Revista Brasileira de Cardiologia Invasiva (English Edition)最新文献

{"title":"A giant in the left anterior descending artery","authors":"Pedro Magalhães , Hélder Ribeiro , Sofia Carvalho , Nuno Ferreira , Paulino Sousa , J. Ilídio Moreira","doi":"10.1016/j.rbciev.2015.08.010","DOIUrl":"https://doi.org/10.1016/j.rbciev.2015.08.010","url":null,"abstract":"","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 3","pages":"Page 231"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.08.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91743807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain assessment during transradial catheterization using the Visual Analogue Scale","authors":"Roberto Léo da Silva,&nbsp;Daniel Medeiros Moreira,&nbsp;Tammuz Fattah,&nbsp;Rosana Silveira da Conceição,&nbsp;Ana Paula Trombetta,&nbsp;Luciano Panata,&nbsp;Luiz Eduardo Koenig São Thiago,&nbsp;Luiz Carlos Giuliano","doi":"10.1016/j.rbciev.2015.08.007","DOIUrl":"10.1016/j.rbciev.2015.08.007","url":null,"abstract":"<div><h3>Background</h3><p>Patients undergoing transradial procedures may experience pain associated with radial artery spasm. The pain can be assessed using the Visual Analogue Scale (VAS), an easy-to-apply, one-dimensional method. This study analyzed the perception of pain using the VAS and correlated it with the perception of spasm by the interventionist.</p></div><div><h3>Methods</h3><p>This was an observational, prospective, single-center registry, which included patients undergoing diagnostic or therapeutic transradial procedures. The VAS consists of a 100-mm horizontal line, which has at its extremes the words “no pain” and “unbearable pain”. The patient was instructed to identify the point that represented the perceived pain during the procedure. The interventionist quantified the spasm as zero for no pain, 1 for pain with no resistance to catheter movement, 2 for mild resistance, 3 for moderate resistance, and 4 for intense resistance.</p></div><div><h3>Results</h3><p>Pain assessment by patients using the VAS was possible in all patients, and had a mean of 25.5 ± 25.7<!--> <!-->mm. For the interventionist, spasm was classified as grade zero in 53 cases (35.8%); grade 1 in 67 (45.3%); grade 2 in 24 (16.2%); grade 3 in 3 (2.0%); and grade 4 in 1 patient (0.7%). Kendall's tau-b and Spearman's (rho) rank correlation coefficients were, respectively, 0.527 and 0.647, showing a moderate positive correlation between the perception of pain by the patient and the perception of spasm by the operator.</p></div><div><h3>Conclusions</h3><p>VAS can be used to assess spasm during procedures that use the transradial access, showing a positive correlation with spasm assessment by the interventionist.</p></div><div><h3>Introdução</h3><p>Pacientes submetidos a procedimentos por via transradial podem apresentar dor associada ao espasmo da artéria radial. A dor pode ser avaliada utilizando-se a Escala Visual Analógica (EVA), um método unidimensional de fácil aplicação. Analisamos a percepção de dor utilizando a EVA e a correlacionamos com a percepção de espasmo pelo operador.</p></div><div><h3>Métodos</h3><p>Registro observacional, prospectivo, unicêntrico, que incluiu pacientes submetidos a procedimentos diagnósticos ou terapêuticos por acesso transradial. A EVA é constituída por uma linha horizontal de 100<!--> <!-->mm, que traz nos extremos as inscrições “ausência de dor” e “dor insuportável”. O paciente foi instruído a marcar o ponto que representava a dor percebida no momento do procedimento. O operador quantificou o espasmo como zero se sem dor, 1 para dor sem resistência à movimentação dos cateteres, 2 para resistência leve, 3 para resistência moderada e 4 para resistência intensa.</p></div><div><h3>Resultados</h3><p>A avaliação de dor pelo paciente por meio da EVA foi possível em todos os pacientes, e teve média de 25,5 ± 25,7<!--> <!-->mm. Pelo operador, o espasmo foi classificado em grau zero em 53 casos (35,8%); grau 1 em 67 (45,3%); grau 2 em 24 (","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 3","pages":"Pages 207-210"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.08.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"104902362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous closure of atrial septal defect or foramen ovale guided by intracardiac echocardiography","authors":"Edmundo Clarindo Oliveira,&nbsp;Marco Antônio Gonçalves de Moura,&nbsp;José Augusto de Almeida Barbosa","doi":"10.1016/j.rbciev.2015.08.008","DOIUrl":"https://doi.org/10.1016/j.rbciev.2015.08.008","url":null,"abstract":"<div><h3>Background</h3><p>Transesophageal echocardiography (TEE) is the most widely used method to guide the percutaneous treatment of atrial septal defect (ASD) and patent foramen ovale (PFO), but the necessity of another professional to perform it and the need for general anesthesia are potential disadvantages. Intracardiac echocardiography (ICE) is seen as an alternative to TEE, as it can be performed by the interventionist and requires only local anesthesia with mild or no sedation. The aim of this study was to report our experience with ASD/PFO occlusion guided by ICE.</p></div><div><h3>Methods</h3><p>The ICE uses an ultrasound catheter, which is intravenously inserted in the right heart chambers and acquires images for the intervention through variable positioning of the transducer. Success and complication rates of the procedure were evaluated.</p></div><div><h3>Results</h3><p>From 2011 to 2015, 201 procedures guided by ICE were performed, comprising 139 in patients with ASD and 62 in those with PFO. Most patients were female (64.2%), ages ranged from 7 to 78 years (36.6 ± 19.3 years), and weight ranged from 28 to 92<!--> <!-->kg (62.5 ± 13.0<!--> <!-->kg). Occlutech Figulla^® prostheses were used and all interventions were successful, with fluoroscopy time of 5.7 ± 2.4<!--> <!-->minutes and procedure time of 21.5 ± 6.4<!--> <!-->minutes. Two patients (2.0%) had transient supraventricular tachycardia and two others had arteriovenous fistula at the access site, with spontaneous resolution in the first month of follow-up.</p></div><div><h3>Conclusions</h3><p>ICE provided accurate anatomical information to guide the closure of the ASD/PFO and successfully eliminated the main drawbacks of TEE.</p></div><div><h3>Introdução</h3><p>O ecocardiograma transesofágico (ECO-TE) é o método mais utilizado para guiar o tratamento percutâneo da comunicação interatrial (CIA) e do forame oval (FOP), mas a necessidade de um outro profissional para realizá-lo e de anestesia geral constituem inconvenientes para seu emprego. O ecocardiograma intracardíaco (ECO-IC) apresenta-se como alternativa ao ECO-TE, pois pode ser realizado pelo próprio operador e demanda apenas anestesia local, com leve ou nenhuma sedação. Nosso objetivo foi relatar a experiência do serviço com a oclusão de CIA/FOP guiada por ECO-IC.</p></div><div><h3>Métodos</h3><p>O ECO-IC utiliza cateter de ultrassom, que é introduzido por via venosa em câmaras cardíacas direitas e, por meio de posicionamento variável do transdutor, obtém as imagens adequadas para a intervenção. Foram avaliadas as taxas de sucesso do procedimento e as complicações.</p></div><div><h3>Resultados</h3><p>De 2011 a 2015, foram realizados 201 procedimentos guiados pelo ECO-IC, sendo 139 em pacientes com CIA e 62 com FOP. A maioria dos pacientes era do sexo feminino (64,2%), as idades variaram de 7 a 78 anos (36,6 ± 19,3 anos) e o peso variou de 28 a 92<!--> <!-->kg (62,5 ± 13,0<!--> <!-->kg). Foram utilizadas prótes","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 3","pages":"Pages 216-219"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.08.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90034051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left main coronary artery stent thrombosis","authors":"Ricardo C. Rodrigues,&nbsp;André Coreia,&nbsp;Marco Gomes Serrão,&nbsp;Décio Pereira","doi":"10.1016/j.rbciev.2016.07.007","DOIUrl":"https://doi.org/10.1016/j.rbciev.2016.07.007","url":null,"abstract":"","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 3","pages":"Pages 229-230"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2016.07.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91599705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital and late outcomes of patients undergoing percutaneous mitral valvuloplasty in a center with intermediate volume of structural procedures","authors":"Pedro Beraldo de Andrade ,&nbsp;Marden André Tebet ,&nbsp;Fábio Salerno Rinaldi ,&nbsp;Igor Ribeiro de Castro Bienert ,&nbsp;Luis Fernando Carvalho ,&nbsp;João Antônio de Toledo Galina ,&nbsp;Robson Alves Barbosa ,&nbsp;Ederlon Ferreira Nogueira ,&nbsp;Sérgio Kreimer ,&nbsp;Vinícius Cardozo Esteves ,&nbsp;Luiz Alberto Piva e Mattos ,&nbsp;André Labrunie","doi":"10.1016/j.rbciev.2016.07.004","DOIUrl":"10.1016/j.rbciev.2016.07.004","url":null,"abstract":"<div><h3>Background</h3><p>Percutaneous mitral valvuloplasty is the treatment of choice for rheumatic mitral stenosis with favorable anatomy, for its ability to prevent complications inherent to a surgical procedure, while maintaining effectiveness. It is necessary to promote comparisons between the results obtained by the procedure performed at referral centers with high patient inflow and at institutions with lower volume and fewer patients, which represents the main objective of this study.</p></div><div><h3>Methods</h3><p>Thirty-one consecutive patients undergoing percutaneous mitral valvuloplasty were analyzed from September 2006 to January 2015. Immediate procedural success and late event-free survival rates were evaluated, defined as cardiovascular death or need for a new mitral valve intervention.</p></div><div><h3>Results</h3><p>The mean age was 40.9 ± 14.2 years, with a predominance of females (96.8%). The mean Wilkins and Block score was 8.1 ± 1.2. All procedures were performed using the Inoue technique, with an immediate success rate of 90.3%. At mean follow-up of 6.8 ± 2.5 years, seven events (22.6%) were observed: two cardiovascular deaths, four surgeries for mitral valve replacement, and one mitral commissurotomy.</p></div><div><h3>Conclusions</h3><p>In a hospital with intermediate procedure volume, the results of percutaneous mitral valvuloplasty in the treatment of rheumatic mitral stenosis with favorable anatomy were comparable to those achieved by high-volume centers.</p></div><div><h3>Introdução</h3><p>A valvoplastia mitral percutânea é o tratamento de escolha da estenose mitral reumática com anatomia favorável, por sua capacidade de prevenir complicações inerentes ao tratamento cirúrgico e com manutenção da eficácia. Faz-se necessário promover comparações entre os resultados obtidos com o procedimento por centros de referência e alta drenagem de pacientes e por instituições de menor volume e casuística, sendo este o objetivo principal deste estudo.</p></div><div><h3>Métodos</h3><p>Foram analisados 31 pacientes consecutivos submetidos à valvoplastia mitral percutânea no período de setembro de 2006 a janeiro de 2015. Avaliaram-se o sucesso imediato do procedimento e a sobrevida livre de eventos tardios, definidos como morte cardiovascular ou necessidade de nova intervenção valvar mitral.</p></div><div><h3>Resultados</h3><p>A média de idade foi de 40,9 ± 14,2 anos, com predomínio do sexo feminino (96,8%). O escore médio de Wilkins e Block foi de 8,1 ± 1,2. A totalidade dos procedimentos foi efetivada pela técnica de Inoue, com taxa de sucesso imediato de 90,3%. Em acompanhamento médio de 6,8 ± 2,5 anos, foram constatados sete eventos (22,6%), sendo dois óbitos de etiologia cardiovascular, quatro cirurgias de troca valvar mitral e uma comissurotomia mitral.</p></div><div><h3>Conclusões</h3><p>Em um hospital com volume intermediário de procedimentos, os resultados da valvoplastia mitral percutânea no tratamento da estenose mitral ","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 3","pages":"Pages 173-176"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2016.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"102316693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In search for optimal results for transcatheter aortic valve-in-valve procedures","authors":"Áurea J. Chaves (Editor)","doi":"10.1016/j.rbciev.2016.07.001","DOIUrl":"10.1016/j.rbciev.2016.07.001","url":null,"abstract":"","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 3","pages":"Page 161"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2016.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"104458844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of occlusion duration on the success rate and outcomes of percutaneous coronary intervention in chronic total occlusions","authors":"Antonio de Castro Filho,&nbsp;Edgar Stroppa Lamas,&nbsp;Mário Barbosa G. Nunes,&nbsp;Dimytri A. Siqueira,&nbsp;Rodolfo Staico,&nbsp;Daniel Chamié,&nbsp;J. Ribamar Costa Jr.,&nbsp;Ricardo A. Costa,&nbsp;Alexandre Abizaid","doi":"10.1016/j.rbciev.2015.08.003","DOIUrl":"10.1016/j.rbciev.2015.08.003","url":null,"abstract":"<div><h3>Background</h3><p>Initial studies have shown that old occlusions or those with indeterminate occlusion duration have been associated with percutaneous coronary intervention (PCI) failure and a worse prognosis. This study aimed to determine the impact of occlusion duration on the success and outcomes of contemporary PCI on chronic total occlusion (CTO).</p></div><div><h3>Methods</h3><p>The authors analyzed a retrospective cohort of consecutive patients submitted to PCI in CTO, who were compared according to the confirmed occlusion duration (COD) &lt; 12 months, ≥ 12 months, or indeterminate occlusion duration (IOD).</p></div><div><h3>Results</h3><p>A total of 168 patients were treated, 122 (72.6%) with COD (80 &lt; 12 months, 42 ≥ 12 months) and 46 (24.7%) with an IOD. Lesion extension was 17.0 ± 13.6<!--> <!-->mm, in 2.90 ± 0.58<!--> <!-->mm vessels, and the anterograde approach was used in 98.8% of cases. Angiographic success was attained in 79.2% of patients (80.0% vs. 73.8% vs. 82.6%; <em>p</em> = 0.73). The main cause of failure was the inability to cross the lesion with the guidewire (68.6%). Occlusion duration had no impact on in-hospital events (4.8% vs. 7.1% vs. 6.0%; <em>p</em> = 0.73), which were almost entirely explained by periprocedural myocardial infarction, or on late outcomes (18.8% vs. 7.1% vs. 15.3%; <em>p</em> = 0.23). At the multivariate analysis, lesion length ≥ 20<!--> <!-->mm (odds ratio - OR = 7.27; 95% confidence interval - 95% IC 1.94-29.1; <em>p</em> = 0.003), calcification (OR = 4.72; 95% CI 1.19-19.1; <em>p</em> = 0.02), and tortuosity of the occluded segment (OR = 15.98; 95% CI 2.18-144.7; <em>p</em> = 0.007) were predictors of failure.</p></div><div><h3>Conclusions</h3><p>Occlusion duration was not associated with increased failure rate of the procedure or worse PCI outcomes in CTO.</p></div><div><h3>Introdução</h3><p>Estudos iniciais mostram que oclusões antigas ou com tempo indeterminado têm sido associadas a insucesso da intervenção coronária percutânea (ICP) e a pior prognóstico. Nosso objetivo foi determinar o impacto do tempo de oclusão no sucesso e nos resultados da ICP contemporânea na obstrução total crônica (OTC).</p></div><div><h3>Métodos</h3><p>Analisamos uma coorte retrospectiva de pacientes consecutivos que realizaram ICP em OTC, e que foram comparados de acordo com o tempo de oclusão confirmado (TOC) &lt; 12 meses, ≥ 12 meses, ou indeterminado (TOI).</p></div><div><h3>Resultados</h3><p>Foram tratados 168 pacientes, 122 (72,6%) com TOC (80 &lt; 12 meses, 42 ≥ 12 meses) e 46 (24,7%) com TOI. A extensão da lesão foi de 17,0 ± 13,6<!--> <!-->mm, em vasos de 2,90 ± 0,58<!--> <!-->mm, e a abordagem anterógrada foi utilizada em 98,8% dos casos. Sucesso angiográfico foi obtido em 79,2% dos pacientes (80,0% vs. 73,8% vs. 82,6%; <em>p</em> = 0,73). A principal causa de insucesso foi a incapacidade de cruzar a lesão com o fio-guia (68,6%). O tempo de oclusão não teve impacto na taxa de eventos cardiovas","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 3","pages":"Pages 183-189"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.08.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"95188775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular therapy for peripheral arterial disease in the femoropopliteal territory: an evolving promising scenario","authors":"Bruno Freitas ,&nbsp;Guilherme B.B. Pitta ,&nbsp;Dierk Scheinert","doi":"10.1016/j.rbciev.2016.07.003","DOIUrl":"10.1016/j.rbciev.2016.07.003","url":null,"abstract":"","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 3","pages":"Pages 164-165"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2016.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"98599088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous occlusion of the left atrial appendage with AMPLATZER® Cardiac Plug for the prevention of thromboembolic events in chronic atrial fibrillation","authors":"Francisco Chamié,&nbsp;Enio Guérios,&nbsp;Valério Fuks,&nbsp;Angélica Bösiger,&nbsp;Marcio Carvalho,&nbsp;João Otávio de Queiroz Araujo","doi":"10.1016/j.rbciev.2015.08.002","DOIUrl":"10.1016/j.rbciev.2015.08.002","url":null,"abstract":"<div><h3>Background</h3><p>Atrial fibrillation (AF) increases the risk of thromboembolic events caused by emboli originating in the left atrial appendage (LAA). Mechanical methods for LAA occlusion have been developed as an alternative to oral anticoagulation. The aim of this study was to present an initial experience with the AMPLATZER^® Cardiac Plug.</p></div><div><h3>Methods</h3><p>Patients with permanent or paroxysmal AF and with contraindications or complications of oral anticoagulation were included. Patients with LAA anatomy and measures compatible with the occluder, and without thrombi, were selected through transesophageal echocardiography.</p></div><div><h3>Results</h3><p>A total of 14 procedures were performed in 13 patients (5<!--> <!-->M:8F), with mean age of 66.7 years. Significant bleeding and previous strokes were found in 69.2% and 53.8%, respectively. AF was permanent in 84.6% and paroxysmal in the remainder. The mean diameters of the ostium and the landing zone were 23.9<!--> <!-->mm and 20.8<!--> <!-->mm, respectively. Bilobulated LAA was observed in 76.9%. Procedures were possible in all cases. Sixteen devices were used in 13 patients, a ratio of 1.2:1, and only one patient required a second device for LAA occlusion. The mean follow-up was 12.2 months. All LAA remain closed, with no residual defect to date. There was only one late death, unrelated to the procedure.</p></div><div><h3>Conclusions</h3><p>LAA occlusion using the AMPLATZER^® Cardiac Plug device was shown to be safe and effective in this small series of patients. The initial results are encouraging and indicate the transcatheter closure of the LAA as an alternative to oral anticoagulation therapy in selected patients.</p></div><div><h3>Introdução</h3><p>A fibrilação atrial (FA) aumenta o risco de eventos tromboembólicos por êmbolos originados em apêndice atrial esquerdo (AAE). Métodos mecânicos para a oclusão do AAE foram desenvolvidos como alternativa à anticoagulação oral. O objetivo deste trabalho foi apresentar uma experiência inicial com o AMPLATZER^® Cardiac Plug.</p></div><div><h3>Métodos</h3><p>Incluímos pacientes com FA permanente ou paroxística, que apresentavam contraindicações ou complicações derivadas da anticoagulação oral. Pacientes com anatomia e medidas do AAE compatíveis com o oclusor, e sem trombos foram selecionados por meio de ecocardiograma transesofágico.</p></div><div><h3>Resultados</h3><p>Foram realizados 14 procedimentos em 13 pacientes (5<!--> <!-->M:8F), com média de idade de 66,7 anos. Sangramento significativo e acidentes vasculares cerebrais prévios foram encontrados em 69,2% e em 53,8%, respectivamente. A FA era permanente em 84,6% e paroxística no restante da amostra. Os diâmetros médio do óstio e da zona alvo mediram 23,9<!--> <!-->mm e 20,8<!--> <!-->mm, respectivamente. AAE bilobulados foram observados em 76,9%. Os procedimentos foram possíveis em todos os casos. Dezesseis dispositivos foram usados e","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 3","pages":"Pages 177-182"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.08.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107988471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predisposing factors for incomplete angiographic revascularization in patients with multivessel percutaneous coronary intervention","authors":"Anderson de Melo M. Ataíde,&nbsp;Luiz Fernando Leite Tanajura,&nbsp;Alexandre Antonio C. Abizaid,&nbsp;Marinella P. Centemero,&nbsp;J. Ribamar Costa Jr.,&nbsp;Vitor Alves Loures,&nbsp;Andrea Cláudia L. Abizaid,&nbsp;Sérgio Luiz N. Braga,&nbsp;Amanda G.M.R. Sousa,&nbsp;J. Eduardo M.R. Sousa","doi":"10.1016/j.rbciev.2015.08.006","DOIUrl":"10.1016/j.rbciev.2015.08.006","url":null,"abstract":"<div><h3>Background</h3><p>Complete anatomical myocardial revascularization is associated with better angina control and lower rates of cardiac events. However, in a significant number of patients treated by percutaneous coronary intervention (PCI), complete revascularization is not achieved. Thus, the aim of this study was to evaluate factors associated with incomplete myocardial revascularization (IMR) in multivessel PCI patients.</p></div><div><h3>Methods</h3><p>This was a cohort study involving 1,049 prospectively and consecutively revascularized patients through PCI with treatment of two or more vessels, between 2012 and 2014, divided into two groups: IMR (n = 324; 30.9%) and complete myocardial revascularization (n = 725; 69.1%).</p></div><div><h3>Results</h3><p>IMR was significantly associated with older age (66.5 years vs. 64.1 years; <em>p</em> = 0.003), arterial hypertension (92.2% vs. 86.0%; <em>p</em> = 0.006), chronic renal failure (36.4% vs. 26.0%; <em>p</em> &lt; 0.001), acute coronary syndrome (26.3% vs. 21.0%; <em>p</em> = 0.05), previous surgical revascularization (16.1% vs. 7.1%; <em>p</em> = 0.001), saphenous venous graft lesions (3.4% vs. 1.0%, <em>p</em> &lt; 0.001), and chronic occlusions (3.3% vs. 1.4%, <em>p</em> = 0.005), as well as lower access to drug-eluting stents (57.8% vs. 64.8%; <em>p</em> = 0.002). In-hospital clinical outcomes did not differ between the groups.</p></div><div><h3>Conclusions</h3><p>IMR occurred in approximately one-third of treated cases, and a significant association was observed with a higher-risk clinical profile and with target lesion interventions commonly associated with lower procedure success. The degree of revascularization had no impact on in-hospital clinical outcomes.</p></div><div><h3>Introdução</h3><p>A revascularização miocárdica anatômica completa está associada a um melhor controle dos sintomas anginosos e a menores índices de eventos cardíacos maiores tardios. No entanto, em substancial número de pacientes tratados por meio de intervenção coronária percutânea (ICP), não logramos sua obtenção. Assim, nosso objetivo foi avaliar os fatores associados à revascularização miocárdica incompleta (RMI) em casos de ICP multiarterial.</p></div><div><h3>Métodos</h3><p>Estudo de coorte envolvendo 1.049 pacientes revascularizados de forma prospectiva e consecutiva por meio de ICP com tratamento de dois ou mais vasos, entre 2012 e 2014, divididos em dois grupos: RMI (n = 324; 30,9%) e revascularização miocárdica completa (n = 725; 69,1%).</p></div><div><h3>Resultados</h3><p>A RMI foi significativamente associada a faixa etária maior (66,5 anos vs. 64,1 anos; <em>p</em> = 0,003), hipertensão arterial (92,2% vs. 86,0%; <em>p</em> = 0,006), insuficiência renal crônica (36.4% vs. 26.0%; <em>p</em> &lt; 0,001), síndrome coronariana aguda (26,3% vs. 21,0%; <em>p</em> = 0,05), revascularização cirúrgica prévia (16,1% vs. 7,1%; <em>p</em> = 0,001), lesões em enxertos venosos (3,4% vs. 1,0%; <em>p</em>","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 3","pages":"Pages 201-206"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.08.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"96554569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}