribution of physiotherapeutic intervention in these surgeries. (Source: Revista Brasileir...

The impact of carotid artery disease on outcomes of patients undergoing coronary artery bypass grafting

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

OBJECTIVE: Although the overall complication rate has been decreased significantly in recent years, stroke is a severe complication after coronary bypass operations. The purpose of this study is to evaluate the influence of carotid artery disease on the results of patients under CABG operation. METHODS: In a retrospective cohort study, 1,978 patients under CABG operation were studied in Shariati Hospital between April 2002 and March 2006. The patients who had only valve replacement or non-CABG procedure were excluded from this study. As part of preoperative evaluation, carotid duplex ultrasonography scans were performed. In order to estimate the degree of carotid arteries stenosis, ultrasound imaging measurement and velocity criteria were considered. The patients were classified into three...

Mortality within the endovascular treatment in Stanford type B aortic dissections

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

CONCLUSION: Endovascular correction of complicated Stanford type B aortic dissections is a feasible and effective treatment option.INTRODUÇÃO: O tratamento endovascular na dissecção de aorta é um procedimento relativamente novo e, embora aparentemente menos invasivo, a eficácia e a segurança dessa técnica não estão totalmente estabelecidas. OBJETIVO: Avaliar a mortalidade e complicações nos pacientes submetidos a tratamento endovascular na dissecção de aorta tipo B de Stanford. MÉTODOS: Foram revisados, a partir de novembro de 2004 a outubro de 2007, em estudo clínico, anatômico, de imagens e dados da autopsia de 23 pacientes com dissecção aórtica tipo B. As principais indicações para o procedimento foram: dor persistente apesar da terapia médica, sinais de isquemia ...

Physical therapy in postoperative cardiac surgery: patient's perception

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

CONCLUSION: We suggest the implementation of preoperative physical therapy protocols with preventive measures and educational as well as new researchs that may characterize the population of users of health plans/private. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Quality of life of patients with implantable cardioversor-defibrillator: the usage of SF-36 questionnaire

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

CONCLUSION: The results showed that individuals' quality of life is impaired, with lower scores for physical and emotional aspects. There was not a correlation between quality of life and age, gender, marital status and educational level. However, they feel comfortable and safe with ICD benefits since it provides their maintenance in being alive protecting them of sudden death. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Right coronary artery anatomy: anatomical and morphometric analysis

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

CONCLUSIONS: Caliber of the RCA and its branches is lesser than the majority of previous studies, while the PRDA frequency is slightly higher than the reported in literature. Clinical and pathological scenarios by these variations should be taken into account: hemodynamic procedures, cardiac surgery and arrhythmias from coronary occlusive disease.INTRODUÇÃO: É necessário conhecer a grande variabilidade da artéria coronária direita (ACD), especialmente por suas implicações nos procedimentos cirúrgicos e eventos clínicos. Esta variabilidade está geralmente relacionada à extensão, à quantidade de ramos, à origem e aos territórios irrigados. OBJETIVO: Avaliar por exame direto a expressão morfológica da ACD em sujeitos colombianos. Métodos: As ACD foram medidas em 221 coraç�...

The impact of blood transfusion on morbidity and mortality after cardiac surgery

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

OBJETIVOS: Analisar o impacto da hemotransfusão sanguínea na incidência de desfechos clínicos no pós-operatório (PO) de cirurgias cardíacas. MÉTODOS: Estudo de coorte retrospectiva. Foram analisados 4.028 pacientes submetidos à cirurgia de revascularização miocárdica (CRM), troca valvar (TV) ou ambas, em hospital terciário universitário brasileiro, entre 1996 e 2009. Foram comparadas as complicações no PO entre os pacientes hemotransfundidos (n=916) e não-hemotransfundidos (n=3112). Foi realizada análise univariada através do teste t de Student, e análise multivariada com o uso de regressão logística Bivariada (Stepwise Forward). Foram consideradas significativas as variáveis com P

Effects of the use of mechanical ventilation weaning protocol in the Coronary Care Unit: randomized study

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

CONCLUSION: The use of a specific protocol based on the spontaneous breathing trial for mechanical ventilation weaning in heart patients had better outcomes than weaning carried out without a standardized protocol, with shorter weaning times and lower reintubation rates. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Brazilian perfusionists and arterial roller pump adjustment: comparison between static and dynamic calibration method

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

CONCLUSION: Brazilian perfusionists tend to adjust roller pumps with less occlusive settings. The amplitudes of the dynamic calibration pressure tend to be smaller for more experienced perfusionists because their skills increase with time. The device can be used by the perfusionist to adjust roller pumps with greater accuracy and mainly repeatability in few minutes. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Design conception and experimental setup for in vitro evaluation of mitral prosthetic valves

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

CONCLUSIONS: In order to improve the analysis of hydrodynamic shear stress and prediction of haemolysis, the experimental results may be used to regulate a numerical model using 'Computational Fluid Dynamics' (CFD). (Source: Revista Brasileira de Cirurgia Cardiovascular)

Predictors of infection in post-coronary artery bypass graft surgery

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

INTRODUÇÃO: Embora a cirurgia de revascularização miocárdica (CRM) seja uma boa alternativa terapêutica na doença arterial grave, pode evoluir com complicações, especialmente infecções. OBJETIVOS: Determinar a incidência de infecção no pós-operatório de CRM e seus preditores clínicos em um centro de referência cardiológico brasileiro. MÉTODOS: Estudo de coorte. Foram coletados dados de todos os pacientes submetidos à CRM entre janeiro/2004 e fevereiro/2006, excluindo-se cirurgias de urgência, sem glicemia pré-operatória e com infecção prévia à cirurgia. Análise estatística: teste t-Student, qui quadrado e regressão logística. RESULTADOS: Foram avaliados 717 pacientes, 61,9 ± 11 anos, 67,1% homens, 29,6% com diabetes, dos quais 137 (19,1%) desenvolveram infe...

Skeletonized left internal thoracic artery is associated with lower rates of mediastinitis in diabetic patients

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

CONCLUSIONS: We suggest that diabetics should be considered for strategies to minimize risk of infection. In diabetics that undergo unilateral ITA, the problem seems to be related to how ITA is harvested. Diabetics should always be considered for use of skeletonized ITA.INTRODUÇÃO: Mediastinite é uma complicação séria da esternotomia mediana e está associada a significativa morbidade e mortalidade. Diabetes é um temido fator de risco para mediastinite, visto com cautela pelos cirurgiões cardiovasculares. OBJETIVO: Identificar fatores de risco para mediastinite em diabéticos submetidos à CRM com uso unilateral da ATI na Divisão de Cirurgia Cardiovascular do Pronto Socorro Cardiológico de Pernambuco - PROCAPE. MÉTODOS: Estudo retrospectivo de 157 pacientes diabéticos operados ...

Osteopontin expression and its possible functions in the aortic disorders and coronary artery disease

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

CONCLUSION: These data may provide evidences that OPN may play a role in the pathogenesis of aortopathies including aortic dissection, aortic aneurysm, and coronary artery disease. OPN might be of potential perspective as a clinically diagnostic tool in the evaluations of the complex remodeling process incorporating vascular injury and repair.OBJETIVOS: A osteopontina (OPN) está estreitamente associada com os processos de oncogênese e remodelação. Entretanto, essa citocina era raramente avaliada na presença de aortopatias, especialmente na dissecção aórtica aguda. O objetivo do presente estudo foi avaliar a expressão de OPN por meio de abordagens moleculares biológicas, de modo a oferecer uma melhor compreensão dos possíveis mecanismos das aortopatias. MÉTODOS: Pacientes conse...

A bovine pericardium rigid prosthesis for left ventricle restoration: 12 years of follow-up

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

BACKGROUND: Myocardial infarction might result in dilated left ventricle and numerous techniques have been described to restore the original left ventricle shape and identify tools for late survival assessment. The aim of this study is to compare our experience with a modified Dor procedure using a rigid prosthesis to the septal anterior ventricular exclusion procedure (SAVE) for left ventricle restoration. The EuroScore index for prediction of late follow up survival was evaluated. METHODS: We evaluated 80 patients who underwent left ventricle restoration between 1999 to 2007 and eight patients were excluded with incomplete data. A modified Dor procedure with rigid prosthesis (MD group) was performed on 53 patients and 19 underwent the septal anterior ventricular exclusion procedure (SAVE...

Fractal dimension in quantifying the degree of myocardial cellular rejection after cardiac transplantation

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

CONCLUSION: FD may contribute to the assessment of myocardial cellular rejection. Higher values are directly associated with progressively higher degrees of rejection. This may help in decision making of doubtful cases and those which contemplate the intensification of immunosuppressive medication. (Source: Revista Brasileira de Cirurgia Cardiovascular)

The importance of the internet for medical societies

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

The Einstein's frog

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

BJCVS has impact factor of 0.963

Revista Brasileira de Cirurgia Cardiovascular — Sun, 11 Sep 2011 07:27:46 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

Erratum

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

We present a case of brachial artery infected aneurysm in a patient with infective endocarditis caused by Streptococcus bovis. A 49-year-old man presented with fever dyspnea and a pansystolic murmur with irradiation to axilla. The echocardiogram revealed vegetation in native mitral valve. After mitral valve replacement with bioprosthesis, it was observed pulsatile mass of five centimeters in diameter at antecubital fossa of right upper limb. It was made the diagnosis of infected aneurysm of the brachial artery, and the surgery was performed successfully. The aim of this case report is to show a rare complication after infective endocarditis (Source: Revista Brasileira de Cirurgia Cardiovascular)

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Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

Iseu Affonso da Costa, pioneer of the brazilian heart surgery: my father, our pride!

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

Fontan postoperative complication: antegrade pulmonary flow

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

Subvalvular aortic membrane resection

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

Infected aneurysm of brachial artery after mitral valve infective endocarditis

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

Ruptured thoracic aortic aneurysm in patient with systemic lupus erythematosus

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

It is reported a ruptured descending thoracic aortic aneurysm in a 25-year-old systemic lupus erythematosus woman who underwent 19 years steroid therapy. She was treated with 2 endovascular stent-grafts, discharged from hospital 13 days after the procedure in good health. Three months later she returned with hemorrhagic shock due to high digestive hemorrhage secondary to an aortic-esophageal fistula. She underwent to an open emergency surgery, and died during the post-operative periodPaciente de 25 anos, do sexo feminino, portadora de lúpus eritematoso sistêmico, fazendo uso de corticoesteroide havia 19 anos, deu entrada em unidade de emergência com aneurisma roto de aorta torácica descendente. Foi submetida a tratamento endovascular com 2 stents, recebeu alta hospitalar no 13º dia de...

Vacuum-assisted venous drainage in cardiopulmonary bypass and need of blood transfusion: experience of service

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

OBJETIVO: Relatar a experiência com a técnica da drenagem venosa assistida a vácuo (DVAV) na cirurgia cardíaca com circulação extracorpórea (CEC) e a necessidade de hemotransfusão. MÉTODOS: Estudo retrospectivo em prontuários médicos de 111 pacientes operados com a aplicação da DVAV, no período de outubro de 2006 a fevereiro de 2008, no Hospital Esperança, em Recife, Pernambuco. A necessidade de hemotransfusão foi verificada dentro do único grupo estudado, com o uso da DVAV, comparada às variáveis, sexo, idade e peso dos pacientes nos períodos pré-CEC e transoperatório, com uso do teste Qui-quadrado e t-Student. RESULTADOS: No período pré-CEC, apenas 10% dos pacientes necessitaram de hemotransfusão, contra 12% da amostra no transoperatório. Foi observado que 17% d...

Alveolar recruitment in patients in the immediate postoperative period of cardiac surgery

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

Complicações pulmonares no pós-operatório de cirurgia cardíaca são frequentes, destacando-se a atelectasia e a hipoxemia. As manobras de recrutamento alveolar contribuem significativamente para a prevenção e o tratamento destas complicações. Desta forma, este estudo buscou agrupar e atualizar os conhecimentos relacionados à utilização das manobras de recrutamento alveolar no pós-operatório imediato de cirurgia cardíaca. Observou-se a eficácia do recrutamento alveolar por meio de diferentes técnicas específicas e a necessidade do desenvolvimento de novas pesquisasLung complications during postoperative period of cardiac surgery are frequently, highlighting atelectasis and hypoxemia. Alveolar recruitment maneuvers have an important role in the prevention and treatment of t...

Cystic medial necrosis: pathological findings and clinical implications

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

Cystic medial necrosis (CMN) is a disorder of large arteries, in particular the aorta, characterized by an accumulation of basophilic ground substance in the media with cyst-like lesions. CMN is known to occur in certain connective tissue diseases such as Marfan syndrome, Ehlers-Danlos syndrome, and annuloaortic ectasia, which usually result from degenerative changes in the aortic wall. The relationships between CMN and congenital heart defects as well as other disorders have been evidenced. The mechanisms are still controversial, even though many molecular studies have been conducted. The aim of the present article is to provide a comprehensive overview of the CMN lesion in terms of pathologic features, clinical implications and etiologies based on molecular research resultsA necrose cís...

Anatomical eponyms in Cardiology from to the 60s to the XXI century

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

CONCLUSION: Should eponyms be abandoned? Of course not, once they remain a useful reflection of medical history. We could prove to our journey from 1960 to 2011, that the best well-known Atlas and Textbooks available do not use so many anatomical eponyms in Cardiology. They are only 25 (without including arteries, veins, and nerves of the cardiovascular system) and all the authors use no more than 9 or 12 of them. We just want to alert the Health and Allied Health Sciences Professional and students that we 'strongly recommend' not to use an eponym when it is made at the expense of an anatomical structureINTRODUÇÃO: Epônimo, do Grego [epi, "sobre"] + [ónoma, nome de pessoa ou objeto], é uma pessoa, real ou fictícia, que dá ou empresta seu nome a alguma coisa. Epônimos são usados di...

Surgical treatment of patent ductus arteriosus in adults

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

CONCLUSION: In this series, the surgical treatment of patent arterial duct in adults could be done without mortality and low incidence of complications (Source: Revista Brasileira de Cirurgia Cardiovascular)

Long term results of septal myectomy in the treatment of obstructive hypertrophic cardiomyopathy

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

CONCLUSION: Surgical septal myectomy can be performed safely, with excellent survival, improvement from symptoms and relief for LVOT obstruction in patients with OHCM. The early benefits were remained at long term (Source: Revista Brasileira de Cirurgia Cardiovascular)

Experimental study of pulsatile implantable electromechanical artificial ventricle

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

CONCLUSIONS: This kind of research is arduous and complex where at each experiment many problems are indentified in the implantability and in the device, which are sistematic correct, to became device/procedure safe and effective (Source: Revista Brasileira de Cirurgia Cardiovascular)

Predictors of mortality in patients over 70 years-old undergoing CABG or valve surgery with cardiopulmonary bypass

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

OBJETIVO: Identificar fatores de risco em septuagenários e octogenários submetidos à cirurgia cardiovascular com circulação extracorpórea (CEC). MÉTODOS: Avaliadas variáveis peri-operatórias de 265 pacientes com mais de 70 anos; desses, 248 (93,6%) eram septuagenários e 17 (6,4%) eram octogenários. RESULTADOS: Não houve diferença de mortalidade entre eles, com mortalidade global de 22 (8,3%) pacientes. Não houve diferença em relação ao tipo de procedimento (revascularização ou tratamento valvar) (P=0,545). As variáveis pré-operatórias não aumentaram o risco de morte. Enxerto arterial ou venoso (P=0,261) e número de enxertos utilizados por paciente (P=0,131) não aumentaram a mortalidade. O grupo de sobreviventes apresentou tempo médio de CEC de 70 ± 27 minutos e o...

Catch up in children with Down syndrome and congenital heart disease

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

CONCLUSIONS: We concluded that malnutrition common in children with DS since birth. DS children with congenital heart and surgical indication were smaller and lighter than those without or with mild disease. PO recovery occurred in 6 months for weight and one year for height, with no difference in the age at the time of surgery (Source: Revista Brasileira de Cirurgia Cardiovascular)

Pulmonary pressure by echocardiophy in chagasic patients on heart transplant waiting list

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

INTRODUÇÃO: O paciente com insuficiência cardíaca desenvolve aumento da pressão pulmonar por mecanismo retrógrado e a hipertensão arterial pulmonar (HP) é um marcador de mau prognóstico. OBJETIVO: Correlacionar pressão pulmonar ao ecogardiograma (eco) e ao cateterismo, em pacientes em lista de espera para transplante cardíaco (TC), especialmente nos chagásicos. MÉTODOS: Avaliamos 90 pacientes no HC-UFMG entre 2004 e 2009. Todos realizaram cateterismo e eco no pré-transplante. A idade média foi de 45,5 anos, sendo 68(75,6%) homens, 42(46,7%) chagásicos, 32(35,6%) portadores de miocardiopatia dilatada e 10(11,1%) isquêmicos. RESULTADOS: A eco-PSAP (pressão sistólica arterial pulmonar) média foi de 45 ± 12mmHg. A cat-PSAP média foi de 47 ± 14mmHg. A eco-PSAP-chagásicos...

Thrombocytopenia in cardiac surgery: diagnostic and prognostic importance

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

OBJETIVO: Pacientes submetidos à cirurgia cardíaca estão mais propensos a desenvolver plaquetopenia. A trombocitopenia induzida por heparina acomete cerca de 5% dos pacientes. O objetivo foi avaliar a importância clínica da trombocitopenia grave em pacientes no pós-operatório de cirurgia cardíaca. MÉTODOS: Estudo prospectivo observacional que incluiu os pacientes de cirurgia cardíaca com plaquetas

Prevalence of infections in surgical sutures on myocardial revascularization surgery

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

CONCLUSION: Besides the raise of wound infections along the 3 years, the prevalence kept stable, once the numbers of maid surgeries proportionately raised. Sex is not a significant variable to the occurrence of myocardium revascularizations wound infection. Old aged people are more predictable to this complication and the causing microorganism is variable (Source: Revista Brasileira de Cirurgia Cardiovascular)

Pediatric cardiac surgery under the parents sight: a qualitative study

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

CONCLUSION: The experience of families was characterized by ambivalent feelings such as fear of death, guilt and helplessness against the different stages of treatment. The anguish and anxiety prevailed in the face of unknown situations when information were required before therapeutic procedures, hospital routines and the actual life situation of the families (Source: Revista Brasileira de Cirurgia Cardiovascular)

Risk factors for mediastinitis after coronary artery bypass grafting surgery

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

CONCLUSION: This study identified the following independent risk factors for mediastinitis after CABG: obesity, diabetes, smoking, use of pedicled ITA and on-pump CABGOBJETIVO: A mediastinite é uma complicação grave da esternotomia mediana, estando associada a significativa morbidade e mortalidade. O objetivo deste estudo é identificar fatores de risco para mediastinite em pacientes submetidos à cirurgia de revascularização miocárdica (CRM), sem o uso bilateral da artéria torácica interna (ATI), na Divisão de Cirurgia Cardiovascular do Pronto Socorro Cardiológico de Pernambuco - PROCAPE. MÉTODOS: Estudo retrospectivo compreendendo 500 pacientes consecutivos operados entre maio de 2007 e abril de 2010. Avaliaram-se 10 variáveis pré-operatórias, sete variáveis intraoperatór...

Long-term survival of octogenarian patients submitted to isolated coronary artery bypass graft surgery

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

CONCLUSION: Results are in agreement with international reports. Mean survival was 6.5 years and the survival rate at 5 years was 65.2% (Source: Revista Brasileira de Cirurgia Cardiovascular)

Nitrite exhaled breath condensate study in patients undergoing cardiopulmonary bypass cardiac surgery

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

CONCLUSION: These data suggest that NO measurement in EBC is feasible in cardiac surgery patientsINTRODUÇÃO: Estudos mostrando alterações das concentrações de nitrito (NO2 - ) exalado, com biomarcador de lesão, são raros em pacientes submetidos à cirurgia cardíaca. Nesse contexto, o seu estudo no pré e pós - operatório de cirurgias cardíacas poderá contribuir para novos dados clínicos. OBJETIVO: O objetivo foi comparar os níveis de nitrito (NO2 - ) do condensado do exalado pulmonar (CEP) no pré e pós - operatório de cirurgia cardíaca com circulação extracorpórea. MÉTODOS: Vinte e oito indivíduos foram alocados em três grupos: 1) controle, 2) revascularização do miocárdio e 3) correção valvar. Os níveis de NO2 - foram dosados por quimioluminiscência em amos...

The implications of serum enzymes and coagulation activities in postinfarction myocardial

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

CONCLUSION: Myocardial rupture leads to extremely high serum enzyme and coagulation activities except for fibrinogen after the onset. The evaluation of these biomarkers may help in making diagnostic and treatment decisions and in judging the clinical prognosis of such patientsOBJETIVO: As associações entre doenças cardiovasculares e enzimas sorológicas ou atividades de coagulação foram amplamente documentadas em pacientes com infarto do miocárdio. No entanto, as alterações destes biomarcadores em pacientes com ruptura cardíaca após infarto do miocárdio foram raramente relatadas. O objetivo deste estudo é apresentar o perfil dos biomarcadores em pacientes com ruptura cardíaca após infarto do miocárdio. MÉTODOS: De 2004 a 2008, 19 pacientes consecutivos foram referidos a est...

The 2000 Bernstein-Parsonnet score and EuroSCORE are similar in predicting mortality at the Heart Institute, USP

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

OBJETIVO: Avaliar o desempenho do 2000 Bernstein-Parsonnet (2000BP) e EuroSCORE aditivo (ES) na predição de mortalidade cirúrgica no Instituto do Coração da Universidade de São Paulo (InCor-USP). MÉTODOS: Desenho prospectivo e observacional. Setecentos e quarenta e quatro pacientes consecutivos submetidos à cirurgia de revascularização miocárdica, valvar ou associada, entre maio e outubro de 2007, foram analisados. A mortalidade foi calculada com os escores 2000BP e ES. A correlação entre mortalidade estimada e mortalidade observada foi validada mediante testes de calibração e discriminação. RESULTADOS: Os pacientes foram estratificados em cinco grupos para o 2000BP e três para o ES. O teste de Hosmer Lemeshow para o 2000BP (P = 0,70) e para o ES (P = 0,39) indica uma boa...

The surgeon

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

The aorta, the elastic tissue and cystic medial necrosis

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

BJCVS: 25 years of brilliant career

Revista Brasileira de Cirurgia Cardiovascular — Sun, 19 Jun 2011 11:09:59 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

Letters to the Editor

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

We report the case of an asymptomatic 43-year-old-man with a lipoma of the interventricular septum. Diagnosis was established during routine medical examination by 2-dimensional echocardiography and confirmed by computed tomography and magnetic resonance imaging. The patient underwent successful resection of the tumor. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Acknowledgment

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

Correction of aortic coarctation with interposition of a tube in a 12 years-old child

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

Correction of coarctation of the aorta with end anastomosis in premature newborn

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

Lipoma resection of the interventricular septum

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

Surgical treatment of pulmonary venous baffle obstruction after modified Senning procedure

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

Paciente de 13 anos de idade, sexo masculino, submetido à correção de estenose de túnel das veias pulmonares (ETVP) após cirurgia de Senning modificada realizada aos 5 meses. O quadro clínico era de congestão pulmonar e broncopneumonias de repetição e o ecocardiograma confirmou ETVP. Uma angioplastia com balão foi realizada previamente à correção cirúrgica com circulação extracorpórea. A placa de pericárdio bovino empregada para ampliação do átrio direito retraiu-se e calcificou, levando a ETVP. A placa foi removida e o átrio direito foi ampliado com um retalho de politetrafluoretileno. O ecocardiograma transesofágico intraoperatório demonstrou redução significativa da estenose.A 13-year-old male was admitted to undergoing correction of a pulmonary venous baffle s...

Surgical repair of D-TGA with an aortopulmonary window and ventricular septal defects

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

We describe a case of D-Transposition of great arteries with an aortopulmonary window and multiple ventricular septal defects in a 5-month boy who underwent successful surgical repair.A transposição das grandes artérias com uma janela aortopulmonar é uma anomalia congênita rara. Descrevemos um caso de transposição das grandes artérias com janela aortopulmonar e múltiplos defeitos do septo ventricular em um menino de 5 meses submetido a tratamento cirúrgico com sucesso. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Leukocytes and the inflammatory response in ischemia-reperfusion injury

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

Os eventos de isquemia-reperfusão desencadeiam uma resposta inflamatória sistêmica que pode levar a lesões celulares e até falência de órgãos. Tais repercussões são notadas no pós-operatório de cirurgias, em especial, com o uso de circulação extracorpórea. Sabe-se, atualmente, que os leucócitos exercem importante papel neste processo. Assim, este estudo aborda o papel dos leucócitos na fisiopatologia das lesões de isquemia-reperfusão e a ativação das cascatas inflamatórias por esse processo e procura auxiliar na compreensão destes mecanismos assim como trazer contribuições acerca das abordagens terapêuticas que possam atenuá-los. Esta revisão bibliográfica retrospectiva foi realizada a partir de documentos científicos publicados nos últimos dez anos, em portu...

Focus on quality of life

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

This article aims to discuss aspects concerning Healthrelated to quality of life concepts. This paper presents some piece of information regarding the quality of life instruments. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Authorship for scientific papers: the new challenges

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

This article discusses the criteria for authorship attribution, the reasons for the growing indices of coauthorship and the challenges to determine authorship in electronic journals. Through literature review and case study (bibliographic search in scientific database), it shows ways to avoid that "misbehaviors" related to the authorship attribution affect the credibility of science. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Cardiothoracic Surgery League from University of São Paulo Medical School: twelve years in medical education experience

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

CONCLUSION: LCCT has met its goals, since most current and former members recognized its role in their medical training, besides it is a good way to produce scientific initiation.INTRODUÇÃO: Ligas acadêmicas são entidades pertencentes a faculdades de Medicina e seus hospitais. Compartilham os objetivos: pesquisa, ensino e assistência à saúde. Há doze anos, fundou-se a Liga de Cirurgia Cardiotorácica (LCCT) pela Faculdade de Medicina da USP, com o objetivo de fornecer aos estudantes de Medicina a oportunidade de ter conhecimento mais profundo em Cirurgia Cardiovascular e para participar de iniciação científica nesse campo. OBJETIVO: Avaliar a experiência adquirida nos 12 anos de existência da LCCT. Métodos: Membros atuais e antigos da LCCT responderam a um formulário entregu...

Analysis of hemodynamic performance of the bovine pericardium valved conduit, implanted in the aortic position in ovines

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

OBJETIVOS: A necessidade de substituição da valva, aorta ascendente e reimplante coronariano em pacientes onde a anticoagulação é indesejável, é crescente. Avaliamos em animais o comportamento hemodinâmico de um conduto valvado aórtico feito com pericárdio bovino tratado pelo glutaraldeído (CVAP). MÉTODOS: Para isto, implantamos CVAPs em oito ovinos e os explantamos após 150 dias de pós-operatório. Realizouse estudo angiográfico e hemodinâmico no pré-operatório e antes do explante. EcoDopplercardiogramas foram realizados nos dias 30 e 150 de pós-operatório (teste) e também em cinco ovinos não operados. Após explantados, submetemos os CVAPs à avaliação macroscópica, radiológica e histológica por microscopia óptica. RESULTADOS: Na análise hemodinâmica, as pre...

Mitral valve repair by Double Teflon technique: cardiac remodeling analysis by tridimensional echocardiography

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

INTRODUÇÃO: A plastia valvar mitral é o tratamento de escolha para a insuficiência mitral, porém a literatura é escassa em relação ao comportamento do átrio e ventrículo esquerdos após a plastia mitral sem utilização de anéis protéticos. OBJETIVO: Analisar a morfologia e a função cardíaca de indivíduos submetidos à plastia valvar mitral pela técnica de Duplo Teflon, por meio da ecocardiografia tridimensional. MÉTODOS: Foram incluídos 14 pacientes com insuficiência mitral mixomatosa, submetidos à plastia mitral pela técnica de Duplo Teflon. Treze pacientes encontravam-se em classe III/IV. Os pacientes foram avaliados nos períodos pré-operatório, pós-operatório imediato (POI), 6 meses e 1 ano após a plastia mitral. Foi utilizado teste de análise de variância...

Cardiovascular behavior during rehabilitation after coronary artery bypass grafting

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

OBJECTIVE: The aim of the present study was to assess the behavior of cardiovascular variables during an in-hospital cardiovascular rehabilitation program in patients following myocardial revascularization surgery. METHODS: A total of 14 patients (mean age: 55.4 ± 6.4 years, 78.6% male) participated in the study, all of whom had a previous diagnosis of coronary insufficiency and indication for elective surgery. The protocol consisted of a group of low-impact (2-3 METs) upper/lower extremity and walking exercises performed both pre and post-operatively (3rd and 4th days). The following variables were evaluated at rest and following the exercise program: heart rate (HR, bpm); systolic arterial pressure (SAP, mmHg); diastolic arterial pressure (DAP, mmHg); mean arterial pressure (MAP, mmHg);...

Pulmonary artery perfusion does not improve brain natriuretic peptide (BNP) levels in suine experimental research

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

CONCLUSION: Main pulmonary artery controlled perfusion for 30 minutes did not yield substantial modifications in BNP expression and histologic pattern of the right ventricular myocardium. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Epsilon-aminocaproic acid influence in bleeding and hemotransfusion postoperative in mitral valve surgery

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

INTRODUÇÃO: O ácido épsilon aminocapróico é um antifibrinolítico usado em cirurgia cardiovascular a fim de inibir a fibrinólise e reduzir o sangramento após circulação extracorpórea (CEC). OBJETIVO: Analisar a influência do uso do ácido aminocapróico no sangramento e na necessidade de hemotransfusão nas primeiras 24 horas em pós-operatório de cirurgias valvares mitrais. MÉTODOS: Estudo prospectivo, 42 pacientes, randomizados e divididos em dois grupos, de igual número: grupo I - controle e grupo II - ácido épsilon aminocapróico. No grupo II, foram infundidos 5 gramas de AEAC na indução anestésica, após heparinização plena, no perfusato da CEC, após reversão da heparina e uma hora após o final da cirurgia, totalizando 25 gramas. No grupo I, foi infundido apen...

The hypoplastic left heart syndrome is not a risk factor for Fontan operation

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

OBJETIVO: Demonstrar a mortalidade hospitalar de crianças submetidas à operação de Fontan e determinar se a síndrome do coração esquerdo hipoplásico (SCEH) constitui fator de risco para mortalidade. MÉTODOS: De agosto 2001 a junho 2008, 76 pacientes foram submetidos à operação de Fontan, sendo divididos em dois grupos: grupo A com 54 pacientes, sendo 31 (40,7%) portadores de atresia tricúspide e variantes, seis (7,8%) de dupla via de entrada ventrículo esquerdo, quatro (5,3%) de defeito do septo atrioventricular total e 13 (17,1%) de outras cardiopatias congênitas complexas; e grupo B constituído por portadores de SCEH, num total de 22 (28,9%) pacientes. RESULTADOS: Os pacientes do grupo A tiveram média de idade de 6,47 anos ± 4,83 e do grupo B de 2,08 anos ± 0,24 P

Relation between respiratory muscle strength with respiratory complication on the heart surgery

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

CONCLUSIONS: The respiratory strength preoperative couldn't be a predictor of postoperative pulmonary complication. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Analysis of aortic root surgery with composite mechanical aortic valve conduit and valve-sparing reconstruction

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

OBJETIVO: Análise comparativa dos resultados imediatos e tardios da reconstrução da raiz da aorta com o tubo valvulado e com a preservação da valva aórtica. MÉTODOS: No período de novembro de 2002 a setembro de 2009, 164 pacientes com idade média de 54 ± 15 anos, sendo 115 do sexo masculino, foram submetidos ao tratamento cirúrgico da raiz da aorta. Foram 125 tubos valvulados e 39 reconstruções da raiz da aorta com preservação da valva aórtica. Dezesseis por cento dos pacientes eram portadores de síndrome de Marfan e 4,3% apresentavam valva aórtica bivalvulada. Cento e quarenta e quatro (88%) pacientes foram acompanhados durante tempo médio de seguimento de 41,1 ± 20,8 meses. RESULTADOS: A mortalidade hospitalar total foi de 4,9%; sendo 5,6% nas operações com tubo val...

Respiratory muscle training in patients submitted to coronary arterial bypass graft

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

CONCLUSIONS: Patients submitted to CABG presents an impaired respiratory muscle strength in their post operatory. RMT performed in this phase was effective to restore the ventilatory capacity in the following parameters: MIP, MEP, PEF and tidal volume, in this group of patients. (Source: Revista Brasileira de Cirurgia Cardiovascular)

EuroSCORE and mortality in coronary artery bypass graft surgery at Pernambuco Cardiologic Emergency Medical Services [Pronto Socorro Cardiológico de Pernambuco]

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

OBJETIVOS: O objetivo desse estudo foi avaliar a aplicabilidade do EuroSCORE em pacientes submetidos à cirurgia de revascularização miocárdica na Divisão de Cirurgia Cardiovascular do Pronto Socorro Cardiológico de Pernambuco - PROCAPE. MÉTODOS: Estudo retrospectivo envolvendo 500 pacientes operados entre maio de 2007 a abril de 2010. Os registros continham todas as informações utilizadas para calcular o EuroSCORE. O desfecho de interesse foi óbito. Análises univariada e multivariada por regressão logística backward foram aplicadas para verificar associação entre cada variável do EuroSCORE e ocorrência de óbito. Foram calculadas medidas de sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo. O poder de concordância do EuroSCORE entre mortal...

One and a half ventricular repair as an alternative for hypoplastic right ventricle

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

CONCLUSIONS: Surgical treatment of congenital cardiac anomalies in the presence of a hypoplastic right ventricle by means of one and a half ventricle repair has the advantages of reducing the surgical risk of biventricular repair compared to the Fontan circulation; it maintains a low right atrium pressure, a pulsatile pulmonary blood flow and improves the systemic oxygen saturation with short and medium-term promising results. Longer follow-up is needed to prove the efficacy of such a repair in the long term.OBJETIVO: Pacientes com cardiopatia congênita complexa e caracterizada por hipoplasia do ventrículo direito têm uma opção de correção paliativa com a operação de um ventrículo e meio. MÉTODOS: De julho de 2001 a março de 2009, nove pacientes (idade média de 5,2 anos, varia...

Oral anticoagulation in carriers of mechanical heart valve prostheses: experience of ten years

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

CONCLUSIONS: The period of time that patients that remain within the desired anticoagulation interval has directly relations with occurrence of complications. Even with careful follow-up at a specialized outpatient unit, only approximately one third of the patients showed an adequate anticoagulation level in more than half of the consultations. (Source: Revista Brasileira de Cirurgia Cardiovascular)

A score proposal to evaluate surgical risk in patients submitted to myocardial revascularization surgery

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

INTRODUÇÃO: Escores para avaliação de risco cirúrgico em pacientes submetidos à cirurgia de revascularização miocárdica são amplamente utilizados. OBJETIVO: Construir um escore capaz de predizer mortalidade em pacientes submetidos à cirurgia de revascularização miocárdica. MÉTODOS: No período entre janeiro de 1996 e dezembro de 2007, foram coletados dados de 2809 pacientes submetidos à cirurgia de revascularização miocárdica no Hospital São Lucas da PUC-RS. Em cerca de 2/3 da amostra (n=1875), foi construído o escore, após análises uni e multivariada. No restante (n=934), o escore foi validado. O escore final foi construído com a amostra total, utilizando as mesmas variáveis (n=2809). A acurácia do modelo foi testada utilizando-se a área sob a curva ROC. RESULTA...

Ex vivo lung evaluation and reconditioning

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

CONCLUSIONS: The ex vivo evaluation model can improve oxygenation capacity of "marginal" lungs rejected for transplantation. It has a great potential to increase lung donor availability and, possibly, to reduce the waiting time on the list. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Mechanical circulatory support: a great gap in Brazilian cardiac surgery

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

Qualis 2011-2013: the Three Rs

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

Multidisciplinary approach to heart disease: the patient as a priority in medical decision

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

Extracorporeal circulation

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

Continuing Medical Education: essential

Revista Brasileira de Cirurgia Cardiovascular — Sat, 19 Feb 2011 02:07:23 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

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Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

The battle of the quality: leaders of Latin American ranking, USP and Unicamp discuss how to raise the impact of its research

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

We report a case of a 48-year-old patient diagnosed with syphilitic aortitis who had undergone surgery for the replacement of the aortic root and aortic valve. The diagnosis hypothesis was pondered because of the in situ aspect of the arterial damage. Although the rarity of the disease, it persists. (Source: Revista Brasileira de Cirurgia Cardiovascular)

To the master, with love (1943-2010)

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

Surgical correction of the anomalous origin of right pulmonary artery of aorta

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

Expansion of the neopulmonary late of Jatene's operation

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

Syphilitic aortitis: diagnosis and treatment. Case report

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

Coronary-artery spasm after coronary artery bypass graft surgery without extracorporeal circulation: Diagnostic and management

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

O espasmo de artérias coronárias no perioperatório de cirurgia de revascularização do miocárdio é uma complicação grave, com elevada mortalidade. Paciente de 51 anos submetido à cirurgia de revascularização do miocárdio sem circulação extracorpórea. Apresentou no 1ºdia de pós-operatório (PO) alteração enzimática e supradesnivelamento do segmento ST, evoluindo, em seguida, em fibrilação ventricular, com reanimação cardiopulmonar com sucesso. Cateterismo cardíaco demonstrou espasmo importante de todas as artérias coronárias e da anastomose entre artéria torácica interna esquerda com artéria interventricular anterior. Utilizados vasodilatadores intracoronarianos e intra-enxerto, com restabelecimento de seus calibres usuais, imediata melhora clínica e estabilid...

Implantable cardioverter-defibrillator in pregnant women with hypertrophic cardiomyopathy

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

We describe the successful implantation of a cardioverter-defibrillator (ICD) in two pregnant women with hypertrophic cardiomyopathy at high risk. The indication of ICD and the necessary care for ICD implantation during pregnancy are discussed and were the main objectives of this case report. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Surgical treatment of chronic type A aortic dissection in patients undergoing coronary artery bypass grafting

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

O tratamento operatório da dissecção aórtica é um desafio para o cirurgião cardíaco, sobretudo nos pacientes submetidos a operação cardíaca prévia. Nosso objetivo neste relato de caso é demonstrar como tratamos a dissecção aórtica crônica tipo A em paciente revascularizado utilizando cânulas arterial e venosa percutâneas.Surgical treatment of aortic dissection is a challenge for the cardiac surgeon, especially in patients undergoing cardiac operations. Our objective in this case report is to demonstrate how we treat the chronic type A aortic dissection in patients revascularized using percutaneous arterial and venous cannulae. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Is it time to adopt beating-heart coronary artery bypass grafting? A review of literature

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

Avoiding the morbidity of cardiopulmonary bypass should theoretically reduce the incidence of organ dysfunction and lead to improved patient outcomes. Recently, cardiac mechanical stabilization techniques were developed, facilitating on-pump CABG (OPCAB). The use of CPB may influence the economic outcome, while maintaining quality of care and patient satisfaction. MEDLINE, EMBASE, Cochrane Controlled Trials Register (CCTR), Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), Science Citation Index (SCI), Current Contents, NHS Economic Evaluation Database (NEED), and International Network of Agencies for Health Technology Assessment (INAHTA) databases were searched from the date of their inception to the end of March 2008, using the search ter...

Myocardium functional recovery protection by omeprazole after ischemia-reperfusion in isolated rat hearts

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

OBJETIVO: Analisar efeitos do omeprazol na proteção da recuperação funcional de corações isolados de ratos submetidos à lesão de isquemia-reperfusão. MÉTODOS: Foram estudados 12 ratos Wistar, peso corpóreo médio de 280g. Após anestesia com injeção intra-abdominal de 10mg de cetamina e 2mg de xilazina, os corações foram removidos e mantidos em perfusão com solução Krebs-Henseleit (95%O2 e 5% CO2, 37ºC, 110-120mmHg de pressão de perfusão e pressão diastólica de 8 mmHg) em sistema Langendorff, modificado, descartável, modelo FCSFA-ServCor (Comex Ltda.). Os seis corações do Grupo I (GI) e os seis do Grupo II (GII) foram submetidos a 20 minutos de isquemia e 30 minutos de reperfusão. Nos corações do Grupo II, imediatamente antes da isquemia, foram administrados vi...

Evaluation of the biological behavior of decellularized pulmonary homografts: an experimental sheep model

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

CONCLUSION: In this experimental model, the Decell-H behaved as an excellent valve substitute. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Farmacologic test pre implants in hypertension pulmonary elevated and still in candidates to heterotopic transplantation

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

CONCLUSION: This methodology allowed the conversion of the technique for heterotopic orthotopically, with good early and late otcomes. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Pericardium closure after heart operations: a safety option?

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

CONCLUSION: Pericardium closure is a simple method to facilitate resternotomy during subsequent re operative procedures. However, cardiac surgeons should be aware of the transient deterioration in hemodynamics associated with it, even thought there was no clinical significance in this study. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Influence of physical activity during leisure time in patients in the follow-up two years after CABG

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

CONCLUSION: The results indicate that LTPA does not modify the late prognostic of CABG patients, but CABG itself promotes physical activity and improves long-term functional capacity. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Serum lactate as mortality and morbidity marker in infants after Jatene's operation

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

CONCLUSION: After Jatene's operation, morbidity and mortality can be assessed with the serum lactate levels, suggesting increased values in the third hour is suggestive of a worse prognosis. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Clinical and surgical profile of patients operated for postinfarction interventricular septal rupture

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

OBJETIVOS: Estudar características clínicas, complicações e desfechos intra-hospitalares de pacientes operados por ruptura do septo interventricular pós-infarto. MÉTODOS: Estudo retrospectivo envolvendo 21 pacientes entre janeiro/1996 e junho/2009. Todas as operações foram realizadas na Divisão de Cirurgia Cardiovascular do Complexo Hospitalar HUOC/PROCAPE. RESULTADOS: Idade média dos pacientes foi de 62,81 anos (± 8,21), sendo 61,9% (n=13) do sexo masculino. Ruptura ocorreu, em média, 4,8 dias após o infarto. Foi observado choque cardiogênico em 57,1% (n=12) dos casos, sendo este fator de risco para óbito (100% com choque vs. 22,2% sem choque; P

Assessment and medium-term follow up of heart transplant candidates undergoing low-intensity exercise

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

CONCLUSION: Regarding cardiovascular behavior, the exercise program proved safe and well tolerated, but there is a need for monitoring. Information obtained upon the initial evaluation and during exercise program is associated to decompensation and death. Such information could assist in determining the stage of the disease. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Treatment of atrial fibrillation using ultrasonic cardiac ablation, during valvular heart surgery

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

CONCLUSION: The results showed that the patients who received treatment for atrial fibrillation simultaneously with valvar surgery had advantages related to the control group. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure?

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

CONCLUSION: The right anterolateral thoracotomy associated with aortic cannulation in mitral valve surgery is a simple technique, reproducible and safety. (Source: Revista Brasileira de Cirurgia Cardiovascular)

VEGF gene therapy for angiogenesis in refractory angina: phase I/II clinical trial

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

CONCLUSIONS: Intramyocardial VEGF165 therapy for refractory angina, in this small trial of no option patients, resulted feasible and safe. Early clinical and scintilographic data showed improvements in symptoms and myocardial perfusion, with regression of ischemia severity in treated areas. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Hybrid procedures for complex thoracic aortic diseases

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

CONCLUSION: Hybrid treatment of CTAD is feasible, especially in high risk patients. Proper integration of surgical and endovascular techniques, in addition to clinical and radiological surveillance, makes this technique a great alternative to conventional surgery. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Transapical aortic valve implantation: results of a brazilian prosthesis

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

CONCLUSION: The transapical implantation of cathetermounted bioprosthesis was a feasible procedure. Long term follow-up is mandatory in order to access efficacy and indications. (Source: Revista Brasileira de Cirurgia Cardiovascular)

The pump

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

Research Ethics Committee: mandatory necessity. Requirement needed

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

BJCVS goes 100% digital

Revista Brasileira de Cirurgia Cardiovascular — Tue, 23 Nov 2010 06:19:05 +0100

(Source: Revista Brasileira de Cirurgia Cardiovascular)

Letters to the Editor

Revista Brasileira de Cirurgia Cardiovascular — Sun, 29 Aug 2010 09:48:14 +0100

We report on a case of a 57 years-old white male, patient, who presented superior vena cava syndrome (SVC) for 3 months, derived from an invasive thymoma in the medium and anterior mediastinum, compromising intrinsic and extrinsic to the SVC. After evaluation by computed tomography and magnetic angioresonance of the thorax, the patient underwent radical resection of the thymoma - bypass from left subclavian vein to right atrium, using polytetrafluoroethylene tube. Relevant case of invasive thymoma causing the occlusion of SVC. The clinic evolution of the patient after 7 months was considered satisfactory. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Dr. Itacir Arlindo Franceschini (28 de fevereiro de 1940 - 27 de setembro de 2009)

Revista Brasileira de Cirurgia Cardiovascular — Sun, 29 Aug 2010 09:48:14 +0100

A cirurgia cardiovascular no Brasil: realizações e possibilidade

Revista Brasileira de Cirurgia Cardiovascular — Sun, 29 Aug 2010 09:48:14 +0100

Heart transplantation in child with non-compacted myocardium

Revista Brasileira de Cirurgia Cardiovascular — Sun, 29 Aug 2010 09:48:14 +0100