Revista Brasileira De Cirurgia Cardiovascular最新文献

{"title":"Effect of Aortic Cross-Clamping Time on Development of Postoperative Atrial Fibrillation in Isolated CABG: A Single-Center Prospective Clinical Study","authors":"Hatice Işıl Çüçen Dayı, E. Calik, Oğuzhan Birdal, M. E. Aydin, F. Borulu, Ziya Yıldız, B. Erkut, Y. Unlu","doi":"10.21470/1678-9741-2022-0458","DOIUrl":"https://doi.org/10.21470/1678-9741-2022-0458","url":null,"abstract":"Introduction Many etiological factors affect the occurrence of atrial fibrillation after coronary artery bypass grafting. In this study, the relationship between cardiopulmonary bypass and cross-clamping times and the development of postoperative atrial fibrillation was examined. Methods All patients who underwent isolated coronary artery bypass grafting with the same surgical team in our clinic between September 2018 and December 2019 were prospectively included in the study, and their perioperative data were recorded. Results One hundred and three patients who met the specified criteria were included in the study. The median age was 62 (interquartile range: 54-71) years, and 82 (79.6%) were male. The patients were divided into two groups: those who developed atrial fibrillation and those who did not. Atrial fibrillation developed in 25 of 103 patients (24.3%). All patients underwent isolated coronary artery bypass grafting under standard cardiopulmonary bypass. The median duration of cardiopulmonary bypass was 72 (interquartile range: 63-97) minutes in those with atrial fibrillation and 82 (61-98) minutes in those without it, and there was no statistical difference (P=0.717). The median cross-clamping time was 40 (32.5-48) minutes in those with atrial fibrillation and 39.5 (30-46) minutes in those without it. Statistically, the relationship between cross-clamping time and atrial fibrillation was not significant (P=0.625). Conclusion Our study found no significant relationship between cardiopulmonary bypass and cross-clamping times and the incidence of postoperative atrial fibrillation. However, we believe that there is a need for large-scale and multicenter clinical studies on the subject.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49511273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Results of Ivabradine versus Metoprolol: The Effects on Atrial Fibrillation in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting.","authors":"Esra Erturk Tekin, Mehmet Ali Yeşiltaş, İsmail Haberal","doi":"10.21470/1678-9741-2021-0201","DOIUrl":"10.21470/1678-9741-2021-0201","url":null,"abstract":"<p><strong>Introduction: </strong>Classic coronary artery bypass grafting (CABG) surgery involves diastolic cardiac arrest under cardiopulmonary bypass, while off-pump CABG (OPCABG) has become widespread in recent years.</p><p><strong>Methods: </strong>174 patients who underwent OPCABG were included in the study. Patients were divided into two groups. Group I (n=90) received ivabradine and Group M (n=84) received metoprolol before surgery until postoperative day 10. Intraoperative arrhythmias and hypotension were recorded. Postoperative atrial fibrillation (AF) and arrhythmia, mortality and morbidity rates were assessed based on the 30-day postoperative follow-up.</p><p><strong>Results: </strong>There were no significant differences in the intraoperative amount of inotropic support and red blood cell transfusion between groups (P=0.87 and P=0.31). However, the rates of intraoperative arrhythmias and hypotension were not significantly higher in Group M (P=0.317 and P=0.47). Ventricular tachycardia/ventricular fibrillation (VT/VF) was observed in 2 patients in both groups. Postoperative AF occurred in 7 patients (7.7%) in Group I and in 10 patients (11.9%) in Group M. Although there was a trend towards a higher prevalence of AF in Group M patients, this did not reach statistical significance. In addition, mortality and morbidity rates were comparable between groups.</p>","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"37 1","pages":"857-865"},"PeriodicalIF":1.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9713664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45659428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Surgical Technique to Preserve the Subvalvular Apparatus in Patients Undergoing Mitral Valve Replacement for Severe Ischemic Regurgitation.","authors":"Jacob Zeitani, Ermal Likaj, Saimir Kuci, Antonio Pellegrino","doi":"10.21470/1678-9741-2021-0320","DOIUrl":"10.21470/1678-9741-2021-0320","url":null,"abstract":"<p><p>Severe functional mitral valve regurgitation should be treated in patients undergoing myocardial revascularization. When replacement is considered the best therapeutic option, preservation of the mitral subvalvular apparatus is crucial, especially in the emergency setting, because of its primary role in preserving geometry and function of left and right ventricles. Here we present a simple and quick technique, where subvalvular apparatus is preserved in toto in patients undergoing mitral valve replacement with a bioprosthesis.</p>","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"37 1","pages":"932-936"},"PeriodicalIF":1.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9713662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47062971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three Different Strategies for Repair of Symptomatic or Aneurysmatic Aberrant Right Subclavian Arteries.","authors":"İsmail Selçuk, Hüseyin Sicim, Ümmühan Nehir Selçuk, Bülent Barış Güven, Ahmet Turan Yılmaz","doi":"10.21470/1678-9741-2021-0439","DOIUrl":"10.21470/1678-9741-2021-0439","url":null,"abstract":"<p><strong>Introduction: </strong>In this study, we aimed to present three different methods for symptomatic aberrant right subclavian artery (ARSA) surgery.</p><p><strong>Methods: </strong>We identified 11 consecutive adult patients undergoing symptomatic and/or aneurysmal ARSA repair between January 2016 and December 2020. Symptoms were dysphagia (n=8) and dyspnea + dysphagia (n=3). Six patients had aneurysm formation of the ARSA (mean diameter of 4.2 cm [range 2.8 - 6.3]). All data were analyzed retrospectively.</p><p><strong>Results: </strong>Median age of the patients (7 females/4 males) was 55 years (range 49 - 62). The first four patients (36.4%) underwent hybrid repair using thoracic endovascular aortic repair (TEVAR) and bilateral carotid-subclavian artery bypass (CScBp). Three patients (27.2%) were treated by open ARSA resection/ligation with left mini posterolateral thoracotomy (LMPLT) and right CScBp. And the last four patients (36.4%) underwent ARSA resection/ligation with LMPLT and ascending aorta-right subclavian artery bypass with upper mini sternotomy (UMS). Two of the four patients who underwent TEVAR + bilateral CScBp had continuing dysphagia cause of persistent esophageal compression. Brachial plexus injury developed in one of three patients who underwent LMPLT + right CScBp. Pleural effusion treated with thoracentesis alone was observed in one of four patients who underwent UMS + LMPLT.</p><p><strong>Conclusion: </strong>Among the symptomatic and/or aneurysmal ARSA treatment approaches, surgical and hybrid methods are used. There is still no consensus on how to manage these patients. In our study, we recommend the UMS + LMPLT method, since the risk of complications with anatomical bypass is less, and we have more successful surgical results.</p>","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"37 1","pages":"801-806"},"PeriodicalIF":1.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9713644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44386886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BOUNDS ON THE CONDITIONAL AND AVERAGE TREATMENT EFFECT WITH UNOBSERVED CONFOUNDING FACTORS.","authors":"Steve Yadlowsky, Hongseok Namkoong, Sanjay Basu, John Duchi, Lu Tian","doi":"10.1214/22-aos2195","DOIUrl":"10.1214/22-aos2195","url":null,"abstract":"<p><p>For observational studies, we study the sensitivity of causal inference when treatment assignments may depend on unobserved confounders. We develop a loss minimization approach for estimating bounds on the conditional average treatment effect (CATE) when unobserved confounders have a bounded effect on the odds ratio of treatment selection. Our approach is scalable and allows flexible use of model classes in estimation, including nonparametric and black-box machine learning methods. Based on these bounds for the CATE, we propose a sensitivity analysis for the average treatment effect (ATE). Our semiparametric estimator extends/bounds the augmented inverse propensity weighted (AIPW) estimator for the ATE under bounded unobserved confounding. By constructing a Neyman orthogonal score, our estimator of the bound for the ATE is a regular root-<math><mi>n</mi></math> estimator so long as the nuisance parameters are estimated at the <math><msub><mrow><mi>o</mi></mrow><mrow><mi>p</mi></mrow></msub><mfenced><mrow><msup><mrow><mi>n</mi></mrow><mrow><mo>-</mo><mn>1</mn><mo>/</mo><mn>4</mn></mrow></msup></mrow></mfenced></math> rate. We complement our methodology with optimality results showing that our proposed bounds are tight in certain cases. We demonstrate our method on simulated and real data examples, and show accurate coverage of our confidence intervals in practical finite sample regimes with rich covariate information.</p>","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"21 1","pages":"2587-2615"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10694186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89684059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tomas A. Salerno: Visionary, Innovator, Friend","authors":"R. Lima","doi":"10.21470/1678-9741-2022-0950","DOIUrl":"https://doi.org/10.21470/1678-9741-2022-0950","url":null,"abstract":"Correspondence Address: Ricardo de Carvalho Lima https://orcid.org/0000-0002-1369-0296 Email: ricardo.lima@upe.br 1Faculdade de Ciências Médicas, Universidade de Pernambuco (UPE), Recife, Pernambuco, Brazil. 2Pronto-Socorro Cardiológico Universitário de Pernambuco (PROCAPE), Universidade de Pernambuco (UPE), Recife, Pernambuco, Brazil. “The future is now, and I wish I was born today” Tomas A. Salerno","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"37 1","pages":"575 - 583"},"PeriodicalIF":0.0,"publicationDate":"2022-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42080940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Anxiety and Depression Symptoms in Individuals According to their Sex, Type of Cardiac Device, and Diagnosis of Chagas Disease.","authors":"Carina Aparecida Marosti Dessotte, Elisa Maia de Oliveira Grotti, Isabelle Brigliadori Ignácio, Paolla Algarte Fernandes, Suellen Rodrigues de Oliveira Maier, Lidia Aparecida Rossi, Rosana Aparecida Spadoti Dantas","doi":"10.21470/1678-9741-2021-0392","DOIUrl":"10.21470/1678-9741-2021-0392","url":null,"abstract":"<p><strong>Introduction: </strong>Implantable cardiac pacemakers or cardioverter defibrillators are alternatives for the treatment of arrhythmias, however, their use has caused changes in the emotional state of patients. The objective of this study was to compare the measures of anxiety and depression symptoms in individuals according to their sex, type of cardiac device, and diagnosis of Chagas disease.</p><p><strong>Methods: </strong>This is an observational and cross-sectional study conducted with adults with implantable cardiac pacemakers or cardioverter defibrillators. Data was collected using a sociodemographic and clinical questionnaire and the Hospital Anxiety and Depression Scale. We used the Student's t-test for independent samples and the Chi-squared test, with a significance level of 0.05.</p><p><strong>Results: </strong>Two hundred forty-four patients participated in the study, 168 with cardiac pacemakers and 76 with implantable cardioverter defibrillators; 104 had Chagas cardiomyopathy (85 with cardiac pacemakers and 19 with implantable cardioverter defibrillators). No statistically significant differences were found in measures of anxiety and depression symptoms according to device type (P=0.594 and P=0.071, respectively) and the presence of Chagas etiology (P=0.649 and P=0.354, respectively). Women had higher mean scores for anxiety (P=0.002) and depression symptoms (P<0.001).</p><p><strong>Conclusion: </strong>In the comparison between the groups, according to the type of implanted device and the diagnosis of Chagas disease, no significant differences were found in the measures of anxiety and depression symptoms. Women showed higher means when compared to men, indicating the need to test and implement interventions to minimize these symptoms in this population.</p>","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"37 1","pages":"423-429"},"PeriodicalIF":0.0,"publicationDate":"2022-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9423806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48145867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Positive Cohort Undergoing Cardiac Surgery: A Possible Un(3H)oly Trinity of Hypoxia-Hemolysis-Hyperinflammation.","authors":"Rohan Magoon, Ramesh Kashav, Jes Jose, Ashish Walian, Souvik Dey","doi":"10.21470/1678-9741-2021-0077","DOIUrl":"10.21470/1678-9741-2021-0077","url":null,"abstract":"<p><p>While the fraternity continues to ponder on the mechanisms by which coronavirus disease (COVID-19) positivity affects the outcome of cardiac surgical subset, we put forth a 3H (Hypoxia-Hemolysis-Hyperinflammation) trilogy aimed at elucidating the liaison between cardiopulmonary bypass (commonly employed for cardiac surgical conduct) and COVID-19 infection. A sound comprehension of the same can doubtlessly assist the perioperative team in staging a well-directed pathophysiology-driven management approach.</p>","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"37 1","pages":"587-590"},"PeriodicalIF":1.1,"publicationDate":"2022-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9423808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48363676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Mitral Annular Calcification and Controlling Nutritional Status Score","authors":"İpek Büber, M. Adalı, D. Kaya, I. Kilic, S. Yılmaz, D. Dursunoglu","doi":"10.21470/1678-9741-2020-0443","DOIUrl":"https://doi.org/10.21470/1678-9741-2020-0443","url":null,"abstract":"Introduction The relationship between mitral annular calcification (MAC) and the controlling nutritional status (CONUT) score has not been previously studied. In this study, we investigated the relationship between MAC and CONUT score to evaluate the nutritional status of patients with MAC. Methods A total of 275 patients, including 150 patients with MAC and 125 patients without MAC, who presented to a cardiology outpatient clinic were enrolled in the study. Results There was no difference in the CONUT score between the two groups. Correlation analysis indicated that CONUT score was positively correlated with left atrial (LA) diameter (r=0.190, P=0.020) and interventricular septum thickness (r=0.179, P=0.028) in the MAC+ group. In multivariate regression analysis, only LA diameter (odds ratio 95% confidence interval = 1,054-1,189, P=0.0001) was independently associated with MAC. Conclusion The present study investigated the relationship between CONUT score and MAC for the first time in the literature. We demonstrated that CONUT score was not significantly higher in patients with MAC without chronic diseases. However, CONUT score was correlated with LA diameter in patients with MAC. We therefore conclude that, for patients admitted with MAC and high LA diameter, CONUT is a valuable nutritional and inflammatory status index.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"37 1","pages":"908 - 913"},"PeriodicalIF":0.0,"publicationDate":"2022-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43096984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Approach and Management Strategies in a Pediatric Cardiovascular Surgery Clinic During the COVID-19 Outbreak","authors":"Ergi̇n Arslanoğlu, M. E. Işık, K. A. Kara, N. Çine, E. Tunçer, H. Ceyran","doi":"10.21470/1678-9741-2020-0614","DOIUrl":"https://doi.org/10.21470/1678-9741-2020-0614","url":null,"abstract":"Introduction The coronavirus disease 2019 (COVID-19) pandemic has required changes in the management of pediatric cardiac surgery. We would like to share the patient treatment and surgical management strategies employed in our Pediatric Cardiovascular Surgery Clinic during the COVID-19 pandemic. Methods A total of 112 patients were followed up in our clinic between 11.03.2020 and 02.07.2020. Their mean age was 1,118 (4-5,740) days. Management and treatment were performed by our pediatric heart team (pediatric cardiac anesthetists, general pediatricians, pediatric cardiologists, pediatric cardiac surgeons, and an infectious diseases specialist). We prepared new protocols and a surveillance system specific to the pandemic to prevent in-hospital transmission and reduce postoperative mortality and morbidity; our operations were performed according to these protocols. All decisions pertaining to the operation timing and treatment strategy of our COVID-19-positive patients were made by the same team. Results During the study period, a total of 112 patients, 69 boys and 43 girls, were hospitalized in our clinic. A total of 333 COVID-19 real-time polymerase chain reaction tests were performed on patients and accompanying persons; positive results were found in three patients and two accompanying individuals. Conclusion By employing new protocols and a surveillance system throughout the healthcare system, we think that early diagnosis and treatment of the pediatric congenital heart disease population, which is susceptible to infections, can continue unperturbed. This and similar approaches can increase postoperative success and prevent transmission in the pediatric population - which are frequently COVID-19 asymptomatic.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"37 1","pages":"466 - 471"},"PeriodicalIF":0.0,"publicationDate":"2022-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49426821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}