Eduardo Belisario Falchetto, Jamil Abdalla Saad, Frederico Lemos de Almeida, Eduardo Kei Marquezini Washizu, Ari Mandil
{"title":"Extrinsic obstruction of the left main coronary artery due to pulmonary artery dilation associated with schistosomiasis","authors":"Eduardo Belisario Falchetto, Jamil Abdalla Saad, Frederico Lemos de Almeida, Eduardo Kei Marquezini Washizu, Ari Mandil","doi":"10.1016/j.rbciev.2015.12.016","DOIUrl":"10.1016/j.rbciev.2015.12.016","url":null,"abstract":"<div><p>This report describes a patient with pulmonary hypertension secondary to schistosomiasis, who sought emergency care due to chest pain at rest. The clinical presentation and other information related to the case raised the suspicion of acute coronary failure, and a severe obstruction was identified in the left main coronary artery. The case report aimed to highlight the need for a differential diagnosis of chest pain complaints in these patients, and emphasizes the choice of percutaneous coronary intervention as an effective and safe treatment in this scenario.</p></div>","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 2","pages":"Pages 148-151"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.12.016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"103543167","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}
Renato Roese Filho, Alan Castro D’Avila, Márcia Moura Schmidt, Alexandre Schaan de Quadros, Cristiano de Oliveira Cardoso, André Luiz Langer Manica, Alexandre Damiani Azmus, Júlio Vinicius de Souza Teixeira, Claudio Vasques de Moraes, Henrique Basso Gomes, Carlos Antônio Mascia Gottschall, Rogério Sarmento-Leite
{"title":"Impact of prior coronary bypass graft surgery on the outcomes of patients undergoing primary percutaneous coronary intervention","authors":"Renato Roese Filho, Alan Castro D’Avila, Márcia Moura Schmidt, Alexandre Schaan de Quadros, Cristiano de Oliveira Cardoso, André Luiz Langer Manica, Alexandre Damiani Azmus, Júlio Vinicius de Souza Teixeira, Claudio Vasques de Moraes, Henrique Basso Gomes, Carlos Antônio Mascia Gottschall, Rogério Sarmento-Leite","doi":"10.1016/j.rbciev.2015.12.007","DOIUrl":"10.1016/j.rbciev.2015.12.007","url":null,"abstract":"<div><h3>Background</h3><p>Historically, patients with prior coronary artery bypass graft (CABG) surgery undergoing primary percutaneous coronary intervention (PCI) have a worse prognosis than patients without prior CABG. However, more contemporary analyses have contested these findings. This study's aim was to evaluate the 30-day clinical outcomes in patients with and without prior CABG submitted to primary PCI.</p></div><div><h3>Methods</h3><p>Prospective cohort study, extracted from the database of Instituto de Cardiologia do Rio Grande do Sul, containing 1,854 patients undergoing primary PCI.</p></div><div><h3>Results</h3><p>Patients with prior CABG (3.8%) showed, in general, a more severe clinical profile. The time of symptom onset until arrival at the hospital was shorter in this group (2.50<!--> <!-->hours [1.46 to 3.66] vs. 3.99<!--> <!-->hours [1.99 to 6.50]; <em>p</em> <em><</em> <!-->0.001), while the door-to-balloon time was similar (1.33 hour [0.85 to 2.07] vs. 1.16 hour [0.88 to 1.58]; <em>p</em> <em>=</em> <!-->0.12). Femoral access was more often used in the group with prior CABG (91.5% vs. 62.5%; <em>p</em> <em><</em> <!-->0.001). Manual thrombus aspiration was less often performed in this group (16.9% vs. 31.1%; <em>p</em> <em>=</em> <!-->0.007), but there was no difference regarding the use of glycoprotein IIb/IIIa inhibitors (28.2% vs. 32.4%, <em>p</em> <em>=</em> <!-->0.28). Angiographic success was lower in the group with prior CABG (80.3% vs. 93.3%; <em>p</em> <em>=</em> <!-->0.009). At 30 days, patients with prior CABG had similar rates of major adverse cardiac events (14.1% vs. 11.2%; <em>p</em> <em>=</em> <!-->0.28), and mortality, although numerically higher, was not statistically significant (13.2% vs. 7.0%, <em>p</em> <em>=</em> <!-->0.07).</p></div><div><h3>Conclusions</h3><p>In this contemporary analysis, patients with prior CABG undergoing primary PCI had a more severe clinical profile and lower angiographic success, but showed no differences regarding 30-day clinical outcomes.</p></div>","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 2","pages":"Pages 102-107"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.12.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87661873","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}
Cristiano de Oliveira Cardoso, Clacir Staudt, Aldo Fernando Somavilla Duarte, La Hore Correa Rodrigues, Cristiane Cauduro Lima, Vasco Morosini Miller
{"title":"Early and late outcomes of patients treated with hybrid sirolimus-eluting stent or everolimus-eluting stent","authors":"Cristiano de Oliveira Cardoso, Clacir Staudt, Aldo Fernando Somavilla Duarte, La Hore Correa Rodrigues, Cristiane Cauduro Lima, Vasco Morosini Miller","doi":"10.1016/j.rbciev.2015.12.009","DOIUrl":"10.1016/j.rbciev.2015.12.009","url":null,"abstract":"<div><h3>Background</h3><p>The Orsiro is a hybrid stent which has passive (amorphous silicon carbide) and active (poly-L-lactic acid, PLLA) coatings. The first layer encapsulates the stent struts, promoting lower local inflammation, whereas the second layer releases sirolimus through a biodegradable matrix. This study's aim was to compare the results of percutaneous coronary interventions (PCI) with Orsiro and Xience™ V stents (everolimus-eluting stent) in daily clinical practice.</p></div><div><h3>Methods</h3><p>Observational study in which patients were divided into two groups: those who received only one or more Orsiro stents, and those who received only Xience<sup>TM</sup> V stents. Early and late outcomes were prospectively collected.</p></div><div><h3>Results</h3><p>Between September 2012 and March 2014, this study included 92 and 108 patients treated with Orsiro and Xience™ V stents, respectively. Clinical, angiographic, and procedure characteristics were mostly similar between groups. Rates of procedure success (98.9% vs. 95.4%; <em>p</em> <em>=</em> <!-->0.22), in-hospital mortality (1.1% vs. 0%; <em>p</em> <em>=</em> <!-->0.40) and stent thrombosis (0% vs. 0.9%, <em>p</em> <em>=</em> <!-->0.30) did not differ between groups. Time of follow-up was 434<!--> <!-->±<!--> <!-->111 and 477<!--> <!-->±<!--> <!-->66 days (<em>p</em> <em>=</em> <!-->0.23), respectively, and differences in mortality (0.9% vs. 0%, <em>p</em> <em>=</em> <!-->0.30), stent thrombosis (0% vs. 0.9%; <em>p</em> <em>=</em> <!-->0.30), or need for repeat revascularization of the target lesion (0% vs. 0.9%; <em>p</em> <em>=</em> <!-->0.30) were not observed.</p></div><div><h3>Conclusions</h3><p>Orsiro and Xience™ V stents showed similar performance, with low rates of early and late clinical and angiographic events.</p></div>","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 2","pages":"Pages 114-118"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.12.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109251223","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}
Fabio Rodrigo Furini , Valter Correia de Lima , Fabio Sândoli de Brito Jr. , Alessandra Teixeira de Oliveira , Marcela da Cunha Sales , Fernando Antonio Lucchese
{"title":"Coronary occlusion after TAVI: safety strategy report","authors":"Fabio Rodrigo Furini , Valter Correia de Lima , Fabio Sândoli de Brito Jr. , Alessandra Teixeira de Oliveira , Marcela da Cunha Sales , Fernando Antonio Lucchese","doi":"10.1016/j.rbciev.2015.12.017","DOIUrl":"10.1016/j.rbciev.2015.12.017","url":null,"abstract":"<div><p>Transcatheter aortic valve implantation (TAVI) is an alternative for patients with aortic stenosis at high surgical risk and for many of those considered inoperable. Despite its minimally invasive features, complications related to the procedure may occur. Coronary obstruction during TAVI is a rare (incidence rate of less than 1%) but potentially lethal complication. In Brazil, this complication was found in 0.72% of procedures – three of 418 cases from Brazilian Transcatheter Aortic Valve Implantation Registry – with an in-hospital mortality rate of 100%. This case report presents prevention and treatment measures for coronary occlusion after TAVI.</p></div>","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 2","pages":"Pages 152-155"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.12.017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"93276453","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}
Patrick Bastos Metzger, Antonio Massamitsu Kambara, Heraldo Antônio Barbato, Fabio Henrique Rossi, Nilo Mitsuru Izukawa
{"title":"Endovascular approach of a patient with bilateral renal artery fibrodysplasia associated with a massive renal aneurysm","authors":"Patrick Bastos Metzger, Antonio Massamitsu Kambara, Heraldo Antônio Barbato, Fabio Henrique Rossi, Nilo Mitsuru Izukawa","doi":"10.1016/j.rbciev.2015.12.015","DOIUrl":"10.1016/j.rbciev.2015.12.015","url":null,"abstract":"<div><p>Renal artery fibromuscular dysplasia is a condition of unknown etiology, with non-inflammatory, non-atherosclerotic origin, associated to the development of stenosis and aneurysms. The authors report a case of bilateral renal artery fibromuscular dysplasia associated with a large renal artery aneurysm, treated with balloon angioplasty and a multilayer stent.</p></div>","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 2","pages":"Pages 145-147"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.12.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"106046280","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}
Cristiano Guedes Bezerra , Gonzalo Daniel Maso Talou , Carlos Alberto Bulant , Breno de Alencar Araripe Falcão , José Mariani Jr. , Pablo Javier Blanco , Raúl Antonino Feijóo , Pedro Alves Lemos Neto
{"title":"Three-dimensional reconstruction of coronary arteries based on the integration of intravascular ultrasound and conventional angiography","authors":"Cristiano Guedes Bezerra , Gonzalo Daniel Maso Talou , Carlos Alberto Bulant , Breno de Alencar Araripe Falcão , José Mariani Jr. , Pablo Javier Blanco , Raúl Antonino Feijóo , Pedro Alves Lemos Neto","doi":"10.1016/j.rbciev.2015.12.013","DOIUrl":"10.1016/j.rbciev.2015.12.013","url":null,"abstract":"<div><h3>Background</h3><p>Coronary three-dimensional reconstruction with the combination of intravascular ultrasound and angiography offers advantages over computed tomography angiography of coronary arteries. The authors aimed to present the pilot phase of the validation of a new model of three-dimensional reconstruction of coronary arteries.</p></div><div><h3>Methods</h3><p>This study used angiography and intravascular ultrasound examinations already performed by clinical indication in individuals with known or suspected stable coronary artery disease. Image processing, segmentation, and three-dimensional reconstruction were conducted following specific methodology. For geometrical characterization purposes, tridimensional center lines were obtained.</p></div><div><h3>Results</h3><p>Three vessels were reconstructed: two left anterior descending arteries and one left circumflex artery. The vessel lumen volume and the overall plaque burden could be easily viewed with three-dimensional reconstruction. The geometric characterization revealed increased absolute values of length, tortuosity, curvature, and torsion, featuring a greater complexity of the center line of the diseased lumen relative to the center line of the external elastic membrane.</p></div><div><h3>Conclusions</h3><p>This new methodology, which integrates conventional angiography and intravascular ultrasound, has increased the practicality of the reconstructions, with a gain in volumetric accuracy of the vessel and overall visualization of key aspects of atherosclerotic disease, such as plaque remodeling and distribution.</p></div>","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 2","pages":"Pages 134-138"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.12.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86815532","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":"Transcatheter treatment of severe mitral regurgitation in Brazil: a new kid on the block","authors":"Guilherme F. Attizzani , Corrado Tamburino","doi":"10.1016/j.rbciev.2015.12.003","DOIUrl":"10.1016/j.rbciev.2015.12.003","url":null,"abstract":"","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 2","pages":"Pages 82-83"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.12.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78163051","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}
Rafael Cavalcante Silva, José Mariani Jr., Breno de Alencar Araripe Falcão, Antonio Esteves Filho, Cesar Higa Nomura, Luiz Francisco Rodrigues de Ávila, José Rodrigues Parga, Pedro Alves Lemos Neto
{"title":"Differences between systolic and diastolic dimensions of the aortic valve annulus in computed tomography angiography in patients undergoing percutaneous implantation of aortic valve prosthesis by catheter","authors":"Rafael Cavalcante Silva, José Mariani Jr., Breno de Alencar Araripe Falcão, Antonio Esteves Filho, Cesar Higa Nomura, Luiz Francisco Rodrigues de Ávila, José Rodrigues Parga, Pedro Alves Lemos Neto","doi":"10.1016/j.rbciev.2015.12.012","DOIUrl":"10.1016/j.rbciev.2015.12.012","url":null,"abstract":"<div><h3>Background</h3><p>Accurate aortic valve annulus sizing has critical importance for the planning of percutaneous transcatheter aortic valve implantation (TAVI) in patients with severe aortic valve stenosis. Although there is a recommendation to perform the measurement during systole, little is known about the importance of the differences between systolic and diastolic dimensions of the annulus.</p></div><div><h3>Methods</h3><p>Consecutive patients referred for TAVI were evaluated with computed tomography for valve annulus sizing during systole and diastole. Area, circumference, minimum and maximum diameters, and their mean derived diameters were obtained in both phases of the cardiac cycle. Bland-Altman plots were constructed to evaluate the differences between the measures.</p></div><div><h3>Results</h3><p>The analysis included 41 patients with severe aortic stenosis. Mean area, circumference, and diameters were slightly greater in systole. However, in 35% of patients, diastolic dimensions were greater. These differences, although statistically significant, were small (the greatest difference of 0.6<!--> <!-->mm in mean diameter). Bland-Altman plots showed good agreement between systolic and diastolic measurements on all parameters evaluated.</p></div><div><h3>Conclusions</h3><p>Small differences were observed in the systolic and diastolic dimensions of the aortic valve annulus with computed tomography scan, which, although statistically significant, probably do not impact the selection of prosthesis or the procedure outcome.</p></div>","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 2","pages":"Pages 130-133"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2015.12.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"98925505","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}